E131: Diagnoses vs Educational Label with Dr. Liz Leggiadro
Have you ever throught your child got a medical diagnoses because of their qualification for an IEP? Did you ever stop to think that the educational label (ie. what the school used to qualify your child for an IEP) does not mean that they have a medical diagnoses?
Have you ever throught your child got a medical diagnoses because of their qualification for an IEP? Did you ever stop to think that the educational label (ie. what the school used to qualify your child for an IEP) does not mean that they have a medical diagnoses?
This episode details out the differences and what you need to know about each situation to get the best support for your child at school!
In this episode we discuss:
1) What an outside evaluation looks like an does for your child
2) What the intention of an educational label is, and how it’s different
3) Deciding if you need one or both of these to get your child what they need
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E131: Diagnoses vs Educational Label with Dr. Liz Leggagio
Samson Q2U Microphone: [00:00:00] If you go to an office outside of the school to get an evaluation done or testing or an assessment done for your kid in order to get a diagnosis, that’s called an outside evaluation, and it can look really similar to what the school does as an evaluation to see if your child qualifies for an I E P, but it’s definitely not the same thing.
And this is one of the things that we see get confusing all the time for parents is figuring out a diagnosis like dyslexia or autism or adhd from an outside evaluation versus what they do to determine if they need an I E P for those same needs inside the school system. So today I have a special guest on the podcast to explain all of this, all of the differences in what you need to know in order to present an outside evaluation to the school, or decide if you need an outside evaluation.
my friend and former colleague, Dr. Liz Legio, who is a clinical psychologist and also a school [00:01:00] psychologist, and she works part-time in both settings. So she’s the perfect person to come on and explain everything to us from both sides so that we can understand the differences between the two, and also
how to coordinate information from one to the other to make sure that your child is truly supported in school. So stick with me because today we are talking about diagnosis versus educational label.
Samson Q2U Microphone-1: You are listening to the Parent IEP Lab, the podcast that helps you become an informed parent advocate to get your child supported and learning in school. I’m Beth Levenfeld, occupational therapist who started to notice trends in parents who got effective IEPs for their kids in over 400 IEP meetings that I’ve participated in over the years, collaboration was the cornerstone of the successful parents advocacy, and that’s what we teach here.
You are here because you aren’t scared of a little bit of work and you realize that you can harness the power a parent has to not only help your child get what they need, but also help fix this scrambled system and get its priorities back on Track One school i e p team at a time
My [00:02:00] mission of the Parent IEP Lab podcast and also the online courses, workshops, and summit of the i E P lab is to break down barriers to being able to advocate with collaboration and the main way we do this is to provide you insider information from the school side so that you have context for what’s happening to create informed intelligent questions.
To ask your I e P team to have a clearer voice in your child’s plan. We also highlight guests that are specialists in those certain areas so that you have connections and resources to find what you need for your specific situation. We only highlight strategies and information that is actually working right now, so you can take action to make some serious headway in getting your child supported. So let’s dive into today’s topic, which is all about outside diagnoses versus educational labels, and think about what we can change and tweak to get the right formula for success for your child to learn and grow at school.
Welcome to the lab.
Samson Q2U Microphone-2: I absolutely love podcasts. I’m a podcast listener, have been for years now, and obviously I enjoy making them because this is the hundredth [00:03:00] hundred and 31st episode, and so I better like it, right? But the only thing that I don’t like about podcasts is that you can find a podcast that you like and then you don’t really wanna scroll back all the way to the beginning
to find the episodes that really pertain to your situation and it’s really hard to sort through all of those episodes to see what would be helpful for you. So in order to help you listen to the parent I e P lab, either if you’re new or maybe you’ve been listening for a while, but maybe you don’t remember all of the good episodes that might pertain to you.
We have a gift for you today, and I’m so excited to bring this to you. So our podcast listening guide is here. It’s ready for you to download straight from your email. We’ve been working hard to select the most helpful podcasts and arrange them into categories, including if you’re new to IEPs, there’s a category for that.
So you can look up the ones that were most helpful for you to get started and get acclimated to IEPs. And also if you have like a neurodivergent student, well, we have [00:04:00] ones that are designed specifically for kiddos with d h, adhd, anxiety, autism, anything that kind of falls into that neurodivergent category.
We also have a category for learning disabilities and we also have a category for students with more medical needs. We also have a list for top downloaded episodes and we also of course, have a list for the top downloaded episodes as well.
