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Is it a difficulty or a diagnosis?

Is it a difficulty or a diagnosis?  A delay or a disorder?  A preference or a problem?  The Creation (and Confusion) of Diagnostic Systems

Text Box:  In what was the first apparent attempt to gather information on mental and learning problems, the U.S. census bureau in 1840 had one category: “idiocy/insanity.”  Forty years later in 1880 the census included seven categories of mental illness (i.e., mania, melancholia, monomania, paresis, dementia, dipsomania and epilepsy).  Classification systems evolved with the work of the American Medico-Psychological Association (which would later become the American Psychiatric Association) and the U.S. Veterans Administration.  In 1952, the American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders (DSM-I).  The Diagnostic and Statistical Manual (now in its fourth edition, text revision – DSM-IV-TR) contains a comprehensive listing of mental disorders, including psychiatric, psychological, social, and learning problems.  In the world of medicine the World Health Organization created the diagnostic system known as the International Classification of Diseases, currently in its tenth edition (ICD-10).  In 1952, ICD-6 included 26 classifications for mental, behavioral, and intellectual problems. 

Historically, in the world of education trade-school was an option for students who had difficulty learning academic subjects, and reform-school was an option for students who were disruptive.  Frequently these “options” were imposed, rather than offered.  By 1975, though, zeitgeist in the United States had become decidedly more kind, and the Federal Government passed Public Law 94-142, the Education for All Handicapped Children Act, which guaranteed a “Free and Appropriate Public Education” for all children.  Thus, the modern “special education system” was born (currently, the special education law is called IDEA: The Individuals with Disabilities Education Act but the concept of providing free and appropriate education remains).  A challenge that was inadvertantly created by the law is the task of defining the word (and then implementing the concept) of “appropriate” in the entitlement known as “Free and Appropriate Public Education.”  This challenge is compounded by the fact that each individual State in the U.S. is tasked with administering their own program, so the definitions and interpretations of “educationally handicapping conditions” can and do vary widely from State to State.  Indeed, each State has an educational classification system of handicapping conditions that serves as a guide for implementing Individual Education Programs for students who meet eligibility criteria for one or more of the classifications. 

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