[gingerbreadhouse]

Howdy,

I am a brand new school nurse and have a 6th grader with PDD who is extremely obese. He's put on 30 pounds since October, the school staff are concerned, and he is reporting that his knees hurt going up and down the stairs and it is taking him a while when he has to change classes. Mom refuses to acknowledge a problem and basically said to mind my own business, and that it does not impact him educationally. My director is pushing me to have a meeting to address these issues with the parent, but I am very uncomfortable doing so given how resistant she is. His teachers also say he smells, especially when it is warm out. I have not noticed an odour but this has been reported by various teachers. How concerned should I be and how should I address these issues. Would a report to Child Protective Services be appropriate.

[michigooseBSN]

Have you considered a call to the pediatrician? HIPAA may prevent his telling you anything without parental permission but it doesn't prevent him from listening to your concerns. I did this once with an excessive absence/school phobia problem whose mother was part of the problem. It worked out very well.

[bergren]

I agree - rule out a biological cause. Any chance the child has Prader Willi syndrome? http://www.nlm.nih.gov/medlineplus/p...isyndrome.html

However, FERPA will not allow you to speak to the health provider without a signed release from the parent. However, for any PDD child, you / special ed should already have a release good for a year to talk to physican. If the child is on meds that you are adminsitering, some states require that you be able to speak to prescriber and the pretense here would be that the dosage may need to be adjusted due to extreme weight gain.

Have you conducted a home visit yet? You might get a better handle on what the real issue is. Don't go alone - go with someone from either the special ed team, the teacher or principal.

What is your schools wellness policy prescribing for all kids and staff , including special ed in terms of activity and nutrition education? Can you use to highlight issues for the entire class?

[bandaider]

I have had much frustration with a similar situation. My student has a BMI of 58.There are zero adolescent weight management programs in our area, I've found adult programs thru local hospitals who have consentedto do one-on-one but parent won't consent because she can't fit it in to her schedule, blah, blah, blah. Her doctor says his hands are tied, CPS can't/won't intervene. I think my student & her parent are just waiting on her to be old enough to try gastric bypass. Bottom line is that without mom's cooperation...I'm out of options.

[sChOOLRN48]

I have a student who is currently going to New Hope at UIC @ chicago! They have done wonders for my student!!!!! tons of testing, diet, lifestyle changes, support for the WHOLE family!!! She has lost a great deal of weight and has gained a huge sense of herself. She is more confident and has more friends!!! I can't tell you how hard she has worked and how proud I am of her. The program is a study and she may get a lap band placed this summer. BUT I don't think that she will need it! She is losing weight so easily with just the hard work!

One of her teachers has pictures from the first week of school up in her room and one day I made her go and look at them & even she couldn't believe how different she looked! She is awsome and an inspiration to me!

I hope if you are in the chicagoland/IL area or just contact them and see if there is any teleconference or lit that you could get! I hope this helps!

peace, Theresa