My 3 1/2 year old son will be starting preschool this fall, in two weeks. It will be his first experience with this type of setting outside of the home. I had met the teachers briefly when registering him and talked a little bit about his diabetes. They seemed receptive and willing to learn about it. I am meeting again with them tomorrow and I have prepared a binder with info about checking his blood sugar, counting carbs. and giving a bolus with his pump, along with info on identifying signs and symptoms of lows and how to treat them. I guess after putting it all together I am wondering if it is too much to expect for them to do? Should I just say I will be there everytime for snack time? Have them at least learn how to check him and keep binder there with the info. but just pack his own snack everyday and be there to do the checking and bolusing? The classes run Wed-Thurs, 12:45-2:45p, so he really isn’t there for very long at a time, but they do have a snack time. I am just unsure how to proceed with it all. I planned to show them tomorrow how to check him and give a bolus and was planning to be there the first week to make sure everything goes well. Is it appropriate for me to then expect them to handle the checking and bolusing at this age? Obviously being available and having them just call if they need me to come over?
Hi Natalie, We have twin boys who are turning 3 next October, and we’re dealing with the same type of concerns. One of them Santi is T1 since age 2, but we have not taken the decision to take him to preschool yet.
I think you’re doing the right thing being there for the first week(s). If you can get there for snack time, you’ll feel much better that he will be able to play for the remaining time. Check him just before going to make sure he does not need to intake food for the activities planned for the day.
I guess you’ll need to know in advance how active are they going to be for the day. If he eats lunch before going, you’ll know the bolus for that lunch will take him through two hours w/o lows, so you just need to compensate for any activities that may require him to intake some extra sugar. If they’re going to be inside, most likely you just need to bolus him for the snack if needed to avoid a high (you may consider free foods, so you/they don’t have to bolus).
Please keep us posted how the first week went, and thanks for sharing…
Hi Natalie,
My son Caleb who is 7 now and starting 2nd grade, was diagnosed at the age of three (almost 4) in the middle of his first year of preschool. two days a week for 2.5 hours each day.
I think you are not expecting too much at all for them to be able to handle your son’s care in the setting you described. I know (and remember) how overwhelming it is to pass over this care, even for a couple of hours. This will be our fifth year of getting the process defined and instructions given and I think it’s the first one I’m not overly stressed about.
Something to be mindful of though is the school’s obligation to provide this care. When Caleb was in preschool, I don’t think they HAD to care for him, though they did. Caleb being in a public school now which receives federal funding provides him different protection. When Caleb was in preschool I was a little more flexible in my requests of his care. When he was first diagnosed and on shots, there really wasn’t much to do. He was quickly on a pump and I went in every day to do his bolus. It got old really quickly. There were just a couple of months of school left so I didn’t think it was worth trying to get everyone up to speed.
His next year of preschool was different and was much better. We started the year with a process and roles clearly defined. I went in for the first couple of months because there was literally a different nurse every day of the week and some turnover as well, and I was constantly training (and being a worried mom). But once we got into a groove, it was so much better for everyone involved for me not to be there every day.
That being said, I think you need to gauge their interest and ability to properly make your decision. If they do not receive government funding, they may have the option of saying they won’t do it. So their reactions may help you determine how much involvement you/they should have. I would encourage that they do as much as possible, of course only to the extent that you are comfortable with their competence to do so.
You sound like you have so much organized to assist them and that is the most important thing. I think you are in a great position to have a very successful school year!
Hi Natalie.
I have a 4 year old boy who is just recently a pumper. Last year he was on needles and the young, smart teacher was willing to poke him if he was acting weird. I would say this is all that you should have them do for now.
It is September, it is stressful, they don’t know the kids’ names yet, they are getting into the groove still, you should ease them into having them do the bolus in a few months.
Coming recently from not being a pumper mom to being a pumper mom, the pump is very nerve wracking to people. I grew up with my mom in the school system and have a teaching degree myself and dated teachers, and September is the wrong time to put faith in the teachers to do something so important.
I would say for all of September, just teach them how to keep your kid safe and then assess from there. Use cheesestrings and pepperoni or carb free jello for awhile.
While my boy was still on needles, my friend’s daughter who pumps, who is 4, got kicked out of preschool in January 2010 because the teachers couldn’t handle all of the responsibility. I was outraged that this could happen. When I registered my boy, who was on needles at the time, for this upcoming Sept 2010 for a different preschool, I got a letter from the preschool saying they won’t take him specifically because they don’t feel they could keep him safe. People just can’t handle the thought of having to take on this extra responsibility, discrimination or not, they get overwhelmed.
