Anxiety over Preschool

Posted on: Sun, 02/26/2006 - 1:29pm
PerplexedMom's picture
Offline
Joined: 02/26/2006 - 09:00

Sorry in advance for the long-windedness...

I live on Long Island, NY, and my public school district has preschooling available for 3 and 4-year-olds (for a small monthly fee.) My PA daughter will be starting preschool there in the fall, at 4 years old.

My girl has never had a serious reaction to peanut - just a few hives on her face a couple of times that went away with Benadryl. In neither case did she eat more than a trace amount of peanut (and we're not entirely sure they weren't both contact reactions.) Her CAP-RAST is, as I recall, at 49 (Class 4, I think, and up from Class 2 the year before). We have Epi-Pens for her, but we also have kind of a wide comfort zone. She was diagnosed at 2, and since that time I've let her have cake at birthday parties, I've let her eat may-contain foods, we eat out at restaurants where peanuts are present, all so far so good. (We may get a new CAP-RAST after her 4th birthday in a couple of months, and I plan to talk to her allergist then about whether we're doing anything horribly, horribly wrong. Last year he told us to pretty much keep up with what we were doing since it appeared to be working OK.)

I've spoken to a couple of teachers of my acquaintance from neighboring districts about perhaps starting a 504 process, and was met with disbelief and ridicule in both cases - and one of the teachers my child's own grandmother! This gives me a really horrible feeling for what I'd be up against in the school district proper if I tried the 504 approach.

And then again...I've been lurking here for two years, I know about the 'no such thing as a mild peanut allergy' thing. But at the same time, we have absolutely no history of anaphylaxis, so I'm not sure we could legally qualify for a 504. Isn't a past serious reaction kind of a prereq?

I know for a fact that the school has experience with peanut-allergic children, though I don't know what their policies have been. From what I learned during registration, we may be the first time the allergy has come up in the preschool program, though, and they didn't seem to know what policies would be in place for the younger children (and I didn't think to ask what it is for the older children).

How do I begin to figure out how to make the school safe for her? Who do I talk to, what do I say? Is there a way to suggest perhaps we should consider filing a 504 without provoking hostility? Given her reaction history and my own admittedly large comfort zone, is fretting like this anything more than anxiety-driven histrionics?

I just feel so overwhelmed. I don't know if the school's policies will be safe enough as is. I don't know what 'safe enough' is. And of course I don't know what the school's policy is. And I'm truly disheartened by the idea that finding 'safe enough' is going to be contentious and leave ill feeling between my family and the school district, which is the last thing I would want (and might even lead to some nasty tensions within my family. Yick.)

If anyone can tell me where to start looking to get a handle on this, I'd so so appreciate it. I think I'd feel a lot better if I could just see where to start...

Posted on: Sun, 02/26/2006 - 10:32pm
notnutty's picture
Offline
Joined: 03/15/2004 - 09:00

First of all, welcome to the Board. I know you have been lurking for awhile, but I am glad to see you joining in.
My son is currently in public school for preschool. The public school provides preschool for a fee. I did not go through the 504 process this year because he was going to confined to 1 classroom and the school decided to make the classroom peanut free. He is only there a couple of hours 3x per week so I felt good about that. I bring him to school and pick him up. The school does not allow ANY outside food to be brought into the classroom, including snacks and birthday treats. The school provides the snack that is coordinated with the diatary planner for the school. We have had a few bumps in the road, but overall this setup has worked for us.
I initially called the school as asked to speak to whoever is the preschool coordinator. I explained to her that my son was pa and we needed to meet to discuss his attendance at preschool. We then had a meeting with the school nurse, teacher, coordinator and the teacher assistant to come up with his Food Allergy Action Plan.
With that being said, I will be getting a 504 put into place for next year. He will be in all day/every day kindergarten and my comfort level changes with that situation.
My son is also experienced anax. (too early to spell [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]) and has had several contact reactions. Maybe others on the Board know more about the 504 eligibility, but I believe you do not need anax. to be elgible. It is hard for a SD to admit that pa does not substantially limit a 4 year old's ability to care for one's self.
What you also should understand that while it appears your daughter's allergy is not severe, you may be surprised someday by a more severe reaction. You said that she is now a "Class 4, I think, and up from Class 2 the year before." There may be a reason for this...if she is receiving small amounts of peanuts over a long period of time, she may actually become MORE allergic. Your daughter may have chance to outgrow this allergy, but I believe it requires complete avoidance. Also Class does not determine the severity of a reaction.
I know everyone has a different comfort zone, however, keep reading the Board. You may find that your comfort zone needs to be modified for her to have the best chance to remain reaction free and to have a chance to outgrow.
I hope some of this helps. Good luck,
Donna
[This message has been edited by notnutty (edited February 27, 2006).]

