I receive many requests from parents asking me to evaluate their child for dyslexia or other types of learning disabilities. This is an appropriate request from a psychologist, and many psychologists (including me) provide evaluations for a range of issues, including learning disabilities, dyslexia, attention deficit hyperactivity disorder (ADHD), and autism. However, when parents request an evaluation from me, my first question usually is “has your child’s school conducted an evaluation?” This question gives me information about the steps the school has (or hasn’t) taken related to the child’s difficulties. It also helps me work with the parent to determine next steps.
I have worked as a psychologist both in and out of the school setting. I can attest that the landscape of psychological services available at both ends is confusing, especially for parents trying to navigate these systems. One of the most confusing things for parents (and many other professionals) is the difference between a psychological diagnosis and eligibility for special education. Here’s the biggest issue that often strikes a chord with parents: just because a child has a diagnosis from a psychologist or medical professional does not mean they will automatically qualify for special education services or be given an Individualized Educational Plan (IEP).
This may seem strange, especially if a child had an evaluation from a neuropsychologist or psychologist who gave them a diagnosis. However, here’s the difference: a licensed psychologist who conducts an evaluation outside of the school uses the Diagnostic and Statistical Manual (DSM) to diagnose a disorder, while the school uses the Individuals with Disabilities Education Act (IDEA) to determine special education eligibility. In other words, school do not (and cannot) diagnose children with a disability. In addition, a school team will only consider a child eligible for special education (even a child with a documented disability) if they demonstrate a significant academic need (more on that later).
Consider this analogy: an injured baseball player goes a medical doctor for diagnosis of an underlying issue (similar to a diagnosis from a psychologist). This same baseball player might also continue to work with a baseball coach or physical therapist to help improve specific baseball skills to prevent further injury (similar to eligibility and services through school).
To help clarify things further, I’ve listed some of the other differences between diagnosis and eligibility below.
Perhaps the most important aspect of an eligibility for special education (and the one that causes the most confusion) is that the child’s disability must adversely affects their educational performance (i.e., they demonstrate a significant academic need). This is the very reason why a child might have a diagnosis (autism, for example) and not qualify for special education services under a similar eligibility category (in this case, the eligibility category would likely also be autism).
In a letter from the Department of Education, policy makers attempted to clarify the phrase “adversely affects a child’s educational performance,” stating the following:
Whether a child's disability "adversely affects a child's educational performance" is considered for all disability categories, because, to be eligible, a child must qualify as a child with a disability [only if they] need special education because of a particular impairment or condition. Although the phrase "adversely affects educational performance" is not specifically defined, the extent of the impact that the child's impairment or condition has on the child's educational performance is a decisive factor in a child's eligibility determination under Part B. We believe that the evaluation and eligibility determination processes…are sufficient for the group of qualified professionals and the parent to ascertain how the child's impairment or disability affects the child's ability to function in an educational setting.
This is the reason why, even if a parent has a report from a doctor or psychologist documenting a disability, the school will likely need to conduct their own evaluation. This is also the reason why I ask parents what steps the school has taken related to their child’s difficulties. If the ultimate goal for the parent is for their child to receive special education services, I typically work with the parent to help explain the difference between the two processes. However, if a parent is seeking answers related to an underlying diagnosis (including looking at the child’s strengths and weaknesses related to different skills), I’m happy to conduct an evaluation with their child.
Alternately, some licensed psychologists with a school background also have training in screening for academic problems and providing academic interventions. This is another option I explore with parents, as it allows me to build a comprehensive profile of the specific academic skills deficits the child may be experiencing.