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Reaching the Diagnosis
Children are diagnosed with ID/DD through medical, psychological, and educational evaluations. These evaluations are usually performed by a team of providers from different disciplines.

Psychological Evaluation

Psychological evaluations include tests for intelligence, adaptive skills, and academic performance in reading, mathematics, written expression and spelling. Assessments for autism, anxiety, depression, social communication, learning, attention and other functions of the brain and behavior can be performed as needed.

Psychological evaluations can be performed by clinical psychologists and are for the purpose of getting the medical diagnosis of ID. In many cases the medical diagnosis is provided by a team, which may also include a physician, occupational therapist, and speech pathologist. A medical diagnosis is required by medical insurance for coverage for services and interventions provided outside school.

Psychological tests can also be performed by a school/educational psychologist for the purpose of getting an educational diagnosis, which is used to qualify for intervention services through school.

Educational Evaluation

Psychological Evaluation

Is performed by the school psychologist for the purpose of receiving school services. This type of evaluation includes special tests for intelligence and adaptive skills, with additional testing for school age children such as: tests for reading, mathematics, written expression and spelling. Additional evaluation for autism, anxiety, depression, social communication, learning, attention, other functions of the brain and behavior may be performed.

Occupational Therapy Evaluation

Is performed by an occupational therapist and assesses the fine motor skills, such as the ability to use the hands to hold a pen or cut with scissors. Sensory processing, such as under or over reaction to sounds, sight, touch, taste, pain and movement, can be assessed.

Speech and Language Evaluation

Is performed by a speech therapist and assesses the ability to understand, talk, communicate and have a conversation.

Physical Therapy Evaluation

For gross motor skills assesses the ability to move and maintain balance and coordination when walking, running and jumping.

Medical Evaluation

Medical evaluations are usually performed by a physician specialized in development and behavior, such as a developmental behavioral pediatrician. The evaluation consists of medical, developmental, behavioral, educational and family history, as well as a physical examination. The physician will review previous evaluations and will also perform a developmental and behavior assessment. The medical evaluation can provide the medical diagnosis of DD/ID, as well as other behavioral and communication conditions that may occur together with intellectual disability, such as autism or Attention Deficit Hyperactivity Disorder (ADHD).

During these evaluations, children will also be assessed for medical conditions which can be seen more frequently in children with DD/ID, such as constipation, abnormal weight gain, hearing, vision, sleep and feeding disorder, pica (eating non-food items), seizures, teeth and gum problems.

Children with DD/ID may need to be referred for audiological (hearing) and ophthalmological (eye and vision) assessments. As part of the medical evaluation, the physician may recommend different blood tests, such as genetic testing, lead toxicity screening and thyroid function. In some children, a brain MRI (special picture of the brain) or EEG (a brain wave study to check for seizures) may also be done.

These are some of the specialists who may be helpful in evaluating and following children with DD/ID:

Developmental behavioral pediatricians

Are physicians trained in assessing development, behavior and learning and can provide diagnosis and recommendations for treatment for DD/ID, autism, learning disability, ADHD.

Psychologists

Are clinicians specialized in the diagnosis of DD/ID, autism, learning disability, ADHD, anxiety, and depression. Psychologists can provide behavior therapy, parent coaching, social skills training and counseling.

Physicians specialized in genetics and genetic counselors

Perform an evaluation for a genetic cause or risk factor for DD/ID for the whole family.

Neurologists

Are physicians specialized in disorders with abnormal structure or function of the brain and can evaluate for seizures or regression of skills.

Psychiatrists

Are physicians specialized in the diagnosis and medication of mental health disorders, such as depression, anxiety, bipolar disorder, schizophrenia.

Additional Medical Tests

Some additional medical tests may be recommended for children with ID/DD, including:

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LEAD

Blood lead levels should be checked every year in children who mouth or eat non-food items, or those who have been exposed to lead. Increased lead level may affect behavior and learning.
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THYROID

Thyroid function is checked in all children at birth. It should be re-checked in children who have DD/ID or children with poor growth in height. Thyroid hormone, which is produced by the thyroid gland, affects development, behavior and growth.
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MRI/EEG

If the child loses skills, has seizures, or has certain findings on the physical and neurological exam, physicians may recommend pictures of the brain, such as brain MRI or a brain wave study such as EEG.
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