Diagnosing Learning Disabilities

Parents navigating the learning disability diagnosis process may find a bewildering range of testing methods, theories of learning, and labels awaiting them. To make matters more confusing for parents, there are different diagnostic systems out there that involve different ways of making diagnostic decisions. Learning disability diagnosis is an inexact science. Some experts disagree on the best ways of determining whether a learning disability exists. Why is there so much confusion?

• First, there are different diagnostic systems in use. Diagnostic methods and standards used to diagnose learning disabilities in public schools are different from those used by evaluators in private practice.
• Second, there are differences in bodies overseeing diagnosis in the public schools and outside of public schools. Public schools and private evaluators are governed by different government agencies, boards, and regulations which define learning disability.
• The Individuals with Disabilities Education Act regulations governing diagnosis of learning disabilities and other types of disabilities in public schools are somewhat general and leave the specific requirements to states to define. Consequently, there are differences from state to state in diagnostic criteria. A child who qualifies as learning disabled in one state may not qualify in another, which can affect families who move from state to state.
• Regulations and diagnostic systems governing evaluators in private practice, namely licensed psychologists or psychiatrists, are even less specific than those used in public schools. The Diagnostic and Statistical Manual of Mental Disorders, also called the DSM, for example, uses largely qualitative criteria rather than statistical methods. As a result, examiner's opinions are more important in the DSM system of determining diagnosis.
• Usually, the learning disability diagnostic processes in public schools more are consistent among schools within individual states, but this may not always be the case.
• Different states may have different standards and practices for the diagnosis of learning disabilities. Consequently, it is possible for a student to qualify in one state but not another.
• Public school systems typically use a combination of:
  • Formal evaluations using an aptitude achievement discrepancy to determine if a learning disability exists and its severity; and
  • Response to Intervention methods to determine if a learning disability could be the cause of a student's academic problems.
• Evaluators in private practice usually use either the Diagnostic and Statistical Manual(as in DSM-IV) or the International Statistical Classifications of Diseases (as in ICD-10) criteria to diagnose learning disabilities.
• Both the ICD and DSM methods of diagnosis rely heavily on an evaluator's professional judgment, which naturally varies from evaluator to evaluator. Terms used to name and describe learning disabilities in these systems are different from those used in the IDEA in public schools.

With all the variability across diagnostic systems, parents may wonder which systems are best and most accurate. They may also wonder whether it is best for them to seek an evaluation through the school or through a private provider. The answer to this question depends on your individual situation. If you want to see if your child qualifies for special education services, it is likely to be to your child's advantage to seek evaluation through your child's school because you can be guaranteed that the resulting evaluation will meet all of the school's requirements. However, in some cases, an evaluation by an outside provider who is a specialist in your child's area of suspected disability may provide additional useful information if the school's evaluation staff does not have expertise in the area of concern. Augmentative communication, for example, is a specialized evaluation that my require the services of a professional specializing in that area. Parents should also be aware that schools must consider any available outside evaluation data in making eligibility decisions.

When are Learning Disabilities Diagnosed?