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  • There are no bad kids: How educators can protect students against harmful diagnoses

    There are no bad kids: How educators can protect students against harmful diagnoses


    Credit: iStock- Tobiaschu

    The first time I met Micah, a Black elementary school student, I was struck by his cherubic face, bright eyes and nonstop knock-knock jokes that had me laughing out loud. He was warm and polite. His grandmother — his guardian — sat close by during the visit, gently encouraging his respectful tone. She described him as responsible and kind, and everything I saw affirmed that.

    So, I was puzzled — then troubled — by his school’s mental health referral. Teachers had described Micah as a “behavior challenge” and asked for help managing his “defiance.” His school records even falsely claimed his mother was a “cocaine addict.” None of it matched the child in front of me.

    As I got to know him, the real story came out: Micah had just watched his father collapse and die after he tried unsuccessfully to resuscitate him. My heart sank as my evaluation revealed that his grief had been misread as misconduct, his pain distorted through the lens of pathology. Frustrated by repeated suspensions and missed learning, his grandmother eventually transferred him to another school.

    As a child psychiatrist, I’ve seen how often Black, Hispanic, and Indigenous children, like Micah, are unfairly mislabeled and misunderstood. One diagnosis keeps showing up in ways that harm these children: oppositional defiant disorder (ODD) — a common childhood behavioral disorder characterized by anger, defiance and vindictiveness. 

    Too often, ODD becomes a “bad kid” label, punishing racially minoritized children for behaviors rooted in trauma, racism or structural inequities, rather than addressing the hardships they face.

    Oppositional defiant disorder is overdiagnosed in Black, Hispanic and Indigenous children because of biased behavior assessments. Adultification bias leads Black children to be seen as older, stronger and less innocent than they are. Anger bias results in Black students being perceived as angry even when they’re not.

    This overdiagnosis often ignores what’s really going on. Anger or irritability can be signs of anxiety or depression, while defiance can be an adaptive response to trauma or discrimination. Gender-nonconforming students of color are at special risk of being labeled defiant when they are simply resisting mistreatment or bullying. 

    But instead of getting support, these kids are too often punished and criminalized. 

    Since racially minoritized children already face higher rates of suspension, expulsion and police involvement, an improper diagnosis reinforces exclusion, pushing them out of school and into the justice system. 

    An ODD diagnosis doesn’t explain a child’s behavior. It blames them for it.

    In 2013, California began to ban suspension for willful defiance, eventually in all grades K-12. This measure reduced overall suspensions, but racial disparities in discipline remain stark. Black and Indigenous students are suspended earlier and more often, with Black students with disabilities most affected in middle school. 

    Disciplinary codes that remain — like “disruption,” “defiance” and “profanity” — are vague and subjective, leaving room for racial bias. In one California school district, Black students with disabilities accounted for three-quarters of all suspensions for these offenses. 

    While students can’t be suspended from school for willful defiance anymore, teachers can still suspend students from class for it. An oppositional defiant disorder diagnosis can still justify exclusion — through special education placements, psychiatric referrals, or other punitive measures — serving as a backdoor for exclusionary discipline. 

    There is no denying that educators face enormous challenges in classroom management, and that they often don’t have the best tools and resources to help. Restorative justice and trauma-informed approaches, for instance, can be difficult to implement because of limited staffing and administrative support. But it’s also true that questioning the “bad kid” label with ODD or defiance can lead to more just outcomes.

    How? Here are four things educators and other adults can do:

    Recognize bias in discipline and mental health diagnoses
    A Black student questioning authority may be labeled defiant, while a white student is called assertive for the same behavior. Bias training and reflective practice are key to addressing these misperceptions. While California has introduced implicit bias training as part of teacher professional development, none of these initiatives specifically address diagnostic bias.

    Contextualize student behavior
    Before labeling a child oppositional, ask: 

    • Are they facing hunger, housing instability or bullying? 
    • Are they reacting to discrimination or past trauma? 

    Building strong relationships with students and families helps uncover the full story.

    Support, don’t punish
    Because they address the root causes of distress, behavioral interventions that teach emotional regulation and restorative practices that repair relationships can be more effective than exclusion.

    Be skeptical of mental health referrals
    Referrals don’t guarantee unbiased care. Psychiatrists, psychologists and therapists aren’t required to account for racism or the school-to-prison pipeline when diagnosing oppositional defiant disorder. California’s medical and behavioral health boards don’t mandate an antiracist approach, meaning students are often assessed without consideration of systemic factors. 

    ODD’s overdiagnosis among Black, Hispanic and Indigenous students reflects a deeper problem, where certain children’s emotions are pathologized and punished, while the emotions of others receive understanding and support.

    By questioning bias and shifting from labels to solutions, schools can ensure every child gets the support they need to thrive.

    For Micah, the Black elementary school student grieving his father’s death, the solution wasn’t medication or behavior interventions. It was removing the ODD label and validating his grandmother’s sense that the school was mistreating him. What helped was switching schools and witnessing his grandmother go to bat for him. These actions gave him what he truly needed: love, support and a sense of belonging.

    There are no bad kids. There are only systems that fail them. Let’s lift them up, not push them out.

    •••

    Dr. Rupinder K. Legha is a double board-certified psychiatrist based in Los Angeles who specializes in child, adolescent and adult mental health.

    The opinions expressed in this commentary represent those of the author. EdSource welcomes commentaries representing diverse points of view. If you would like to submit a commentary, please review our commentary guidelines and contact us.