The guide has episodes hyperlinked into it so that you can open it on your phone or your computer and just listen in one click. So go ahead and get your copy. You can go to the iep lab.com/listen and that link is below this episode in your podcast player as well.
And I hope you enjoy this guide so that you can actually have some help with finding the episodes that most pertain to your situation. So let’s get into today’s episode with my friend and former coworker, Dr.
Liz Legio.
I’m excited to be here. So we are talking about, mainly, I know we’re gonna be on tangents a little bit and that’s okay. But we’re mainly talking about the difference between [00:05:00] outpatient diagnosis, like clinical diagnosis and an educational label.
So why don’t we just start out with telling us a little bit about yourself, why you got into being a psych, and why you chose to be in both of the settings that you’re in. Gladly. Yes. So I, so my program that I went through for my doctorate was a school psych program, right? So really gearing us, um, to really work in the schools as school psychs, while also allowing us and training us to also work on a clinical setting.
And so I did my formal internship in a school, right? So it was that year, kind of full-time placement in a school, and I really loved it and. I had such a lovely time doing it that I wanted to stay in the schools to some capacity. However, I also wanted to get an understanding of what a clinical setting looks like and what a, you know, what the kind of issues that come up and arise in a clinical setting versus a school setting.
And [00:06:00] so, Basically, I was offered this beautiful opportunity once I graduated to split my time in a school setting and in a clinical setting, and kind of get the best of both worlds for me, which I’ve really loved. And so do you just do assessments in that clinical setting or do you do other services as well?
Okay. Correct. Yep. I’m a testing psychologist in the clinical setting only assessment. Yep. Awesome. And can we just dive into what is the difference between getting a diagnosis? And maybe tell us a little bit, because that diagnosis part, I don’t know if people know. What school or what psychologist diagnosed versus what a doctor diagnosis.
So maybe tell us a little bit about that. Yeah. It’s so confusing, right? And there’s so many terms and, and there are so many, acronyms to get through. Absolutely. So, As a psychologist, as a clinical psychologist, in the practice that I work in, I typically will and I work with, um, [00:07:00] with kids and adolescents and young adults.
And really kind of the primary referral concerns that we’re getting are, are issues. Related you know, anxiety, depression, mood struggles, um, autism, A D H D. Mm-hmm. Definitely learning struggles and then, you know, anger management components and those kinds of pieces. Um, so really when folks are coming into the clinical setting, they’re saying, man, there is some kind of functional impact.
There’s something that’s happening for my kiddo or my adolescent, you know, they’re, it’s affecting their home life, it’s affecting their school. Um, right. We’re seeing just these struggles and we kind of wanna know what’s going on and what, what it is, right? Like what is this? Mm-hmm.
Help us understand. And so that’s my role as a psychologist in that clinical setting to really work with families and they, and the young people and the kids and say, okay, let’s try and get a sense of like what this is. What are these [00:08:00] symptoms that help us guide recommendations?
Those recommendations can impact school, absolutely. Mm-hmm. But they also are outside recommendations, right? Like psychotherapy or occupational therapy. Mm-hmm. Or speech and language therapy. Right. Yeah. So that’s really interesting too cuz like when people come to like say outpatient OT or S L P, like. We can’t diagnose, so they just might show up without a diagnosis and we’re just like, okay, like fine motor skills or sensory strategies are low, so we can give you these strategies.
Whereas you can actually like actually give them an answer. The diagnosis? Yes. And then what does that give them? Okay. So they have a diagnosis of Yes. Autism or a D like yes. Thank you. That’s such a good question. Yeah. So as a psychologist, you know, and we operate off of the, the DSM five, right?
Like the diagnostic and statistical manual, and so we can give a formal medical diagnosis. Right. Which kind of goes into that piece of, that’s different than an educational identification. Mm-hmm. Yeah. [00:09:00] With a formal medical diagnosis, right? For example, a medical diagnosis of A D H D, they can take, the families can take that report, that formal diagnosis, they can take it to their pediatrician or primary care physician.
And that really, um, That’s that body of evidence that that medical doctor will typically look at and say, oh, okay. I know what this is, right? This is a D H D. If we’re gonna do a medical intervention, I know then as a medical doctor or a psychiatrist, mm-hmm. Then that gives me the information on what to treat and how to treat it.
