There can be many dilemmas and pitfalls involved in diagnosing children, teens, and young adults with developmental and behavioral difficulties. A diagnosis is not an end, but a beginning from which to start a process. This is the process of finding the interventions, treatments, and supports families and individuals need to lead happy and productive lives.
Diagnoses in children under the age of three are particularly difficult because of the natural developmental processes at work. Infants and children in this age range are changing rapidly in the maturation of their cognitive, behavioral, emotional, adaptive, motor, language, social and physical development. Any approach to problems in this age group must incorporate information from multiple sources (school, home, caregivers, and activities) and follow a developmental sequence. This means a solid foundation in understanding the normal course of early child development. We utilize a strengths based perspective where current competencies are identified and reinforced. Relationships between family members and the stability of the family unit are also of central importance in the child’s development. Diagnoses in this age group may, at times, be tentative or provisional. We may be able to clearly identify a behavior or interaction style as atypical, and in need of monitoring. There are also cases of clear cut diagnoses particularly: autism, language delays, anxiety, fine and gross motor skills delays, genetic syndromes, neurological impairments (seizures, brain anomalies, etc) regulatory disorders and sensory integration problems. Other diagnoses may be premature but clear signs are apparent such as ADHD, learning disabilities, and other concerns. There may be emerging signs of a disorder which does not yet meet full diagnostic criteria at this time, but requires monitoring and intervention. There are also times where early trauma may mask what is happening to a child and what looks like a deviation in development is a response to insecure attachment and maladaptive coping skills. Continued monitoring and ongoing assessment are the best tools to insure a child’s healthy development if a true need is identified.
These are the most common years to identify ADHD and learning disorders. Many social and emotional issues are also identified at this time including: separation anxiety, generalized anxiety, phobias, OCD, depression, gender identity, bipolar disorder, conduct disorder, oppositional defiant disorder, depression, eating disorders, tic disorders and central auditory processing disorders. Many assessments and tests we formally use to make diagnoses more precise are based on norms and references for ages six years and up. These same diagnoses continue in the teen years complicated by the psycho-social issues related to puberty and identity issues in adolescence. Regardless of age or presenting problems diagnoses are the starting point to seeking help and guidance for you or your child. A diagnosis is not static. Children and teenagers are in a state of dynamic change throughout most of their lives. Change brings both instability and new challenges. These changes may be favorable or provide new barriers to be overcome. However, understanding that raising children is a process can make the journey hopeful and joyful. We rise to challenges, we use untapped resources when strained, and we find a way when there is none. These are steps along the universal journey of parenthood for everyone. My goal is to assist each and every family on their journey.
For older teens independence and self-sufficiency present new challenges and risks. We welcome the opportunity to assist families in helping launch their teenage children entering adulthood on a path to become productive and autonomous members of society.