Emotional Disturbance or Autism Spectrum Disorder

[5states1year]

Hoping someone can help answer a question to help this sweet child of mine out. 

Background: We have been fighting with the school district for 2 years now. First full evaluation was end of 2nd grade where they determined his autism score was too low to determine eligibility and because his grades were fine he didn't need services, not even a 504 plan. 

Fast forward to December 2022, middle of 4th grade. Something happened at school that he witnessed and his school refusal behaviors (that have existed since preschool) escalated like crazy and then behaviors at home escalated in sync. 

I requested a new IEP evaluation process or an IEE based off the denial in 2021. They granted the IEE, saying they would probably come to the same conclusion with their own testing and I would ask for the IEE again at that point. 

We had a company called the Cohen Institute do all of the academic and autism testing. The results came back with an A-DOS 2 score of 7 for ASD which is right at the bottom cutoff. They did other tests and their conclusion is still ASD. 

The school district psychologist got the report and called the Cohen Institute to ask more about the autism diagnosis and request speech and language evaluations. Cohen Institute doesn't do those so we are back working with another agency for them plus occupational evaluation to ensure no more delays. 

Concern is this: the district psychologist said they wanted more testing to determine if eligibility category should be Emotional Disturbance or ASD due to ASD results being on the bottom end of the testing. Most of his autism tendencies show at home or when in new situations or uncomfortable and he "holds it together" really well at school. 

He has autism. We are 100% sure of this. He's 10 and still acts like a cat regularly for one thing, and so many other signs, plus psychiatrist diagnosis in 2021. 

But the district sounds like they might determine Emotional Disturbance as the eligibility category.

So here's the QUESTION:

How do we ensure ASD as the primary eligibility category? 

This is particularly critical in our case because we anticipate that no public school will be able to meet his twice exceptional needs (unless there's a self-contained classroom that will let him excel at his fast pace) and we can qualify him for ESA funding to pay for private school where he can learn at his own pace. But the category must be ASD for full funding to actually cover tuition. 

Not only that, but I can see that the emotional stuff (shut down and extreme school refusal) is a result of him not getting services for ASD. (He has missed 40 full days and over 27 partial days of school this year and many other days that were a huge hassle to get him there.) 

I'm also concerned that he will be treated differently for ED than ASD. 

Please help. I honestly wish someone could attend the meeting with me if they go this route that can advocate for autism but I have 7 kids and one income and can't afford any fees for an advocate so I'm pleading here to at least get some guidance. 

Post Note: This school has called CPS on us and the cops twice for "signs" of abuse or neglect like physically helping him into the building and him having his hair uncombed and smelling like urine one day. And when he refuses to go to a class but is on campus and not causing a disturbance, they call and make us come pick him up. His primary complaint for school refusal is that he's bored and learns faster than the other kids. However, we are noticing that he is starting to struggle with completion of problems when they are a challenge, so that is probably adding to the frustration of school. 

[Carolyn Rowlett]

The school had their chance to do testing in all areas of suspected disability, and they decided not to.  If they didn't suspect ED then, why are they now?  What has changed?  Nothing.  I would not consent to the ED testing. The worst that can happen is they take you to mediation or due process, and it's ordered that they can test in this area.  In the meantime, they have to proceed with what they have, which is a psychiatric diagnosis and and IEE concluding ASD.  An eligibility determination must be held within 60 days of your consent to the evaluation (in this case, the IEE).  Hold them to that.  Don't allow them to put this off because now they're wanting to do further testing.  It sounds like you have a pretty strong case for eligibility in the category of autism. 

[5states1year]

3 hours ago, Carolyn Rowlett said:

The school had their chance to do testing in all areas of suspected disability, and they decided not to.  If they didn't suspect ED then, why are they now?  What has changed?  Nothing.  I would not consent to the ED testing. The worst that can happen is they take you to mediation or due process, and it's ordered that they can test in this area.  In the meantime, they have to proceed with what they have, which is a psychiatric diagnosis and and IEE concluding ASD.  An eligibility determination must be held within 60 days of your consent to the evaluation (in this case, the IEE).  Hold them to that.  Don't allow them to put this off because now they're wanting to do further testing.  It sounds like you have a pretty strong case for eligibility in the category of autism. 

