180 Chapter 7 reading comprehension, they will likely specialize in the former, creating skill patterns necessary for the drug trade. At a developmental timescale, the child adaptively develops patterns that we later refer to as an undesirable (otherwise labeled maladaptive) attractor state. Of course, change from this undesirable to a more desirable one could occur at a slower timescale (if at all) than the behavioral change patterns that we described in Chapter 6. Nevertheless, the possibility of change exists, which may give hope to some. On the other hand, framing it as an attractor state is not (yet) a common language and above all somewhat of an abstract definition that is perhaps too idiographic. It could mean anything, which is why I expect society to be more ready for the first three propositions. I am fully aware that it is unlikely that such alternative expressions will take root in the intellectual disability field (or general society) anytime soon. It may be too soon for such a change. However, I do consider it important to discuss current practices with people who have the diagnosis, clinicians who give the diagnosis, other care professionals, policymakers, philosophers, and scientists. There is a lot of valuable research into the problems that people with this diagnosis have, leading to better understanding, which—directly or indirectly—has a positive impact on their wellbeing. I am unaware, however, of any debate about the nature of the very diagnosis that so much valuable research evolves around. This is the case with other clinical diagnoses (e.g., Hopwood, 2024, te Meerman et al., 2023) and for mental healthcare diagnoses in general (e.g., Fried, 2022; van Os et al., 2019). I argue that the intellectual disability field should follow because our (implicit) assumptions also about the diagnosis have a large societal impact. The extent to which this impact is positive or negative is as of yet unknown. I am hopeful that science and practice can come together to discuss the appropriateness of changing our label-giving patterns, similar to how people in specialized care work hard to change persistent behavioral patterns. Acknowledgments I would like to thank Roy Otten, Evelien Poelen, Anna Lichtwarck-Aschoff, and Dilek Sezen-Hulsmans for their feedback on earlier versions of the general discussion and epilogue. I also thank Merlijn Olthof for his valuable feedback on the epilogue.
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