We appreciate our online community taking the time to ask questions and share advice, suggestions, and experiences with others on the Community HELPLINE.
Thank you for being part of the Wrightslaw Way Community.
Parent 1 asks: Does the school psychologist have the right to make the statement that his impression is not that of a child with an autism spectrum disorder? He said there is no school documentation of any criteria that would indicate an educational diagnosis of Autism.
My 11 yr. old daughter has a diagnosis of ADHD, ASPERGER’S DISORDER, RAD. by a Board Certified in both General Psychiatry and Child and Adolescent Psychiatry. She was diagnosed last year.
I really don’t know what to do. Please help! Thank you.
Parent 2 responds: Sad to say, this happens around the country. Medical diagnosis does not equal educational diagnosis.
Try sending a letter to your school district saying that your child has been medically diagnosed as being on the Autism Spectrum.
Explain that you are concerned about the impact of this diagnosis upon her ability to access the educational opportunities offered by the school district. Ask that the district’s autism expert evaluate your daughter.
Girls on the Autism Spectrum demonstrate their difficulties differently from boys. They often “fly under the radar” in school and fall apart at home.
Parent 3 shares: We went through the same thing with our district for our daughter, who was also 11 and diagnosed with Asperger’s, ADHD Inattentive Type.
We asked our district for an IEE because we disagreed with the school psychologist. The district argued with us for two months, but they finally “allowed” us to get an IEE.
We got a second ASD diagnosis, ADHD and a new diagnosis of an anxiety disorder.
We had been fighting with the district for a year. My daughter was not getting the support she needed and had regressed. It wasn’t easy and it took us over a year to get some of the support.
Start by asking for the IEE and put it in writing.
Tell the school you respectfully disagree with the school psychologist based on the diagnoses made. Tell the school you would would like to obtain an IEE.
Good luck and don’t give up! Keep us posted!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If you would like to be part of the Wrightslaw Way Community, visit the Community HELPLINE.
Your post about the educational diagnosis of autism is thought-provoking. It’s interesting to learn about the varying perspectives within the field. Thanks for presenting this information and contributing to the ongoing conversation – your insights are valuable!
is there a law against a school phsyc. calling children and youth on a 16 year old student that refuses to see them?
School Psychologists are mandated reporters. If they suspect something is causing the child to miss sessions, they are required to report it.
I went through the same thing with our district in regards to my 11 yr old son. I had a diagnosis from the Regional Center, psychiatrist letter, and still they refused services. So I went ahead and contacted the Board of Supervisors, the State Educational Board, and filed a complaint of new Civil Rights. Well it only took 1day for the district to call .me set up a SIP meeting and I’m pleased to say my son has been given everything he needs.
Really I am fighting this now and I have been for years. I am tired of giving the school chances and I am ready to take the next step.
good situation for this topic. My son diagnosed in 2016 h functioning autism by licensed phycologist from Hospital system. Dsm- v- newer conservative testing . The school at that time accepted diagnosis because it w performed by Ghs-. Then after he graduated speech in 2017 the school moved to 504 w accomm but Autism still being disability. We switched schools /new school noticed math issues. Called meeting decided he needed retested to get back Iep. I agreed but couldn’t understand why they wouldn’t accept medical test. Turns out he has 2 disability issues so they gave him 120 min per week for lang120 math- word processor as well. However to get Iep labeled correctly w autism instead of special education they are now stating CARs test. 3@ min social, 2 teacher evals, do I agree or sue?
I have been a school psychologist for almost twenty years and yes, what that school psychologist is “kind of” correct. Just because a student has a diagnosis of ADHD or Autism does not necessarily qualify them for special education services. If there are evaluations that can be reviewed by the school, you should provide them. If they satisfy the requirments of a special education evaluation, the school can choose to use them or choose to complete their own evaluation. However, in addition to meeting the diagnostic criteria through an evaluation, there has to be an adverse effect on the student’s learning/education. There are many individuals with disorders who do not receive special education services because they are able to function adequately within the school environment.
