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CA Assessment Accessibility Resources Matrix Aug. 2021

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CA Assessment Accessibility Resources Matrix Aug. 2021

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10.15.2020 Writing 504 Plan in BeyondSST 

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10.15.2020 Writing 504 Plan in BeyondSST 

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Referring a student from SST to 504 in BeyondSST

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Referring a student from SST to 504 in BeyondSST

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Writing & Facilitating 504 Plans 9.9.2020

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Writing & Facilitating 504 Plans 9.9.2020

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U.S. Dept. of Ed. 504 Plan Resource Guide

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U.S. Dept. of Ed. 504 Plan Resource Guide

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Dyslexia Guidelines

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Accommodations for students with Dyslexia

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Accommodations for students with Dyslexia

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For kids with dyslexia, reading can be challenging. Spelling and writing can be challenging too. What classroom accommodations help level the playing field for students with dyslexia? Here's a look at some of the supports teachers can use to help students who struggle with reading, spelling, and writing.

Classroom materials and routines

Post visual schedules and also read them out loud.

Provide colored strips or bookmarks to help focus on a line of text when reading.

Hand out letter and number strips so the student can see how to write correctly.

Use large-print text for worksheets.

Use audiobooks like those available through services like Bookshare, a free online library for students with disabilities.

Allow the student to use a text reader like a Reading Pen or text-to-speech software.

Use speech-to-text software to help with writing.

Have on hand "hi-lo" books (books with high-interest topics for students reading below grade level).

Provide extra time for reading and writing.

Give the student multiple opportunities to read the same text.

Use reading buddies during worktime (as appropriate).

Partner up for studying - one student writes while the other speaks, or they share the writing.

Pre-teach new concepts and vocabulary.

Provide the student with typed notes or an outline of the lesson to help with taking notes.

Provide advance organizers to help the student follow along during a lesson.

Provide a glossary of content-related terms.

Use visual or audio support to help the student understand written materials in the lecture.

Give step-by-step directions and read written instructions out loud.

Simplify directions using key words for the most important ideas.

Highlight key words and ideas on worksheets for the student to read first.

Check in frequently to make sure the student understands and can repeat the directions.

Show examples of correct and completed work to serve as a model.

Provide a rubric that describes the elements of a successful assignment.

Help the student break assignments into smaller steps.

Give self-monitoring checklists and guiding questions for reading comprehension.

Arrange worksheet problems from easiest to hardest.

Completing tests and assignments

Grade the student on the content that needs to be mastered, not on things like spelling or reading fluency.

Allow understanding to be demonstrated in different ways, like oral reports, posters, and video presentations.

Provide different ways to respond to test questions, like saying the answers or circling an answer instead of filling in the blank.

Provide sentence starters that show how to begin a written response.

Provide extended time for taking tests.

Provide a quiet room for taking tests, if needed.

Do you have a student with dyslexia? Read a one-page fact sheet to learn more about this common learning difference.

About the author

About the author

Amanda Morin is the author of "The Everything Parent's Guide to Special Education" and the former director of thought leadership at Understood. As an expert and writer, she helped build Understood from its earliest days.

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Accommodations for Students With Dyslexia | Help in the Classroom

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For kids with dyslexia, reading can be challenging. Spelling and writing can be challenging too. What classroom accommodations help level the playing field for students with dyslexia? Here's a look at some of the supports teachers can use to help students who struggle with reading, spelling, and writing.

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The term "504 Plan" refers to a plan developed to meet the requirements of a federal law that prohibits discrimination against people with disabilities, Section 504 of the Rehabilitation Act of 1973 (commonly referred to as "Section 504"). A 504 Plan sets out the actions the school will take to make sure the student with diabetes is medically safe, has the same access to education as other children, and is treated fairly. It is a tool that can be used to make sure that students, parents/guardians, and school staff understand their responsibilities and to minimize misunderstandings.

Take a look at our sample 504 Plan available below. It lists a broad range of services and modifications that are often needed by students with diabetes, ranging from kindergarteners to high school seniors. All plans should specify that school staff must be trained to recognize hypoglycemia and hyperglycemia and to respond in accordance with the child's Diabetes Medical Management Plan.

However, each plan should be individualized to the specific needs, abilities, and medical condition of the individual student. It is important to only include provisions that are relevant to the specific child. For example, a section on self-management probably would not be included in a kindergartener's plan. But the ability to bring in a blood glucose meter during an exam is critical for a high school student.

Some school districts prefer to use their own 504 Plan form. This is perfectly fine as long as it contains language to appropriately meet all of the student's diabetes care needs at school. The content is what matters.

Typical provisions in 504 plans:

Multiple staff members are trained to check blood glucose levels and administer insulinand glucagon.

All school staff-including teachers, coaches and bus drivers-who interact regularly with the student know how to recognize high and low blood glucose levels and respond appropriately.

Capable students are allowed to self-manage anywhere, anytime, and keep their diabetes supplies with them.

Needed assistance is provided in the classroom to increase safety and decrease missed class time.

Full participation in all sports, extracurricular activities, and field trips, with the necessary diabetes care assistance and/or supervision provided.

Permission to eat whenever and wherever necessary, including eating lunch at an appropriate time with enough time to finish eating.

Permission to take extra trips to the bathroom or water fountain.

Permission for extra absences for medical appointments and sick days without penalty.

Alternate arrangements for classroom time missed for medical appointments, because of periods of high or low blood glucose, or illness related to diabetes.

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The term "504 Plan" refers to a plan developed to meet the requirements of a federal law that prohibits discrimination against people with disabilities, Section 504 of the Rehabilitation Act of 1973 (commonly referred to as "Section 504").

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Position Statement SUMMARY
It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is an essential member of multidisciplinary educational teams participating in the identification, evaluation, and monitoring of students who may be eligible for services through the Individuals with Disabilities Education Improvement Act (IDEIA) (2004) and Section 504 of the Rehabilitation Act of 1973, as amended through the Americans with Disabilities Amendment Act (ADAA) in 2008. Evaluations must be comprehensive, multifactorial, and nondiscriminatory; and they must be conducted by qualified professionals (Heward, 2015; Yonkaitis & Shannon, 2017). In the school setting, the school nurse is the professional qualified to conduct a comprehensive health evaluation. The school nurse identifies needed health accommodations, outlines plans of care, provides nursing services, and evaluates the effectiveness of the health services provided to students. School nurses should be consulted regarding any information needed in the areas of health (Minchella & Brubaker, 2017; Yonkaitis & Shannon, 2017).

BACKGROUND

The Education for All Handicapped Children Act has been reauthorized over the past forty years. The latest 2004 reauthorization, titled the Individuals with Disabilities Education Improvement Act, is often referred to as IDEIA or IDEA 2004 (Yonkaitis & Shannon, 2017). IDEIA provides specific provisions for identifying and evaluating students who may need special education services. It also outlines the components for Individualized Education Programs (IEPs) as well as procedural safeguards (Yonkaitis & Shannon, 2017).

School districts are mandated to identify, locate, and evaluate all children with disabilities, regardless of severity, to determine if they qualify for special education services, including the related service of school nursing or health services (I34 C.F.R. §104.32). This is referred to as Child Find and includes all children from birth to age 21. Some of the children identified through Child Find are eligible for services other than special education.

Additionally, IDEIA mandates that individuals with appropriate expertise in the area of concern should conduct the evaluation and determine additional data needed (Yonkaitis & Shannon, 2017). As a licensed healthcare professional, the school nurse is the multidisciplinary evaluation team member qualified to evaluate health concerns. Under IDEIA the student's federal civil right to a nondiscriminatory comprehensive evaluation is not upheld if non-nursing educational professionals who are unqualified to conduct a health assessment assume this role (Shannon & Yonkaitis, 2017). If a school nurse does not conduct a health evaluation, the evaluation team lacks important information. During the health evaluation, information is obtained regarding potential health-related barriers to student learning. This information assists in determining if the student "qualifies" for special education programming or accommodations. The health evaluation also provides essential information to determine related services, programs, and accommodations and provides the basis for individualized healthcare plans (IHP) and emergency action plans (EAP) - known in some school districts as emergency care plans.

Section 504 of the Rehabilitation Act of 1973 established legal support for students with disabilities. This federal civil rights law ensures that every student is entitled to a free and appropriate public education (FAPE) (U.S. Department of Education [USDE], 2010). Under Section 504, FAPE consists of the provision of any necessary supports for the student in the general education classroom with related aids or services designed to meet the student's individual educational needs as adequately as those needs of nondisabled students are met (USDE/ Office of Civil Rights [OCR], 2015). An individual with a disability means any person who "(i) has a mental or physical impairment that substantially limits one or more major life activities; (ii) has a record of such an impairment; or (iii) is regarded as having such an impairment" [34 C.F.R. §104.3(j)(1)]. An impairment under Section 504 standards can be a health-related condition such as diabetes, epilepsy and allergy; or it can be a disability such as low vision, impaired hearing, heart disease or chronic illness that limits that child's ability to receive an appropriate education as defined by Section 504.

In 1975, the Education for All Handicapped Children Act was passed. It provides specialized educational programming for exceptional children, further reinforcing the rights of school children (USDE/ OCR, 2010). In an effort to broaden the definition of a disability, the Americans with Disabilities Act Amendments Act (ADAA) was passed and became effective in 2009. The Section 504 regulatory provision at 34 C.F.R. 104.35(c) requires that evaluation team members must be knowledgeable regarding the needs of the student and draw from a variety of sources (USDE/ OCR, 2015).
RATIONALE
The American Academy of Pediatrics (AAP) recognizes the role of the school nurse as the healthcare expert in the school setting (AAP, 2016). The Every Student Succeeds Act (ESSA) of 2015 recognizes school nurses as "Specialized Instructional Support Personnel" who provide leadership of chronic disease management as part of a comprehensive plan of services for student success (ESSA, 2015).

School nurses are the link between the healthcare and educational communities and are valuable resources to students, families, staff, and communities. School nurses use their professional knowledge to assess and identify students who have health, socio-emotional, or developmental issues that increase risks for learning problems and other school-related challenges. Input from school nurses is essential to determine the impact that health conditions have on learning and on the ability of individual students to participate in their educational programs (Minchella & Brubaker, 2017). If health-related barriers are not recognized, appropriately interpreted, and addressed, students risk academic failure. Although the referral processes for special education or Section 504 can be requested by anyone, the school nurse has the expertise and duty to identify students with health-related disabilities and should initiate an evaluation for medical/health reasons (Alfano, Forbes, & Fisher, 2017).

