Certainly, you don't want to under-react to the evidence before you that something is not right -- that a student is in distress, or even that a student may pose a threat to self or others. But ESPECIALLY in the kind of small, one-on-one situations you describe, Nicole, the reason that the disability community has so carefully guarded confidentiality of disability-related information becomes clear. All that is asked is that you be sure you are responding to the behavior, and not to the label. If the behavior is questionable or unacceptable from any student, the same is true for a student with a disability!