AAP Voices Blog

Speaking Different Languages: Bridging the Divide Between School Psychology and Pediatrics

A 9-year-old with autism came to see me after weeks of escalating behavior at school, bolting from the classroom, refusing to complete work, and hitting peers. His mother had already attended several school meetings, and the team was committed to finding solutions.

In our clinic, we reviewed recent changes in his health, including medication adjustments, sleep disruptions, and sensory sensitivities that could all contribute to the behaviors. At the same time, the school psychologist was conducting a functional behavior assessment, uncovering patterns in the classroom environment that I had not yet seen.

Each team was deeply committed, yet we were working in parallel, not together. Without a streamlined way to share information in real time, our efforts were not fully aligned, and the family was left trying to connect the dots between two well-meaning but disconnected systems.

That experience stuck with me. As a developmental-behavioral pediatrician, I often work with families whose children depend on both the medical and educational systems.

These systems are filled with talented, committed professionals, but too often, they function in silos. We speak different professional languages, have different timelines, and operate under different laws and funding structures.

Families are left to translate between us, carrying the burden of relaying technical details from one system to the other.

Before I went to medical school, I earned a master’s degree in school psychology. That training gave me the unique privilege of understanding the perspectives, language, and constraints of both professions, and it has made me even more aware of the gap that families are asked to bridge every day.

In my work alongside school psychologists Amy Wine, MS; Rachel Flood EdS, NCSP; Christine Leuzzi, EdS, EdS, NCSP; Laura Brockman, PsyD; Steven L Hofberg, EdS, BCBA, NCSP; Gina Giorno, EdS, - Philadelphia College of Osteopathic Medicine School psychology alumni who I met post-graduation as well as current students - I have learned how easily these disconnects happen, and how much better care can be when we collaborate from the start. We have talked about the barriers, which include:

• Communication gaps caused by no standardized, secure way to share updates.
• Varying Language such as how the same word, like “support,” can mean different things in a clinic note versus an Individualized Education Program (IEP).
• Role misunderstandings as physicians focus on diagnoses and treatment while school psychologists focus on educational access and eligibility.
• Resource limitations across both fields as we all face high caseloads and too few specialists.
• System differences based on the federal health privacy law, Health Insurance Portability and Accountability Act (HIPAA), and federal education laws, such as Individuals with Disabilities Education Act (IDEA and Section 504. Often both are housed in separate documentation systems.

Layered on top of these are the real-life barriers families face such as transportation issues, work schedules, language differences, and distrust rooted in past experiences with institutions.

Still, I have seen what is possible when we find ways to work together. Joint training sessions, shared case discussions, and simple tools like standardized communication templates can make a difference. Sometimes it is as straightforward as having a brief phone call before writing a letter for a family, ensuring that my recommendations align with the school psychologist’s perspective and the resources actually available.

When we coordinate care, children benefit not just academically but socially, emotionally, and developmentally.

For me, bridging the divide starts with humility. I have medical expertise, but school psychologists spend their days in the educational environment observing how a child functions in real time. By listening to each other, we can give families clear, consistent guidance, the kind that builds trust instead of breaking it.

To my fellow pediatricians: If you work with a child who has an IEP or is in the evaluation process, reach out to their school psychologist. Ask how you can best support their recommendations and share your own observations. Even one conversation can spare a family the stress of navigating conflicting advice.

Our systems may have been built in isolation, but the children we serve need us to work as one team. The bridge starts with us.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.