Moving abroad can be an exciting and rewarding experience for the whole family. But for children, adjusting to a new culture, language, and school system isn't always easy. When learning difficulties arise or persist, parents may face an added challenge: understanding what's behind their child's struggles and finding the right support in an unfamiliar country. Where can they turn for answers when the specialists and resources they would normally rely on are thousands of miles away?
Attention difficulties, slow processing, problems with memory, struggles with reading or maths, poor organization, clumsiness, anxiety around learning, difficulties with social interaction... These signs can have many different causes. They may be temporary and context-related, but they can also prompt an investigation into a possible neurodevelopmental disorder (NDD), such as ADHD, a specific learning disorder, developmental coordination disorder, or autism spectrum disorder.
For expat families, however, finding answers to these questions can be a far more complicated journey.
When language becomes a factor in assessment
The first challenge is often linguistic.
A child may attend an international or local school, move between several languages every day, and yet still have English as their mother tongue or dominant language.
A cognitive or neuropsychological assessment is not simply a matter of translating questions from one language to another. The tests used are standardized: the instructions, materials, testing conditions, and norms are all designed to compare a child's performance against a reference population.
Assessing an English-speaking child with tools that don't match their linguistic background can therefore complicate how results are interpreted. A difficulty understanding the language of assessment must not be mistaken for a cognitive, attentional, or learning difficulty.
Bilingualism or multilingualism also needs to be considered. Speaking several languages is obviously not a disorder. That said, a child's language history, the age at which they were exposed to each language, and the languages spoken at home and at school are all important factors when interpreting certain results.
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Tools that aren't always available in the host country
The second challenge is access to qualified professionals and assessment tools.
Depending on where they live, families may not easily find a professional trained in child neuropsychological assessment. And even when a professional is available, they may not have access to the original versions of the test batteries commonly used back home.
On top of this, healthcare systems and the recognition of different professional roles vary considerably from country to country. The pathways for exploring ADHD, autism spectrum disorder, or a learning disorder are not organized the same way everywhere.
Some families start the process locally, consult professionals back home at the same time, or use a trip home during the school holidays to schedule appointments.
This can become a genuine logistical challenge, with several months sometimes passing between the first concerns and the completion of the various assessments needed.
Telling the difference between adjustment difficulties and neurodevelopmental disorders
The international living experience itself also needs to be factored in.
Moving to a new country can mean a new school, a new language of instruction, different teaching methods, a different daily rhythm, and new social reference points. Some children go through an adjustment period during which their academic performance fluctuates.
Not every school difficulty points to a neurodevelopmental disorder.
At the same time, automatically attributing difficulties to the move can delay the identification of a pre-existing condition. A child who already showed signs of attentional, executive, language, or learning difficulties before leaving may find those difficulties become more visible as academic demands increase.
The key is to consider the child's full developmental history: were the difficulties present before the move? In more than one setting? How long have they been going on? What impact are they having on learning, independence, or daily life?
The neuropsychological assessment: one piece of the puzzle
When indicated, a neuropsychological assessment can explore different aspects of how a child functions: intellectual ability, attention, executive functions, memory, and certain learning-related skills, depending on the concerns at hand.
However, it should not be seen in isolation.
Understanding a child's difficulties generally requires drawing on multiple sources of information: parents' observations, input from the school, developmental history, previous assessments, and, where necessary, the views of other healthcare professionals.
In some cases, a multidisciplinary approach may be needed, bringing together, for example, a doctor, speech-language therapist, psychomotor therapist, occupational therapist, psychologist, or neuropsychologist, depending on the difficulties identified.
An assessment should therefore not be reduced to a set of scores. Its real value lies in the analysis of the child's profile and the concrete recommendations that follow.
Keeping the school in the loop
For expat families, another key question is what to do with the results once the assessment is complete.
A highly detailed report that is difficult to apply in the classroom is unlikely to have much practical impact. Maintaining a connection with the school is therefore especially important.
When a child attends an international school abroad, the teaching team needs to understand the findings and, where relevant, use them to inform discussions about classroom accommodations.
Extra time, reduced copying requirements, chunked instructions, visual supports, adjusted workload, help with organization, or a specific seating arrangement: the recommendations depend above all on the individual child's profile.
Open communication between the family, the school, and the professionals also helps avoid a common pitfall: ending up with several assessments carried out in different countries at different times, with no real continuity between them.
If you plan a move abroad and your child is already receiving support in your home country, take care of a few things before you leave.
Keeping previous assessments and reports, noting the contact details of professionals who have worked with the child, gathering important school documents, and sharing relevant information with the new school can make a significant difference to continuity of care.
For families already living abroad, a good first step is often to contact the school. Teaching teams may know English-speaking professionals practicing locally or be aware of resources available in the country.
Video consultations can also make certain appointments easier, such as initial interviews, parent meetings, or coordination calls. That said, not all standardized assessments can be carried out remotely under the same conditions. Always check the testing format against the tools being used and the purpose of the assessment.
New ways of supporting expat families
As more and more families move abroad, professionals are increasingly thinking about new ways to provide support.
One emerging option is for some professionals to travel abroad on a case-by-case basis to carry out assessments on-site, working alongside families and schools, where the regulatory framework of the country in question allows for it.
This reflects a broader shift: rather than routinely asking families to return home to access certain professionals or tools, it is becoming possible to imagine bringing part of the support closer to where the child actually lives.
These interventions are not a replacement for local professionals or the medical pathways required when a diagnosis needs to be made. They can, however, help build bridges between different healthcare and education systems.
A challenge that goes beyond diagnosis
For families, the question is ultimately not whether a diagnosis is reached.
The real goal is to understand why a child is struggling, identify their strengths and vulnerabilities, and determine what can concretely help them at school and in daily life.
In an expat context, this process sometimes requires more coordination, as several languages, school systems, and professional frameworks may all come together around the same child.
The challenge in the years ahead will likely be to make these connections easier, so geographical mobility does not become an additional barrier to accessing the right assessment for children with learning difficulties or neurodevelopmental disorders.
