The Law, School, and Child With Diabetes

Abstract

The rights of children with diabetes at school are based on the Individuals with Disability Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973. These laws provide protection against discrimination for children with disabilities, including diabetes. Confusion regarding differences between a 504 Plan and Individualized Education Plan (IEP) has been expressed by some diabetes educators. A 504 plan deals with medical issues, such as diabetes, while an IEP deals with educational challenges or special needs. A 504 plan includes information like instructions for blood glucose monitoring, procedures for treatment of hypo- and hyperglycemia, precautions to take before and/or after physical activity, guidelines for snacks, and medication procedures/dosages. An IEP plan may specify a need to repeat information to students with diabetes if the child has had an insulin reaction or extremely high blood sugar, causing problems with concentration. Children with diabetes use a 504 plan for accommodation related to diabetes and need not have an IEP unless they have special academic needs. The American Association of Diabetes Educators (AADE) supports effective diabetes management for all school-aged children during the many hours a child spends at school and school-related activities. Effective diabetes management requires a collaborative effort including school personnel, the student with diabetes, the student’s parents/guardians, and the family’s health care provider. AADE has endorsed the following principles to ensure diabetes is properly managed whenever a child with diabetes is present at school or a school-related activity: (a) all school personnel who have responsibility for a student with diabetes should receive training that provides basic understanding of diabetes and the student’s needs, how to identify medical emergencies, and which school personnel to contact with questions; and (b) the school nurse has a primary role of coordinating, monitoring, and supervising care of a student with diabetes. In addition to a part- or full-time school nurse, a small group of school personnel should receive training in routine and emergency diabetes care; and (c) children possessing the necessary skills and maturity to do so should be permitted to self-manage their disease in the classroom wherever they are in conjunction with a school-related activity. While supporting the need for more school nurses, AADE believes it is neither safe nor practical to rely only on school nurses to provide diabetes care. In addition, AADE recognizes that students with diabetes need a plan for effective diabetes management. A copy of AADE’s Position Statement, Management of Children With Diabetes in the School Setting is published in this issue.