School-Based vs. Clinical Evaluation: What’s the Difference?

By Eve Kessler, Esq.

AT A GLANCE

Evaluation is the first step in addressing learning difficulties or ADHD • Parents—especially those new to learning challenges—often are confused about the differences between school-based evaluations and clinical evaluations • Here is a straightforward explanation that will help you determine what’s best for your child


To be eligible to receive special education services, a child with suspected learning or attention difficulties must first undergo an evaluation to define and describe their problems. Based on the evaluation findings, an IEP or 504 Plan can then be developed to address their unique challenges through the implementation of special education supports and services.

Many parents are not aware that there are two types of evaluations—school-based evaluations and clinical evaluations. One is not better than the other. Each type is designed to assess different concerns, and depending on your child’s challenges you can determine which type will provide the answers necessary to help your child move forward. In some cases, both may be in order.

For students to receive comprehensive intervention plans that address multiple needs, it may be advantageous to have both school-based and clinical evaluations.

School-Based Evaluations

A free, school-based evaluation is required by federal law to determine a student’s initial or continued eligibility for special education supports and related services in public school.

Not all students who struggle in school are eligible to receive special education supports and related services. To be eligible, the Individuals with Disabilities Education Act (IDEA) requires that their condition meet the definition of one or more of the 13 specific federal eligibility categories and that their disability adversely affects their learning and academic performance.

The categories cover a range of difficulties and include Specific Learning Disability; Autism Spectrum Disorder (ASD); Speech or Language Impairment; Other Health Impaired (OHI), which includes ADHD; Emotional Disturbance; Hearing Impairment; Visual Impairment; and Intellectual Disability.

Process: A school-based evaluation collects information from a variety of sources, including a psychological assessment conducted by a school psychologist; an educational assessment by a certified special education teacher; and occupational therapy, physical therapy, and/or speech and language assessment by related service providers (e.g., occupational therapist, physical therapist, or a speech-language pathologist).

In addition to test data, it may take into account interviews with the student, parents, and teachers; behavioral observations; background history; and behavior/attention rating scales.

Results: The evaluation describes how your child presents in a school setting and uses educational criteria to determine eligibility for special ed supports and services under a particular disability category. It also gives the school-based team recommendations to help formulate appropriate interventions, modifications, accommodations, and goals and objectives for the student’s Individualized Education Plan (IEP).

The school-based evaluation will not make a clinical or medical diagnosis of a neurodevelopmental or psychological disorder.

Clinical Evaluations

Clinical evaluations use clinical or DSM-5 diagnostic criteria to make specific clinical or formal neurodevelopmental and psychological diagnoses (eg., anxiety, mood disorders, ADHD, ASD), which allow families to access medical, pharmacological and behavioral health benefits through their insurance providers and community-based treatment services.

Process: Clinical evaluations include psychoeducational, neuro-psychological, psychiatric, or multidisciplinary assessments administered by a clinical psychologist, neuropsychologist, or psychiatrist. They are based on comprehensive medical, developmental, social, behavioral and educational histories, record reviews, and psychological/neuropsychological testing.

Results: Clinical evaluations determine a formal diagnosis, based on a child’s overall clinical presentation/profile, and help families understand the diagnosis. They provide medical, home, and school-based treatment plans, recommendations, and referrals for appropriate services, including school-based and educational services.

Eve Kessler, Esq. a retired criminal appellate attorney, is Executive Director of SPED*NET, and a Contributing Editor of Smart Kids. This article is based on a seminar, Demystifying Evaluations and Helping Your Child Receive Appropriate Services, by David Porrino, Ph.D., a clinical neuropsychologist and Director of Diagnostic Testing at Sasco River Center, Wilton, CT., and Laura Heneghan, Esq.

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