I work at a preschool, and there is a little boy who very obviously has some diagnosable problem, probably selective mutism, or a more generalized anxiety disorder.
His parents have not taken him to a doctor for a formal diagnosis because (they claim) they don’t want their son labeled.
Now, I am bottom of the totem pole here, but I actually have a lot more experience with disabled people anyone also, and my experience suggests that this child is going to be labeled whether they like it or not. He can have a clinical label, like “Selective Mutism,” and get proper treatment, or a label like “weird,” “problem child,” “trouble,” “attention-seeking,” or “retard,” none of which will reflect to truth, all of which will cling to hm, and none of which will help him get appropriate treatment.
I am considering saying something to the principal, but have not decided.
My own child has a minor learning disability, and for quite a while we avoided getting a formal diagnosis, precisely because a “label” would impose a set of expectations and limitations on her which we felt would not be beneficial to her. But there came a point where the disadvantages of that were outweighed by the advantages of the supports and accommodations that, for bureaucratic reasons, could not be made available to her without a diagnosis. So at that point we sought an assessment and a diagnosis.
The school was helpful and supportive in the process of deciding when that point was reached.
So, yeah, talk to the principal, and to the child’s classroom teacher, if there is one. Obviously you know the parents’ attitude to diagnosis because the issue has already been discussed with the, so there’s a dialogue there. Obviously everyone’s case is different, and I have no way of knowing whether now is the optimal time to seek a diagnosis for this boy, but even if there’s a conversation with the parents about the plusses and minuses of having a diagnosis, that gives them a framework within which they can consider the question.
Like UDS, I’d speak with the principal and the homeroom teacher, and work with the family.
I have some friends who belong to a heavily-dyslexic family; they say that the spread of consciousness about dyslexia has been tremendously helpful, as now people will be happy to read something for them, teachers have protocols at hand for when parents ask “I know it’s real early, but since both my spouse and I are dyslexic we’d appreciate it if you can keep an eye on our kid about it”… but I’ve also known people who couldn’t read for whatever reason and who did their best to hide it instead of asking for help. “I need help” always has two sides.
My concern, besides labeling, is that the parents are paying a** lot **of money for the child to go to a preschool that is consistently rated one of the top five in Indianapolis (it is rated so highly, that half the children there are not Jewish, even though it is an expressly Jewish preschool, set in a synagogue, and the older children learn Hebrew, while the only holidays celebrated are Jewish ones), but this child is not learning any social skills whatsoever, because he is almost four, and has never responded vocally to another child; he says only “yes” and “no” to adults. He will only go places if led by the hand by a familiar adult. He plays very little, and when he does, he is still at the “parallel play” stage.
If the child had a formal diagnosis, he could get medication appropriate for a child (there are several drugs that are used for seizures in BABIES that are safe as antianxiety drugs for children at lower doses, plus a few specifically antianxiety & antipsychotic drugs designed for adults that have been used for anxiety in autistic children for years with success, and no undesirable side effects.
He could also get Cognitive Behavior Therapy, and have it paid for by insurance.
IM experienced O, he needs something ASAP, or he will just keep getting further behind in socialization, and then will need remediation in social skills in addition to everything else. Right now, little three & four year-olds are very tolerant. Five and six year-olds, not so much. Seven and eight year-olds are hell on wheels when it comes to seeking out the weakest member of the flock.
Sounds to me like this is a conversation to have in so many words with the parents. Start by establishing your expertise above and beyond “day care mommy” which *may *be how they perceive you now.
Depending on their wealth, the “lot of money” hey’re paying may be a big sacrifice, or may just be what they think of as the pocket change necessary for any kid of their station. So yes, they are not getting their money’s worth because they’re not availing themselves of expertise such as yours and the individual attention the school could apply if asked. But no, there’s no *a priori *reason for you to assume the cost somehow motivates them to demand every service the school might possibly provide.
If nothing else, their concept of their own social standing may suffer from having a “defective” child. This is how, in less enlightened eras, people killed, banished, or abused their less-than-ideal offspring.
Never underestimate the power of denial in shaping human behavior.
There are two aspects to labeling, what people will say and what goes on their ‘permanent’ record. I can understand the parents not wanting to tell the school about any formal diagnosis that may affect the way the school treats their child, nor label him themselves with any such diagnosis. Maybe they have seen a doctor but don’t want to go public with any information, but it is kind of stupid not to look into a possible identifiable and maybe treatable problem, they just don’t have to go and tell everyone about it.
You’ll find a lot of the times it’s the parents that fear the label. They also fear being blamed or simply they don’t buy into something.
To some a little “hard work and discipline” is worth more than therapy and to be fair in some cases it can be.
When I was in clinical studying to be a psychologist, I saw the opposite problem more, parents trying to find someone to give their child a label when there was nothing wrong, psychologically with the child.
I taught at a private school in the UK.
I was the tutor for a very bright pupil who clearly had a problem. His parents didn’t want him to get tested, but finally agreed when their kid was facing suspension.
He was diagnosed with ADHD, took Ritalin and became a model pupil.
My daughter (almost 7) is very-high-functioning ASD/Asperger’s.
We sent her in for testing because her school highly recommended it (she was in preschool there; now is in 1st grade at the same school). The “labeling” as far as the school was concerned was a totally great thing; they have bent over backwards to help us accommodate her and help her succeed academically, and knowing she had a “label” actually helped in that they understood and knew that she would need some extra help. People at church know about her diagnosis and that’s also been really helpful. We have a couple of other disabled kids in our ward/congregation, including another ASD child, so people get it.
