Another mom’s question about whether her child had RAD or autism sparked my thinking about the complexity of diagnosing post-institutionalized and traumatized children. You can find my musings in these blogs :

Autism and RAD
The Combo Platter

So for me the next logical question is if our children have a smattering of any number of disorders but no clear cut determination of one particular disorder, does the diagnosis matter?

I think the answer is “not really”…but “yes”. Let me explain.

In our day-to-day life the labels that doctors have given LuLu are of little concern to us. Parenting her is challenging and the interplay between her various diagnoses is intense. But it’s not like I have found “the answer” by finding the labels. We’ve had nearly “all” of them and there can be a case made for each and every one. In the days when I was still hung up on labels I kept asking myself “How can one child have all of the following stuff: RAD/PTSD, ADHD, Tourettes/OCD, ODD, sensory integration dysfunction, auditory and visual processing disorders, language disorders and PDD- NOS!!!”

So, what good is it to know what labels your child has? Do these labels matter? Yes in so much that they:

1. help to determine which therapies and medications are appropriate. Without some of these labels we would have never pursued attachment therapy, sensory integration therapy, neurofeedback, for example. Without a grasp of all the possible disorders, our psychiatrist might have prescribed a stimulant for ADHD or an SSRI for anxiety without first looking at the way that would affect her other disabilities.
2. help to get the needed services in school. Both ADHD and Tourettes are diagnoses that can lead to the Other Health Impaired eligibility for special education under IDEA. The processing and language disorders, along with the sensory integration dysfunction are often addressed with special services through the schools, because they all have great potential to make learning much more difficult.
3. help you to find parenting techniques that work. Parenting children with attachment disorder or Oppositional Defiant Disorder or even OCD is a bit like running the Parenting Triathlon. You need all the training you can get. Things like Love & Logic parenting and The Explosive Child would have been unknowns to me had my child not received labels associated with these techniques. And now understanding the whole interplay between Tourettes/OCD/ADHD has given me even more parenting tools in my toolbelt.

Meanwhile the arguments of the professionals rages on. And parents are confused daily by professionals who contradict each other and DSM-IV definitions that indicate certain disorders can’t co-exist. The sad truth is that neurologist is the final medical frontier and even though research in mental illnesses has exponentially increased, research into traumatized children with combo platters is almost non-existent.

So parents are left with less-than-accurate labels and often less-than-adequate resources/support. Yet, somehow we do the best we can with the tools we have.