What’s in a psychological diagnosis for children and adolescents?
When parents first contact a specialist in child development, usually they have been concerned for some time and have developed a reasoning or understanding of their child’s behaviour. Is my moody teen depressed? Does my explosive child suffer from attention deficit and hyperactivity disorder? Is my five year old actually school-phobic? Or does my picky adolescent have an eating disorder? Such questions bring us into a larger domain of diagnosis: how do we know when a child or adolescent fits a specific diagnosis? And whether they do or don’t, what is the effect on their development?
Officially, psychological diagnoses refer to a description of a specific series of symptoms that have been present and/or absent for a specific amount of time. Such classifications can only be carried out by a trained clinician such as a psychologist or psychiatrist. However, each diagnostic description is itself rooted in larger contextual questions – which diagnostic manual is used in which country? Which diagnoses are recognized by the health insurance company? Do all clinicians speak the same diagnostic language used to understand human behaviour?
Diagnoses can appear then as the axes around which meaning, understanding, treatment and healthcare pivot. They can structure the words that clinicians use to understand behaviour and emotions, they can give or take away potential meaning from parents observing their own children, indicate treatment, and even provide or deny access to healthcare.
Parents negotiating their child’s development, may find relief when a diagnostic description resonates with their experience. They may feel that, finally, they will be able to pursue appropriate treatment to help their child get back on a healthy developmental path. While a diagnosis can confirm a parent’s intuition, it can simultaneously create a fear of stigmatization that their child may permanently belong to a certain developmental category and potentially aggravate complex feelings.
Once a diagnosis is pronounced, will the treatment directly address the symptoms - and will the diagnosis then be removed? In the absence of aggravating symptoms, perhaps will we never understand why those symptoms arose in the first place?
Children vary immensely and, to add to the whirlwind, they grow and change so dynamically compared with adults. Capturing both the underlying depth as well as the symptomatic surface of emotional, cognitive and social capacities, may take the shape of collaboration between parents, school, and various clinicians. For example, psychiatric medication may treat symptoms while psychotherapy will attempt to address the underlying dynamics.
Ultimately, the experiences of suffering, seeking help, receiving a diagnosis and treatment will be as singular as each child. In addition to alleviating symptoms, parents and clinicians strive to promote and sustain child and adolescent emotional and behavioural health.
Rebecca Weber, PhD, is a Clinical Psychologist specialized in Child and Adolescent psychotherapy. She works in private practice in Ferney-Voltaire. Originally from California, her research and clinical work focus on gender, migrant families and school violence. For more information please visit her website.
Rebecca Weber has a weekly show on WRS called Kids in Mind.
Please note: any psychological advice or information provided in the Kids in Mind column in The Voice magazine is general information and should not be used to evaluate, diagnose or treat any specific concerns. Always check with your medical-care provider if you have questions about your own children. The Voice magazine or Dr. Weber are not responsible or liable, directly or indirectly, for any damage resulting from the use of information contained in, or implied published here.