Behavior is a symptom.  The brain is the cause.

Simply putting the word “Disorder” after a set of symptoms is not a diagnosis.

Imagine if you had an infection that caused a fever, and you went to the doctor and received a diagnosis of a “Fever Disorder.” That’s not a diagnosis. That’s just putting the word “Disorder” after the set of symptoms.

Do we have medications to treat a “Fever Disorder”?  Absolutely.  There’s Tylenol, and Advil, and aspirin. But since we’re only treating the symptom we continually have to medicate to suppress the symptom. The moment we stop the medication the fever returns because we have not resolved the underlying cause of the fever. And our treatment of the “Fever Disorder” is only partially effective. It brings the fever down from 103 to 100, but it doesn’t get rid of the symptom, it just suppresses the symptom somewhat.  Yet our “treatment” for a Fever Disorder is empirically validated in clinical trials to reduce the symptoms of a Fever Disorder

If, on the other hand, we use the symptom of the fever to diagnose the cause, the underlying infection, then we instead treat with antibiotics, we cure the infection and the symptom, the fever, goes away – often without even having to address the symptom directly. Diagnosis is using the symptom to identify the underlying cause. We then treat and resolve the cause and the symptom goes away.

Behavior is a symptom.  The brain is the cause.

Inattention is a symptom, hyperactivity is a symptom, oppositional behavior and defiance are symptoms. Simply putting the word “Disorder” at the end of a set of symptoms (Attention Deficit Hyperactivity Disorder; Oppositional Defiant Disorder) is not a diagnosis, it’s simply a “Fever Disorder.”

A diagnosis involves using the symptom of the child’s behavior to identify the underlying cause in the integrated or non-integrated functioning of the underlying brain systems. Once we understand what is causing the particularly symptom display by the child, we then intervene specifically to resolve the cause and restore the integrated functioning of the various brain systems, and the symptoms go away – often without having to even address the symptoms directly.

An organized and well-regulated integration of brain systems produces organized and well-regulated behavior. Disorganized and dysregulated brain systems produce disorganized and dysregulated behavior.

When the underlying brain systems are disorganized and dysregulated, the child emits behavior that is too rigid, overly demanding and inflexible, too emotional, that is defiant and oppositional, impulsive, over-active, the child tantrums, is aggressive, etc.

When the underlying brain systems are organized and well-regulated, the child emits behavior that is relaxed, pleasant, and cooperative. The child is pleasant to be around. The child is relaxed and smiles.  The child is cooperative with the directives of parents and teachers. The child understands the social context of his or her behavior and gets along well with peers. Organized and well-regulated brain systems produce organized and well-regulated behavior.

There are six Primary Brain Systems underlying behavior:

1. Sensory-Motor Systems
2. Emotional Systems
3. Language and Communication Systems
4. Relationship Systems
5. Executive Function Systems
6. Three Motivational Systems

The functioning of each of these Primary Brain Systems will be described in separate essays.

We all live in a brain, so we all have direct personal experience with each of these brain systems, so they are actually pretty easy to understand once their functioning is explained.

Once we understand the functioning of the underlying brain systems, we can then use the child’s symptoms – the child’s behavior – to diagnose the underlying cause. We then address and resolve the cause of the child’s behavior and the symptom goes away, and we achieve a pleasant and cooperative child who grows into a mature, cooperative, and responsible young adult.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857