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Is ‘Diagnostic Uncertainty’ Good News or Bad News?

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Usually, when there is a developmental delay with a very young child, we do not automatically suspect a “disorder.”  A child may be delayed for any number of reasons.  Perhaps a child who has had chronic ear infections has a language delay due to negatively impacted hearing.  Perhaps a child who was just adopted from an orphanage abroad is developmentally delayed due to low stimulation from a poor staff to child ratio in the orphanage.  In most cases, though, there is not such an obvious “cause” for a developmental delay.  Rather, a developmental delay is just that, a delay.  A “late-walker” or a “late-talker.”  Most things in the natural world occur on the bell curve.  Consider an easy to understand example: some children are tall and some are short, but most are average.  Now apply that logic in a developmental example: some children begin talking early and some talk late, but most begin to talk somewhere within average range.  So to apply this logic to the question of whether a child has a “disorder” or a “delay,” most children who talk late do not go on to have a “Language Disorder,” but there will indeed be a small subset of those language-delayed children who indeed go on to demonstrate a “Language Disorder” in later childhood.  Although we may have hunches or bits of predictive evidence, at very early ages, we often simply do not know how to predict which children will “turn the corner” and “blossom” on their own, which children will require formal intervention for a short time, and which children will have longer-term learning/social/behavioral problems.  Again, as indicated above, one thing we know for sure, is that “F.E.A.T.S. Techniques”  can be used to promote positive development for all children.   

Is it premature or is it valid to diagnose a 3-year-old with Attention Deficit Disorder, a 14-month-old with autism, or a 2-year-old with apraxia?  We do not have a “diagnostic crystal ball,” and it is often difficult for parents to accept uncertainty about their child’s developmental status and prognosis.  Parents who refuse to accept “diagnostic uncertainty” may say, “I want/need/demand an explanation for my child’s developmental delay.”  They may then feel compelled to go on a quest for an explanation (or diagnosis) that may (or may not) ultimately play out to be correct.  Other parents may choose to welcome “diagnostic uncertainty,” taking it to mean that their child simply has a developmental delay, rather than a disorder. 

Although most children with delays progress well and do not go on to have disorders, we have included here information on some developmental disorders (apraxia, articulation, auditory processing disorder, autism and pervasive developmental disorder, dyslexia), language delays, and behavioral difficulties.  If you have concern about your child’s development, it is important to have your child formally assessed by the appropriate professional. 

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