Classification

The term 'classification' is unfortunate as it carries with it the stigma associated with previous legislation (e.g. Mental Deficiency Act 1913) and the associated history of institutionalization consequent upon the eugenics movement at the beginning of the twentieth century. However, systems of classification are an important way of organizing information and thereby enabling the reliable passing of that information to others and providing a framework to guide intervention. Whilst there are clear strengths to this process, any system of classification has serious limitations. It will tend to focus on a few particular characteristics to the potential exclusion of others, and none can impart a truly comprehensive picture. Methods of classification have inevitably changed over time in an attempt to better clarify the key issues and to minimize stigma that might be associated with any given label. However, the central principle of any system of classification is to bring order to knowledge in a manner that may then enable further advances or the instigation of interventions that previous research has shown to be effective. There is no single universal system—the system of classification used depends on the reasons for its use. These may be as diverse as being predominately administrative or for the purposes of guiding intervention and the use or not of specific treatments.

Classification systems also differ with respect to whether they are dimensional or categorical in nature and whether there are quantitative or qualitative differences. Mental retardation illustrates this difference in that measures such as intellectual ability are clearly dimensional and continuous whereas particular syndromes are categorical. More recently such obvious categorical distinctions have begun to break down as the genetic basis for syndromes are more clearly elucidated. For example, in fragile X syndrome there is variation in the extent of the number of repeat sequences in the FMR-1 mutation, both within carrier and affected individuals and across particular groups.(5) Below, different systems of classification are examined and then the relationship between assessment and classification is considered.

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