I know I am quite a few years late to this forum, but if anyone has a response for me.. I would greatly appreciate it. My son is currently being evaluated by the school psychiatrist who is not just denying school services for his ASD, but also claiming that he disagrees with the diagnosis all together. He was diagnosed by a private psychologist with high functioning level 2 autism spectrum disorder in February, and has been in ABA therapy since June.
Things that my son does on a VERY regular basis, they say that they have never observed before. Little to no communication since the process has started. This is the first time I have even spoken to the school psychologist today, he has gotten no background from me what so ever on my son. And is still saying he doesn’t agree with the diagnosis. If anyone has any advise…. HELP.
Haley, this is why the federal special education law gives parents the right to request an independent education evaluation done by an outside evaluator paid for by the school district. Your state parent training and information project can explain this and other options that you have. http://www.parentcenterhub.org/find-your-center/
I’m really worried and anxious about my sons situation. he has a clinical evaluation in two weeks but the schools team of diagnosticians said he didn’t qualify for anything under the autistic spectrum. Just under the ADHD. It scares me especially because the clinic wants those test results. I’m worried it means hes not autistic, or he wont show up on the spectrum in the clinical evaluation. Its stressful because he’s been kicked out of 3 after school programs because of his behavioral issues and i feel he needs to be in a facility that can handle autistic outbursts. I’m hopeing that just because the school says “hes not autistic” ……that he still could be clinically diagnosed as autistic or HFA.
Can school psychologist make a diagnosis of autism?
Yes and no. A school psychologist has the ability to assess a student for any of the 13 disability categories under IDEA. However, some of us have recieved specialized training in determining eligibility for autism, while others may not have. In my opinion, it requires a team approach to determine if a student has autism, and that team should consist of a speech and language pathologist with training in pragmatic communication, an occupational therapist with training in sensory evaluations and interventions, as well as a school psychologist who is trained in autism evaluations and interventions. Goal areas could include pragmatic communication, executive functioning, occupational therapy, behavior, social skills, emotional regulation, adaptive skills, and reading, writing, and/or math.
Jackie – a school psychologist can diagnose a child with an emotional disturbance. A school psychologist is one of the eligibility team members but more often than not they are the only team member to fully understand eligibility criteria for special education. I strongly feel like the whole team should by aware of criteria but it has been my experience that this is not the case.
Does a school psychologist have the right to diagnose a child with emotional disturbance?
We are going through this very thing with my 10yo son. We are on a medication holiday for the Ritalin that he has been on because the school did not see “significant” issues related to autism. He has Asperger’s, ADHD and a chronic genetic blood disorder. The educational diagnosis is only to show an “Adverse affect on educational performance”. Talk to your doctor. I highly recommend the books and trainings that are available on Wrightslaw. They have been very helpful to us!!
School psychologists (or Licensed Specialists in School Psychology, as they are called in some states) are trained and qualified to make mental health diagnoses, such as ADHD, depression, anxiety, or autism spectrum disorder. However, just because a student has a mental health diagnosis does not mean there is an educational need for special education services. If the student has a mental health diagnosis, the IEP team / ARD committee must first determine if the student meets one of the categories of disabilities under IDEA (Autism is one of those). The committee must then determine if there is an educational need for special education services. Remind the committee that educational need does not only refer to academics (i.e., grades, test scores). Educational need also refers to social skills, emotional & behavioral functioning.
Just wanted to point out Lori that only a licensed school psychologist or Dr. can make a medical diagnosis of Autism. School psychologists don’t have to be licensed, at least in NY.
mary
In GA a school psychologist does not have to be licensed. Additionally you can run into a problem if the school insists on doing theirs first, (since 11th Cir. said they have that right if a re-eval has not been done in over 3 yrs.,) and then when you are getting your private provider ready for the IEE, if there are a limited # of assessments used on an older child with Autism, (almost adult), cannot do the evaluation. I had to get the licensed provider to agree to do a diagnostic letter, so a child would still have what was needed for colleges. It is a mess.
