Diagnosis vs Disability

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Many parents are surprised to find that the “disability category” qualifying their child for special education and related services is different from their medical “diagnosis”.  For young children moving from ECI (Early Childhood Intervention) to preschool, the criteria that qualified them for infant services may not be the same as the criteria that makes them eligible for public school services when they turn three. Federal law (IDEA 2004, Part B) has 13 disability categories that States must use to determine if students, ages 3-21, are eligible to receive special education and related services. 


Here are some examples:

  • A child with Down Syndrome may be eligible for IDEA services under “Intellectual Disability (ID)” or “Speech Impairment (SI).”  Down Syndrome is the child’s Medical Diagnosis; Intellectual Disability or Speech Impairment is his or her Disability Eligibility Category. 
  • A child with Cerebral Palsy who qualifies for special education and related services under “Orthopedic Impairment (OI).”  CP is the Medical Diagnosis; OI is the Disability Category. 
  • A child with an autism spectrum disorder may qualify for special education under “Autism (AU)” or “Speech Impairment (SI)”.  Asperger’s Syndrome or Pervasive Development Delay – Not Otherwise Specified (PDD-NOS) may be the medical diagnosis;  AU or SI will be the Eligibility Category. 


The federal law (IDEA) uses the following terms to define a “child with a disability”:

  • Autism,
  • Deaf-blindness,
  • Deafness,
  • Emotional disturbance,
  • A hearing impairment,
  • Intellectual Disability,
  • An orthopedic impairment,
  • Other health impairment,
  • A specific learning disability,
  • A speech or language impairment,
  • Traumatic brain injury,
  • A visual impairment including blindness, or
  • Multiple disabilities.


IDEA contains definitions for each of these disability terms. States can choose how they want to assign disability categories, as long as they cover all of the federal disability terms and definitions.


Texas uses the following list of disability categories to determine if a student (aged 3-21) is eligible for special education and related services:

  • Auditory Impairment (AI)
  • Autism (AU)
  • Deaf-Blindness (DB)
  • Emotional Disturbance (ED)
  • Intellectual Disability (ID) (formerly called Mental Retardation)
  • Multiple Disabilities (MD)
  • Orthopedic Impairment (OI)
  • Other Health Impairment (OHI)
  • Learning Disability (LD)
  • Speech Impairment (SI)
  • Traumatic Brain Injury (TBI)
  • Visual Impairment (VI)
  • Non-Categorical Early Childhood (NCEC)


These listed disability categories are more general in nature than a specific diagnosis.  Only a few specific diagnoses are mentioned under the federal definitions.  However, it is interesting to note that one of the changes made to IDEA 2004 was the specific mention of Tourette’s Syndrome under “Other Health Impairment”.


A Note to Parents of Children, Ages 3-5


Under IDEA, younger students (ages 3-9) may be eligible for special education and related services under a broader disability category called “Developmental Delay.”  States can choose what to call this general category, how they define it, and what age range it applies.  In Texas, this category is called “Non-Categorical Early Childhood (NCEC)”. It is for students aged 3-5 who have general delays in their physical, cognitive, communication, social, emotional, or adaptive development; and who, because of these delays, need special education and related services. 


It is often difficult to diagnose very young children. With early intervention and appropriate services, children may not need special education by the time they reach first grade. The “Non-Categorical Early Childhood” category allows preschoolers to benefit from special education and related services without being labeled with a specific disability. In Texas, a child between the ages of 3-5 may be described as “NCEC” if he or she has been diagnosed as having one of the following:

  • Intellectual Disability,
  • Emotional Disturbance,
  • Specific Learning Disability, or
  • Autism.


Who decides a student’s disability category?


The ARD (Admission, Review and Dismissal) committee decides if a student is eligible for special education and related services and his/her disability eligibility category. This decision is made only after the child has been assessed and evaluated according to state and federal guidelines.  Federal regulations state that determination of eligibility must:

  • “Be made by a group of qualified professionals and the parent.”
  • “Draw upon information from a variety of sources, including aptitude and achievement tests, parent input, teacher recommendations, physical condition, social or cultural background, and adaptive behavior.”


Schools are required by law to provide a full and individual evaluation of students referred to special education at no cost to the student’s family. A student may not be labeled a “child with a disability” for any of the following reasons:

  • Lack of appropriate instruction in reading,
  • Lack of instruction in math, or
  • Limited English proficiency.

A student who does not qualify for services under IDEA may be eligible to receive supports and services under Section 504 of the Rehabilitation Act of 1973.  That's because Section 504's definition of disability is broader than the IDEA's definition and not limited to specific disability categories.  Parents typically ask for services under Sec. 504 when: 


  1. their child has a physical, mental, or other medical condition that is not covered by IDEA or,
  2. their child has a disability covered by IDEA, but the child does not need special education or related services to “benefit” from their education. 


For example, a student with cerebral palsy who fully participates in general education curriculum with accommodations only, and who doesn’t require special education or related services (i.e. transportation or speech) may be eligible under Section 504 instead of IDEA.    


If the ARD committee decides that a child is not eligible for special education or related services, the school must notify parents of this decision in writing and explain why the child has been found “not eligible.”  If you do not agree with this decision, see “What to do when things aren’t working?” for an overview of complaint options.


What Parents Need To Know


Parents should recognize that a disability label should open doors for their children, allowing them access to services –not limit them.  When schools assign a child a disability category, they are doing this only to ensure that a student is eligible to receive special education or related services.  A student’s disability category should not take away from his or her individual gifts and talents, lower expectations, or affect his or her placement in the general curriculum.


Additional Resources:


Disability Resources


Resources for Teachers By Disability (Includes Instructional strategies and accommodations)


TEA Legal Framework for Child Centered Special Education Process – criteria listed for each of the disability categories.


Center for Parent Information and Resources – Categories of Disability Under IDEA (NICHCY)


For information relating specifically to eligibility of children with learning disabilities, visit the Learning Disabilities Association of America or GreatSchools websites.


Revolutionary Common Sense articles used with permission from K. Snow, Disability is Natural: