Diagnosis vs. Identification of Learning and Thinking Differences

ByPeg Rosen

The doctor tells you your child has and . So does the IEP team at school. So they’ve both diagnosed your child, right? Not exactly.

People often say the school “diagnosed” their child. But technically, that’s not what happened. Schools don’t diagnose conditions. Only doctors and other clinicians do.

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School supports

What schools do is somewhat different. IEP teams “identify” learning and thinking differences. Then they determine if a child is eligible for special education supports and services.

This chart explains the differences between a school identification and a clinical diagnosis.

	School identification	Clinical diagnosis
What it refers to	A learning “disability” or health impairment (including ADHD) that’s identified after a school evaluation	A medical condition (including ADHD) or learning “disorder”
Who makes the determination	An IEP team at school	A doctor, clinical child psychologist, pediatric neuropsychologist, speech-language pathologist, or other qualified clinical professionals
The basis for using the term	• Schools identify conditions based on IDEA, the special education law. • The law covers 13 categories of disability. For a child to be eligible for special education services, the school must identify learning and thinking differences that fall under one of those categories. • Most learning differences fall under “specific learning disability.” ADHD often falls under “other health impairment.” • Conditions must also affect the child’s ability to function in the classroom or elsewhere in school at the time they’re identified. • Child must be reassessed, and issues formally identified, at least every three years.	• Clinical professionals diagnose conditions found in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). • Conditions don’t have to affect school performance in order for clinicians to diagnose them. • Diagnoses that aren’t covered by might be used under . • Conditions are considered ongoing unless symptoms change and the diagnosis is revised.
The purpose behind it	• It determines if a child is eligible for special education. • It entitles eligible student to the supports and services needed to get a free appropriate public education through an IEP. • The same information may be used by a 504 committee at the school to determine eligibility for a 504 plan.	It is used to understand the cause of symptoms and to guide decisions on treatment. (It may also provide information to help with the evaluation process at school.)
What the evaluation process might involve	• Observation in classroom and other school settings • Review of developmental milestones, plus medical and family history • Standardized assessments of intellectual ability, speech and language skills, and more • Mental health screening • Parent or caregiver interviews • Teacher input • Review of educational history	• Physical exam and other medical testing • Review of developmental milestones, plus medical and family history • Standardized assessments of intellectual ability, speech and language skills, and more • Mental health assessment • Parent or caregiver interviews • Teacher input • Review of educational history
Cost	Free, if done through the public school special education process	Parent pays; health insurance may provide some coverage
How they relate to each other	An IEP team might consider any clinical information that’s available when it’s determining if a child is eligible for special education. That includes a clinical diagnosis. A diagnosis alone doesn’t satisfy IDEA requirements for getting supports and services in school, however.	A clinician should consider how the diagnostic process could be helpful for educational planning. A diagnosis doesn’t automatically qualify a child for special education. It might be enough to qualify the child for 504 accommodations, however.