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    Juvenile Arthritis at School: 504 Plans, IEPs, and Pain Issues

    Learn how special education plans can help children with juvenile arthritis thrive in the classroom.
    By Virginia Anderson
    WebMD Feature
    Reviewed by Louise Chang, MD

    Sam Williams and his parents knew something was wrong when it hurt for the 8-year-old to grip a baseball bat, but they never considered juvenile arthritis.

    It hurt to write, giving Sam a sound excuse for not wanting to do his homework -- or even his work at school. After several weeks, Sam's pain grew worse -- and moved into his knees. He also had pain in his jaw and had trouble walking.

    "His brother had to carry him piggyback up the stairs," says Rose Williams, Sam's mother.

    After several months, Sam was diagnosed with juvenile rheumatoid arthritis, a disease of the immune system that causes pain and swelling in the joints, among other problems.

    Although medication and physical therapy can help, kids with arthritis often have problems in school. Because joint pain and stiffness are often worse in the morning, students may often be tardy or miss school days. They may not be able to perform well in physical education or other physical activities. For many children with juvenile arthritis it may be difficult for them to even carry their books.

    But because juvenile arthritis is often misunderstood, it is sometimes hard for children to get the support they need at school, says Harry Gewanter, MD, a pediatric rheumatologist in Richmond, Va. He says it's important for parents to talk to their children's teachers and school officials about a special support plan for children called a 504 plan, named after section 504 of the Rehabilitation Act of 1973.

    Juvenile Arthritis: What to Include in a 504 Plan

    Your child is entitled to a 504 plan under federal law as long as a doctor confirms that a child needs it. It is legally binding and focuses on support for the child in school. It is for children with a medical diagnosis.

    Even if you don't think you will need a 504 plan, approach the school and talk to your child's doctor to prepare a plan, Gewanter says.

    "Anybody who has juvenile arthritis should have a 504 plan, at least for a safety net," Gewanter says. The plans are individualized according to a student's particular needs, Gewanter explains.

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