Okay. As a psychologist, right. I don’t do anything in the world of medication that’s outside of my area of expertise. Okay? Right. Because I’m not a medical doctor. Psychologists don’t prescribe. Mm-hmm. That’s a psychiatrist, which, or like a primary care doctor. Mm-hmm. Which is what gets super confusing for folks, understandably, all the time.
Yes, totally right. So I hear families all the time that are like, okay, so we’re gonna see you if you know [00:10:00] you’ve diagnosed A D H D. So what medication do you recommend? And it’s like, oh wait, we can talk about, I mean, we can talk about medication as an intervention, it’s effectiveness and the research and literature.
That supports that. Mm-hmm. But as far as specifics, we always say like, Hey, hey, hey, we’re gonna send you to the medical folks because that’s not our area of expertise. Okay. We’re not medical doctors. We don’t prescribe. So then they, so a family could take that report, say for example, that um, you know, we make a medical diagnosis of like major depressive disorder.
Or generalized anxiety. Mm-hmm. You know, that can be also, that can be a medication intervention where they talk to their physician or a psychiatrist about what medications might help treat that. But then we also give recommendations towards what type of other treatment might be beneficial. So psychotherapy, right.
Or um, You know, in some situations it might be, you know, um, therapy to help with, uh, traumatic experiences, right? Or more [00:11:00] animal assisted therapy or equine therapy, just really depending on the nature of the difficulties and, and what that young person or kiddo needs.
And then the other thing related to that therapy piece is that I think that diagnosis, from my experience in the clinic open opens up. More payment options with insurance to cover things like o, ot, p t, speech, that kind of thing. Right. That is my understanding as well.
Yeah, absolutely. Yeah. Yeah. So for many insurance companies, and honestly for many, you know, for many treatment providers Right. To, to bill. They, they need kind of that formal diagnosis mm-hmm. Um, to move forward. So that does help open the door for families. Absolutely. They get more access to services because services are so expensive otherwise, right.
I mean, yeah. Or they have, like, if you don’t have an official diagnosis, you get like seven sessions a year. Mm-hmm. And most clinics don’t work like that. They should work like that, but they don’t. Right. So then you’re like really limited on what you can access, so, [00:12:00] Absolutely. So, um, I’ve always wanted to ask you this question.
Oh, I understand because I get different answers. So, who pays for this, this diagnosis? These outside evaluations? Mm-hmm. Yeah. In clinical setting. Yeah, that’s a really great question. Yeah, that comes up all the time. So, It really, really depends on, it’s so dependent. So it can, it depends on the insurance that someone has.
It depends on the need and the resources available in the community. So typically in the setting that I work in, we accept, we accept a broad range of insurances at the practice that I’m at and Medicaid. So typically, right when folks come in, it really. For many, I will say for many or for most, their insurances will cover part of the evaluation.
Okay. And they do typically [00:13:00] have some out-of-pocket costs. Okay. So it is also, it’s also dependent upon insurance. Like what? What they will, depending on what the referral question is, right? And the referral question, meaning what is the right, what is the concern that the family has, right? Mm-hmm. Do they have, do the, does the family have concern about attention and concentration concerns?
Is it solely learning struggles that we’re wondering about? Because some insurances will say, Ooh, you know what? We’ll cover, we’ll cover digging into all these, all these other areas, you know, like all these other diagnostic. Areas like a D H D, autism. Mm-hmm. Mood pieces. But you know what, we don’t cover just learning struggles, right?
We don’t. If you come in and your only concern is that, you know, you’re, you’re, you’re worried about your child’s ability to, you know, read, write, and do math. A lot of insurances are like, we don’t cover that just by itself. Okay. And so as a psychologist, you [00:14:00] know, typically in the, in the interview process, with parents.
What we also really wanna dig into is, okay, so if your kiddo is coming in and you have concerns about, you know, their ability to read, um, compared to same age peers, right. We’re also really looking at the other areas that can impact their functioning, that might also be related to that, right? So we’re gonna ask about, Hey, we wanna make sure that this isn’t because they have a problem paying attention, right?
Or because they don’t have anxiety surrounding some of these subject areas or in school. So a lot of times that’s a really lovely way to kind of, um, get past that piece with insurance where we’re saying, Hey, We wanna make sure that we’re not missing anything. So we’re gonna dig into more than just their, their specific learning struggles.
