1. What categories of special children are entitled to special education under IDEA?

The Individuals with Disabilities Education Act (IDEA) requires public

schools to provide special education and related services to eligible students. But
not every child who struggles in school qualifies. To be covered, a child’s school
performance must be “adversely affected” by a disability in one of the 13 categories
below.
1. Specific learning disability (SLD)
The umbrella term “SLD” covers a specific group of learning challenges.
These conditions affect a child’s ability to read, write, listen, speak, reason, or do
math. Here’s what could fall in this category:
 Dyslexia
 Dysgraphia
 Dyscalculia
 Auditory processing disorder
 Nonverbal learning disability
SLD is the most common category under IDEA. In 2018, 34 percent of
students who qualified did so under this category.

2. Other health impairment

The umbrella term “other health impairment” covers conditions that limit a
child’s strength, energy, or alertness. One example is ADHD , which impacts
attention and executive function .

3. Autism spectrum disorder (ASD)

ASD is a developmental disability. It covers a wide range of symptoms,
but it mainly affects a child’s social and communication skills. It can also impact
behavior.

4. Emotional disturbance
Various mental health issues can fall under the “emotional disturbance”
category. They may include anxiety disorder, schizophrenia, bipolar disorder,
obsessive-compulsive disorder, and depression . (Some of these may also be
covered under “other health impairment.”)

5. Speech or language impairment

This category covers difficulties with speech or language . A common
example is stuttering. Other examples are trouble pronouncing words or making
sounds with the voice. It also covers language problems that make it hard for
kids to understand words or express themselves.

6. Visual impairment, including blindness

A child who has eyesight problems is considered to have a visual
impairment. This category includes both partial sight and blindness. If eyewear
can correct a vision problem, then it doesn’t qualify.

7. Deafness
 Kids with a diagnosis of deafness fall under this category. These are kids
who can’t hear most or all sounds, even with a hearing aid.

8. Hearing impairment
The term “hearing impairment” refers to a hearing loss not covered by the
definition of deafness. This type of loss can change over time. Being hard of
hearing is not the same thing as having trouble with auditory or language
processing.

9. Deaf-blindness
Kids with a diagnosis of deaf-blindness have both severe hearing and
vision loss. Their communication and other needs are so unique that programs
for just the deaf or blind can’t meet them.

10. Orthopedic impairment

An orthopedic impairment is when kids lack function or ability in their
bodies. An example is cerebral palsy.

11. Intellectual disability

Kids with this type of disability have below-average intellectual ability.
They may also have poor communication, self-care, and social skills. Down
syndrome is one example of an intellectual disability.

12. Traumatic brain injury

This is a brain injury caused by an accident or some kind of physical force.

13. Multiple disabilities

A child with multiple disabilities has more than one condition covered by
IDEA. Having multiple issues creates educational needs that can’t be met in a
program designed for any one disability.
1. What assessment procedures were used by specialists and concerned people with respect
to:

6.1. Mental Retardation;

Mental retardation is a disorder that is characterized by significant

limitations in cognitive functioning and adaptive behavior. Conducting a
thorough assessment is essential to providing effective services for
individuals with mental retardation. Reliable and valid assessment
protocols incorporate multiple methods and multiple sources in order to
obtain the information needed to make an accurate diagnosis of mental
retardation as well as to guide intervention efforts. When assessing
cognitive ability, it is important to ensure that testing procedures are
sensitive to the child's ethnic, cultural, or linguistic background. Using tests
in which the child's relevant characteristics are represented in the
standardization sample of the test, or employing an examiner who is
familiar with aspects of the child's ethnic or cultural background will help
accomplish this. The criterion for a diagnosis of mental retardation is
approximately two standard deviations below the mean (IQ of about 70 or
below), taking into consideration the standard error of measurement for
the specific assessment instrument used, and the instrument's strengths
and limitations. Selection of assessment procedures and interpretation of
results should take into account factors that may limit test performance
(that is, the child's sociocultural background, native language, and
associated communicative, motor, and sensory difficulties). When
significant scatter in subtest scores is present, the profile of strengths and
weaknesses, instead of the mathematically derived full-scale IQ reflects
the child's learning abilities more accurately.

6.2. Learning Disabilities;

People who assess children for learning disabilities are usually

experts in education, speech and language, audiology, or psychology. By
conducting a series of tests, evaluations, and interviews, they work to
understand what stands between your child and academic success.

