Doctors and Schools

Some of the most important professionals in your children’s lives are their teachers and their doctors.  Parents depend strongly on the skills and knowledge that these professionals bring to their jobs.

Teachers often have an opinion about what the doctor should do, and doctors often have an opinion about what the teacher should do for a child.  It can be a real problem for parents to sort it all out, particularly since some medical professionals are not supportive of schools and school staff, and our culture gives doctors a much higher level of respect than teachers.

Experienced teachers have seen lots of children with various medical problems, and they can be very accurate in referring families for medical concerns.  But all they should do is state the reasons for their concern and the symptoms they observe, and then make the referral.  Teachers cannot make a medical diagnosis.

It is also inappropriate for principals, school psychologists, and guidance counselors to make medical diagnoses.  And nobody at a school should ever tell you that your child needs medication.  That’s actually against regulations!  It is appropriate for school staff to give you their observations and their concerns, but after that any decision about medication is just between you and your doctor.

By the same token, experienced doctors have seen lots of children with developmental problems, and they can be very accurate in referring families for educational concerns.  But all they should do is make the referral to the school by calling or writing a note to the teacher, the principal, or the Child Find Coordinator.  It is inappropriate for doctors to write “Billy Brown needs an IEP” or “Amanda Smith is learning disabled”  or “Josh Jones needs speech therapy” on a prescription pad.  Doctors do this all the time, and parents often think they have a doctor’s order for services.

Doctors give orders in medical settings, but they cannot order a school to do anything.  I’ve never met a doctor who understood the disability guidelines or the legal process for determining eligibility for special services at school. A doctor’s order does not supersede or replace those guidelines or that process.

Doctors provide important information for determining eligibility for services, and any medical information must be considered in educational decisions, but it is just one piece of a comprehensive evaluation.

When doctors suspect developmental disorders in children, they use medical and psychiatric guidelines to arrive at a diagnosis.  The guidelines for these diagnoses are not the same as those used by school psychologists, speech pathologists, occupational therapists, and educators when determining eligibility for school services.

Educators must use the federal law (IDEA: Individuals with Disabilities Education Act) and state regulations to determine if children are eligible for special education services.  IDEA defines the disabling conditions that can be addressed through special education.  Eligibility has three prongs: the child has a disability, the disability adversely affects the child’s educational performance, and the child requires special education services in order to receive a free and appropriate public education.  All three criteria must be met for a child to be eligible for special education services.

Educators also use Section 504, another federal law, to determine if a child with a disability requires “reasonable accommodations” to participate successfully in regular education.

Doctors often refer parents to private agencies for evaluation in situations in which the school system is able to provide the necessary evaluations at no out-of-pocket cost to parents.  Parents may prefer to have their children evaluated privately, but they should know all the options before making that decision.  Just because something costs money doesn’t mean it is better!  I have seen many sloppy, low quality private evaluations over the years, and many excellent ones provided by school personnel.  And remember – the school evaluations are not actually free.  They are paid for by your tax dollars.

Doctors make diagnoses.  Educators determine eligibility for services.  Doctors use medical diagnostic guidelines; educators use IDEA and Section 504.  A doctor’s diagnosis alone does not make a child eligible for special services at school.

Just as school staff should never demand that a doctor give your child a diagnosis or medication, doctors should never demand educational services or an IEP.

Doctors and school staff must respect each other’s knowledge and expertise, and understand that the medical system and the educational system have different rules and procedures.  Medical and educational professionals should focus on providing the information and expertise necessary to help you know your options and make the right decisions for your child.           

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