Toileting - 504 plan

[Christi Blunt]

If a kindergarten student is on a 504 plan with diagnosis of Autism, ADHD, & Anxiety and has troubles getting herself clean after a bowl movement, is the school required (hands on) to help her wipe? The school informed us the nurse can coach her but not physical help her. Is this true? Is there a law or some kind of documentation I can provide the school? This is in the state of MO. Thank you so much for your help.

[JSD24]

None of those diagnoses would prevent her from getting herself clean after a bowel movement.  She would need to have an OT evaluation showing that she physically cannot wipe or that she has sensory issues due to the autism that's preventing her from wiping sufficiently.  Since this falls under OT, I'm guessing it would be the school OT that should be teaching her & not the nurse.

Also possible that with the ASD & ADHD, there are executive functioning issues where all the steps are not done with having a BM at school.  Could there be distractions like an echoy bathroom that's painful to her hearing where she rushes and doesn't do a good job wiping?  Having her use a small bathroom that might be in the nurse's office might be a solution.

Personally, I feel that allowing a student to spend time with a dirty bottom falls under child abuse.  Her peers are likely to shun her if she smells or wipes so poorly the BM seeps through her clothes.  Her classmates are bound to notice.

To provide a better perspective, how does she do with this task outside of school?  If there is a developmental delay that prevents her from learning this skill, it might be appropriate for the nurse to assist.  (Given this is a life skill that peers have mastered, I can see this going  into the IEP along with a SDI for the appropriate person to assist and/or coach depending on why this is happening.)

[Christi Blunt]

Thank you so much! This is great information.

 

She has severe anxiety in the bathroom, so she takes a post it note to cover the automatic flush. At home, she struggles with wiping as well. She also has a condition where she can't also feel when she needs to void. So in the 504 plan, she is being told to go to the bathroom multiple times a day.

 

The school will not give her an IEP and only 504. We are currently working on an IEE to get an IEP.

[JSD24]

The way IEPs work is you have an eval that shows the student has a need.  Ask for a bottom wiping eval.  See if there is a delay and then figure out how to teach and/or accommodate.  I'm not sure if an OT is going to be willing to do this.  You might need to go outside the school to show this need.