Issues in the classification of children who fail in school: categorical versus descriptive approaches.

The classification of children who are failing in school has become a matter of national interest and concern since 1975 when the passage of PL 94-142 created a system of categories for designating the specific disorders which lead to the need for special education. This paper explores two trends in classification: namely, categorization and the descriptive approach. The benefits of categorization include the ability to create a national data base, from which epidemiologic and trend information are available; the ability to study local variation and relate this to intervention systems, and the ability to monitor the resources expended on special education. However, a number of liabilities are built into categorization system. The most serious of these is the fact that individual variation is not recognized by a categorical approach. Clinically, many multidisciplinary teams have preferred to provide parents and schools with descriptive classifications which take into account the variety of influences and symptoms at work in particular situations. Practical suggestions are offered in this paper to help pediatricians use both the categorical and descriptive approaches in helping parents as their children are diagnosed as a result of their school failure. Finally, challenges are raised to the pediatric community to help with resolving the major issues in the field, namely the variation in classification across sites and the exclusion of some children who have multiple etiologies for their school failure.