Last year, I came to pick up my boy from preschool and saw everyone was at the park. They were one teacher down because the substitute left early to go pick up her son from school. There were some elementary school kids in the park too. The teacher clanged the bell for the kids to line up and I looked for Payton and he wasn’t there. I looked in the park and he wasn’t there. I looked at a bunch of kids just about to run behind the ice rink and there was my (3 year old at the time) boy, running away with the elementary school kids. I didn’t say anything, I wanted to see if the teachers would notice. They counted everyone and said someone was missing. I said " It’s Payton and he is running away". I pointed. They yelled his name twice before he stopped running. He turned to come to us and I met him and poked him and he was 3.1 b.g. He had been confused due to being low. I thought, OMG!. How can I ever be sure my boy is safe? The teacher is 40, the other one is 25. Together they should be able to handle this.
I never had them count carbs. I only asked that they poke him if he was weird and call me.
Only release control when you are sure someone else will be responsible with it and only a little at a time so as to not overwhelm. Pre-pack his snack and make sure they make him eat it all. For now do NO carbs and tell them they have to make him eat it.
In Nov or Dec or whenever you feel the next step can happen, divide the snack into baggies of 5 carbs each. If he refuses to eat his 5 carb pack of carrots for ex, leave a 5 carb back up plan. I used to leave arrowroot cookies which are 5 carbs each. If my boy didn’t eat something, they could substitute something he would eat. If you have Animas, you can use EZ carb on the Ping remote and all the teacher has to do is enter 15 carbs and push ok a couple of times and that is it for the Bolus.
Alternatively, raise up his basal to compensate rather than doing a bolus.
Right now I have Payton registered for a new preschool that is attached to the elementary school my son is at. I plan on getting a lawn chair and parking myself outside the door for a few weeks so the teachers will not stress over the safety of my child. For all of Sept I will be dropping by and doing his bolus and I will have the teacher watch how easy it is or if she wants to try I will let her for a few weeks until Sept is done.
The hospital offers seminars that teachers can go to. They will tell the teachers how to recognize highs and lows and how important it is for kids to finish their snack etc. I don’t think they teach how to bolus, I just think it is a basic, keep the kid safe kind of talk.
My strong suggestion is to give them information that talks about highs and lows and how to poke. I think you should be there for one week showing how to poke. Be there for another week watching them poke. I actually gave the teachers posters of how to recognize highs and lows. It is more accessible.
Do not go in there with all of the information. You want to build their confidence. If the nurses gave you all of the information at first diagnoses you may have crashed and burned. Take it slow.
NOTE: This advice is only for pre-school. Once you hit Public school, the teachers are required to keep your kid safe so you can hand over some responsibility.
Good luck.
p.s. In Canada they have a P.U.F.F program that will get an AID for Kindergarten for your child. Do you have a program like that?
My son was diagnosed halfway through his 3yr old year of preschool. We would just check him before he went to school, and then we created a list of snacks that are 15g carbs or lower (because he gets 1 freebie snack of 15 or less between meals without needing insuin) and the parents were more than willing to make sure to bring snacks like that that he could have. We always brought a backup or emergency snack in his backpack just in case it was needed, but it usually wasn’t.
Of course we did talk about what to watch for, and his teacher would call my cell if she had any questions or concerns. It went really well and we’ll do the same this year for his second year of preschool. However, Austin isn’t on the pump yet, so I know that makes things a lot different. Good luck with everything, I hope it’s a good experience for you all.
Melissa,
What is the P.U.F.F. program?
Cheryl
Hi, Natalie~
I don’t think it’s too much for them to learn if they’re agreeable. Most things in the binder they won’t use on a daily basis, but being prepared for the worst will give them & you peace of mind. Going the first week for snack will be good to set up the routine. I usually let a new babysitter shadow me in the routine the first day, then the 2nd day shadow her as she does things I normally do. After that I tell her to call me for any questions, etc. This usually works pretty well. One thing I read somewhere that would make the carb counting easier for them is to write the carb content on each item with a marker or sticker. You could include instructions for giving the bolus with the food to help them in the beginning, almost a little cheat sheet. I would also have a frequently used carb sheet in the binder as well for back-up.
I also read somewhere that it’s important for our kids to know they’re safe with other adults aside from us. I’m still working on that, but the sensor has helped a lot with that.
Finally, to encourage you a bit, we had a new babysitter over and when it was time to check Elisabeth’s BG, she wanted to do it herself (with my assistance)! She even checked the babysitter’s BG at the babysitter’s request! My older daughter also checked hers because she wanted to do the routine as well. One day things will be a bit easier as they can take on some of the testing for themselves.
