FeaturesAug/Sep 2014 Issue

School Safety: Gluten-Free Guidelines

Take these 4 important steps to help your school accommodate your child.


It’s time to trade beach bags for book bags. What steps can you take to ensure your child’s food sensitivity or allergy is properly handled in school?

According to Amelia Smith Murphree, general counsel and vice president of civil rights advocacy for the Food Allergy & Anaphylaxis Connection Team (FAACT), the key to classroom accommodation is a spirit of collaboration between parents and the school. “It’s essential,” she says.

“This partnership between parents and the school should begin before classes start and be cultivated throughout the year,” says Michael Pistiner, MD, a pediatric allergist at Harvard Vanguard Medical Associates, a medical practice that serves the greater Boston area.

1| Do Your Research

The first step to safety is to learn how allergies are handled at your child’s school. It helps to understand this in the broader context of federal regulations and guidelines.
In 1990, Congress passed the Americans with Disabilities Act, a law that protects the civil rights of students with disabilities. Amendments in 2008 expanded the definition of disability to allow broader coverage, meaning more students could qualify for protection. Then in 2013, the Centers for Disease Control and Prevention published voluntary guidelines on behalf of the 6 million U.S. school children with food allergies. These guidelines recommended strat-egies that schools can take to accommodate allergies. They can be specifically tailored to your state and school district, helping ensure that evidence-based or best-practice standards are implemented at your school without anyone having to reinvent the wheel.

Parents should ask how their particular school handles allergies, says Pistiner, who is co-founder and content creator of AllergyHome.org. Are your school’s policies consistent with CDC’s guidelines? What history does your school have managing food allergies and anaphylaxis? Then check out the physical attributes of the school building—are there sinks in the classrooms?—and work through the specifics with the school nurse or designee.

2|  Work with the School

Before the school year begins, contact the school nurse and develop a written emergency plan, says Carolyn L. Duff, RN, president of the National Association of School Nurses. “Parents can expect the school nurse to create a plan of care, including an emergency action plan, and train the right staff to implement it,” she says.
Your child’s allergist is an excellent resource. “The doctor knows the child’s developmental capabilities and medical history, like whether he or she has asthma,” Pistiner says.

Your child’s plan should cover the basics of prevention and emergency preparedness. Who at the school will read labels and prevent cross contact? Is epinephrine readily available? Who can administer the epinephrine auto-injector? The plan should include the strategy for field trips, the school bus, substitute teachers and other occurrences. It should also address prevention and preparedness strategies when the school doesn’t have a full-time nurse. Your child’s developmental level should be taken into account, as should his or her social abilities and risk of food-allergy bullying.  

“A kindergartner can’t be expected to do the same things as a high-school student,” Pistiner says.

“Each plan should be crafted based on that student’s specific needs,” Murphree says.  
Before the school year starts, parents should give the nurse:

✓ Updated medications (epinephrine, inhaler), along with an emergency action plan.
✓ A contact list in case of emergency.
✓ Updated permission slips for treatment.
✓ A history of the allergy (age of diagnosis, symptoms, treatment).
✓ The child’s developmental understanding of the allergy. Does your child know what foods to avoid? Can he read labels? Can she recognize her own symptoms? The responsibility falls on the school to prevent and treat a reaction, regardless of the child’s developmental level, Murphree says.

Be certain the school’s information about your child is complete and up
to date.

3|  Decide How to Document

Depending on your child’s circumstances, there are various ways to officially document his medical condition and treatment plan. This formal documentation instructs the school how to keep your student safe and included.

Individual Health Plan (IHP). Also called an Individual Health Care Plan (IHCP), this is a written agreement between parents and the school. It is not governed by federal law.
Section 504 Plan. The Rehabilitation Act of 1973 prohibits schools that receive federal funding from discriminating against qualified disabled students. Murphree recommends that parents look into requesting an evaluation for a Section 504 plan from their school district’s Section 504 coordinator and from the principal of their school. This request should be made in writing.

Individual Education Plan (IEP). As part of the Individuals with Disabilities Education Act of 1975, a qualified student can receive special education and related services. Students with an IEP are also covered by Section 504, even without separate Section 504 documentation. Accommodations related to the student’s food allergies may be included in the IEP or in a separate document, such as an IHP or 504 plan.
Some parents are more comfortable with an IHP than another form of documentation because their school truly works with them and voluntarily accommodates their child, says Murphree. “But I personally feel that a Section 504 plan is the best option for accommodation in a public school,” she adds, noting that Section 504 offers fewer administrative hurdles to legal protection.

4|  Prepare Your Child

The first day of school is almost here. You have a plan in place, all forms are completed and the book bag is packed. But is your child ready?

Make sure your child knows what to expect. If it’s her first time at a particular school, set up a tour of the school for her before classes start. Depending on your youngster’s developmental stage, talk to her about different scenarios, such as who to go to if there’s a worry or accidental exposure. Review the emergency care plan and rules for self-carrying an epinephrine auto-injector and where the auto-injectors are stored at school.  

Pistiner recommends that parents role-play with their youngster to reinforce essential skills.

“Practice how to get help from a grownup, how to refuse unsafe food, how to explain the allergy to friends,” he says. “Talking with children about developmentally appropriate ways they can participate in managing their own food allergy is a big part of keeping them happy and safe.”

Contributor Wendy Mondello has a child with severe multiple food allergies and asthma. She lives in North Carolina.



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