The school nurse uses information obtained during the process of developing an IHP to assist with eligibility determination and, when indicated, to assist IEP and 504 Plan teams to determine educational modifications and accommodations. The creation of an IHP uses the nursing process and demonstrates adherence to professional scope and standards (American Nurses Association [ANA] & NASN, 2017). Development of an IHP is strictly the responsibility and within the scope of practice of a school nurse.
School Nurse Responsibilities
It is the responsibility of the school nurse to understand the federal and state laws related to working with students with disabilities, long term illnesses, or other disorders (Alfano et al., 2017; Ellermeier, Will, & Strawhacker, 2017; Galemore & Sheetz, 2015; Minchella & Brubaker, 2017). State laws may require specialized licensure or credentials prior to performing IEP evaluations or for team participation in developing IEPs (Shannon & Yonkaitis, 2017).

The school nurse is the appropriate person to provide care coordination for health-related disabilities in the school setting (ANA & NASN, 2017). "While the IEP team as a whole tackles the academic, developmental, social, and emotional needs of the student, the responsibility of addressing the healthcare needs of the student falls squarely on the school nurse" (Alfano et al., 2017, p.145).

When health services are determined to be necessary for students to access their educational programs, it is the school nurse's role to provide a direct or related service in an IEP. In those cases, the school nurse is responsible for supplying specific information describing which type of health services should be provided and how often the service(s) need to be provided (Galemore & Sheetz, 2015; Minchella & Brubaker, 2017).

The school nurse's role in the Section 504 or IDEIA process may include:

Assisting in identifying students who may need special educational or health-related services/accommodations (Child Find) (Gibbons, Lehr, & Selekman, 2013).

Assessing the identified student's functional and physical health status in collaboration with the student, parent(s)/guardian(s), teachers and other school staff, and healthcare providers (Gibbons et al., 2013).

Developing IHPs and EAPs based on nursing assessments.

Recommending health-related accommodations or services that may be required for the student to access the educational program.

Assisting students, parent(s)/guardians, and teachers to identify and remove health-related barriers to learning (Gibbons et al., 2013).

Providing in-service training for teachers and staff regarding the individual health needs of the student (Gibbons et al., 2013).

Training and supervising unlicensed assistive personnel to provide specialized healthcare services in the school setting according to state delegation guidelines (Gibbons, Lehr, & Selekman, 2013, p. 269- 270).

Participating in transition planning, including promotion of successful post-school employment and/or education, and transition of medical care.

Evaluating the effectiveness of the health-related components of the IEP and/or 504 plan with the student, parent(s), and other team members and revising the plan(s) as needed (Gibbons et al., 2013, p. 269- 270).

The school nurse plays an integral role in planning, implementation, and evaluation of IEPs and Section 504 Plans. For a student with disabilities, it is the school nurse's role to identify needed health accommodations, outline a plan of care, provide nursing services, and evaluate the health-related components of the IEP and/or 504 Plan. An IHP is written to meet professional school nurse standards (ANA & NASN, 2017; Ellermeier et al., 2017). The student's IHP and/or EAP may guide the student's Section 504 Plan health-related accommodations. As IHPs and EAPs are fluid documents, IHPs and EAPs should not be included in an IEP but might be referenced to provide rationale for the needed service(s) (Galemore & Sheetz, 2015; Ellermeier et al., 2017).
CONCLUSION
The school nurse is the recognized healthcare expert in the school setting (AAP, 2016; ESSA, 2015). School nurses have the unique knowledge and experience essential to evaluate the health of students in order to identify health-related barriers to learning and the accommodations necessary to provide access to education. School nurses work collaboratively with other team members to identify, evaluate, and develop plans for students in need of services. School nurses should be involved in and present at all meetings where an IEP and/or Section 504 plan related to a student's health condition is being discussed and developed. School nurses are integral to ensuring the civil rights of all students so that they can achieve optimal success and well-being at school (Yonkaitis & Shannon, 2017).
REFERENCES
Alfano, A. L., Forbes, M. S., & Fisher, L. A. (2017). Education law for children with disabilities: The individuals with disabilities education act (IDEA) and section 504 of the rehabilitation act of 1973 (Section 504). In Resha, C. A. & Taliaferro, V. L. (Eds.), Legal Resource for School Health Services (pp. 141-151). Nashville, TN: SchoolNurse.com.

American Academy of Pediatrics, Council on School Health. (2016). Role of the school nurse in providing school health services. Pediatrics,137(6), e20160852. doi: 10.1542/peds.2016-0852

American Nurses Association & National Association of School Nurses. (2017). School nursing: Scope and standards of practice, 3rd ed. Silver Spring, MD: ANA & NASN.

Americans with Disabilities Amendment Act (ADAA), (Public Law 110-325) (2008), 42 U.S.C. 12102

Education for all Handicapped Children, (Public Law 94-142) (1975). 20 U.S.C. 1401

Ellermeier, K., Will, S. I.S., & Strawhacker, M. T. (2017). 504 plans and accommodations- Using the IHP information. In Will, I. S., Arnold, M.W., & Zaiger, D. S. (Eds.), Individualized healthcare plans for the school nurse: A comprehensive resource for school nursing management of health conditions (2nd ed.) (pp.11-23). Forest Lake, MN: Sunrise River Press.

Every Student Succeeds Act, S. 1177, 114th Cong., (2015) (enacted).

Galemore, C.A., & Sheetz, A.H. (2015). IEP, IHP, and section 504 primer for new school nurses. NASN School Nurse, 30(2),85-8. doi: 10.1177/1942602X14565462

Gibbons, L. J., Lehr, K., & Selekman. J. (2013). Federal laws protecting children and youth with disabilities in the schools. In Selekman, J. (Ed.), School nursing, a comprehensive text (2nd ed.) (pp. 257-283). Philadelphia PA.: F.A. Davis Co.

Heward, W. L. (2015). Exceptional children: An introduction to special education, 10th ed. Boston, MA: Pearson.

Individuals with Disability Education Improvement Act (2004), 20 U.S.C. 1400 et seq. Retrieved from https://wwwecfr.gov/cgi-bin/text-idx?SID=c- 688c2abdc1f488fd574e7d3ba37713&mc=true&node=pt34.1.104&rgn=div5#se34.1.104_131

Minchella, L. & Brubaker, C. (2017). Special education: Other health impaired (OHI). In Will, I. S., Arnold, M.W., & Zaiger, D. S. (Eds.), Individualized healthcare plans for the school nurse: A comprehensive resource for school nursing management of health conditions (2nd ed.) (pp.11-23). Forest Lake, MN: Sunrise River Press.

Rehabilitation Act of 1973, 29 U.S.C. § 701

Shannon, R. A., & Yonkaitis, C. F. (2017). The role of the school nurse in the special education process; Part 2: Eligibility determination and the individualized education program. NASN School Nurse, 32(4), 249-254. doi: 10.1177/1942602X17709505

U.S. Department of Education, Office for Civil Rights. (2010). Free appropriate education for students with disabilities: Requirements under Section 504 of the Rehabilitation Act of 1973. Retrieved from https://www2.ed.gov/about/offices/list/ocr/docs/edlite-FAPE504.html

U.S. Department of Education, Office for Civil Rights. (2015). Protecting students with disabilitie s. Retrieved from https://www2.ed.gov/about/offices/list/ocr/504faq.html

Yonkaitis, C. F., & Shannon, R. A. (2017). The role of the school nurse in the special education process: Part 1: Student identification and evaluation. NASN School Nurse, 32(3), 178-184. doi: 10.1177/1942602X17700677

Acknowledgment of Authors:
Louise Wilson, MS, BSN, RN, NCSN
Claire Molner, MEd, BS, ASSN, RN, NCSN
Lindsey Minchella, MSN, RN, NCSN, FNASN
Elizabeth Zeno, MA, BSN, RN, LSN

This document replaces the following position statement: Section 504 and Individuals with Disabilities Education Improvement Act- The Role of the School Nurse (Adopted January 2013).

Adopted: January 2018

Suggested Citation: National Association of School Nurses. (2018). IDEIA and Section 504 teams - The school nurse as an essential team member (Position Statement). Silver Spring, MD: Author.
All position statements from the National Association of School Nurses will automatically expire five years after publication unless reaffirmed, revised, or retired at or before that time.

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IDEIA and Section 504 Teams - The School Nurse as an Essential Team Member

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Position Statement SUMMARY It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is an essential member of multidisciplinary educational teams participating in the identification, evaluation, and monitoring of students who may be eligible for services through the Individuals with Disabilities Education Improvement Act (IDEIA) (2004) and Section 504 of the Rehabilitation Act of 1973, as amended through the Americans with Disabilities Amendment Act (ADAA) in 2008.

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PENT

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CASEL

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The Collaborative for Academic, Social, and Emotional Learning is helping make evidence-based social and emotional learning an integral part of education from preschool through high school.

Learn about the Fundamentals of SEL Learn more about SEL

Getting started with systemic implementation

Our SEL is strategically placed as a universal strategy to build resilience, cultivate protective factors, like strong relationships with peers and adults, and reduce stigma around mental health help-seeking.

Dr. Susan Bunting
Former State Secretary of Education

We need to address inequities in education and we need better pathways to success... [which requires recognizing that students' social and emotional learning] is just as important as their academic growth.

Miguel Cardona
US Secretary of Education

Learning should be inherently joyous. It should be a joyous pursuit, enabling all students to have fun and find their passions. It's the purpose of learning.

Dr. D'Andre Weaver
Superindentant

Our platform is made possible by:

This site uses cookies to improve your experience and help CASEL understand how our site is being used. By continuing to use our site, you consent to the use of cookies. Review our Privacy Policy for more information.

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Advancing Social and Emotional Learning - CASEL

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CASEL is helping make evidence-based social and emotional learning an integral part of education, preschool through high school.

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COVID-19 Q & A

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504 FAQs

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Introduction | Interrelationship of IDEA and Section 504 | Protected Students | Evaluation | Placement |
Procedural Safeguards | Terminology

This document is a revised version of a document originally developed by the Chicago Office of the Office for Civil Rights (OCR) in the U.S. Department of Education (ED) to clarify the requirements of Section 504 of the Rehabilitation Act of 1973, as amended (Section 504) in the area of public elementary and secondary education. The primary purpose of these revisions is to incorporate information about the Americans with Disabilities Act Amendments Act of 2008 (Amendments Act), effective January 1, 2009, which amended the Americans with Disabilities Act of 1990 (ADA) and included a conforming amendment to the Rehabilitation Act of 1973 that affects the meaning of disability in Section 504. The Amendments Act broadens the interpretation of disability. The Amendments Act does not require ED to amend its Section 504 regulations. ED's Section 504 regulations as currently written are valid and OCR is enforcing them consistent with the Amendments Act. In addition, OCR is currently evaluating the impact of the Amendments Act on OCR's enforcement responsibilities under Section 504 and Title II of the ADA, including whether any changes in regulations, guidance, or other publications are appropriate. The revisions to this Frequently Asked Questions document do not address the effects, if any, on Section 504 and Title II of the amendments to the regulations implementing the Individuals with Disabilities Education Act (IDEA) that were published in the Federal Register at 73 Fed. Reg. 73006 (December 1, 2008).
INTRODUCTION
An important responsibility of the Office for Civil Rights (OCR) is to eliminate discrimination on the basis of disability against students with disabilities. OCR receives numerous complaints and inquiries in the area of elementary and secondary education involving Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. § 794 (Section 504). Most of these concern identification of students who are protected by Section 504 and the means to obtain an appropriate education for such students.