Findings from these evaluations may reveal any of a number of

issues, ranging from hearing loss or low vision to difficulties with focus,
use of language, or reading.1 Fortunately, there are tools and techniques
for managing almost any learning-related disability—but until the issue has
been diagnosed, there's not much anyone can do.

Diagnosing a learning disability in public schools requires several

types of tests. Common tests used to diagnose a learning disability
include tests of intelligence, achievement, visual-motor integration, and
 language. Other tests may also be used depending on the evaluator’s
preferences and the child’s needs.

Intelligence tests (often called IQ tests) most commonly used to

diagnose a learning disability include the Wechsler Preschool and Primary
Scale of Intelligence (WIPPSI), Wechsler Intelligence Scale for Children
(WISC), and the Wechsler Adult Intelligence Scale (WAIS).

Other common intelligence, or cognitive, tests include the Stanford-

Binet Intelligence Test, Differential Abilities Scales (DAS), the Woodcock
Johnson Test of Cognitive Abilities, and the Comprehensive Test of
Nonverbal Intelligence (CTONI). Findings from these tests can help
pinpoint areas of strength and weakness. With this information, schools
can often suggest educational options or offer special support.

Common achievement tests used to diagnose a learning disability

include the Woodcock-Johnson Tests of Achievement (WJ), the Wechsler
Individual Achievement Test (WIAT), the Wide Range Achievement Test
(WRAT), and the Kaufman Test of Educational Achievement (KTEA).

These tests focus on reading, writing, and math. If your child has
fallen behind in a particular academic area, schools can offer remedial
support, tutoring, and other tools to help your child catch up.

Common visual motor integration tests include the Bender Visual

Motor Gestalt Test and the Developmental Test of Visual Motor
Integration. Findings from these tests may help to determine if a child's
brain is properly connecting visual cues to motor coordination.

In other words, are they able to draw what they see? If they are
having a difficult time integrating visual and motor skills, it will be very
tough for them to learn to write or draw properly without special support.

Common language tests used in the diagnosis of learning

disabilities include the Clinical Evaluation of Language Fundamentals
(CELF), the Goldman Fristoe Test of Articulation, and the Test of
Language Development. These tests explore your child's ability to
understand spoken and written language and to respond verbally to
questions or cues.

6.3. Blind and Having Low Vision;

The Snellen test is also known as the visual acuity test. Usually a
chart called the Snellen’s chart is used. It contains progressively shortening
random letters and numbers and is placed 6 meters away from the patient.
The patient is asked to read the letters with each eye separately and both
 together. Ability to read the letters at each size determines the visual acuity.
The first number represent how far away from the chart the patient was when
he or she was able to successfully read the letters on the chart. The second
number represents how far away a person with healthy vision should be able
to read the chart.

Healthy vision scores 6/6. If the score is 6/60, it means that the patient
can only read something 6 meters away what a person with healthy eyesight
can read 60 meters away.

Being partially sighted, or sight impaired means if level of sight loss is

moderate and blindness, or severe sight impairment means when level of
vision loss is so severe that a person is unable to complete any activities that
require eyesight. Partial sight or sight impairment is defined as 3/60 to 6/60
vision or having a combination of moderate visual acuity (up to 6/24) and a
reduced field of vision.

Blindness is defined as having poor visual acuity (less than 3/60) but
having a full field of vision or having poor visual acuity (between 3/60 and
6/60) and a severe reduction in the vision field or having average visual
acuity (6/60 or above) and an severely reduced field of vision.

Visual field is the range of vision that a person can see without tilting
or turning one’s head. This measures the peripheral vision of the eyes. The
test uses a device strapped over the patient’s eyes. Lights are flashed on
and off in the patient’s peripheral vision. He or she is then asked to press a
button every time they see a light. Any gap of field of vision is detected.

Tonometry test uses specialized instruments to determine fluid

pressure inside the eye to evaluate for glaucoma.

Ocular Motility Assessment tests if there is squint of other problems in

the movement of the eyeballs.

Other tests like Visually evoked potential (VEP), Electroretinogram

(ERG), Electro-oculogram (EOG) are sometimes prescribed to test if the
signals from the eye are travelling adequately to the brain.

These may help if the patient is very young and clinical examination is
difficult or if there are multiple handicaps that make diagnosis difficult.

