Diagnosis Momentum

If there is one thing that is hard to shake off, it’s a label.

Labels are lethal for a child’s development. They act as badges, tags and markers and for some they are life-sentences.

The problem is diagnosis momentum: once diagnostic labels are attached to children they tend to become stickier and stickier.

What starts out as a temporary marker (such as an ability group), it then grows in the minds of others and increases momentum until it becomes a definite state of being and all other possibilities or routes are ignored or excluded. Once you are in ‘the bottom group’ then it’s hard to escape. Label someone as having ADHD or dyslexia and that’s for keeps. When the diagnosis is made the thinking stops.

Our diagnostic protocol is often next to hopeless because most of the time we don’t know what we are diagnosing. But this is dangerous because those labels don’t come off even if you soak them in hot, soapy evidence-based water. They are stubborn and even after repeated washes the label is still there like a scar.

Diagnostic errors occur more commonly than other kinds of errors, they are more likely to harm children and they are more likely to be preventable. Sometimes teachers and parents can jump in with both feet and make diagnostic errors based on common symptoms that could relate to half a dozen other areas of interest.

Who says that someone has ADHD? Diagnostic errors often result from biases and failed heuristics (mental shortcuts) and who is qualified to make the ultimate decision?

Assessment and diagnosis are the most critical skills of a teacher yet the least developed in terms of teacher training.

As teachers we can often fail to gather sufficient information, interpret data incorrectly and fail to synthesise data so that we ‘treat’ pupils with labels that they don’t actually deserve or we don’t address issues that do exist and get missed. There’s also plenty of outside influences clouding our judgement.

In the 2017 GL Assessment report, ‘Hooked on labels and not on need’, more than half of the 810 teachers surveyed agreed there was a widespread misdiagnosis of special education needs among children, with most saying that was due to ‘parental pressure’. The report says,

It is not that teachers think that SEN is an inflated problem, rather that some children who deserve support are not receiving it because it has been diverted to others who do not need it.

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