Dear Hal,
First let me begin by saying that I have been getting your newsletter for a few months now, and I have almost completed my reading of ScreamFree Parenting. It is amazing how much the principles in the book have helped with not only my relationship with my kids (I have four kids, ages 15, 13, 12, and 5), but with my marriage and relationship with other members of the family as well (read...my mother ;- )).

My oldest son has always struggled in school. Over the years, we have dealt with several diagnoses - ADD, visual processing disorders, depression, Sensory Integration Disorder, and even Aspergers Syndrome.

Well, now he is 15, and I feel like we have the same struggles as when he was 7. He is shutting down and giving up at school. Last year, I pulled him out of all special ed classes, but he does still receive modifications in math in the regular classroom. I started thinking that he was living "down" to the expectations that had been tragically communicated and was fulfilling the labels that had defined him all these years. Funny how you also talk about the negative power of labels in your book—and boy, have I seen that.

One week, in your answer to the question about the kid with possible bi-polar disorder, you mentioned the risk of being careful with the diagnosis, as sometimes lifelong "accommodation behaviors " can be created which can truly cripple the child later. I sat with that thought for a few minutes and felt such pain for my son. I can see in my son a total fear of rejection and failure, as this issue influences other parts of his behavior. I guess my question is this. How can I begin to help my son break free of some of these "accommodation behaviors?" What does my role in changing the pattern need to be? I can see how I have helped to get to this place, but I have no idea where to begin to change myself.

First of all, I love this question! (Mainly because it's so complimentary of me! :) But I really love it because it speaks so clearly of a mom dedicated to her own growth for the benefit of the whole family.

The issue of diagnoses and accommodation is thorny, but obviously common. And I certainly am not going to attempt to solve the problem here. But I do have some observations that may be helpful.

In my experience as a therapist, and now as an author and speaker, I feel surrounded by two extreme perspectives. And representatives from both sides seem very eager for me to see it their way. One extreme is the large group of folks who decry that ADHD and other similar child psychology diagnoses are rampantly over-diagnosed. Or worse, an entirely made-up disease that's simply an excuse for the symptoms of bad parenting. And the whole phenomenon is creating, they fear, an entire generation of kids unable and unwilling to tackle life's challenges, an entire generation with a ready excuse hanging around their neck, justifying their own failures.

On the other side are those parents who couldn't seem to wait for the ADHD diagnosis because it was this godsend answer to all the unanswerable problems in their home. These are the parents who then preface every statement about their children and their relationship with them with "First of all, you have to know that my son has ADHD." For these folks, this diagnosis is both a curse to complain about and a blessing that excuses them from all their own struggles with their kids.

The truth is, both extremes usually scare me. The "ADHD doesn't exist" crowd frightens me with their almost sanctimonious ability to assume an expert position over all struggling parents and children. The "ADHD is a godsend" gang scares me with their double-sidedness. They hate that ADHD exists because it's causing all the family struggles they're experiencing, but they seem to love the disease because it provides a convenient excuse from tackling all the family struggles they're experiencing.

Somewhere in the middle are lots of folks with lots of questions. Questions like yours. In this middle are parents who find themselves, at times, at a loss. "What's going on with my child? Does anyone else have battles like this? Worries like this? Why does it seem like nothing works, nothing makes any difference? I don't like the idea that he/she has a 'disorder', and I certainly don't like the idea of medicating my kid, but what if? Would it be so wrong to get a little help from science? I'm not looking for a way to abdicate my responsibilities as a parent, but something's got to change."

ADHD is an attempt to explain a common set of observed symptoms. There is no blood test to diagnose it, or depression, or a learning disorder. All we have is an exhaustive, scientific effort to collect, organize, and differentiate observed behaviors. But because all observation is up to interpretation, and affected by the natural biases of the observer, behavioral science can never be as "exact" as a biological science. Never. (And even biological science struggles with its own levels of “certainty,” but that’s a topic for another time).

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