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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Selecting a good school or treatment  program is a matching process.  Once we know what will benefit a child (or young adult, then  we begin to have some basis for understanding which schools or programs might offer those benefits.  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 criteria for what might be good choice of school or program, and, only then, considering specific schools and programs. 

Formal diagnostic information is likely to be of some help 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.  He 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 realy 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. However we hope to have developed this sufficiently by the end of 2008 that it will be significant help in determining what the needs of a child or young person are before making a choice of a school or program. 

Some of the concepts to explore, on which we intend to give 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.

Last update 8-24-08; minor edit 10-06-08