GUIDELINES FOR DEALING WITH FOOD ALLERGIC CHILDREN TO BE ADOPTED IN NASSAU COUNTY PUBLIC SCHOOLS
Dear Friends and Supporters,
Please join us at a press conference on Oct. 14, 11:00 am, at the Mineola Legislative Building (1 West St., Mineola). At this press conference, Dr. Ackman, the Commissioner of the Nassau County Board of Health, will announce the Health Department's commitment to food allergy education in all Nassau County Schools, and his commitment to adopting policies in all Nassau County Schools to ensure a safe school environment for our food allergic children.
Last month, at the Board of Cooperative Educational Services (BOCES) meeting of Nassau County School Superintendents, more than 50 Nassau County School District Superintendents received copies of the attached guidelines which we drafted, titled "Food Allergy Guidelines for Schools," together with supporting materials. The materials were distributed with a cover letter from Dr. Ackman urging all schools to take note of this serious issue and establish protocols and procedures for dealing with food allergic children. These Guidelines will provide school personnel (from superintendents, principals, nurses and teachers to cafeteria workers and bus drivers) with the "best practices" for preventing allergic reactions in various school settings and teach them how to deal with emergencies in the event they do occur.
Of course, we didn't accomplish this feat alone. We are extremely grateful to the Food Allergy & Anaphylaxis Network, Mount Sinai Hospital's Jaffe Food Allergy Institute and The Food Allergy Initiative for their assistance and support. We are also thankful to Jill's law firm, Schulte Roth & Zabel LLP and Stephen Mandel, a Schulte associate, for making available the resources of the firm for this project. Through the invaluable help and support of Nassau County legislator Craig Johnson, we established contact with Dr. Ackman and Dr. Mapes, the District Superintendent of Schools for BOCES, the entity responsible for any county-wide initiative in the schools.
Our guidelines are broken down into various segments, as is the typical school day. We give suggestions, for example, on what the classroom teacher should be aware of, what the role of the school nurse should be, and how to deal with lunch/recess, field trips, etc. While many try to make schools "peanut free," we believe that this is not necessarily the best approach, especially in light of the fact that so many children are allergic to things besides peanuts. We feel that it is unrealistic to make schools "peanut free", as it causes undue conflict with some parents, and that, even if this were to be accomplished it would provide a false sense of security for the schools. We believe making schools "allergy aware" and providing them with the proper education is likely to be far more effective. We must all train our children and the school community to provide a safe environment in which our children can learn and flourish like all other children.
We need to make a strong statement about the importance of this issue. By filling the Mineola legislative building, we believe we can accomplish this, so we urge you all to join us and to bring your children (food allergic or not). We appreciate your taking your children out of school for this and feel that by missing an hour of school your children will be able to go to school safely for many years to come. Further, what better lesson could we teach our children than to empower themselves and try to change things for the better instead of feeling victimized by the limitations put on them due to their food allergy. Please feel free to contact either one of us if we may be of any additional assistance. Thank you in advance for your support. If you would like to join us, please RSVP to one of us by Monday, October 10th. Hope to see you all on October 14th!
Amanda Bromberg 516-625-8627 [email]firstname.lastname@example.org[/email]
Jill Mindlin 212-756-2530 [email]email@example.com[/email]
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On Oct 6, 2005
Thank you for posting this. Is there a link?
On Oct 7, 2005
No link sorry. I received this in an email from someone who is heavily involved with the Food Allergy Initiative.
On Oct 7, 2005
Would it be possible for you to post the contents of the documents that were attached to the e-mail you received?
