By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA
Why Diagnosis Matters
Most parents seek out a neuropsychological evaluation because they’re looking for answers. Often, someone in the child’s life—whether a parent, teacher, or caregiver—has noticed something that doesn’t quite add up. Pursuing testing is a wise and proactive step toward understanding the root of a child’s challenges. In many cases, families hope to find a diagnosis that explains what’s going on. To borrow a phrase from psychiatrist and author Dan Siegel, “You have to name it to tame it.” Having a name for a child’s difficulties is often the first step toward effective support and intervention. Many parents describe feeling validated and relieved when a professional can identify and explain what their child is experiencing. Knowing there is an understandable reason behind their child’s struggles can be both reassuring and empowering.
Why A Clear Diagnosis Isn’t Always Possible
Despite everyone’s best efforts, sometimes a child’s challenges don’t fit neatly into a single diagnostic label. There are several reasons for this:
- Human complexity: Diagnoses can be helpful frameworks, but they don’t always capture the full picture. Children are wonderfully complex, and their unique mix of strengths and challenges often doesn’t align perfectly with one specific category.
- Overlap between conditions: Diagnoses are often presented as distinct “boxes,” but in real life, there is a lot of overlap between conditions. It’s often more accurate to picture diagnoses as overlapping circles in a Venn diagram, with many children’s experiences falling in the spaces where these circles intersect. It’s not always possible—or even helpful—to fully separate features into distinct diagnoses.
- Gradual emergence of symptoms: Some conditions develop slowly and may not be fully recognizable until later in life. For example, mild Autism Spectrum Disorder can be subtle and hard to identify, especially in gender-conforming girls and women. Social challenges may not be obvious in early childhood but can become clearer as social demands increase in adolescence, delaying a clear diagnosis.
- Lack of formal diagnostic labels: There are profiles commonly seen in clinical settings that don’t yet have formal diagnostic labels. For instance, significant executive functioning weaknesses can greatly impact daily life and academics, but there is no official diagnosis for this. Similarly, while we may use the term “Non-Verbal Learning Disorder” to describe certain patterns of difficulty with visual-spatial skills, organization, social cues, or motor abilities, this label isn’t formally recognized in current diagnostic systems.
What To Do Next
Receiving an evaluation without a clear diagnosis can be disappointing and even anxiety-provoking for parents; however, a neuropsychological assessment still offers significant value. The true strength of a thorough evaluation lies in its ability to provide a detailed understanding of your child’s unique strengths and challenges, and to clearly outline the supports and interventions that will be most helpful. Even among children who share a diagnosis, there can be important differences in how their difficulties present. A high-quality assessment goes beyond simply assigning a label; rather, it paints a comprehensive picture of your child as an individual. Ultimately, the most effective recommendations are those tailored specifically to your child’s needs, regardless of whether they meet criteria for a particular diagnosis.
If you find yourself in this situation, allow yourself space for your feelings. It’s natural to crave clear answers, and it can be difficult to live with uncertainty. Yet, there are concrete steps you can take:
- Recognize challenges independently of diagnosis: Throughout history, people have faced real and significant difficulties long before science could provide official explanations. For example, prior to advanced imaging, vision problems caused by multiple sclerosis were often mislabeled as “hysterical blindness” until CT scans revealed nervous system lesions. Similarly, before HIV was identified as the cause of AIDS, individuals suffered and died from the illness without a clear diagnosis. Sometimes, it takes time for science to catch up. In the same way, your child’s needs are real and valid, regardless of whether a formal diagnosis has been made.
- Advocate for your unique child: Similarly, focus on addressing their specific areas of need, rather than waiting for a label.
- Seek appropriate support services: There’s no need to wait for a formal diagnosis to pursue executive function coaching, psychotherapy, occupational or speech therapy, or specialized academic support. In some cases, early intervention may even help prevent a difficulty from becoming a full-blown diagnosis.
- Try to be patient and stay open to change: Remember that your child is still developing in very significant ways. Consider re-evaluation in a few years, as more information may become clear over time.
Remember, your child is more than a label. The insights from a neuropsychological evaluation can guide you in supporting their growth and well-being, even when there isn’t a specific diagnostic term to describe their unique profile. If you have questions or want to discuss whether a neuropsychological evaluation might be helpful, our team is here to support you.
About the Author

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.
Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.
Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.
Dr. Rodriguez lives north of Boston with her husband and three young children. She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.
To book a consultation with Dr. Rodriguez or one of our many other expert neuropsychologists, complete NESCA’s online intake form.
NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, NY, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Boston area since 2006. He specializes in the assessment of children and adolescents who present with a wide range of developmental conditions, such as Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder (reading, writing, math), Intellectual Disability, and Autism Spectrum Disorder; as well as children whose cognitive functioning has been impacted by medical, psychiatric, and genetic conditions. He also has extensive experience working with children who were adopted both domestically and internationally.
research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.
is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. She tailors each assessment to address a range of referral questions, such as developmental disabilities, including Autism Spectrum Disorder, learning disabilities, attention challenges, executive functioning deficits, and social-emotional struggles. She also evaluates college-/grad school-age/adult individuals with developmental issues, such as ASD and ADHD, particularly when there is a diagnostic clarity or accommodation question.

attention deficit disorders, communication disorders, intellectual disabilities, and learning disabilities. She particularly enjoys working with children and their families who have concerns regarding an autism spectrum disorder. Dr. Milana has received specialized training on the administration of the Autism Diagnostic Observation Schedule (ADOS).


young adults with diverse developmental and learning abilities. Since 2013, she has served as Director of Transition Services at NESCA, offering individualized transition assessments, planning, consultation, coaching, and program development. She specializes in working with students with complex profiles who may not engage with traditional testing tools or programs. Ms. Challen holds a BA in Psychology and a Minor in Hispanic Studies from The College of William and Mary, along with a Master’s and Certificate of Advanced Graduate Study in Risk and Prevention Counseling from the Harvard Graduate School of Education. She is a member of CEC, DCDT, and COPAA, believing it’s vital for all IEP participants to have accurate information about transition planning. Ms. Challen has also been actively involved in the MA DESE IEP Improvement Project, mentored candidates in UMass Boston’s Transition Leadership Program, and co-authored a chapter in Technology Tools for Students with Autism.
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