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Diagnosis from school psychologists

Briefly, under federal law, a DSM diagnosis is neither required for nor sufficient for a diagnosis under IDEA's categories. The requirement for a DSM IV diagnosis may vary from state to state, if a state requires a DSM IV diagnosis for ED, but even then it is not determinative in establishing entitlement under IDEA or Section 504.

You can make a DSM IV diagnosis if you are qualified to make a DSM IV diagnosis according to OSEP. Being qualified means you are certified but it also means you have the appropriate experience and training. The latter only you can decide. Still not only OSEP but the President's Commission has said that school psychologists are eminently well qualified to diagnose ADHD.

School psychologists are not supposed to be making EDUCATIONAL diagnoses of disability. You may diagnose a child as having an attention deficit hyperactive disorder (although I rarely do because I believe that diagnosis should be multidisciplinary.) You should not be diagnosing the child as "Other Health Impaired" because OHI implies entitlement, and only IEP teams are empowered to make that determination. (My basis for wanting medical input even under Section 504 is that the diagnosis of ADHD is a process of elimination, and you can't eliminate non neurological medical causes, like allergies or pinworms, without a complete physical. But that's just me.)

Additionally, with respect to ADHD, if your state requires a medical evaluation before a team declares a child to be OHI, then your diagnosis of ADHD would not entitle him under IDEA but still could under Section 504.

Educational entitlement is also a group or team decision under 504, and DSM IV (or ICD 10) disability labels (unlike the OHI label) do not automatically imply entitlement under Section 504 either. In the ICD, even flatulence has a number. (Although I'd be more than willing to grant a child with that disability testing in a separate room as an accommodation.)

Guy, SP


Name of Symptom/Sign: Flatulence

ICD-10 code: R14

ICD-9 code: 787.3