Diagnosis and Intervention in Young Children: The Continuing Gap

Abstract

Modern diagnostic systems have replaced theory-based, highly inclusive, explanatory terminology with descriptions of symptoms at low levels of inference often empirically determined. This shift has caused, inadvertently, an increased rift between diagnosis and treatment in young children. It is argued that the primary purpose of a diagnostic system is guidance for intervention; this was provided by the omnibus terminology of the early 1900s but is sacrificed when we revert to skin-level descriptors. Treatment of young children, as a result, is largely determined today by intervention philosophies, not by child diagnostic specification. To heal the rift, a proposal is offered for diagnoses in the form of problem formulations—statements of deficiencies in terms of hypothesized interventions—based on what is most central or amenable to change.