504 plan for interstitial cystitis--I'm stumped!

Published

Specializes in school/military/OR/home health.

Ok, I have a middle schooler with interstitial cystitis, which I know is rare for the age group but from the looks of it, she has had issues since early childhood and is a chronic truancy problem. I'm sure not all of her absences are due to her medical issues but that's neither here nor there. I was trying to have a discussion with parent about a 504 and besides unquestioned and quick access to a bathroom, I cannot for the life of me imagine what to put on a 504.

Anyone have anything to add? I really want to get this kid to attend school more often and my only real tool is the 504.

Up Vote Up Vote ×
Specializes in ICU/community health/school nursing.

You need a formal diagnosis for a 504 (I assume that interstitial cystitis is from the doc?) Is the doc worried about it? What did the doc say? Unlimited RR access? May have and consume water in class?

2
Up Vote Up Vote ×
Specializes in Oncology, Med/Surg, Correctional, and School nursi.

Does the student have a significant amount of pain associated with her IC? What is the pain management plan? Does the parent given a specific reason(s) that she is missing so much school? Embarrassment, pain management, etc? What accommodations can be put in place for the specific reasons she doesn't attend school?

2
Up Vote Up Vote ×
Specializes in school nursing, ortho, trauma.

i would imagine that the unrestricted access to the rest room would help qualify her for a 504, especially since she is of age for state testing, if your district does that. I know a lot of testing has strict rules on how often a student can leave the testing room and unless the child has a 504, they have to take their breaks at prescribed times. Unrestricted access during class and testing should probably be an accomodation, maybe even extra time for testing / assignments if the child is known to need these.

2
Up Vote Up Vote ×
Specializes in School nursing.

Adding to Flare, on the 504 plan I'd put these:

Unrestricted access to bathroom

"Stop-the-clock" testing: if student needs to stop during testing to use the restroom, they are allowed to do so and not have this affect any remaining time they have to complete the test.

Make-up work plan if student is absent for 2 or more days in a row d/t this medical condition (not sure this will apply, might warrant more discussion with the doctor)

Visit to nurse's office as needed

4
Up Vote Up Vote ×
Specializes in school/military/OR/home health.

Thank you all--I have not been able to speak with parent or doctors yet. Admin had come to me to see what her story was regarding truancy, and all I could say was she has no 504 but she has had this condition and chronic absenteeism since first grade (she is in seventh now). She has skipped around different districts and it looks like she is doing it due to the truancy issues, and I think she hadn't been anywhere long enough to get a 504 started.

I just wasn't really sure I could do much in a 504 beyond bathroom access, which admittedly she already has established. Which could also be the reason she has no 504.

Lots of unanswered questions with this kid (and parent), I just thought I would get my ducks in a row.

1
Up Vote Up Vote ×
Specializes in ICU/community health/school nursing.
53 minutes ago, NurseBeans said:

Thank you all--I have not been able to speak with parent or doctors yet. Admin had come to me to see what her story was regarding truancy, and all I could say was she has no 504 but she has had this condition and chronic absenteeism since first grade (she is in seventh now). She has skipped around different districts and it looks like she is doing it due to the truancy issues, and I think she hadn't been anywhere long enough to get a 504 started.

I just wasn't really sure I could do much in a 504 beyond bathroom access, which admittedly she already has established. Which could also be the reason she has no 504.

Lots of unanswered questions with this kid (and parent), I just thought I would get my ducks in a row.

I was reminded last week by a lovely, calm, SPED professional that we can provide all the things mom is requesting ONCE we get the Dr's note about dx and treatment. Because all of us were hop-to-ing it and none of us realized it's only on mama said so.

2
Up Vote Up Vote ×
Specializes in school nursing, ortho, trauma.

Yes! I have had my fair share of parents wanting accommodations to be instituted immediately based on their word. When they are asked to get a note from the MD with the diagnosis, the heels drag and the immediacy of having these accommodations wanes.

2
Up Vote Up Vote ×

Call me a cynic, but the odds that she really has IC are vanishly low.

She is a victim of some type of sexual or bathroom abuse.

Some type of abuse or perversion in the home is greatly more likely by a factor of 1000x than IC.

However, once some physician has formally attested that indeed she does have IC, then you have to do every accommodation back flip you can possibly imagine.

In my opinion, you and all the other professionals are being taken for a big ride.

Up Vote Up Vote ×
Specializes in school/military/OR/home health.
19 hours ago, Oldmahubbard said:

Call me a cynic, but the odds that she really has IC are vanishly low.

She is a victim of some type of sexual or bathroom abuse.

Some type of abuse or perversion in the home is greatly more likely by a factor of 1000x than IC.

You know, I had thought this too, and the other nurse I work with said the whole situation is giving her weird vibes. The student has a clotting disorder according to mom, and she told me early on this year that her father had died from a blood clot. She gets anxiety every time she has leg pain because of it. But my admin says she spoke with dad and he is going to be at this meeting tomorrow...maybe it's step dad, maybe the student and mother are big fat liars, maybe something else. But it's all weird and I hope we get to the bottom of it.

Either way, she has a diagnosis and I am going forward with a 504 unless mom says otherwise.

2
Up Vote Up Vote ×
Specializes in kids.
19 hours ago, NurseBeans said:

You know, I had thought this too, and the other nurse I work with said the whole situation is giving her weird vibes. The student has a clotting disorder according to mom, and she told me early on this year that her father had died from a blood clot. She gets anxiety every time she has leg pain because of it. But my admin says she spoke with dad and he is going to be at this meeting tomorrow...maybe it's step dad, maybe the student and mother are big fat liars, maybe something else. But it's all weird and I hope we get to the bottom of it.

Either way, she has a diagnosis and I am going forward with a 504 unless mom says otherwise.

The meeting is a perfect time to get releases to talk to the MD so you can ask w how this coindition is expected to impoact the child and what can the school do to support her.

Up Vote Up Vote ×
+ Join the Discussion