A diagnosis is an important piece of the puzzle we are trying to solve when we try to help kids with disabilities learn how to function. Many parents are relieved when they get a diagnosis for their acting-out, "problem child" because they see it as a guideline for the future. They think, "Now we'll know what to do; this is it? we'll finally get our child the help he needs." The truth is that I've seen families go through the drudgery of doctors and diagnoses many times. I've worked with kids who had Attention Deficit Hyperactive Disorder (ADHD), Oppositional Defiant Disorder (ODD), Conduct Disorder, Obsessive Compulsive Disorder (OCD), and many others. I've also seen individual kids with five different diagnoses: every time they were hospitalized or went to a new therapist, they would get a new one. But sadly, in the end their parents were left with the fact that simply having a diagnosis didn't necessarily mean they could get help improving their child's behavior, or get them the skills they needed to learn how to function successfully.

A diagnosis doesn't mean that you are assured treatment for your child from which you will see change. A diagnosis doesn't mean you're going to get funding to help give your child the success he needs. And a diagnosis does not mean he's going to get the services he really needs. Sadly, there are no guarantees. I've worked with many parents whose kids had been given multiple diagnoses, but their children were still punching holes in the wall, cursing them out and having meltdowns at home and in school.

I believe these kids can change, and that the process of change works best when it starts at home. I've worked with acting-out children for thirty years, and I've found that if there's a culture of accountability at home or in school, it enhances these kids' potential to respond. Real change does occur, but it takes a lot of work and sacrifice on the parts of all the adults involved. I'll tell you what I've told many parents in my office: "It doesn't end with the diagnosis, it just starts there."