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L I S A M R U I Z , M D

C H I L D P S Y C H I A T R Y F E L L O W , P G Y - 4

J A N U A R Y 2 7 , 2 0 1 4

504s

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What About School & Chronic Illnesses?

Do you keep the patient home?

Do you force the patient to continue as is?

Does the patient qualify for school accommodations?

What does that even mean? How to get started?

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Case 1 Outpatient Clinic

15y/o WF moderate depression & migraines

Progressively worsening past 2 months

Recent work-up negative, no PMH, no meds

High functioning but declining performance Missing school, falling behind, grades dropping

Supportive parents

Psychosocial stressors No previous treatment

Psychiatry/psychology new appt 6 months out

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Case 2 - Inpatient

9y/o HF lupus mood lability w/ anxiety

Ready for discharge tomorrow

Parents worried about school

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Case 3 Outpatient Clinic

6y/o WM mild tics and ADHD combined type

Doing well on Methylphenidate

Neighbor mentioned 504 plan

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Definitions

Accommodation:A change to the way a student receivesregular curriculum content usually delivered by a regularclassroom teacher

Modification:A change in teaching strategies or in

expectations concerning content the student will master usually delivered by a regular classroom teacher

Specialized instruction:A change to the content,performance expectations, and method of instruction

usually delivered by staff with special training

Behavioral planning:Developing and applying aprotocol to address specific behaviors that interfere with thelearning environment usually developed by a specialized

team

504

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IDEA(Special Education)

504(Regular Education)STUDENT

NEED

Pre-Assessment Activities

No Referral

No t Eligible

Not Eligible

Free Appropriate

Public Education

IDEA

Reviewed Annually504

Reviewed

Periodically

Consideration of IDEA Consideration of 504

Evaluation Data review and

evaluation , ifnecessary

Disabilityadversely affects

educationalperformance?

Disabilitysubstantially

limits one ormore major life

activities

IDEA Eligible 504 Qualified

Education reasonablydesigned to confer

benefit

Is the educational

programcom parable to thatprovided to non-

disabled students?

Specially Designed

InstructionAccom modations

StudentAccom modations

and/or Services

Physical Instructional

Related Aides& Services

Specialized

Education

IndividualEducation Program

(IEP)

Related

Services

NO

NO

YES

YES

NO

YES

Healthcareplan

MTSS

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504

What is it? Section 504 is part of the Rehabilitation Act of 1973 that applies to

individuals with disabilities & education

Eligibility?

Those students who have a physical or mental impairment whichlimits 1 or more major life activities that impacts education:

Caring for one self Speaking ThinkingBreathing Communicating Walking

Learning Seeing WorkingBending Eating StandingHearing Sleeping LiftingReading ConcentratingNon-volitional bodily functionsPerforming manual tasks

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504 Accommodations

Examples:HIV, Tourettes syndrome, ADHD, heart malfunctions, anxiety,depression, urinary conditions, blood disorders, chronic fatiguesyndrome, school phobia, respiratory conditions, epilepsy,

cancer, birth defects, TB, intermittent symptoms

Accommodations: Environmental: adjust class schedule, change student seating

Organizational: peer tutoring, set time expectations for hmwk Behavioral: contracts, awards, progress reports

Presentation: small groups, peer tutors

Methodology: alter pace, audiovisual instructions

Curriculum: supplementary materials, practice test

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Case Application

How to get started?

Obtain release of information

Make correspondence to principal

See Samples (hand-outs) Parent letter

Examples of Accommodations

Red Flags

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Case 1 Outpatient Clinic

15y/o WF moderate depression & migraines

Recent work-up negative, no PMH, no meds

High functioning but declining performance Missing school, falling behind, grades dropping

Supportive parents

Psychosocial stressors

No previous treatment Psychiatry/psychology new appt 6 mo out

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Case 2 - Inpatient

9y/o HF w/ lupus mood lability & anxiety

Ready for discharge tomorrow

Parents worried about school and flare-ups

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Case 3 Outpatient Clinic

6y/o WM mild tics and ADHD combined

Doing well on Methylphenidate

Neighbor mentioned 504 plan

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Take Home Points

Release of information

Patient advocator School should be looking for these kids

Doctors cant order 504 Rather is a suggestion for review or possible helpful

recommendations

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Write These Down!