Section 504 is a federal law designed to protect the rights of individuals with disabilities in programs and activities that receive Federal financial assistance from the U.S. Department of Education (ED). Section 504 provides: "No otherwise qualified individual with a disability in the United States . . . shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance . . . ."

OCR enforces Section 504 in programs and activities that receive Federal financial assistance from ED. Recipients of this Federal financial assistance include public school districts, institutions of higher education, and other state and local education agencies. The regulations implementing Section 504 in the context of educational institutions appear at 34 C.F.R. Part 104.

The Section 504 regulations require a school district to provide a "free appropriate public education" (FAPE) to each qualified student with a disability who is in the school district's jurisdiction, regardless of the nature or severity of the disability. Under Section 504, FAPE consists of the provision of regular or special education and related aids and services designed to meet the student's individual educational needs as adequately as the needs of nondisabled students are met.

This resource document clarifies pertinent requirements of Section 504.

For additional information, please contact the Office for Civil Rights.
INTERRELATIONSHIP OF IDEA AND SECTION 504 1. What is the jurisdiction of the Office for Civil Rights (OCR), the Office of Special Education and Rehabilitative Services (OSERS) and state departments of education/instruction regarding educational services to students with disabilities?
OCR, a component of the U.S. Department of Education, enforces Section 504 of the Rehabilitation Act of 1973, as amended, (Section 504) a civil rights statute which prohibits discrimination against individuals with disabilities. OCR also enforces Title II of the Americans with Disabilities Act of 1990 (Title II), which extends this prohibition against discrimination to the full range of state and local government services, programs, and activities (including public schools) regardless of whether they receive any Federal financial assistance. The Americans with Disabilities Act Amendments Act of 2008 (Amendments Act), effective January 1, 2009, amended the Americans with Disabilities Act of 1990 (ADA) and included a conforming amendment to the Rehabilitation Act of 1973 (Rehabilitation Act) that affects the meaning of disability in Section 504. The standards adopted by the ADA were designed not to restrict the rights or remedies available under Section 504. The Title II regulations applicable to free appropriate public education issues do not provide greater protection than applicable Section 504 regulations. This guidance focuses primarily on Section 504.

Section 504 prohibits discrimination on the basis of disability in programs or activities that receive Federal financial assistance from the U.S. Department of Education. Title II prohibits discrimination on the basis of disability by state and local governments. The Office of Special Education and Rehabilitative Services (OSERS), also a component of the U.S. Department of Education, administers the Individuals with Disabilities Education Act (IDEA), a statute which funds special education programs. Each state educational agency is responsible for administering IDEA within the state and distributing the funds for special education programs. IDEA is a grant statute and attaches many specific conditions to the receipt of Federal IDEA funds. Section 504 and the ADA are antidiscrimination laws and do not provide any type of funding.

2. How does OCR get involved in disability issues within a school district?

OCR receives complaints from parents, students or advocates, conducts agency initiated compliance reviews, and provides technical assistance to school districts, parents or advocates.

3. Where can a school district, parent, or student get information on Section 504 or find out information about OCR's interpretation of Section 504 and Title II?

OCR provides technical assistance to school districts, parents, and students upon request. Additionally, regulations and publicly issued policy guidance is available on OCR's website, at http://www.ed.gov/policy/rights/guid/ocr/disability.html.
4. What services are available for students with disabilities under Section 504?
Section 504 requires recipients to provide to students with disabilities appropriate educational services designed to meet the individual needs of such students to the same extent as the needs of students without disabilities are met. An appropriate education for a student with a disability under the Section 504 regulations could consist of education in regular classrooms, education in regular classes with supplementary services, and/or special education and related services.

5. Does OCR examine individual placement or other educational decisions for students with disabilities?

Except in extraordinary circumstances, OCR does not review the result of individual placement or other educational decisions so long as the school district complies with the procedural requirements of Section 504 relating to identification and location of students with disabilities, evaluation of such students, and due process. Accordingly, OCR generally will not evaluate the content of a Section 504 plan or of an individualized education program (IEP); rather, any disagreement can be resolved through a due process hearing. The hearing would be conducted under Section 504 or the IDEA, whichever is applicable.

OCR will examine procedures by which school districts identify and evaluate students with disabilities and the procedural safeguards which those school districts provide students. OCR will also examine incidents in which students with disabilities are allegedly subjected to treatment which is different from the treatment to which similarly situated students without disabilities are subjected. Such incidents may involve the unwarranted exclusion of disabled students from educational programs and services.

6. What protections does OCR provide against retaliation?

Retaliatory acts are prohibited. A recipient is prohibited from intimidating, threatening, coercing, or discriminating against any individual for the purpose of interfering with any right or privilege secured by Section 504.

7. Does OCR mediate complaints?

OCR does not engage in formal mediation. However, OCR may offer to facilitate mediation, referred to as "Early Complaint Resolution," to resolve a complaint filed under Section 504. This approach brings the parties together so that they may discuss possible resolution of the complaint immediately. If both parties are willing to utilize this approach, OCR will work with the parties to facilitate resolution by providing each an understanding of pertinent legal standards and possible remedies. An agreement reached between the parties is not monitored by OCR.

8. What does noncompliance with Section 504 mean?

A school district is out of compliance when it is violating any provision of the Section 504 statute or regulations.

9. What sanctions can OCR impose on a school district that is out of compliance?

OCR initially attempts to bring the school district into voluntary compliance through negotiation of a corrective action agreement. If OCR is unable to achieve voluntary compliance, OCR will initiate enforcement action. OCR may: (1) initiate administrative proceedings to terminate Department of Education financial assistance to the recipient; or (2) refer the case to the Department of Justice for judicial proceedings.

10. Who has ultimate authority to enforce Section 504?

In the educational context, OCR has been given administrative authority to enforce Section 504. Section 504 is a Federal statute that may be enforced through the Department's administrative process or through the Federal court system. In addition, a person may at any time file a private lawsuit against a school district. The Section 504 regulations do not contain a requirement that a person file a complaint with OCR and exhaust his or her administrative remedies before filing a private lawsuit.
STUDENTS PROTECTED UNDER SECTION 504
Section 504 covers qualified students with disabilities who attend schools receiving Federal financial assistance. To be protected under Section 504, a student must be determined to: (1) have a physical or mental impairment that substantially limits one or more major life activities; or (2) have a record of such an impairment; or (3) be regarded as having such an impairment. Section 504 requires that school districts provide a free appropriate public education (FAPE) to qualified students in their jurisdictions who have a physical or mental impairment that substantially limits one or more major life activities.

11. What is a physical or mental impairment that substantially limits a major life activity?

The determination of whether a student has a physical or mental impairment that substantially limits a major life activity must be made on the basis of an individual inquiry. The Section 504 regulatory provision at 34 C.F.R. 104.3(j)(2)(i) defines a physical or mental impairment as any physiological disorder or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological; musculoskeletal; special sense organs; respiratory, including speech organs; cardiovascular; reproductive; digestive; genito-urinary; hemic and lymphatic; skin; and endocrine; or any mental or psychological disorder, such as intellectual disabilities, organic brain syndrome, emotional or mental illness, and specific learning disabilities. The regulatory provision does not set forth an exhaustive list of specific diseases and conditions that may constitute physical or mental impairments because of the difficulty of ensuring the comprehensiveness of such a list.

Major life activities, as defined in the Section 504 regulations at 34 C.F.R. 104.3(j)(2)(ii), include functions such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working. This list is not exhaustive. Other functions can be major life activities for purposes of Section 504. In the Amendments Act (see FAQ 1), Congress provided additional examples of general activities that are major life activities, including eating, sleeping, standing, lifting, bending, reading, concentrating, thinking, and communicating. Congress also provided a non-exhaustive list of examples of "major bodily functions" that are major life activities, such as the functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions. The Section 504 regulatory provision, though not as comprehensive as the Amendments Act, is still valid - the Section 504 regulatory provision's list of examples of major life activities is not exclusive, and an activity or function not specifically listed in the Section 504 regulatory provision can nonetheless be a major life activity.

12. Does the meaning of the phrase "qualified student with a disability" differ on the basis of a student's educational level, i.e., elementary and secondary versus postsecondary?

Yes. At the elementary and secondary educational level, a "qualified student with a disability" is a student with a disability who is: of an age at which students without disabilities are provided elementary and secondary educational services; of an age at which it is mandatory under state law to provide elementary and secondary educational services to students with disabilities; or a student to whom a state is required to provide a free appropriate public education under the Individuals with Disabilities Education Act (IDEA).

At the postsecondary educational level, a qualified student with a disability is a student with a disability who meets the academic and technical standards requisite for admission or participation in the institution's educational program or activity.

13. Does the nature of services to which a student is entitled under Section 504 differ by educational level?

Yes. Public elementary and secondary recipients are required to provide a free appropriate public education to qualified students with disabilities. Such an education consists of regular or special education and related aids and services designed to meet the individual educational needs of students with disabilities as adequately as the needs of students without disabilities are met.

At the postsecondary level, the recipient is required to provide students with appropriate academic adjustments and auxiliary aids and services that are necessary to afford an individual with a disability an equal opportunity to participate in a school's program. Recipients are not required to make adjustments or provide aids or services that would result in a fundamental alteration of a recipient's program or impose an undue burden.

14. Once a student is identified as eligible for services under Section 504, is that student always entitled to such services?

Yes, as long as the student remains eligible. The protections of Section 504 extend only to individuals who meet the regulatory definition of a person with a disability. If a recipient school district re-evaluates a student in accordance with the Section 504 regulatory provision at 34 C.F.R. 104.35 and determines that the student's mental or physical impairment no longer substantially limits his/her ability to learn or any other major life activity, the student is no longer eligible for services under Section 504.

15. Are current illegal users of drugs excluded from protection under Section 504?

Generally, yes. Section 504 excludes from the definition of a student with a disability, and from Section 504 protection, any student who is currently engaging in the illegal use of drugs when a covered entity acts on the basis of such use. (There are exceptions for persons in rehabilitation programs who are no longer engaging in the illegal use of drugs).

