A student with a dual diagnosis has two separate disorders that interfere with some area of life. Among older students, a dual diagnosis can also refer to co-occurring substance abuse and learning disabilities or mental health disorders. Sometimes a dual diagnosis helps parents and teachers better assist a student because the second diagnosis provides further insight into the student's behavior and better access to treatment. However, two diagnoses can also be much more challenging to manage than one.
Dual diagnoses come in all shapes and sizes and any student with two diagnoses has a dual diagnosis. A high schooler with attention deficit disorder and a history of alcohol dependence, for example, has a dual diagnosis of ADD and substance abuse. Learning disabilities, developmental disorders and mental health conditions often come in pairs. For example, a child might have dyslexia and ADD or autism and oppositional defiant disorder.
The effect of a dual diagnosis is often multiplicative rather than additive. For example, a child with autism and dyslexia might not only show symptoms of autism and dyslexia; the two disorders can interact with one another in problematic ways. The child's difficulty reading, for example, could compound social difficulties, make her hesitant to talk or increase the presence of repetitive and stereotyped behaviors. Dual diagnoses can also be hard to catch. A child who's showing symptoms of multiple disorders might be misdiagnosed several times before the dual diagnosis is discovered.
Special education teachers often play a role in helping parents get competent help, so if you suspect a student has a dual diagnosis, carefully monitor his symptoms and check in with his parents frequently. Avoid treating the student as a diagnosis and instead, ask him what you can do to help; you might be surprised at the solutions he creates. Even if you have years of special education experience, research is constantly developing, and some disorders are less common than others. Take time to research dual diagnoses and each specific disorder a student has so that you're fully-equipped to help her learn.
The way you use language can affect your perceptions, so be sure to use language that your students and their parents are comfortable with. Many parents refer to their students as dually exceptional or twice exceptional. If the child uses a nickname for his disorder, mirror his use of language, and don't force him to put a label or diagnosis on his own behavior.