I know it must be much harder to care for one of your children with T1 than it is to deal with your own diabetes. If I screw up on my own management there is no guilt involved - I just keep plugging and try to do better next time. It is different when you screw up with your kids who trust and depend on you. The sacrifices you've made to help your son manage his disease are obvious, and he's lucky to have you taking care of him. Thankfully my kids all managed to avoid my diabetes, but I have a friend at work with a now 12 year old T1 son and we talk all the time about the hardships of managing someone else's BG.
What I don't understand about this story is how the parents in this story are so not about helping their child, but rather seem to be all about pushing off their responsibilities to others while trying to maximize their financial gain.
That's the irony of this whole situation. By writing the 504 plan the way they apparently did, they made it incumbent upon all parties, including the parents, to accommodate. If the 504 plan calls for multiple testing in class to safeguard against dangerous deviations from normal BGs, then anything the parents give their okay to that could lead to deviations that endanger the child then comes under scrutiny as well.
Like I said, if I were responsible for that 504 plan, then witnessed the child eating candy or desserts, which could definitely lead to deviations in BG, with any indication at all that such behavior was condoned in any, way, shape, or form, by the parents, as a mandated reporter, I have no choice but to report the incident. Mandated reporters cannot, I repeat, cannot follow-up or investigate on their own.
At that point, it's handed over to DCS to get to the bottom of the matter.
I'm not sure I agree it's obviously about financial gain. It seems to me to be about punishing the school for being jerks, for going on three years. The whole bit about the principal leaving a message she thought she was leaving for the nurse for Mrs Plaintiff seemed to color the relationship but the parents seem to sort of flit in and out of the picture with the school but they don't stop being parents.
The school district is responsible for children. The teachers don't take care of medical needs but graciously (ha) assume the responsibility of calling the cavalry to see what the BG is and fix it. That might be where the problem lies. I spent a lot of years blasting mornings and running low so I don't look at that as negligence on the part of the parents. I don't think there's enough detail in the opinion, e.g. are the "deadly" snacks "dessert" or hypo treatment? That would make a big difference to me. I am also intrigued (after sitting on my deck and reading as the sun set...) by the possibility that the principal seems to claim to have "known" that the parents weren't taking care of A.C. at home? This could be available by scrolling back in the pump and/ or meter and become available.
It seems odd that this would be the first KWD to come through the school. I agree taking care of anyone else's D has got to be brutal.
I agree with Jag. When I read this story I thought, what I'd do is keep this child at home and work with her, both her health and academic issues, myself. I'd make sure she had positive activities with other kids in the neighborhood so she would grow up with friends. Her school experiences are just going to label her as a problem that other kids and their parents won't want to get involved with; so much for sending her to school for a social life. My goal would be for her to be able to go back to school when she was old enough to be capable of managing her own diabetes sufficiently.
I think it's counterproductive to make pushing your kid into public school your primary goal. I had a child with learning issues. Nothing worked until I kept him home and we worked through those issues ourselves. It was a hardship to not be able to work during that time, but it would have been selfish to use public school as a babysitting service just so I could make more money. The little girl needs tools to help her succeed in life. It sounds like all she's learning from her adult models both at school and at home is to blame someone else.
To address Consumne Jan's comments, the parents are teaching her that her BG and her right to as normal a life as possible, including testing anywhere, any time, is important enough to fight for. Since a 6 year old may not be up to testing their own BG, the nurse is, in fact, a reasonable solution to which she is reasonably entitled. It strikes me that it may be more useful, both in terms of diabetes and social normalization, that it may have been preferential for the school to obtain an additional nurse to be put with the student to improve the supervision of the situaion and make it less of a distraction than forcing the teachers to call on the phone 5-10x/ day but they failed to come up with that solution. Towards the end of the complaint, the appellate judge reviews the school's behavior and finds it at least questionable on a number of occasions that are in the evidence that is present. Whether discovery is closed or additional facts may materialize is unknown (I looked around online but couldn't find the underlying case...) but the questions need to be asked and answered to a jury for the reasons the judge explains. I work with cases that sometimes are not dissimilar to this and, while the school has lost a battle, they have not lost the "war" and can go back to the trenches. If I were defending the case, I would be leery of some of the evidence. The other question is what the parents are looking for to settle the case. If they are demanding $$$, there's questions about how much a case like this is worth and I haven't had one exactly like this. The other thing I could perhaps see them demanding might be some commitment to accommodation which I would be more interested in for my co-diseased friends whose condition has been gentled by bloodshed...
