My Child Is Struggling in School: A Psychologist’s Guide to IEPs, 504 Plans, and Where to Start

Written By Janell Mihelic

Dear Concerned Parent,

If your child is struggling in school or showing emotional or behavioral challenges and you don’t know where to start, you’re not alone. I have this conversation often in my private practice with parents, and I find myself wishing every parent, whether they can access a psychologist or not, had this information available. It’s so hard to know where to even begin.

So, I’m sharing my thoughts here in case they help you or someone you care about. If you have any questions, feel free to reach out to me or my team. Even if we’re not the right fit for services, we’re happy to point you in the right direction. You can schedule a free 15-minute consultation with any of us through our website: www.TheThoughtLoft.com.

The information I provided is specific to Nevada, but it may be applicable to other states.

Here’s a general roadmap I offer to families navigating this process:

Step 1: Talk to Your Child’s Teachers or School Administrators

Start by asking the school for help. Teachers often have valuable insight, and your child may already be showing signs of needing support that the school can document. They also have the benefit of seeing your child in the context of their peers, which can help highlight differences in learning style, behavior, or development.

You could begin the conversation with a message like:

“Dear Teacher, I’m concerned about my child’s [fill in the blank]. Could we find a time to talk briefly about what you’re seeing in the classroom? I’m wondering if they might need some extra support with [fill in the blank]. Thank you, Parent.”

Teachers may recommend a “wait and see” approach, which is often reasonable for mild concerns. Have you heard the analogy about kids being like popcorn? I wish I knew who first said it, but it’s brilliant: even though all the kernels are in the same pot and under the same heat, each one pops at its own time. That’s true of kids, too. They develop on different timelines, and there’s a wide range of what’s considered “normal.” As a parent, I can remember so often worrying about my children just to have them wake up the next day and finally figure out whatever they were working on developmentally. 

That said, if a child appears to be outside that typical developmental range, it may be time to consider whether an intervention would be helpful. Schools can often begin those interventions through two main avenues:

  • IEP (Individualized Education Program): For students who need specialized instruction and meet eligibility in one of 13 disability categories.

  • 504 Plan: For students who don’t need special education but do need accommodations (like extended time, movement breaks, or sensory tools).

To initiate an IEP evaluation, parents can submit a written request asking the school to consider whether their child qualifies. The school psychologist will assess whether the child meets eligibility criteria.

It’s important to note that IEP evaluations by school psychologists are not the same as comprehensive psychological evaluations. We have many qualified and dedicated school psychologists working in CCSD (https://ccsd.net), but most are not licensed psychologists. This means they can determine if a child qualifies for special education services, but they cannot provide a formal diagnosis.

For some children, a diagnosis may not significantly change the support they receive. But for others, having a formal diagnosis opens access to additional services outside of school, like therapy, medication, or community-based support. For example, a child on an IEP for executive functioning and impulse control may meet criteria for ADHD. With a formal diagnosis, they may access treatment like medication, psychotherapy, occupational therapy, or parenting support programs. 

Also, sometimes having the diagnosis provides relief to a child to have a name or a label for their struggles. For example, a family member of mine was diagnosed with dyslexia. When they were told about their diagnosis in 3rd grade, it provided them much relief to know what caused their struggles and provided them access to an affirming, strength-based community of other dyslexics talking about their unique strengths and weaknesses. 

To qualify for a 504 Plan, a child needs a formal medical diagnosis, such as ADHD, diabetes, or a seizure disorder. A 504 provides accommodations but does not include specialized instruction.

Charter schools are legally required to offer the same support as public schools. Private schools are different; while some in Nevada are very accommodating, they are not obligated to provide the same level of services since they are not publicly funded. If your child attends a private school, ask how equipped they are to support your child with their unique educational needs. 

If you’re trying to work with your school and feel your concerns are not being addressed, these organizations can help:

  • PEP Nevada – Offers free training and support to parents navigating IEP and 504 processes.

  • Child Find Services (Clark County) – Provides free evaluations for children not yet identified but who may need services.

  • IEP Defenders – Local advocates who help families understand their rights and prepare for school meetings.

If your child is not yet in school, start with Child Find. They provide free evaluations and may recommend early interventions like speech or occupational therapy, or a spot in a preschool classroom within CCSD.

Step 2: Check In with Your Child’s Pediatrician

Sometimes school struggles are tied to medical concerns. For example:

  • A child who can’t focus may have sleep apnea, an iron deficiency, or thyroid imbalance.

  • A child with frequent stomachaches or meltdowns may be dealing with anxiety or sensory processing difficulties.

A pediatric exam and lab work can help identify medical issues that may be affecting learning or behavior. Pediatricians can also refer your child to other specialists when needed.

It is also useful to check on your child’s basic needs. For example, is your child getting enough sleep? Is your child getting enough to eat? Is your child having enough play time or connecting with their parents/siblings/friends? If your answers are no, consider shifting things for 1 month and examining if it makes a difference for your child.

Step 3: Consider a Comprehensive Psychological Evaluation

A licensed psychologist trained in psychological testing (sometimes called a neuropsychologist) can help you understand your child’s learning profile and emotional needs more clearly. Not all psychologists use the term “neuropsychologist,” but many are still highly trained in evaluation, this is something I’ll write more about in a future post.

A high-quality psychological evaluation will:

  • Identify your child’s cognitive strengths and areas of struggle

  • Clarify diagnoses like ADHD, Autism, learning disorders, or anxiety through psychological assessments

  • Offer tailored recommendations for school and home

  • Provide written and verbal feedback to you regarding your child’s results

  • Help you and your child understand how their brain works and how to support it

If your child already has a diagnosis, I recommend re-evaluation approximately every three years. In particular, consider reassessment before major transitions like middle school, high school, or college (especially if your child may need accommodations in higher education settings).

But a frustrating note on funding:

Most insurance plans do not cover academic testing and will only reimburse for what they define as “medically necessary.” Most insurance companies I have worked with do not believe that academic testing is medically necessary. I strongly disagree with this stance and would love to see a law be made that requires all insurance plans to cover academic testing for all children under the age of 18 in Nevada (any law makers want to take this on?). Understanding how a child learns is absolutely essential and has long term implications for a child’s academic and employment future. That said, many insurance plans will cover evaluations for behavioral or emotional concerns like ADHD or anxiety. Some psychologists are able to bill insurance for these parts of the evaluation. You can also use Health Savings Accounts (HSA/FSA) to cover costs.

I recommend asking providers about coverage before scheduling and calling your insurance company to clarify what’s included under your plan. To find out about your insurance coverage, I would call the insurance company (their phone number is usually on the back of your insurance card) and ask them the following questions:

“My child needs a psychological evaluation as their are struggling with … [fill in the blank]. What does my child’s insurance plan cover in terms of psychological evaluations? What is the deductible? What will be our co-pay? Do we need a prior authorization? Do I have out of network benefits? Will my child’s insurance plan cover academic testing? Do you have a list of providers for me to call for this service in the general Las Vegas area?”

Step 4: Consider Other Helpful Referrals

Depending on your child’s needs, it may be useful to consult with:

Final Thoughts

I know this can feel overwhelming, and you may be carrying this worry alone. But you don’t have to. Many of us parents have walked this path before (myself included). There are people who care deeply and resources to help you and your child thrive.

Whether you seek support through your school, your medical team, or a psychologist, know this: by paying attention and taking action, you’re already doing something powerful for your child.

With warmth and support,

Dr. Janell Mihelic

Janell Mihelic
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