Everything you need to know: The complete guide to diagnosis before first grade

Many parents often feel that their children have difficulties, and it is not just a feeling. Data on the ground shows that every seventh student in the Israeli education system is eligible for special education services. However, there are a variety of diagnoses today, each focusing on a different issue. Some diagnoses exist within the education system, and some are conducted by private centers or non-profit organizations.

Ahead of the start of the school year, Dr. Sarit Tagansky, director of the 'Function' center in Givatayim, explains the role of each. The recommended process for making a decision is consultation with the kindergarten staff: the teacher and the professionals (psychological service/MATIYA) know the child's functioning in the group and can direct them to the accurate diagnosis. In addition, contact a pediatrician for referrals to child development services at the HMO for occupational therapy, speech therapy, or developmental assessment.

Diagnoses ahead of entering first grade are intended to assess the child's overall abilities — cognitive, motor, linguistic, emotional, and behavioral — to ensure readiness for the school framework and to identify the need for support or adjustments. This is done already in kindergarten: the teacher observes, and if there are difficulties, invites the kindergarten psychologist, from where the child is referred to the necessary specialist.

Readiness / preparedness diagnosis for first grade

The goal is to examine the child's emotional, social, cognitive, and motor readiness ahead of the transition to a school framework. It is recommended when there is doubt about the possibility of staying another year in kindergarten (developmental/emotional delay) or in cases of a request for early entry to first grade. An educational psychologist conducts this through the required psychological service or privately, provided they have a license accepted by the Ministry of Education.

Occupational therapy diagnosis

The goal is to assess fine and gross motor skills, sensory regulation, and visual-motor functions. Checks include pencil grip, quality of drawing/copying shapes, movement planning, organization in space (such as cutting and pasting), independence in dressing, and sensory sensitivity. The diagnosis is performed by a certified occupational therapist.

Speech therapy diagnosis

The goal is to assess the language and speech skills required for acquiring reading and writing and for social communication. This includes "phonological awareness" (identifying sounds, rhymes, breaking down and assembling words), vocabulary, understanding what is heard, word retrieval ability, sound pronunciation, and interpersonal communication. The diagnosis is performed by a certified speech therapist.

Psychological / psycho-didactic diagnosis

The goal is a comprehensive assessment of cognitive abilities (intelligence), basic learning skills, and the emotional-personality profile. Checks include spatial perception, working memory, conceptualization ability, anxiety level, self-confidence, and social skills. The emphasis is mainly on the transition from kindergarten to school. Usually, this is a developmental psychological diagnosis or an expanded readiness diagnosis, as a full didactic diagnosis of learning disabilities is typically performed only during second grade and above. The diagnosis is performed by an educational, developmental, or clinical psychologist.

Diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) from age 6

The purpose is to identify difficulties in attention, hyperactivity, and impulsivity that affect academic and social functioning. Checks include clinical observation, structured questionnaires for parents and the teacher (such as the Conners questionnaire), and sometimes computerized tests (such as MOXO or CPT) as an auxiliary tool. The diagnosis is performed only by a pediatric neurologist, a child development physician, or a child psychiatrist.