Understanding the Differences Between Medical Diagnoses and Educational Eligibility


Your child's medical diagnosis and eligibility for Early Intervention or Special Education may use the same terminology (such as autism, traumatic brain injury, or learning disability), but how your child's healthcare provider, the Early Intervention Program, and your school district address your child's needs may be different. Healthcare providers, the Early Intervention Program, and school districts follow different laws and standards. Knowing the different standards can help you understand why and how your school team makes decisions about services for your child.


  • Family: Families provide support, love, care, and a sense of belonging by providing social, emotional, physical, and other support to each other. Family includes parents, brothers, sisters, children, grandparents, aunts, uncles, foster parents, and others who share responsibility and support for each other.

  • Professional: A professional is a member of a profession with particular experience and expertise in their practice area. A professional is someone whose job requires special education, training, and skill and who is subject to standards and ethics in their field.
  • Team: A team is a group of diverse individuals working together for a common purpose. The individuals on a team should have common goals and objectives and work together toward achieving those goals.
  • Diagnosis: A diagnosis includes both a process and a result. The process includes a healthcare or other medical provider collecting information about your child and interpreting signs and symptoms. This process may (and sometimes may not) lead to a diagnosis that describes your child's condition or disability. A diagnosis is a way of describing your child, but that diagnosis does not define your child. A diagnosis is simply a way of guiding the team toward services and supports for your child.
  • Eligibility: Eligibility is the set of requirements your child must meet to participate in a program or receive the services and supports provided by that program. Most programs have their own set of eligibility requirements. A child can meet the requirements for a medical diagnosis or early intervention; however, those requirements may not meet eligibility requirements for special education. 

What Families Should Expect

  • You will go through an eligibility determination process to see if your child qualifies for the program or services. You will receive information about the program's eligibility requirements that will help you determine if your child is eligible for services. You should ask for it if you do not receive written information about eligibility. Understanding the exact processes, timelines, and criteria for eligibility is important when advocating for your child.
  • Families should expect the program they are working with to explain their specific eligibility process. 
  • You may be asked to provide information to help determine your child's needs. This information could include details to help determine your child's diagnosis or eligibility for a program or services. You may also be asked to provide this information within a certain timeframe. If you have questions about the timeframe, you should ask about that, as there may be required timelines for you to respond within.
  • Each program follows its own standards when providing services, and programs that provide the same kind of services can use different standards. For example, a district physical therapist and a private physical therapist both provide physical therapy, but they provide the therapy using different standards. The school uses an "educational" standard, and the private therapist uses a "clinical" standard. Your child's private therapist may recommend a level of services that your district does not need to provide. 

What Families Want Their Team Members to Know

  • The way you handle the diagnosis and eligibility process can have a profound impact on the way I feel about the process. Treating me with care and respect can ease this difficult time by listening to my concerns, not questioning my parenting skills, and handling the process with sensitivity.
  • I wish to be told about my child's diagnosis or eligibility for services as soon as possible, together, in a private, direct, honest, and compassionate way, and to have immediate and easy access to services that provide accurate, comprehensive and practical support and guidance.
  • Wading through a lengthy diagnosis and eligibility determination process takes time and effort. Please do what you can to ensure the process moves forward in a timely way. You can help me by personally connecting me to professionals who can evaluate my child, and avoiding, if possible, providers with historically lengthy waiting lists.

 What Team Members Want Families to Know

  • All professions have structures, procedures and timelines we must follow. These processes may feel like they are delaying the outcomes. These processes may feel like an intrusion into your family life; however, the procedures are in place to ensure the best outcome in the screening and evaluation of your child. Let us know if you think we are not following the process on time or if you don't understand why we are asking you for information.
  • You can help us give you the information you need about your child's diagnosis and eligibility by letting us know if you need more explanation about the process and terms. Parents come to us with different levels of knowledge, so knowing your comfort level and understanding of the process and terms can help us communicate with you most effectively.

Questions to Consider

For Families:
  1. Do I have the information I need about my child’s needs?
  2. Do I know where to find information about my child’s needs?
  3. Have I found healthcare providers and other professionals that work well with me and my child?
  4. Do I understand the standards for getting the services and supports I want for my child?
  5. Do my child’s professional providers listen to my concerns?

For Professionals:
  1. Do we tailor our communication styles to the needs of the family (knowledge level, stage in the process, daily stressors)?
  2. Do we have procedures in place to provide screening and evaluation results to families in a timely fashion?
  3. Do we follow mandated structures, procedures and timelines?
  4. Have we asked parents about their preferred way to receive information (in person or in writing, or both, in stages, over time or all at once)?
  5. Have we explained the results of the screening or evaluation thoroughly and provided information about services and supports?
  6. Are we compassionate in the way we interact with families?


Children with Medical Handicaps Program
Disability Rights Ohio
Individuals with Disabilities Education Act
Ohio Coalition for the Education of Children with Disabilities
Ohio Coalition for the Education of Children with Disabilities Newsletter: Medical Diagnosis vs Educational Eligibility
Ohio Department of Education: Special Education
Ohio Statewide Family Engagement Center
PEATC: Medical Diagnosis vs Educational Eligibility
Understood: The Difference Between School Identification and a Clinical Diagnosis
What Can I Expect in Early Intervention? An Introduction to the Ohio Early Intervention Program

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Last Modified: 9/29/2023 4:40:21 PM