The Cost of Diagnosing Learning Disabilities

For kids with learning disabilities, parents can either trust the school's (free) evaluation or hire a private evaluator—which comes with quite a cost.

Watching my third-grader navigate remote school, I realized she struggled reading simple passages and seemed unable to keep up with the class during their online sessions. I had known prior to the pandemic that she was behind, but I didn't realize how bad it was until I saw it for myself. Why hadn't the school let me know? I wanted more information, and I had no idea where to start—or what it would cost to get answers.

The process of having your child evaluated for learning disabilities, meeting with the school, interpreting test results, and deciding how to help your child is daunting. And it's one countless parents will have to navigate—according to the National Center for Learning Disabilities (NCLD), one in five students in the U.S. experience a learning disability or attention issue.

"The school can evaluate your child for free. Or you can hire a private evaluator, which costs $1,000 to $5,000, depending on where you live and the specialist doing the test. A neuropsychologist costs more than a child psychologist, and you may have to travel or take off work, which will add to the expense," says Amanda Morin of Understood, a non-profit dedicated to serving the millions of families of kids who learn and think differently.

Read on to learn about the options for obtaining free school evaluations, independent educational evaluations (IEEs) at the school's expense, or out-of-pocket IEEs.

Who Is at Risk for Learning Disabilities?

According to NCLD, Black and Latinx students are disproportionally identified for special education, placed in more restrictive educational settings, and disciplined at markedly higher rates than their peers. Researchers hypothesize that students of certain races and ethnicities who experience poverty at higher rates may be more likely to experience things like low birth weight, exposure to lead, and experiencing childhood trauma that can lead to learning disabilities.

Specifically, adverse childhood experiences (ACEs) predispose kids to learning disabilities or behavioral challenges. A study published in Child Abuse and Neglect found that those with four or more ACEs were 32 times more likely to experience a learning disability.

According to the research organization Child Trends, Black and Latinx children are more likely to experience ACEs than their White and Asian peers. Further, the experience of racism, itself, can have toxic effects, leading some researchers to recommend including experiencing racism as a chronic stressor when evaluating ACEs.

ACEs include seven categories:

  • Psychological abuse
  • Physical abuse
  • Sexual abuse
  • Living with someone who misuses substances
  • Living with someone with a mental illness
  • Witnessing domestic violence
  • Having a household member in jail or prison

In addition to income levels and ACEs, according to the National Institutes of Health, poor nutrition, exposure to lead, injury, and fetal exposure to alcohol and drug use can all increase the risk of developing a learning disability.

Identifying Learning Disabilities in School

"Many teachers are skilled at spotting children falling behind, and schools have strategies to keep kids from falling through the cracks. Yet, the onus is largely on the caregiver to step forward when a child is struggling," says Morin. She explains that "there's no trigger that says if a student's test scores drop, it's an automatic evaluation. Instead, the trigger for special education testing in every state is either parent or teacher referral."

"Kids in poorer school systems have less access to resources like technology and tutoring that can help them [and their parents]," writes Ellen Braaten, Ph.D., director of the Learning and Emotional Assessment Program (LEAP) at Massachusetts General Hospital and assistant professor of psychology at Harvard Medical School, in her book, Bright Kids Who Can't Keep Up.

That said, kids in high-income districts can go also unidentified: "Richer schools don't have the infrastructure to identify kids who are struggling," Dr. Braaten, "because they're used to parents stepping in to get kids what they need."

Parent Involvement

If you suspect your child has a learning disability, it's up to you to approach the school, which adds a mental and emotional cost. These non-monetary costs can be especially daunting for parents with barriers such as job and family demands, non-native English-speaking skills, or other socio-economic roadblocks.

The cost to society of not referring children—or getting them the help they need—is enormous. Kids whose learning disabilities go undetected are far more likely to drop out of school and have a higher chance of ending up in the criminal justice system, says Morin. Indeed the NCLD reports that students with learning disabilities are more than three times as likely to drop out of school.

