So I'm reading Quirky Kids, which I basically like, even though they defend pediatricians (actually, I love our practice, but I've heard way, way too many stories about people who got the laissez-faire line). The thing that I really like about it is that it's very smart about the whole diagnostic quagmire, about the different diagnoses a quirky kid may receive. In particular, I loved this paragraph:

Many children will accumulate more than one diagnosis over time, as they get tested and retested and as they grow and change. Many quirky kids don't fit any single diagnosis. Depending on the child's age and developmental stage and on the orientation and training of the person doing the assessment, these children can receive many different diagnoses as they grow. Some diagnoses will fit for a while and then be outgrown, whereas others will continue to be relevant even as your child grows and changes. You may find yourself holding on to a particular diagnosis, not because it fits so well but because it helps you with the school system!

Word. And this:

We want to clarify, before we start on the nitty-gritty of diagnosis, that we feel the point of all this--the point of the workup, the testing, the careful consideratin of your child by multiple experts--is not to come up with the right label, the right name, the right answer on some cosmic medical-student exam. The reason to have your child tested is to help your child--and to help you help your child. Diagnoses are worth having only insofar as they point the way to reasonable and realistic expectations, useful therapies, and greater understanding.

This summarizes the problem so succinctly. We don't have a medical model to work with, really, when it comes to these kids: there's such a disconnect between what our kids actually need and what and how our institutions provide care. And parents begin usually by some kind of interaction w/the medical system, and then we walk out of the appointments like Adam and Eve with all the world before us. It's one reason why I've always been very clear that I want the evals for educational reasons: what does my kid need? I know who she is, but what does she need?