From America On-Line:
Our daughter has been diabetic since age 25 months; she is now 6 and started first grade recently. We have concerns about how the school manages her care. Her diabetes has always been just a part of our lives - fully integrated into her schedule and family activities. The school nurse is insisting that she leave class and go to the nurses office to do her testing (2 - 3) times a day. She is missing lots of class time while being exposed daily to an office full of sick kids and a over stressed nurse. Our philosophy is that our daughter is not sick and should be allowed to test her own blood glucose numbers in class under supervision of teacher who is willing.
Question is: can we insist that the school make this accommodation under Americans with Disabilities Act? Is there any literature that provides guidance to schools handling young diabetics, not just in the technical aspects but with psychological concerns?
This question was referred to several members of the Diabetes Team, who have each given an answer:
Answer from Dr. O'Brien:The problem of doing blood sugars at school is a real one for all sorts of reasons and it is in part a recognition of this that has kept insulin injections to twice a day. In the future it seems probable that there will be more emphasis on good control from an early age and that children will increasingly move to "intensive insulin therapy" and using Lispro with the need to test blood sugars after meals. Not all physicians agree with this and it is possible that noninvasive methods of doing blood sugars will solve the problem of pricking fingers if not of injecting.
It is important to be non-confrontational with school staff: most of them have enough problems as it is. Parents need to talk to teachers and school nurses and teachers need to talk to the class. One of the best solutions is to see if a nurse educator or even an experienced parent who is sponsored by the ADA or a regional diabetic team will take on this role.
Answer from Jeff Hitchcock, the Editor and parent of a school-aged child with diabetes:It has been my experience that routine blood sugar testing for kids in grade school, especially as young as first grade, is not necessary. Testing should be limited to those times when the child feels low or the teacher suspects hypoglycemia, unless the child injects insulin before each meal, in which case regular pre-lunch testing is essential.
The issue of testing in the classroom versus the clinic is common. Teachers are concerned about liability in the event they miss a low, and parents are concerned about time out of the classroom. My daughter's school recently allowed her to test in her classroom after I discovered that her teacher refused another girl's request to go to the clinic to perform a blood test (there is another girl with diabetes in my daughter's class). Though the principal, assistant principal, nurse, nurse's aid and teacher were quite against it at first, the mere mention of the Americans with Disabilities Act and Section 504 brought almost immediate acceptance. Follow-up discussions with the teacher indicate that all is going well.
School and Daycare Issues offers guidance on how to deal with less than cooperative school staff.
Original posting 5 Nov 96
Last Updated: Tuesday April 06, 2010 15:08:52
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