Values of Labelling Flashcards
Advantages associated with labelling a neuro developmental disorder
- Push for Academic Performance Drives Diagnosis
- Hope for Enhancing Treatment Access, Availability and Effectiveness
- Ease of Communication
- Knowledge that comes with the Label can be Empowering
- Reattributing Symptoms to the Diagnosis can Buffer Self-Image
Disadvantages with labelling a neuro developmental disorder
- People Only See the Diagnosis Not the Person
- All or Nothing Diagnosis
- Diagnostic Labels can lead to Self-Fulfilling Prophecies and Stigmatisation
- Diagnostic Labels may Mislead Understanding of the Cause
- Medications with Aversive Side Effects may be prescribed
Push for Academic Performance Drives Diagnosis
- It is argued that one of the many reasons labelling an individual with a neurodevelopmental disorder may be beneficial is to provide assistance in an academic environment.
- For instance when researching the surge in ADHD diagnoses, Hinshaw and Scheffler (2014) found that diagnosing an individual with a neurodevelopmental disorder such as dyslexia or ADHD in an academic setting, will in effect isolate these students from their peers.
- In short, it is argued that children who are labelled are underachieving and in turn this will enable schools to receive more funding for additional support for assessment and remedial teaching of these children.
- In addition to this, Blum and Bakken (2010) noted that schools push diagnosis and labelling in order to receive government funding so labelled individuals can receive the necessary support.
Hope for Enhancing Treatment Access, Availability and Effectiveness
- For instance, labels may guide research and suggest certain treatments or interventions that could help in the severity or alleviate symptoms associated with the disorder (Corrigan, 2007).
- However, the counter argument of research proposes that individuals may be deterred from seeking professional help in order guard against the stigmatisation associated with that disorder and resultant feelings of inferiority (Wills & DePaulo, 1991).
- Although, Norwich (1999) argues that the failure to provide a diagnostic label to a neurodevelopmental disorder deprives the individual of the possibility of receiving the necessary support.
Ease of Communication
- Arguably the most ubiquitously acknowledged use for labelling an individual with a diagnosis is to simplify correspondence between two parties when discussing the disorder.
- For instance, Trull and Durrett (2005) state that the use of diagnostic labels allow for “verbal shorthand for representing features of a particular disorder”.
- Labels allow for the main features, problems, needs and outcomes to be considered and universally understood.
Knowledge that comes with the Label can be Empowering
- It is argued one of the main advantages for diagnostic labelling is the removal of uncertainty to what is causing a particular individual to act or feel in a certain way.
- In addition to this it also allows for research to be undertaken on the disorder to increase knowledge of the disorder.
- Furthermore, it encourages individuals who have been labelled with a neurodevelopmental disorder to seek the correct help or treatment.
- For instance Young et al. (2007) found that individuals who were diagnosed with ADHD cited feelings of relief due to the removal of uncertainty about their condition.
- In further support of this, Murphey (1995) found individuals felt a sense of relief knowing their disorder had a name and they did not suffer alone.
Reattributing Symptoms to the Diagnosis can Buffer Self-Image
- On a more individual level of those who are diagnosed with a neuro developmental disorder it allows for them to distance/separate themselves from the more negative attributes associated with the disorder
- and their behaviour, advocating that it is not the individuals diagnosed who are the reason for the poor behaviour or difficulties in class it is the diagnosis they are labelled with.
This encourages individuals to combat the stigma associated with a diagnostic label by reattributing their preconceived limitations or disabilities as something outside of their control, and in a sense clears them of all blame.
- For instace, Gazzaniga et al. (2010) argue that a label opens the individual to reattributing poor behaviour or behaviour outside that of acceptable social norms to that specific disorder, this method of self serving bias it also associated with higher self-esteem.
People Only See the Diagnosis Not the Person
- Advocates of the removal of diagnostic labels argue that individuality is stripped from those labelled causing many to only see the label rather than the person as an individual.
- For instance, many may attribute specific preconceived assumptions and traits associated with their opinion of a disorder on to someone with that particular diagnostic label, these preconceived assumptions may be related to personality, social ability, universal attractiveness and intelligence such as an individual with dyslexia being stupid (Jussim, Manin, Nelson & Soffin, 1995), despite research stating that dyslexia and intelligence are unrelated.
- When this happens it creates an ‘us and them’ dichotomy with positive personal characteristics of a labelled individual often being ignored.
- In a study on the effects of being labelled with Attention Deficit Hyperactivity Disorder (ADHD), Ohan, Visser, Strain and Allen (2011) found that both teachers and trainee teachers who had read a report on a child who displayed characteristics of ADHD rated children as less socially desirable and had less conviction in their ability to teach or control the child, when the label of ADHD was present in the report.
