We have become very good at naming things. Possibly too good.
Across education, early years, health, social care and wider public services, there is an understandable desire to diagnose, define and categorise. We want to know what something is. We develop criteria, thresholds, pathways, acronyms and descriptors. We seek an explanation for why a child behaves in a particular way, why somebody finds something difficult, why a family is struggling, or why an individual needs more support. This behaviour that has become well-established in children’s lives, is now permeating adulthood, and occupying the attention of the chattering classes.
And, of course, there can be enormous value in that. A diagnosis can bring recognition after years of uncertainty. A definition can unlock understanding. A label can help someone make sense of their experiences, find others who share them, secure support or simply replace the distressing question of “what is wrong with me?” with a much more constructive understanding of difference and need.
But I increasingly wonder whether we have started to mistake naming the problem for solving it. There is something reassuring about a definition. Once we have found the right word, generated the assessment, completed the referral or allocated somebody into the correct category, it feels as though something important has happened. Administratively, it probably has. For the individual, however, the most important question remains stubbornly unanswered: What do you need, and what are we all going to do about it? That is a much more demanding question. Because people do not experience labels. They experience life.
Two children with exactly the same diagnosis may need completely different things. Two families experiencing poverty may have entirely different barriers, strengths and circumstances. Two people experiencing loneliness will not necessarily benefit from the same intervention. Two children described as having additional needs cannot be adequately served simply because we have successfully identified the category into which they fit.
Definition tells us something. It rarely tells us everything. Yet our systems are often built the other way around. We identify the category and then reach for the corresponding response. If you are X, you receive Y. If you meet this threshold, here is the service. If you do not quite meet it, perhaps you receive nothing at all. The individual gradually disappears behind the definition.
And sometimes labels inadvertently give services permission to become bland, generalist and even tone deaf. We can say we have “provided support” because the programme exists. We can say we are “meeting need” because somebody has been referred. We can demonstrate that an intervention has been offered without asking the uncomfortable question of whether it was actually the right intervention for that particular person. There is a world of difference between offering a service and meeting a need.
That distinction matters enormously in early years and childcare. We quite rightly talk about inclusion, SEND, disadvantage, vulnerability, school readiness, speech and language, parental engagement and countless other areas of need. These terms help us organise our thinking and resources. But children themselves stubbornly refuse to organise themselves into neat strands of a strategy document.
A four-year-old does not wake up thinking they belong to an intervention category. They wake up as themselves. They arrive carrying the experiences of their home, family, relationships, health, community, language, personality and development. They bring what happened yesterday and what happened that morning. They bring extraordinary strengths alongside things they find difficult. They may need encouragement, predictability, food, quiet, movement, reassurance, challenge, familiarity or simply an adult who notices them properly. That last point increasingly feels important to me.
Noticing is different from diagnosing. Noticing requires curiosity. It asks us to remain interested in the person after the paperwork is complete. It says: I know what the assessment tells me, but I also want to know you. The danger otherwise is that diagnosis actually reduces curiosity. Once we think we have the explanation, we stop looking.
“They do that because they have…”
“She struggles because she is…”
“That family is…”
“This community is…”
The sentence is completed and, subtly, so is our thinking. I worry about the implications of that for services too. A definition can become an excuse for a standardised response, particularly in systems operating under enormous pressure. It is understandable. Budgets are stretched, professionals are busy, demand is high and services have to operate at scale. Categories make complexity manageable. But people are complex whether our systems find that convenient or not.
Perhaps the real test of a good service is therefore not how sophisticated its definitions are, but how effectively it adapts once it understands the person in front of it. That requires a shift from “What are you?” to “What do you need?” And perhaps another question: “What would make a difference?” Those questions sound deceptively simple. In reality, they require more of us.
They require listening rather than assuming. They require professional judgement rather than simply following a pathway. They require us to understand strengths as well as deficits. They require flexibility in services and sometimes the humility to recognise that the thing we have available is not necessarily the thing somebody needs. Most importantly, they make us accountable for what happens next.
That may be why definitions can sometimes feel more comfortable. Diagnosis can locate the issue within the individual. Meeting need places responsibility partly back on the rest of us. If a child cannot access an environment, is the question only what condition they have, or should we also ask what needs to change about the environment?
If a parent cannot use a service, do we simply describe them as “hard to reach”, or ask how reachable our service actually is? If somebody does not respond to an intervention, do we conclude that they have failed to engage, or wonder whether the intervention failed to engage them? Those are very different ways of looking at the world.
None of this argues against diagnosis, assessment or definition. Quite the opposite. Good assessment can be enormously powerful. The challenge is what we do with the knowledge it provides. A diagnosis should open a conversation rather than close one. A definition should increase our curiosity, not diminish it. An assessment should be a route towards personalised support, not simply evidence that the system has done its job.
There is also something fundamentally human about resisting the temptation to reduce people to one characteristic. We are all collections of contradictions, strengths, experiences, relationships and needs. What works for us can change from one day to another, never mind from one stage of life to the next.
Perhaps we need to become a little less obsessed with asking “What is it called?” and much more determined about asking “What will help?” Because ultimately, people do not need us simply to understand the definition of their needs. They need us to meet them.
