About two weeks ago, I wrote about a proposed revision to the DSM-V that retreats from an earlier draft proposal by eliminating use of the word dyslexia. I expressed concerns about the difficulties faced by dyslexic students and parents of dyslexic children in getting a formal diagnosis, generally required as a first step toward receiving special services or accommodations.
Today I would like to look at this question from a different angle: if dyslexia is a gift, perhaps it does not belong in a manual for diagnosing psychiatric disorders at all. The full title of the DSM is Diagnostic and Statistical Manual of Mental Disorders. The book is in essence a psychiatrist’s bible, the ultimate guide on how to figure out and label whatever is wrong mentally or emotionally with the psychiatrist’s patients.
Over-inclusive language and labeling in the DSM has been criticized by many as contributing to over-medication — and over medicalization - of conditions that may be part of the normal ups and downs of life. One study reported that half of US teens met the criteria for diagnosis of a mental disorder. In that context, a diagnosis opens the doors to prescribing of powerful drugs that may do more harm than good, especially to a a growing child.
Although the goal of inclusion of the term dyslexia into a diagnostic manual is to make it easier for individuals to get recognition and help for their difficulties, the flip side is that the label can come with a stigma, or be used as a barrier. As long as dyslexia is deemed a “disorder,” educators and employers will continue to look at dyslexics as being less capable and less deserving of advancement.
Perhaps the time has come to recognize that “dyslexia” is a characteristic, not a disease. Because it is common — perhaps impacting as many as 20% of all schoolchildren to some degree — maybe it should be the responsibility of educators to learn how to teach children with dyslexic characteristics within the normal classroom environment. That is, perhaps parents should be relieved of the educational burden of proving that there is something wrong with their children in order to get specialized services. The burden should shift to educators to learn to reach and teach all of their students, not just the ones who have “average” or “typical” learning styles.
The need for “diagnosis” only arises because of educational and societal barriers. Within a school context, a child is only referred for “diagnosis” because it is apparent that the child is struggling and falling behind. But all a dyslexia diagnosis does, especially with the language now proposed by the APA for “Specific Learning Disorder”, is to confirm what the parents and educators already know: that the child is indeed struggling and falling behind. There is not one word in the current proposed diagnostic standard, with or without the use of the term “dyslexia”, that would shed light on the reasons for the student’s struggle or point the way to a specific path to address the learning difficulties. Instead, it is “diagnosis” that relies entirely on circular reasoning. A child who has difficulties in acquiring basic academic skills would be referred to a psychologist or psychiatrist, who would then report back that the child indeed has difficulties acquiring basic skills.
Perhaps it is time to dispense with the idea of “diagnosing” a medical condition, and to recognize that “dyslexia” is a legitimate and important way to describe a particular profile of learning strengths and weaknesses. Perhaps it is time to move beyond blaming the student for what is really a failure of the educational system to address the needs of all learners.