What Clinicians Should Know About Individualized Education Plans and 504 Plans

education plans and 504 plans


By Eun Paik, MD

When children need help at school for ADHD, anxiety, autism, learning disorders, or other issues, it is often the clinician’s job to help the parents navigate options for academic accommodations. Is an IEP the right fit versus a 504, and what is the difference? 

As an Amen Clinics psychiatrist treating children with a variety of brain health disorders, I have learned over the years how vitally important this subject is for my patients. The purpose of this article is to provide a distillation of the basics of 504 and IEP plans. It will discuss how they differ in the real world, how they are obtained, and how to best explain the process to patients and parents.

504 Basics

Short for Section 504 of the Rehabilitation Act, the 504 is a federal civil rights law passed in 1973 that bans discrimination in public schools and protects students with disabilities that affect their ability to learn.

What does a 504 provide?

A 504 provides accommodations to students with disabilities to ensure equal access to all learning and school activities.

Who is eligible for a 504?

There are two requirements for a 504 plan. A student must have a physical or mental impairment that significantly limits one or more essential life activities. In addition, the disability must impact the student’s ability to learn in a general education classroom.

What types of accommodations are provided by a 504?

A 504 provides accommodations, such as extended time on tests, audiobooks, and digital recorders to list a few.

Who is involved in a 504?

The child’s caregivers, teachers, and school principals typically make up the 504 team.

Does a 504 require written documentation?

No, a 504 does not need to be recorded in a formal document.

What does a 504 cost?

504 services are provided at no cost to the family.

What is an IEP?

An Individualized Education Plan (IEP) is a provision of the Individuals with Disabilities Education Act (IDEA), which is a federal mandate.

What does an IEP Provide?

An IEP provides special education and services to fit a child’s unique needs.

Who is eligible for an IEP?

A student may apply for an IEP if they have any of the following 13 disabilities: Autism Spectrum Disorder (ASD), Specific Learning Disability (such as dyslexia), Other Health Impairment (such as ADHD), Emotional Disturbance, Speech or Language Impairment, Visual Impairment, Deafness, Hearing Impairment, Deaf-Blindness, Orthopedic Impairment, Intellectual Disability, Traumatic Brain Injury, or Multiple Disabilities.

What types of accommodations are provided by an IEP?

An IEP provides accommodations that can involve simple assistance to actual changes in the curriculum or environment to suit a patient’s unique needs.

Who is involved in an IEP?

The IEP team must consist of at least the child’s caregiver, one general education teacher, one special education teacher, a professional capable of interpreting IEP results (usually a psychologist), and a district representative with special education authority.

Does an IEP require written documentation?

Yes, the IEP is a formal document that is legally binding.

What does an IEP cost?

IEP services are provided at no cost to the family but in terms of cost can run up to $20,000 annually per student.

3 Real-World Differences Between 504s and IEPs

Although these two plans may sound similar, there are some very important differences in the way they are administered in actual practice. Based on my experience working with children who need special education accommodations, there are some key differences that may be anticipated.

1. 504s are often largely ignored by schools. 

As a result, general education teachers are often unaware of a student’s issues or the accommodations they need.

2. 504 accommodations can get lost in transition. 

When a student transitions from one level of school to the next (elementary school to middle school or middle school to high school), there is often a lack of communication between the two schools. This means the teachers and staff at the new placement are often unaware of the student’s disability and accommodations.

3. Schools are usually more willing to provide a 504 than an IEP. 

504s are far less costly than IEPs, which cost schools tens of thousands of dollars annually per student. In addition, the fact that the IEP is legally binding makes schools less inclined to provide it.

4 Steps to Getting an IEP

An IEP offers more assurances that a child will receive the necessary accommodations, but it takes considerably more effort to obtain one. There are 4 basic components of the process.

1. Request an Educational Assessment

The first step to getting an IEP is requesting an educational assessment. Parents must submit a letter by certified mail stating the child’s disability and giving permission to assess the child. The school must complete the assessment within 60 days of the letter’s receipt.

