copyright © 2009-2010 school nutrition association. all rights reserved. outside the school lunch...

Copyright © 2009-2010 School Nutrition Association. All Rights Reserved. www.schoolnutrition.org

Outside the Outside the School Lunch Box:School Lunch Box:

Accommodating Students with Accommodating Students with Special Dietary NeedsSpecial Dietary Needs


Food and Nutritionas Supplementary or Related

ServicesJuly 13, 2010

Special Education Services

Special Education Services

Diane Hawkins


Special Education

Eligibility: 1.Presence of an

identified disability

AND2.Educational

need for specialized programming as a result of said disability.


IDEA/IDEIA

• Federal funding source for eligible students enrolled in Special Education Programs in public school settings

• Eligible students demonstrate a need for specialized programming due to a recognized specific disability


Decisions, Decisions, Decisions

Admissions, Review, Dismissal Committee

THE ARD


The Plan

The Individual Educational Plan

The IEP


Individual Educational Plan

• Establishes eligibility

• Reviews present levels of academic and functional performance

• Establishes instructional goals and objectives

• Determines placement and programming


504

• Federal law intended to protect the rights of individuals with disabilities in programs and activities that receive federal financial assistance

• Eligible students demonstrate, have a record of demonstrating, or are regarded as demonstrating a physical or mental impairment that substantially limits one or more major life activities


504 and IDEA/IDEIA504

• Broad Disability Categories

• Applies to schools, agencies and other institutions that receive federal funds

• Un-funded mandate

IDEA/IDEIA• Specific

Disability • Applies to Public

Schools• Funded via

Federal and State sources


504 versus IDEIA/IDEA504

Broad Disability Categories

Physiological conditionCosmetic disfigurement

Anatomical LossOrganic Brain SyndromeMusculoskeletal Disorder

Conditions affecting special sense, genital-urinary, respiratory,

speech, cardiovascular, or reproductive organs

Others

IDEA/IDEIA Specific Disability

CategoriesLearning Impairments

Mental RetardationOther Health Impairment

Visual ImpairmentAuditory Impairment

Traumatic Brain InjurySpeech Impairment

Autism Spectrum DisorderEmotional DisturbanceOrthopedic Impairment


In general …

Special Education Students are

covered under 504

BUT504 Students

are not necessarily Special Education

eligible


Who Decides?

Special Education

Admissions, Review, Dismissal (ARD)

Committee

Membership: Parent(s), Administrator, General/Special Educator,

and others as needed

504

504 Committee

Membership: Parent(s), Administrator,

Educator(s), and others as needed


Plans of Action

Individual Education Plan (IEP)- Special Education

504 Plan-504


In Essence, 504 and IDEA Obligate Schools to …

• Provide routine maintenance of devices (feeding pumps, ventilators, etc.) that are not medically implanted. This is required only to the extent that:– The devices are usable within the school setting

and needed to provide FAPE (Free and Appropriate Public Education).

– The devices need not be maintained by a medical professional.

• Provide medical services required to receive FAPE. Remember

Schools (ARD/504 Teams) decide what

services are required, not doctors.


So, What about School Nutrition ?

ObligationsThe assurance that unique nutritional needs of students are met if by so doing, the student is able to access a Free and Appropriate Public Education.


Federal Funds Prohibit…

Usage of Federal Funds to purchase

meals or snack items for students


Remember …

Services beyond those needed to assist students with receiving their education are not the responsibility of the school under IDEA, even if medically required or recommended.

(Jose Martin, LLP, 2009)


Thus…

It must be decided whether a service is solely medical in nature and, as such, not the responsibility of the school under IDEA, or when a service is required educationally.


Relevance

Any service, equipment or device that bears a direct influence on the ability to provide a free and appropriate public education.


Into the IEP

• Health Services• Food/Nutrition

Services• All relevant

supports and services


Students with Special Diets

and the role ofHealth Services

Students with Special Diets

and the role ofHealth Services

Julie Lindley, RN, BSNDirector of Health Services & PEGrapevine-Colleyville ISD


IHPIndividualized Healthcare Plan

Students whose healthcare needs affect or have the potential to affect safe and optimal school attendance and academic performance require an IHP.

Only Registered Nurses (RNs) may write IHPs.


Team Members

Parent(s)

Dietitian

School Nurse

Principal

Student

Cafeteria Manager

Teacher


Most Common MedicalConditions Which Require

Special Diets in the School Setting

Celiac Disease

Latex Allergies

Crohn’s/Ulcerative Colitis

Diabetics

Food Allergies


Celiac Disease

Lifelong autoimmune digestive disorder.

Gluten causes damage to the small intestine.

Gluten is a protein found in wheat, rye

and barley.

Treatment is a gluten-free diet.


Latex Allergies

Latex allergy is a reaction to certain proteins found in natural rubber latex.

Children with spina bifida have the highest risk for developing a latex allergy.

Foods associated with latex allergies:avocados bananas chestnutskiwis passion fruit

Exposure to latex or the associated foods may cause anaphylactic reactions.

Treatment is food avoidance and epi-pen for a reaction.


Crohn’s/Ulcerative Colitis

Also known as Irritable Bowel Disease (IBD) is a chronic disease that causes inflammation and ulceration of the small intestine (Crohn’s) and colon/large intestine (Ulcerative Colitis).Restriction of high-fiber foods such as nuts, seeds, corn, popcorn, and various Chinese vegetables. Treatment is a low-fiber/low-residue diet and medications.


Type 1 Diabetes

The body does not produce insulin which converts sugar, starches and other food into energy needed for daily life. Dietary restrictions are not needed, a well balanced diet is recommended.Students must count the carbohydrates they eat at each meal for insulin administration.Provide school nurse and families with menus and nutrition information for products served in the cafeteria.Treatment is a balance of medication/diet/exercise.


Food AllergiesEight foods account for 90% of all food allergiesmilk egg peanut tree nutsfish shellfish wheat soyOccurs when the immune system mistakenly attacks a food protein causing the release of histamine.Symptoms of an allergic reaction include:swelling of throat itching/tingling of mouthsensation of warmth difficulty breathingwheezing swelling of the face/mouthhives vomiting/diarrheaTreatment is food avoidance and epi-pen for a reaction.


Tips for a Successful School Plan

Must work as a team!

Education, education, education!diseases anaphylactic reactionsepi-pen use food allergy/food intolerance

Provide school nurse and families with nutrition information for products served in the cafeteria.


Accommodating Students

with Special Dietary Needs

Accommodating Students

with Special Dietary Needs

Christina Smith, MS, RD, LS, SNANutrition Services ManagerDallas ISD Food & Child Nutrition Services


Our Demographics

• 150,000 students• 68% Hispanic, 26% African American,

4.5% White, 1.5% Asian and American Indian

• 86% economically disadvantaged• Over 300 special diets on record• Nearly 200 students with documented

diabetes


Our Stakeholders and Partners

• Registered Dietitian and cafeteria staff

• School nurses and Diabetes educator

• Parents• Speech and Language Pathologist• Occupational Therapist• ARD coordinator Special Education • Community children’s hospitals


Our Processes

• Dietary Order Form• Annual Renewals• Onsite visits• POS Alert• Ingredient decks• Staff Training• Recipes and Menus


Our Next Steps

• Strategies to close the gap• Increased automation and training


School District Best Practices and Parental

Perspectives

School District Best Practices and Parental

Perspectives

Sharon WelbornNicole NotarianniTexas Department of Agriculture


Questions Questions and and

AnswersAnswers

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