From Clinic to Classroom: Investigating IEPs and Diagnostic Clinical Evaluation Recommendations for Students with a Fetal Alcohol Spectrum Disorder Diagnosis

Abstract

Fetal Alcohol Spectrum Disorder (FASD) is associated with neurodevelopmental, cognitive, behavioral, and adaptive impairments that affect educational functioning and access to special education services. Despite increasing recognition of FASD, students on the fetal alcohol spectrum remain under-identified in school settings, and little is known about the extent to which clinical diagnostic recommendations align with school-based educational supports. This study compared interdisciplinary clinical diagnostic reports and school-based Individualized Education Programs (IEPs) for children diagnosed with FASD to examine patterns of alignment and mismatch in eligibility determinations, services, and educational recommendations. Results indicated that 51% of participants had a preexisting IEP at the time of diagnosis, with moderate overall agreement between clinic recommendations and school-based eligibility determinations. However, discrepancies were frequently observed in the extent to which IEPs addressed students’ documented neurodevelopmental and functional needs, particularly among students with greater central nervous system impairment and in areas related to occupational therapy and transition planning. Findings suggest that educational identification and service provision may be more strongly associated with observable functional impairment than with categorical FASD diagnoses alone. Implications highlight the importance of interdisciplinary collaboration and the role of school psychologists in translating clinical evaluation findings into educationally relevant supports and interventions for students on the fetal alcohol spectrum.