Doctor Letters and Special Education Needs

Today, I'm writing to strongly urge parents of school children with medically-based disabilities to ask their child's doctor to write a summary letter for the child's school district that verifies and thoroughly describes the child's medical condition, and informs the school about the child's health-related needs at school and extra curricular activities.  I recommend that parents copy the letter and give the copy to their child's school district.  I further recommend that parents ask the doctor to write updated letters each time there is any significant change in the child's health, or at the least, at the beginning of middle school and the beginning of high school.

Although I've never had a case in which the parents of a child with a medical disability had not given copies of his or her medical records to the school district, I've noticed that some of those records are written in a manner that could be misinterpreted by school personnel who have no medical background.  This is why I strongly urge parents to make sure that letters written for the purpose of verifying their child's disability and communicating his or her health needs to the school are thorough and written in clear and unambiguous language.

In the absence of a letter of this type, school districts address the educational needs of a student with medical disorder without regard to the medical basis of the disability.  While in some circumstances, the school may provide sufficient services, in other cases it may not, and in still others cases, a school's lack of knowledge about a student's medical risks can be exceptionally dangerous.

An painful example of this is the California wrongful death case in which the court's decision turned on its interpretation of a doctor's letter contained in the school district's records. 

The letter, which had been written several years before the student's death while running laps in gym class, described the boy's heart problem as mild and said he could "undertake a full school program, including moderate involvement in sports and running games," then added that "he should not be committed to any sustained, grueling, competitive training or conditioning program, such as might be undertaken with varsity football or basketball."  The school nurse testified that she interpreted this to mean that the boy needed no special handling, did not need adaptive PE, and that no health warning note needed to be sent to the gym instructor.  The instructor testified that because he didn't know about the boy's weak heart, he thought the boy was having a seizure, and didn't start cardiopulmonary resuscitation.