Obtaining Support Services in Schools: A Guide for Children with Crohn’s Disease

Crohn’s Disease is a lifelong condition that occurs in all ages which causes inflammation to the digestive system. It is an inflammatory bowel disease that affects the digestive track and causes abdominal pain, mental and physical fatigue, weight loss and malnutrition.

The onset of Crohn’s disease is usually in childhood but can develop in early adulthood. The symptoms are unpredictable; they may be constant or come and go, referred to as flare-ups.

There is no known cure for Crohn’s disease, but treatment can alleviate symptoms. Medication can be effective in reducing digestive inflammation for many; however, some patients require surgery to remove small parts to the digestive symptoms.

Despite the advancement of treatment options in recent years, those afflicted with Crohn’s  experience deleterious effects to physical health, emotional well-being and social functioning. Living with Crohn’s challenges overall psycho-social functioning. Unpredictable flare-ups, frequent doctor visits and the physical effects of the disease cause disruption to daily life activities. Children in particularly, are susceptible to frequent school absences causing disruption to the continuity of the learning process. Youngsters with Crohn’s also struggle with the acceptance that the disease is lifelong and that their daily living activities such as school attendance and achievement, socialization, and physical activity will be disrupted throughout their lifetime.

Children with Crohn’s are often embarrassed by the stigma of having a disease rooted in the digestive system. The stigma of such a disease renders children suspectable to isolation, bullying, and the onset of depression.

Due to the pervasive physical and psychological effects of Crohn’s, children and their parents are strongly advised to obtain formal support services through the school district to ameliorate the learning, social and emotional effects of the disease.

Under the Individuals with Disabilities Act (IDEA), children who have a condition that affects learning may qualify for special education accommodations and services. Children with Crohn’s should qualify for special education services under the federal classification of Other Health Impaired (OHI).

Special education is typically thought of as applying to children with cognitive disorders. In fact, there are 13 classifications under federal law qualifying children for special education. In addition, to the classifications of Autism, Intellectual Disability, Learning Disability, the Other Health Impaired classification encompasses all health conditions that interfere with academic achievement, socialization, and emotional functioning.

To qualify for formal school-based services, a parent should request a formal Child Study Team evaluation from their school. This evaluation typically consists of 1) a psycho-social evaluation to review the child’s health status, developmental background and family history; 2) a psycho-educational evaluation which assesses cognitive functioning, educational achievement, and emotional functioning; 3) an evaluation conducted by a physician which documents the diagnosis of Crohn’s disease.

Public schools are required to conduct these evaluations without charge to the family.

After these evaluations are conducted, the Child Study Team will determine if the disability (in educational terms) significantly impedes academic achievement and/or the access to curriculum. Once a child is found eligible for special education, an Individual Learning Plan (IEP) is adopted to memorialize the provision of school-based services.

Special education services for students with Crohn’s Disease may include:

  • Individual counseling to support social and emotional wellness.
  • Group counseling with other students who have a physical disease with a focus on developing coping skills.
  • Occupational therapy to support functional living skills that may be affected by the disease.

Children with Crohn’s may also benefit from academic modifications and accommodations including:

  • Extended time for tests and assigned classwork (this may include the SAT)
  • A modified academic schedule if a child is not able to attend the normal school day.
  • Exemption from physical education classes.
  • Modifications to the length and scope of assignments during flare-ups.

Special education services for children with Crohn’s are instrumental in supporting academic, emotional and social functioning. Eligibility for these services ends with high school graduation, but formal support is available in college. This support is covered under Section 504 of the Rehabilitation Act, also referred to as a 504 Plan. College students with conditions such as Crohn’s may also qualify for formalized support through a 504 Plan in college. 504 Plans for students with Crohn’s may include the provision of:

  • Priority class scheduling
  • The allowance to take a reduced course load
  • Extended time for tests and the completion of coursework
  • Counseling services offered through the college

Summary

Crohn’s disease is a lifelong physical condition that affects emotional wellness, socialization, and academic achievement. Children particularly are suspectable to bullying, social isolation and feeling depressed. Self-advocacy is vital in obtaining holistic treatment. Children with Crohn’s and their families are advised to explore formal support services offered by schools. Children with Crohn’s are afforded under federal law, school-based services and accommodations which are instrumental in providing academic and psychological support.