The other day, I gave a lecture on "Understanding Developmental Disorders" at an on-line conference for parents currently raising children. Following the talk, a Q&A session was held where I answered questions submitted in advance by participating parents. The majority of the questions asked were the following: What symptoms signal the need to visit a medical facility for advice and treatment? Developmental disorders are considered signs of bumpy development, but what criteria are used to assess if my child has a bumpy development?
I know from experience in clinical practice and from recent websites that many parents are very concerned and anxious about whether their child or they themselves have a developmental disorder and ask questions about this. Therefore, in the lecture, I explained how developmental disorders are diagnosed and placed particular emphasis on the fact that diagnostic standards do exist and can be found in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5)*and other resources.
After the lecture, I received a comment saying, "I was surprised to hear that diagnostic standards actually exist," which I found surprising. I thought that it was clear and self-explanatory that doctors never made a diagnosis or provided treatment based on their own experience or how it felt to them. I had also assumed that most people visiting doctors would know this and share the understanding of this fact.
I then realized that the participants were using the term "bumpy development" (hattatsu no dekoboko) in their questions. There are some specialists in the field of child psychiatry and psychology who wish to avoid using the Japanese word shōgai meaning "disability," and when they translated the DSM-5 compiled by the American Psychiatric Association (APA), shōgai (disability) was replaced with the Kanji character shō, which means "syndrome." In other words, the word "disorder" in Autism Spectrum Disorder (ASD), Attention Deficit/Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Learning Disorder (LD) and Intellectual Disorder was directly translated and replaced by a word meaning "syndrome." Although this was not the opinion of the entire medical community, but was rather a direct Japanese translation by a psychiatric association with no requirement to follow it, the translated terms are commonly used now except for Conduct Disorder (soko-sho) and Intellectual Disorder (chitekihattatsu-sho).
Furthermore, some doctors suggested that developmental disorder is neither a disorder nor disability, but oddly defined it as a "bumpy development," rejecting the very concept of disorder itself. It appears that some people may be relieved to learn that it is not a disability but rather an unbalanced development. Nevertheless, one wonders if the real situation is not knowingly covered up by such manipulative and vague wording as "bumpy (dekoboko)." Certainly in psychiatric associations, there are also those who disapprove of and dislike diagnosis based on categorizing and listing symptoms (the Kraepelin Diagnosis), but that view taken by physicians specializing in the field is not easily understood by the others outside the profession.
As seen here, many (not few) have come to know that there are clear diagnostic criteria for developmental disorders instead of the vague term "bumpy development" after I introduced the actual manual with an explanation. In my view, that is the responsibility of experts and specialists who have introduced and spread the use of the vague terminology of standards of development.
- *1 American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Publishing.