Posted on: Mon, 02/27/2006 - 3:57am
PurpleCat's picture
Offline
Joined: 01/28/2006 - 09:00

Hello!
Here is an opinion very different from most I have read on this board. I do not have a 504 plan for my daughter nor do I believe I need one or that they are always necessary.
My daughter attended public preschool, all day kindergarten and is now in first grade in the same town but in a different school. In both cases, I met with teachers, school nurses, the principal, head teacher and cafeteria personel. We had good discussions and created a safe plan for my daughter. Both schools have accomodated all of my requests and even offered a few additional ideas of their own. They have been caring and considerate and have been good listeners. They have always called me with any questions or concerns as they arise.
Good, clear, open lines of communciation and good personal relationships build a very strong support group and a safe environment!
Every situation is different - just know, there are other approaches that can be successful.
------------------
Keep Smiling
DD - allergic to peanuts, tree nuts, coconut, and egg

Posted on: Mon, 02/27/2006 - 4:03am
Corvallis Mom's picture
Offline
Joined: 05/22/2001 - 09:00

I also had a grandmother who was a teacher express utter disbelief about 504 protection for her anaphylactically, multiply food allergic only granddaughter.
Four years later, she is definitely on-board. Recently told me that DD should "of course never be in a setting without a 504 plan." [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img]
So don't let a lack of familiarity on the part of educators fool [i]you[/i], okay?
A 504 isn't just for kids who are demonstrably medically fragile, like my daughter. It is for any child who requires a systematic, broad set of measures to be consistently implemented in order for that child to have the same educational opportunities as every other child. Does this sound like your situation to you? It does to me. The nature of specific elements of your 504 plan may be quite different from my daughter's-- that is okay. But it doesn't mean you don't need one in place.
With all due respect, I have to say that the previous poster is lucky. I have also been "lucky" but also had my luck change unexpectedly. I would agree that there are times when you can achieve these same goals [i]without[/i] a 504 in place. But if you do, you need to be aware that they are NOT OBLIGATED to keep making those accomodations. Largesse is a beautiful thing, there is no doubt. But when you don't have a legally binding plan in place, you will force those who care for your child to make choices on the fly. Most of the time, they will err on the side of caution. But this isn't always a good thing either, because it can lead to totally un-necessary exclusion and a lot of hurt on the part of your child. Better to have it worked out.
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
[This message has been edited by Corvallis Mom (edited February 27, 2006).]

Posted on: Wed, 03/01/2006 - 3:05am
PerplexedMom's picture
Offline
Joined: 02/26/2006 - 09:00

Thank you, everyone, for taking the time to respond. Sending your child to school is supposed to be hard even without an allergy to contend with!
Now I'm wondering: how long does a 504 process tend to take?
I'm thinking of perhaps punting on the 504 question until early June, when we'll be seeing the allergist and having this year's bloodwork done. I'll see if the allergist has experience in documenting for 504s, and get his advice on what accommodations he'd suggest at school. Sounds sensible?
And for notnutty... I have an ongoing and furious battle with myself about whether our comfort zone is the right fit or not. We certainly don't even use may-contain products anything like every day, and the daycare we use is totally nut-free... At the end of the day, the only concrete evidence I can point to is that I haven't had anything like a peanut reaction in several months. Not even mystery hives.
I'm killing myself trying to find studies about exposure levels vs. outgrowing, too, to see if there's research that shows I'm officially the Worst Mom Ever, and can't find anything at all.
But... no reactions. Doesn't that mean I can't be all wrong?

Posted on: Wed, 03/01/2006 - 5:38am
iansmom's picture
Offline
Joined: 07/26/2001 - 09:00

