Dear Dr. Browne,

My co-worker has a 7-year-old son who has already been retained once in kindergarten, and now the school says he has not learned enough to proceed to first grade next year. The school psychologist has advised my friend that she should take her son to a doctor to have him evaluated for possible petit-mal seizures. The classroom teacher has also suggested that the boy may have ADHD, or even be autistic. Does the school have any further responsibility for evaluating the cause of the boy's problems? My friend wants to do the right thing for her son, but she is also worried about how much she will have to pay for all the suggested testing. What would you tell the mother to do?

Sincerely,

A concerned friend

Answer:

Dear Concerned Friend,

This is a concerning situation. It is very unusual for a child to be retained twice in kindergarten, let alone that the school psychologist is suggesting a number of serious diagnoses that may be affecting this child’s progress. Autism is usually discovered and diagnosed at a much earlier age. It is a serious diagnosis and can impede a child’s school progress. In contrast, ADHD or petit mal seizures are extremely unlikely to keep a child from learning and progressing to first grade.

My answer is limited by the small amount of information available in your question. I would like to know what types of evaluation the school has completed and the results of those evaluations. Legally, the school should do a thorough evaluation in the areas of suspected disability if there is evidence that a child is not progressing appropriately and particularly if a parent requests such an evaluation.

My advice is that your friend should talk with the school psychologist again to obtain more details about her son’s assessment. The parent should request in writing an assessment for special education eligibility. The request for assessment should be mailed to the district’s Director of Special Education. There is a legal timeline that must be followed. The district will respond to the parent and prepare an assessment plan. No assessment or evaluation can take place without the parents’ signed consent. The parent should make her written request immediately as the assessment timeline stops during the summer months. I also think that she should bring her son to their pediatrician for a physical examination and share the school’s testing results and concerns about her son. Most pediatricians are able to evaluate her child’s development and make recommendations regarding further medical evaluations.

The most serious of the diagnosis suggested is autism, but as I said above, it is unlikely to remain undetected until a child is 7 years old. It is unlikely that her child has autism or two other, much less of concern, diagnoses of ADHD or seizures. Your friend should not be pursuing costly tests and interventions for now. The steps that I have outlined should be a sufficient beginning.

I would like to hear about the outcome of her concerns and particularly if my suggestions are helpful.

Kay S. Browne MD
Behavioral pediatrician