IDEA and Kids with Special Dietary Needs

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girl eats lunch at schoolOur 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 a child who is unable to eat school meals because of her disability.

USDA’s 2016 Food and Nutrition Service (FNS) regulation (SP 59-2016) requires school food authorities to make reasonable modifications to accommodate a child with disabilities.

These regulations require substitutions or modifications in school meals for a child whose disability restricts her diet.

UPDATE: NEW GUIDANCE 2017. USDA has a new 2017 Guidance Manual Accommodating Children with Disabilities in the School Meal Programs”.  It explains the school food service role in providing meals to students with special dietary needs. The Guidance Manual can be found at https://www.fns.usda.gov/nslp/guidance-and-resources.

Download the 2017 Edition of Accommodating Children with Disabilities in the School Meal Programs. This guide provides guidance on the requirement for school food authorities to ensure equal access to Program benefits for children with disabilities, which includes providing special meals to children with a disability that restricts their diet.

The guide includes nine major sections: Introduction; Statutory and Regulatory Requirements; Making a Meal Modification; Reimbursement for Modified Meals; Meal Modifications and Substitutions; Meal Service Accommodations; Procedural Safeguards and Training; Non-Disability Situations; and Appendices.

Nutrition Services under an IEP

IDEA requirements may impact the service of meals. Any nutrition-related services included in a child’s IEP deemed necessary for the child to receive a free appropriate public education (FAPE) must be provided at public expense and at no cost to the child’s family. Part B of IDEA funds may be used for this purpose.

Schools are reminded that they may have additional obligations to children with disabilities under the IDEA, beyond the scope of FNS guidance.

The guidance addresses IDEA 2004 and the ADA and makes it clear that if a student has a documented disability that restricts her diet, the school food service department must make the substitutions in lunches and afterschool snacks for the student.

If a meal modification for a child’s disability can be made within the Program meal pattern, a medical statement is not necessary. See the Meal Modifications section of the Guidance on page 13.

If a medical statement is required, it must include:

  • an explanation of how the disability restricts the child’s diet
  • an explanation of what must be done to accommodate the child’s disability
  • the food or foods to be omitted from the child’s diet, and the recommended alternatives for a modified meal

If this information is already in your child’s IEP or 504 Plan, you may not need a separate medical statement. Use a team approach. Clear communication about the requirements for the medical statement can help reduce the burden for families, school service professionals, and other school personnel.

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.

Allergies and Anaphylaxis

Nutrition Services in Cases of Food Allergies

When accommodating a child’s food allergy, no food item offered to the child may contain traces of substances that may trigger an allergic reaction.

See more guidance about managing food allergies in schools in The Food Allergy Book. https://fns-prod.azureedge.net/sites/default/files/ofs/foodallergybook_english.pdf 

According to the ADA, physical or mental impairments do not need to be life threatening to constitute a disability. For example, a food allergy does not need to cause anaphylaxis in order to be considered a disability.

A non-life threatening allergy may be considered a disability and require a meal modification, if it impacts major bodily functions or other major life activities.

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 https://www.wrightslaw.com/blog/when-a-school-refuses-to-protect-a-child-with-life-threatening-allergies/

 Food Allergy Management

Your school should have an appropriate Food Allergy Management and Prevention Plan in place to promote the health and well-being of children with food allergies.

School plans should establish priorities for reducing the risk of exposure to food allergens and establish practices for responding to food allergies.

For information, articles, caselaw, legal reference files, resources, and free publications relating to allergy, anaphylaxis go to Allergies and Anaphylaxis.

Other Special Dietary Needs

A child’s impairment also may be considered a disability even if medication or other mitigating measures reduce the impact of the impairment. If a disability is episodic (or temporary), the child must be provided a reasonable modification.

Center for Disease Control (CDC) Guidance and Resources

Managing Food Allergies in Schools

https://www.cdc.gov/healthyschools/foodallergies/index.htm

Managing Food Allergies in School Toolkit

https://www.cdc.gov/healthyschools/foodallergies/toolkit.htm

USDA Guidance and Resources

http://www.fns.usda.gov/school-meals/guidance-and-resources

2016 USDA Policy Memorandum on Modifications to Accommodate Disabilities in the School Meal Programs SP 59-2016

https://www.fns.usda.gov/policy-memorandum-modifications-accommodate-disabilities-school-meal-programs

2017 Guidance Manual SP 40-2017 Accommodating Children with Disabilities in the School Meal Programs”. 

https://www.fns.usda.gov/2017-edition-accommodating-children-disabilities-school-meal-programs

2017 USDA Guidance and Questions and Answers (Q & As): Accommodating Disabilities in the School Meal Programs. The Q&As discuss relatively common situations which have raised questions in the past and provide direction for SFAs working to ensure children with disabilities have an equal opportunity to participate in the School Meal Programs.

https://www.fns.usda.gov/school-meals/accommodating-disabilities-school-meal-programs-guidance-and-qas

Procedural Safeguards and Training

LEAs must have a procedure in place to ensure parents know how to request a modification for their child and understand their right to examine the record and file a grievance when a requested modification is not granted.

See the Procedural Safeguards requirements overview in Sp 59-2016.

State Regulations

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

More about Food Allergies and Written Plans

Food Allergies: Section 504, Written Plans, Allergy Alerts

FARE: Section 504 and Written Management Plans

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Fiona

My son needs his food heated in a toaster oven. However, school refused to comply and even told me then he just does not eat lunch! I am so furious because all I want is for his lunch to be heated using a toaster oven. School says they do not have to heat lunch as its not a daycare center. What should I do

tasha

Do you have medical documentation as to why he has to have a heated lunch? Are there alternative foods you can send for lunch that do not have to be heated?

Gianna

Hi Tasha,
My son has autism along with sensory processing disorder and won’t eat anything not warmed in a toaster oven.

Louise

Please help. My child needs to be gluten free. When I bought it up at our IEP meeting the school said they do not have to provide gluten free items for my child. They also said that I should prepare lunch for him at home. Why can’t the school understand that my child wants to be able to buy lunch as well? This is a private school so can I force them to make this change and include gluten free food items as well?

Jana

My daughter has CHARGE Syndrome. She has a feeding tube for all meals. Her charter school will not list nursing services as a related service. How do the guidelines protect her since she has to be supervised while eating mdical food through a feeding pump?

Chuck

Check with your state parent training and information center. They can offer you advice, and assistance. http://www.parentcenterhub.org/find-your-center

nancy

Does anyone know if it is possible to get SD to provide feeding and/or training by Speech Therapist to a capable Aide for a student beginning CPSE from EI and if so, which I believe should be provided, does there need to be a 504 for medical need and an IEP for established ASD academic issues or would it be better to use OHI to cover both? TIA

Chuck

Yes, this is possible, and is a reasonable request. You should put any requests in writing to the principal and special ed director. If there are problems in getting this, you can use the state and federal dispute resolution processes. The procedural safeguard documents they give you should discuss these processes.

Monica

Can someone please help me how to get a school to comply with a child having celiacs disease ? They stated they would NOT be purchasing any gluten free items. The only GF grains are Fritos and Tostitos (chips) and cereal. How is this comparable to regular meals on a daily basis just so they can say they ” offer the grain ? ” please advise

Ellen

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.

tara

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

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.

New to This-Mom

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.

Laura

We have celiacs disease what did you find out when it comes to laws and things?

BOver

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!

Christina

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!)

Mom-4

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….

Debbie

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.

Wanda

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.

Debbie

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

Sharon

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

Sharon