If you’re working with your child’s school to establish a 504 Plan after a diagnosis of type 1 diabetes, you may be wondering about specific accommodations to request. There is, of course, no one-size-fits-all (or even one-size-fits-most) approach to creating the perfect 504 Plan. Still, what are some ideas to at least start thinking about? Here’s a look at how other D-parents have navigated the 504 Plan process, including key questions they asked that helped set up their child with diabetes for a healthy, safe, and successful school year.

Will she be allowed snacks whenever needed?

“Early in elementary school, my daughter had a run-in with the lunch lady about not finishing her lunch before it was time for recess. When I asked how we could avoid this in the future, we came up with this accommodation to be added to her 504 Plan: ‘Will be granted ample time to finish all meals and snacks, and may consume them anywhere on school grounds.’ Six years later, we still find ourselves pointing to this stipulation more than any of the others on her 504 Plan. It is OK to finish the grapes on the bench of the playground. It is OK to stop and eat a snack halfway through rehearsal for the school musical—even if nobody else is allowed. Over the years, this is the part of living with diabetes that staff have had the hardest time understanding, so it’s been nice to have it written down.”

—Pam O., mom of a 13-year-old daughter and blogger at AdventuresInDiabetesParenting.blogspot.com

How will absences be handled?

“There are a couple things that I always make sure I have in our 504 Plan, one of which is ‘If the child misses three days in one month (which do not need to be consecutive days), a tutor will be available to help catch up on studies.’ We felt that if our daughter was out of school more than a couple days a month for highs or lows or doctor appointments, she would miss a lot of information, making it difficult for her to stay up to date with what was going on in class. We also found it important to state explicitly that the absences do not need to be three days in a row, because a child with diabetes may have issues one day and be fine the next.”

—Julie D., founder of PumpWearInc.com and mom of two grown sons and a 17-year-old daughter, each of whom has type 1 diabetes

Where will blood sugar checks and treatment take place?

“The most impactful provision in Caleb’s 504 Plan is the one that allows him to check his blood sugar wherever he is. From first grade on, he has not been required to visit the nurse’s office to perform diabetes care. Instead, he has been able to do all his routine care in the classroom or wherever he is. This minimizes disruption to instruction, keeps him safe as he’s able to act quickly, and gives him a greater sense of inclusion in the class. This benefits his emotional health as much as his physical health and academic progress.”

—Lorraine, mom of 12-year-old Caleb and blogger at ThisIsCaleb.com

Will he be accompanied to the nurse’s office?

“The best 504 accommodation for my son hands down has been the rule that he brings a ‘buddy’ with him every time he goes to the nurse’s office to check blood sugar. Not only is it a fantastic safety precaution (I have nightmares about him collapsing in the hallway due to a low and not being noticed), but it is an incredible self-esteem builder. Kids fight over who is going to walk him down, and he’s really gotten close to his circle of buddies. He’s in fifth grade now and has been doing this routine since kindergarten. I think it’s a great way to educate other kids about what my son goes through. They’ve come to respect him for the warrior that he is. And that’s priceless!”

—Dena P., mom of 11-year-old Reid and blogger at ShotMama.com

Who will train teachers and staff about diabetes and our 504 Plan?

“Sometimes we take for granted the common-sense things that are still important to spell out in the 504 Plan. When my daughter was in seventh grade, I made the choice to ask the school nurse to go over the 504 Plan with my daughter’s teachers without my personally being present. Not long after school started, my daughter was admonished for eating in class. I had to follow up with that teacher and the nurse to make sure the reasoning behind her need to eat a granola bar was understood. This year, for high school, I opted to meet with every teacher myself so I could emphasize the importance of the accommodations. Because they might not see my daughter looking ‘sick,’ they need to know how important following the 504 Plan is for keeping her healthy.”

—Dayna F., mom of 15-year-old Hannah and blogger at Sciencehorse.com

Will substitute teachers know what to do?

“The most important thing we ask our 14-year-old daughter’s teachers to do [and list in the 504 Plan] is just not get in her way. If she needs their help, she’ll ask for it. That works fine nine days out of ten, but what about that one day when the teacher is out and a substitute is sitting behind the desk? Nothing good can come of a student taking out what looks to be a cell phone during algebra class, and when it’s followed by a finger-pricking needle, things only get worse! To handle those situations when someone new is in charge, we provide the regular teacher with a photo and one-page introduction to Lia and type 1 diabetes, which the teacher can then slip into the substitute teacher folder. So when Lia says she has to test, eat, drink, bolus, or pee, there are no strange looks.”

—Steve G., dad of 14-year-old Lia and blogger at WithoutEnvy.com

Are these accommodations age-appropriate?

“There are not only protective measures suggested within a 504 Plan but also stipulations that promote independence and privacy. As a middle schooler, our child has free use of her phone as the primary means to communicate directly with us—her primary caregivers. This minimizes disruptions to learning and social time between classes and promotes normalcy.”

—Jewels D., mom of 13-year-old Emma and blogger at SheSugar.com

Do these accommodations still work?

“My daughter is 15 years old and a 10th grader now. Back when she was in elementary school, she was only allowed to test her blood sugar in the nurse’s office under supervision and was not allowed to have an additional meter in her backpack. Now, as a high school student, she has more flexibility. She always has her meds and meter in her bag and the school office has their own set of medicine, supplies, and juice boxes for lows.”

—Penelope W., mom of a 15-year-old daughter

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

Related topics:
A Better Way to Prep for Your 504 Meeting
What Your Child’s Teacher Doesn’t Know About Type 1
Talking to School Personnel

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