Читать книгу The Handbook of Language and Speech Disorders - Группа авторов - Страница 21

Receiving a diagnosis in the form of a disability label may start a cascade of constructive consequences if the diagnosis is an accurate one. The first constructive consequence is that the diagnosis may transform an unorganized and unclear set of complaints and symptoms into a more organized and comprehensible disorder (Balint, 1957). Once framed with a label, the disorder becomes easier to conceptualize, discuss, and act upon. It is often the case that organized categories help all involved parties achieve greater understanding and communication about complex behavioral entities that are generalized by the labels (Damico, 2019; Darley, 1975; Leyens, Yzerbyt, & Schadron, 1994). In a study of children with ADHD, for example, one of the authors (Damico & Augustine, 1995) found that parents of many children eventually diagnosed as exhibiting ADHD often had nagging feelings that something was wrong but they could not put their finger on the problem. Indeed, based upon an interviewee’s comment, the researchers in the study explained this phase of confusion as a period of “undefined malaise” (Damico & Augustine, 1995, p. 261) in which the parents did not know how to characterize their children’s problems or where to turn for assistance. Once a diagnosis was provided, however, the parents felt that they had a better understanding and could proceed in a positive direction.

In line with the first consequence, once a valid and accurate label is obtained it can also lead to opportunities and extra resources that are not available without a diagnostic label (Gillman, Heyman, & Swain, 2000; Sutcliffe & Simons, 1993). As previously stated, many governmental regulatory bodies, educational remedial guidelines, and insurance providers require a standard diagnosis before treatment is provided. Federal and state special education regulations, for example, require official diagnoses before intervention is even planned. In the ADHD study just reported (Damico & Augustine, 1995), school systems did not tend to orient to the needs of the students studied until a formal diagnosis was obtained. When the formal label was delivered to the schools, however, it acted as a catalyst. Various accommodations and services not previously offered to the child and parents now were provided. The label, therefore, had a reactive power over the schools, the parents, and even the children. This need to employ diagnostic labels to achieve such ends is not unique to ADHD. Numerous researchers have discussed this issue across many of the communicative and cognitive exceptionalities (Gibbs & Elliott, 2015; Gipps, 1999; Glaser & Silver, 1994; Klassen, Tze, Betts, & Gordon, 2011; Messick, 1984; Rogers, 2002; Rolison & Medway, 1985; Skrtic, 1991; Sleeter, 1996).

Positive impact, however, goes even further with services provided. An appropriate label does not just create reactionary influences to provide service delivery; it also enables a discerning clinician to carefully prepare a treatment plan that is tailored to the needs of the individual now accurately identified and labeled. In doing so, having the valid diagnostic label may lead to specific intervention that will overcome the identified deficits (Archer & Green, 1996; Brinton & Fujiki, 2010; Gross, 1994; Kamhi, 2014; Müller, Cannon, Kornblum, Clark, & Powers, 2016). In effect, strong assessment resulting in an accurate diagnosis is essential for good intervention to occur. To use a metaphor from Brinton and Fujiki (2010), “you must know where you are going to plan your route.”

Finally, an accurate diagnosis may have positive psychological and social consequences. For instance, individuals affected by various behavioral or medical symptoms can legitimate their problems and achieve self‐understanding once an accurate and valid diagnostic label is provided (Broom & Woodward, 1996). The individuals with impairment can address feelings of confusion, isolation, or inadequacy and construct new identities, and this, in turn, can assist in dealing more effectively with their problems (Gross, 1994; Gus, 2000; Kelly & Norwich, 2004; Riddick, 2000). Therefore, the diagnostic label can have a substantial positive impact on the lives of the individuals with disabilities (Broom & Woodward, 1996; Damico & Augustine, 1995; Gibbs & Elliott, 2015; Link, Cullen, Struening, Shrout, & Dohrenwend, 1989).