Child evaluations can be conducted privately by doctors and independent practitioners, or can be conducted at no cost through the NYC Department of Health if your child is 0-3 years, or through the NYC Department of Education if your child is 3+ years. There are benefits and challenges to both private and government-funded assessments; it’s advisable to consider all options before scheduling any appointments for your child.
Private Evaluations
Private evaluations performed by doctors and independent practitioners can produce highly detailed findings about a young child’s developmental functioning, learning style, temperament, strengths and challenges. Private evaluations and medical exams are kept confidential and results can be used by parents/guardians to compare against school reports, school social worker observations, as well as government-funded assessments. The cost for private evaluations can be significant, however, depending on a family’s health insurance options.
To find an independent evaluator or private practitioner, you can search the directory of American Academy of Pediatrics, visit a local family center for recommendations, ask other parents at a parenting group or in a parent e-forum, or go to Urban Exceptional’s Facebook group and ask our community. You can also look to hire an educational consultant or special needs advocate to provide professional guidance and direction in navigating the evaluation process for your child.
NYC Departments of Health & Education Government-Funded Assessments
While only a limited number of exams are performed by the NYC Department of Health (for children 0-3 years) and the NYC Department of Education (for children 3+ years), these free screenings can be a useful first step in assessing your child’s current strengths, challenges and needs, and can help a family determine whether pursuing private testing would be worthwhile.
For Children 0 – 3 Years
A developmental screening conducted through the NYC Department of Health for a child 0-3 years typically includes these standard assessments:
- Occupational therapy exam
- Physical therapy exam
- Speech and communication evaluation
- Social and family history (an interview with parents)
- Adaptive skills observation(“adaptive” meaning the skills to take care of oneself in an age-appropriate way, such as eating/dressing/cleaning)
Once a parent/guardian files a formal evaluation request, an Initial Service Coordinator is assigned. The Initial Service Coordinator will provide a list of registered evaluation centers throughout NYC where licensed pathologists and psychologists can conduct a standard set of developmental, cognitive and educational assessments for your child. Be sure to confirm receipt of the request, and keep records of all reports and documentation to refer back to when necessary.
Government-funded evaluations do not usually include psychological assessments; however, you can request it if you feel a psychological assessment is critical to your child’s evaluation. This is subject to approval and must be conducted by a licensed psychologist registered with the NYC Department of Health, if approved.
All evaluation reports are kept confidential until children reach 5 years old, and may not be shared without parental permission. If at any point you choose to discontinue a government-funded evaluation of your child, parents have the right to end the process at any time without financial penalty.
Note: If your child does not speak English, s/he needs to be tested in their primary language. Parents and legal guardians also have the right to request translations of evaluation reports and all communications into their preferred language. If your child is bilingual, your child can be assigned a bilingual evaluator fluent in both English and your child’s home language.
For Children 3+ Years
For children 3+ years old, a government-funded evaluation is conducted through the NYC Department of Education regardless of whether your child attends a public, charter, parochial or private school.
Evaluations are coordinated through the NYC Department of Education’s Special Education office, although results will only include recommended special education services if your child receives a qualifying diagnosis. For a complete guide, download the NYC Department of Education’s Family Guide to Special Education Services
A government-funded evaluation for children 3+ years typically includes these standard assessments:
- Educational observation
- Psychoeducational assessment
- Speech and communication evaluation
- Occupational therapy exam
- Physical therapy exam
- Social and family history (interview with parents and children)
After filing a formal evaluation request, a parent/guardian will receive a Notice of Request for Initial Referral to begin the assessment. Be sure to confirm receipt of the request, and keep records of all reports and documentation to refer back to when necessary.
Government-funded evaluations do not typically include psychological assessments; however, you can request it if you feel a psychological assessment is critical to your child’s evaluation. This is subject to approval and must be conducted by a licensed psychologist registered with the NYC Department of Education, if approved.
All evaluation reports are considered part of a child’s educational record once they enter Kindergarten. If at any point you choose to discontinue a government-funded evaluation of your child, parents have the right to end the process at any time without financial penalty.
Note: If your child does not speak English, s/he needs to be tested in their primary language. Parents and legal guardians also have the right to request translations of evaluation reports and all communications into their preferred language. If your child is bilingual, your child can be assigned a bilingual evaluator fluent in both English and your child’s home language.
Pros and Cons of a Government-Funded Assessment
A free diagnostic evaluation of your child can be a useful first step to understanding your child’s behaviors and needs, and can also help a family determine whether further private testing would be worth the cost. There are a few challenges to this process, however, that families should consider before initiating a government-funded assessment.
One significant challenge to consider is that evaluators contracted with the NYC Departments of Health and Education also serve as intervention service providers, creating a conflict of interest in the system. This conflict of interest can lead to skewed evaluation results at times, resulting in a graver diagnosis of a child than is necessarily accurate and recommended intervention services which may not be most appropriate.
This well-intentioned practice is an effort to relieve families of the financial burden of paying out-of-pocket for multiple therapies, especially for children with mild developmental delays who might otherwise not receive a more serious diagnosis and therefore would not qualify for funded intervention services. Unfortunately these types of skewed findings can lead to confusion and extra worry for parents, so it is important to bear this conflict of interest in mind when pursuing a government-funded evaluation.
An additional challenge is that the NYC Departments of Health and Education reimburse evaluation agencies at lower rates than what private practitioners typically charge, which can sometimes result in families encountering evaluators who are fairly new and inexperienced in their field, or who may not be as knowledgeable in their assessment as a more experienced professional.
These challenges may or may not present themselves in your case, but it is important to be aware and bear them in mind should these issues arise.