504 Eligibility Considerations

High School Scenario:

Trevor is a sixteen year old junior who was diagnosed with Type I Diabetes in June. To manage his diabetes throughout the school day, Trevor requires blood glucose checks at 10 am, before lunch, and 20 minutes before dismissal- before boarding the bus home. He requires insulin by injection at lunchtime and requires help calculating his carbohydrate intake. Trevor is learning about his blood glucose levels and the appropriate actions to take when his numbers fall below 80 or above 200; however, he is still having difficulty learning what it feels like to have low or high blood glucose levels. Teaching staff has reported that Trevor’s is embarrassed to leave the classroom to get his insulin levels checked, and often times skips out on his scheduled times so as not to be embarrassed. Trevor is also on the wrestling team and frequently watches his caloric intake to make weight and has passed a least twice in a term in school because of his insulin levels. No reports of seizure have been made during the school day, but he has seized at home when he has been hypoglycemic. Trevor’s parents report concern about his impact of his Diabetes and the symptoms of hypoglycemia during his school day, as well as Trevor’s indifference to monitoring himself because he is embarrassed. Trevor is functioning on grade level with passing grades. His parents request consideration for eligibility for a 504 plan in concert with a Health Care Plan.

Symptoms of hypoglycemia (low blood sugar) include the following:

· Shakiness

· Dizziness

· Sweating

· Hunger

· Headache

· Pale skin color

· Sudden moodiness or behavior changes, such as crying for no apparent reason

· Clumsy or jerky movements

· Seizure

· Difficulty paying attention, or confusion

· Tingling sensations around the mouth

A number of things can cause hyperglycemia (high blood sugar):

· If you have type 1, you may not have given yourself enough insulin.

· You ate more than planned or exercised less than planned.

· You have stress from an illness, such as a cold or flu.

· You have other stress, such as family conflicts or school or dating problems.

The signs and symptoms include the following:

· High blood glucose

· High levels of sugar in the urine

· Frequent urination

· Increased thirst

504 Eligibility Considerations

Elementary School:

Jessie is a 10 year old boy entering 4th grade and overall does fairly well in school- testing in the proficient range. Jessie was diagnosed with ADHD at the age of seven, and he takes 50 mg of Concerta every morning at home before he comes to school and on the weekends. His family is supportive and compliant with providing the medication to Jessie on a regular basis. Jessie’s teachers report he is disorganized, does not report to class with the necessary materials and need frequent reminders to stay on task. Jessie is functioning on grade level with passing grades. Jessie is also diagnosed with Asthma and uses an inhaler when playing sports or during exercise. Jessie plays Lacrosse for the local youth athletic league, and last season Jessie experienced an asthma attack on the field that required a trip to the emergency department. Jessie’s parents have requested consideration for eligibility for a 504 Plan.

Common signs and symptoms of asthma include:

· Coughing. Coughing from asthma often is worse at night or early in the morning, making it hard to sleep.

· Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe.

· Chest tightness. This may feel like something is squeezing or sitting on your chest.

· Shortness of breath. Some people who have asthma say they can't catch their breath or they feel out of breath. You may feel like you can't get air out of your lungs.

Many things can trigger or worsen asthma symptoms.

· Allergens from dust, animal fur, cockroaches, mold, and pollens from trees, grasses, and flowers

· Irritants such as cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home décor products, and sprays (such as hairspray)

· Medicines such as aspirin or other non-steroidal anti-inflammatory drugs and nonselective beta-blockers

· Sulfites in foods and drinks

· Viral upper respiratory infections, such as colds

· Physical activity, including exercise

Other health conditions can make asthma harder to manage. Examples of these conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. These conditions need treatment as part of an overall asthma care plan. Asthma is different for each person.

504 Eligibility Considerations

Middle School:

Leah is a 7th grade student who was home schooled from K-5. She has been diagnosed with severe food allergies since she was 10 months old and is allergic to tree nuts, shellfish, and eggs. To avoid anaphylaxis, a life threatening allergic reaction, Leah cannot ingest or have contact with these foods. She carries her emergency medication (EpiPen) at all times and has had a history of anaphylaxis at ages 2, 6 and 11 years. Leah is very aware of symptoms related to the Anaphylaxis and can recognize them readily. She is efficient with her EpiPen use and alerting an adult of her symptoms in her controlled home & community environment. Her parents have requested that she eat lunch at a nut free / allergen free table in the cafeteria. Leah and her parents have spoken to the nursing staff extensively to develop an emergency care plan for the management of anaphylaxis during the school day and are highly concerned about their daughter’s safety in the school setting from the bus ride to school through to the bus ride home. Leah is functioning on grade level with passing grades. Leah’s parents request consideration of eligibility for a 504 plan in concert with her Health Care Plan.

Anaphylaxis is highly likely to occur when any ONE of the following happens within minutes to hours after ingestion of the food allergen:

1. A person has skin symptoms or swollen lips and either :

· Difficulty breathing, or

· Reduced blood pressure (e.g., pale, weak pulse, confusion, loss of consciousness)

2. A person was exposed to a suspected allergen, and two or more of the following occur:

· Skin symptoms or swollen lips

· Difficulty breathing

· Reduced blood pressure

· Gastrointestinal symptoms (i.e., vomiting, diarrhea, or cramping)

3. A person was exposed to a known allergen, and experiences:

· reduced blood pressure