We wanna make sure, right, but it’s not, it’s not due that their struggles with learning aren’t due to some of these other factors, and we really can’t assess that. Without digging into it. Right, yeah. And doing some formal [00:15:00] testing surrounding those areas. Yeah. So this way That’s awesome. Yeah. Oh, sorry. So if, um, like say I wanna bring my child to be evaluated, but money is a big issue, could I like call the office and talk to somebody about it first and kind of feel it out?
Yes, absolutely. Okay. So we have, I mean, typically I would say at the majority of practices, right there is that person, that billing specialist, okay. That is really committed to folks generally speaking, to not have any surprises with cost. Okay? So folks are typically gonna get a sense of what their costs are for an evaluation before they ever get far into it.
Nobody oh my gosh. Nobody wants to be surprised, myself included with some outrageous bill that comes in the mail and you know, you’re shocked and you’re like, oh my gosh, I can’t afford that. And that’s not what I was expecting. And that’s way more that I am able to pay. Yeah. You know, so I think I would say for the most part, practices are very, Cautious and [00:16:00] understanding of that, you know, of not being, mm-hmm.
Of not having those costs be a surprise. Okay. That’s awesome.
how long does it take you? From start to finish, how many hours do you think you have in one evaluation?
Oh my goodness. Well, so there, there, this goes into something else too, right? There’s a difference between testing and assessment measures. Mm. Okay. Right. So testing, the actual testing, which involves like norm referenced, you know, test that someone sits down and does like an IQ assessment or a cognitive assessment or executive functioning testing.
Formal executive functioning testing. Mm-hmm. Formal academic testing. Right. That. In and of itself often takes in a clinical setting, right? Those components take several hours. Yeah. And then actual assessment measures involve like clinical interviews, right? Mm-hmm. Observations, collabor. Yeah. Talking to the school, doing observations and those pieces.
So, uh, you know, a clinical [00:17:00] assessment, you know, is, is a, it’s a pretty time consuming process. It takes many hours and um, which is why it’s comprehensive. Mm-hmm. Which is the p Cause you’re digging into so many pieces. Mm-hmm. I think that’s so good for setting parents up for that expectation.
Hey, it’s not gonna be like, Two hours, then you get a diagnosis spit out on a receipt at the end, like Exactly. Yeah. It really is a more involved process than that, which is awesome, and that’s why there’s so much time to do the I E P too in the school setting because so many people are doing so many things that are similar to that.
Right, exactly.
So then let’s transition into what an educational label actually is. Yes. So, you know, when we, when I say the difference between, you know, I referenced earlier a medical diagnosis, right? Mm-hmm. That’s that clinical setting, that’s that, um, you know, medical diagnosis that you would get from, you know, a psychologist, a psychiatrist, or from a medical office, right?
[00:18:00] Mm-hmm. Where it goes in your health record to say, Hey, this is what it is. And educational identification really is, Different in that, and educational identification is something that school districts use, to describe a set of, you know, struggles or difficulties that a child experiences, but it’s not a formal diagnosis.
Right? So for example, can I give an example? Yeah, of course. Okay. So for example, right, if we’re saying, Hey, you know, um, we are, we are seeing these symptoms in the school setting that are really consistent with those on the autism spectrum. Mm-hmm. And we’re gonna move forward with special education and we’re gonna move forward with an educational identification of autism that doesn’t necessarily translate to that student being able to.
Have outside services like a b a therapy or occupational therapy or speech language therapy mm-hmm. Provided [00:19:00] to them, because it’s an educational identification. Right. So in the school setting, we can’t formally diagnose, if that makes sense. Mm-hmm. We can only identify a set of care characteristics or struggles or deficits and identify them educationally and say, here’s what we’re gonna do.
Here’s the criteria that you meet. Um, according to Right, like the checklist. Yes. Right.
Um, so I’d love to go through a couple different situations that we both encounter. And the first one is somebody who has a child with an educational label of say, s sl D. And I see this one all the time. I hear this all the time. Hey, my kid was just given this educational label of a learning disability, but nothing else.
So like they feel like they have this label, but like they don’t actually know how to help them or what it actually is. So can we talk about like what would be the advantages of going and getting more testing from an outside [00:20:00] evaluation? Sure. A caveat to this really would be is that I think sometimes too that the, and I’ve heard this as you have heard this, that IEPs can be really, the actual i e P document can be really difficult to read, right?
