Q: Our daughter was diagnosed with type 1 diabetes over the summer. It's now almost time for back-to-school, and we're gearing up for a meeting with her teachers and the nurse. How do we explain her needs? What kind of help can we expect from the school?
A: I like to tell parents of children with type 1 diabetes that fostering a safe, enriching environment for their son or daughter at school really comes down to three key steps: preparation, education, and communication. It sounds like you've already been in touch with your child's school to let them know about the diagnosis. Next contact your child's diabetes care team to develop the medical management plan, and bring it with you to the meeting with the school to create the 504 Plan to spell out the accommodations your child needs at school (including things like blood sugar monitoring and receiving insulin injections at school).
Meeting with the school gives you the opportunity to lay out your child's specific needs and to hear how these needs will be met. It's a great idea to invite members of your child's healthcare team to this meeting, in addition to the teacher, principal, and school nurse. These staff members can then determine how best to disseminate info and training to other key people who will touch on your child's life over the course of a typical day, including bus drivers, gym teachers, and cafeteria workers, which may happen in a second meeting that you'll attend as well.
The school nurse typically steps in to teach other personnel how to recognize high and low blood sugars, what to do in case of hypoglycemia (low blood sugar), and explain how and when your child's blood sugar will be measured. You will also go over your child's diabetes medical management plan in detail, so don't forget to bring it along. Depending on your daughter's age, you may want to bring her in for at least part of this meeting. Younger children might be better off just coming in for a few minutes at the beginning or end, but it can be very helpful for older kids to hear the expectations detailed in their care plan.
Part of the meeting should be spent deciding on a form of communication between school and home. This could be a notebook that the child shuttles back and forth each day. Or for the tech-savvy, the nurse might agree to send you a text with noontime blood sugar numbers. Agree on a list of conditions that would require you to be notified immediately. Also come up with guidelines for how much about your daughter's condition should be shared with her classmates. In early elementary school, parents may plan a school visit at the beginning of the year to explain their child's diabetes to his or her class and encourage students to ask questions. Older kids may want to keep information about their diagnosis more private.
Lastly, even if you are aware that a few other children in the school have type 1 diabetes, don't assume that all staff members are knowledgeable about it. You may want to bring useful information about type 1 diabetes to pass out at the meeting; offer your contact information for any follow-up questions. As the year progresses, concerns will no doubt crop up. Establishing a strong school-home partnership is a great way to make it through any rough patches.
-- Cynthia Pasquarello, B.S.N., R.N., C.D.E., Pediatric Nurse Manager, Joslin Diabetes Center, Boston, MA
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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