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1:1 aides

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I am trying to find a list of qualifying conditions that would indicate a student would qualify for a 1:1 aide but coming up short.  Can you tell me which disabilities would trigger this intervention.  I have an IEP meeting coming up for a student that has been remote since he came to us (from another country where he had no schooling) but will be in person next year so I need to know what the options are.

 

 

k1p1ssk, BSN, RN

Specializes in pediatrics. Has 10 years experience.

Would the aide be for behavior or for medical intervention? Typically, our students only have 1:1s if they have an Intellectual, Developmental, or Medical Disability that renders them unable to perform ADLs or if their behavior is such that they are a safety risk (self-harm, harm to others, or flight risk).

So, it isn't necessarily a specific diagnosis. For example, if a student has a seizure disorder, but typically only has 1-2 seizures per year, that wouldn't warrant a 1:1, but a student who experiences drop seizures 2-3x per week might. A 12 year old, 6th grade student with an ID who can navigate the hallways and keep a schedule doesn't necessarily need a 1:1, but a 15 year old in a HS who has a cognitive level of a 4 year old and needs help toileting probably does. 

And with all that said, the 1:1 for medical reasons/diagnosis would probably be on a 504 rather than an IEP, unless the 1:1 was also providing academic support. 

So in other words, look at the student and their abilities and figure out what purpose the the 1:1 would serve first. If they're coming from another country and had no formal schooling, do they even have a formal diagnosis of anything regarding cognition or behavior? 

Edited by k1p1ssk

amoLucia

Specializes in LTC.

k1p1ssk - interesting answer.

The student has pseudo spina bifida, would need help with toileting and transfers for sure.  Transport is already set up to and from school.  He is also quite delayed in academics but it's hard to tell why because he's had so many obstacles to overcome, including his first year of US schooling (he is a first grader) in the middle of a pandemic.  To be honest, I'm not sure what else as I haven't met or worked with him but I am trying to do research now so that I am prepared when the IEP comes up.  I want to know if there is some 'line' where it's too much for the school nurse and I would say we need to start talking 1:1

k1p1ssk, BSN, RN

Specializes in pediatrics. Has 10 years experience.

19 minutes ago, arlingtonnurse said:

The student has pseudo spina bifida, would need help with toileting and transfers for sure.  Transport is already set up to and from school.  He is also quite delayed in academics but it's hard to tell why because he's had so many obstacles to overcome, including his first year of US schooling (he is a first grader) in the middle of a pandemic.  To be honest, I'm not sure what else as I haven't met or worked with him but I am trying to do research now so that I am prepared when the IEP comes up.  I want to know if there is some 'line' where it's too much for the school nurse and I would say we need to start talking 1:1

IMO, toileting and transfers would be an automatic 1:1. How long would a transfer and toileting take? A school nurse is there for the entire school population, and if a significant amount of your time is dedicated to caring for a single student, you can't necessarily be there for the rest of the school. In some schools I've worked in the aide has some basic training for the toileting, etc. and is also the academic support. 

9 minutes ago, nursetlm said:

Does he wear AFOs?

Not sure, would that make a big difference with his needs?

Purple036, LVN

Specializes in School Nursing. Has 4 years experience.

I have a student who has hydrocephalus. They require tubal feedings and the parent request this take place in bed. The student is wheelchair bound but very mobile when laying bed therefore needing the student to be shifted up into 45 degree angle continuously. Also, the student has GERD and gags alot during feedings especially when they have a cold. Due to this I requested an aid to be with the student during feedings for monitoring and care. It also helps this year due to COVID and having to be in one place for an hour is not feasible for the only school nurse.  

nursetlm, ADN

Has 9 years experience.

Had a little guy with SB who had some difficulty with bowel/bladder and was also wearing AFOs for some lower leg stability- our PT was able to help with getting him qualified and on an IEP- which allowed him to have an aide.  For a month I was doing all cares/ toileting (to an extent) and putting on/ off afos- which was very difficult with the amount of kids (elementary) that I see daily (always busy.)  I was thankful that he was able to get an assistant to do his cares now.  I do miss seeing him though. : -)

amoLucia

Specializes in LTC.

20 minutes ago, nursetlm said:

Had a little guy with SB ...

what's SB? spinal bif?

cowboysandangels, BSN

Specializes in Peds. Has 21 years experience.

It is such a case by case issue.  We only have 1:1 for extreme cases.  The last one we had was for a student that needed deep suctioning and a vibration vest.  If it was something that the school nurse needed to watch closely throughout the day and could not perform her duties with the other student, then it needs to be discussed.