The Cost of Diagnosing Your Child's Learning Difficulties: What Parents Need to Know
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 difficulties, 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. One in five students face learning and thinking difficulties such as dyslexia, ADHD, trouble with written expression, dyscalculia, and others.
"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.
Identification and Parent Involvement
It's up to you to approach the school when you have a concern, which adds a mental and emotional cost, especially for parents faced with barriers such as job and family demands, limited English-speaking skills, or other socio-economic roadblocks to taking a more active role in their child's education. The National Center for Learning Disabilities cites that a 2019 study from Drs. Schifter, Grindal, Schwartz, and Hehir found that certain marginalized groups are over-identified for special education, placed in more restrictive educational settings, and disciplined at markedly higher rates than their peers.
"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."
Parent involvement is critical no matter your income; unfortunately, lower-income parents and kids alike are the ones who face the greatest barriers to that necessary involvement. "Kids in poorer school systems have less access to resources like technology and tutoring that can help them [and their parents]," writes Ellen Braaten, PhD, 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."
The cost to society of not referring children—or getting them the help they need—is enormous. "Kids whose learning disabilities go undetected are three times more likely to drop out of school and have a higher chance of ending up in the criminal justice system," says Morin. "Trust your instinct if you think something's not adding up with your child."
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So, what are the advantages to public school testing, aside from being free of cost? "Your child may know their evaluator," A known evaluator can help kids feel comfortable, Dr. Braaten explains, "and 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."
Kids whose learning disabilities go undetected are three times more likely to drop out of school and have a higher chance of ending up in the criminal justice system. Trust your instinct if you think something's not adding up with your child.
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 choose to set its own timeframe.
When a Private Evaluation Makes Sense
You may want to know more about your child's differences than the school can provide. "The school is looking at identifying issues holding your child back in the classroom vs. 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.
"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."
This is why I wanted an outside evaluation. 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 what my daughter has helped her learn to blame her dyslexia when she reads slowly instead of calling herself dumb. We also found a local support group, and she's made friends with kids who are like her.
One final reason you might go with outside testing is if you disagree with the school's test results. Should this happen, 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 reach for your wallet. The school must review outside testing results, but it doesn't have to accept them. 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
I was shocked at the expensive price tag for my daughter's evaluation and felt lucky we could afford it. But I also felt outraged for all the parents who couldn't. The good news is you can find low-cost options by doing a little bit of homework. Here are a few:
Local universities and teaching hospitals. Students 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, be that memory issues, premature birth complications, autism spectrum disorder, ADHD, etc.
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.
Set up a consultation with a neuropsychologist to discuss the results of school testing. 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 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.