The appellate judge address the concerns about money as being secondary to the case and found that the facts, at least the facts to which the parties testified (or submitted affidavits "correcting" the errors in their testimony...), did not support that there were not questions of fact in the school districts behavior. I do have some sympathy for the teachers having to deal with the situation these days in schools but I don't have any sympathy for the behavior of the school. I also don't feel that homeschooling is always the best solution. It can work for some people but, however horrible many experiences in our educational system can be, learning the social skills and participating in society are critical lessons to learn that are not as likely to come from a sheltered, home school type of environment.
Interesting case. Glad I'm not on the jury. I think it is very possible that all parties involved were acting with the best of intentions, yet failing miserably. It sounds to me like the principal's actions were probably retaliatory. At the same time, the parents were putting the child in danger by poorly managing her diabetes. Although, it sounds as if they were doing the best with what they knew and following standard treatment advice.
As a kid, I'd go to the nurses office before lunch to test. I had occasional blackouts, but luckily never full lost consciousness, while I was at school. Most of my teachers did not know that I was diabetic, and it wasn't much of an issue, generally.
I dunno if there's quite enough data to say that it's "poor" control. The opinion notes that running up in the AM was a strategy. I fiddle w/ my pump when it runs up but it may be that the parents, perhaps being locked into the "plan" were following doctor's orders and not able to be as flexible as I am? If I were on the jury (ha ha, like they'd let any of "us" near that jury!), I would want to see the logs and perhaps ask what they were doing about it. A lot of times health people look at a log and see one bad number and say "bad diabetic!" but I can't say I agree or not. I will say that I think the appellate court seems to have a very good grasp of the intricacies of the disease, enough that I wonder if the judge had some personal experience with diabetes somehow?
When A.C.’s pump would warn that her levels were too high or too low, which happened about five times per day and sometimes up to ten times in a day, her teachers would immediately contact the school nurse. Once, A.C. had an incident at home where her blood sugar dropped so low that she had to receive glycogon (a shot that quickly raises blood sugar) and be hospitalized for several days.
My point is that "following doctor's orders" and "poor control" aren't mutually exclusive. I certainly wouldn't fault the parents for lack of effort, although some of their efforts may have been misdirected.
As a former school administrator I see several sides of this issue. Let's begin with the basic problem, testing in the classroom as opposed to the school requirement that she test in the school nurses office. There are many reasons this is a typical rule in schools. None of those good reasons involve classroom disruption. From my point of view I would say that if the child can do this, by herself, without creating a disruption, then I would say yes let her do it. However, require that if she is low or high she must leave the classroom for adult oversight of testing and treatment if needed. I doubt the parents would agree with this stipulation.
In fact the nurses office has never been shown to be a more germ or disease transmitting center than any other room in a school building. However, I would have allowed the child to test in the office under adult (nurse) supervision. I am sorry but it is absolutely critical that a child in grade 2 have some supervision in this matter, so the school, who is 100% liable for the child be at knowledgeable of the high or low, and the correction path. In grades 5 thru 12 I might take a different approach but in grade 2 the nurse needs to know.
Now with regard to main issue, the calling of CPS (Child Protective Services in Indiana) would be a last and likely not taken action. I think the principal did look vindictive to call. Now I understand this as well. Principals are people as well, and like all people they get fed up with parental nonsense. In this case the parents were practicing parental nonsense designed to do nothing but create drama and problems at school. you cannot blame the principal for finally lashing out, he or likely she is human. In fact it is the law in Indiana that if a principal suspects abuse they must call, it is not optional. So what to do. Well I would say do not call unless we see direct signs of abuse. High or low blood sugar unless the child is unconscious is not a good criteria for calling.
One factor over looked here is that in a typical elementary school as many as 3-5 kids per hundred will have major medical issues. These issues are life threatening and require significant interventions sometimes. When parents of a medically fragile child take up this kind of resources they are denying other children the care they require. Now folks may say well hire another nurse or 2 or 15. But the issue is that nurses and teachers are paid from the same funds. So, how many teachers should the school unemploy in order to have more nurses? Or how many nurses should not be employed to have more teachers? It is an absolute ying and yang of educational funding. There is no free lunch.
When parents jump into these kind of ridiculous battles they occupy those very resources they want for their child. No I don't think the principal should have called CPS but I sure understand why he did it.
The message here is work with your local school and do not play these dumb games. The only people who gets hurt in this type of situation is the child. Adult issues should never usurp the main purpose of going to school. Trust me fighting with the school is not a good solution.
I was thinking the same thing. I felt bad for the child. I couldn't understand while reading why if her numbers were so crazy they weren't changing something (her diet) to try and help. I know that my t1daughter who was diagnosed at 4 has NEVER had to use her glucagon pen yet. I worked with my pre-school and now her elementary school to find a 504 plan that works for everyone most especially my daughter who is the one that has to live with all of this. I don't think that the principal was correct in her response but the parents response wasn't much better. Sorry.
