Our kids arent broken. We need to stop treating every struggle like a disorder

My patient Zach was an objectively awesome tenth grader. He was academically talented and motivated, with a mix of A's and A-minuses in accelerated classes. He was a starter on the varsity basketball team. He did Math Olympiad. He even played the French horn in the school band, though he admitted that was mostly for his college application and to get out of an art history requirement that had a reputation for being pretty onerous.

He started preparing for the ACT in April of his sophomore year, hoping to get it over with the following fall. His tutor charged $800 an hour, with a minimum of two-hour sessions, twice a week. Within weeks, he was in my office complaining that there was no way he was going to do well. He couldn't get the pacing right and never finished all the questions in the allowed time. Mind you, he was consistently getting 34s on his practice tests. A perfect score on the ACT is 36. It's an exceptionally rare score. And Zach was very close to it. But Zach wanted to go to the University of Pennsylvania, and he said that a 34 still wasn't good enough. Zach was already in the top percentile of test takers nationally, and he still felt like a failure.

I am a clinical neuropsychologist. I offer psychotherapy and cognitive remediation to children with learning disorders and related developmental disorders. Zach came to see me because he wanted me to write him a letter saying he needed testing accommodations. Maybe with time-and-a-half hed get the perfect score he really needed.

STUDENTS DIVIDED OVER UNIVERSITY OF MICHIGAN HIDING FIRST-SEMESTER GRADES FOR 2027 FRESHMEN

When nothing is enough, when excellence is the minimum acceptable, we fall short. And when we fall short, we reach for labels and accommodations and services to close the gap. Of course, sometimes children have real disorders and disabilities, and labels and supports are crucial. But in other cases, the struggles are healthy, normal parts of development, and medicalizing them backfires. The supposed quick fixes may seem helpful in the moment, but more often than not, they make kids even more miserable.

How we learn to live by the numbers

Zach isn't alone in his anxiety about scores and percentiles. We're all socialized to care about measurements, and we think about how our data compare to everyone else's. From day one, pediatricians measure our kids' height, weight, and even head circumference, and tell us where those numbers fall relative to same-age peers. I remember my son's first checkup. I was so excited to hear that my chunky little guy was in the 95th percentile for both height and weight.

Its only a matter of time before our obsession with toddler head circumference turns into an obsession with teenage ACT scores. We get emotionally attached to these numbers. We give them more importance than they deserve, and we read them more negatively than we should. I talk to parents all the time who are worried about a score in the 37th percentile. In reality, the 37th percentile is solidly average.

More isn't better

What I usually explain to parents is that in most domains, more isn't better. The average range is wide, and it's the middle thats often optimal.

Take attention. With too little, we have trouble in school. With too much, we become hypervigilant about tiny, insignificant details and lose the forest for the trees. Anxiety works the same way. Too much and y