Disability diagnosis: who to consult? And where?

Diagnosis most often occurs during childhood, when parents or those close to the child have concerns about their development. However, it can also take place in adulthood in certain situations when the person presents complex disorders, or when no professional has previously diagnosed the difficulties the person has experienced, or when an accident or illness causes their health to deteriorate suddenly.

If you have any doubts about the health of your loved one, if you feel that their abilities are deteriorating if they are an adult, or that they are not progressing if they are a child, the first person you should talk to is your loved one's usual doctor.

If it is a child, it also happens that other people who know him/her may have questions about his/her development: the nurse from the PMI, the nursery nurse, the teacher, the school doctor… They may advise you to go and consult a doctor to ask all the questions and start to understand what is going on.

In all cases, it is the general practitioner who knows your loved one who will give you advice or prescriptions for further tests and to implement the various necessary treatments, whether in the hospital, in the community, or at home. This general practitioner will listen to you and refer you to other, more specialized professionals, depending on the difficulties you describe or that they observe. You can meet these specialists either at a diagnostic center or in their private practice.

There are many specialist doctors, and they are trained more specifically in a particular subject, for example:

The pediatrician

He is a general practitioner who specializes in children.

The neurologist

He specializes in brain function. He can be consulted in cases of cognitive disorders such as significant learning disabilities, intellectual disability, and diseases of the nervous system such as epilepsy or neurodegenerative diseases.

The pediatric neurologist

He specializes in brain function for children. A neuropediatrician is consulted in cases of motor problems such as delayed walking, difficulties in body movements, eye movements, learning difficulties (reading, writing, drawing, etc.), behavioral problems (concentrating, staying in place, behaving appropriately, etc.) or brain disorders such as epilepsy.

The rehabilitation physician

This is essentially the "disability doctor." They work with a team (other doctors, physiotherapists, occupational therapists, psychomotor therapists, speech therapists, psychologists, etc.). Their specialty is to rehabilitate motor disorders and dysfunctions caused by illness or disability to the greatest extent possible. They are also called PMR specialists, for "Physical Medicine and Rehabilitation."

The psychiatrist

He specializes in mental disorders and mental illnesses. He can be consulted in cases of psychological or emotional difficulties (distress, behavioral problems, etc.) but also in cases of developmental disorders (learning disabilities, autism, etc.).

Other doctors are sometimes necessary, depending on the difficulties or disability of your loved one (cardiologist for the heart, phoniatrist for the voice, ENT specialist for hearing and speech…)

The psychologist

Through an interview and tests, he assesses the level of psychological development of your loved one: what are their strengths and difficulties in several areas such as intellectual development, relationships, emotional maturity or behavior.

The neuropsychologist

This is a psychologist specially trained to assess cognitive functions, for example: memory, attention (ability to concentrate), executive functions (ability to organize one's thoughts)... After the diagnosis, if certain cognitive functions pose a problem, the neuropsychologist proposes remediation, that is to say consultation and work sessions with your loved one to improve these cognitive functions.

The speech therapist

He assesses the person's level of oral and written language through an evaluation (tests), then proposes rehabilitation, that is to say, work sessions to improve their oral or written language.

The psychomotor therapist

He assesses your loved one's psychomotor skills and difficulties in their daily life: how they move, hold and move objects, stand, speak, and exhibit unusual behaviors… He participates in rehabilitation by suggesting exercises.

The occupational therapist

It primarily assesses arm motor skills and visuospatial functions (the ability to coordinate movements based on what is seen). If your loved one has difficulties, it can suggest adaptations: organizational assistance, specific devices or equipment, etc.

The physiotherapist

He assesses motor disorders, gait disorders, balance problems, and posture problems, and he provides rehabilitation.

The orthoptist

He works with an ophthalmologist. He examines vision, visual acuity (can your loved one see well, see clearly…) and eye movement (do their eyes move properly). He offers rehabilitation sessions if your loved one has vision or eye movement problems that impact their daily life.

Your primary care physician will refer you to these professionals, either in private practice or at the hospital, to conduct assessments and refine your loved one's diagnosis. It is also possible to contact a diagnostic center, with or without a referral depending on the type of center, although waiting times can sometimes be long. These centers primarily specialize in pediatric diagnostics, but some also perform adult diagnostics.

Early Medical and Social Action Centres (CAMSP)

They welcome children with difficulties, aged 0 to 6. The mission of a CAMSP (Early Intervention Medical-Social Center) is to understand the root causes of a child's difficulties in order to help them progress in daily life. They can liaise with the child's primary care physician and other professionals involved in their care. It is possible to contact a CAMSP without a referral, although waiting times can sometimes be long.

Medical-Psycho-Pedagogical Centers (CMPP)

They offer the possibility of welcoming children from 0 to 20 years old to further their diagnosis and help them progress. You do not need a diagnosis to go there. These are independent professionals who practice in their offices.

It is possible that the CAMSP or CMPP are overwhelmed and that the available appointments are too far in the future. In this case, you can also contact a private practitioner.   Furthermore, having access to a CAMSP or a CMPP does not prevent you from using independent professionals to supplement the care of your child.

Mental Health Centers (CMP)

These are free consultation centers for all people suffering from psychological distress, catering to children, adults, and the elderly.

Coordination and Referral Platforms for Neurodevelopmental Disorders (PCO-TND)

These are new centers for support and diagnosis. For children with neurodevelopmental disorders (that is, disorders affecting their development such as autism, intellectual disability, or learning disabilities), you may be referred to one of these PCO-TND (Centers for the Evaluation and Guidance of Neurodevelopmental Disorders). Your primary care physician, when organizing your child's diagnostic process, may contact a PCO-TND. This center primarily serves children from birth to age six. It will support you by directing you to the most appropriate professionals who meet your child's needs. Furthermore, they can schedule appointments for you and will ensure your child's diagnosis progresses smoothly, working alongside you throughout the process.

Resource centers, diagnostic centers, or reference centers

They primarily handle the diagnosis of complex disorders. At these centers, you can delve deeper into the diagnosis of your child's condition and access the necessary care. The resource centers also offer extensive documentation on various disabilities for individuals of all ages who require information.