PerplexedMom, you can't possibly be the Worst Mom Ever. If you were, you wouldn't even be here at PA.com.
It's to be expected that you will occasionally re-examine your comfort zone. This is an ongoing process, after all. Both you and your child grow and learn, needs change, situations and available foods change, and you need to re-evaluate periodically. This is a good thing.
Something to keep in mind when deciding whether to seek a 504 plan is that you'll be depending on people who know considerably less than you do about PA and your child's specific health situation to keep her safe. Having a 504 plan in place gives them something specific to refer to when making decisions, and an enforceable document should you have a need to point out problems with compliance. Two of the hallmarks of PA are its unpredictability (severity of past reactions do not necessarily predict the severity of future reactions) and its severity (any reaction has the potential to become life-threatening). Given that, a 504 can help school personnel to take this as seriously as is needed.
The process doesn't have to be contentious. Much depends on the individuals involved and their willingness to make the situation work. You've undoubtedly read some of the accounts from folks here who have had difficulty getting a 504 in place. We, on the other hand, have had a relatively easy time of it, and I'm in the process of writing a letter to our SD superintendent in praise of our principal and school staff re: PA and the 504 process. The factors that made the biggest difference in our situation, I believe, were the principal's willingness to make this work, his acknowledgment that PA is serious, and his intention to make this a team effort. I know it helped that he'd formulated a 504 plan previously to accomodate a latex allergy, so he was familiar with the process. Until you start down the road, I think it's premature to assume that you will have a rough time of it. I expected more difficulty than we had, and was primed to be combative. I'm relieved that I didn't go off the deep end from the beginning and end up alienating such a wonderful staff without cause. Not to say that you might not have a good reason to get combative about this, but until you get started, you won't know for sure.
While the primary weight of responsibility for keeping your child safe at school falls to the school staff, we made sure to let them know that we felt that we were part of the team, and recognized that we and DS have our responsibilities as well in the process. This may have helped staff to feel less like we were forcing something distasteful on them, and promoted the idea that creative solutions and willingness to keep our eyes on the goal would get the job done.
I have no idea if any of my ramblings will help you, but I hope so. Best of luck!

Posted on: Sun, 02/26/2006 - 10:32pm
notnutty's picture
Offline
Joined: 03/15/2004 - 09:00

First of all, welcome to the Board. I know you have been lurking for awhile, but I am glad to see you joining in.
My son is currently in public school for preschool. The public school provides preschool for a fee. I did not go through the 504 process this year because he was going to confined to 1 classroom and the school decided to make the classroom peanut free. He is only there a couple of hours 3x per week so I felt good about that. I bring him to school and pick him up. The school does not allow ANY outside food to be brought into the classroom, including snacks and birthday treats. The school provides the snack that is coordinated with the diatary planner for the school. We have had a few bumps in the road, but overall this setup has worked for us.
I initially called the school as asked to speak to whoever is the preschool coordinator. I explained to her that my son was pa and we needed to meet to discuss his attendance at preschool. We then had a meeting with the school nurse, teacher, coordinator and the teacher assistant to come up with his Food Allergy Action Plan.
With that being said, I will be getting a 504 put into place for next year. He will be in all day/every day kindergarten and my comfort level changes with that situation.
My son is also experienced anax. (too early to spell [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]) and has had several contact reactions. Maybe others on the Board know more about the 504 eligibility, but I believe you do not need anax. to be elgible. It is hard for a SD to admit that pa does not substantially limit a 4 year old's ability to care for one's self.
What you also should understand that while it appears your daughter's allergy is not severe, you may be surprised someday by a more severe reaction. You said that she is now a "Class 4, I think, and up from Class 2 the year before." There may be a reason for this...if she is receiving small amounts of peanuts over a long period of time, she may actually become MORE allergic. Your daughter may have chance to outgrow this allergy, but I believe it requires complete avoidance. Also Class does not determine the severity of a reaction.
I know everyone has a different comfort zone, however, keep reading the Board. You may find that your comfort zone needs to be modified for her to have the best chance to remain reaction free and to have a chance to outgrow.
I hope some of this helps. Good luck,
Donna
[This message has been edited by notnutty (edited February 27, 2006).]

Posted on: Mon, 02/27/2006 - 3:57am
PurpleCat's picture
Offline
Joined: 01/28/2006 - 09:00

Hello!
Here is an opinion very different from most I have read on this board. I do not have a 504 plan for my daughter nor do I believe I need one or that they are always necessary.
My daughter attended public preschool, all day kindergarten and is now in first grade in the same town but in a different school. In both cases, I met with teachers, school nurses, the principal, head teacher and cafeteria personel. We had good discussions and created a safe plan for my daughter. Both schools have accomodated all of my requests and even offered a few additional ideas of their own. They have been caring and considerate and have been good listeners. They have always called me with any questions or concerns as they arise.
Good, clear, open lines of communciation and good personal relationships build a very strong support group and a safe environment!
Every situation is different - just know, there are other approaches that can be successful.
------------------
Keep Smiling
DD - allergic to peanuts, tree nuts, coconut, and egg

Posted on: Mon, 02/27/2006 - 4:03am
Corvallis Mom's picture
Offline
Joined: 05/22/2001 - 09:00