6.4. Speech and Language Disorders;

A speech and language evaluation is the measurement of a person’s

communication skills. It is done to find out if a person has communication
problems. The evaluation is done by a speech-language clinician.
 The speech-language clinician gathers information by asking
questions about the child and testing the child. Depending upon the age and
attention span of the child, the evaluation may be completed in one session.
Or, it may be spread over several sessions. The length of the evaluation will
vary with the amount of testing that needs to be done.

A parent may be asked for a description of your child’s:

 Health History – including any serious illnesses, operations,

accidents or recurring health problems.
 Developmental History – including the ages at which your child
started doing certain activities like sitting, walking, making
speech sounds, etc.
 Family – including names and ages of brothers and sisters,
discussion of family members who may have speech or
hearing problems, etc.
 Speech and language behaviors – including your comments
about your child’s speech and language skills and any causes
of concern.
 School history – what schools your child has attended.

During the child’s evaluation, the clinician observes the child doing
different tasks. The clinician will evaluate the child’s:

 Understanding and use of different words

 Correct use of words in correctly formed sentences
 Use of language for different purposes
 Pronunciation of speech sounds
 Physical ability to produce speech
 Voice quality
 Fluency or smooth flow of speech

The clinician also briefly checks the child’s motor skills, which
involve coordinating muscle movements. Large motor abilities like walking
and running are checked. Fine motor activities like writing or drawing are
also checked. A hearing screening is part of any speech and language
evaluation. There may be a hearing problem that may affect speech and
language development. The clinician also checks the child’s mouth,
looking for any structural problems with the tongue, lips, teeth, or roof of
the mouth. The clinician uses formal tests and informal observations of the
child’s communication abilities. The clinician also notes such things as the
child’s attention span, activity level, play skills, or any unusual behavior.

Formal tests are a way of comparing the child with other children of
the same age. There are many tests available. The clinician tries to
choose those that will give the information needed about a child’s
problem. In a formal test, the child is asked to cooperate on certain tasks.
The child’s ability to perform these tasks is compared to the ability of other
children. The clinician is looking for an overall age level at which the child
performs. The clinician also notes the kinds of tasks that give the child
trouble. Later, if the child is enrolled in therapy, the clinician will do more
tests to determine which specific skills to teach. Formal tests are designed
to get a sample of the child’s skills on various kinds of tasks, including:

1. Receptive vocabulary – What words does the child understand? The

child is asked to point to pictures or objects named.

2. Expressive vocabulary – What words does the child use? The child is
asked to name objects and/or pictures. At older age levels (over four
years), the child may be asked to explain what a word means, or to
complete a sentence such as “Fire is hot, ice is ___.”
3. Receptive grammar – How well does the child understand different
language forms? The child might be asked to find a picture that “goes
with” a sentence said by the evaluator. Or, the child might be asked
to follow a request using some objects, such as “Put the car in the
box. Now put both cars in the box.” This checks the child’s
understanding of plurals.

4. Expressive grammar – What language forms can the child use? The
child might be asked to imitate various types and lengths of
sentences. The child might be asked to complete a sentence with a
particular form, such as plurals. “Mary has a dress and Joan has a
dress. So they have two ___.”

5. Auditory memory – How well does the child remember what is

heard? The child might be asked to follow a series of directions that
gradually increase in length, such as “Put the cup in your lap and
open the book” or “Touch the dog, the book, the cup, and the spoon.”
The child might be asked to repeat a series of unrelated words or a
series of numbers. The child might also be asked to repeat a series
of related words, such as dog, cow, and horse. The child’s ability on
each task would be compared.

6. Auditory discrimination – Can you child hear small differences

between words? The child might be asked to tell whether two words
sound the “same” or if they sound “different”. For example, are “sing”
and “ring” the same or different? The child might also be asked to
point to a picture in a book. Pictures of words that sound similar
would be on the same page.
 7. Word-finding – How well does the child think of words to use? The
child might be asked to rapidly name a series of common objects, or
a series of pictures of common objects. The child might be asked to
name as many words as possible in a limited amount of time.

8. Articulation – What speech sounds can the child make? How clear is
the child’s speech? The child’s pronunciation of vowels and
consonant sounds is recorded. The child is usually asked to name a
picture. The names of the pictures contain each of the sounds of
English at the beginning, middle, or end of the word. The clinician
notes any mispronunciations. Sometimes, a picture story is used.
This shows the clinician if your child makes more errors in saying
sentences than in saying single words. The clinician also has the
child imitate some of the error sounds. This shows if the child can
imitate the sound all by itself (in “isolation”), in a syllable, in a word,
or in a sentence.