Libby.
I live in georgia and have a child diagnosed medically with asd, aspergers range, and school testing showed borderline. I am being told that there is no evidence of school impact because he holds it in all day, according to the neurologist and psychiatrist/cognitive therapist. He breaks down as he gets in my car and I have emailed issues repeatedly for two years. I can not get him services because they tell me their is no educational impact or evidence of issue at school. I have tried everything. Any ideas where I can go next? It is so frustrating. His older brother is in the same school system but was diagnosed outside of Ga and his father and grandfather also have asd. I just can’t seem to get help.
Mandy,
Did you ever get an answer to your question? I am dealing with a similar situation. Child on the Spectrum and Anxiety, but high IQ. School sees it as no Educational impact and support is not needed.
In my building, we look at social/emotional/behavior, pragmatic communication, executive functioning, sensory processing, language skills, and academic deficits when determining if there is an educational impact. Questions to ask: Does my child participate in learning groups? Does my child have friends at school? Does my child have difficulty paying attention, getting work done, or starting work? Does my child interact with peers or teachers appropriately?
All kids will have some of these issues, some of the time, but kids who have these issues consistently will need more support and probably need specially designed instruction. I’ve had this argument with my colleagues that passing classes is not the only adverse impact that we are required to look at. It includes the soft skills, too.
Yes, exactly! Especially for those kids with high functioning autism.
School Psychologists in GA are certified by the state. Licensure refers to psychologists in private practice.
This is confusing to me. In order to hold a job, a school psychologist must always be licensed by either the state school board, the state psychological association, or both.
In some states, school psychologists do provide a medical diagnosis, and they bill for services as long as it is within their scope of practice. OSEP has opined that school psychologists are qualified to provide diagnoses for IEP teams as long as it does not conflict with state limitations on licensing. However, in some states, it is explicitly stated that the ability to diagnose can only happen by PhD psychologists or an MD, etc.
I can’t speak for all districts, and I know some public evaluations are poorly done. I’ve seen several and probably done a few.
I will say though, there is value to a well-done school evaluation for Autism. For one, I typically spend 4-6 hours in observation of a child, across settings, in addition to assessments like an ADOS. In the clinical world, I could never swing that.
My results sometimes conflict with outside evaluations. However, when I ask parents, or even providers, I rarely hear of more than 45-60 minutes being spent directly with a child, and differential diagnosis ( choosing between diagnoses with similar symptoms) is primarily based on rating scales. 10 minute parent interviews and a checklist for developmental history. These types of evaluations can give weight to a school’s refusal to evaluate or their choice to conduct and/or use district evaluations instead of private evaluations for decisions.
Whether school or private, always politely question decision-making of a psychologist. Ask why. Ask how much time was actually spent talking or playing with your child AND assessing/testing them. After working in multiple states, clinical and school-based, I can promise that higher level credentials does not always mean a higher quality evaluation. Like any profession, I guess.
that is correct Mary, a school psychologist should be at the Ph.D. level to be able to “diagnose” officially. However, the school psychologist whether at a Ph.D level of Specialist level is able to do the complete evaluation and give their diagnostic impressions according to the DSM-V, which can be used to identify for speical education disabilities. You do not need a “medical” diagnosis but do need to do an evaluation that satisfies the diagnostic criteria of the DSM-V. In addition, that school psychologist is able to have a Ph.D. sign off on their report. So yes, they can evaluate for it but can only give diagnostic impression for special education purposes.
The DSM-V is not used to determine eligibility for special education. Eligibility is a regulatory issue, the criteria outlined by IDEA. The DSM-V has nothing to do with special education eligibility. I wish we were more aligned with the ICD-10 and DSM -V, but that’s up to Congress.
