Help for 3 year old with type 1 in school

Hi everyone,

I'm asking for help for a friend of mine. Her daughter has type 1, diagnosed in May. The little girl will be 4 in November, and is enrolled in Universal (Public) Pre-Kindergarten.

I've had type 1 for 25 years, but so many things have changed since then I'm not able to be much help to her when it comes to diabetes and school.

The little girl is on a pump and just got a CGM. She is in school Monday thru Friday from 9:00-11:30 am. No meals are served while she is at school, but they do have a snack, and holidays are celebrated. At this point, the child goes to the nurse's office after eating and tells what she has had, and the nurse enters the carb count into her pump. She checks her blood sugar in the office and checks for ketones when necessary.

They have run into a couple of problems so far this year. First, there are 18 students in the class and because of how young they are they need to have a teacher and an aide in the classroom. If the child needs to go to the nurse's office, one of them needs to leave the class to go with her. The mom is worried that because they don't want to get in trouble for not having the correct ratio of adults to students in the room, so they might not be taking her daughter to the nurse's office as often as they should. Also, the mom was called to the school twice today. Once, her daughter's pump was "beeping" and they didn't know what was wrong. Her CGM needed to be calibrated and they didn't push yes to send the result of her meter reading to the pump. The other time the nurse "wasn't comfortable" giving a correction bolus to offset a high reading. Although the mom is happy to help, she is wondering how much she can expect of the school personnel.

I know there are laws protecting kids with diabetes, but I don't know how she can go about setting procedures in place to make sure her daughter is taken care of. Because of the child's age, she is unable to do a lot of the things that most kids can do by themselves in school.

Any help would be appreciated. Thank you!

This mother must be going out of her mind with worry. The child is still a baby in her mother's eyes. She is placing her child in the care of these people, they should do their utmost to ensure that they are well informed and have the ability to deal with any situation that arises. They seriously need to sort this out. This child won't be the last to come under their care who has diabetes, so they just need to learn.

First, the child should have a 504 plan in place that covers her medical needs while she's in school. You are correct in that A LOT has changed since we were kids with T1 in school, and things have generally changed for the better. In the 504 plan, the mother needs to make sure that her daughter's needs are clearly delineated. There are some excellent resources here on TuD and other websites about what to include.

Second, if the mother suspects that her daughter isn't being taken to the nurse's office when needed, this issue needs to be addressed ASAP. This is a serious health issue and the school needs to find an acceptable way to address it. They need to understand that high and low BGs can have detrimental affects on brain development, overall health, and behavior.

Third, the mother needs to work with the school to find acceptable solutions. That many kids with just two teachers is a lot to manage. The mother may have to work with the school to petition for additional staff.

Unfortunately, it sometimes takes the threat of legal action to get movement, and that may be what this family has to do. I feel like I've read that other children this age have an aide assigned to them to help manage things. From what you describe, that may be the only acceptable solution.

Most public schools in the US and Canada have assistant programs.
There can be an assistant assigned to her classroom who knows what he or she is doing regarding diabetes. This will not cost anything but needs to be requested and paperwork and all that.

In my daughters school there are kids that have assistants for everything from behavioral problems to signing assistants to blind assistants.

I'm sure one can be set up for your kid until she can learn to manage it herself.

This way you have one person focused on that one child. Generally that person would need to take the child to the nurse because most of them would not be legally trained, but at least it moves things along more smoothly.

I have to say if it was my kid, I would be camped outside the classroom doing work on my laptop, It is only half day anyway.

Thanks, everyone! I will definitely pass your suggestions on to the mom.

Thank you, great points. I feel so bad that they have to deal with this on top of the new(ish) diagnosis. I'm sure it will work out, but I will encourage the mom to go to the administration/school board/whatever is necessary.