Informal tasks include talking with the child, having the child
discuss pictures, answer questions, and tell simple stories. If the child is
an infant or toddler, the clinician observes how the child plays, how the
child uses objects and toys, and how well the child understands words and
requests. The clinician also looks at how the child expresses wants and
needs and obtains information and objects. The clinician looks to see if
these functions are expressed nonverbally (with gestures, eye contact,
tugging, and pointing) or with words.

Other measurements taken during the evaluation are:

1. Oral peripheral examination

The clinician conducts what is called an “oral peripheral
examination.” This includes observing the child’s face, lips, teeth,
tongue, palate, and throat. It also includes observing how well they
work in such activities as feeding, moving the tongue, moving the
lips, or making alternating lip and tongue movements rapidly. The
clinician might ask questions about the child’s feeding skills. The
muscles of the mouth are first developed in feeding activities such
as sucking, swallowing, and chewing before the muscles are used
for speech.

2. Voice
If there is a voice problem, the evaluator will be concerned
with how long the child can hold a tone on one breath, what the
child’s pitch range is (how low and how high the child can sing),
and the pitch that the child usually uses to talk. The clinician might
also ask questions about how the child uses the voice. For
example: Does the child talk loudly? Does the child yell a lot?
 3. Fluency
The clinician also tries to find out if there is a fluency
problem. As the child speaks, the clinician listens for sounds and
words that are repeated or prolonged, hesitations, and fillers such
as “um” and “uh”. The clinician might ask to describe how your child
talks and whether or not the child avoids talking.

What should be the result of the speech and language evaluation?

A written report of a thorough speech and language evaluation will
include the following:

1. Information about the child’s history and home environment that

may be helpful in understanding the communication problem.

2. A description of the child’s abilities in the areas of making speech

sounds, language use, voice, and fluency of speech.

3. A description of the child’s physical structures for speech (lips,

tongue, palate, etc) and how well the muscles work compared to
other children of that age.

4. The results of a hearing test to rule out the possibility of a hearing

problem.

5. A description of special problems such as physical limitation,

behavior problems, emotional problems, short attention span, over
activity, or poor motor skills.

6. Recommendations for future action which might include:

a. Referral to another professional such as a medical
doctor
b. Additional testing
c. Re-evaluation at a later date
d. Participation in a speech therapy program, including
suggestions for:
i. Type of therapy
ii. Frequency of therapy
iii. Length of sessions
iv. Goals for therapy
v. Parent participation
e. No need for therapy

6.5. Physical Disabilities, Health Impairments and Severe Disabilities;

 Although primary called physical disabilities, the U.S. Department
of Education uses the term "Orthopedic impairment" in it's formal
definition. "Orthopedic impairment means a sever orthopedic impairment
that adversely affects a child's educational performance. The term
includes impairments caused by congenital anomaly (e.g. clubfoot,
absence of some member, etc.), impairments cause by disease (e.g.,
poliomyelitis, bone tuberculosis, etc.), and impairments from other causes
(e.g., cerebral palsy, amputations, and fractures or burns that cause
constractures)" (IDEA 2004, Sec. 300.7). 

It is important to note that the disability must negatively effect the

student's educational performance to be eligible for services. The four
most common physical disabilities that teachers are likely to encounter
are:
o Cerebral Palsy
o Muscular Dystrophy
o Spina Bifida
o Orthopedic and Musculoskeletal Conditions

Although you should never fall into the trap of stereotyping, you
should know that the view of the wold of persons with theses disabilities,
and their interactions with others, are likely to be a bit different from those
of people without. They often have unique reactions to live events. The
conditions of students with physical disabilities may be relatively mild to
more severe. Different body parts may be affected. Disabilities may be
due to central nervous system damage or muscle or orthopedic
impairments.