This is my 20th year as a school psychologist. And I’m the parent of three kids with Autism. Only two qualify for special education. The third is “too high” and doesn’t “need” an IEP. My SLP disagrees, says she needs pragmatics, but I can’t evaluate my own kid (she attends my school). And the other psych that could do it is my bff (we’re the only 2 allowed to eval for ASD in my district). Her pediatrician won’t order an evaluation. But her new therapist just ordered one yesterday at her intake! Maybe now…
For autism, at least in the state of Minnesota, you can use the DSM-IV criteria for Autism to satisfy the Educational Criteria needed to qualify for Autism.
I’ve worked in California, Washington, and Oregon. And in all 3 states I had to be licensed. I have heard that Hawaii doesn’t require a license, but hadn’t heard that about NY, GA, or NJ. Oregon actually has a specialist license for Autism Specialists. Here in Washington, we don’t, but my district requires specialized training. My bff and I are the only 2 in my district of 6000 students.
Mary, all school psychologists must be licensed by their state educational agency to work in a school. Some school psychologists are also licensed by their state’s psychology board, which oversees psychologists in private practice. Here’s a link to each state’s licensing requirements for school psychologists: https://www.nasponline.org/standards-and-certification/state-school-psychology-credentialing-requirements
Well i too have been in your shoes. The school wouldn’t test my son for autism because they didn’t feel he was autistic. they said he was mental disturbed and he was already diagnosed with bipolar and ADHD and it does run in the family. I did a lot of research found a web site called child brain .com. it does a online test, gives you an idea of what you think or are concerned about with your child. Just letting people know that may read this. For you, i don’t know your income, but they go by your income and that is MHMRA. Another web site is texas .gov that has programs and grant info and autism speaks.com ,nami.com.
MHMRA will diagnose your child on paper if she has it. they do the testing too. The school had no choice but to put it on my child’s records at school. You should have your child’s hearing tested because inner ear hearing loss sometimes runs hand in hand. my son was tested at six months and he’s deaf in both ears.
1. The school psych, like any other member of the team, has a right to express his opinion.
2. Also there is no educational diagnosis category for autism.
3. Using the appropriate diagnostic tools & training, a school psych can make an autism diagnosis, although the team makes the final decision.
However, that being said…..
1. Opinions don’t help the IEP process. Data/facts do. Since he said there is no educational data to support an autism diagnosis, what is he basing that data on? Was school information even look at by the outside psychiatrist. Were questionnaires/interviews done with school staff?
2. Many students across the country with autism are somehow getting an educational diagnosis that allows them to get services.
There is a Special Education Classification of Autism. It is one of the 14 classifications under the Federal IDEA.
Yes.
The school Psy is ONLY ONE MEMBER of an IEP team. of which you the parent are also. The school psych. many times administers tests to get baseline results to find a childs educational level, IQ level and many other criteria. None of these tests will give nor is the school psych. qualified to make a diagnosis of this sort. For a School psych to overstep their professional boundaries in such a way leaves them and the district open for serious liability to go against a certified physician who is licensed to make such a diagnosis.
We are presently in the same situation. Our daughter is nine and has diagnoses of Asperger’s, semantic-pragmatic deficit, and lack of coordination. We requested and received an IEE at school district expense. The IEE psychologist and speech language pathologist who observed and evaluated our daughter at school recommended an IEP; the school district disagreed. The district claims our daughter receives “reasonable benefit from general education” without specialized instruction and support. Meanwhile we provide private speech-language and occupational therapy services at our expense. Due process? We can’t afford an attorney. What next?
