The validity of psychiatric diagnoses: The case of ‘specific’ developmental disorders

► Children with developmental disabilities are typically misclassified based on ability scores. ► The most common classification error is for disordered children to be classified as typically developing. ► Of the disorders examined, only mental retardation was separated by a natural boundary from ot...

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Bibliographic Details
Published in:Research in developmental disabilities 2011-11, Vol.32 (6), p.2704-2713
Main Authors: Dyck, Murray J., Piek, Jan P., Patrick, Jeff
Format: Article
Language:English
Subjects:
Adolescent
Attention Deficit Disorder with Hyperactivity - diagnosis
Attention Deficit Disorder with Hyperactivity - psychology
Attention Deficit Hyperactivity Disorder
Autism
Autistic Disorder - diagnosis
Autistic Disorder - psychology
Biological and medical sciences
Child
Child clinical studies
Child Psychiatry - methods
Child Psychiatry - standards
Child, Preschool
Children
Clinical Diagnosis
Cognitive Measurement
Communication Disorders
Developmental coordination disorder
Developmental Disabilities
Developmental Disabilities - diagnosis
Developmental Disabilities - psychology
Developmental disorders
Diagnostic and Statistical Manual of Mental Disorders
Disability Identification
Discriminant Analysis
Exceptions
Expressive Language
Female
Humans
Intellectual Disability - diagnosis
Intellectual Disability - psychology
Intelligence Tests
Language Development Disorders - diagnosis
Language Development Disorders - psychology
Language Tests
Latent class analysis
Male
Measures (Individuals)
Medical sciences
Memory, Short-Term
Mental Retardation
Miscellaneous
Mixed receptive-expressive language disorder
Motor Skills Disorders - diagnosis
Motor Skills Disorders - psychology
Normality
Nosology. Terminology. Diagnostic criteria
Psychiatric diagnosis
Psychiatric Status Rating Scales
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Reproducibility of Results
Social Cognition
Techniques and methods
Validity
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Summary:► Children with developmental disabilities are typically misclassified based on ability scores. ► The most common classification error is for disordered children to be classified as typically developing. ► Of the disorders examined, only mental retardation was separated by a natural boundary from other disorders. ► Motor skills and communication disorders are separate from each other, but not from autism or typical development. ► Cluster and latent class analyses distinguish higher from lower functioning children, not distinct disorders. We tested whether developmental coordination disorder (DCD) and mixed receptive expressive language disorder (RELD) are valid diagnoses by assessing whether they are separated from each other, from other childhood disorders, and from normality by natural boundaries termed zones of rarity. Standardized measures of intelligence, language, motor skills, social cognition, and executive functioning were administered to children with DCD ( n = 22), RELD ( n = 30), autistic disorder ( n = 30), mental retardation ( n = 24), attention deficit/hyperactivity disorder ( n = 53) and to a representative sample of children ( n = 449). Discriminant function scores were used to test whether there were zones of rarity between the DCD, RELD, and other groups. DCD and RELD were reliably distinguishable only from the mental retardation group. Cluster and latent class analyses both resulted in only two clusters or classes being identified, one consisting mainly of typical children and the other of children with a disorder. Fifty percent of children in the DCD group and 20% in the RELD group were clustered with typical children. There was no evidence of zones of rarity between disorders. Rather, with the exception of mental retardation, the results imply there are no natural boundaries between disorders or between disorders and normality.
ISSN:0891-4222
1873-3379
DOI:10.1016/j.ridd.2011.06.001