I also had a grandmother who was a teacher express utter disbelief about 504 protection for her anaphylactically, multiply food allergic only granddaughter.
Four years later, she is definitely on-board. Recently told me that DD should "of course never be in a setting without a 504 plan." [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img]
So don't let a lack of familiarity on the part of educators fool [i]you[/i], okay?
A 504 isn't just for kids who are demonstrably medically fragile, like my daughter. It is for any child who requires a systematic, broad set of measures to be consistently implemented in order for that child to have the same educational opportunities as every other child. Does this sound like your situation to you? It does to me. The nature of specific elements of your 504 plan may be quite different from my daughter's-- that is okay. But it doesn't mean you don't need one in place.
With all due respect, I have to say that the previous poster is lucky. I have also been "lucky" but also had my luck change unexpectedly. I would agree that there are times when you can achieve these same goals [i]without[/i] a 504 in place. But if you do, you need to be aware that they are NOT OBLIGATED to keep making those accomodations. Largesse is a beautiful thing, there is no doubt. But when you don't have a legally binding plan in place, you will force those who care for your child to make choices on the fly. Most of the time, they will err on the side of caution. But this isn't always a good thing either, because it can lead to totally un-necessary exclusion and a lot of hurt on the part of your child. Better to have it worked out.
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
[This message has been edited by Corvallis Mom (edited February 27, 2006).]

Posted on: Wed, 03/01/2006 - 3:05am
PerplexedMom's picture
Offline
Joined: 02/26/2006 - 09:00

Thank you, everyone, for taking the time to respond. Sending your child to school is supposed to be hard even without an allergy to contend with!
Now I'm wondering: how long does a 504 process tend to take?
I'm thinking of perhaps punting on the 504 question until early June, when we'll be seeing the allergist and having this year's bloodwork done. I'll see if the allergist has experience in documenting for 504s, and get his advice on what accommodations he'd suggest at school. Sounds sensible?
And for notnutty... I have an ongoing and furious battle with myself about whether our comfort zone is the right fit or not. We certainly don't even use may-contain products anything like every day, and the daycare we use is totally nut-free... At the end of the day, the only concrete evidence I can point to is that I haven't had anything like a peanut reaction in several months. Not even mystery hives.
I'm killing myself trying to find studies about exposure levels vs. outgrowing, too, to see if there's research that shows I'm officially the Worst Mom Ever, and can't find anything at all.
But... no reactions. Doesn't that mean I can't be all wrong?

Posted on: Wed, 03/01/2006 - 5:38am
iansmom's picture
Offline
Joined: 07/26/2001 - 09:00

PerplexedMom, you can't possibly be the Worst Mom Ever. If you were, you wouldn't even be here at PA.com.
It's to be expected that you will occasionally re-examine your comfort zone. This is an ongoing process, after all. Both you and your child grow and learn, needs change, situations and available foods change, and you need to re-evaluate periodically. This is a good thing.
Something to keep in mind when deciding whether to seek a 504 plan is that you'll be depending on people who know considerably less than you do about PA and your child's specific health situation to keep her safe. Having a 504 plan in place gives them something specific to refer to when making decisions, and an enforceable document should you have a need to point out problems with compliance. Two of the hallmarks of PA are its unpredictability (severity of past reactions do not necessarily predict the severity of future reactions) and its severity (any reaction has the potential to become life-threatening). Given that, a 504 can help school personnel to take this as seriously as is needed.
The process doesn't have to be contentious. Much depends on the individuals involved and their willingness to make the situation work. You've undoubtedly read some of the accounts from folks here who have had difficulty getting a 504 in place. We, on the other hand, have had a relatively easy time of it, and I'm in the process of writing a letter to our SD superintendent in praise of our principal and school staff re: PA and the 504 process. The factors that made the biggest difference in our situation, I believe, were the principal's willingness to make this work, his acknowledgment that PA is serious, and his intention to make this a team effort. I know it helped that he'd formulated a 504 plan previously to accomodate a latex allergy, so he was familiar with the process. Until you start down the road, I think it's premature to assume that you will have a rough time of it. I expected more difficulty than we had, and was primed to be combative. I'm relieved that I didn't go off the deep end from the beginning and end up alienating such a wonderful staff without cause. Not to say that you might not have a good reason to get combative about this, but until you get started, you won't know for sure.
While the primary weight of responsibility for keeping your child safe at school falls to the school staff, we made sure to let them know that we felt that we were part of the team, and recognized that we and DS have our responsibilities as well in the process. This may have helped staff to feel less like we were forcing something distasteful on them, and promoted the idea that creative solutions and willingness to keep our eyes on the goal would get the job done.
I have no idea if any of my ramblings will help you, but I hope so. Best of luck!

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