Dr. Joo is President of Diagnostic Services at Jigsaw Dx, and an expert in psychoeducational assessments. Learn more about her background here.
We offer different types of evaluations for children who are struggling in school. These evaluations help children get a diagnosis and, hopefully, the accommodations, services, and/or an Individualized Education Plan (IEP) they need to reach their full potential.
A commonly considered option is psychoeducational evaluations done through the school system. Legally, schools are responsible for conducting a psychoeducational evaluation to determine if a child meets criteria for an IEP and special educational services. However, often schools are heavily impacted and do not have enough staff to complete these assessments for all children in a timely manner. Jigsaw Dx provides them faster. Also, sometimes parents want an outside assessment to bring back to the school.
Parents might also consider taking their child to a psychologist, but not all psychologists conduct assessments. Even among those who do, not all are trained in neuropsychological evaluations or have expertise in school-related settings. Most psychologists who perform assessments tend to focus more on mental health aspects, such as depression and anxiety. A major difference with Jigsaw is that our evaluations are significantly less expensive. In-person psychoeducational evaluations in an office can cost between $5,000 and $7,000, while neuropsychological evaluations can range from $8,000 to $10,000—at least in areas like the Bay Area, though costs may be lower elsewhere. Another big difference is the convenience of having the evaluation conducted at home.
A typical psychoeducational evaluation includes:
Once the evaluation is complete, we provide a diagnosis and detailed recommendations. While schools are not obligated to implement all the recommendations, if they see that the report is valid and includes a legitimate diagnosis, they often adopt most of the recommendations.
A regular psychologist conducting a psychoeducational evaluation in their office would likely follow a similar process. The key differences between our services and those of an in-office psychologist are the lower cost, greater convenience, and shorter wait times.
It’s important to note that not all evaluators are trained equally. Some professionals may have specialized training in autism, while others may not be familiar with the nuances of school-related issues.
The youngest we evaluate is typically around six years old because we need to see how the child is functioning in a school environment, given that it's an education-based evaluation.
There are different types of evaluations we offer beyond the standard psychoeducational assessment. These include neuropsychological evaluations, among others. Parents often consult with us to determine which assessment is best for their child because many are unsure of the differences between them.
Recently, the term "neuropsych" has become something of a buzzword in the community. A lot of parents will come to us saying, "I need a neuropsych evaluation," without realizing that they may not actually need all the nitty gritty details of their child’s brain function that a neuropsychological evaluation provides. Often, a simpler assessment will suffice.
In terms of concerns, many of the cases we see at a younger age are related to autism, developmental delays, or ADHD. That’s often what we encounter. In slightly older school-age children (elementary school), we begin to see concerns about dyslexia and other learning disabilities. For children with ADHD or autism, parents are often already concerned before they start school. These days, parents are so savvy that by the time their children are in school, those concerns are almost confirmed for them. The ADHD symptoms become more apparent in school, where the children may be hyperactive, impulsive, and unable to sit still, prompting teachers to comment on how disruptive they are. In girls, ADHD tends to fly under the radar for a bit longer because they often display more inattentiveness. Even if they have the hyperactive type, they are often better at disguising it and behaving more appropriately in social settings. This ability to control their ADHD can sometimes lead to the development of anxiety, so they might not be identified until later.
We can’t implement an IEP or anything like that, but we do the assessment, provide the diagnosis, and offer recommendations. We give feedback and provide a full report (about 20 pages) that outlines all the areas of the child's functioning, their strengths and weaknesses, diagnoses, and recommendations. The recommendations aren’t just school-related; they also include services such as ABA, individual therapy, or an executive functioning coach. We also offer home recommendations that parents can implement with their child. From that point, the parent takes the report to their school and says, "Okay, my child has this diagnosis. I'd like to see if they are eligible for special education or a 504 plan." They will then work with the school. Often, the school is already aware that something is going on and encourages the parent to have their child evaluated.
It’s important to clarify that schools also conduct these evaluations for free. That’s why some parents opt not to pay for an evaluation, but the issue is that schools can sometimes take up to a year to complete the process. By then, the child has lost the entire school year.Schools are legally required to respond within a certain timeframe (usually 30 to 60 days). However, sometimes what schools do—and I understand because they also lack resources—is to respond to the parent's request by saying, "Okay, we’ve received your application. Let’s set up a meeting," which might be scheduled within that 30 to 60-day window. But this means the entire process is not completed for about a year.
It depends on the grade level, but especially in the younger grades, that's when the fundamentals are being taught. For example, a child with ADHD might be very smart, but if they’re unable to focus and actually learn the foundational skills in reading, writing, and math—which are critical in first, second, and third grades—they’re going to struggle academically later on. This is the time when these essential skills are being taught, and if the child misses out on building that foundation, they’ll continue to struggle even if they wouldn’t have if their ADHD had been addressed early.
Over time, what could have been just ADHD can also turn into a learning disability because the foundational skills were never properly established.In the early years, school is also about developing a love for learning and positive experiences in the classroom. If all a child experiences is frustration and getting into trouble, then school itself can become a trigger for them. This can lead to more disruptive behaviors, including oppositional defiant behaviors. It can also cause significant issues like anxiety, depression, and low self-esteem.Children with ADHD who are not treated—whether through medication or other interventions—are at a much higher risk of dropping out of school compared to those who receive treatment. So, not getting the proper evaluation and support can have serious long-term consequences.