It can be really confusing. It can be really hard to understand. I mean, I think that my caveat to, to part of this conversation too, would also be to really support and recommend parents, um, meet with the case manager of the I E P also and go through the i e P together once they’ve received it, if they’re confused or if they have questions.
I think a lot of parents are wondering like if they have a specific learning disability in reading, do they have dyslexia and some states are going ahead and like doing that testing, but Colorado isn’t at that at this point.
It just falls under that S SLD category, and so I think that’s kind of a hot button topic that comes up that parents are wondering about too. Yeah, [00:21:00] that’s a great question because dyslexia absolutely is a hot button topic and, um, color, department of Education even recently put out some information specific to kind of some myths about dyslexia.
Mm-hmm. Okay. Um, kinda that fact sheet. So I, what, what I often see in a clinical setting is if families get a specific, learning disability, educational identification in school, Especially when it comes to reading and they want a formal medical diagnosis that says the word dyslexia
because those are, that child struggles, right? With phonological awareness, spelling, automaticity, those pieces that make up kind of that aspect of dyslexia. To, to have, to have the term dyslexia. Yes. That typically comes from a formal psychological evaluation. Mm-hmm. And to, and to get that specific support.
Um, Man, this is difficult to even explain sometimes because [00:22:00] in schools, you know, what we typically see is right that they will have reading struggles often in elementary school, potentially related to phonological processing, automaticity, spelling. Mm-hmm. And those kinds of pieces. But schools are also wanting to say, Hey, we also wanna provide support in reading fluency.
Right? And how quickly and accurately can read in reading comprehension. Right? So it’s kind of oftentimes overarching reading goals, right? Yes. To all of these needs. Um, and so if parents, If parents want more specific support or more clarity on, okay, is this dyslexia? Yes. Then we often see them coming to a clinical setting.
Okay. Caveat, can I, the, the caveat also there is that in a clinical setting, you know, dyslexia really does fall. I mean, it really does fall under that general DSM diagnosis of a reading disorder. Right. Ok. And we, I typically talk about it in terms [00:23:00] of. Here are the specific areas, right? It’s phonological awareness that are struggles.
It’s automaticity how, how automatic and effortlessly that child is able to recognize sight words or familiar words, right? And then that spelling piece. We still typically diagnose it as, at least in our practice, you know, a, a specific reading disorder. And then we kind of talk about it in terms of with, you know, commonly known as dyslexia.
Right. But we’re also making sure that, that folks are aware there is more to a reading disorder than, than characteristics of dyslexia. Okay. That makes a lot more sense. So there’s, it’s a lot deeper topic and that’s probably why it’s a hot button topic, because it’s so complicated. So yes, yes. A reading, yes, a reading disorder or a specific, um, you know, a specific learning disorder in reading is the big umbrella.
That’s what you see is a big umbrella. And [00:24:00] underneath that umbrella are kind of the different areas of struggle, right, that someone can have with reading. Sometimes those can be characteristics commonly known as dyslexia. Other times those can be characteristics or symptoms that are consistent with reading comprehension struggles, right?
That person may do really well, you know, being able to decode words they might be able to do really well. Um, you know, with automaticity, they recognize sight words. Their spelling is in the average range. But their comprehension is really a struggle, and that’s the area that they’re having a difficult time, right?
We’re reading fluency, so how quickly and effortlessly I’m able to take all these independent pieces and, and put them together and read effortlessly. So think of the big umbrella that is a specific learning disorder and reading, and then the pieces underneath it that are the specific pieces. And that’s probably why it’s so nice to have [00:25:00] that evaluation, to have somebody explain exactly what that profile is.
And that’s what you’re saying. You can sit down with the case manager and they can go through what they found in the I E P, but man, it’s a lot more detailed in this, this diagnosis process. Right? Right. And likely in Colorado, you are not going to hear, you’re not going to hear folks in a school setting typically talk about the term dyslexia.
Yeah. So we never even talk about it. I mean, it, it comes up in like parent requests, right? And like concerns. Or they, they say that they have dyslexia and they’re worried that their kid does, right. That kind of thing. But for sure. So let’s move on to this second kind, common example that happens is, That a lot of times parents will be pushing for an I E P and they, they know that their kid needs more support.
They’re trying to get through this crazy system of getting them more support and maybe they have gotten denied a couple times [00:26:00] and not gotten the testing done through school. So they’re like, I know something’s up. Let’s go get like an outside evaluation. I. And then kind of talk us through, if that happens to you a lot, and then what happens when you bring that evaluation back to the school?
