(Warning: this post is to be taken with the proverbial pinch of salt. Not suitable for anyone without a sense of humour!)
Sam is 8 years old has just been diagnosed with ADHD, severe dyslexia, anxiety and attachment disorder and obsessive-compulsive disorder. We think he might be on the autistic spectrum too. He’s taken the diagnosis quite well. He’s currently lying on a cushion in the living room watching the rest of the family and thinking about dinner.
You might wonder how all those diagnoses managed to come together at once and so quickly.
Sam is hyperactive, he will race around the garden running circles and leaving a muddy figure-of-eight in the middle of the lawn. He always has his nose in everyone else’s business and likes to be the centre of attention. He is generally unaware of other people and barges into them, often knocking over the youngest child in the house and being totally oblivious to the fact. If we haven’t got a tight hold of him, he is known to run out of the house and across the main road at the end of the street. With the exception of eating he loses concentration on tasks very quickly and he is most definitely impulsive breaking several Christmas and birthday presents within hours of them being opened. It’s fair to say he gets over-excited and he has been known to wet himself! We used a checklist for ADHD from the internet and he scored high in most areas.
We know he suffers from anxiety and attachment disorder. If Mum tries to leave a room, he has to follow her. On the rare occasion she has managed to make it upstairs to the loo on her own, he tends to wreck things. On one occasion he smashed all the dishes in the kitchen. On another he pooed in the lounge. He overcompensates when people arrive to the house making a massive fuss of them and trying to invade their personal space.
Mum thinks he has severe dyslexia too. She’s been reading with him for years and he still doesn’t know what the words say. He really struggles to repeat them. She borrowed a book from the library and everything they mentioned in there we were able to identify in Sam. The thing is, he’s not incredibly frustrated by his difficulty, he seems to have given up.
This is Sam. He is a lurcher (a cross between a whippet and a greyhound.)
This post is written with an element of humour, because I’ve seen it happen so many times in the past. Many a parent and teacher have in good will, downloaded a checklist from the internet and managed to self-diagnose issues.
I like a good checklist, they can be very helpful in trying to pinpoint difficulties and relative strengths, and I’ve written a few myself over time…but equally so, they are very suggestive. When you are reading the statements you automatically start to look for examples.
Most checklists are simple ‘yes’ or ‘no’ lists. If something has only happened once in their lifetime, should we really be ticking ‘yes’? Well it depends, if we’re looking at a checklist for depression and it asks whether a parent has died then we would not expect that to happen ‘frequently’. On the other hand if it asks whether someone has cried, then we have to consider why they were crying and is it in excess of what we would expect?
The most helpful checklists are those which use a frequency output (Never, Rarely, Often, Frequent) or a Likert Scale (0-5 where 0 is never). Giving a weighting to each of those will give a better picture of the individual. They may have a tick against every statement, but they only experience them rarely. Or they might have only a few ticks, but they are observed frequently.
I once ran a parent coffee morning and we bought along a number of different tools that SENCOs can use in school in trying to identify children with SEN. To start with I read out a series of statements and just asked them to raise a hand if that statement ever applied to them. I ‘diagnosed’ the whole group of 14 adults with OCD! We then asked them to complete a questionnaire and indicate how often each statement applied. By the end of the session only 1 individual had a high enough score that we would flag them for further investigation. (Fortunately, this was an individual who did have an official diagnosis of OCD and we had warned her beforehand what we would be doing.)
I’m also wary of going to visit a paid specialist for a diagnosis for similar reasons. If I tell a dyslexia specialist that I think I have dyslexia, then their testing regime is likely to ‘look for’ dyslexia. This doesn’t always address that there may be other difficulties leading to ‘dyslexic-style’ difficulties.
For me, however, it is never about the label or the diagnosis that is given. It is about the support the child needs. Do we say that only children with dyslexia can access an intervention phonics group? No, we provide it for all students who need that program of support regardless of their label and whether they even have one.