I'm all for teaching self-advocating, but I'm also not going to tell someone they have to do so out loud. Plenty of adults who need GACs (and who are not ashamed of their impairment(s)) use letters to communicate their needs to GS. Sometimes it's due to anxiety talking in general, sometimes it's due to personal nature (i.e. when bathroom issues are part of the need), and there are many other reasons why a letter might be better or more comfortable for the requester. There are also times to teach advocating and times to not worry so much about it. I'm not sure I'd expect a 5 1/2 y/o to be able to explain her needs and if I were the kid in question, I'd far prefer to have a CM given a letter than to be talked about in third person about medical stuff I probably don't understand. The OP's daughter is probably getting enough of that right now with going through the diagnosis process. (I know it often can't be helped with doctors, teachers, etc.) I will say, as someone who has multiple impairments (of multiple types), that I don't think of 'deficit' as a negative word. I have executive functioning deficits; all that means is that my brain doesn't process things the same way as is considered 'normal'. I feel the same way about the words 'disability' and 'impairment'. Disability is not inherently negative and neither is having an impairment. There is nothing wrong with having deficits, impairments, or being disabled. The negative parts are in how society views those things. I don't really have a problem with parents considering their kids as having deficits unless they then teach the kid that having them is inherently bad (this is why I get upset when people talk about hating an impairment their kid has; most kids can't make the distinction between the condition and their selves). The OP didn't sound to me like she considers her kid any less because of her impairments or like she's presented being different as being bad.