Yes, I can actually talk about it too, on both ends of being school psychologist, that that receives outside clinical evaluations. Mm-hmm. As well as being the psychologist that sends outside clinical evaluations. That’s why you’re here. You’re the perfect person to talk about this. So, uh, with both sides, I think that’s, Um, you know, that’s allowed me to get some really lovely perspective of what happens, and how frustrating it absolutely can be for parents, which I hear all the time.
So, in the clinical setting, I often have parents that come in and. You know, it’s not so much that they’re necessarily, it’s not so much like an adversarial situation with the [00:27:00] school. Right. It’s, I, I don’t typically hear, you know, I don’t typically hear these, these, oh, you know, I’m so mad at the school for not doing this.
It’s more confusion about why, right? Mm-hmm. I don’t understand. It seems like my child is having a ton of struggles, you know, from my perspective. Mm-hmm. And you know what I keep hearing from school or you know, I feel like maybe my voice isn’t heard at school. Yeah. With the folks I’ve been talking to and you know, I just, yeah.
I feel like maybe we’re not getting anywhere. I don’t, I don’t even know the support that they necessarily need. Yeah. I just wanna have kind of someone talk to me about that or hear my voice or explain why, right. Yes. In a way that maybe I understand. Or that makes no sense to me. So, And generally too, you know, if, if parents are coming in and they’re having, you know, and they’re seeing, or they’re concerned about school performance more often than not, They’re often [00:28:00] reporting similar struggles at home, right?
Yes. Whether it’s, whether, you know, so I mean it’s, it’s often really consistent. Rarely do I ever work with a family where they’re like, oh, it is only happening. These struggles are only happening in school. Mm-hmm. Yeah. It’s typically where they’re perceiving these struggles happening in the home too, and so they want some support as well, so.
From the clinical perspective, when I meet with a family and we talk about, like, we go through, you know, we do an evaluation or we do an assessment and you know, at the end of the day their child or their young person might come out with, you know, a formal diagnosis of something. Right.
What is hugely important in a clinical sense for me is to get input from the school. Mm-hmm. Absolutely. You know, and that’s part of, you know, when folks are looking for an evaluation right? Or looking for someone to do an evaluation, which we’ll probably talk about, right? But getting that school piece and getting that perspective from school.
So I like [00:29:00] to, you know, my rule at them is really, I like to work with the school, work with the teachers, communicate with the teachers, get a sense of what they see or what they don’t see. In school and talk about maybe why there would be a discrepancy between what you know parents are seeing at home versus what they’re seeing at school.
And so, you know, a lot of times too in a clinical setting, I talk to parents about what is likely, you know, what they’re likely to expect, um, from a school when they take this report to them. Right. That’s really nice that you do that. I don’t feel like everybody does that. Do you?
I mean, a lot of folks in our office, a lot of, yes. Most folks in our office do because mm-hmm. We do wanna work so closely with the school and not have it be an adversarial situation.
Yes. Like a versus them situation. Yes. Because at the end of the day, that doesn’t benefit the, the child. Mm-hmm. Agreed. What the, the words that I typically will talk about with, um, parents is educational impact, [00:30:00] right? Mm-hmm. And when I then put my school psych hat on, we’re gonna be talking about the same thing, that educational impact, right?
Mm-hmm. So talking about, okay, so depending on the struggle, right? Depending on the symptoms or what we’re talking about, does school see the same? Does school see an educational impact? Does school see struggles that are, you know, above and beyond what we would typically expect to see with a typ, you know, with the same aged peer?
Mm-hmm. And that can be really hard because I think a lot times parents talk to me about, well, their grades, right. A lot of it has to do with the grades. I’m really concerned about their grades and they’re not passing or they’re having these struggles. Mm-hmm. And I think what gets truly miscommunicated a lot of times is that in the school setting, you know, we’re really not, grades are absolutely important.
I don’t wanna say that they’re not. They are not always the most, um, Realistic picture of what that child is like capable of doing or able to do. Yeah. They can often be, grades can [00:31:00] often be so very subjective too. Mm-hmm. Per class. Mm-hmm. And so it’s really it’s really hard to know. Um, you know, when if this child has, you know, an a, a B in one class and an F fn one class, we really have to dig in and see, okay, what is the difference?