16. Are current users of alcohol excluded from protection under Section 504?

No. Section 504's definition of a student with a disability does not exclude users of alcohol. However, Section 504 allows schools to take disciplinary action against students with disabilities using drugs or alcohol to the same extent as students without disabilities.
EVALUATION
At the elementary and secondary school level, determining whether a child is a qualified disabled student under Section 504 begins with the evaluation process. Section 504 requires the use of evaluation procedures that ensure that children are not misclassified, unnecessarily labeled as having a disability, or incorrectly placed, based on inappropriate selection, administration, or interpretation of evaluation materials.

17. What is an appropriate evaluation under Section 504?

Recipient school districts must establish standards and procedures for initial evaluations and periodic re-evaluations of students who need or are believed to need special education and/or related services because of disability. The Section 504 regulatory provision at 34 C.F.R. 104.35(b) requires school districts to individually evaluate a student before classifying the student as having a disability or providing the student with special education. Tests used for this purpose must be selected and administered so as best to ensure that the test results accurately reflect the student's aptitude or achievement or other factor being measured rather than reflect the student's disability, except where those are the factors being measured. Section 504 also requires that tests and other evaluation materials include those tailored to evaluate the specific areas of educational need and not merely those designed to provide a single intelligence quotient. The tests and other evaluation materials must be validated for the specific purpose for which they are used and appropriately administered by trained personnel.

18. How much is enough information to document that a student has a disability?

At the elementary and secondary education level, the amount of information required is determined by the multi-disciplinary committee gathered to evaluate the student. The committee should include persons knowledgeable about the student, the meaning of the evaluation data, and the placement options. The committee members must determine if they have enough information to make a knowledgeable decision as to whether or not the student has a disability. The Section 504 regulatory provision at 34 C.F.R. 104.35(c) requires that school districts draw from a variety of sources in the evaluation process so that the possibility of error is minimized. The information obtained from all such sources must be documented and all significant factors related to the student's learning process must be considered. These sources and factors may include aptitude and achievement tests, teacher recommendations, physical condition, social and cultural background, and adaptive behavior. In evaluating a student suspected of having a disability, it is unacceptable to rely on presumptions and stereotypes regarding persons with disabilities or classes of such persons. Compliance with the IDEA regarding the group of persons present when an evaluation or placement decision is made is satisfactory under Section 504.

19. What process should a school district use to identify students eligible for services under Section 504? Is it the same process as that employed in identifying students eligible for services under the IDEA?

School districts may use the same process to evaluate the needs of students under Section 504 as they use to evaluate the needs of students under the IDEA. If school districts choose to adopt a separate process for evaluating the needs of students under Section 504, they must follow the requirements for evaluation specified in the Section 504 regulatory provision at 34 C.F.R. 104.35.

20. May school districts consider "mitigating measures" used by a student in determining whether the student has a disability under Section 504?

No. As of January 1, 2009, school districts, in determining whether a student has a physical or mental impairment that substantially limits that student in a major life activity, must not consider the ameliorating effects of any mitigating measures that student is using. This is a change from prior law. Before January 1, 2009, school districts had to consider a student's use of mitigating measures in determining whether that student had a physical or mental impairment that substantially limited that student in a major life activity. In the Amendments Act (see FAQ 1), however, Congress specified that the ameliorative effects of mitigating measures must not be considered in determining if a person is an individual with a disability.

Congress did not define the term "mitigating measures" but rather provided a non-exhaustive list of "mitigating measures." The mitigating measures are as follows: medication; medical supplies, equipment or appliances; low-vision devices (which do not include ordinary eyeglasses or contact lenses); prosthetics (including limbs and devices); hearing aids and cochlear implants or other implantable hearing devices; mobility devices; oxygen therapy equipment and supplies; use of assistive technology; reasonable accommodations or auxiliary aids or services; and learned behavioral or adaptive neurological modifications.

Congress created one exception to the mitigating measures analysis. The ameliorative effects of the mitigating measures of ordinary eyeglasses or contact lenses shall be considered in determining if an impairment substantially limits a major life activity. "Ordinary eyeglasses or contact lenses" are lenses that are intended to fully correct visual acuity or eliminate refractive error, whereas "low-vision devices" (listed above) are devices that magnify, enhance, or otherwise augment a visual image.

21. Does OCR endorse a single formula or scale that measures substantial limitation?

No. The determination of substantial limitation must be made on a case-by-case basis with respect to each individual student. The Section 504 regulatory provision at 34 C.F.R. 104.35 (c) requires that a group of knowledgeable persons draw upon information from a variety of sources in making this determination.

22. Are there any impairments which automatically mean that a student has a disability under Section 504?

No. An impairment in and of itself is not a disability. The impairment must substantially limit one or more major life activities in order to be considered a disability under Section 504.

23. Can a medical diagnosis suffice as an evaluation for the purpose of providing FAPE?

No. A physician's medical diagnosis may be considered among other sources in evaluating a student with an impairment or believed to have an impairment which substantially limits a major life activity. Other sources to be considered, along with the medical diagnosis, include aptitude and achievement tests, teacher recommendations, physical condition, social and cultural background, and adaptive behavior. As noted in FAQ 22, the Section 504 regulations require school districts to draw upon a variety of sources in interpreting evaluation data and making placement decisions.

24. Does a medical diagnosis of an illness automatically mean a student can receive services under Section 504?

No. A medical diagnosis of an illness does not automatically mean a student can receive servicesunder Section 504. The illness must cause a substantial limitation on the student's ability to learn or another major life activity. For example, a student who has a physical or mental impairment would not be considered a student in need of services under Section 504 if the impairment does not in any way limit the student's ability to learn or other major life activity, or only results in some minor limitation in that regard.

25. How should a recipient school district handle an outside independent evaluation? Do all data brought to a multi-disciplinary committee need to be considered and given equal weight?

The results of an outside independent evaluation may be one of many sources to consider. Multi-disciplinary committees must draw from a variety of sources in the evaluation process so that the possibility of error is minimized. All significant factors related to the subject student's learning process must be considered. These sources and factors include aptitude and achievement tests, teacher recommendations, physical condition, social and cultural background, and adaptive behavior, among others. Information from all sources must be documented and considered by knowledgeable committee members. The weight of the information is determined by the committee given the student's individual circumstances.

26. What should a recipient school district do if a parent refuses to consent to an initial evaluation under the Individuals with Disabilities Education Act (IDEA), but demands a Section 504 plan for a student without further evaluation?

A school district must evaluate a student prior to providing services under Section 504. Section 504 requires informed parental permission for initial evaluations. If a parent refuses consent for an initial evaluation and a recipient school district suspects a student has a disability, the IDEA and Section 504 provide that school districts may use due process hearing procedures to seek to override the parents' denial of consent.

27. Who in the evaluation process makes the ultimate decision regarding a student's eligibility for services under Section 504?

The Section 504 regulatory provision at 34 C.F.R.104.35 (c) (3) requires that school districts ensure that the determination that a student is eligible for special education and/or related aids and services be made by a group of persons, including persons knowledgeable about the meaning of the evaluation data and knowledgeable about the placement options. If a parent disagrees with the determination, he or she may request a due process hearing.

28. Once a student is identified as eligible for services under Section 504, is there an annual or triennial review requirement? If so, what is the appropriate process to be used? Or is it appropriate to keep the same Section 504 plan in place indefinitely after a student has been identified?

Periodic re-evaluation is required. This may be conducted in accordance with the IDEA regulations, which require re-evaluation at three-year intervals (unless the parent and public agency agree that re-evaluation is unnecessary) or more frequently if conditions warrant, or if the child's parent or teacher requests a re-evaluation, but not more than once a year (unless the parent and public agency agree otherwise).

29. Is a Section 504 re-evaluation similar to an IDEA re-evaluation? How often should it be done?

Yes. Section 504 specifies that re-evaluations in accordance with the IDEA is one means of compliance with Section 504. The Section 504 regulations require that re-evaluations be conducted periodically. Section 504 also requires a school district to conduct a re-evaluation prior to a significant change of placement. OCR considers an exclusion from the educational program of more than 10 school days a significant change of placement. OCR would also consider transferring a student from one type of program to another or terminating or significantly reducing a related service a significant change in placement.

30. What is reasonable justification for referring a student for evaluation for services under Section 504?

School districts may always use regular education intervention strategies to assist students with difficulties in school. Section 504 requires recipient school districts to refer a student for an evaluation for possible special education or related aids and services or modification to regular education if the student, because of disability, needs or is believed to need such services.

31. A student is receiving services that the school district maintains are necessary under Section 504 in order to provide the student with an appropriate education. The student's parent no longer wants the student to receive those services. If the parent wishes to withdraw the student from a Section 504 plan, what can the school district do to ensure continuation of services?

The school district may initiate a Section 504 due process hearing to resolve the dispute if the district believes the student needs the services in order to receive an appropriate education.

32. A student has a disability referenced in the IDEA, but does not require special education services. Is such a student eligible for services under Section 504?

The student may be eligible for services under Section 504. The school district must determine whether the student has an impairment which substantially limits his or her ability to learn or another major life activity and, if so, make an individualized determination of the child's educational needs for regular or special education or related aids or services. For example, such a student may receive adjustments in the regular classroom.

33. How should a recipient school district view a temporary impairment?

A temporary impairment does not constitute a disability for purposes of Section 504 unless its severity is such that it results in a substantial limitation of one or more major life activities for an extended period of time. The issue of whether a temporary impairment is substantial enough to be a disability must be resolved on a case-by-case basis, taking into consideration both the duration (or expected duration) of the impairment and the extent to which it actually limits a major life activity of the affected individual.

In the Amendments Act (see FAQ 1), Congress clarified that an individual is not "regarded as" an individual with a disability if the impairment is transitory and minor. A transitory impairment is an impairment with an actual or expected duration of 6 months or less.
34. Is an impairment that is episodic or in remission a disability under Section 504?
Yes, under certain circumstances. In the Amendments Act (see FAQ 1), Congress clarified that an impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active. A student with such an impairment is entitled to a free appropriate public education under Section 504.
PLACEMENT
Once a student is identified as being eligible for regular or special education and related aids or services, a decision must be made regarding the type of services the student needs.

35. If a student is eligible for services under both the IDEA and Section 504, must a school district develop both an individualized education program (IEP) under the IDEA and a Section 504 plan under Section 504?

No. If a student is eligible under IDEA, he or she must have an IEP. Under the Section 504 regulations, one way to meet Section 504 requirements for a free appropriate public education is to implement an IEP.

36. Must a school district develop a Section 504 plan for a student who either "has a record of disability" or is "regarded as disabled"?

