Determining Need
Successor to "Bridge to Understandingtm"
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In order to make a good decision about a school or treatment program for a child or young adult, it is first necessary to understand the needs of that person.  As stated in our Search Guide page, the most frequent fallacy in selecting schools and programs is "This place worked well for Johnny, so it will be good for Billy as well."  Johnny and Billy probably have entirely different needs.  Schools and programs that seem to be for everyone with emotional or behavioral problems are rarely if ever the best choice. 

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FamilyLightsm is an educational consulting firm specializing in work with families with a young person with behavioral, emotional or psychological difficulties.  We offer in-depth personal guidance to families on a fee basis and free guidance on the internet. FamilyLightsm attempts to be fully objective and accepts no advertising nor referral fees.

Selecting a good school or treatment  program is a strategic planning and matching process.  Once we know what a child (or young adult) needs we have some basis for creating an over-all plan to get those needs met.  Schools and programs can be a useful tool in getting the results we seek in addressing the needs of a child, but a school or program by itself is never the whole solution.    To reinforce a point made on the Search Guide page, making a good choice requires first understanding the needs of the child or young adult of concern, then developing an over-all strategy and plan, developing criteria for what kinds of school or program would serve best in implementing the plan, and, only then, considering specific schools and programs. 

Your selection of a school or program without a plan that is based on a thorough understanding of  the needs of the person at issue, is likely to lead to unfulfilled expectations.  From that plan you get criteria for  school(s) or program(s) that fit the criteria, assuming that a school or program is relevant to the need and fits the plan at all,

Formal diagnostic information is likely to be of some help in determining need, but is never adequate to make a determination. First, many young people in need of a school with special support and/or a therapeutic program, do not have a kind of pathology that involves a diagnosable condition.  Of those that do, many have diagnostic labels that tell us exactly nothing.  Probably the majority of teens we work with have the following diagnoses:  Oppositional and Defiant Disorder, Attention Deficit Hyperactivity Disorder (Inattentive type), and depression in some form, usually mild.  A diagnosis of some form of substance abuse frequently accompanies that.  These are the generic diagnoses we see when clinicians can't or won't bother to actually evaluate the situation.  In fairness, we do see evaluations where these are appropriate evaluations, but in those cases we get an expanded report that explains what has been ruled out and fine tuning on description of the person diagnosis that communicates understanding beyond the diagnostic labels. 

The diagnostic labels formally assigned are not reliable indicators of what the clinicians believe.  Too often, a psychiatrists or other clinician will say things to me like, "I assigned a diagnosis of bipolar disorder.  I don't really know whether or not that is right but it will help her get services."  Or I hear, "I'm concerned about the possibility of a thought disorder, but I did not list a diagnoses, because I don't want that record following him around."  Or there is this demonstration of the incompetence of public mental health and social services in  Allegheny County, Pennsylvania:  An eleven year old boy who is the kind of kid neighbors love -- most of the time -- except he has well documented rage attacks --  is diagnosed in a written report signed by a man whose signature indicates he is a licensed psychologist and that he works for a private agency contracted with the county.  The boy is known to live in a highly dysfunctional family. The obvious behavior is consistent with what we see with children with serious neurological problems including certain kinds of epileptic activity, with high functioning children on the autistic spectrum, with children simply reflecting the behavior of their parents and a number of other things.  There was no evidence of psychological testing.  There was no evidence of medical neurological evaluation.  Their was evidence of a report that would support expensive services provided by his agency, without any evidence of serious effort to determine what the problem really is.

Allegheny County, Pennsylvania, (Pittsburgh and suburbs) is unfortunately all too typical of many other jurisdictions, where public services are basically a welfare program for medical and social services agencies of marginal competence, where the real agenda is keeping the money flowing to the established financial interests and some psychiatric research at a large research center, without serious regard for the impact on the patients and clients.  Too often "evaluations" are designed to keep the money changing hands and not to describe children accurately.

The children and young adults with the very similar diagnoses described above are very different in personality, learning style, motivation, maturity level, social awareness, skills, aptitudes, life experience, ethnic background, cultural background, and, most importantly, the family dynamics of their homes.  Unfortunately, there is little consideration given to neurology in many cases although that is usually relevant.  There is too little consideration to history, as a opposed to reacting to what the clinician sees immediately.  There is too much attentions to promoting a pet diagnosis.

This page and the links that we will add to it will probably grow continuously over time.  We won't predict a time for this to be "finished" as it probably never will be. We believe that this website has reached a point of development that allows it to contribute in a meaningful way to both professionals and parents who are beginners, in making good decisions about planning for meeting the needs of young people with behavioral and emotional issues.  Through 2009 we expect this website to become, along with other websites that will be accessed through our links, a comprehensive guide to planning for an purchasing resources for young people in need.  This page will give increasingly sophisticated insight into the process of determining need so that you can have a viable plan, as a platform for purchasing the services of a school or program.  

Some of the concepts to explore, on which we intend to give increased insight include the following:

  • Formal diagnostics

  • Motivation

  • Testing and evaluation

  • Developmental issues

  • Family dynamics

  • Substance abuse

  • Neurological and neuropsychological concerns

  • And more to come

Keep checking on this page to see what we add. For now, obtain a good good diagnostics through a variety of means that include individualized testing from reputable psychologist and your observations so that you thoroughly understand the needs. 

Feedback is invited. We will publish selected feedback.  Email

Disclaimer: No  program review, no matter how positive, is a blanket endorsement. No criticism is a blanket condemnation.  When we express our level of confidence in a school or program, that is our subjective opinion with which others might reasonably disagree.  When we assert something as fact, we have done our best to be accurate, but we cannot guarantee that all of our information is accurate and up to date. When we address compliance with our guidelines, you need to remember that these are only OUR guidelines -- not guidelines from an official source.  We have also set the bar very high, and do not expect any school or program to be in total compliance.  It is not appropriate to draw a conclusion of impropriety (or even failure to live up to conventional wisdom) from our lack of confidence in a school or program or from less than perfect conformity to our guidelines.  Some will say we expect too much. Readers are responsible for verifying accuracy of information supplied here prior to acting upon it. We are not responsible for inaccuracies.

Last update March 3, 2009

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