Nutrition Interventions for Children with Special Health Care Needs

Chapter 12 - Accommodating Special Dietary Needs in the School System
educated in regular school classrooms. Often, the disability prevents the child from
eating meals prepared for the general school population. Students with special
nutritional needs usually have the same or greater nutritional needs as students
without physical disabilities; however, they may have a difficult time meetings those
needs (1).
School Food Service Requirements
Students who may need modified or special meals can be classified in two major
categories: 1) those who are unable to eat regular school meals because of a
disability and 2) those who have a chronic medical condition but are not determined
to have a disability. A sample order form that a physician or recognized medical
authority may use for students with disabilities or a chronic medical condition to
modify a diet is included (Appendix P).
Students with Disabilities
The US Department of Agriculture’s (USDA) nondiscrimination regulation (4), as
well as the regulations governing the National School Lunch Program (5) and School
Breakfast Program (6), make it clear that substitutions to the regular meal must be
made for students who are unable to eat school meals because of their disabilities
when that need is certified by a statement or order signed by a recognized medical
authority.
The order must include (3):
• The student’s disability and an explanation of why the disability restricts diet
• The major life activity affected by the disability
• The food or foods to be omitted from the student’s diet and the food or choice of
foods to be substituted
Students with Chronic Medical Conditions
For a student without a disability, but with a chronic medical condition that requires a
special diet, an order signed by a recognized medical authority must be provided. (In
Washington State a recognized medical authority is defined as a physician, licensed
physician’s assistant, an advanced registered nurse practitioner (ARNP), or a licensed
Naturopathic Physician).
This order must include:
• Identification of the medical or other special need which restricts the child’s diet
• The food or foods to be omitted from the child’s diet and the food or choice of
138 Nutrition Interventions for Children With Special Health Care Needs