When I am evaluating a child or an adult, my goal goes beyond determining the label(s) for “diagnosis.” My goal is to help patients, parents, spouses, educators, and treatment providers understand WHY a child or adult is struggling. Things that look like what someone “won’t” do may actually be something that he or she “can’t” do. Or not. In either case, to figure out the interventions and accommodations that will help (and those that won’t), it is critical to clarify what is giving rise to the problem(s) to begin with. ​A comprehensive neuropsychological evaluation of neurocognitive, academic and emotional function should do just that. When findings of a child’s assessment are discussed, parents should feel, “I am really understanding my child.” Adult patients should feel, “I am really understanding myself.” Significant others of dependent adults should have comparable insight. The report that is generated to describe the findings should be written in plain English, so anyone with whom it is shared will understand as well. The more clearly those involved in a child’s or adult’s life understand what is driving his or her difficulties, the more confident and empowered all will feel in moving forward and implementing treatments, accommodations or services that are recommended.

Neurodiversity

Our understanding of brain functioning has expanded in the last 25 years. It seems we’ve come a long way from categorizing people as “normal” versus “abnormal”, but vestiges of those attitudes remain. We can’t help it. Blame our brains.

Brains exist for one reason: to insure we survive. Our brains categorize things in the world to determine what may be a threat. Familiar and predictable? Good. Normal. Unknown and unpredictable? Bad. Abnormal.

But our definitions of Normal and Abnormal evolve as we do. We learn more about things that initially register as odd or different. When what is novel becomes more understandable and familiar, it is less threatening. Our cultural references change. It wasn’t so long ago that we thought left-handed people were evil.