Navigating Food Allergy Plans at SchoolBy Ruth Lovett Smith

I thought I had this food allergy thingdown. It had been three years sincemy son's diagnosis and I was used tocarrying two EpiPens@, Benadryl@,hand wipes, a variety of "safe"

snacks, and more. We were vigilantabout everything from reading labels,to ordering food in a restaurant, toonly eating food from home at playdates and birthday parties. Then cameKindergarten.

I never once worriedabout my son going toschool. I hadn't thoughtabout the fact that I wouldno longer be with himto help him make safechoices. Then the daycame and I realized I wasexpected to trust numerousstrangers to take care ofhim and keep him safe.

I left EpiPens@ atthe school, gave the nursethe forms signed by ourallergist, signed a form the nursegave me, and dropped my son off,assuming he was in good hands. Ididn't ask if the school had a policyfor managing life threatening foodallergies. I didn't think I had to,considering that food allergies wereon the rise and the MassachusettsDepartment of Education hadpublished guidelines several yearsprior encouraging schools toimplement food allergy policies andprotocols.

I quickly learned that therewasn't a written food allergy policy atour school and that there seemed to bea lack of information and educationamongst the staff. Within the first fewmonths of Kindergarten my son found

himself eating alone at the "allergy

aware table" at lunch. On a holidayhe was given a cookie and was told itwas safe by a teacher, after which hedeveloped an itchy tongue. He oftenfelt left out of classroom birthdaycelebrations when cupcakes werebrought in.

I brought my concerns to theattention of the school principalwho unfoftunately was less than

sympathetic. It didn'tseem right to methat my son couldbe left out or pushedaside due to his foodallergies. Weren't allchildren supposed tobe treated equally?It was then that Irealized I needed toeducate myself moreto keep my son notonly safe but fullyincluded in school.

Through research Iquickly learned that many childrenhave some form of a care plan inschool. I consulted with the schoolnurse and realized that the form Ibrought in from my allergist was aFood Allergy Action Plan and that theform I signed that was provided bythe nurse was an Individual HealthCare Plan. The Food Allergy ActionPlan was on the top and the IndividualHealth Care Plan was on the back.It was blank with the exception ofheadings like Bus, Classroom, andField Trips.

This started a yearlong process oftrying to get accommodations to fill inthe information under those headings.Since I met with some resistance Ipursued a 504 plan, which carries

more legal weight than an IndividualHealth Care Plan. I think the fact thatmy son already had an IndividualizedEducation Plan 0EP) for a socialdelay put us in a better position.

A group consisting of membersof the special education team, schoolnurse, principal, classroom teacherand my husband and I sat downmultiple times to draft an IndividualHealth Care Plan. It addressednumerous concerns such as classroomaccommodations, where my sonwould sit at lunch, field trips and otherissues. This IHCP would be attachedto his current IEP.

I also addressed the schoolcommittee and superintendent ofschools about our concerns and what Ihad learned. Eventually a written foodallergy policy and series ofprotocolswas put into place.

Not all food allergies or foodallergic children are created equal;therefore, not all school plans will bethe same. However all children withlife-threatening food allergies shouldhave some type of plan. A written plankeeps parents and all school staffonthe same page regarding recognizingallergic reactions, treatments andaccommodations in school.

Which Plan is Right for You?(see next page)

Ruth Lovett Smith is a volunteersupport group leader of AAFA NewEngland's Nashoba Valley Allergyand Asthma Educational SupportGroup, and is the founder of BestAllerg,, Sites, an on-linefood allergydirectory and resource guide.

Please share YOaR stury. How have you handled "real-l@" challenges of living with allergies or asthma?Let us know what happened and how everything worked out. (Send to: sharons@afone.org, or call TSt-444-7778.)

Food Allergy Plans at School (continued)

These are the types of documents that you may needto create together with your child s doctor and schoolnurse.Emergencv Care Plan or Food Allergy Action PlanThis is a written plan based on information from yourallergist. It should list the patient's allergies - which onesare life threatening, what the symptoms of an allergicreaction are, and what medications the patient shouldreceive. how much. and when.

lndividualized Health Care Plan (fHCP)An IHCP is a written plan that many food allergicchildren have in school. It usually includes theEmergency Care Plan but also goes a step further toinclude other accommodations in school. This planshould be developed with the help of the school nurseand can also include input from the classroom teacherand school principal. Many accommodations can belisted in an IHCP and it is up to the school, parents, andchild's needs as to what is appropriate.

Section 504 PlanSection 504 is a civil rights law that prohibitsdiscrimination on the basis of disability. It applies to

all institutions, including public schools, which receivefinancial assistance from the federal government. TheU.S. Department of Education Section 504 regulationdefines an "individual with handicaps" as "any personwho (i) has a physical or mental impairment whichsubstantially limits one or more major life activities, (ii)has a record of such an impairment, or (iii) is regardedas having such an impairment." Individuals with lifethreatening food allergies often qualify for a 504 planas the major life activity that is limited is breathing. A1lschool districts should have a section 504 coordinator.This is the person to contact to staft the process ofdetermining eligibility. A 504 plan can be wriften in asimilar fashion to an IHCP.

Individualized Education Plan (IEP)An IEP falls under the federal law known as theIndividuals with Disabilities Education Act (IDEA). Toqualify for an IEP the disability must affect learning.There are currently foufteen specific disabilities coveredunder the IDEA; life-threatening food allergies andasthma are typically covered under a category called"other health impairment" (OHI).All school districtsshould have a process for requesting an IEP evaluation.Contact your school or special education director.

RLS