Hope this helps. I know Rory will do great!! Do you have the illustrated Hypo/Hyper diagram? I usually include that wherever Elisabeth is, and teachers at Sunday school post it where everyone can see it.
Keep up the good work, Mama!
Jessica
Thanks for the wonderful replies everyone! I know I had read some where that in preschools the teachers are not obligated to do the care for the child unless interested and willing to learn. So I guess I will just see what their thoughts are tomorrow about what their comfort level is. It would be after lunch time so he would still have that active insulin. I thought about just sending a “free” snack or one with low carb count, however I plan for that and then he doesn’t always cooperate with the plan. We had a babysitter over not too long ago for the first time, for just a short amount of time. I had checked and fed him just before leaving and told her he should be good until my husband got home and just let her know some free snacks he could have, but he really gave her a hard time.
I figured most of the info. in the binder would just be for reference if needed and I would want them to call me for most anything. I think I should just offer to be there at snack time and do the bolus. I just want him to feel that comfort level with others but I can’t guarantee their comfort levels or mine I guess. I guess I will mainly focus on making sure they recognize when to check him and how to check him and what to do based on that. And that he should be allowed to eat at anytime if needed. I am really not that far from the church but if he is acting low I would like to know they would be able to check him promptly and treat and then call me. I could pick up from there if needed so not much time is taken away from the whole class. It is 2 teachers for up to 12 kids. I like the idea of a poster with visuals for signs and symptoms of lows too. I will have to look for that.
He will have to do another year of preschool before starting kindergarten so maybe next year will be the opportunity for them to feel comfortable with doing more and help us with teaching others pump care in preparation for kindergarten. Thanks again, I will keep posted how it all goes!
Program Unit Funding (PUF) for Children with Diabilities. I live in Alberta Canada. The Edmonton PUF coordinator can be contacted under Edmonton Public Leadership Services 780-429-8030. They will provide help for up to 3 years for some disabled children and it ends when the child starts Grade 1. Unfortunately Diabetes Type I is only ever approved for Kindergarten, not preschool, not elementary school. Perhaps other provinces offer programs like this. I also heard of G.R.I.T. in Alberta which does almost the same thing. To get an Aid though, GRIT has to get it approved through PUF (I think). I need to worry about that next year. If you need more information, contact Aleigha Kravontka on my Facebook Group “Canadian Diabetes Type I” because she was approved for her Kindergarter.
Anyway, the school has to apply through PUF to get help for your child in the school. Here is a PUF fact sheet the school looks at:
http://education.alberta.ca/media/1176471/programunitfundingpufapplication.pdf
Unfortunately we are on our own for Preschool as they said Preschool is not “necessary”.
Hi Natalie ~ My daughter is almost 11 years old and was diagnosed when she was 10 months old but I remember those days well! I would say the willingness and interest of the pre-school workers is going to be your biggest indication of how his care should be handled. I’d say train them well, making sure they fully understand how critical a low can become and know how to do glucagon, etc. I always came for the first several times and made sure they really understood how to bolus, etc. It’d be nice for you to be able to have a little break though once things are figured out… I was (and still am) always a phone call away and never very far away. This whole letting go gradually thing can be hard, but good as long as you feel your son is in capable, conscientious, knowledgable hands! Best of luck to you!
Hi Natalie,
My 3 and half year old is in preschool right now as I type this. Her teacher’s willingness is amazing and yes she is overwhelmed. She knows when to ask questions and when to call me. That is a biggie. She has also been teaching preschool for 23 years. Experience helps.
I also had my local Medtronic rep go the school for a staff training. She left a binder of info for the whole staff. Reach out for help from your local docs, insulin reps, jdrf chapters and such so they get a deeper training than just a worried parent.
Good luck and God Bless you.
Erin
Thank you Melissa,
I’ll send this info on to another Mom in Alberta.
Cheryl
BTW- Austin’s preschool is just a small in-home school, with just one teacher and an aide and about 10 kids in a class, it sounds like a lot of you are dealing with much bigger schools so I’m sure that makes things very different. I’m terrified of Kindergarten next year, but I’m getting a lot of helpful advice for that from this discussion- thanks!