No. In public elementary and secondary schools, unless a student actually has an impairment that substantially limits a major life activity, the mere fact that a student has a "record of" or is "regarded as" disabled is insufficient, in itself, to trigger those Section 504 protections that require the provision of a free appropriate public education (FAPE). This is consistent with the Amendments Act (see FAQ 1), in which Congress clarified that an individual who meets the definition of disability solely by virtue of being "regarded as" disabled is not entitled to reasonable accommodations or the reasonable modification of policies, practices or procedures. The phrases "has a record of disability" and "is regarded as disabled" are meant to reach the situation in which a student either does not currently have or never had a disability, but is treated by others as such.

As noted in FAQ 34, in the Amendments Act (see FAQ 1), Congress clarified that an individual is not "regarded as" an individual with a disability if the impairment is transitory and minor. A transitory impairment is an impairment with an actual or expected duration of 6 months or less.

37. What is the receiving school district's responsibility under Section 504 toward a student with a Section 504 plan who transfers from another district?

If a student with a disability transfers to a district from another school district with a Section 504 plan, the receiving district should review the plan and supporting documentation. If a group of persons at the receiving school district, including persons knowledgeable about the meaning of the evaluation data and knowledgeable about the placement options determines that the plan is appropriate, the district is required to implement the plan. If the district determines that the plan is inappropriate, the district is to evaluate the student consistent with the Section 504 procedures at 34 C.F.R. 104.35 and determine which educational program is appropriate for the student. There is no Section 504 bar to the receiving school district honoring the previous IEP during the interim period. Information about IDEA requirements when a student transfers is available from the Office of Special Education and Rehabilitative Services at http://idea.ed.gov/explore/view/p/%2Croot%2Cdynamic%2CQaCorner%2C3%2C

40. What are the responsibilities of regular education teachers with respect to implementation of Section 504 plans? What are the consequences if the district fails to implement the plans?

Regular education teachers must implement the provisions of Section 504 plans when those plans govern the teachers' treatment of students for whom they are responsible. If the teachers fail to implement the plans, such failure can cause the school district to be in noncompliance with Section 504.

41. What is the difference between a regular education intervention plan and a Section 504 plan?

A regular education intervention plan is appropriate for a student who does not have a disability or is not suspected of having a disability but may be facing challenges in school. School districts vary in how they address performance problems of regular education students. Some districts employ teams at individual schools, commonly referred to as "building teams." These teams are designed to provide regular education classroom teachers with instructional support and strategies for helping students in need of assistance. These teams are typically composed of regular and special education teachers who provide ideas to classroom teachers on methods for helping students experiencing academic or behavioral problems. The team usually records its ideas in a written regular education intervention plan. The team meets with an affected student's classroom teacher(s) and recommends strategies to address the student's problems within the regular education environment. The team then follows the responsible teacher(s) to determine whether the student's performance or behavior has improved. In addition to building teams, districts may utilize other regular education intervention methods, including before-school and after-school programs, tutoring programs, and mentoring programs.
PROCEDURAL SAFEGUARDS
Public elementary and secondary schools must employ procedural safeguards regarding the identification, evaluation, or educational placement of persons who, because of disability, need or are believed to need special instruction or related services.

42. Must a recipient school district obtain parental consent prior to conducting an initial evaluation?

Yes. OCR has interpreted Section 504 to require districts to obtain parental permission for initial evaluations. If a district suspects a student needs or is believed to need special instruction or related services and parental consent is withheld, the IDEA and Section 504 provide that districts may use due process hearing procedures to seek to override the parents' denial of consent for an initial evaluation.

43. If so, in what form is consent required?

Section 504 is silent on the form of parental consent required. OCR has accepted written consent as compliance. IDEA as well as many state laws also require written consent prior to initiating an evaluation.

44. What can a recipient school district do if a parent withholds consent for a student to secure services under Section 504 after a student is determined eligible for services?

Section 504 neither prohibits nor requires a school district to initiate a due process hearing to override a parental refusal to consent with respect to the initial provision of special education and related services. Nonetheless, school districts should consider that IDEA no longer permits school districts to initiate a due process hearing to override a parental refusal to consent to the initial provision of services.

45. What procedural safeguards are required under Section 504?

Recipient school districts are required to establish and implement procedural safeguards that include notice, an opportunity for parents to review relevant records, an impartial hearing with opportunity for participation by the student's parents or guardian, representation by counsel and a review procedure.
46. What is a recipient school district's responsibility under Section 504 to provide information to parents and students about its evaluation and placement process?
Section 504 requires districts to provide notice to parents explaining any evaluation and placement decisions affecting their children and explaining the parents' right to review educational records and appeal any decision regarding evaluation and placement through an impartial hearing.

47. Is there a mediation requirement under Section 504?

No.
TERMINOLOGY
The following terms may be confusing and/or are frequently used incorrectly in the elementary and secondary school context.

Equal access: equal opportunity of a qualified person with a disability to participate in or benefit from educational aid, benefits, or services

Free appropriate public education (FAPE): a term used in the elementary and secondary school context; for purposes of Section 504, refers to the provision of regular or special education and related aids and services that are designed to meet individual educational needs of students with disabilities as adequately as the needs of students without disabilities are met and is based upon adherence to procedures that satisfy the Section 504 requirements pertaining to educational setting, evaluation and placement, and procedural safeguards

Placement: a term used in the elementary and secondary school context; refers to regular and/or special educational program in which a student receives educational and/or related services

Reasonable accommodation: a term used in the employment context to refer to modifications or adjustments employers make to a job application process, the work environment, the manner or circumstances under which the position held or desired is customarily performed, or that enable a covered entity's employee with a disability to enjoy equal benefits and privileges of employment; this term is sometimes used incorrectly to refer to related aids and services in the elementary and secondary school context or to refer to academic adjustments, reasonable modifications, and auxiliary aids and services in the postsecondary school context

Reasonable modifications: under a regulatory provision implementing Title II of the ADA, public entities are required to make reasonable modifications in policies, practices, or procedures when the modifications are necessary to avoid discrimination on the basis of disability, unless the public entity can demonstrate that making the modifications would fundamentally alter the nature of the service, program, or activity

Related services: a term used in the elementary and secondary school context to refer to developmental, corrective, and other supportive services, including psychological, counseling and medical diagnostic services and transportation

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special education; disabilities; disability discrimination; fape; free appropriate public education

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Frequently Asked Questions about Section 504 requirements for the education by school districts of students with disabilities

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NASP: Helping Children Cope with Changes durung COVID19

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NASP: Helping Children Cope with Changes durung COVID19

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National Association of School Psychologists (NASP)

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Families across the country are adapting to the evolving changes in daily life caused by the COVID-19 pandemic. Most schools, places of public gathering, and nonessential businesses are closed, and parents and other caregivers are faced with helping their families adjust to the new normal. This includes trying to keep children occupied, feeling safe, and attempting to keep up with schoolwork as best as possible. None of this is easy, but it helps to stay focused on what is possible in order to reinforce a sense of control and to reassure children that they are okay, and that the situation will get better.

It is very important to remember that children look to adults for guidance on how to react to stressful events. Acknowledging some level of concern, without panicking, is appropriate and can result in taking the necessary actions that reduce the risk of illness. Teaching children positive preventive measures, talking with them about their fears, and giving them a sense of some control over their risk of infection can help reduce anxiety. This is also a tremendous opportunity for adults to model for children problem-solving, flexibility, and compassion as we all work through adjustting daily schedules, balancing work and other activities, getting creative about how we spend time, processing new information from authorities, and connecting and supporting friends and family members in new ways. The following tips can help.

STAY CALM, LISTEN, AND OFFER REASSURANCE

Be a role model. Children will react to and follow your reactions. They learn from your example.

Be aware of how you talk about COVID-19. Your discussion about COVID-19 can increase or decrease your child's fear. If true, remind your child that your family is healthy, and you are going to do everything within your power to keep loved ones safe and well. Carefully listen or have them draw or write out their thoughts and feelings and respond with truth and reassurance.

Explain social distancing. Children probably don't fully understand why parents/guardians aren't allowing them to be with friends. Tell your child that your family is following the guidelines of the Centers for Disease Control and Prevention (CDC), which include social distancing. Social distancing means staying away from others until the risk of contracting COVID-19 is under control. Showing older children the "flatten the curve" charts will help them grasp the significance of social distancing. Explain that while we don't know how long it will take to "flatten the curve" to reduce the number of those infected, we do know that this is a critical time-we must follow the guidelines of health experts to do our part.

Demonstrate deep breathing. Deep breathing is a valuable tool for calming the nervous system. Do breathing exercises with your children.

Focus on the positive. Celebrate having more time to spend as a family. Make it as fun as possible. Do family projects. Organize belongings, create masterpieces. Sing, laugh, and go outside, if possible, to connect with nature and get needed exercise. Allow older children to connect with their friends virtually.

Establish and maintain a daily routine. Keeping a regular schedule provides a sense of control, predictability, calm, and well-being. It also helps children and other family members respect others' need for quiet or uninterrupted time and when they can connect with friends virtually.

Identify projects that might help others. This could include: writing letters to the neighbors or others who might be stuck at home alone or to healthcare workers; sending positive messages over social media; or reading a favorite children's book on a social media platform for younger children to hear.

Offer lots of love and affection.

MONITOR TELEVISION VIEWING AND SOCIAL MEDIA

Parents/guardians should monitor television, internet, and social media viewing-both for themselves and their children. Watching continual updates on COVID-19 may increase fear and anxiety. Developmentally inappropriate information, or information designed for adults, can also cause anxiety or confusion, particularly in young children.

Dispel rumors and inaccurate information. Explain to your child that many stories about COVID-19 on the internet may include rumors and inaccurate information. Older children, in particular, may be accessing a great deal of information online and from friends that contains inaccuracies. Talk to your child about factual disease information.

Provide alternatives. Engage your child in games or other exciting activities instead.

TAKE TIME TO TALK

Let your children's questions guide you. Answer their questions truthfully, but don't offer unnecessary details or facts. Don't avoid giving them the information that experts indicate as crucial to your children's well-being. Often, children and youth do not talk about their concerns because they are confused or don't want to worry loved ones. Younger children absorb scary information in waves. They ask questions, listen, play, and then repeat the cycle. Children always feel empowered if they can control some aspects of their life. A sense of control reduces fear.

BE HONEST AND ACCURATE

Correct misinformation. Children often imagine situations worse than reality; therefore, offering developmentally appropriate facts can reduce fears.

Explain simple safety steps. Tell your child this disease spreads between people who are in close contact with one another, when an infected person coughs or sneezes, or when one touches infected objects or surfaces.

Stay up-to-date on the facts. Go to https://www.cdc.gov/coronavirus/2019-ncov/index.htmlfor additional factual information.

