Diagnosis vs Eligibility
The Diagnosis and Eligibility table provides a comparison of autism evaluations for diagnosis as conducted in most private settings or autism specialty centers with autism evaluations for eligibility for Special Education services as conducted in the public schools in accordance with IDEA.
| Diagnosis | Eligibility |
|---|---|
| Based on a set of criteria (e.g., DSM 5-TR, ICD-10) | Based on federal law (IDEA) |
| A single condition with different levels of symptom severity in two core domains | Refers to a broad disability category |
| Used in private settings | Used only in public school system |
| May be determined by an individual or team | Must be determined by a team |
| Clinically significant impairment in functioning | Adverse effect |
| Generally lifelong | Reconsidered every 3 years |
Aspy and Grossman
Professionals who provide autism evaluations in public schools use autism criteria defined in IDEA or state guidelines. Some states use criteria from the same Diagnostic and Statistical Manual (DSM) as is used in the private autism specialty centers. Others use the definition provided in IDEA.
A strength of evaluations conducted in public schools is that the professionals who provide autism evaluations in public schools work as a team. This is spelled out in the law – IDEA. Including professionals with different backgrounds from different fields of training helps to address the many areas that may be involved in autism –
- sensory,
- communication,
- cognitive,
- social,
- emotional,
- motor, etc.
In private settings evaluations may be conducted by a team or by a single professional.
Regardless of the location of the autism evaluation, the characteristics of autism as defined in the DSM and IDEA are very similar. The main difference is the purpose of the autism evaluation in the public schools in the United States is to determine if there is a disability (autism) that may result in eligibility for special education services.
This requires a consideration of adverse effect.