Students with early diagnosis and adequate supports are more likely to succeed in school. So, Morin says, "Trust your instinct if you think something's not adding up with your child."

An image of a boy doing school work.
Getty Images.

School-Based Evaluations

So, what are the advantages to public school testing, aside from being free of cost?

Familiarity

Your child may know their evaluator and a known evaluator can help kids feel comfortable. Further, Dr. Braaten explains, "the testing itself is in a familiar location. Plus, the people doing the evaluation may be the same ones who are giving your child services after the evaluation."

Efficacy

The school evaluation also might also be faster than a private company's. Once you sign your consent, evaluators have to follow specific guidelines; the Individuals with Disabilities Education Act (IDEA) sets a deadline of 60 days. However, each state can set its own timeframe within those boundaries.

Independent Educational Evaluations (IEEs)

While a school evaluation can often be adequate, sometimes an IEE is warranted.

You want a diagnosis

You may want to know more about your child's disability than the school can provide. "The school is looking at identifying issues holding your child back in the classroom versus providing a diagnosis," says Morin.

"For example, if a child is struggling with attention issues, the school evaluation will determine whether those attention issues warrant special education services within the school. Yet, a private evaluator can determine whether the child has ADHD," writes Dr. Braaten. That's because schools can not provide diagnoses; only a health care provider, like a physician or psychiatrist can.

"It's an important distinction," she says. "The school will only recommend services they can already provide, and their budgets constrain them. But a private evaluator has no limitations. They look at what the child needs not only to get by in school but to thrive."

Schools use nonspecific language, and Dr. Braaten says she often sees parents in her clinic who've gone years without knowing their child has dyslexia or another disorder. Putting a name to an experience can help kids understand their disability and how to work with it. Having a diagnosis can also lead you to support groups, where kids can make friends with others who share their disability, and parents can network with other caregivers to share resources and camaraderie.

You want a second opinion

One final reason you might go with outside testing is if you disagree with the school's test results. As part of IDEA, when you disagree with the school-based evaluation, you have the right to request a private evaluation at the district's expense.

"The main reason parents pursue this route is if they believe the school's testing wasn't thorough enough," says Morin. "This is why it's helpful to be as specific as you can before testing begins."

There's one other point to consider before you get an IEE. Under IDEA, the school must consider outside testing results, but the independent testing must meet the school's criteria for evaluating a student for special education services. For that reason, it's best to ask the school ahead of time what tests they want to see and how they feel about using outside results to assess the child's classroom needs.

Options for Low-Cost Testing

If you don't qualify for an IEE at public expense, or you don't have the resources to pay out of pocket, don't give up. You may be able to find low-cost options by doing a little bit of homework.

Local universities and teaching hospitals

Residents at universities and hospitals may offer free evaluations as part of their training. And teaching hospitals may test your child for research. Check with the psychology, psychiatry, or neurology departments. For tutoring, check with the education department.

The Learning Disability Association of America (LDAA)

The LDAA website offers resources that may help you find low-cost evaluations and tutoring.

Health insurance

Check with your health insurance ahead of time. Some plans will cover all or part of the testing. Dr. Braaten says to approach your insurance with medical terminologies. For example, if you suspect memory issues, premature birth complications, autism spectrum disorder, ADHD, or another disability, name them.

Consider a hybrid approach

You can request the school do some testing, such as those involved with occupational or speech therapy. Then, you can see a private evaluator for neuropsychological testing.

Discuss school testing results with a neuropsychologist

Dr. Braaten says many practices are offering this service to help parents keep the cost lower. The practitioner can review the school's results, meet with your child, and give you their professional opinion.

The Bottom Line

The essential thing for parents to remember is that you don't need to rush. Instead, take time to research your options and talk to other parents who've done this before. Whichever route you choose, the good news is you're on your way to getting your child the help they need.

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