Right. Why, why is it. Is this child getting something in this class where they’re, you know, performing, where they’re getting A’s and B’s, you know, what are they getting in that class that maybe they’re not getting in this other class? And it really. Kinda then devolves in, evolves into this like, brainstorming session mm-hmm.
With, with school, with parents, with me as the outside psychologist or with the school psychologist in the building or the school counselor in the building. Yeah. Because so, so many different times too. Like what I hear a lot is, Oh, they’re failing this class. And then if you dive into it, sometimes it’s that they’re not turning stuff in.
Right? Right. And so you’re like, oh, you just need [00:32:00] support with how to keep organized or those skills to build organization. And like, that’s not necessarily about the learning piece at all. That’s the environmental absolute, the end piece. Yeah. Yeah, for sure. And so, and when I think when I’m, you know, when I think about giving parents, you know, support in those realms, Really what I would recommend the most is to really, have kind of like a facilitated conversation about, you know, and explaining, okay, let’s dig into some of these grades, right?
Let’s dig into some of these pieces, why they might be struggling. Mom, dad, parents, you know, when you folks, what are your real concerns at school? Right? Mm-hmm. Like, let’s really dig into those and see, and see if your concerns. Are consistent with what we really see at school. Because oftentimes from a school psych perspective at school, you know, we’ll have parents that say, oh my gosh, we have all these concerns about, these emotional responses that are happening at home and at school we’ll dig in and we’ll say, okay, let me observe this young person, right? [00:33:00] Or this kiddo, let me talk to their teachers. Let me, let me observe them during lunch and see how they’re doing with their friends.
Let’s really dig in and see what we have. And a lot of times, not all the times, but a lot times there are these conversations with parents where we’re like, Hey, This is pretty typical behavior of sixth grade, right? I mean, yes. We see a lot of sixth graders. It is not just your kid. Right? So it can be a very normalizing and validating experience, I think sometimes too, to parents.
Mm-hmm. And so, but that always isn’t enough, right? Sometimes parents are like, Nope, I really have these major concerns. I need more. I really just feel like I’m not being heard, right? Yeah. And I feel like that educational impact, that’s actually the next topic that I was going to get into is this part is so hard.
Mm-hmm. And gosh, your evaluations are so much more intense than I think I realized, because I don’t do that part in the I E P process, and I know that we try to observe in class, like there for [00:34:00] certain categories you have to have an observation in there, but it is just like all encompassing, like you’re digging into every part of that part’s life.
But the hard part is like say that somebody has an outside diagnosis of autism and they bring that to the school and the school’s like we just don’t see educational impact. That happens quite a bit and it sucks, and I don’t know, well know how to explain the educational impact part. I think there’s piece too that psychoeducation for parents that you know.
You know, that medical diagnosis, that diagnosis of autism is not synonymous necessarily with needing an iep. Mm-hmm. Either sometimes. Yes, definitely. Right? Sometimes, depending on the intensity. The frequency, the severity of the symptoms or of the behaviors? Absolutely. An i e P is appropriate to get that child the support that they [00:35:00] need.
Mm-hmm. I think a pretty regular misconception is that, that this diagnosis clinically equates with automatically getting an iep. Mm-hmm. Or even needing an iep. Yeah. I mean, I can say from experience that I’ve worked with several young people where, you know, I’ve met them clinically and diagnosed them with autism, but they have some absolutely beautiful skills and they’re really able to access their education.
Um, With, really with some minor supports and some minor accommodations that don’t necessitate needing that intensive support that comes with the, with an I E P. Mm-hmm. So I, you know, I just hope that parents, you know, that, that that’s maybe a piece for parents too, because that’s not always in the child’s best interest either, is having Right.
This really intensive Yes. Tier three special education support. Not all students need that. Mm-hmm. And the knowing. The knowing that piece [00:36:00] can be really hard though. Yes, for sure. Well, and that’s interesting that you say that because in the autism groups that I’m in with actual autistic people in there, they’re saying the same thing about outpatient therapy too.
Like okay, like if the child is struggling, And wants to communicate but can’t. Okay. Then go get speech. If they’re struggling with a specific thing that they need help with and that it’s making them upset, then yeah, they might need that. But this total, like prescribing a b a every time prescribing OT speech every time for just because it’s that diagnosis, I think that’s gonna go away.
And so that i e p process is, I think, a, a pretty good one to determine like, no, you actually have to prove the needs and like, What that service is actually addressing. Yeah. Because it’s not just a given anymore. Absolutely. Which I love actually. And there are many situations where, right, where a young person.
