Although I see kids for psychotherapy, most of my time as a psychologist is spent as a diagnostician. I gather background information, I do tests, I scour through records, and I do lot of thinking and a lot of writing. Then I meet with parents and I go over the results.

Most of the time, parents are satisfied and grateful for the report and for my recommendations. I believe that this is a testament to their parenting and also a reflection of my experience delivering complicated information about serious problems. There are other times when I am pretty sure that the news I am going to share is going to be much different than expected and it’s going to be viewed as bad. At these times, I’m tempted to tell parents, “I don’t make the news; I just report it.”

But to do so would be flip and unprofessional. I have to keep my eye on the highest priority, which is to communicate clearly and respectfully in order to provide good patient care.

Since I specialize in conditions that impact school functioning, I do a lot of intelligence testing. As I tell parents, there is no be all and end all measure of intelligence or of every type of intelligence. But the tests I use are rigorously developed and evaluated; they are useful in helping answer questions about why children are not doing as well with school as one would expect.

Working at grade level is the expectation. But some children do not work to grade level in many areas. This can be due to a number of things such as learning disability, ADHD (although ADHD does not always impact academic learning), or lower than average intellectual ability. Lower than average intellectual ability includes intellectual disabilities but some children just have lower than average intelligence; in other words, they do not have the degree or pervasiveness of difficulty that we used to call “mental retardation”. And to make matters worse, these students usually struggle in school without special education support because they do not easily fit into one of the special education categories.

The kids who are “merely” below average often fly under the radar. If they have a cooperative nature, work very hard, and gets lots of parent support, they can actually do quite well in school until material gets less concrete and more abstract. These are the kids who start sticking out in adolescence, a time when for most teens, abstract thinking skill development accelerates rapidly. (Alas, if they could apply these higher order thinking skills to making better life decisions…)

I sometimes find myself doing private testing for an early adolescent child who has had a history of learning difficulties, which have accelerated only to learn through testing that the probable reason is low intelligence. Then I have to think about how to share this “bad news”.

There are parts of our society that confuse “goodness” with intelligence. Intelligence is a good thing but it does not make a person good nor does low intelligence make a person “bad”. Most of intelligence appears to be inherited. Another bit is subject to environmental experiences. Most people are average.

When it comes to talking to the parents about the results of these evaluations, it is very difficult to say, “Your child is a very hard worker and is actually doing better in school than we would expect.” That’s not exactly the best news to hear.

So, we do a lot of talking and I do a lot of explaining and placing things into context. I do a lot of talking about what it takes to be a happy and successful person in life, things that are not necessarily related to high intelligence.

But I try to make the challenges clear, too. A lot of kids get yelled at for not doing better at school even though they are working EXTREMELY hard. A lot of kids also need as many educational resources that a school district and family can afford to provide. They are “it takes a village” kids. I have to make my best argument for getting the child as much support as possible but I can’t do that if I gloss over the difficulties.

I wish every child had the same resources and same opportunities but they don’t. It’s my job to try to make sure that they can do their best with the particular package of strengths and challenges that they have. I remind myself of older kids that I see who have beaten the odds and moved mountains. Invariably, they are hard working kids, with parents who have provided early and long lasting support, with supportive teachers and healthcare providers.

Sometimes, but certainly not always, great things can result from the bad news.