Labels: Do we love them or hate them?
In our home we have ADHD, anxiety, depression, Bipolar Disorder, Attachment Disorder, and Post Traumatic Stress Disorder. Obviously this is NOT how we introduce ourselves!
We are a family with two parents, 4 boys and a cat. We each have our strengths and weaknesses and we try very hard not to define ourselves by them. Everyone has their own opinion about “labeling.” Some people believe that once you stick a label on a child, you cannot peel it back off. Many doctors are hesitant to give a label. I’ve had doctors say, “we need to deal with the behavior. It doesn’t matter what you call it!” I disagree. If you give me the “label,” I can research it on the Internet. I can join a support group! I can meet other families dealing with children with these behaviors. I can relax and say, “A ha! This behavior is typical of children with THIS!” and find ways to deal appropriately with a behavior. If I know WHY a child does what he does, I am much better able to cope with the behavior.
I can just as enthusiastically argue the flip-side of the same argument. Sometimes it’s difficult to tell what is typical boy behavior, or teen behavior, and what is a symptom of a greater disorder. Child staying awake all night for days? Must be mania! Or could it be anxiety over a test or a new girlfriend? Child cleans his room and throws away things he may need without carefully assessing what he is doing. Must be mania! No, it might be impulsive teenage boy tired of mom telling him to clean his room!
Of course I am not saying that the “labels” were given without a lot of thought and testing. The children had extensive evaluations by more than one professional. The key is that the behaviors we saw were above and beyond what you would see in typically developing children. Our kids also responded well to medication when needed, along with the other interventions that were put in place. I just say this as a sort of “disclaimer” because i know there are people out there who do not believe in labeling and many do not believe in any of the diagnoses children are given these days. I would never ask for someone to give me their opinion on what their thoughts are on my children’s diagnoses or behavior. I live with it.
There have been a few occasions when one of our children did not get their medication on a particular day. That is a great way to accidentally re-evaluate the situation, to see if the medication is still a necessity. Obviously this cannot be done with all medications, but it is especially helpful for the ADHD medications that are given daily. I have seen my oldest son become better able to manage his ADHD as he got older and no longer needed it, whereas my 13-year-old recognizes he cannot focus as well without it and will go to the nurse (where I keep a back-up if he forgets in the morning). When he was younger, he could not get through the day without a call from the principal on a day without his medication. If we forgot to give it in the morning he was not even able to make the connection that he forgot it on the days when the school sent him home for out of control behavior. We would find out later that his morning medicines were still in the container. Luckily this was a rare occurrence, but a nice “test” of the “label.” Children grow, they hit puberty, their metabolism changes. Sometimes medications stop working and need an adjustment and sometimes they are no longer needed.
Another argument people have, and I grapple with as well, is the need for accommodations. At what point do you draw that line between accommodating and enabling? I find I am walking that line more and more as the children get older and are able to “manage” their disabilities, or control their behaviors better. I believe wholeheartedly in natural consequences. If you do not turn in your work, you get a zero. But is it not turned in due to the ADHD and poor organization skills or laziness? Sometimes it can be one thing one day and the other the next!!
As my oldest son hit the upper elementary school grades, his grades started to slip and his attitude towards school got worse and worse. I asked the school repeatedly for accommodations and even with documentation from the doctors regarding his ADHD, was denied. In middle school the teachers said he was lazy and unmotivated. I knew there was something else going on. But he was bright and could get straight A’s on tests even when he was not doing classwork or homework. Eventually he was diagnosed with bipolar disorder and was sent to another school which was better equipped for handling students with emotional disabilities, where he thrived. I am not saying that if the elementary school would have given him some accommodations that he would not have ended up in the same school. What I am saying is that his emotional disabilities were getting in the way of his learning, and accommodations may have made school a little more bearable for him (and me). Once he got the appropriate “label” the new school was better able to help him.