http://www2.massgeneral.org/schoolpsychiatry/interventions_begin.asp

http://www.ncld.org/parents-child-disabilities

http://departments.weber.edu/teachall/504/handbook.html

http://www.utahparentcenter.org/resources/school-services/

http://www2.massgeneral.org/schoolpsychiatry/interventions_begin.asphttp://www2.massgeneral.org/schoolpsychiatry/interventions_begin.asphttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://www.utahparentcenter.org/resources/school-services/http://www.utahparentcenter.org/resources/school-services/http://www.utahparentcenter.org/resources/school-services/http://www.utahparentcenter.org/resources/school-services/http://www.utahparentcenter.org/resources/school-services/http://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttps://www.umail.utah.edu/owa/redir.aspx?C=p2xqF5HDZ0mmP1DshZeZR_5_klv8x9AIMFt6_NF1bL8UlEfSN40di1ZQft7XagQ6mp4u2Uhd6U8.&URL=http://www.ncld.org/parents-child-disabilitieshttp://www2.massgeneral.org/schoolpsychiatry/interventions_begin.asphttp://www2.massgeneral.org/schoolpsychiatry/interventions_begin.asp

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Summary

Issue 504 IEP __

Respon Gen educ Special education

Funding No addl State/federal

Admin Sect 504 Coord Sp. Ed. Director

Eligibility Maj life activ 14 qualifyingaffecting educ categories

Covers 3-18y/o 3-21y/o

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References

www.schools.utah.gov/sars/DOCS/disability/emer504.asp www.utahparentcenter.org/what-is-a-section-504-plan-does-my-

student-qualify-for-one/ kidshealth.org/parent/growth/learning/iep.html# www.ncld.org/students-disabilities/iep-504-plan/what-is-iep

www2.ed.gov/about/offices/list/ocr/504faq.html www.rochester.k12.mi.us/pages/6275/medical-action-plans en.wikipedia.org/wiki/Individualized_Education_Program departments.weber.edu/teachall/504/handbook.html http://www.updc.org/umtss/ Nichcy.org

www.milupus.org autismcouncilofutah.org/wp-content/uploads/2010/.../504-

Handbook.pdf AACAP. Practice parameter for psychiatric consultation for schools. J

Am Acad Child Adolesc Psychiatry. 2005;44(10):1068-1084.

http://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://kidshealth.org/parent/growth/learning/iep.htmlhttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www2.ed.gov/about/offices/list/ocr/504faq.htmlhttps://www.rochester.k12.mi.us/pages/6275/medical-action-planshttp://en.wikipedia.org/wiki/Individualized_Education_Programhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://www.updc.org/umtss/http://www.updc.org/umtss/http://www.updc.org/umtss/http://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://departments.weber.edu/teachall/504/handbook.htmlhttp://en.wikipedia.org/wiki/Individualized_Education_Programhttp://en.wikipedia.org/wiki/Individualized_Education_Programhttps://www.rochester.k12.mi.us/pages/6275/medical-action-planshttps://www.rochester.k12.mi.us/pages/6275/medical-action-planshttps://www.rochester.k12.mi.us/pages/6275/medical-action-planshttps://www.rochester.k12.mi.us/pages/6275/medical-action-planshttps://www.rochester.k12.mi.us/pages/6275/medical-action-planshttp://www2.ed.gov/about/offices/list/ocr/504faq.htmlhttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://www.ncld.org/students-disabilities/iep-504-plan/what-is-iephttp://kidshealth.org/parent/growth/learning/iep.htmlhttp://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.utahparentcenter.org/what-is-a-section-504-plan-does-my-student-qualify-for-one/http://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asphttp://www.schools.utah.gov/sars/DOCS/disability/emer504.asp