The Cohen Institute Psychologist, who is on our side, sounded like the extra testing will actually help confirm the autism. I kind of agree considering it will show he is emotionally together?

[5states1year]

1 minute ago, 5states1year said:

The Cohen Institute Psychologist, who is on our side, sounded like the extra testing will actually help confirm the autism. I kind of agree considering it will show he is emotionally together?

The extra testing is basic speech and language and occupational. Not looking for ED but for more info to choose from. It's still independent party doing the testing and reports. 

[Carolyn Rowlett]

That's fine.  But I would still insist on having the eligibility determination within the required timeframe.  If for some reason the school district denies eligibility, you would be entitled to another meeting when the new test results come in.

I'm confused as to how the extra testing is "not looking for ED," when that's the area of testing that the school wants?

[JSD24]

The only way to ensure the ASD box is checked on the IEP is to refuse to sign the IEP unless that's what they check.  It might delay the IEP getting put in place as this can take time to do.  You might want to request a facilitated IEP meeting.  Not sure if the parent education group  in your state can help you advocate.  Every state has one.  I'd reach out to them for help.

[Jenna]

In my state, schools get different funding from the state Dept. of Education based on the eligibility category. Here, schools get the most funding for autism/traumatic brain injury. I agree with @Carolyn Rowlett. Why is the district proposing the ED category? What's the district's interest in pursuing that instead of ASD?

[TiredASDparents]

In Indiana, we have the Indiana Disability Rights(a state government department). You can apply for free advocacy services. Check if your state has the same and apply ASAP. 

I'm newer to this as well, though we have found more testing is better. It is more proof of his deficits and could help strengthen his ASD level diagnoses.

My understanding is the ADOS-2 is not the best screening tool for high-functioning and/or highly intelligent children or adults. The MIGDAS-2 enabled our daughter to be diagnosed with ASD during her 2nd assessment. Her ADOS-2 score was a 6 during both assessments. However, her older brother also has ASD. The clinician admittedly scored her more conservatively due to her likelihood of modeling his behaviors. The MIGDAS-2 is more personalized and enabled her to confidently diagnose our daughter with ASD - Social-Communication: Level 1; RRB; Level 1 

Regardless of his ADOS-2 score being 7, the IEE diagnosed him with Autism. I'm sure the school system is stuck on infinite replay of the....medical/clinical diagnoses is different from the educational. His issues at school are obviously stemming from his ASD and impacting all facets of his education, which should satisfy the educational diagnoses of Autism. 

I would ask for a diagnoses letter from the Cohen Institute, if they didn't already provide you one. The assessment is great, but it's too much information for most of the CCC members. A diagnoses letter stating he has Autism(and probably other disabilities) and needs supports to receive FAPE. If they can list specific supports, that would be an even stronger letter. I would also ask for a similar letter from any and all of his current therapists(such as Occupational, Speech, Behaviorist, Pediatric Psychiatrist, and etc.). 

If your son has a state case worker and/or a coordination of benefits case worker, ask either of them to help you advocate for your son. 

[Lisa Lightner]

This exact scenario happens all the time and is a huge pet peeve of mine.

The child on paper should match the child in front of you. Period.

https://adayinourshoes.com/emotional-disturbance-category-iep-criteria-accommodations/

https://adayinourshoes.com/iep-disability-classification/

[JSD24]

There are studies that show anxiety comes with an ASD diagnosis a lot of the time.  The bar for a school ASD diagnosis is different from a medical diagnosis.  This is why a school can see a student with ASD as a student with an ED disability.  In theory, additional ASD testing is what's needed to get the school to see that ASD is the accurate disability category.

In my state, the state dept of ed penalizes schools that over-identify students in any IDEA category - my district was dinged for too many Asian students with an ASD box checked.  I think this might play into why students are misidentified.  The CDC keeps coming out with new numbers on how many kids have autism - latest is 1 in 34.  I'm not sure if states adjust their 'over-identify limits' when this happens.