You have a parent with a child who has seen various specialists and is diagnosed with autism. The parent then goes to the school to ask for assistance and the school states the child is not eligible for services. So what is going on?
The difference between a medical diagnosis of autism and the educational eligibility under “autism” in the IEP is actually pretty big-and it matters.
A medical diagnosis is given by licensed healthcare providers-typically a developmental pediatrician, psychologist, neurologist or psychiatrist-using the criteria from the DSM-5. This diagnosis can be used to access therapies, insurance benefits and other medical related services such as OT, PT, ABA. It is based on a comprehensive evaluation that includes clinical history, direct observation, review of the DSM criteria for autism and review of cognitive function and adaptive skills.
An educational eligibility under the “Autism” category in IDEA is determined by the school team (often a school psychologist) and is only about whether the characteristics of autism adversely affect the child’s educational performance. IDEA has defined 14 eligibility categories for IEPs. One of them is Autism. The school’s task is to evaluate the child and determine if they fit the eligibility criteria for any of the specific categories. A child might have a medical diagnosis of autism, but not qualify under educational standards, or vice versa.
Can a school “diagnose” autism?
Schools cannot and should not diagnose. In fact, the term “diagnose” should not be used in the educational domain. They do not have the authority to do so. The DSM-5 is very specific about who can officially diagnose autism. It is correct to say “child has an autism classification/eligibility” for school services.
When doing IEP evaluations, the school’s task is to evaluate the child and determine if they fit the eligibility criteria for any of the specific categories. Determining eligibility is not the same as diagnosing. The child must also be in need of specialized services. It is important to note that these services are not automatic with an eligibility determination.
Qualifying under the autism category in the school setting can come with more specialized services such as:
- Social Skills Training
- Behavioral Interventions
- Sensory Integration Supports
- Speech/language services
- Occupational Therapy
They are not interchangeable.
- A medical diagnosis doesn’t guarantee IEP eligibility
- An educational classification doesn’t mean the child has a medical diagnosis of ASD.
In the end, families often have to have multiple evaluations in order to determine their child’s eligibility for both medical and educational treatments and interventions unless they can find an evaluator who is both licensed and qualified to make a “medical diagnosis,” as well as certified to make an “educational classification.”
Call SmartCare BHCS or refer families who are seeking support in asking for an IEP and/or obtaining autism evaluations.
| Medical Diagnosis | Educational Eligibility |
| Made by a doctor or clinician | Made by the school team |
| Determines medical treatment | Determines school eligibility |
| Focuses on the diagnosis itself | Focuses on how the disability impacts learning |
| Uses DSM or medical criteria | Uses IDEA eligibility criteria |
| Can exist without school services | Requires educational impact |
| May guide outside therapy | Guides IEP services and supports |
RESOURCES:
https://adayinourshoes.com/autism-whats-the-difference-between-medical-and-educational-diagnoses/
https://www.neuroassessconsult.com/what-is-educational-autism/
AUTHOR:
Shirley Fett, FNP, PMHS
Vista Hill SmartCare BHCS, Parent Care and Cal MAP