Reply to Denied evaluation for autism spectrum child at FCPS. Now what?

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Reply to "Denied evaluation for autism spectrum child at FCPS. Now what?"

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[quote=Anonymous]I think there is a lot of confusion in this thread between the idea of a "medical diagnosis" and an "academic diagnosis", because of the imprecise language and assumptions.

First, any child who goes thru the IDEA process has to demonstrate that they have one of the disorders listed in the statute.  These vary widely -- autism, speech/language impairment, hearing impairment, visual impairment, orthopedic impairment, neurological impairment (like TBI), specific learning disability, etc.  (see IDEA statute at IA6023 for full list).  Because the IDEA disorders vary so widely, the kind of professionals who can "diagnose" these issues also varies widely -- doctors, psychologists, speech/language pathologists, audiologists, etc.  In fact, school-based psychologists are qualified to diagnose many of these issues (autism, emotional disturbances, ADHD) for the purposes of meeting the "disorder" prong of the IDEA test.  Other school-based staff, like a speech pathologist, can diagnose speech/language impairment, hearing impairment (school audiologist), etc.   All of these "diagnoses" are made on the basis of different types of assessments, depending on the practitioner, but the diagnosis usually conforms to the DSM diagnosis definition, because that is standard across all professions (i.e. the doctor, psychologist and speech pathologist all can/should be referring to it).  I think this is what one PP is referring to as "medical diagnosis", assuming that only a doctor can make such a diagnosis, which is incorrect.

A "diagnosis" of an IDEA-listed disorder is necessary (but not sufficient) for IDEA, but it does not have to be made by a doctor.  However, when a doctor makes the diagnosis, typically, if the school-based team disagrees ABOUT THE PRESENCE OR ABSENCE OF THE DISORDER, then the doctor's diagnosis usually trumps because he/she is the typically the most educated/highly trained person providing information to the IEP team.  For example, if your IEP team says, "we think your DC is autistic and we want to place him/her in an autism program," and your doctor has explicitly ruled out an "autism" diagnosis (and you provide the IEP team a written report from the doc to that effect), then it will be nearly impossible for the IEP team to continue to treat your DC as autistic (if you oppose it).  In this sense, the doctor's "diagnosis" trumps the team's "diagnosis".

BUT, the IEP team can still trump a doctor in a different area and that is in making the determination that the child is a "child with a disability" within the meaning of IDEA.  This is confusing to many people, because in everyday language we assume that a person with a "diagnosis" is de facto "disabled".  But to be a "child with a disability" within the meaning of IDEA, the child must have one of the listed disorders AND "by reason thereof need special education and services."  Therefore to be deemed a "child with a disability under IDEA, families have to prove that their child has 1) a disorder that 2) adversely effects educational performance and 3) needs special education.  Typically, the IEP team (and not the doctor) makes the determination about prongs 2 and 3 (adverse impact and special education).  I think it is this idea to which a PP refers as "academic diagnosis" -- although I think the more accurate term is "eligibility determination".

To get back to OP's original problem -- which was that the school team denied an IEP to her child diagnosed with autism on the basis that he/she was at grade level -- I would suggest looking at this link from NASP (the National Association of School-based Psychologists) -- http://communities.nasponline.org/blogsmain/blogviewer/?BlogKey=1680188d-e8fa-44c8-b4b9-c1dfdf549ee2.

It basically states that a school psychologist is qualified to diagnose autism and that, " Because of the significant problems in social interaction development common to all autism spectrum disorders, it is recommended that children with any ASD be eligible for special education services under the category of autism."

So, it seems clear that a student with autism who is doing "fine" academically but only needs help with social interaction should be eligible for IEPs.

OP, FWIW, I have found that the most "helpful" person at the table is often the school psychologist.  I put "helpful" in quotes, because I found that they rarely are rarely voluntarily helpful, but if you direct your information and questions to them explicitly during a taped meeting, they have a harder time saying no than other staff because they have, a professional ethical obligation to speak up on the students behalf, and not just meet the needs of the school.  Often, if you point the school psych to specific data that supports your position in the three prong test, and you explicitly ask if they agree with the decision to deny an IEP, they will have a more difficult time saying "no".  (IME, anyway.)  FWIW, IME, the school psychologist has often NOT read the underlying private reports provided but instead rely on summaries of those documents made by the sped team chair or the other specialist (SPL, OT, etc.), so if you disagree with the way the other professional is presenting the underlying report, raise the specific data at the IEP table.  Provide the article I've linked to and ask the school psychologist on tape if he/she agrees with the decision not to provide an IEP to the child. (give them the paper a week ahead of time).

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