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IDEA and Kids with Special Dietary Needs

04/19/10
by Wrightslaw

Our doctor has recommended that my daughter, on an IEP, be gluten and dairy free.  The school is giving me a hard time, though I know they are providing a special lunch for at least one other student.

You’ll need to do some research (and so did we).

The U.S. Department of Agriculture’s (USDA) nondiscrimination regulation (7 CFR 15b), as well as the regulations governing the National School Lunch Program and School Breakfast Program, make it clear that substitutions to the regular school meal must be made for children who are unable to eat school meals because of their disabilities.

These regulations require substitutions or modifications in school meals for children whose disabilities restrict their diets.

USDA has a Guidance Manual “Accommodating Children with Special Dietary Needs in the School Nutrition Programs”.  It explains the school food service role in providing meals to students with special dietary needs. The Guidance Manual can be found at http://www.fns.usda.gov/cnd/Guidance/acccommodating_children.doc

Nutrition Services under an IEP

The guidance addresses IDEA 2004 and the ADA and makes it clear that if a student has a documented disability that restricts their diet, the school food service department must make the substitutions as listed by a licensed physician on a medical statement form.

The physician’s statement must identify:

  • the child’s disability
  • an explanation of why the disability restricts the child’s diet
  • the major life activity affected by the disability
  • the food or foods to be omitted from the child’s diet, and the food or choice of foods that must be substituted

If your child’s IEP includes a nutrition component, the school is required to offer special meals, at no additional cost, if your child’s disability restricts her diet. When nutrition services are required under a child’s IEP, school officials need to make sure that school food service staff is involved early on in decisions regarding special meals.  It would be wise to include food service staff on the IEP Team.

Nutrition Services under a Health Care Plan

Some states supplement the IEP with a written statement specifically designed to address a student’s nutritional needs. Other states employ a “Health Care Plan” to address the nutritional needs of their students.

Nutrition Services in Cases of Food Allergies

If you request food substitutions for your child who does not have a documented disability (as defined under either Section 504 or IDEA), the school food service department may make the substitutions listed on the medical statement, but is not required to, make food substitutions for her.

However, when a doctor states that  food allergies may result in severe, life-threatening (anaphylactic) reactions, the child’s condition would meet the definition of “disability,” then the substitutions prescribed by the licensed physician must be made.

Under no circumstances are school food service staff to revise or change a diet prescription or medical order.

If your child has “life threatening” food allergies that are part of his disability you should read When a School Refuses to Protect a Child with Life Threatening Allergies at http://www.wrightslaw.com/blog/?p=58

Other Special Dietary Needs

USDA Guidelines define a person with special dietary needs as someone who” may have a food allergy or intolerance (for example, lactose intolerance) but does not have life-threatening (anaphylactic) reactions when exposed to food(s) to which he/she is allergic.”

At the very least, the  Guidelines strongly encourage “food substitutions or modifications for children without disabilities with medically certified special dietary needs who are unable to eat  regular meals as prepared.”

State Regulations

Be sure to check your state regulations as well as your local district policy regarding  school nutrition programs.

USDA Guidance and Resources

http://www.fns.usda.gov/cnd/guidance/default.htm

USDA – School Food Service
http://healthymeals.nal.usda.gov/nal_display/index.php?tax_level=1&info_center=14&tax_subject=265

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11 responses so far ↓

  • 1 Ellen 06/11/13 at 4:29 pm

    Prader-Willi Syndrome is another condition that requires a special diet. It is a genetic syndrome (chromosome 15) that causes a constellation of medical and cognitive disabilities. The most challenging aspect is the constant intense hunger, the food-seeking behaviors, and the restricted calorie diet. I prefer to send lunch with my child so that I can have control over what exactly is in it, but my school district told me about the procedure for getting special lunches for my child. You can find the form at Seattle Public Schools website. Click on District, then Departments, then N, then Nutrition, then Food Allergies and Special Diet Requests at the bottom of the page.

