Thursday 18 July 2019

Stella O'Malley: We should avoid 'medicalising' kids who are perhaps just a bit different

It is well known that Albert Einstein was slow to learn how to speak. Photo credit should read -/AFP/Getty Images
It is well known that Albert Einstein was slow to learn how to speak. Photo credit should read -/AFP/Getty Images
Stella O'Malley

Stella O'Malley

Whenever I work with a client within a counselling context, I am invariably on their side.

It doesn't matter how badly they may have behaved; once the client and I meet in a therapeutic setting, I stand shoulder to shoulder with the client in a bid to support them as they untangle the difficult patterns of their life.

This is why I wasn't surprised when Teresa Griffin, the head of the National Council for Special Education, said that some children are being wrongly made to "fit a certain category of disability in order for them to get a resource".

These children are being "unnecessary labelled" with disorders by doctors so as to get the educational resources they need. Sadly, there is no option for the doctor to recommend, "The child has no recognisable condition right now but clearly needs extra support"; instead all resources are based solely upon the diagnosis.

But doctors aren't only diagnosticians. They are advocates and if a child clearly has behavioural or developmental problems, but doesn't fit the criteria to be diagnosed with a condition, then it is understandable why their doctor might be willing to fudge the issue a little bit by providing the diagnosis.

Especially when doctors know if they send the child away without giving a diagnosis, then this child will receive no extra support from the education system.

I became acquainted with this system when my children's teachers fully accepted - as I did - that my children had dyslexia.

At the time, I didn't see any point in getting the diagnosis; it was patently obvious that both children had dyslexia. I didn't see any point in spending €490 on two assessments that would tell me something that I already knew. But then I was told the school couldn't allocate any extra resources to my children until they were officially diagnosed. Evidently, we had to get a diagnosis if I wanted to ensure my children were adequately supported in school.

I then had the choice to wait for the State to provide this assessment or pay for it myself. It might have taken years to get the assessment and, apparently, early intervention is key for these issues. So, feeling ripped off by the system, I arranged for an educational psychologist to give my kids a series of tests to give me the unsurprising news they were dyslexic. It cost me €980.

As I am not an educational psychologist, I couldn't penetrate the results of these assessments and therefore, other than allocating school resources for my children, the assessments didn't add to our lives in any way.

Any good teacher knows exactly which children need support and which are rolling along nicely without any extra support.

If there was more autonomy within the system, then teachers could identify undiagnosed children who need extra resources.

Perhaps we need to trust the educators instead of the medics to identify who needs the extra educational resources?

Doctors need to be able to diagnose wisely without fear of becoming the very obstacle that prevents their patients from benefiting from key support and resources. If the system continues to rely upon doctors to be the inappropriate gatekeepers for the allocation of educational resources, then we will soon fall into a situation where we will be medicalising difference.

This is becoming a controversial issue in the US where children who don't conform to certain narrow guidelines are often diagnosed with some condition or other.

Many experts argue that bland conformity is threatening to override individuality, immaturity, dreaminess and many other normal personality traits and tendencies.

It is well known that Albert Einstein was slow to learn how to speak. He was also described as a dreamy, slow and dull child who had a bizarre habit of softly repeating every sentence he uttered to himself before he spoke out loud. Einstein definitely wasn't standard issue and would undoubtedly have been cause for serious concern among teachers and doctors today.

Diagnoses for brain conditions, such as ADHD, ASD, dyslexia, depression or anxiety, are a very inexact science and perhaps these diagnoses should be written in pencil? Conditions based in the brain cannot be diagnosed with a blood test or a brain scan and so medics are forced to rely on more complex -and fallible - methods of assessment. In addition, although there are some cognitive tests children can take, nevertheless they need to have attained a certain level of education and ability before they can even take the test.

Falsely assuming every child's problem stems from a biological imbalance in the brain may give the child short-term educational benefits; however, it may also saddle them with an incorrect view of themselves that could take many long and difficult years to unravel.

Aristotle tells us that "knowing yourself is the beginning of all wisdom", but how can a person know themselves if they have been wrongly identified as having a condition that is hard-wired into their brain?

Stella O'Malley is a psychotherapist, writer and public speaker with over 10 years' experience as a mental health professional

Irish Independent

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