I’ve never moderated before….diabetes and school - 504s
I am not an overly confident person all of the time. I
rarely say “No” if asked to do something even if I am scared that I won’t do it
well or have no idea where or how to get started. In the end I normally
surprise myself and am successful at the task I was assigned. Still - I have
been sitting at my computer much of the day working out exactly what I want to
provide to parents while I moderate a lunch time table talk regarding school
and diabetes.
I know what I insist on having listed in my kiddos 504
plans. But do I have the right stuff, the best stuff, too much stuff, not
enough stuff? I have checked every online reference I could find regarding
writing a 504 for a student with diabetes. I have been pleasantly surprised at
how much help is available to parents and schools regarding 504s for cwd. I
hadn’t thought to look when I was writing my daughters first 504. I knew what a
504 was because of my education background so I just included everything I felt
would keep my daughter safe and provide a “normalish” academic setting for her.
Turns out I had included 99% of what others online suggest to include. I missed
the part where I would insist bus drivers be trained in emergency care (kinda a
big thing for me to miss now that I think about it.)
At the lunchtime talk I hope to provide parents with sample
504s. So many parents that I have mentored want a fill in the blank form. I
discourage parents from trying to find a fill in the blank form since each
child and every school is different. A 504 is an individualized plan – but not
to be confused with an IEP (individualized education plan) – that may potentially
also be handy if the student has learning difficulties but is not part of the
504 plan. (Sorry digressed)
I will have a list of important 504 items to include – as seen
below:
Items to include in
student with diabetes 504
(Some items may not apply due to age/understanding of the student – 504
items not limited to this list)
·
Blood sugar tests prior to ALL assessments including state
exams (specify the target blood glucose levels that are acceptable to begin an
assessment – I use 80-180.)
·
Unrestricted bathroom use
·
Unrestricted access to water
·
Snacks permitted outside normal snack time if blood glucose
level deems necessary – snacks to be consumed in the classroom setting to
reduce missed academic time if blood glucose levels permit.
·
Unrestricted access to nurse
·
Unrestricted access to testing supplies
·
Authorized to keep cell phone on person at all times
·
Trained personnel to recognize high and low blood sugar
symptoms as well as provide basic and emergency medical care including testing
blood sugars and administering insulin and glucagon: teachers, office staff, coaches
& bus driver(s)
·
Adhere to doctors orders regarding who (child or adult) can
administer insulin, count carbohydrates and test blood glucose levels – also note
where the above actions should take place (nurse’s office, classroom, cafeteria
– the bathroom is NOT acceptable)
·
Additional time to complete assignments or tests that were
missed due to diabetic issue
·
Typed class notes for all instructional time missed due to
diabetic issue
·
Trained medical adult to attend all field trips if parent
cannot attend
·
Permission for parent/guardian to attend field trips and
ride bus if necessary
·
Insuring full participation in all sports and extracurricular
activities is allowed and necessary assistance or supervision is provided.
·
Eating whenever and wherever is necessary including eating
lunch at an appropriate time with enough time to finish eating
·
Permitting extra absences for medical appointments and sick
days when necessary
·
Require the school (nurse) to keep a daily log of blood
glucose checks, carbohydrate intake, and insulin bolus amounts – this can be
maintained at the school for parent or nurse reference or requested to be sent
home daily/weekly/monthly.
·
Teacher(s) will provide all substitutes with a folder containing
information regarding diabetes, student’s blood glucose testing schedule,
symptoms of high and low blood glucose, and emergency procedures
·
School nurse will be notified at the start of the school day
if a substitute is teaching in the student’s class.
As well as sample letters to substitutes – also seen below –
substitutes do not have access to 504 plans so it is important to provide the
information in a separate folder used by substitutes.
Insert picture of child here
Hello my name is ______________.
I have Type 1 diabetes.
I will go to the nurse a few times during
the day to check my blood sugar and receive insulin. In the afternoon I will
need to check my blood sugar prior to boarding the bus to go home. If my blood
sugar is questionable I may need to eat a snack before getting on the bus. I
may also need to use the bathroom more often than other students and consume
more water than other students.
If
my blood sugar is low I cannot be left alone.
If I tell you that I feel low I will need to go to the nurse and a classmate or
adult will need to escort me. The other student will not need to wait at the
nurse’s office with me. On rare occasions I may be severely low (hypoglycemia)
and may become disorientated, if that happens please call the nurse to the
classroom immediately and if I am coherent enough give me a juice to drink
while waiting for the nurse. Symptoms that might suggest that my blood sugar is
very low are: pale skin, glossy eyes, inability to concentrate, shakiness, and
dizziness. If you suspect that I am experiencing any of these symptoms please
send me to the nurse or call the nurse. If I am low I will need to eat/drink
fast acting carbohydrates such as juice or glucose tabs which I keep in the
nurse’s office and in the classroom. I will have to stay in the nurse’s office
until my blood sugar is at a safe level, usually about 15 minutes. Likewise I
might at times have a high blood sugar (hyperglycemia). Symptoms of
hyperglycemia are headaches, stomach aches, increased need to use the bathroom,
and overall crankiness. In cases of high blood sugars I will need to go to the
nurse to receive insulin and test my urine to be sure I do not have dangerous
levels of Ketones. I usually will not have to stay in the nurse’s office after
receiving insulin.
My blood sugar levels play a large role
in my ability to think straight, for this reason it is important I test my
blood sugars about 15 minutes before taking any tests or participating in any assessments.
I can eat anything my classmates eat. I
do not have a restricted diet as a Type 1 diabetic. I just have to take insulin
for all carbohydrates I eat. Thus, if we have special birthday treats or
classroom treats outside our normal snack time I will have to take my blood
sugar before eating them.
-
Blood Sugar testing schedule: (Times are examples and should be adjusted according to your child's schedule)
·
8:30ish – AM Check
·
11:00 – Lunch Check
·
12:50 – Specials (PE, Music,
Theater Arts, Art) check
·
2:35ish – PM Check
·
If you have any question you
can ask me, call the nurse or call my mom.
·
Mom: _______________________
Phone #_______________________
·
Dad: ________________________
Phone # ______________________
Also I plan to provide what I call the “Odds and Ends” –
suggestions that will help keep the child safe and foster a good relationship
between the teacher(s) and parent(s). Seen Below:
Odds and Ends
·
Be
sure each teacher/classroom has fast acting carbohydrates available. I put a
couple juice boxes and a tube of frosting in a ziplock bag for each teacher to
keep handy.
·
Provide
an alarm clock for students that stay in a homeroom class for the majority of
the school day. I provide an old iPhone that allows for multiple alarms. Alarms
are set for various times throughout the school day that alert my son that it
is time to test his blood sugar.
·
Provide
spare supplies to the nurse.
o Extra vial of test strips
o Extra meter
o Extra syringes
o Ketone strips
o Vial of insulin
o Batteries for pump and meter
o Extra infusion set if using pump
·
Provide
snacks to nurse to keep in his/her office to treat lows or provide a carb
cushion prior to PE or other strenuous activity
·
Provide
a substitute folder for all teachers including: art, music, theatre arts, and
PE.
If your reading this and you have experience either
attending school with diabetes or have a child with diabetes that attends
public school and you have additional suggestions regarding what information I
could/should share please consider leaving a comment. I have learned so much
from those who have gone before me – I am always learning and would love the
opportunity to share all that I can with others walking the same path.