”Back to Normal” Makes an Argument for Shedding Labels
When one of my children was five years old, they entered kindergarten. The child we entrusted to the school was a high energy, affectionate, interesting kid. A kid who “bounced,” just like A. A. Milne’s Tigger in the Winnie-the-Pooh stories. A kid not always aware of their hyperactivity, nor of others’ reactions to it.
Only a few weeks later, the principal took me aside: “Gail, when are you going to get that kid on meds?” And thus began a long journey with a diagnosis, a label, which made my child a problem, not just in school, but at church, in sports, and just about everywhere else. And a long journey with a caring physician who, thank goodness, was always willing to put at the center of decisions my child’s own assessment of the way they felt, both on and off medicine. Although those years are past and my child is now grown, memories of that time still evoke pain, sadness, and outrage.
I recently read Back to Normal, by Enrico Gnaulati, a clinical psychologist specializing in childhood issues (Beacon Press, 2013). He asserts that we are giving diagnostic labels and psychiatric medications to children who may just be delayed in social, emotional, or linguistic development, or who may have temperaments that make it difficult to respond to the expectations of family, school, and culture. He observes that a diagnosis is often the key to medical insurance coverage and educational supports for a child who is having difficulty. Yet, diagnosis is often made quickly, without long-term observation of the child, and without exploring potentially complex explanations for hard-to-manage behaviors. Certainly there are children who have an autism spectrum disorder, bipolar disorder, or ADHD and for whom medication is an important help. However, he suggests that many children are given diagnostic labels that turn out to be inaccurate and unnecessary.
While I am unconvinced by Gnaulati’s attribution of certain kinds of behaviors to gender-related development issues, much of his writing is useful for religious educators and volunteers who work with children and families in congregational contexts. It really boils down to understanding each child as an individual, not a diagnosis, and understanding that the congregational culture and expectations may pose difficulties for some children that require creative adaptations. His book also refused to take either side of the nature/nurture debate with regard to causes of some children’s difficulties. For example, he writes:
…Believing an ADHD kid suffers from a brain disease can engender compassion. By the same token, it can lead to a sense of futility that nothing fundamental can be done on the teacher’s or the kid’s part to bring about lasting change. There may be the sense that the kid’s hyperactive behavior must be simply tolerated, managed, or controlled (whether through medication or behavioral methods) – not changed. This can lead to negative reactions, whether openly expressed or just ruminated on.
He goes on to point out that removing the label and dealing with the child can empower parents, families, and teachers (and congregations, I might add!) to more effectively help a child to grow and develop needed skills. It can also reduce the stigma and stress faced by a child with difficulties and the parent(s) who love them.
Read Welcoming Children with Special Needs: A Guidebook for Faith Communities for guidance in creatively supporting all children and families.
Read the Multigenerational Pastoral Care page on UUA.org and follow links for more resources and guidance.
“Fidget objects” are a tool suggested in the UUA Tapestry of Faith children’s programs to help children settle down and focus quietly when it is time for their group to listen.