On Oct 7, 2005
FOOD ALLERGY GUIDELINES FOR SCHOOLS
SECTION 1. BACKGROUND Approximately 11 million Americans suffer from food allergies, 3 million of whom are children under the age of 18. Peanut allergies alone doubled in children from 1997 to 2002. Alarmingly, food allergies account for over 30,000 emergency room visits and cause approximately 150-200 fatalities each year. Since there is no cure for food allergies, strict avoidance of the offending food(s) is the only way to prevent a reaction. Anaphylaxis is a sudden, severe, potentially fatal, systemic allergic reaction that can involve various systems of the body (such as the skin, respiratory tract, gastrointestinal tract, and cardiovascular system). Symptoms can occur within minutes to hours after ingestion of the allergy-causing substance and these reactions can be mild to life-threatening. Trace amounts of a food allergen are enough to elicit a reaction. Some children may react by ingestion of the allergen only, while others may react by contact with an allergen (i.e., touching an unclean table surface, holding hands, using a keyboard) or inhalation (i.e., cooking demonstration using a food allergen). For this reason, developing a food allergy protocol, including individual emergency plans is crucial to protecting students with food allergies. To protect the lives of students will food allergies, school personnel should be taught how to keep all children safe. Just as they would for a student with diabetes, epilepsy, or other health concern, every reasonable accommodation should be made for children with food allergies because their condition can be life threatening. Until there is a cure, education is the key. In an effort to assist administrators in educating their staffs, we have created some basic guidelines to help manage and protect children with food allergies in school. These guidelines aren't demands, but suggestions that would better ensure the safety of students with food allergies. An emergency action plan should be in place in the event a student has a severe allergic reaction. To rehearse the plan, the school should conduct practice drills periodically. Specific duties and responsibilities should be delegated and practiced. Children's needs should be addressed including social issues. Appropriate literature should be used to teach the students about anaphylaxis as well as empathy for their food allergic classmates. All personnel coming into contact with children who have a food allergy before, during and after school should receive education on food allergies. This training should include, as appropriate, the following topics: cross contamination of food, accidental exposure to allergens, recognizing symptoms of allergic reactions and anaphylaxis, and dealing with social stigmas. The local emergency response team (911) should be alerted by school personnel with the names of the allergic children. It should also be noted that they will need to carry epinephrine on board if an emergency occurs. SECTION 2. ADMINISTRATION Since the Administration oversees all elements of the school experience, they are best suited to provide a comprehensive approach to food allergy protocol. The administration should: 1) Notify parents, in writing, of allergy related issues. 2) Coordinate efforts in establishing policies with respect to food allergies. 3) Oversee educational programs for school personnel most likely to come into contact with a child with a food allergy. 4) Be knowledgeable about federal and state laws that pertain to the equal educational opportunity for students with disabilities: the Americans with Disabilities Act (ADA), the Individuals with Disabilities Education Act (IDEA), Section 504 of the Rehabilitation Act of 1973, the Family Educational Rights and Privacy Act (FERPA) as well as USDA guidelines for children with special dietary needs. 5) Coordinate the transport of an individual's emergency medicine from teacher to teacher, with the student throughout the day. 6) Coordinate a meeting with parents, teachers, school nurse, the transportation director and other relevant parties to address the individual needs of each food allergic child.
SECTION 3. CLASSROOM TEACHER The classroom teacher functions as the child's primary caregiver for the majority of the school day. Accordingly, they should be well trained in all aspects of food allergies. 1) Teachers should receive training on food allergies including how to avoid accidental exposure, how to read food labels and how to recognize and manage a reaction. 2) Substitute teachers should be educated about food allergies and emergency procedures and receive written notification of an allergic child's needs. 3) A photo bio of each allergic child (with parental consent) should be displayed in the classroom (out of view of the students themselves). 4) Posters should be prominently displayed in each classroom detailing emergency procedures. 5) Emergency response drills should be practiced at least once a semester. 6) Walkie-talkies or cell phones to facilitate communication with nurse's office, principal's office and emergency response team (911) should be available in the classroom. 7) A food-free curriculum or a curriculum that does not involve the 8 major allergenic foods should be encouraged along with food free celebrations. If food will be part of a celebration, parents should be encouraged to send in pre-packaged treats with ingredient labels. 8) Parents of food allergic children should receive written notice of all classroom celebrations and be invited to attend. 9) No snacks should be permitted to be brought into a classroom known to have a child allergic to those snacks. 10) A strict no sharing policy should be encouraged and enforced. 11) At open school night the parents, in conjunction with the nurse and teacher, should present a brief description of the child's allergy and suggest various "safe" snacks. 12) Parents of food allergic children should be advised to keep "safe" snacks in the classroom. 13) The parents of food allergic children should be provided with a list of materials used in all art, science and craft projects so they may inform the teacher if any items contain hidden allergens. 14) Allergies should be taken into account when choosing classroom pets and their foods. 15) Teachers should monitor and make sure children are sensitive to bullying issues and intervene as necessary. 16) Teachers should maintain open communication with the allergic child's parents, the school nurse and the administration. 17) Teachers should take all complaints from food allergic children seriously.
