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Your five-year-old son wanders around his kindergarten classroom distracting other kids. The teacher complains: he can’t sit through her scintillating lessons on the two sounds made by the letter e. When the teacher invites all the kids to sit with her on the rug for a song, he stares out the window, watching a squirrel dance along a branch. She’d like you to take him to be evaluated. And so you do. It’s a good school, and you want the teacher and the administration to like you. You take him to a pediatrician, who tells you it sounds like ADHD. You feel relief. At least you finally know what’s wrong. Commence the interventions, which will transform your son into the attentive student the teacher wants him to be. But obtaining a diagnosis for your kid is not a neutral act. It’s not nothing for a kid to grow up believing there’s something wrong with his brain. Even mental health professionals are more likely to interpret ordinary patient behavior as pathological if they are briefed on the patient’s diagnosis.[15] “A diagnosis is saying that a person does not only have a problem, but is sick,” Dr. Linden said. “One of the side effects that we see is that people learn how difficult their situation is. They didn’t think that before. It’s demoralization.” Nor does our noble societal quest to destigmatize mental illness inoculate an adolescent against the determinism that befalls him—the awareness of a limitation—once the diagnosis is made. Even if Mom has dressed it in happy talk, he gets the gist. He’s been pronounced learning disabled by an occupational therapist and neurodivergent by a neuropsychologist. He no longer has the option to stop being lazy. His sense of efficacy, diminished. A doctor’s official pronouncement means he cannot improve his circumstances on his own. Only science can fix him.[16] Identifying a significant problem is often the right thing to do. Friends who suffered with dyslexia for years have told me that discovering the name for their problem (and the corollary: that no, they weren’t stupid) delivered cascading relief. But I’ve also talked to parents who went diagnosis shopping—in one case, for a perfectly normal preschooler who wouldn’t listen to his mother. Sometimes, the boy would lash out or hit her. It took him forever to put on his shoes. Several neuropsychologists conducted evaluations and decided he was “within normal range.” But the parents kept searching, believing there must be some name for the child’s recalcitrance. They never suspected that, by purchasing a diagnosis, they might also be saddling their son with a new, negative understanding of himself. Bad
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