This page was developed in collaboration with educators to guide physicians in communicating with teachers and school personnel to ensure that patients receive appropriate education and school-related services.

The details you provide for school personnel will help determine 1) your patient's eligibility for Special Education, and 2) the exact nature of the child's special needs in the school setting. Your information will also be used in developing his/her Individualized Education Program (IEP), which may include special dietary, personal care, and medical requirements during school hours. The three steps detailed on this page will enable you to facilitate communications between you and the school. You will also find information about common issues and questions primary care providers confront as they work with schools, educators, families, and kids.

Some of the information provided here may vary by state or school district. Check with your state education agency or your local school district for specific information regarding federal regulations and state rules. For information about your state, see "Resources" below or see State Education Contacts and Information.

1. Initiate communication with the school.

2. Request an evaluation.

3. Request special services.

After receiving the referral from the parent or the (LEA), usually the local school district or school, and the parents’ written Consent for Evaluation (provided by the school), the school team will look at existing data and determine what further evaluation is necessary. Even if the child does not qualify for special education, he/she may be eligible for other services under Section 504 of the Rehabilitation Act of 1973, which applies to all children with disabilities. Section 504 requires schools to make programs and activities accessible and usable for children with disabilities. This may include providing for physical access and special accommodations like modified assignments to help children benefit from their education. If a disability substantially limits one or more of a child's major life activities then Section 504 may apply. (See Eligibility for Section 504 below.)

A team comprised of school specialists, teachers, the student, and his/her parents, reviews the data from the evaluation and decides if the child qualifies in one of the categories under the Individuals with Disabilities Education Act (Individuals with Disabilities Education Act (IDEA)). Physicians or other professionals may participate in such reviews in person, by phone, or through written communications. In order to receive Special Education, the child must (1) meet the definition of one of the disabilities listed below, (2) adversely affects the student's learning ability, and (3) require specialized instructon to benefit from his/her education. It is possible for a child to have a disability and still not be eligible for services under IDEA if they are able to benefit from education without specialized instruction. The requirements for each category are determined by federal regulations and state rules.

The Federal categories include:

• Autism,
• Intellectual Disability,
• Emotional Disturbance,
• Hearing Impairments/Deafness,
• Orthopedic Impairments,
• Other Health Impairments,
• Specific Learning Disabilities,
• Speech/Language Impairment,
• Traumatic Brain Injury,
• Visual Impairment (Including Blindness).

Classification depends upon the particular characteristics associated with the condition and how the condition manifests itself in the student. State definitions may vary slightly. For more information about definitions, please see your state education rules and see "Resources" below. Some states may use a different term other than “intellectual disability”. For the Federal definition of a child with a disability, see: Definition for a child with disabilities

Those who do not qualify for special education services may qualify for a 504 Accommodation Plan since the eligibility criteria differ. Section 504 protects students with disabilities from discrimination and provides equal access in the educational setting. A 504 Accommodation Plan helps students receive additional supports to assist their participation in educational experiences.

Anyone who meets the eligibility criteria of having a mental or physical impairment which substantially limits one or more major life activities (e.g., caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working) may qualify for a Section 504 Accommodation Plan.

IDEA eligibility has the same requirements for school-aged students and students ages 3-5. LEAs have a process to find and identify children with disabilities. If there is a concern about a child’s development in the areas of language, social/emotional, motor, cognitive or adaptive skills contact the school district of the child’s residence. The LEA will be able to provide information on how to seek a special education evaluation.

Once a student is determined eligible for Special Education, several things happen. First, parents and educators work together to develop an Individualized Education Program (IEP) for the student. The information you have supplied for the referral will also be considered in the development of this plan, including special dietary, personal care and medical requirements. Physicians or other professionals may participate in IEP meetings in person, by phone, or through written communications. Once established, the student's IEP is implemented by his/her school personnel.

The IEP may include health- or disability-related plans or a separate Individualized Health Plan (IHP) may be developed. [Janz: 1993]

• If a health issue is identified during an evaluation, the school nurse or the case manager (usually the resource teacher) will request a release of information from the parent to obtain health information from the Medical Home or healthcare providers.
• The school nurse uses professional judgment to determine if a student requires an individual healthcare plan (IHP) and initiates the IHP to meet student's health needs and the impact on the educational process.
• The school nurse meets with the parent to take a health history and develop the health plan. The school nurse:
  • Assesses the student to determine the needs and barriers related to student safety and well being;
  • Collaborates with parents and healthcare providers;
  • Coordinates care during school hours;
  • Educates faculty and staff regarding student needs;
  • Promotes communication among family, school, healthcare providers; and
  • Supports the student.
• The IHP is sent to the parent and healthcare providers.
• The parent and healthcare provider signs off on the health plan.
• Ideally, the nurse will attend the IEP meeting to offer health information input.

USDA regulations (7 CFR Part 15b) require substitutions or modifications in school meals for children whose disabilities restrict their diets. Another way you can help your patient is to provide a signed statement clearly defining:

• the child's disability;
• an explanation of why the disability restricts the child's diet;
• the major life activity/activities affected by the disability;
• the food(s) to be omitted from the child's diet, and food or choice of foods that must be substituted.

Food allergies that may result in severe, life-threatening (anaphylactic) reactions also meet the definition for "disability", and must also be accommodated, with your written statement.

For more information and a sample form see:
Accommodating Children with Special Dietary Needs in the School Nutrition Programs ( 849 KB)

If your patient will need medication during school hours, you can help by providing as much detail as possible to the school. Although policy on this varies by state, this information will be discussed and, if possible, incorporated into your patient's IEP or Health Plan. For sample forms see: Medication Administration Form (Utah) ( 40 KB) and Asthma Medication Authorization & Self-Administration Form (UDHHS/USOE) ( 340 KB).