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  • How parents can limit children’s harmful cellphone use at home

    How parents can limit children’s harmful cellphone use at home


    The use of personal devices has increased since the Covid pandemic closed school campuses in 2020.

    Credit: Brett Sayles / Pexels

    Children who use cellphones, smartwatches and other personal devices excessively are more likely to have shorter attention spans, be more anxious, have trouble thinking critically, be less physically fit and have problems interacting socially, according to research.

    The debate about how much screen time is too much has been ongoing for more than two decades, but it has gained urgency in recent years as young people have become more reliant on cellphones and other devices. 

    The use of personal devices increased during pandemic school closures, with 12- to 13-year-olds more than doubling their recreational screen time to 7.7 hours a day in 2020, according to research led by the University of California San Francisco.

    Adolescents have since decreased the number of hours they are on the phone, but cellphone use is still well above pre-pandemic levels, said Dr. Jason Nagata, an associate professor of pediatrics at UC SanFrancisco. 

    California Gov. Gavin Newsom brought the issue to the forefront earlier this month when he urged school district leaders to take immediate action to restrict cellphone use on campuses this school year. Newsom said excessive cellphone use by young people is linked to anxiety, depression and other mental health issues.

    Cellphones, smartwatches and other personal devices aren’t inherently good or bad, Nagata said. They can be a useful tool for communication, education and socialization, but they also have their dangers, he said.

    “The goal of parents and for teens is really to try to optimize all of the benefits, while really minimizing the risks,” Nagata said. “And, I do think that one of the risks associated with constant connection on phone use is that some teenagers and adults really can develop signs and symptoms of an addiction.”

    Up to 95% of young people ages 13-17 nationwide report using social media platforms. A third say they use it “almost constantly,” according to the Office of the Surgeon General.

    “If kids are on their phones 24/7, it doesn’t help them develop a sense that they can create, understand and generate thoughts and ideas,” said Dr. John Piancentini, a psychologist and professor at UCLA Health on its website. 

    Too much screen time can be bad for kids

    Excessive cellphone use can impact a child’s mental health, resulting in anxiety and sometimes disruptive behavior disorders, according to research. Teens who use social media too much can develop body image issues and eating disorders, Nagata said. Others may feel less connected to friends and family.

    Excessive phone use also has potential health consequences. One of the primary ways that phone use can adversely affect a young person’s health is by displacing sleep, which is essential to health and development, Nagata said. The blue light emitted by cellphones and other devices can suppress melatonin, a hormone that helps a person to sleep.

    Cellphone sounds, such as notifications and rings, can also disturb rest. Sleep is important for teenagers in particular. Research shows that one-third of teens already get fewer hours of quality sleep than is required for optimal growth, development and academic achievement, Nagata said.

    Young people who excessively use cellphones are also more likely to have sedentary lifestyles and to focus on the screen instead of what and how much they are eating, he said.

    Increasingly, school districts are banning cellphones and other personal devices to keep students focused on school work and to encourage them to interact more with their teachers and peers. But what can parents do to ensure their children have a healthy relationship with their cellphones and other devices?

    Warning signs of addiction

    There is no consensus among researchers or physicians about exactly what constitutes phone addiction or problematic phone use, Nagata said. Despite that, the issue has become dire enough for the Surgeon General Vivek Murthy to issue an advisory in May, calling on policymakers, technology companies, researchers and families to minimize the harm of social media and to create safer, healthier online environments to protect children online. 

    “I think, in general, parents and kids have a sense that maybe their use is too much, maybe it’s leading to problems at home, maybe it’s leading to problems at school,” Nagata said. “And so those might be indications that someone has problematic phone use or a phone addiction.”

    Nagata said there are a few indications that your child may not have a healthy relationship with their phone: 

    • If they are upset at the thought of being without their phone.
    • If they stop whatever they are doing to answer calls, texts or messages.
    • If they argue with others over the amount of time they are on the phone.
    • If they can’t reduce the amount of time they are on their device.
    • If time on the device interferes with schoolwork, chores or in-person socializing with family or friends.

    Parents can limit phone use

    Decreasing the use of cellphones and other devices before adulthood can be particularly important because research shows that screen-use patterns in young adulthood persist through adulthood.

    Tips to decrease screen time:

    • The American Academy of Pediatrics recommends having a family media use plan that outlines when phones can be used and when they can’t. 
    • Initiate screen-free times before bedtime so that children get enough sleep. Parents could consider prohibiting screens in the bedroom and turning off devices and notifications at night.
    • Establish that dinner and social times are screen-free times to better promote conversation and socialization.
    • Parents should have regular conversations with their children about screen use and find opportunities for children to put away their phones and do nonscreen activities with friends.
    • Parents should try to work with the parents of their children’s friends to institute similar rules on social media and screen use to make implementation easier.
    • Parents should adhere to the family media plan and model good cellphone practices.

    “The biggest predictors of children’s screen use are their parent’s screen use,” Nagata said. “It’s really important to practice what you preach.”

    Parental monitoring and limiting of adolescent screen use were both linked to lower adolescent screen time, according to UCSF research. Punishing adolescents by taking away their devices or rewarding them with more screen time was not effective, Nagata said.

    “There is not a one-size-fits-all solution for screen rules, so parents should consider their children’s ages, what electronic devices are in the household, and the family’s needs for communication and school work on electronic devices when constructing a family media use plan,” Nagata said.





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