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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.asp8/13/2019 504 Accommodations
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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.
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