All or Nothing Diagnosis
- One of the frequently cited issues with labelling is that it is an all of nothing event.
- An individual with a neuro developmental disorder displaying a broad range but not all of the symptoms associated with that disorder will receive the label regardless of whether they display the full spectrum of symptoms depending on the threshold diagnosis criteria for a particular disorder.
Diagnostic Labels can lead to Self-Fulfilling Prophecies and Stigmatisation
- Labelling can alter the way an individual is viewed in a detrimental way. It may cause as aforementioned an ‘us and them’ dichotomy and lead to an individual being bullied which in turn may result in the labelled individual internalising behaviour displayed on to them.
- Diagnostic labels may also lead to self-fulfilling prophecies where an individual will self attribute behaviour they believe to be associated with the disorder, such as an individual behaving badly because of their ADHD diagnosis or performing poorly in a range of subjects due to the dyslexic label.
- For instance, as Goffman (1963) states, assigning an individual with a diagnostic label is to acknowledge someone as being inferior to the general population.
- In support of this, Klinger et al. (2003) found that high functioning autistic adolescents often feel shame and experience depression at the actualisation of their dissimilarity to their friends.
Krohn, and Rivera (2006) conducted a study on labelling and subsequent delinquency and found that being labelled as a ‘delinquent’ earlier in one’s life meant that there was more chance that subsequently they would behave to the label and the more they did this then the more they came to believe that this was an acceptable and valid persona.
Diagnostic Labels may Mislead Understanding of the Cause
- Another popular argument in the removal of diagnostic labels is that labeling a neurodevelopmental disorder may deceive researchers, teachers and parent as to the true cause of the disorder.
- It is argued that behavioural and cognitive characteristics of ADHD and dyslexia may in fact be manifested in a poor education system failing to meet the individual requirements of the individuals labeled.
- For instance, some individuals learn better or behave better in smaller groups
Medications with Aversive Side Effects may be prescribed
- It is argued that the inclusion of diagnostic
labeling may lead so medications being prescribed with unintended debilitating side effects. - For instance, in a commonly misdiagnosed disorder, it is argued many of the treatments associated with ADHD have to possibility to cause a range of problems such as sleeping disorders, fluctuating appetite and issues in child and adolescent development.
- These have further detrimental effects when considering the evidence that many prescription medications for neurodevelopmental disorder are linked to future substance abuse and drug addiction
Conclusion
- Research discussed thus far generally conforms to there being empirical positives and negatives to the use of diagnostic labels for neuro developmental disorders amongst others.
- For instance, noted disadvantages include stigmatisation and lowered self-esteem and the use of medications that may not have completely advantageous effects; positive effects of labelling are seen to enable easier, more efficient communication about the disorder, the ability to seek correct treatment and clear understanding of the disorder, this knowledge could be empowering.
- However, it is argued that the negative effects of labelling are noted more frequently and with more severity than the positive ones, as the positive effects often manifest themselves earlier than the more detrimental negative effects and therefore are frequently neglected (Young et al., 2007).
Issues with comorbidity
Leyfer et al (2006)
If comorbidity isn’t recognised and only a single label is given without addressing another, treatments and interventions become more challenging and resulting in low quality of life for child and family
Boyle (2007)
Appropriate diagnosis = knowledge empowerment and resources through funding and legislation for both labels
The consequences of comorbid condition, particularly if they go unidentified and untreated, may be severe. Individuals with ADHD are at significant risk for developing secondary psychological problems, such as depression or aggression. These have been attributed to negative experiences, academic failures, frustration and rejection (Herbert, 2003; Silver, 2003).
Co-morbidity may increase this vulnerability further.
Furthermore, the combination of difficulties makes emotional and behavioural problems more likely. For example, young people with ADHD and a learning disability were found to have significant more behavioural problems (e.g., aggression or withdraw) that those who had either one of these diagnosis (Cruddace, 2006).
In addition, comorbidity creates more problems than just one disability added to another. In a study by Cruddance and Riddell (2006) young people with ADHD and a comorbid learning disability had more sever learning problems than children who have a learning disorder but no ADHD, and also more sever attantional problems than those with ADHD but no learning disorder.
Issues with heterogeneity
Shafali (2014)
- ASD represents a heterogenous group of disorders which presented a substantial challenge to diagnosis and therefore treatment
Poland et al (1994)
- DSM provides no representation of underlying biological, psychological or environmental processes involved in aetiology
- If the DSM remains atheroetical to pathology it will continue to fail to represent the casual processes operating within the same category as individuals who exhibit superficial similarities but who differer significantly on underlying process
- There is very likely massive unrepresented heterogeneity across individuals falling within the DSM diagnostic categories - Therefore due to the structure of individuals deficits and capacities being ignored and the context of their functioning and the casual processes involved there are difficulties in labelling and treatment.