Students with other health impairments may be weak and

sometimes in pain. Lack of stamina may often be a debilitating factor.
They may miss a lot of school due to their illness. Within the school-age
population, approximately 0.14% have physical disabilities and about
0.59% have other health impairments. 

o Physical Disabilities
 3 children in 1000 are affected by Cerebral Palsy
 1 in every 3,500 male births inherit Muscular Dystrophy
 1 in every 1,000 births develop spinal bifida

o Other Health Impairments

 Asthma is most common with 6.7 million children under 18 years
being affected.
 Approximately 3 million Americans have epilepsy.
 Approximately 1.1 million Americans live with HIV/AIDS.
 It is important when assessing the needs of students with physical
disabilities or other health impairments to determine the actual intellectual
ability of the student outside of just their physical needs. Remember, the
basis of being covered under IDEA, is that the educational development of
the student is being hindered by the disability or impairment.

Assessment first occurs in the medical area in which condition of

the student is initially  diagnosed and medical interventions developed.
Second, within schools, eligibility for special education must be
determined based on the extent to which the condition affects the
student's learning ability. If the child meets criteria, an individualized family
service plan may be developed if he or she is served in an early
intervention program, or an IEP if served in public school.

Third, as part of these plans, related services such as Physical

Therapy (PT) or Occupational Therapy (OT) may be offered. In this case,
additional assessments will be conducted, and plans will be developed to
meet the student's needs.

If a student is not eligible for special education services, it is still

possible that a Section 504 plan may be developed in order for the student
to participate in school.

6.6. Emotional and Behavioral Disorders

A variety of assessment tools and strategies are used to gather

relevant functional and developmental information about the child,
including information provided by the parent, and information related to
enabling the child to be involved in and progress in the general curriculum
(or for a preschool child, to participate in appropriate activities).

Assessments or measures are administered by trained and

knowledgeable personnel in accordance to the instruction provided by the
producer of the assessments to insure validity and reliability. Assessments
or other evaluation materials include those tailored to assess specific
areas of educational need and not merely those that are designed to
provide a single general intelligence quotient. Assessment tools should be
selected and administered to a child with impaired sensory, manual or
speaking skills in a manner in which the assessment results accurately
reflect the child‘s aptitude or achievement level or whatever other factors
the test purports to measure, rather than reflecting the student‘s impaired
sensory, manual or speaking skills (unless those skills are the factors that
the test purports to measure).
 When standardized tests are considered to be invalid for the
specific pupil an alternative assessment must be utilized and specified on
the assessment plan.

An individual assessment of the pupil's educational needs shall

include, but not limited to, all the following:

 Testing and assessment materials

o are selected and administered so as not to be racially, culturally,
or sexually discriminatory;
o are provided and administered in the pupil's primary language or
other mode of communication, unless the assessment plan
indicates reasons why this provision and administration are not
clearly feasible;
o have been validated for the specific purpose for which they are
used;
o are administered by trained personnel in conformance with the
instructions provided by the producer of the tests and other
assessment materials;
o individually administered tests of intellectual or emotional
functioning shall be administered by a credentialed school
psychologist;
o include those tailored to assess specific areas of educational
need and not merely those which are designed to provide a
single general intelligence quotient;
o are selected and administered to best ensure that when a test
administered to a pupil with impaired sensory, manual, or
speaking skills produces test results that accurately reflect the
pupil's aptitude, achievement level, or any other factors the test
purports to measure and not the pupil's impaired sensory,
manual, or speaking skills unless those skills are the factors the
test purports to measure.

 No single procedure is used as the sole criterion for determining

whether a pupil is an individual with exceptional needs and for
determining an appropriate educational program for the pupil.
 The pupil is assessed in all areas related to the suspected disability.
 The assessment of a pupil shall be conducted by persons
knowledgeable of that disability.

Identify Areas of Suspected Disability

Answering the following questions with a Yes or No may help the school psychologist
identify which area(s) of emotional disturbance need to be targeted in the evaluation
process.
I. An inability to learn which cannot be explained by intellectual, sensory or
other health factors
 o Is there or has there been Attendance issues?
o Is there a history of a processing disorder or learning disability?
o Does the student display a disorder in thought, reasoning, perception, or
memory, which can be attributed to an emotional condition?

