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Medical Diagnosis vs. Educational Classification

Angie Neal, MS, CCC-SLP

July 16, 2018

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Question

What is the difference between a medical diagnosis and educational classification?

Answer

A medical diagnosis is much different from a school classification in several ways. For example, simply because a student has a medical diagnosis of autism, does not necessarily mean the student automatically qualifies as eligible for the school classification of autism. Why is that? The primary reason is that because there are different methods for arriving at a medical diagnosis, versus a classification, and the purpose of the assessments is different as well.

In terms of a medical diagnosis, the method of assessment varies wildly from one practitioner to the next. It might be based on parent report only, or may be made via an in-depth evaluation tool, such as the Autism Diagnostic Observation Schedule (ADOS). Some assessments consist of observation of the child in the doctor's office, on one occasion. Some practitioners send a checklist to the school and some do not. Some utilize team evaluations with developmental pediatricians, psychologists, OT, and speech, with all of them looking at development through their respective lenses.

The purpose of a medical assessment is more in line with helping the family access private therapies, including Applied Behavior Analysis (ABA) and OT, which are sometimes not available through the school setting. A medical diagnosis may also include ruling in or out the presence of a genetic syndrome, another disorder, or another condition, which has characteristics similar to autism. These include but are not limited to: Prader-Willi Syndrome, Fragile X, Angelman Syndrome, Landau-Klefner, 22q deletion, Reactive Attachment Disorder, Obsessive-Compulsive Disorder, Selective Mutism, traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), bipolar disorder, anxiety disorder, gastrointestinal problems, or attention deficit/hyperactivity disorder (ADHD) that may need pharmacological management.

In determining an educational classification, the assessment must include information about academic achievement across several areas; not just social communication, sensory processing and interests, but how the student may be doing with academic skills, such as writing and/or reading comprehension. It must also look at the functional impairments that may adversely affect educational performance, such as working independently, working in groups, navigating the school, interacting with peers, and so forth. This information is then used to determine eligibility and design an appropriate treatment program that can be measured in the school setting through annual goals, or accommodations, or whatever the team determines is appropriate for that child in that setting at that time.

The method in which the information is gathered, and the purpose of the educational assessment, are quite different than from a medical setting. It is not at all uncommon for parents to come in with a medical diagnosis and want an IEP. Then when the team tells them they still have to do an assessment, it is really hard for parents to understand. Sometimes this can really set the wrong tone, in terms of trust. "Do not you trust my doctor and his diagnosis?!" It is important to have a detailed understanding of these differences so that you can take this information and provide this level of clarification to the parents.

Please refer to the SpeechPathology.com course, Pragmatics and Social Communication: Assessment, for more in-depth information on standardized versus non-standardized assessments of pragmatics, components of social communication, and key terms as well as recommendations for early social communication.


angie neal

Angie Neal, MS, CCC-SLP

Angie Neal is a school-based speech-lanuage pathologist from Greenville, SC. She earned her Certificate of Clinical Competence after obtaining her Master's Degree from San Francisco State University. Mrs. Neal has worked in inpatient and outpatient rehabilitation settings with both children and adults. She completed ASHA's Leadership Development Program for School-based SLPs in 2013 and presented at ASHA on the topic of social communication in the school setting at the national convention held in Philadelphia, PA in 2016.  She presents throughout the United States on topics related to social communication, language and literacy and effective school-based therapy.  Mrs. Neal is the author of The Pirate Who Couldn't Say Arrr (Tate Publishing), Spelling that Makes Sense (TPT) and Simply Social at School (Super Duper Publications).  


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