KEEP EXPLANATIONS AGE-APPROPRIATE

Early elementary school children. Provide brief, simple information that balances COVID-19 facts with appropriate reassurances that adults are there to help keep them healthy and to take care of them if they do get sick. Give simple examples of the steps people make every day to stop germs and stay healthy, such as washing hands. Use language such as "adults are working hard to keep you safe."

Upper elementary and early middle school children. This age group often is more vocal in asking questions about whether they indeed are safe and what will happen if COVID-19 spreads in their area. They may need assistance separating reality from rumor and fantasy. Discuss the efforts national, state, and community leaders are doing to prevent germs from spreading.

Upper middle and high school students. Issues can be discussed in more depth. Refer them to appropriate sources of COVID-19 facts. Provide honest, accurate, and factual information about the current status of COVID-19. Engage them in decision-making about family plans, scheduling, and helping with chores at home.

For all children, encourage them to verbalize their thoughts and feelings. Be a good listener!

STAY CONNECTED TO SCHOOL

Locate learning resources. Schools' capacity to conduct virtual learning experiences will vary greatly, but most schools are providing lessons and learning activities for children to do. Take advantage of the many companies and online platforms currently offering free learning opportunities.

Identify additional resources. Know if your school or district is providing additional resources, such meals, or technology, such as a laptop or tablet.

Stay in touch. Find out how the school is communicating with families and students. Be sure to read any communications you receive. Check with you children, particularly older ones, as they may be receiving information directly that would be helpful for you to know.

Connect with school staff. Reach out to your child's teacher and other relevant school staff if you have concerns about their coping and keeping up with assignments or activities.

KNOW THE SYMPTOMS OF COVID-19

According to the CDC, symptoms of fever, cough, and/or shortness of breath appear within 14 days after being exposed to the disease.

For some people, the symptoms are similar to having a cold; for others, they are more severe or even life threatening.

MODEL BASIC HYGIENE AND HEALTHY LIFESTYLE PRACTICES

Practice daily good hygiene. Encourage your child to practice these simple steps to prevent spreading the virus.

Wash your hands multiple times a day for 20 seconds. Singing "Twinkle, Twinkle Little Star" or "Happy Birthday" twice is about 20 seconds.

Compliment your children when they use a Kleenex or sneeze or cough into the bend of their elbow. Teach them the importance of throwing away used tissues immediately after sneezing or coughing.

Sadly, handshakes and hugs need to be limited to immediate family members, at least for now.

Foster a sense of control. Offering guidance on what your child/children can do to prevent infection offers them a greater sense of control, which reduces anxiety.

Build the immune system. Encourage your child to eat a balanced diet, get enough sleep, and exercise regularly; this will help them develop a robust immune system to fight off illness.

BE AWARE OF YOUR CHILDREN'S MENTAL HEALTH

Most children will manage well with the support of parents and other family members, even if showing signs of some anxiety or concerns, such as difficulty sleeping or concentrating. Some children, however, may have risk factors for more intense reactions, including severe anxiety, depression, and suicidal behaviors. Risk factors can include a pre-existing mental health problem, prior traumatic experiences or abuse, family instability, or the loss of a loved one. Parents and caregivers should contact a professional if children exhibit significant changes in behavior or any of the following symptoms for more than 2 weeks.

Preschoolers -thumb sucking, bedwetting, clinging to parents, sleep disturbances, loss of appetite, fear of the dark, regression in behavior, and withdrawal.

Elementary school children -irritability, aggressiveness, clinginess, nightmares, school avoidance, poor concentration, and withdrawal from activities and friends.

Adolescents -sleeping and eating disturbances, agitation, increase in conflicts, physical complaints, delinquent behavior, and poor concentration.

ADDITIONAL RESOURCES
For more information related to schools and physical and mental health, visit www.nasponline.org and © 2020, National Association of School Psychologists, 4340 East Wes t Highway, Suite 402, Bethesda, MD 20814, 301-657-0270 www.nasn.org.
Adapted from, Talking to Children About COVID-19 (Coronavirus): A Parent Resource, National Association of School Psychologists and National Association of School Nurses, NASP, 2020.

Contributor: School Psychologist Kathy Sievering

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Helping Children Cope With Changes Resulting From COVID-19

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Families across the country are adapting to the evolving changes in daily life caused by the COVID-19 pandemic. Most schools, places of public gathering, and nonessential businesses are closed, and parents and other caregivers are faced with helping their families adjust to the new normal.

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Assistive technology (AT) is "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities" of children with disabilities. (IDEA, 2004, Sec. 300.5). For students with disabilities, IDEA requires that Assistive Technology (AT) must be considered as part of the IEP developed for each student that is eligible.

Assistive Technology Observation-Screening Request

Web Resources

Open Access website contains resources related to Assistive Technology, Augmentative or Alternative Communication, and Universal Design for Learning.

Resources for Spanish-speaking children for use by professionals and families of Spanish-speaking children with complex communication needs.

This site shares quick posts, tips and a list of Bilingual Spanish-English apps and manufacturers.

This blog is a companion to the website, www.aacintervention.com At this site you can find quick posts, mini tips, and think out louds.

The Paul V. Sherlock Center on Disabilities at Rhode Island College partners with state and national agencies, schools, institutes of higher education and community providers to offer: Interdisciplinary pre-service and community education, technical assistance, services, research, and information.

Video Links

Video Tutorials in English:

Video Tutorials in Spanish:

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Assistive technology (AT) is "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities" of children with disabilities. (IDEA, 2004, Sec. 300.5).

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Share your videos with friends, family, and the world

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Video: BeyondSST referring to 504 Plan team

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Video: BeyondSST referring to 504 Plan team

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Accommodations for students with Anxiety Disorders

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Accommodations for students with Anxiety Disorders

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It's not uncommon for students who learn and think differently to also struggle with anxiety. They might worry a lot or be withdrawn at school. They may hesitate to participate in the classroom, make frequent trips to the bathroom or the nurse's office, or even refuse to go to school at all. All of this can get in the way of learning.

What are some classroom accommodations for kids with anxiety? Here are strategies teachers can try.

Providing emotional support

Encourage the student to use self-calming or anxiety-reducing techniques that were taught by a counselor or therapist.

Allow the student to have a self-calming object or family pictures on hand.

Build in "call home" breaks (for students with separation anxiety).

Let the student seek help from a designated staff member with mental health expertise when feeling anxious.

Classroom setup, schedules, and routines

Provide classroom seating where the student is most comfortable (near a door, near the front of the room, near the teacher or a friend).

Let the student sit near the back of the room or by an exit during assemblies.

Assign the student a designated buddy for lunchtime, recess, and/or hallways.

Allow preferential grouping for field trips so the student is with a teacher or friends.

Provide a "take a break pass" to let the student walk down the hallway, get a drink, or leave the classroom when needed.

Create a plan for catching up after an absence or illness (for example, excusing missed homework or having a known time frame for making up work).

Give advance notice of planned substitute teachers or other changes in routine.

Give the student notice and extra time before upcoming transitions, like before recess and lunch, and rehearse transitions in a private or low-stress environment.

Giving instructions and assignments

Clearly state and/or write down classroom expectations and consequences.

Break down assignments into smaller chunks.

Check in frequently for understanding and "emotional temperature."

Provide a signal before calling on the student and a signal for the student to opt out of answering.

Offer written instructions in addition to spoken directions.

Exempt the student from reading aloud or demonstrating work in front of the class.

Let the student present projects to the teacher instead of to the entire class.

Introducing new concepts/lessons

Give extended time on tests and/or separate test-taking space to reduce performance anxiety.

Allow use of word banks, cheat sheets, or fact cards for tests (for students who freeze or "go blank" during in-class tests).

Set time limits for homework or reduce the amount of homework.

Assure that work not completed in that time won't count against the student.

Provide class notes via email or a school portal for the student to preview.

Give notice of upcoming tests (no "pop quizzes").

When students are being treated for anxiety, it's crucial for all of the people working with them to be in contact with their mental health providers about using school strategies like these. Together, you can all ensure the accommodations are a good fit for the student.

About the author

About the author

Amanda Morin is the author of "The Everything Parent's Guide to Special Education" and the former director of thought leadership at Understood. As an expert and writer, she helped build Understood from its earliest days.

Reviewed by

Reviewed by

Jerome Schultz, PhD is a clinical neuropsychologist and lecturer in the Harvard Medical School Department of Child Psychiatry.

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Accommodations for Students With Anxiety Disorders

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It's not uncommon for students who learn and think differently to also struggle with anxiety. They might worry a lot or be withdrawn at school. They may hesitate to participate in the classroom, make frequent trips to the bathroom or the nurse's office, or even refuse to go to school at all.

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Sometimes anxiety is easy to identify - like when a child is feeling nervous before a test at school. Other times anxiety in the classroom can look like something else entirely - an upset stomach, disruptive or angry behavior, ADHD, or even a learning disorder.

There are many different kinds of anxiety, which is one of the reasons it can be hard to detect in the classroom. What they all have in common, says neurologist and former teacher Ken Schuster, PsyD, is that anxiety "tends to lock up the brain," making school hard for anxious kids.

Children can struggle with:

Separation anxiety: When children are worried about being separated from caregivers. These kids can have a hard time at school drop-offs and throughout the day.

Social anxiety: When children are excessively self-conscious, making it difficult for them to participate in class and socialize with peers.

Selective mutism: When children have a hard time speaking in some settings, like at school around the teacher.

Generalized anxiety: When children worry about a wide variety of everyday things. Kids with generalized anxiety often worry particularly about school performance and can struggle with perfectionism.

Obsessive-compulsive disorder: When children's minds are filled with unwanted and stressful thoughts. Kids with OCD try to alleviate their anxiety by performing compulsive rituals like counting or washing their hands.

Specific phobias: When children have an excessive and irrational fear of particular things, like being afraid of animals or storms.

Here are some tips for recognizing anxiety in kids at school, and what might be causing it.

When a child is squirming in his seat and not paying attention, we tend to think of ADHD, but anxiety could also be the cause. When kids are anxious in the classroom, they might have a hard time focusing on the lesson and ignoring the worried thoughts overtaking their brains. "Some kids might appear really 'on' at one point but then they can suddenly drift away, depending on what they're feeling anxious about," says Dr. Schuster. "That looks like inattention, and it is, but it's triggered by anxiety."

It might look like truancy, but for kids for whom school is a big source of anxiety, refusing to go to school is also pretty common. School refusal rates tend to be higher after vacations or sick days, because kids have a harder time coming back after a few days away.

