In this study, we adopt the concepts of Michel Foucault on the medical gaze and Nikolas Rose on psychological expertise to differentiate between two forms of expertise evident in the education of intellectually disabled children. We draw on a discourse analytic study carried out in South Africa on intellectual disability in relation to educational practice to examine the operation of a medico-psychological gaze that calls for disability expertise in the management of disability. We conclude our discussion by noting that the dichotomy between impairment and disability that is proposed in the social model of disability does little to destabilise the power of the medico-psychological gaze since impairment is conceded to biomedical knowledge as an object of positive knowledge. This tacit acceptance of the medical authority gives sanction to disability expertise that operates in diffuse ways to regulate the educational experience of learners with intellectual disability. The implications of this conception for inclusive education are briefly explored, and further areas for research are suggested. (Contains 5 tables and 1 note.)