Negative aspects: I haven’t told any of the other parents at her school because I’m pretty sure that she’d get labeled as “the ASD kid” (although I expect a couple of them probably suspect). Also, we tried to get her into another school that I think would be much better for her in several ways, but the fact that she had the ASD label probably contributed to her rejection. (That wasn’t all of it – she probably was a little too immature at the time. We will probably reapply this year and I expect her to get in this time. Still, I wonder if she would have gotten in had we not disclosed the label – which I think was the right thing to do, mind you, as they explicitly asked.)
Knowing as a parent: no down sides WHATSOEVER. I was crushed when we got the diagnosis, but the diagnosing psychologist said, correctly, that my child was still the same before and after the diagnosis, and we had a lot more tools to work with once the diagnosis happened.
The psychologist even said that we did not need to tell our school or anyone if we didn’t want to (though we did, because the school pretty much knew already that something was wrong, as I’ve already said).
At age 4, when she was diagnosed, my child would mostly parallel play. She hated large groups of people and although she was occasionally willing to play with another child one-on-one, preschool was hard for her because she would just shut down in the large group. The teacher at the time actually thought she had selective mutism and was shocked when I told her that she talked fine at home and even with other children in one-on-one (highly supervised!) settings. And she’s doing really well and isn’t even in therapy any more – but she also had a bunch of therapy from age 4-5, and a lot of that was focused on teaching me skills so that I could take that role. (It also probably helps a lot that I am probably subclinical Asperger’s, so to a certain extent I can teach her what I wish someone had taught me when I was her age with respect to socialization and emotional cues.)
Anyway, the point of that rambling comment is that it’s possible the child does not have a serious disability; I don’t regard my daughter’s disability as serious at this point. But early diagnosis is key, regardless!
If you talk to the parents, I would say the messages are : 1) let them know that the child is the same whether a diagnosis is made or not; 3) they do NOT have to disclose the “label” (if there is one) to anyone – but 3) it would give them access to more tools to help their child.
I had this same argument w/ my mom about my nephew, who was born premature and has had developmental delays of many kinds in the four years since. His parents and my mom blame the toilet, social and verbal delays on - his being a boy, on him being shy or just quiet or putting a lot of thought into the task or question he’s been asked; even on his being satisfied, doesn’t ask for much, laid back. When he gets a diagnosis that says otherwise (possible autism, etc) they change doctors to try to find one to *understand *him. They do this all to avoid a label and figure since he’s been in the EI classes it will catch him up, he’ll outgrow it as though these are simply bad habits he’s developed out of laziness. The denial is stunning to me, b/c I know if he was showing signs of a malady like cancer or pneumonia they’d want him treated immediately; but b/c these are mental issues they suffer from the same stigma as other psychiatric concerns.
If the child isn’t able to do their work in class and be apart of the class
discussion I think it would be a very good idea to talk to the principal . It would be better for the child to have the ‘correct’ label rather than being called lazy , stupid ,or retarded and ship off to a reject class and get no help. I been there , I am hard of hearing and had the wrong ‘label’ for 8 years it was 'retarded ’ and not the correct one, HOH. You can see the way I write that I didn’t get the help I needed so pleases speak up for the child , it was my first grade teacher that realize I was HOH when I failed first grade for the second.
I’m with LSL Guy on this one. I would definitely have a talk with the parents and point out to them the serious disadvantages of doing nothing. Point out that the child is going to get labelled regardless, but probably inaccurately. The value of a correct label and treatment cannot be overestimated. And that you will be obligated to talk to the principle otherwise.
As the parent of 2 kids with “labels”, the sooner the child is diagnosed, the better. I have been told several times about my ASD kiddo that if we had gotten the diagnosis earlier, we could have gotten a better outcome with some therapies at a younger age.
The parents may not want to believe that there is anything “wrong” with their child, or they may fear that a “label” will harm their child. My experience has been exactly the opposite. Knowing how my children are not neurotypical has made their lives and their educational experiences much, much better.
Maybe I’m biased from some years spent working with Child Protection, but this sounds to me like “failure to provide adequate & necessary medical care”, which is a component of Child Neglect or Abuse, and should be reported to the local Child Protection Services.
And here in Minnesota, if you are a worker at a school, you are a ‘mandated reporter’, meaning you are legally required to report this to the authorities, and can face repercussions (including loss of your license), if you do not. To say nothing of what is morally required.
So seriously think about your duty to report this to appropriate authorities. Either within the school, or the legal system.
If you do talk to the parents, and you should, I wouldn’t try “the child is almost four, isn’t talking to the other children, so maybe he should be on anti-psychotic drugs” if you want it to be productive. Just a hunch.
Whatever you do, don’t hold a crucifix or Star of David out at arm’s length fending off the kid while talking to the parents. I predict that won’t go well either.
Well, I’d call this half-right. Calling out all of the ways the child is not meeting normal milestones IS the right thing to do, and it explains why you are concerned and feel that their child should be evaluated. You needn’t go so far as to recommend treatment (drugs, holy water or other satirical nonsense notwithstanding).
Seems like the parents are aware there are some issues and are worried about how best to proceed. If you have worked in disability before, you are probably much more comfortable and familiar with the topic than they are. You already have a diagnosis and treatment in mind, so you are a long way ahead of them. The parents need to be on board for interventions to work, so you can only go as fast as they are comfortable with.
I would talk to the principal, and the other teachers so you can present a clear developmental picture, including the behaviors you have noticed and the developmental impacts. Maybe whoever has the best relationship with the parents can talk to them, or it might carry more weight coming from the principal. But there is a lot of stuff the parents will be worried about, and ‘labelling’ is just the surface.
