Health History to determine IEP Eligibility?

KKEGS, MSN, RN · Oct 31, 2016

I haven't encountered resistance to my asking about health history and I am brand new to school nursing this year but I am also curious why we would need that level of detailed information too? We have a fairly basic Student Health History questionnaire that I mail to parents or fill in while I ask them questions over the phone. It just asks if the pregnancy or delivery had any complications, was the baby born early or on time, did he/she have an extended hospital stay, birth weight, etc but it's not super detailed. If anything jumps out as needing follow up questions I'll do that.

I have had a couple of parents hesitate when I request permission to get clinic records but I haven't had any one refuse. I tell them it helps me clarify questions we may have regarding diagnoses, medications, major illnesses, immunization records, etc. For certain types of services I also have to have verification of a medical diagnosis.

I also reassure them that the information is kept confidential and under lock and key and I do not share the information with anyone other than the people who need to know.

MrNurse(x2), ADN · Nov 1, 2016

We don't have IEP's, 504's etc. as we are private, but I was just discussing this with my wife how reluctant some parents are to discuss their child's medical history. Despite explaining that files are private and not seen by others. I spoke at BTS night and explained I need to know meds should their child have an adverse reaction, and I still have blank health forms on students I know have meds they are taking. These are probably the same people who latch onto every conspiracy theory out there.

rbytsdy · Nov 3, 2016

I'm genuinely curious why you would ask the number of pregnancies a woman has had. How does it influence her child's academic progress? How does length of labor impacts the child?

I only ask if there were any issues with the pregnancy or birth. Our standard health form asks about gestation time and milestones.

There was a huge facebook thread a couple years ago in a neighboring town where women were getting worked up at the health form asked if the child was a lady partsl birth or cesarean. In a state where 40% of the births are cesarean, that information tells me very little.

MrNurse(x2), ADN · Nov 4, 2016

The public system may be used to collect data for health departments which can compile studies of academic performance for gestational and birth manner differences. I get it and would not think twice, and I would say they are the ones who believe conspiracy theories, but after this week...

kidzcare · Nov 7, 2016

I'm genuinely curious why you would ask the number of pregnancies a woman has had. How does it influence her child's academic progress? How does length of labor impacts the child?

I'm not certain, but I'm wondering if it's related to maternal health and if the pregnancy was complicated. If a woman had 4 miscarriages before a successful pregnancy, there may be a pertinent underlying issue or there may have been medication given during pregnancy that affected the fetus.

Also a multiple birth has been shown to be a risk factor for a variety of problems (speech delay, learning disabilities). This would probably be reported when asked about the specific pregnancy.

Now I'm just rambling... I'm thinking it could also be pertinent when thinking about home life. A child who has many siblings may feel lost in the home and might be acting out in school which could prompt the eligibility meeting. A child who has a special needs sibling might feel neglected and jealous of the attention given to the other sibling and try to get attention by pretending they need extra help.

tdean13, RN · Nov 15, 2016

I only ask for prenatal/birth history if the IEP is for an early childhood student. Beyond EC age it is not really relevant.