Going to school can also be a problem for kids who have trouble separating from their parents. Some amount of separation anxiety is normal, but when kids don't adjust to separation over time and their anxiety makes going to school difficult or even impossible, it becomes a real problem. Kids with separation anxiety may also feel compelled to use their phones throughout the day to check in with their parents.

Acting out is another thing we might not associate with anxiety. But when a student is compulsively kicking the chair of the kid in front of him, or throws a tantrum whenever the schedule is ignored or a classmate isn't following the rules, anxiety may well be the cause. Similarly, kids who are feeling anxious might ask a lot of questions, including repetitive ones, because they are feeling worried and want reassurance.

Anxiety can also make kids aggressive. When children are feeling upset or threatened and don't know how to handle their feelings, their fight or flight response to protect themselves can kick in - and some kids are more likely to fight. They might attack another child or a teacher, throw things, or push over a desk because they're feeling out of control.

Sometimes kids will do perfectly well on tests and homework, but when they're called on in class teachers hit a wall. There are several different reasons why this might happen.

"Back when I was teaching, I would notice that when I had to call on someone, or had to figure out who's turn it was to speak, it was like the anxious kid always tended to disappear," says Dr. Schuster. "The eager child is making eye contact, they're giving you some kind of physical presence in the room like 'Call on me, call on me!' " But when kids are anxious about answering questions in class, "they're going to break eye contact, they might look down, they might start writing something even though they're not really writing something. They're trying to break the connection with the teacher in order to avoid what's making them feel anxious."

If they do get called on, sometimes kids get so anxious that they freeze. They might have been paying attention to the lesson and they might even know the answer, but when they're called on their anxiety level becomes so heightened that they can't respond.

Anxiety can manifest in physical complaints, too. If a student is having unexplained headaches, nausea, stomachaches, or even vomiting, those could be symptoms of anxiety. So can a racing heart, sweaty palms, tense muscles, and being out of breath.

When a child starts doubting her abilities in a subject, anxiety can become a factor that gets in the way of her learning or showing what she knows. Sometimes this can be mistaken for a learning disorder when it's really just anxiety.

However anxiety can also go hand in hand with learning disorders. When kids start noticing that something is harder for them than the other kids, and that they are falling behind, they can understandably get anxious. The period before a learning disorder is diagnosed can be particularly stressful for kids.

When a student doesn't turn in her homework, it could be because she didn't do it, but it could also be because she is worried that it isn't good enough. Likewise, anxiety can lead to second guessing - an anxious child might erase his work over and over until there's a hole in the paper - and spending so much time on something that it never gets finished. We tend to think of perfectionism as a good thing, but when children are overly self-critical it can sabotage even the things they are trying their hardest at, like school work.

You might also notice that some anxious kids will start worrying about tests much earlier than their classmates and may begin dreading certain assignments, subjects, or even school itself.

Some kids will avoid or even refuse to participate in the things that make them anxious. This includes obvious anxiety triggers like giving presentations, but also things like gym class, eating in the cafeteria, and doing group work.

When kids start skipping things it might look to their teachers and peers like they are uninterested or underachieving, but the opposite might be true. Sometimes kids avoid things because they are afraid of making a mistake or being judged.

Dr. Schuster notes that when kids get anxious in social situations, sometimes they have a much easier time showing what they know when teachers engage them one-to-one, away from the group.

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How Does Anxiety Affect Kids in School? - Child Mind Institute

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Sometimes school anxiety is easy to identify - like when a child is feeling nervous before a test at school. Other times anxiety in the classroom can look like something else entirely - an upset stomach, disruptive or angry behavior, ADHD, or even a learning disorder.

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Assistive Technology For Remote Teaching and Learning.pdf

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AT during Distance Learning

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Assistive Technology Google Extensions for Chrome Zoom Session

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You may have heard that assistive technology (AT) can help your child with learning and thinking differences. However, AT like computer software and apps can cost money. The good news is there are many free online tools your child can try.

To use web-based AT tools, your child will need a computer or a tablet, an internet connection, and a web browser like Safari, Chrome, Firefox, Microsoft Edge, or Internet Explorer. (These tools can typically be used on smartphones, too, but they may not function the same as they do on a computer or tablet.)

If you don't own a computer or tablet, your child may be able to use one at school. A local library or a community center may also have computers available.

Here are some free online AT tools that can help kids (and adults) with reading, writing, organization, and math issues. Keep in mind that these tools may not work perfectly all the time.

Bookshare is the largest online library of accessible books in the world. All of its books are digital and can be read aloud with text-to-speech (TTS). Kids can read and listen to them online with the Bookshare Web Reader. Bookshare has a huge selection of titles, from the latest popular books and magazines to textbooks and classics. Bookshare is a program ofBenetech, an Understood founding partner. To qualify for Bookshare, your child must have a documented print disability. If your child has a learning difference like dyslexia, your child may qualify. Nonstudents may also be able to access Bookshare for free through a local public library.

NaturalReader offers free TTS. Kids can paste text or import documents into the tool, press play, then listen and read along as the text is read aloud. They can choose different voices and speed up or slow down the reading speed. NaturalReader also offers many free e-books with TTS.

Online OCR converts text in image files into digital text files using optical character recognition (OCR). Kids just have to upload a file, enter a Captcha code, and press "convert." Once converted, the files can be read aloud with TTS. The tool will convert up to 15 images per hour for free. When they register as users, kids can purchase additional images at 100 pages for $7.95.

Rewordify simplifies text to make it easier to understand. Kids paste text or a web page address into the tool. Rewordify then replaces the difficult words in the text or web page with simpler words or definitions. In the tool's settings, kids can choose their reading level. They can also choose how the simplified text is displayed. Rewordify has a library of classic literature and historical documents with simplified text. Some kids may find it easier to understand the Rewordify version of certain texts, like Shakespeare's plays or the Declaration of Independence.

Quizlet is a study tool that lets students create electronic flashcards. Lots of kids may enjoy Quizlet, but it has features that are especially helpful for kids with reading issues. The flashcards can have images and audio recordings. They can also be read aloud with TTS. Quizlet offers activities and games to help with studying, too, and syncs to a mobile app for studying on the go.

TalkTyper is a simple online dictation tool. When kids speak into their computer mic, the tool types out what they're saying. The dictated words and sentences are collected in a basic word processor and can be edited with a keyboard. The finished writing can then be printed, emailed, or copied and pasted elsewhere. Two other online dictation options are Dictation and Speechnotes. All three of these tools work only in the Chrome web browser.

EasyBib creates citations for books, videos, websites, and other sources. So when kids are writing research reports, creating a bibliography, or listing their sources, EasyBib makes it easier. Kids just need to input basic information about the source, like a book title or a web address. Then EasyBib automatically fills in the details and provides a citation in the correct format. EasyBib also puts citations into alphabetical order. Kids can download, copy and paste, or print the completed list. The free version of EasyBib creates citations in the common MLA format. There's also a version that costs $9.95 per month, which can create citations in other formats.

Grammarly is an online proofreader. It's more advanced than typical proofreaders found in word processing programs like Word and Pages. The tool finds possible mistakes in spelling, grammar, and punctuation, and suggests corrections. It also gives explanations so kids can learn from their mistakes. Kids can paste text right into the tool, or upload documents from a hard drive. The free version has basic spelling and grammar checking. The premium version makes vocabulary suggestions, checks for plagiarism, and allows kids to use the tool directly in Microsoft Office programs (Windows only). The price of the premium version starts at $30 per month.

Scrible allows kids to take notes on internet articles as they research online. Kids can use highlighters, sticky notes, and other tools to mark key information. All of their work is saved in an online account. Scrible automatically creates citations for articles and puts them into a bibliography, too. The free version of Scrible has all of the basic note-taking tools. The Pro student version ($35 per year) has more storage space and more functions, like .

MindMeister is a digital graphic organizer. It's a helpful organization tool, as kids can use it to organize ideas with visual mind maps, diagrams, and pictures. It also helps with taking notes, outlining the main ideas in a book, or getting started writing an essay. The tool comes with several built-in templates. Kids can also create their own diagrams from scratch. The free version of MindMeister lets kids work on three projects at a time. There's also a version that costs $4.99 per month, which allows unlimited projects and has advanced features, like saving to different file types. Another digital graphic organizer tool to check out isMindomo.

National Library of Virtual Manipulatives is a large library of math manipulatives. These are virtual objects like number lines and blocks that let kids solve math problems in different ways. The library is broken down by grade and by topic. For instance, if kids pick grades 3-5 and numbers, they'll find objects like a virtual abacus, pie charts, and Venn diagrams.

Geogebra is an online drawing and graphing tool. Kids can type in an equation and the tool graphs it on virtual graph paper. If kids draw a shape or line on the virtual graph paper, Geogebra will translate it into an equation. For instance, draw a circle, and the tool will give the equation for that circle. Graphs and equations can be saved or printed. The tool has a calculator function, too.

WebMath is an online calculator and problem solver. It has templates for many different math problems, like counting coins, calculating area, and even solving calculus equations. The templates are divided into categories like Algebra and K-8 Math. Kids choose a template and fill in the numbers and symbols. WebMath gives the answer, along with a step-by-step explanation for how it's solved. Some of these free tools, like MindMeister, can also be helpful for kids who struggle with organization. Another organization tool isGoogle Keep, which lets kids create digital sticky notes, arrange them on a blank screen, and set reminders for each note. It also syncs with mobile apps for iOS and Android and Chrome tools.

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You may have heard that assistive technology (AT) can help your child with learning and thinking differences. However, AT like computer software and apps can cost money. The good news is there are many free online tools your child can try.

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Impulsive behavior. Incomplete homework. Inconsistent focus. Whatever your child's school challenges, these teacher-approved accommodations can put some real muscle behind his 504 Plan and put the attention back on learning.

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Low grades on assignments can be improved by 504 accomodations for adhd.

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A student fidgeting during a test which 504 accomodations for adhd can help ease and mitigate.

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A teacher assigning homework on the blackboard, which 504 accomodations for adhd can help your child to complete by improving communication.

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An apprehensive student contemplating his writing assignment, which 504 accomodations for adhd can help manage.

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Every 504 Plan Should Include These ADHD Accommodations

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Impulsive behavior. Incomplete homework. Inconsistent focus. Whatever your child's school challenges, these teacher-approved accommodations can put some real muscle behind his 504 Plan and put the attention back on learning.

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Allergies & Asthma

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Notice: Covid-19 and Schools

It is important to remember that the COVID-19 outbreak is a constantly evolving situation and guidance is likely to change as more is understood about this novel coronavirus. For general information on COVID-19, such as signs & symptoms, please visit our

COVID-19 Information Center

Each school year brings its own unique challenges for students with asthma and allergies. As we move through the COVID-19 pandemic becoming endemic, it's important to know the facts.

