Chronic illnesses, such as ongoing or reoccurring conditions like asthma, allergies, diabetes or epilepsy, affect at least 10-15 percent of American children.

If your school-age child has a chronic illness, it is important for you to tell the school directors, teachers and healthcare personnel about your child's special healthcare needs. This requires writing down all of your child's healthcare needs and an emergency plan for the school nurse or healthcare provider. This document should include:

• the child's medical history, which you can get from your child's healthcare provider;
• the child's special needs (for example, if she needs a dose of insulin twice a day, or what activities might cause her to have a seizure);
• permission and directions for the school nurse to give your child medications;
• instructions and/or an outline for giving emergency treatment to your child signed by your doctor or healthcare provider;
• special dietary needs (for example, a list of foods your child is allergic to);
• transportation needs;
• potential problems and precautions;
• the child's healthcare provider's name and
• phone numbers of people you want the school to contact if there is an emergency with your child.

Developing a Plan

You may ask your child's healthcare provider to help you write down your child's health needs.

Once the school knows of your child's special needs, they often will arrange a meeting with you, your child (if age-appropriate) and any school staff and healthcare personnel such as the school nurse. They may ask the child's doctor or other healthcare provider to come to the meeting or offer written statements.

At this meeting, you and the school may create a 504 Plan or an individualized education program, which is a legal document detailing the supportive services the child will receive. The plan sets short- and long-term goals for the child. The plan should be reviewed regularly to make sure it continues to meet the child's needs.

You must let the school know if there are any changes in the child's needs or health, or if the emergency contact information has changed.

Medication & Supplies

• Ask about the school's policies for medication storage and self-usage. Make sure your child can take the medicine in a comfortable place.
• Provide written permission from your child's healthcare provider for giving your child medications.
• Give the school a supply of your child's medication in the same bottle it was in when you picked them up at the pharmacy. Keep the label on the bottle.   
• Replace medications and supplies as needed. This supply should remain at school.

Emergencies

Provide the school with your home phone number, work phone number and cell phone number, if you have one, and then give them the same information for another responsible person just in case they can't reach you. The school needs to have this information on hand at all times in case of an emergency or medical problem.

School District Responsibilities

Federal laws such as the Individuals With Disabilities Education Act and the Americans With Disabilities Act state every child should be allowed to attend school in the "least restrictive" setting possible. It is the school's responsibility to make sure a student's healthcare information stays private.

The school district is responsible for creating guidelines for handling common chronic illnesses like asthma, allergies, diabetes and epilepsy.

The district must provide a safe environment for the student to take care of his health in the classroom and at all school-related activities such as field trips. The district should educate all staff about chronic illness, including how to teach other children to be considerate of people with a chronic illness.

Communication Is Key

Do not be afraid to talk to the school about your child's condition or any concerns you have as you arrange the health management plan. If the school does not know all the facts, they may misunderstand your child's behavior or performance.

Regular meetings with your child's teachers will help you see how your child is doing at school and if her condition is affecting her schoolwork or behavior. If your child has to miss school for a long time, talk to the teachers to see how she can keep up with the class.

As you work with the school to develop the best ways to help your child manage her condition, continue to help your child develop self-care skills and encourage good general health, personal care, nutrition and physical activity.

Children with chronic health conditions perform better in school when their needs are met. They have better school attendance, are more alert and have more energy. They have fewer symptoms and can enjoy physical activities and special events, such as field trips, a lot more.

Compiled by Abigail Scott, senior associate editor at ADVANCE.

Resources for this article can be accessed at www.advanceweb.com/nurses. Click on Education, then References.

Resources
American Academy of Pediatrics. (2007, October). Parenting corner Q&A: Chronic health conditions. Retrieved July 7, 2008 from the World Wide Web: http://aap.org/publiced/BR_Chronic_School.htm
NIH. Students with chronic illnesses: Guidance for families, school, and students. Retrieved July 7, 2008 from the World Wide Web: http://nhlbi.nih.gov/health/public/lung/asthma/guidfam.pdf