I'm headed to a 504 meeting for a 4th grader next week who has some abdominal issues. Said student has very poor attendance (and teacher often reports when things get stressful or student gets in trouble, student is absent the next day-always excused as illness). Student is failing everything (intermediate aged elementary student). Student recently started a fairly benign anticholinergic drug. Student's parent flew student across country to special doctor for me (local doctor couldn't find anything wrong with student??? IDK). Student rarely makes it to my office when not feeling well-teacher screens student hard. Student NEVER looks ill, never demonstrates any behavioral signs of nausea, pain or difficulty (although student thinks having thrown up once in 2nd grade is of importance).She eats a not very nutritious diet. Now student and parent are coming up with excuses such as "too much noise in classroom"-wearing noise cancelling headphones... Can't walk fast enough in line through school, so needs to be able to walk slower.
Student looks like a healthy person, slightly overweight, bored, not socially apt and parent strikes everyone as a hypochondriac. 504 meeting next week. I got an invitation based on administration of new med at school. Seriously, I don't think the district wants to take on a 504 and repercussions if not needed. I just want student to find a way to be a successful and happy human. I don't think she has a serious stomach ailment (we'll see what paperwork parent produces at meeting, but I'm not privy to anything very serious). Paperwork for med was prescribed for "abd pain". Student NEVER appears to be in any pain.
What's my role at this meeting? How do I come prepared. I think someone needs to find a way through to parent in explaining that their actions are really inhibiting students ability to thrive by acting as though she is seriously ill and letting her stay home from school 50% of time and blaming school for everything. Student has a great teacher who manages classroom wonderfully. Anybody have a situation like this? Anybody have a good way to handle this? Anyone with ideas of my role here? I don't see parent as receptive to typical and logical arguements (zero signs of pain, noise cancelling headphones not helping, student stays home whenever student gets in trouble, student doesn't eat a healthy diet, etc, etc...
Thanks for any help in coming prepared to this meeting and any thoughts on how to break through the situation and move it toward a solution that helps the student move forward.
You don't need an official note to create a 504 plan at school in many states. However, official documentation is needed in my state for state testing (i'm in MA, so MCAS) and other testing such as SAT, AP, and ACT if the student receives testing accommodations. (504 plans can also travel with a student to college. Not everything will be granted, usually extra time and small group testing.)
A 504 plan is accommodation based vs. academic modifications (IEP) and the parent or teacher alone can call for a meeting if they feel the student needs extra support. The paperwork the doctor submitted with possible medical diagnosis is enough to proceed. One can debate the need for them, but guidelines can also be written in about proper use of accommodations. I hate to type this, but I have many students I suspect that know what their 504 plans says and use it to play the system more than they should.
I go to a lot of 504 meetings and I actually write up the purely "medical" 504 plans - i.e. the ones I have in place for diabetic students that don't involve really any additional academic supports. (Student is still assigned a SPED liaison, but I still handle emailing teacher if student is high and unable to take a test, for example). I learn new stuff about 504s all the time :).
Specializes in ICU/community health/school nursing.
You don't need an official note to create a 504 plan at school in many states.
Our counselors usually don't start a 504 where the parent is requesting modification based on a medical condition without specific orders. And they request new orders yearly (and they work with me to get them)....
Our counselors usually don't start a 504 where the parent is requesting modification based on a medical condition without specific orders. And they request new orders yearly (and they work with me to get them)....
Oh, our SPED team will set up the meeting while getting the paperwork, but they did get the paperwork as well. But it isn't needs to actually have the meeting. Our SPED administrative assistant will not activate the 504 plan without though (she is awesome!)
We don't request new orders yearly for a 504 - it is every 3 years per code on our end. But the 504 is re-evaluated every year to make sure the accommodations are needed, used, more are needed and is adjusted accordingly. New orders may be needed if additional accommodations are added (depending on what is added) but not if things are good and remain the same.
We had the meeting today. It was a strange format, I thought. The first thing that happened was that the parent produced some paperwork about all the obscure diagnoses that the student carries (Cyclical Vomiting Syndrome, Spontaneous Joint dislocation syndrome, Functional Abdominal syndrome... and the like), in addition to ANXIETY! Everyone then agreed the student qualified for a 504, then we proceeded to talk about how her diagnoses affect her daily life activities. I thought it was weird that nobody asked about these diagnoses, because after all, there are a lot of kids in our schools who carry diagnoses, but don't need a 504. I also thought it was weird that we approved her for the 504 before we talked about the health and living affects of her illnesses. Her teacher got brave before anyone else when talking about the accommodations she is already providing for the student (noise cancelling headphones to help deal with the stress of noise) and pointed out that the student is often making farting noises with the headphones already and needing 45 minutes to fix her hair before placing the headphones on her head and getting to work.
We talked extensively about the student's attendance - 50%. Nobody on the 504 team had seen the medical evaluation form for her doctors to fill out from our district. I asked the parent why she thought the student has never vomited at school in the 2 years I've worked there, and yet is home almost half the time this year with "severe vomiting". Parent claimed students illness is unusual and not predictable.
Overall it was a bizaare experience, but I was glad the teacher stood up for herself in how the student is manipulating her accommodations and was glad that it was made very clear to the student that these accommodations are for her to use and not abuse. I wish I would have asked why we were approving the 504 plan before discussing the affects of the student's medical diagnoses-who knows about cyclical vomiting syndrome right off the top of their head? I wish we could have deferred a decision until we hear back from her medical providers, rather than just taking parent at her word. I was also glad to hear she's getting counseling for her anxiety-I brought up my thought that the student's stomach may be hurting because she has an uneasy feeling and is anxious and we all want to avoid things that make us feel like this...
We'll see how it goes. This will at least give the students teacher next year a formal process to go through rather than having to start all over with this parent as well as a way to enforce not getting manipulated into all kinds of other taxing things. I don't feel like the process got any closer to helping the student succeed academically or emotionally. We'll see. It was a great learning process. I'm wondering if anyone has any information about 504s and their legal process (wondering about whether we should have approved the plan prior to consideration of what we were approving)... Thanks all for the conversation and space,
North
Does your school have a lot of 504s? Maybe your admin team doesn't know they can say no without legal repercussions?
Based on what you put above, we would not of approved the 504 at my school. What accommodations were even put in there? The excusable of absences for this "unusual and nonpredictable disease"?
It sounds like the teacher is doing what she can but the student is non compliant.
What did you guys end up doing? I know in our district there is not one school without carpet?
We held a very long 504 meeting where the parent's left the meeting pretty angry. In the 504 process the school needs to provide *reasonable* accommodations, not give in to demands. Since there was no medical proof of their child being unable to perform at their best at school (no excessive absences, ED visits, no breathing issues in school) The accommodation from the district was was that the district would approve for the student to be home schooled in the carpet free environment of their own home, which of course is not what the family wanted so they backed down.
NutmeggeRN, BSN
2 Articles; 4,743 Posts
Beat me to it!