Was I Better Off Without a Diagnosis?
2025-05-01T15:01:59Z
I have mixed-brain dominance, which was not diagnosed when I was a child. Should it have been? In what ways would my life have been better—or worse?
Not until I was in my 40s did a special-education teacher friend suggest that I had mixed-brain dominance. I had mentioned to her that although I am right-handed, I preferred shooting a rifle with my left hand, often reversed the last few digits of telephone numbers, and had difficulty reassembling something I had taken apart. As a child, I told her, I remember confusing d’s and b’s, and having trouble distinguishing p’s from q’s. I am miserable at multiple-choice tests and knock things over.
If you judge a diagnosis and intervention by its outcome, it is hard to imagine how being labeled “mixed dominance” would have made my life better. I played high school varsity basketball, my grades were good enough to have graduated from college, and I earned a doctorate, retired as a professor emeritus, authored many books, and have led a productive and happy life.
I might even say that having mixed dominance has served me well, as getting information often twisted leads to unexpected insights by having viewed things from a skewed angle.
My mixed dominance does have its occasional downside, however, although mostly inconsequential. For example, I once unscrewed a lightbulb in the wrong direction, leaving shards of glass in my hand.
Controversy Regarding Autism Diagnosis
This brings me to a controversy regarding autism—not its cause, but the diagnosis itself. Holden Thorp, professor of chemistry and medicine at George Washington University and editor of the journal Science, writes, “Far from being solely a deficit, I believe, my neurodiversity has made me a better scientist because my autistic thinking leads me to search for patterns, a crucial skill in science.” Thorp points out there is a difference of opinion whether people like him, who has no learning difficulties, warrant a diagnosis, while he is careful to note that “even people with milder symptoms of autism can struggle with the acceptance and support for organizational challenges, sensory issues and social communication that a diagnosis can help provide.”
Whether a diagnosis is helpful is much like the discussion regarding early detection of, say, prostate cancer. There are risks and benefits associated with screening tests, as they can sometimes make matters worse. After weighing the benefits of early testing against the harms associated with false positives or negative outcomes, such as invasive testing that shows that there is no cancer after all, Evans et al. concludes, on balance, such testing is warranted. However, “serious consideration is whether screening programmes should be offered to large sectors of the population or more targeted towards those at high risk of a condition.”
Like Thorp, I don’t see my condition as a limitation but as an asset. I am glad that I hadn’t been diagnosed for my manageable struggles and labeled a child in need of special attention. But many others absolutely benefit from a proper diagnosis and subsequent support.
I can’t generalize from my own history, except to say that testing, diagnosis and interventions need to be done with care. Who should be diagnosed and treated is a matter of judgment, something to be decided by discerning parents and expert doctors. In case of communicable diseases, the calculation is different as the health of others needs to be factored in and, in fact, may outweigh other considerations.
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