Educational Autism vs Medical Autism: What’s the Difference?

I’m sure if this has happened to you, it sure felt like a gaslighting moment. You have a child. The child sees various doctors and specialists, some of whom have diagnosed the child with autism.

Then, you go to the school to ask for assistance. And you’re told that your child does not have autism. Wait, so what is the difference between educational autism and medical autism?

You are not being gaslighted. (at least not about this!) There is a difference between medical and educational autism and I find that most parents don’t understand the difference.

I mean, how can that be? Right?

Educational Autism

So let’s clear this up for parents everywhere–I’m going to explain the difference between medical autism and educational autism. And yes, there is a difference!

Medical Autism vs. Educational Diagnosis

The US Medical system has literally thousands of medical codes. Some are for diagnoses and conditions. Others are for therapies and treatments.

Systems of medical coding have been in place throughout the world for centuries.

However, it’s only in recent decades that our US system basically “lives and dies” by codes. This is due to managed care. If the diagnosis or treatment doesn’t have a code, it ain’t gonna happen!

Is Autism a Medical Diagnosis?

Yes, autism is considered a medical diagnosis.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects social interaction, communication, and behavior. It is typically diagnosed by healthcare professionals, such as psychologists, psychiatrists, or developmental pediatricians, based on clinical evaluation, observation, and assessment of symptoms. (bold is mine and explained below)

The diagnostic criteria for autism are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is a widely accepted reference used by medical professionals to diagnose mental health conditions.

The DSM is the big book of diagnoses that our medical system relies upon. Again, due to our managed care system (read: insurance companies), if your condition is not in the DSM, it is very difficult to get things covered.

There are many in the autistic community (themselves autistic) who say that the words disease or disorder should not be used to describe them. It’s an idea that is only recently getting (long overdue) traction, called neurodivergence.

The DSM gets revised periodically and it was just revised a few years ago. The newest version is the DSM 5 (DSM V). Autism and Intellectual Disabilities both received significant changes to their listing in the DSM 5.

Autism is in the DSM 5. If you remember, Aspbergers was removed. But that’s another story for another day.

So, you took your kid to a specialist. The specialist assigned your child a diagnostic code, using a diagnosis from the DSM 5. Your child’s specialist felt that your child met the criteria (listed in the DSM 5) for a diagnosis of Autism.

The DSM 5 will list the criteria for all the diagnoses, and how many of them a person has to meet to qualify.

While you may not care if your child has a medical diagnosis of autism, it was pave the way for services like PT, OT and speech therapy. Yes, schools provide related services like this. But, generally the services you acquire privately are better–more intense, more specialized and more frequent.

Educational Autism

Let’s move away from our doctor for a moment. Now you’re at the school. You’ve requested and received IEP evaluations. My guess is that you are assuming that your child will be listed as autistic and receive services due to his/her autism.

But, when you get to the meeting to discuss the report, they tell you, “No autism.”

Or, sometimes the reverse happens. Your child has a diagnosis of some kind, something other than autism. And when you get your IEP evaluations, they tell you, “We want to check the autism box.”

And you don’t think your child has autism.

After this happens, frustrated parents everywhere hop into my chat group and proclaim, “They diagnosed him with autism, and I know he doesn’t have autism!”

Or, “They said he doesn’t have autism but his doctor said he does!”

Sound familiar?

Can a School Diagnose Autism?

Schools cannot, and usually do not, diagnose. They did not give your child a diagnosis of autism.

First, they do not have the authority to do so. The DSM is very specific about who can officially diagnose autism. (and it’s a very short list, hence the long wait for many specialists, but that’s also another blog post for another day)

If they were actually trying to attach a diagnosis to your child, it would basically be the equivalent of practicing medicine without a license. And I don’t think most school personnel are going to take that risk.

Educational Autism vs Medical Autism

I have written a lengthy post about IEP Disability Classification and why it matters. But here is the Cliff Notes version of Disability Categories.

IDEA has defined 14 eligibility categories for IEPs. One of them is Autism.

When doing IEP evaluations, the school’s task is to evaluate your child and determine if they fit the eligibility criteria for any of the specific categories. But when you are being told either Yes or No to autism, they are not diagnosing. Nor are they necessarily refusing to acknowledge an existing diagnosis.

What they are doing is this: Determining Eligibility for a category. And determining eligibility is not the same as diagnosing.

Educational Autism on the IEP

IEP meetings are stressful and emotional. And parents can be overwhelmed and only hear keywords that stick out to them. So I think that a lot of parents hear a diagnosis of autism, but that is not what the school has said.

IEPs have become so litigious in recent years, I find that many school personnel are very careful about their words.

But my guess is that no, you were not told your child has a diagnosis (or not) of autism. That’s just likely what you heard, as you have a lot of information to disseminate under very emotional conditions.

I find that parents use the word ‘diagnosis’ casually and sort of slang when what they are talking about is not a diagnosis.

What I’m trying to politely say here is this. When you say, “My son has an educational diagnosis of autism” you’re using incorrect terminology.

Not shaming anyone. But learning the difference, and learning this part of the process will help you become a better advocate.

Understanding the categories and their role in the process will be so beneficial to you, I promise.

If you wanted to be more correct, it would be “Yes, my son has educational autism.”

Or, “Yes, he/she/they is autistic” because it’s really no one’s business how or where you got the classification.

Educational Autism Diagnosis

If you disagree with your child’s doctor’s diagnosis, you seek out a 2nd or 3rd opinion. Perhaps a neuropsych.

If you disagree with your school district evaluations, you ask for an IEE. And that may or may not include a neuropsych. As always, keep a good paper trail so that you have the data you need to make your case.

Yes, kids are put into the incorrect disability classification. It happens. Read and use your procedural safeguards if you disagree with any part of your IEP.