LANGUAGE WE USE... CHILD AND YOUTH CARE IN SOUTH AFRICA

This blog is not talking about the language we use when talking to or with young people. It's about the language we use when we we describe behaviour, especially in a written descriptive profile, reports and in discussing young people with other professionals. Yes, there can be  a degree of spill over from our professional descriptive language and what we say to young people. That's exactly why we have to get it right. The risks and implications are well articulated in the article: Brown A.M Appropriate language in Child and Youth Care. CYC-net, Issue 85 February 2006/ Best Practice .

Now to the issue of this talk. The question was whether we, as child and youth care workers, can "rephrase" diagnostic terminology like manic depressive (bi-polar) and ADDH? 'the question  continued. "When taking to young people about themselves can we rephrase or avoid using diagnostic terms?"

I recall an occasion when a child and youth care descriptive profile was sent to a psychiatrist following the arrest of a 16 year old boy for the sexual harassment of three young women in the street of the local town. The child and youth care worker and the multi disciplinary team assembled the descriptive profile as a developmental assessment. He had three days of assessment by psychiatrist(s) in the psychiatric hospital. The report back was "We can add nothing more to the developmental assessment that you have submitted"....no labels (fortunately), just comment on context, some advice on management and a way forward.

It means that when we do profiling (and talking to young people) we can rephrase, avoid labeling, use purely descriptive language and produce a powerful tool, acceptable to and useful for, other professionals in the best developmental interests of the child.

We do this because it is the language of the child and youth care profession. We do this because we know that labels are damaging in the immediate, short and long term.

Until I came into child and youth care, I was suspicious of this thing called 'self fulfilling prophecy'. I soon learnt differently. If we told a young person, "you have a behavioural disorder", then that's what you get. " Sorry, but you know I have a behavioural disorder!"  Same with bi-polar and any other label.  I experienced young people 'living into' the labels.

Then, when labels follow young people into other life-spaces, they are viewed differently. In school, clubs, family and community and even into the adult workplace even when the behaviour of the person no longer reflects the childhood symptoms. I experienced children and young people refused entry into, so called 'normal' schooling simply on the strength of a label. In simple terms, children and young people can be given labels which can be inaccurate or misdiagnosed.
Our descriptive language is a professionally learnt language/communication style/ profiling skill in which we do rephrase and contextualise what we observe. 

To do this, the formula are really quite simple sounding but in practice it is not that easy.

The first is to learn to use description. 

"About every three weeks in a predicable cycle, Luckys facial features appear to change.  His eyes seem to pull back at the sides, giving him a somewhat 'Chinese' appearance. When this happens we experience a change in his behaviour which lasts about three days. His way of speaking and addressing staff takes on a changed tone.he refuses to do chores During one of these periods he stole clothing from the boy's lockers and sold them at the taxi-ranks in town. This is a repetitive occurence during those three day periods"

That could be a descriptive profile in strictly behavioural terms.The Diagnostic label was, Temporal Lobe Epilepsy (TLE)... sorted with simple medication. Explanation to Lucky was not that much different from the descriptive behavioural profile.

We contextualise.

We always describe behaviour within the circumstances in which it happens.In that way we can rephrase. Given the life-space situation, eg school ,family, in these relationships, in that company, when this happens, Lucky...does this or that.

I always said that child and youth care workers in my employ will hate me because, if they say. "He was disruptive", or "rude". or "unmanageable", I would say "Don't tell me that. Tell me what he DID and in what circumstances". 

Lastly, when the final Developmental Assessments are tabled, if diagnostic terminology is used, state clearly, the source from which they came, the name of the professional, and the tests administered, the results and  on what date. There has been a pattern over time of certain diagnoses being somewhat popularised: Tourettes Syndrome, ADDH, Aspergers, behavioural disorder and the like... all held later with some suspicion. Diagnostic fashion seems to  change and diagnostic labels have been refuted and changed.... Caution! In one year, I remember,that the Diagnostic and Statistical Manual of Mental Disorders (DSM) itself was called into question. (I haven't seen comment on the latest 5th edition).

Child and youth care workers describe observed behaviour in context. That's what we do and that's what we do best as one of our unique skills. We don't diagnose and we don't label. We write what we see and hear. We say what we see and hear. When we do this, we practice within our unique profession.