Navigating the School

Navigating the School


Planning, Education, Accommodation

There are plenty of restrictions that come along with a diagnosis of Perthes. Some are obvious, such as limiting weight bearing. Others may only come to light through trial and error, for example, does your child need a little extra time in the restroom at school now that he or she is in a cast? You may need a specialized plan. While every school system is different, here are some tips to get started.

504 Plan

What is a 504 plan? Section 504 is a federal statute (anti-discrimination law), which protects the rights of individuals with disabilities to equal opportunity in programs and activities which receive federal funds. A 504 plan can include accommodationsmodifications and special services that are similar to those in an individual education plan. It’s important to be proactive when forming and modifying your child’s 504 plan.

A person is eligible for a Section 504 evaluation if they:

  • Have a physical or mental impairment that substantially limits a major life activity

  • Have a record of such impairment or

  • Are regarded as having such an impairment

To begin the process there must be a referral made by the parent, teacher, administer, etc. At this point the school may attempt to address any concerns and make accommodations. If this is not resolved, consent forms for formal process are sent home for parental signature and, pending parental consent, the campus begins the 504 evaluation. Some other items that may be collected with consent for evaluation include a parent input form, proof of doctor’s medical diagnosis, teacher input form, release of confidential information form.

Individualized Health Plan

Individualized Health Plan addresses a medical or physical disability. This may be necessary if your child has medication in the school’s clinic or if he or she has physical restrictions. If a child has a condition for which an IHP is recommended, it may be recommended that he or she have a 504 plan in place.

Important Distinctions

Neither a 504 plan nor an IHP is “special education.” Each 504 plan or IHP is evaluated on a case by case basis. 504 committees do not want to discriminate by over accommodation or under accommodation. Teacher, nurse, and parent input is vital and necessary to determine appropriate accommodations. No two plans should be identical due to differences in student needs.

Many parents are concerned that such a plan will cause discrimination against their child. These plans are meant to “level the playing field” not provide an advantage to your child. These plans are also confidential. To ensure fairness, evaluation should be data-driven and directly related to, in this case, Perthes disease.

Things to Consider

If your child is doing well with informal accommodations, that’s wonderful! There is potential, however, for informal accommodations to fall through. This may happen due to switching or substitute teachers, miscommunication, or simply forgetfulness. We are all human after all.

Some things that can be included in a plan could be increased time to use the restroom due to casts, access to accessible restrooms (the only restroom that may accommodate a wheelchair could be far from your child’s classroom). Additionally participation may need to be modified for certain activities or the activity itself may be modified to include participation via adaptive equipment. When you take the time to educate the school and your child’s teachers on Perthes disease, accommodations can be made without causing undue stress and feelings of isolation for your child.


Adapted from Perthes Parent Conference, Texas Scottish Rite Hospital for Children, 2017.