An Argument for Heuristic Fairness
The members of the Work Groups who proposed the new classification of TDD recognize that there is a population of children who are highly impaired, whose condition has not received enough research and who deserve a “home” in the DSM in order to bring appropriate attention and resources to their needs. In the Rationale Papers which support the new classification, caveats are noted again and again regarding the preliminary nature of the findings. Nevertheless, the proposal is justified by the reasoning that the needs of this population are so great and so misunderstood, that its inclusion as a separate category is in keeping with the heuristic considerations of the Task Force Guidelines.
We are in agreement that there is a significant population of children whose mental health needs are ignored and who would benefit from an appropriate classification that will prompt intense and pointed research. We can not support the evidence leading to the TDD category. If a compelling reason for creating the TDD classification is the need to spur research and awareness, then we see no reason why the FOH phenotype, which is supported by substantial evidence-based research, should not be proposed as well.
The inclusion of a proposed FOH phenotype along side the TDD phenotype would allow field trials to provide important information, in advance of the next publication, regarding the relative utility and accuracy of the two phenotypes. This would increase the purpose of field trials and tend to make them less of a self-fulfilling process.