Schools do not diagnose. They only determine eligibility. Students can have any outside diagnosis and disorder, but that does not mean they automatically need special education services. Special education does not take the place of outside therapy and counseling. Two vastly different areas of targeted support
I’m in the same situation. My 6 year old son shows a lot of behavior of Autism, I requested that the school did some testing to make a determination. At his IEP meeting the school psychologist told me that because he talks ( even off topic and frequent rambling ) that he doesn’t fit the criteria for autism. And told me that he has ADHD. I talked to sons therapist and pediatrician about possible ADHD and the both told me that he does not have ADHD and he needs to be reevaluated. I feel like the school downplayed his symptoms so they don’t have to provide special services to him. I really don’t know what to do at this point.
One option is to request that the district pay for an independent educational evaluation (IEE). Your state parent training & information center can help you in understanding this & other options you have. http://www.parentcenterhub.org/find-your-center/
I just received a referal for a clinical psychologist. My sons therapist wants him evaluated by a more qualified professional. She said it is very common for schools to misdiagnose autistic children as ADHD. I’m just not sure if the school will listen to me if I do get a clinical diagnosis. My son needs help. And the school system is failing him
The state parent training & information center will have staff that can assist & support you. You can try to get the state education agency involved to assist you.
It’s also very common for schools to prematurely label a child as autistic in lower grades when the primary issue is ADHD. Children are put in very restrictive placements and do more to harm student instead of receiving medical intervention. Additionally, schools can’t diagnose for ADHD. Diagnosing is a medical model following the DSM-V. Schools can, by using rating scales, verify elevated concerns with inattention and impulsivity/hyperactivity. Bottom line, just like ruling out vision and hearing, ADHD should also be ruled out. Most students in our school district receive treatment for ADHD. It elevates intelligence, students stay on task, learn to study, improve social skills, improve communication skills, improve adaptive skills, and improve emotional regulation.
Call the school board. Also there are people who will go with you to these meetings IEP that also have a lawyer involved in case school doesn’t do their part. Ive also heard if school does testing and you don’t agree – get your own done by private doc. the school may have to reimburse. good luck.
It is important to make the distinction here that schools DO NOT diagnose students with anything. Students can come in with an outside diagnosis, but that does not mean they automatically qualify for special education services. These decisions are made as a team that the parents are part of and the team examines the data collected about the concerns about the child in the school environment ONLY. While outside diagnoses are taken into account, we have to look at how the child functions at school to make an eligibility determination. These are guidelines that are set by the state that all public schools in the state follow. School psychologists are trained to give assessments, interpret data, and be a team member when making eligibility determinations, not diagnose.
School psychologists are trained to identify and (often) diagnose. Barring some specific state laws, they often can make diagnoses of any disorder as long as it is within their scope of practice, and they are doing it solely within the school system.
Often, it just isn’t necessary. However, it is sometimes necessary when seeking Medicaid reimbursement or when we think it is necessary to communicate a specific set of symptoms across providers (e.g., emotionally disabled student moving between therapists, in/out of hospitals, etc). Or even when a child needs an ADHD diagnosis for OHI, but parent is unable to see pediatrician.
It is true that schools do not diagnose, but often the SLP, OT, PT, or school psych can..and should..especially if it would otherwise mean a hardship on the parent or child. Neither we nor our diagnoses can unilaterally place or qualify a child for special education. Our assessment data must still meet policy requirements for disability identification.
I’m not saying that the school is right or wrong, but there is a major difference for providing school based services vs outside services
My son had a very similar diagnosis, Aspergers and Movement Disorder, and struggled with language based courses. I had to fight for services in the correct placement. He was stuck in an SEBD placement, denied a FAPE, and DOJ has all of this on file. Now he is taking 4 AP classes after a year of private school, a year of OT paid for by GA Cyber Academy AT MY OWN HOME AFTER SCHOOL. I threatened a complaint against Fulton County Schools for the Child find eval and got my private eval paid for while he was in the private school for Autism. He was finally able to attend his neighborhood school and thrive with a great principal, an IEP that gradually implemented inclusion, reading instruction, extra help with writing, and he had advanced Math by 8th grade, and is taking AP Calculus, AP Physics, AP English, finished AP Macroecon, and is taking AP Govt.