  • 2 tara 09/26/12 at 1:24 pm

    my son has special heating instructions-school wants to heat his food a microwave (I have many concerns over this) I have already gotten the dr’s notice saying that because of his mental condition, food must be heated in toaster oven. School still heats food in microwave (it is not in his IEP yet) I will get that put in his IEP, I dont know what else to do to get them to heat the food properly

  • 3 Eosinophilic Esophagitis 04/20/12 at 10:35 am

    I found your article to be thought provoking and you also raise many good things to consider. I’m glad I came across this website and saw your article. It helped me out with a paper I had to write for a class I’m taking for my major at my university. I will be citing you as a source. Thanks for the great article.

  • 4 New to This-Mom 05/19/11 at 2:06 pm

    Hello, would someone please help me, I need to find some reference information regarding food allergies (hidden disablity) and how food allergies affect your behavior, ability to focus, and classroom performance. Our kid is having behavioral problems from about six different foods, the main one being wheat. We are schedule for a 504 meeting tomorrow. Waiting on your response.

  • 5 BOver 08/19/10 at 2:48 pm

    I do not understand why only “children with disabilities” are provided with special nutritional needs by school systems. I think there should be equality for ALL children who have special dietary needs if medical documentation is provided. I believe laws that do not provide the same needs to all children is discriminatory. As a parent with a child who gets very ill “but not life threatening” I think it stinks!

  • 6 Christina 05/24/10 at 12:02 pm

    Wanda, I love the sound of your pilot program. Since finding this information last week, I have requested an IEP mtg to include the GFCF diet in my middle son’s IEP. I would like to offer to help start something like you are doing; any tips, advice, and information would be greatly appreciated. (I also have to contact the county school system, where my oldest will be attending next year, to get it written into his IEP, too!)

  • 7 Mom-4 04/23/10 at 2:31 pm

    Unfortunately schools still say ‘no’ to this because,.. they can. Our child has a diagnosis of being anaphylactic to peanut and tree nut from two physicians HOWEVER the school’s attorney’s still says it is only a ‘Special Dietary Need’ and the school is not required to make any such accommodations, substitutions, checking of labels, etc. We are waiting for the complaint to be addressed by the USDA, an investigation has already occurred. Waiting on Washington now….

  • 8 Debbie 04/21/10 at 1:05 pm

    I posted this on your Facebook page, but want to make sure someone sees it. While many food allergies are life-threatening, there are some that are not, yet make the person VERY sick. I posted above about one way to get an IEP but I would love to see an article about how to handle accommodations for OHIs. We are personally dealing with GI disorders and migraines, and I know many others deal with the same issues, so it would be great to have articles outlining suggestions as to how to handle various different types of challenges & accommodations.modifications to help. These things also affect education. My son loses time from school due to his eosinophilic esophagitis, but he is actually missing more class time recently due to his migraines (with or without the actual headaches). Migraines & GI issues are more common problems.

  • 9 Wanda 04/21/10 at 12:45 pm

    I am sorry for this parent having to go thru this. I actually was able to partner with our district to offer GFCF hot lunch in our district. We are actually doing a pilot in May. This program has been well received in our district. If you have questions, please post them here and I’ll try to answer them.

  • 10 Debbie 04/21/10 at 11:23 am

    Unfortunately, there are many who are eligible for an IEP but are told they can only get a 504 plan. I have explained that if you have an OHI that causes you to lose time from school, that affects their education. You can ask to have them reduce the # of days before homebound starts. It’s something that cannot be done via a 504, only via an IEP as it is technically a “special ed” accommodation, so that may be your “in”. This would be appropriate for those in the eosinophilic community (Eosinophilic Esophagitis, Eosinophilic Gastroenteritis, etc) and probably celiac, etc. as well. While the food is not going to kill them, it makes them VERY sick! My son has EE and a feeding tube so I can’t take chances w/ cafeteria food, but my daughter only has to avoid dairy. Even a little as an ingredient makes her very sick but no dx, 504 or IEP

  • 11 Sharon 04/19/10 at 3:58 pm

    If the school refuses to provide a correct diet, wouldn’t this be considered a civil rights violation?

    Sharon