2. Discuss the Results of the Assessment

The school should contact parents to set up an initial domain meeting to discuss the assessment results. As a clinician, you may be asked to attend this meeting along with family members, attorneys, and educational advocates. Family members often ask clinicians to help them interpret the results of the assessment as they do not know how to make sense of the document. It is also important to review the actual assessment tools, as I have had the unfortunate experience of having school staff deliberately skew rating scale results to prevent adequate diagnosis.

3. Be Prepared for Resistance

Based on personal experience, parents can expect to meet with some level of resistance when requesting an IEP. Some of the common avoidance tactics employed by schools include saying the child is not failing and as such does not need an IEP. Another is that the child will be “labeled” in a detrimental way.  Sometimes they will simply state that that they do not need to give the child an IEP because they feel that the child does not need one. It is important for clinicians to be prepared for these eventualities.

4. Take Action if the IEP is Denied

In the event that a school denies the child an IEP, there are still avenues of recourse. For example, they may request an Independent Educational Evaluation at the school’s expense. Some parents take legal action and file civil suits or can file for a Due Process Hearing where they can ask a court to make a determination if the school has done all due diligence.

The IEP in Action

When the process is successful and a child is granted an IEP, parents may look to their child’s psychiatrist, counselor, or therapist for guidance on what to expect from the plan. There are several mandatory components to an IEP, including descriptions of:

  • The child’s current strengths, weaknesses, abilities, and skills in the academic, social, and physical arenas
  • The services the child will be receiving
  • Accommodations to be provided
  • How the child will participate in standardized testing
  • How the child will be included in Gen Ed classes and activities

Understand that IEPs must be reviewed at least once a year and re-evaluated once every 3 years. Unfortunately, schools often try to phase out services as quickly as possible, which is why it is important to know about “stay put” rights. If a school wishes to implement changes to the IEP but the parents disagree with those changes, they have the right to evoke stay put rights. This must occur within 15 days of the date of the written notice of the proposed change. Parents can do this by filing for due process or submitting a request for mediation.

By advising parents on how to secure the appropriate academic accommodations, whether a 504 or an IEP, these patients will have a greater chance of succeeding not only in school but also in life.

About the Author: Eun Paik, MD, Amen Clinics Chicago

Dr. Eun Paik is a Board-Certified Child and Adult Psychiatrist whose treatment philosophy combines conservative pharmacologic management, appropriate forms of psychotherapy, and a thorough knowledge of the rapidly evolving field of Cognitive Neuropsychological. Her particular areas of interest include affective disorders, Autism Spectrum Disorder, and Attention Deficit Hyperactivity Disorder.



  1. Thanks for the article. For clarification: As a neuro, clinical, and school psychologist, working in schools in many states, since 1967, before IEP’s and 504 plans were a regular part of the curriculum, I have never seen a school where a 504 plan is not written formal contract.

    The information you provide is very important and could save much in the way of time, legal fees, and ongoing consternation.
    Thanks for making this information available.

    Dr. Susan Carey

    Comment by Dr. Susan MacLeod Carey — October 28, 2019 @ 9:46 AM

  2. When my children were in school, both of them had an IEP but NOT for disability, but rather for their intellectual giftedness. Your article omitted that children who are tested for high intelligence are also entitled to an IEP or academic accommodation.

    Have they done away with including the gifted children under the these regulations ? It would be good to know this as a clinican as well.

    Beth Gerhard-Burnham, PhD. LIMHP,LPC

    Comment by Beth Gerhard-Burnham — November 8, 2019 @ 9:01 AM

  3. Working with children with disabilities in the school system in Florida, having state facilitated IEP meetings, advocating for children through the IEP process, and filing state complaints because of the deficiencies in the provision of support in school, I can express my serious concerns about the implementation of the IEP/504 plan system.

    Simply put, it doesn’t work.

    In Florida, IEP’s are not followed simply because teachers and staff do not possess the training & competency to implement these needed services which ends up with children sitting in rooms and being “housed”.

