The Paradigm


‘Learning Difficulty’, it became popular in the eighties as ‘retard’ and ‘invalid’ faded from high minded conversation and towards discriminatory banter. Now it’s ‘Learning Disability’ – in the United States at least, where the collective wisdom of physicians dictates how the Western World and those societies which aspire to it carry themselves in their day to day lives.
Across the other side of the world from that bureaucracy, myself and several of my nearest and dearest have lived that day to day life with a condition of this nature and – having reconciled with it, have watched it begin to affect the next generation. The great irony is that, for me, a juvenile – that is pediatric – version of my illness exists. Pediatric Bi Polar Disorder popped into the medical lexicon at around the same time as ADHD, Dyslexia and Dyspraxia. It showed itself at around the same time as another consideration among not only physicians but patients and parents too: what is the correlation between all these illnesses? And does the pitfall of malady that we like to dramatise, especially when it comes to our kids, actually look more like a spider diagram?
Surely, there must be a reason lurking in the annals of the medical profession that explains this unidirectional burst of recognising Learning Difficulties as we do now. Of course, there are the usual issues with institutions and individuals who are paid money to find out the symptoms of these illnesses and diagnose more people with them but how did they come to choose such an idiosyncratic set of criteria to turn a ‘problem child’ into new members of the handicapped section of society?
Well, in a not totally disimilar manner from a parent running to google to get a summary of all the malady’s scariest factors, medical journals at the turn of the century granted the publication of a handful of literature reviewing other studies on the matter of learning difficulties and the means doctors were using to diagnose them. In their attempt to chart a course for how the profession was starting to understand this new wave of mental illness they found a worrying grove; quite apart from not worrying enough, there was a pathology of overdiagnoses, especially in the United States, where there exists a prominent history of undertreating public health concerns throughout the late twentieth century. [QUOTE]

While this tendancy to overdiagnose homoginised much of the population, it only created a greater strivance for parents to investigate what might be wrong with their children and garner individiual attention for their condition. This related to me all too easily; treating Pediatric Bipolar Disorder quickly ran out of control.
As fast as the peer-reviewed system of evidence churned out studies on the condition (and much faster than anyone heard about the overdiagnoses) the media whipped up stories of academic bias and overmedicated kids. For better or worse, the most hyperbolic instance of this came in the form of sixty minutes’ coverage of the case of Rebecca Riley, who was diagnosed with the illness aged just two years old and was dead from an overdose of medication aged four.
It’s impossible to acknowledge a tragic case like that one, scaremongering not withstanding, and try to spin in some positive reasoning to assess our children as children – to nip it in the bud. Equally, I believe that a parent can best take account of all the traits and idiosyncrasies that make our children individuals and relate it to character, not illness. Rather than having an adversarial attitude to admitting fault with your child, their development or their parenting, try to go against the grain of the current medical ‘paradigm’.
Reviewing the information that doctors were using to treat our children at the turn of the century, epidimeologists Edwin C. Levin and Peter L. Parry surmised:

Social historians and prominent psychiatrists describe a paradigm shift in psychiatry over recent decades: from an era of “brainless psychiatry,” when an emphasis on psychodynamic and family factors predominated to the exclusion of biological factors, to a current era of “mindless psychiatry” that emphasizes neurobiological explanations for emotional and behavioral problems with limited regard for contextual meaning.’  

I’d submit that it falls to us to provide the context, to draw the faultlines that connect traits and behaviours to illness and furthermore connect learning difficulties to eachother.
This strategy isn’t without it’s caveats however; mothers and fathers are not physicians and our children certainly aren’t either. Trying to establish a dialogue with doctors often causes them to compromise the precision of their judgement and for us to wander out of the comfort zone of our knowledge. When in the early 2000s this uncertainty spread as quickly as the paternal desire to intervene, senior doctors also spotted a paradigm shift in how parents responded to the new wave of diagnoses. Writing for the Lancet at the end of the decade, Dr. Andrew Skull noted:

‘A simplistic biological reductionism (has) increasingly ruled the psychiatric roost. Patients and their families learned to attribute mental illness to faulty brain biochemistry. … It was biobabble as deeply misleading and unscientific as the psychobabble it replaced.’

Again, it’s a pretty damning condemnation of the pseudo-intellectual way in which some parents can come across in their strivance to find out what’s wrong and to what extent. But don’t let it go to your head, don’t let it go to a neurotic place. Sunlight is so often the best disinfectant and buried in these complex studies and disturbing numbers is an incentive to consider each of the ways our children can be enouraged or disprarraged throughout their lives and their interaction with society. And prevention is the best cure.

By Lamia Islam

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