As a former school administrator, how much experience did you have with either dealing with mandated reporter issues directly, or dealing with teachers who were acing as mandated reporters?
Maybe it's just because I work in an extremely large urban school district, but our responsibility as mandated reporters are made very clear to us every year. We are required to take a yearly course, and pass a yearly exam or we are not even allowed contact with students. I am not exaggerating when I say that, in my 11 years as a classroom teacher, I have reported at least one incident every year.
The thing that I find interesting about this case is that a teacher approached the principal with concerns and her intention to file a report. The principal decided, unilaterally, at that time, that the report should not be filed. Had that been my district in my state, I, as the teacher, would have simply filed the report anyway. As mandated reporters, we are instructed to advise our principal that we have filed a report, not ask the principal if we should file the report. We are instructed to call the appropriate authorities immediately upon suspicion of child abuse, period. We then have 36 hours to file a written report, at which time, we advise our supervisor.
Certainly, state law differs on mandated reporter laws but what I'm absolutely concerned about is the consequences to me as a mandated reporter depending upon the findings of this court. We can argue up and down, back and forth, til the cows come home, about whether or nit a report should have been filed in this case. Given what happened at Penn State under Pennsylvania State law, I would imagine that the prevailing attitude would be to err on the side of child safety rather than the convenience of the suspected parties. If, under the ruling of this court, mandated reporters can be held liable, I know a ruling like that would certainly give me pause regardless.
This discussion has been very interesting because there are so many factors on both sides that must be considered.
I admire the parents of all kids with diabetes because I cannot imagine how very difficult it would be to manage someone else's blood glucose and how much stress and worry would accompany that 24/7/365. I think of the worries I've had with my own non-diabetic child over the years and realize how insignificant those worries have been compared to managing your child's pancreas.
As a mother, I would not care about the resources available to the school, I would want all resources that *my* child *needed* to be safe while at school so I cannot fault these parents in that sense. Sure the other kids are entitled to a good education but that should apply to all kids, even those with diabetes. So if a KWD has to trot across the school's campus and into another building and up the stairs to get to the nurse's office to test their bg every time they are high or low or just because, think of the instruction that the KWD is missing out on - is that fair? And should a KWD be traipsing across campus to the nurse's office with low blood sugar?
As a parent, I would also probably have aggressively pushed this issue if only for the benefit of other KWD yet to come through this school; "paying it forward" and pushing the issue for that sole reason. As a PWD, it would anger me to have the school judge my child's bg history and treatment plan because we all know how challenging it is to achieve good control. I could never and would never, as a PWD, point the finger at these parents or their child and say "bad numbers = bad diabetic".
My endo primarily treats Type 1 kids - they also use university Psych grad students to work with the kids because the emotional issues can be so complex. While I agree that limiting carbs is best for me, I know that my endo's clinic teaches KWD how to build those sweet kid treats into their meal plan and how to cover with insulin. We all know that sometimes the science experiment works and sometimes it doesn't. I can't consider it abusive to want your KWD to be as *normal* a kid as possible. All parents want that for their kids.
I also am in awe of the enormity of the job that schools are expected to do these days. Having worked at the state department of education level for many years, I well know the federal and state laws and regulations that school administrators must deal with and must do so with fewer and fewer resources. Many schools in my community do not have full time nurses because of budget cuts. Those who are pushing for smaller government should take note.
All that being said, it just seems to me that a little more common sense on both sides of this case could have found a solution that worked for all parties and especially the child. I think each side got so wrapped up in proving their own point that the grown-ups lost perspective and didn't protect the interest of the child.
When I didn't ask it wasn't ever an issue, but when I have spoken to the teacher or school administrator about testing or eating in class it has become one.
When I was a kid with T1 in a public school, it was long before the concept of "504 plans" or ADA compliance. I would describe how it was done as "don't ask don't tell" - as long as I didn't make a big deal out of it, the school wouldn't kick me out. That's a little unfortunate and while it worked for me in junior high and high school, it probably wouldn't work in an elementary school setting.
This was precisely my experience as well, except beginning when I was in 3rd grade. Things could have been better, but they could have been a lot worse. Obviously, this little girl's situation is much worse.
I wonder if she would be doing better on shots at that age? Also, I wonder how accommodating a private school would be to t1 kid?
Well, I was a private school kid when I was dxd in '96. I was a sophomore. I don't know if it was the nature of the school, the small size of the school, or what, but I had no issues with the school making any necessary accommodations for me. Then again, I took no insulin at school (I was on R & NPH). But because of that, the only way to lower a high bg was to walk it off. Spent lots of chem and physics walking (funny how the highs were always in those classes...lol!).
