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Dr. Joo is President of Diagnostic Services at Jigsaw Dx, and an expert in psychoeducational assessments. She answered the most common questions from parents on school evaluations in Part 1 and is back with more answers. Email Info@jigsaw-dx.com with further questions.
A medical diagnosis is different from an educational disability category. There isn’t a diagnosis in the educational setting. So when a school does a psychoeducational evaluation, they might give the diagnosis of autism, but they are really just looking for symptoms that affect a student’s access to the educational curriculum. Even if a child doesn’t meet the full criteria for autism—maybe they only exhibit a few traits (like significant rigidity)—if those traits are affecting the first grader’s ability to participate in the curriculum, the school will categorize them under autism. The IEP will say autism, even though a formal diagnosis may not be required.
However, in the clinical setting, meeting the diagnostic criteria is essential. To be considered on the autism spectrum, it’s not just about one symptom (even though some people think that’s the case). You still need at least five symptoms to be on the ASD spectrum. To receive an autism spectrum disorder diagnosis clinically, you need to meet five out of the seven criteria. The criteria are much more stringent medically.
So there are times when we will say, “No, this child does not have autism,” and the school will say, “They are under the autism category.” The parents get confused and say, “But they were diagnosed with autism at school. How come they aren’t diagnosed with you?” Well, they weren’t actually diagnosed; they are categorized under the eligibility category of autism.
There are also cases where the situation is reversed—where we diagnose a child with autism, but the school says, “Yes, they have autism, but they’re excelling in all their classes. It’s not affecting anything.” In that case, the school may decide not to provide an IEP or special education services. While this is rarer, I have seen it happen.
The cost is a significant barrier to getting a child evaluated, as well as fitting the evaluation into their schedule, which could require a full day or multiple days of testing. Another major issue is convincing their child to participate. This can be quite daunting. Many kids, especially since COVID, have developed significant social anxiety, so the thought of going into a school or office setting—especially if they’re already struggling—can be overwhelming. The anxiety of meeting strangers and having to perform in front of them can cause a lot of resistance. Many parents find it difficult to get their children to agree to these assessments and actually participate.
However, when assessments are done virtually, children are typically much more relaxed in the comfort of their own home. They feel protected, experience less social anxiety, and can take breaks in familiar surroundings. This often leads to better participation, higher motivation, and a more accurate representation of their true abilities, rather than the anxiety and resistance they might exhibit in an office setting.
There is also stigma to consider. I’ve encountered many parents who are resistant to getting an IEP for their child because they’re afraid of labeling their child. Now, it’s not just a medical label—it becomes part of their school record. Parents fear that this label will follow their child to college and potentially prevent them from getting accepted. There’s a lot of concern around stigma or the fear of it. Some parents worry that if their child is placed in a special classroom, they’ll be stuck there for their entire school career. These kinds of fears can make parents hesitant to move forward with the evaluation process
No, Maybe they were back in the day. But in today’s day, I don’t know when exactly it changed, but it’s very different today. First of all, schools are lacking in resources. If anything, there is a fight these days to get them into a more intensive classroom than to not, because of the fact that schools are lacking in resources. So when they feel like your child is ready to leave the special class and graduate to the regular ed curriculum, they will. Because they need to free up space for all these other kids in these classes. So if anything the opposite fear today is well-founded - of kicking your kid out too early! Today, the “label” is actually very useful. It’s a gateway to support, services, and community!
When it comes to going to college too, these labels can help you! Because, number one, you can get accommodations for standardized testing. You can get accommodations once you’re actually in school. You can get connected with the disability department and then you get extra time for exams in school. If anything, it will help them.
I’ve heard back from so many parents and learning specialists for their students, saying, “Oh my gosh, they’re thriving now!” They’re on the right medication, especially for ADHD, and they’re now much more organized with their work. They’re excelling in school, able to focus, and study effectively. I’ve had many stories like that—especially with kids who are smart but have a disability that previously impacted their ability to excel in school. I think that’s where I’ve noticed the most difference. For kids who aren’t as academically strong and are already struggling, their progress really depends on the quality of services they’re receiving. Unfortunately, I can’t control that as much. If the school isn’t offering great services and the child doesn’t have the intellectual capability to figure things out on their own, they’re not going to thrive as much. But yes, I’ve had kids who weren’t receiving services before or weren’t on the right treatment, and now they’re doing really well.
Recently, a mom of a child I evaluated told me, “This is amazing. I don’t know why everyone isn’t doing it this way.” Her child had ADHD, and she loved the fact that he was at home, in the comfort of his own space. I had a side camera where I could see everything, so I wasn’t missing anything! I could see him fiddling with things down by his feet—everything! Mom loved that he could take short breaks within his room, play in the living room, and then come back. His mom was right next door if he needed her. She was able to pop in a couple of times to soothe him and overhear some of the assessment, and she felt like he performed so much better because he was doing it from home. This child had been pulled from school because his teacher kept saying he was too disruptive and was getting in trouble all the time. They decided to homeschool him. Now, after the evaluation, he’s actually going to a charter school next year, and they’re so excited!