What Is ÇÖZGER? Getting It for a Child with ADHD in Turkey

Your child has been diagnosed with ADHD and someone told you to "get a report."

Then you find out that there is no single thing called a report. There are three separate processes, they run in three separate institutions, each serves a different purpose and none replaces another. This is where parents lose the most time.

This article explains one of those three, ÇÖZGER.

First, let's separate the three

ÇÖZGER is the health side. It is issued at an authorized health institution, determines the child's special-needs level and forms the basis for social rights.

The RAM board decision is the education side. It is made at the Guidance and Research Center (RAM) attached to the Ministry of National Education and determines which supports will be given at school. I explained it in the RAM article.

The medication use report is the reimbursement side. It is needed for the SGK (the Social Security Institution) to cover the cost of the medication; I wrote about it in a separate article.

Trying to settle all three in the same appointment means going to three different institutions. Going with the order known saves a few weeks.

What ÇÖZGER changed

Before 2019, children were also assessed with the same logic as adults: a disability percentage was calculated and life was arranged according to that percentage.

The Regulation on the Special Needs Assessment for Children changed this. The new logic is this: a child is a growing being, and instead of attaching a percentage to them, it is more accurate to describe what they need.

That is why in ÇÖZGER the result is reported not as a percentage but as a special-needs level. A scale is used that begins with the statement "has a special need" and continues with rising levels, and the meaning of each level is defined in the legislation.

The difference sounds administrative, but it is not. The percentage logic told the child "you are lacking this much." The needs logic says "you need this much support." The same child, a different sentence.

What is looked at

The name of the diagnosis alone does not produce a level. What is looked at is how much support the child needs in daily life activities.

For ADHD specifically, the topics that enter the assessment are usually these: sustaining attention, impulse control, being able to carry out daily routines independently, functioning in the school environment, peer relationships, safety risks and the presence of accompanying conditions.

That is why the result can differ in two children with the same diagnosis. Sentences circulating on the internet such as "ADHD is given this level" have no counterpart in the legislation.

How the application runs

The general flow is as follows:

1. Applying to an authorized institution. You apply to a health institution authorized to issue ÇÖZGER. Which hospitals are authorized varies from province to province; you need to ask beforehand.
2. Examinations in the relevant branches. In ADHD the child and adolescent psychiatry assessment is the core; other branches are added depending on the picture.
3. Board assessment. The child health board evaluates the examination findings and the file together and issues the report.
4. Result. The report is entered into the system and can be seen through e-Devlet (the e-government portal).

The regulation provides for the report to be completed within a certain period after the application. When that period runs over, it is your right to ask in writing the institution you applied to.

What to bring to the file

The board works with the documents in front of it. Concrete information describing what the child is like at home and at school shows more than twenty minutes in the examination room.

What helps:

• Doctors' reports showing the current diagnosis, and the treatment history.
• Psychometric assessment results, if any.
• Written information from the school: the teacher's observations, a note from the guidance service, the RAM board decision if there is one.
• Concrete examples from daily life.

The last item is the most often skipped. "He struggles" is not assessable data. "Getting ready in the morning takes three separate reminders, he cannot start homework on his own, he cannot stay put for more than ten minutes in a crowded setting" is assessable data.

These are hard to remember on the day of the examination. Starting to write them down a few days ahead is the most useful preparation for this process.

The right to appeal

If you are not satisfied with the report, you can appeal. The appeal is made not to the hospital that issued the report but to the provincial health directorate, and there is a time limit.

Submitting the same file again when appealing is not meaningful. New information needs to be added: a branch assessment that was left out, an additional document from the school, a new diagnosis that has come in the meantime.

Ask the institution where you received the report, in writing, about the deadline and the procedure; practice can differ from province to province.

The age-18 limit

ÇÖZGER is valid until age 18. After that the adult legislation comes into effect and the assessment is done from scratch; I explained that side in the disability report article.

Knowing this transition beforehand is important, because families caught unprepared assume that rights will continue on their own once the child turns 18. They do not.

What I take from it

What I noticed while writing this article is this: the system expects the most organization from the family that needs the most support.

Three separate institutions, three separate documents, three separate calendars. No one explains on a single page which report opens which door, and the parent learns it by trial and error.

The only thing within my power was to write down the order. The health side is ÇÖZGER, the education side is RAM, the medication side is the use report. The three are separate, all three are necessary and none of them waits for another.

The information here is a general framework. Because practice can vary from province to province and the legislation can be updated, get written confirmation from the institution you will apply to.