SECTION 4. NURSES RESPONSIBILITIES As a medical professional, the nurse is best suited to educate the school community and ensure the safety of the food allergic children. School nurses should: 1) Work with parents and teachers to develop an Individual Health Plan (IHP) for each child with a severe food allergy including an emergency plan which incorporates the individual's Allergy Action Plan. (See Exhibit B for a form of Allergy Action Plan) 2) Provide in-service education for all staff including teachers, administration, cafeteria staff and aides that will come in contact with food allergic children. 4) Keep all medication with instructions in a readily accessible location. Train appropriate school staff to administer medication in case of nurse's absence. 5) Label all medications with names, photos, dosage, expiration dates, emergency numbers and all other pertinent information. 6) Devise and conduct emergency response drills with staff. 7) Take all health complaints from food allergic children seriously.
SECTION 5. CAFETERIA, RECESS, PLAYGROUND Since lunch/recess is an integral part of the child's day, he/she must be able to eat and play in a safe environment. 1) Tables and chairs should be washed with soap and water prior to all lunch periods and floors and chairs should be inspected for noticeable spills. 2) Food service employees should be trained to recognize symptoms of anaphylaxis, how to avoid cross contamination, proper food service preparation and how to read food labels (see attached Exhibit A for common terms for allergens.) 3) Either one staff member makes all peanut butter and jelly sandwiches or sealed, prepackaged peanut butter and jelly sandwiches should be served. 4) One cafeteria attendant, monitor, teacher or other responsible adult in the cafeteria per lunch shift should be trained in emergency administration of medication. 5) Each allergic child is to have a photo bio in the cafeteria with medical info and emergency procedure (with parental consent). 6) With regard to purchasing, all allergies should be taken into account. Ingredient lists should be available to food allergic children and their parents. 7) A strict NO sharing policy is to be taught and enforced to avoid peer pressure. 8) Parents of food allergic children should be told to keep an alternative nonperishable lunch at school for their food allergic child. 9) Food allergic children should sit at allergen "full" or "free" tables depending on the school's designation. The social stigma of isolation should be taken into account when making such designations. Others with "safe" lunches could be invited to join allergic children. 10) Children should wash hands before and after eating or be provided with wipes. 11) Walkie-talkies or cell phones to facilitate communication with nurse's office, principal's office, and emergency response team should be available in the cafeteria.
SECTION 6. THE SCHOOL BUS When a student travels on a school bus, s/he can come into contact with food which can trigger a dangerous reaction. Accordingly, certain safeguards should be implemented. 1) Ideally, a "no eating" policy should be enforced on the bus or at least one that prohibits the highly allergenic foods, such as peanuts and tree nuts. 2) For the safety of the allergic child, s/he should have an assigned seat up front where the driver can see him/her at all times. 3) Parents of all children on the bus should be informed that there is an allergic child on the bus (with parental permission) and be asked to adhere to the school's policy re: bringing food onto the bus. 4) Bus drivers should conduct a walk through of the bus before and after children ride the bus to ensure the bus is free of all allergens. 5) Bus drivers should have a cell phone on the bus to facilitate communication with designated school personnel and emergency response team in case of emergency.