Thank you. I basically went over with them the importance of recognizing when he may be going low and be capable to check right away and treat it. The one teacher has Type 2 diabetes so she is very much familiar with checking and recognizing those symptoms. The other teacher used to work as an EMT, so she has a little background in recognizing symptoms and what to do. It also turns out the 3 year old class will probably be no more than 6-7 kids. So that is nice knowing that it will be a small class. I decided to not go through the pump training at this time with them. I did show them how to check him and how it all works with the pump but we mutually decided it would be best if I came over for snack time and took care of his bolus. I would still pack snacks that can be ready if needed for treating lows, but with me being there at snack time I can take care of figuring the carbs. with the given snack and do his bolus. I have to tow my 2 year old along which they were absolutely fine with. He will have another year of preschool before starting kindergarten so there will be more opportunity through this year into the next to provide the training on the pump. And they will be more familiar with it all and more comfortable with taking on that repsonsibility. And I will be more comfortable with it too, I would think.
It is weird the thought of handing the task over to someone else. My mom is the only one, other than my husband and myself, who has done any of his care. And I am still the only one doing site changes and handling that care. And to think the little guy still isn’t at a point to really learn it himself. He helps with little things, putting the test strips in , holding the lancet against the finger and pushing the button…etc. He will even make comments like “Hey mom how many carbs are in this?” and the other night he was eating some crackers and his aunt was wondering if he was allowed to be doing so and he said “It’s ok, mommy already covered me for it”
It will be a nervewracking start I am sure, his typical rowdy boy behavior and reluctantcy to go number 2 in the potty will “hopefully” be the most of the worries! lol
I went through this with my son’s school. He went to preK from 130 to 330…it was at a public school and they have a RN there which was great…she called me everyday at 230pm (snack time) with his sugar. It gave me peace… but I still parked in the parking lot and used those 2 hours for reading and regrouping myself… … its one of the hardest things to do so do it at your own pace…
So far things have been going fairly well. The first day I came over for the usual snack time, around 2:15, and checked him and did the bolus. However they still had time before the end of class and had another activity to do but he didn’t want to stay and wanted to go home then. So his teacher offered to move snack time to the very end so he wouldn’t miss out on his full time. That was nice because I could see that becoming an issue each time. He had one day when he was running lower and I am so glad I had checked him before going in and decreased his basal. He would have gone very low for them I am sure. And there was one day I tried to do a big grocery shopping trip before coming back and of course didn’t make it there by 2:30. So I called quick to see what they were having for snack and instructed to give a small protion of that and his drink in his backpack. I figured I would check him right away when I picked him up and correct if needed. I felt absolutely horrible though about that happening. I should have known I wouldn’t get through the store and checkout in time. They do know to check if he is acting low and so far that hasn’t happened. And the other day his teacher wanted to watch more while I do his stuff so they may slowly start to learn it. I felt a twinge of panic with that , but also relieved to know they are willing to start learning.
By the second week he was in time out everyday! They said he had started to “open up” which I guess may not be a good thing lol. He is showing his true colors I guess and not listening at times, which is typically how he is at home. The one day they told me I would be so proud of the stories he tells while he sits in time out. He was talking about daddy drinking beer and playing the Wii, lol He is definitely going to be a handful!
I am in a similar situation. My son started preschool 2 weeks ago. He goes 2 mornings a week so he eats his meals at home and has a snack at school. My husband and I sat down with both of his teachers and one of the directors (who happens to have Typ 1 D). We took about 45 minutes to talk about signs of high/low sugars, how to check, when to check and the communication we need to have. So far, we have not had any problems. We do send him a snack every day just so we know exactly what he is eating and so that the teachers do not need to worry about counting carbs. He is not yet on a pump and the preschool is not aloud to give needles so if his sugar goes too high, we will have to go there to give him his insulin. It is hard trusting someone else to handle this huge responsibility but I am so glad we put him there. Every time they check his sugar, the teacvher texts me his #'s. My husband is a mail carrier and the preschool is on his route so he is right there should there ever be an emergency.
I don’t think you’re asking too much of the teacher. This will be a good experience for him/her as well. It’s an opportunity to learn about a disease that is spreading fast.
My daughter is going to be 4 on November and she has been going to daycare for 2 years now. I found that the more training you give to the teacher the better they feel in helping them with high and lows. You can find great presentations on ADA (American Diabetes Association), I used some of them to teach my daughter’s teachers.
She is there 4 hours every day and she eats a snack in the middle.
I tried low carb snacks but I found that protein/small amount of carbs are the best (ex: cheese, turkey and carrots). She can eat it without having to bolus and does not get high (I guess protein does help)
At school they check her if they see her weird, if she requests a check and ALWAYS before going to the playground.
I went to the school the first 2 days so the teachers could practice the “pricking” with me there and after that they knew they could call me if they needed something.
It’s great when they are trained because you feel sooo much better when your little one is being taken care of…