II. An inability to build or maintain satisfactory relationships with peers and

teachers
o Does the student participate in social activities?
o Does the student report having friends?
o Does the student withdraw from peer and/ or adult contact?
o Is the student unable to initiate or maintain relationships or is he unwilling?
o Does the student avoid communicating with peers or adults? If so, is the
student fearful of peers/adults?
o Is the problem with peers/adults related to antisocial subgroup behavior?
o Are conflicts with adults primarily with authority figures, issues of control,
and/or power struggles?
o What is the student’s affect? Is it appropriate or is it distorted?
o Does the student almost always choose solitary activities?
o Does the student show emotional coldness, detachment, or flattened
affectivity?
o Are the students peer relationships short-lived, anxiety provoking and even
chaotic?
o Are the student’s peers alienated by intensity of student’s need for
attention?
o Are there constant conflicts and tension in almost all of the student’s social
relationships?

III. Inappropriate feelings or behaviors under normal circumstances?

o Is the problem with peers/adults related to antisocial subgroup behavior?
o Are conflicts with adults primarily with authority figures, issues of control,
and/or power struggles?
o What is the student’s affect? Is it appropriate or is it distorted?
o Does the student accept responsibility for their behaviors or do they
project blame to others or they confused?
o Is the student generally anxious or fearful?
o Does the student have severe mood swings of depression happiness to
rage/anger for no apparent reason?
o Does the student display extreme mood liability or is the behavior the
result of a quick temper?
o Does the student display behaviors associated with a conduct disorder or
ODD?
o Does the student have delusions, auditory or visual hallucinations,
disorganized speech, grossly disorganized or catatonic behavior, flat or
inappropriate affect?
 o Does the person have control of their behavior?
o Does the student suspect that others are exploiting, harming, or trying to
deceive you?
o Does the student worry or preoccupied with unjustified doubts about
loyalty or trustworthiness of friends?
o Is the student reluctant to confide in others because of unwarranted fear
that information will be used maliciously against them?
o Does the student perceive attacks on their character or reputation, which
are not apparent to others and is quick to react angrily or to counterattack?
o Does the student read hidden demeaning or threatening meanings into
benign remarks or events?
o Does the student persistently bear grudges and is unforgiving of insults
injuries or slights?
o Does the student display unexplained rage reactions or explosive,
unpredictable behavior?  Does the student display manic behavior?
o Does the student display repetitive, ritualistic, stereotyped motions?  Is
the student oriented to time or place?
o Does the student display bizarre ideas or statements?
o Does the student display a lack of contact with reality?
o Does the student have a sense of reality or is it distorted without regard to
self-interest?
o Does the student display a marked illogical thinking, incoherence,
loosening of associations or magical thinking?
IV. General pervasive mood of unhappiness or depression
o Does the student fail to demonstrate an interest in special events or
interesting activities?
o Is the student overly dependent or impulsively defiant?
o Is the student generally anxious or fearful?
o Does the student have severe mood swings of depression happiness to
rage/anger for no apparent reason?
o Do the behaviors appear associated with a conduct disorder or ODD?
o Does the person have control of their behavior?
o Does the student have an interest in their usual activities?
o Does the student display persistent feelings of depression, hopelessness,
sadness or irritability?
o Is the student engaging in extreme self-destructive behavior?
o Is the student displaying behaviors associated with poor self-esteem or
inadequate self-concept (e.g., blames self or inadequacies, real or
imagined)?
o Is the student reporting recurrent thoughts of death or suicide? Does this
occur often?
o Does the student have outburst of over activity or manic behavior?
o Does the student now have or in the past had problems with any of the
following? A poor appetite or overeating; insomnia or hypersomnia; low
 energy or fatigue; low self-esteem; poor concentration, feelings of
hopelessness?
o Has the student experienced a diminished interest or pleasure in all or
almost all activities most of the day, nearly every day? When?
o Is the student experiencing feelings of hopelessness and sadness? Does
this occur often? What are the circumstances they might feel that way?
o Has the student experienced a significant weight loss or weight gain?
o Has the student experienced recurrent thoughts of death (not just fear of
dying), recurrent suicidal ideation? When?
o Has the student experienced problems associated with psychomotor
agitation or retardation nearly every day (must be observable by others)?
When?

V. Tendency to develop physical symptoms or fears associated with personal or

school problems
o Does the student have any physical symptoms or fears associated with
personal or school problems?
o Does the student display-disabling anxiety when talking about school?
o What does the student say when he/she is questioned about the problem?
o Has the student experienced panic reactions?
o Is the student generally anxious and fearful?
o Are the parents reporting the behavior and has it been observed by an
educator?
o Has the parent sought treatment to determine cause?
o Also consider if a formal health diagnosis exists.