There's so much information and misinformation available - come to Allergy & Asthma Network for trustworthy, evidence-based guidance on COVID-19, asthma and allergies. We'll help you navigate the school year. What's most important? Be flexible. Expect things to change as we adjust to new guidance as it is available.

The U.S. Centers for Disease Control and Prevention (CDC) offers general guidance for in-person learning at K-12 schools and early childhood settings:.

Promote COVID-19 vaccinations and booster shots as a way to prevent severe illness.

Consider making COVID-19 testing and vaccinations available on site as a public service. Or, connect students and school staff to off-site vaccination locations.

Encourage students and school staff to stay home when sick with any COVID-19 symptoms. Symptoms may include fever, sore throat, fatigue, cough, shortness of breath, chills, muscle or body aches, runny or stuffy nose, nausea, vomiting, diarrhea and/or loss of taste and smell.

How can school nurses assist schools as they develop plans for reopening?

School nurses are trusted leaders in helping schools make decisions about their COVID-19 response and should be involved in all planning to reopen schools, and deal with potential illness. Some of the activities that school nurses can help with include:

Sharing disinfection procedures

Implementing ventilation procedures (with consideration for students with asthma and allergies)

Updating signs, messaging and markings that promote COVID-19 safety

Developing appropriate care plans for students and staff who become ill

Knowing the latest guidance from the CDC and enact the guidance as appropriate for the school setting

Are there any recommendations regarding ventilation in schools with consideration for students and staff with asthma and/or allergies?

There have been concerns related to the use of air conditioners and ventilation systems during the COVID-19 pandemic. Considerations for schools include:

Most air conditioners recirculate air within a space - adding a filter into the HVAC system will filter out some viral particles.

Air purifiers may help to a point.

Regularly opened windows can bring in fresh air - be aware that this may expose students with environmental allergies to pollen and other outdoor allergens.

COVID-19 is spread by respiratory droplets. These droplets fall to the ground within 6 feet, so social distancing remains key.

NOTE: Hand sanitizers work well to help kill viruses on hands, but they do not "clean away" food allergens. Continue to use soap and water or wipes to remove food allergens from hands and surfaces.

Should school staff be trained on signs and symptoms of COVID-19?

Yes, school staff should be trained on the signs and symptoms of COVID-19. They should know what to do if they suspect that they have symptoms or if a student develops symptoms while at school. Training for staff will vary by school district. Parents should feel free to contact their school district or administrator to discuss how staff is trained and to ask about the district's procedure if a case of COVID-19 is suspected or confirmed.

How should schools handle food service during COVID-19?

The CDC offers recommendations for school nutrition staff, teachers, building managers and custodial staff to reduce the risk of spreading COVID-19 during mealtimes. These include:

Maintain 6 feet separation between students when picking up meals and when eating.

Improve ventilation in indoor cafeterias and eating areas, including bringing in fresh, outdoor air when possible,

Ensure proper handwashing or use of hand sanitizer before and after eating.

Stagger mealtimes to avoid large crowds in indoor cafeterias.

Encourage students and food service personnel to wear a mask when picking up meals and when finished eating, especially if the community has reported high levels of COVID-19 cases.

Increase disinfection and sanitation policies as appropriate - but keep in mind the chemicals in some disinfectants can trigger asthma. Make sure the policy takes this into account. For example, the school may want to disinfect after the school day is over.

The school should make arrangements to accommodate the isolation of a student who becomes ill with the symptoms of COVID-19 during the school day.

Work closely with local health departments to stay updated on the latest guidance about COVID-19.

Ensure adequate supply of face masks and PPE for school nurses, school staff and any students who may require it.
Use vinyl or nitrile gloves. Do not substitute with latex gloves.

Limit the number of students in the health office at one time.

Identify isolation space and appropriate staff supervision for students with respiratory or viral symptoms.

Develop protocols for when to isolate and dismiss students.

Are people with asthma more at risk from COVID-19?

People with moderate to severe asthma may be at higher risk of getting very sick with COVID-19, according to the CDC.

COVID-19 can affect the respiratory tract (nose, throat, lungs), which can lead to an asthma attack. It could also lead to pneumonia or acute respiratory disease. A recent study from the Journal of Allergy & Clinical Immunology demonstrated that those with non-allergic asthma may be up to 48% more at risk from severe COVID-19. The same study did not find increased risk for people with allergic asthma.

What precautions should a student or staff member with asthma take during the COVID-19 pandemic?

In addition to practicing activities to prevent COVID-19, it is crucial that people with asthma make sure their asthma is well controlled. This includes:

Make sure you have your asthma medications and supplies (at least 30 days on hand).

Follow your
If you don't have an asthma action plan, make an appointment TODAY to develop one with your doctor.

Take your asthma medications as directed and don't stop any without first discussing with your doctor.

Know your asthma triggers and avoid them when possible.

Know how to use your inhaler -

Learn ways to cope with stress and anxiety as strong emotions can sometimes trigger an asthma attack.

Be sure your Asthma Action Plan is up to date. Discuss any concerns with your doctor.

Should a child or staff member who is coughing from asthma and/or allergies be forced to go home?

Two primary COVID-19 symptoms are coughing and shortness of breath. These may overlap with symptoms of asthma and allergies. Students experiencing a cough and/or shortness of breath should consult with their healthcare provider before attending school.

Are disinfectants and hand sanitizers safe for students or staff with asthma?

Routine cleaning and disinfecting is key to maintaining a safe environment for faculty, students, and staff.

Cleaning removes dirt and some germs and is generally done with soap and water.

Disinfecting kills most germs and should be done with approved cleaning agents for the school setting.

For many students and staff, cleaning products and disinfectants are triggers for their asthma. People with asthma should try to stay away when cleaners are being used and immediately following their use.

What COVID-19 face mask policies should be in place in schools?

CDC guidelines to wear face masks are based on levels of COVID-19 in each community. The levels are determined by the total number of people with COVID-19 admitted to the hospital; hospital beds in use; and the total number of new COVID-19 cases in the area.

If a community has a high level of COVID-19, it's recommended people wear a mask indoors in public settings, including K-12 schools. Masks do not need to be worn outside.

If a community has a medium or low level of COVID-19, face masks are based on personal preference or risk. However, for communities at medium level, people who are immunocompromised or at high risk for severe illness should talk with their doctor about wearing a mask indoors.

Check your community's level on CDC's website.

Some individual schools or school districts may elect to continue having students wear masks. Check with your local school for information.

Should masks be worn by people with asthma?

CDC recommends people living in a community with high levels of COVID-19 wear a face mask indoors. This includes people who are immunocompromised or at risk for severe illness, such as those with moderate to severe asthma. If the level of COVID-19 in a community is medium, people who are immunocompromised or at risk for severe illness should speak with their healthcare provider.

What are potential complications for children and COVID-19?

As a result of COVID-19, some children have experienced Multisystem Inflammatory Syndrome in Children, or MIS-C. It is a condition where different parts of the body become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

The exact cause of MIS-C is unknown, but many children with it had COVID-19 or were around someone with it.

What are the symptoms of Multisystem Inflammatory Syndrome in Children?

Not all children have the same MIS-C symptoms. MIS-C can be serious, even life-threatening, but most children diagnosed with it get better with medical care.

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COVID-19 School Resources for Managing Asthma and Allergies

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It is important to remember that the COVID-19 outbreak is a constantly evolving situation and guidance is likely to change as more is understood about this novel coronavirus. For general information on COVID-19, such as signs & symptoms, please visit our COVID-19 Information Center There's so much information and misinformation available - come to Allergy & Asthma Network for trustworthy, evidence-based guidance on COVID-19, asthma and allergies.

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CDC Resource

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Centers for Disease Control and Prevention

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ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

Signs and Symptoms

It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviors. The symptoms continue, can be severe, and can cause difficulty at school, at home, or with friends.

A child with ADHD might:

daydream a lot

forget or lose things a lot

squirm or fidget

talk too much

make careless mistakes or take unnecessary risks

have a hard time resisting temptation

have trouble taking turns

have difficulty getting along with others

Learn more about signs and symptoms
Types

There are three different ways ADHD presents itself, depending on which types of symptoms are strongest in the individual:

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are equally present in the person.

Because symptoms can change over time, the presentation may change over time as well.

Causes of ADHD

Scientists are studying cause(s) and risk factors in an effort to find better ways to manage and reduce the chances of a person having ADHD. The cause(s) and risk factors for ADHD are unknown, but current research shows that genetics plays an important role. Recent studies link genetic factors with ADHD.

In addition to genetics, scientists are studying other possible causes and risk factors including:

Brain injury

Exposure to environmental risks (e.g., lead) during pregnancy or at a young age

Alcohol and tobacco use during pregnancy

Premature delivery

Low birth weight

Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.

Diagnosis

Deciding if a child has ADHD is a process with several steps. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms. One step of the process involves having a medical exam, including hearing and vision tests, to rule out other problems with symptoms like ADHD. Diagnosing ADHD usually includes a checklist for rating ADHD symptoms and taking a history of the child from parents, teachers, and sometimes, the child.
Learn more about the criteria for diagnosing ADHD
Treatments

In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried. What works best can depend on the child and family. Good treatment plans will include close monitoring, follow-ups, and making changes, if needed, along the way.
Learn more about treatments
Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with ADHD. In addition to behavioral therapy and medication, having a healthy lifestyle can make it easier for your child to deal with ADHD symptoms. Here are some healthy behaviors that may help:

Get Help!

If you or your doctor has concerns about ADHD, you can take your child to a specialist such as a child psychologist, child psychiatrist, or developmental pediatrician, or you can contact your local early intervention agency (for children under 3) or public school (for children 3 and older).

The Centers for Disease Control and Prevention (CDC) funds the National Resource Center on ADHD, a program of CHADD - Children and Adults with Attention-Deficit/Hyperactivity Disorder. Their website has links to information for people with ADHD and their families. The National Resource Center operates a call center (1-866-200-8098) with trained staff to answer questions about ADHD.

For more information on services for children with special needs, visit the Center for Parent Information and Resources. To find the Parent Center near you, you can visit this website.

ADHD in Adults

ADHD can last into adulthood. Some adults have ADHD but have never been diagnosed. The symptoms can cause difficulty at work, at home, or with relationships. Symptoms may look different at older ages, for example, hyperactivity may appear as extreme restlessness. Symptoms can become more severe when the demands of adulthood increase. For more information about diagnosis and treatment throughout the lifespan, please visit the websites of the National Resource Center on ADHD and the National Institutes of Mental Health.

More Information

Reference

Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., . . . Wang, Y. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews. doi:10.1016/j.neubiorev.2021.01.022

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ADHD is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), and in some cases, are overly active.

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ADHD Sample Accommodations