I am a school psychologist in a middle school. There is a female student who has been diagnosed with CAH and is on many medications. She has not experienced any adrenal crisis at school to date. However, she has been hospitalized for adrenal crisis in the past. She has excessive absences (50), (22)tardies and early dismissals due to side effects such as stomaches, malaise, UTI, etc. I have had several conferences with her parents and we both would like to see her remain in class. however, if home tutoring would be more helpful then that may be the direction we need to go. I have asked her mother to please discuss these issues with her doctor, so we can provide the supports that she needs. 

She is presently failing in several academic subjects. She has refused to get dressed for Physical Education and is failing because of it. She leaves class often to visit the nurse with various complaints. However, she is able to sit and talk with one of the aides in the student support services.

Our goal is to keep her in class so she can pass to the 9th grade. Is walking around in the gym beneficial for her? The 504 Plan, currently, has Adaptive P.E. accomadations for her which essential is just dress out stay in the gym and don’t work up a sweat. She has Gatorade for her to drink with the nurse. Our dilema is determining when the complaints warrant a trip to the nurse or stay in the class.She has gotten in the pattern of skipping  the same classes that she finds boring and uses her symptoms to stay down in the student service area.

I am concerned for her health and her education. If you have any suggestions or guidelines that can help us, I would deeply appreciate it. I have search the internet and found no guidance for children in school. What the school system can do for her. 

Thank you.

Sincerely,

Suzanne MUnzer