COD E R E D

Childhood ConditionsDiabetes (n=11)Average school-basedpolicies = 5 (range 3-11)School-based Programmatic RecommendationsCounseling, psychological & social services■ Provide and coordinate school-based counseling,psychological and social services for students with asthmaas appropriate.■ Advise parents and teachers on behavior strategies andmake sure children with asthma are not treated differentlythan other children. Help children cope with the disease andcultivate independence.Physical education■ Teachers should encourage participation of children withasthma in safe and enjoyable sports and physical activities.■ Insure students with asthma have access to preventivemedication before physical activity and immediate access toemergency medication.■ Adjust physical activities after an asthma attack orsymptoms and during recovery period.■ Reduce outdoor activities and physical education whenpollution is high and/or in cold weather. Some indooractivities replacement may be beneficial.Healthy school environment■ Eliminate marketing of unhealthy foods to children.■ Design and expand coordinated school health programsfor diabetes.Pupil/student health education■ Establish education and awareness programs in diabetesprevention and delay for students. Conduct focus groupsand other types of qualitative research to evaluate theeffectiveness of programs.■ There is insufficient evidence (c)to recommend selfmanagementeducation in schools for children andadolescents with diabetes.School personnel education■ Provide diabetes education to school personnel andtraining to administer emergency medical treatment tostudents with severe hypoglycemia (normativeimplementation). Utilize schools to promote active selfmanagement.School health services■ Implement regulations that permits students withauthorization to test their blood glucose levels on schoolgrounds.■ Utilize nurse educators based at schools or schooldistricts to link students to health care systemsPhysical education■ Physical education standards should be established forafter-school programs.Evidence-based Recommendations■ Evidence-based recommendationspertaining to prevention of diabetesand improved academic performanceare linked to those regarding physicalinactivity and nutrition.(c) available studies provided insufficient evidence to assess the effectiveness of the intervention. Note: Under the Individuals withDisabilities Education Act (IDEA) of 1997, schools are required to promote the health, development, and achievement of students withasthma. (The American Association of School Administrators). School health services are a related service under the Individual withDisabilities Education Act (IDEA), section 504 of the Rehabilitation Act (1973) and Title II of the American Disability Act (ADA). Schoolhealth services must be provided to students if indicated by Individualized Education Program (IEP) under IDEA and section 504 or TitleII of ADA. Not all the students with asthma are covered under IDEA, but they might be covered under IEP or ADA. (National AsthmaEducation and Prevention program & U.S DHHS & U.S Department of Education)E-47