The COVID-19 pandemic sent Heidi Whitney's daughter into a tailspin.
Suddenly the San Diego middle schooler was sleeping all day and awake all night. When in-person classes resumed, she was so anxious at times that she begged to come home early, telling the nurse her stomach hurt.
Whitney tried to keep her daughter in class. But the teen's desperate bids to get out of school escalated. Ultimately, she was hospitalized in a psychiatric ward, failed "pretty much everything" at school and was diagnosed with depression and ADHD.
As she started high school this fall, she was deemed eligible for special education services, because her disorders interfered with her ability to learn, but school officials said it was a close call. It was hard to know how much her symptoms were chronic or the result of mental health issues brought on by the pandemic, they said.
"They put my kid in a gray area," said Whitney, a paralegal.
Schools contending with soaring student mental health needs and other challenges have been struggling to determine just how much the pandemic is to blame. Are the challenges the sign of a disability that will impair a student's learning long term, or something more temporary?
It all adds to the desperation of parents trying to figure out how best to help their children. If a child doesn't qualify for special education, where should parents go for help?
"I feel like because she went through the pandemic and she didn't experience the normal junior high, the normal middle school experience, she developed the anxiety, the deep depression and she didn't learn. She didn't learn how to become a social kid," Whitney said. "Everything got turned on its head."
Schools are required to spell out how they will meet the needs of students with disabilities in Individualized Education Programs, and the demand for screening is high. Some schools have struggled to catch up with assessments that were delayed in the early days of the pandemic. For many, the task is also complicated by shortages of psychologists.
To qualify for special education services, a child's school performance must be suffering because of a disability in one of 13 categories, according to federal law. They include autism, attention-deficit/hyperactivity disorder, learning disabilities like dyslexia, developmental delays and "emotional disturbances."
It's important not to send children who might have had a tough time during the pandemic into the special education system, said John Eisenberg, the executive director of the National Association of State Directors of Special Education.
"That's not what it was designed for," he said. "It's really designed for kids who need specially designed instruction. It's a lifelong learning problem, not a dumping ground for kids that might have not got the greatest instruction during the pandemic or have major other issues."
In the 2020-2021 school year, about 15% of all public school students received special education services under federal law, according to the National Center for Education Statistics.
Among kids ages 6 and older, special education enrollment rose by 2.4% compared with the previous school year, according to federal data. The figures also showed a large drop in enrollment for younger, preschool-age students, many of whom were slow to return to formal schooling. The numbers varied widely from state to state. No data is available yet for last year.
While some special education directors worry the system is taking on too many students, advocates are hearing the opposite is happening, with schools moving too quickly to dismiss parent concerns.
Even now, some children are still having evaluations pushed off because of staffing shortages, said Marcie Lipsitt, a special education advocate in Michigan. In one district, evaluations came to a complete halt in May because there was no school psychologist to do them, she said.
When Heather Wright approached her son's school last fall seeking help with the 9-year-old's outbursts and other behavioral issues, staff suggested private testing. The stay-at-home mom from Sand Creek, Michigan, called eight places. The soonest she could get an appointment was in December of this year - a full 14 months later.
She also suspects her 16-year-old has a learning disability and is waiting for answers from the school about both children.
"I hear a lot of: 'Well, everyone's worse. It's not just yours,'" she said. "Yeah, but, like, this is my child and he needs help."
It can be challenging to tease out the differences between problems that stem directly from the pandemic and a true disability, said Brandi Tanner, an Atlanta-based psychologist who has been deluged with parents seeking evaluations for potential learning disabilities, ADHD and autism.
"I'm asking a lot more background questions about pre-COVID versus post-COVID, like, 'Is this a change in functioning or was it something that was present before and has just lingered or gotten worse?'" she said.
Sherry Bell, a leader in the Department of Exceptional Children at Charleston County School District in South Carolina, said she is running into the issue as well.
"In my 28 years in special education, you know, having to rule out all of those factors is much more of a consideration than ever before, just because of the pandemic and the fact that kids spent all of that time at home," said Bell.
The key is to have good systems in place to distinguish between a student with a lasting obstacle to learning and one that missed a lot of school because of the pandemic, said Kevin Rubenstein, president-elect of the Council of Administrators of Special Education.
"Good school leaders and great teachers are going to be able to do that," he said.
The federal government, he noted, has provided vast amounts of COVID relief money for schools to offer tutoring, counseling and other support to help students recover from the pandemic.
But advocates worry about consequences down the line for students who do not receive the help they might need. Kids who slip through the cracks could end up having more disciplinary problems and diminished prospects for life after school, said Dan Stewart, the managing attorney for education and employment for the National Disability Rights Network.
Whitney, for her part, said she is relieved her daughter is getting help, including a case manager, as part of her IEP. She also will be able to leave class as needed if she feels anxious.
"I realize that a lot of kids were going through this," she said. "We just went through COVID. Give them a break."
Sharon Lurye in New Orleans contributed to this report. The Associated Press education team receives support from the Carnegie Corporation of New York. The AP is solely responsible for all content.