Over years of evaluating children for learning disorders, Dr. Katie S. Davis noticed an interesting phenomenon: Some parents seemed visibly disappointed when she told them their kids didn’t meet the criteria for ADHD or autism.
“I found that those conversations can be more difficult to have than with a parent whose kid is really disabled and whose needs are very high,” Davis, a clinical neuropsychologist and author of “Actually, You’re Fine,” told Business Insider.
Though she would try to reassure those parents that their concerns about their children’s behavior were valid and worth addressing even without a formal diagnosis, “it’s not as tangible or concrete as parents want, and they often leave the conversation feeling dissatisfied.”
Parent-reported diagnoses of several childhood developmental and learning conditions have increased in recent years. For example, the estimated share of US children ages 3 to 17 with a current ADHD diagnosis rose from 8.6% in 2016 to 10.5% in 2023. Separately, a study of children ages 6 to 17 found parent-reported lifetime learning-disability diagnoses rose 16.4% over the same period.
While some argue that greater awareness of learning disabilities and disorders accounts for the increase, Davis doesn’t feel that explains the full story. From what she’s observed, ever-growing expectations for kids — and parents desperate for explanations for why their child is lagging behind — also play a role.
She said rushing to a diagnosis can have negative long-term implications for everyone.
“People don’t think that ADHD means anything, people don’t think dyslexia means anything,” Davis said. “Then those people who are truly disabled by those conditions have enough battle to justify their need for accommodations and services.”
Higher and higher expectations
In order to qualify for a diagnosis such as ADHD, symptoms must be present in at least two major settings, such as both at home and at school. For autism, they must be persistent across multiple contexts.
But some parents focus on how their child behaves in the classroom, in part due to ever-increasing expectations around academic success, Davis said.
“Doing well in school is no longer good — you have to be at the top of the pack,” Davis said, noting that similar patterns have arisen in higher education settings with parents arguing for their teenagers’ grades to be inflated. “Parents want excellence, and if it’s not excellent, it’s bad.”
When worrying about their child’s behavior, some parents zero in on their child’s behavior in class while overlooking how their child compares to others, Davis said.
“If you’re in a kindergarten classroom, probably all of the kids to some degree are going to have trouble sitting on the rug for 30 minutes at circle time,” Davis said. Most will cluster in the middle of the bell curve, while some will get antsier earlier or later. The kids who consistently stand out compared to their peers are the ones who should probably be evaluated, Davis said.
Otherwise, “for nine kids out of 10, that sounds like a kid in an elementary school.”
Labels are a double-edged sword
Whether they’re diagnosed with ADHD or not, a child being hyperactive in class isn’t a parent’s fault. Still, parents can feel like they’re personally responsible.
“There is an eagerness to medicalize the feelings of insecurity, because if it’s due to a diagnosis, then it’s not a knock on your decisions,” Davis said.
Whether or not their child is formally diagnosed, Davis warned against treating it as a catch-all explanation for everything your child does.
“Despite our best intentions, if we put a label on the kid and the kid is aware of that label, they are given the message ‘there is something wrong with how you are developing,'” she said. Even positive spins, like “ADHD is a superpower,” can send a message to the kid that their life will be forever defined by struggle, she said.
It can also imply that symptoms like difficulty focusing or reading can’t meaningfully improve with the right interventions.
“We all want to develop resilience in our children, to make them feel like they have agency and control and they’re in charge of their own destinies,” Davis said. “Especially when kids are very young and don’t understand the fluidity of these labels, we could potentially be working against them.”
Try softer interventions first
Davis wants to be clear: Diagnoses such as autism and ADHD are real. There are children who are unambiguously and significantly impaired by them in every setting, who need clear support academically and socially. “There are evidence-based interventions at our disposal that are enormously helpful,” she said.
However, for parents who believe their child falls into some gray areas, Davis recommended trying a few things before booking an evaluation appointment. She compared it to a young child with a mild fever: A responsible pediatrician would guide parents through modest steps, such as taking a temperature and offering plenty of fluids, before rushing to the ER.
Instead of assuming your child might have autism if they struggle to make friends or always hang out alone at recess, Davis suggested first making other plans with their parents to set up playdates. You can also sign up your child for a karate class or call the school’s teacher to see if they can intervene and help the kids play together more.
Alternatively, she said, if you immediately seek out a diagnosis and place your child into therapy and social skills groups, you could be taking away from more enriching social activities.
If a child continues to struggle, Davis recommended getting a neuropsychological assessment — a form of standardized test that is broader than getting an autism or ADHD evaluation.
While not perfect, she said neuropsychological assessments can measure a child’s motor skills, sensory processing, attention, cognitive efficiency, language, memory, and social functioning. Their scores are typically compared with norms for peers of the same age.
More importantly, it helps parents know which interventions are the best. “If your kid perceives life to be very stressful or upsetting, they’re not making it up. Let’s talk about what we can do to support them better in that environment,” Davis said. “But we don’t need a diagnosis to do that.”
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