Health service and school: new interactions. Comparison between the Italian system and the Swedish system on the diagnostic process of pupils

The present study aims to compare the Italian and the Swedish systems of special scholastic support followed by a discussion on the understandings they are founded upon and the social implications they favour. The two systems are compared using a priori criteria regarding the focus of intervention, the role of the operators, and the relation to the client. What emerges are two systems that are different in terms of the level of institutionalisation of medical and/or neuropsychiatric certifications related to scholastic support, the role of school and that of health services. In Italy, it is only a biomedical assessment that can lead to the most extensive scholastic support. The Swedish system on the contrary assigns a key role to the head teacher and the pupil health team who can decide on special support based on various kinds of evaluations. However, even though neuropsychiatric diagnoses are almost non-significant on a policy level in the Swedish system, the biomedical discourse might in practice be the prevalent understanding of learning difficulties. The connection between difficulties in school and psychiatric diagnoses favour a re-interpretation of the pupil through biomedical explanations and in the worst scenario a deviant career. To counteract, both systems might benefit from a context-based intervention aiming at generating alternative identity possibilities for the pupils.