The Label That Unlocks Funding

The assessment does not support a straightforward diagnosis. A WISC-V FSIQ of 72 with a 95% CI of 68–76 is in the borderline range, and the Vineland composite of 78 is also below average but above the usual intellectual disability threshold. Intellectual disability requires deficits in both intellectual and adaptive functioning with onset in the developmental period; this profile is not conclusive, and the confidence interval crosses 70. 'Suspected FASD' cannot be confirmed without confirmed prenatal alcohol exposure, and the referral note gives adoption as the basis for suspicion, which is not evidence of exposure. Other explanations should be tested: language and cultural bias in standardised testing, hearing or vision, trauma and attachment disruption, ADHD, specific learning disorder, and classroom or family stress. The WISC-V norms and item content may not be culturally fair for a Māori child who speaks te reo at home; an interpreter is not enough without considering test bias, dynamic assessment, and multiple sources. A one-hour feedback session is also inadequate for a complex, uncertain formulation.

The assessor has a conflict of interest: being paid by the school as a consultant for the funding application creates pressure to produce a diagnosis that unlocks resources. That conflict must be disclosed, and the diagnostic and funding roles should be separated, ideally with an independent review of any diagnosis. The report should describe functional needs - classroom accommodations, literacy support, behavioural regulation, whānau involvement - without inventing a diagnostic certainty that the evidence does not support. The parents' wish to avoid a label is understandable, but 'just dyslexia' would be inaccurate if the profile is broader and would not necessarily secure the right support. The assessor should explain the uncertainty, the difference between a diagnosis and a needs description, and the implications of each for funding, identity, and school placement. The school should be told that ORS funding criteria may be met through functional evidence rather than a speculative FASD diagnosis. Beneficence and justice point toward getting the child support without misusing a diagnostic category.

Feedback should be planned, not squeezed into an hour. It should include the parents and, where appropriate, the child, with a te reo Māori interpreter or cultural support person, and should start from strengths and the family's questions. The assessor should explain the scores in plain language, including the confidence interval and what the tests do and do not measure, and should be explicit that cultural and linguistic factors may affect validity. The report should state the evidence, the uncertainty, the differential hypotheses, and recommended next steps: a culturally informed assessment, classroom observations, a literacy assessment, and a review after intervention. It should not state 'FASD' without exposure evidence, nor 'just dyslexia' to satisfy the parents. It should describe needs and accommodations, distinguish diagnosis from funding eligibility, and record the conflict-of-interest disclosure. The family should have time to ask questions, know how to request corrections, and understand complaint and review pathways. A follow-up meeting after the school has read the report would reduce the risk of the label travelling without the nuance.