Absolutely benefits from an I E P [00:37:00] because Right. We have a bunch of evidence to support that there is a significant need. Mm-hmm. I, you know, I just, I want parents to know that there are other ways to get support for your kiddo and your young person without having. You know, to always go or necessarily go that, you know, that special ed, that i e p route.
Mm-hmm. Um, cause there are lots of other ways that we can really brainstorm and get formal supports for that young person. Without it being as intensive necessarily as what an I E P involves.
sometimes I’ve even seen some doctors write on prescription pads.
Child needs an I e P, here’s a prescription Yeah. For it. Yeah. I, I just want parents to know that really, you know, They are separate entities, right? Clin, you know, an outside evaluation. Mm-hmm. An educational, um, i e P evaluation or evaluation for an I E P. Um, and, and that, you know, one is [00:38:00] really not synonymous just by itself with the other, right?
Mm-hmm. That having, having a clinical report and handing it over to the school and saying, this report says that my child needs an I E P and you have to give it to them because it is written in this clinical report. That often can be off-putting for a school, right? Mm-hmm. That’s true. My hope, my hope to other providers too, right?
Is that we’re all really cautious of, of our language when we’re writing reports and we’re really cautious of saying, you know, we wanna advocate for that child, certainly. Mm-hmm. But we also don’t wanna create a situation that is adversarial between school and, you know, and the child and the parents.
Mm-hmm. Because that doesn’t, that doesn’t help. Kiddo. Mm-hmm. So just kind of that piece of, that, that evaluation report, you know, when you’re gonna bring that to the school, really talking to the school about, Hey, how can we incorporate this information that I got from this outside report?
How can we incorporate that [00:39:00] into your, into your knowledge about my kid? Right? Mm-hmm. And I just want you to look at this report and read through it and just have another sense, have another piece of information about my kiddo and my child mm-hmm. That maybe you folks didn’t know, right? Mm-hmm. And so coming at it from that angle, in my experience, has been the most productive for parents and produces
the most, the most benefit and the most support for the, for the kiddo or the audience. Yes. Yes. Approach is so important. Absolutely. Because, and I think having the assumption that everybody wants to do their best and wants to support the kid in keeping the child at the center Yes. Which I talk about all the time, is really the best way to go.
Oh my gosh. And to avoid those kinda territorial pieces of Yes, well this, you know, this clinical person is telling us what to do and they’re not in the schools and the school person Right. Saying, well, we know this. Yes. And, and it just, yeah. Working together, like you said, and, and, and how best. How [00:40:00] best to get there at the end of the day to get that young person or kid what they need.
Yeah, exactly. Oh my gosh. Thank you so much for coming on the podcast. I have loved having you here. I always learned so much from you. I, I remember the first I E P I was in with you. And I just like turned to you and I was like, I actually understand what you’re saying, like all this. Are you saying that sometimes psychologists talk a lot about data and numbers and that sometimes it’s hard to understand what we’re saying?
Mm-hmm. You’re so succinct and like, so parent friendly and like team friendly in general so that we can learn so much from you. Thank you so much for being here. Thank you. And Beth, thank you for all the work that you’re doing to help parents and, and be an advocate for, for kids and young people. It’s.
Incredibly important and in a system with so many hoops to jump through, I think the more support that families can get and kind of knowing how to get information, you’re doing an invaluable service. Thank you for what you’re doing. Thank you. I’m very much [00:41:00] enjoying it, especially cuz I get to learn on the process as well.
Thank you.
Samson Q2U Microphone-3: Thank you so much for listening to that episode with Dr. Liz Gio, and an extra special thank you to Liz for coming on and sharing her amazing wealth of knowledge with us. So I hope that episode of discussing that outside medical diagnoses versus the educational label gave you a little bit of clarity, and if you have any further questions, maybe you’ve been through a school not accepting an outside evaluation, or you’ve had trouble with getting them to implement some accommodations or recommendations or want to know how to present it.
If you’re just getting a new outside evaluation, then head over to the Facebook group. That link is below this podcast in your podcast player, and you can also find the link to download your free parent IEP Lab podcast listening guide, which is brand new as of this episode.
And you can go to that link@theieplab.com slash listen. And that link is also below this podcast in the description as well. Thank you so much for listening, and I’ll see you same time, same place next week. Thanks so much.