    Of course, Florida is probably the bottom of the barrel, the least progressive, and the lowest quality when it comes to the psychiatrist, counseling and educational needs of not only atypicL children with disabilities, but typical children without disabilities.

    Take away message: don’t come to Florida if you have a child with special needs.

    Comment by Shelly Lynn Henry, MS, BCBA — November 25, 2019 @ 5:42 AM

  4. That is unfortunate to hear about Florida. I believe this is true for most areas because parents do not know their rights and they are busy and overwhelmed by the issues at home, especially if they work or are single parents with children who are struggling in school. It was pretty much the same for my children in a California school outside of Sacramento. I found that if a student looked “normalish” they acted like they did not know how they could possibly help ADHD/ADD, Dyslexia, or Central Auditory Processing, Autism or Anxiety and would placated me for two years with parent teacher meetings where they did not write any of my concerns down. At that time, I did not know the power of writing myself. The principal and school psychologist acted like they were listening and concerned when, in the end, nothing would change. I learned that everything must be in writing to be considered a legal request/document and in order for the countdown to begin between when the parent requests educational and psychological testing and when the school responds. If your e-mail falls on deaf ears or with an unwanted response you can then go to the district to challenge the school’s denial, if they do not grant testing. If the district does not grant testing you can call the Department of Educatioin, or I just like to go to the media. Some local T.V. stations have numbers to call if you feel you are being taken advantage of and they can call the District Office and/or Principal to get the ball rolling if nothing is done it might become a local story but most of the time the school and district want to avoid negative stories especially about children with disabilities being left behind. There are also local Boards in California that can offer help to educate parents about how to advocate for their children under the Individuals with Disabilies in Education Act. In Sacramento and the outlying area, it is Area Board 3. Although I was educated on the laws (you can Google them) and had my request in writing, I decided to bring in a lawyer into the situation and the school lawyered up as well. Now our schools are pretty good for students who have a diagnosis. The sad part is that many children go undiagnosed because doctors are not diagnosing and the schools do not want to provide the help because it is a lot more work for them, so they do not usually offer that there may be a learning disability, etc.. This is a clue, if the school feels that your child should repeat a grade ask them how that will benefit your child. Trust me, it will negatively affect their self esteem so there better be a good reason. If a child has a learning difference/disabilty being taught the same thing over will not ensure they understand it. These children often need to be taught differently-for my children and myself, tutors did this work for us. If the student is immature, maybe repeating the class would help; if they were out ill or missed a lot of school, this may be the only reason to repeat a grade. In my opinion, doing the same thing the same way and expecting different results is the definition of crazy. If they didn’t get it the first time, why would they understand it if the information is presented the same way, the second time? If anyone in placer county needs advocacy, I look at all things regarding your child and focus on what you feel is important, not the school. Sometimes a child is depressed and needs therapy or if they were bullied and feel they are struggling alone, changing to a charter school or look at different options would help them feel safe. Also, knowing if a highschool uses a quarter system over a semester or year program could mean that finding a better fit for your child would be best. In the end, most parents just want our children to feel like they are getting the help they need and not being left behind.

    Comment by Angela — March 4, 2020 @ 12:34 PM

  5. Important:
    I almost forgot,
    Do not go to an IEP or 504 alone and discuss with the person who attends with you what your goals are as a parent for your student so they can keep this in mind if the meeting goes off track or these goals have been overlooked. Google accommodations for __ (whatever the diagnosis is) so you will know what to request what works best for your child in the IEP/504 meeting. You do not have to remove accommodations even if your child met a goal, they may need them later because different teachers work better with your student than others. If you feel that the meeting was not in your child’s best interest or if you felt pressured or if no one else could attend the meeting with you DO NOT SIGN THE IEP/504 meeting agreement…you can always send it in a few days when you have gone over it with a friend, spouse or lawyer-make sure to get a copy of the form so you can sign it at home. IEPs/504s follow your child into college and they can significantly help them in higher education and can be used for priority class selection and to request speical housing if neccessary.

    Comment by Angela Mclaughlin — March 4, 2020 @ 1:06 PM

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