SECTION 7. CLASS TRIPS Various safety measures need to be in place when food allergic children go on school-sanctioned field trips. 1) Parents of food allergic children should be notified about a field trip in advance so they have the time to research potential food allergy dangers in the trip destination. Teachers should only arrange class trips that can be enjoyed by all. 2) The teacher should carry an emergency plan for the child. 3) The bus should be made free from allergens prior to the children's boarding. 4) A nurse or designated party (including the teacher) should carry emergency medicines and be trained in administration. 5) The teacher and bus driver should carry a cell phone to facilitate communication in case of emergency. 6) The teacher and the bus driver should be aware of where the nearest hospital is. 7) Children should wash hands before and after meals and wipes should be provided to facilitate cleanliness if bathroom facilities are not accessible. 8) Food allergic parents are to receive notice of an upcoming trip and an invitation to accompany the class.
SECTION 8. ADDITIONAL RESOURCES For additional information or to obtain training materials, please contact:
The Food Allergy & Anaphylaxis Network 11781 Lee Jackson Hwy., Suite 160 Fairfax, VA 22033-3309 (800) 929-4040 [url="http://www.foodallergy.org"]www.foodallergy.org[/url] [email]firstname.lastname@example.org[/email]
The Food Allergy & Anaphylaxis Network (FAAN) is a nonprofit organization whose mission is to raise public awareness, to provide advocacy and education, and to advance research on behalf of all those affected by food allergies and anaphylaxis. FAAN publishes a multitude of resources for managing food allergies, including the School Food Allergy Program (SFAP), a comprehensive program that helps schools safely and successfully manage students with food allergies; and Food Allergy News, a bimonthly newsletter with recipes, product information, and medical and dietary information. Call or write for a free listing of other publications that may be of interest to you, including the Food Allergy News Cookbook, "How to Read a Label" cards, Off to School with Food Allergies booklet, Alexander, the Elephant Who Couldn't Eat Peanuts video and storybooks, or Food Allergy News for Kids newsletter.
The Food Allergy Initiative 237 Park Avenue 21st Floor New York, NY 10017 Phone: 212-527-5835 Fax: 212-527-5837 [url="http://www.foodallergyinitiative.org"]www.foodallergyinitiative.org[/url]
The Food Allergy Initiative (FAI) is a national non-profit organization dedicated to finding a cure for life-threatening food allergies. In addition to funding research and clinical activities to identify and treat those at risk, FAI supports public policy initiatives to create a safer environment for those afflicted, and educational programs to heighten awareness among health and child care workers, schools, camps, and members of the hospitality and food service industries about food allergies and the danger of anaphylaxis
Jaffe Food Allergy Institute Mount Sinai Hospital 1468 Madison Avenue New York, New York 10029 (212) 241-5548
Note: Certain of the suggestions were taken from materials prepared by: American Academy of Pediatrics American School Food Service Association Massachusetts Dept. of Education National Association of Elementary School Principals National Association of School Nurses National School Boards Association The Food Allergy and Anaphylaxis Network The Food Allergy Initiative
Research assistance provided by Stephen Mandel and Schulte Roth & Zabel, LLP Additional Assistance provided by The Food Allergy Initiative
On Oct 7, 2005
Thank you very much for for posting this Allison. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
Food free curriculum! Particularly loved that in Section 3:
[i]7) A food-free curriculum or a curriculum that does not involve the 8 major allergenic foods should be encouraged along with food free celebrations. If food will be part of a celebration, parents should be encouraged to send in pre-packaged treats with ingredient labels.[/i]
Okay, here's my $64,000 question: how is this enforced?
My school district also has "guidelines" very similar to these. Same "food free" classroom criteria. But I learned that teachers soon came to see them "only as guidelines" that, sadly, did not hold the same incentive to uphold as did a 504 plan or district [i]policy [/i].