Discussing the ‘Obsession’ With Childhood Disorder Labelling

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From Sociology Lens Insights: “In recent decades, we have too often passed the buck of social problems to children who lack the power to say no to stigmatizing psychiatric labels. Laura Batstra and Ernst Thoutenhoofd call for reflection on these non-evidence-based, ineffective and sometimes even harmful practices.

The instability of labels

Recently, a well-designed cohort study reported that nearly 40% of 213 toddlers classified with an autism spectrum disorder (ASD) no longer met the criteria for ASD at the age of 5-7 years. ‘Recovery’ from ‘autism’ was not associated with the intensity of the treatment received. Treatment, by the way, often concerns Applied Behavior Analysis (ABA), itself noted to be particularly child-unfriendly in a recent assessment of it. The suggestion that children often ‘recover from autism’ is in line with previous studies into the (in)stability of autistic behavior. Likewise, it has been known for some time that around two-thirds of children who are given an ADHD classification do not meet the criteria for it after eight years: it seems that ADHD, mistakenly associated by a range of biomarkers, such as smaller brains, tends also by and large to miraculously disappear, given a few years of maturation.

Absence of evidence

Findings of this sort are not only strikingly at odds with the overly confident biomedical rhetoric associated with the mental disordering of children, they are also particularly disturbing in terms of the research ethics of child welfare and child rights. After all, research on the usefulness of psychiatric classifications should have been conducted well before millions of children worldwide were given these developmental disorder labels.

A major scientific intervention was unduly made in the lives of all these needlessly diagnosed children, giving them a label that they will only be able to shed with great difficulty. Diagnostic intervention in the lives of children and their families happened and continues to happen in complete absence of convincing scientific evidence that childhood disorder diagnoses would do more good than harm. It is often noted that youth care should be conducted in an evidence-based manner, but the deplorable evidence-base for childhood classifications means that it is not. Not only do children often ‘grow out of’ supposed childhood disorders, it has moreover also been concluded that disorder labels do not improve the quality of life of the vast majority of diagnosed children in the longer term. Diagnoses sooner bring about substantive risks, including reduced feelings of self-efficacy and reduced confidence in the ability to learnlower expectations by teachersexclusion, and feelings of (self)stigma.

Sound scientific proof for beneficial long-term effects is also lacking for treatments given to children with mental disorder diagnoses in young persons’ mental healthcare systems. There is no evident support for the so-called ‘intervention as prevention’ hypothesis: the widespread but scientifically unfounded supposition that early intervention can preempt later problems. A study involving 1420 children followed long-term has shown that psychiatric treatment in fact resulted in increasing the risk of substance abuse among participants.”

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