Back to School with Food Allergies (Recording)

Presented by Allergy & Asthma Network

This webinar was recorded on July 22, 2025

As the new school year approaches, families of children with food allergies face important decisions and preparations to keep their kids safe, feel included by peers, and supported in the classroom.

Join Autumn Burnette, MD, and Laurel Francoeur, Esq. for a virtual conference that will support parents and caregivers with the tools they need to navigate school systems, communicate effectively with school staff, and advocate for their child’s health and rights.

This session will include a focused discussion on 504 plans, including how to request one, what accommodations to consider, and how they help ensure a safe learning environment for students with food allergies.

In this virtual event, you will learn:

• Key components of an effective 504 Plan for students with life-threatening allergies
• What families need to know about carrying and storing epinephrine at school
• Collaborating with school nurses, teachers, and administrators
• Best practices for educating classmates and reducing stigma.

CE is not available for this event. 

Meet the Speakers!

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Special thanks to ARS for their support in making this event possible.

Transcript: While this transcript is believed to be accurate, errors sometimes occur. It remains your responsibility to evaluate the accuracy and completeness of the information in this transcript. This transcript is not intended to substitute for professional medical advice.

My name is Ruthie marker. Thank you for joining me. I am the education program manager here at Allergy & Asthma Network. I’m excited to welcome you to this afternoon’s webinar. We have a great session planned. I would like to take a few moments to go over some housekeeping notes before we dive into today’s visitation. All participants will remain muted just to minimize background noise. Today session will be recorded and will be available on our website within a few days in case you would like to revisit it or share it with family and friends. The webinar will last one hour, including time for questions at the end. Feel free to submit your questions via the Q&A box at any point. You will find it at the bottom of your screen. Someone will be monitoring chat. We will do our best to answer as many questions as possible. Please note that while we are not offering continuing education credits, we do provide a certificate for attendance. You will receive a follow-up email during the days after this webinar with additional resources and a link to download your certificate of attendance.

With that out of the way, let us jump in. Today’s presentation is titled ” back to school with food allergies.” We would like to give a special thanks to ARS, who has provided funding and support to make this possible. As a new school year approaches, families of children with food allergies face important decisions to help keep their children safe, feel included by peers and supported in the classroom. This virtual conference session will help support parents and caregivers with tools they need to help navigate the school system, communicate effectively with school staff and advocate for their child’s health and rights. Our first speaker is a food allergy attorney and advocate and national speaker who became — began in this space after her son’s reaction. She has authored multiple books and help shape state and federal food allergy policy. She founded allergy law project. She is a graduate of M.I.T. and Suffolk law and was named top woman of law in Massachusetts in 2019. With that, Laurel, I will turn it over to you to share your story.

Laurel: Thank you. I’m an attorney. I specialize in helping parents and people with food allergies, and it all began in 2001 when my son was diagnosed with food allergies. At the time, he had allergies to peanuts, tree nuts, eggs, soy, sesame, and shellfish, and there was very little literature around in that timeframe. One of the groups I reached out to was parents of food allergic kids . My son began school, and when he was in kindergarten, he had a life-threatening reaction to food. They had done a gingerbread house project unbeknownst to me, and he got frosting on his hands that had egg in it.

He licked his hands and started having an allergic reaction. The school did not recognize it as a reaction. When I got to the school, I realized what was happening, gave him an EpiPen and took him to the hospital. We had other issues with that because he was only five and he did not know at the time that food allergies were life-threatening. When we got to the ER, the hospital Dr. said, you realize he could have died. He overheard that and had some emotional trauma after that because he did not know beforehand that he could die. We addressed that and I decided then and there that I would dedicate my practice to learning all I could about food allergies and helping people with food allergies. One of the first things I did was help get a law passed in Massachusetts so that students in the classroom in Massachusetts could have epinephrine in the classroom. Before that, it could only be kept in the nurses office. For my son, his class was on one end of the building and the nurses office was on the other end of the building, so he really needed quick access. It took seven years, but we finally got that bill passed with my local representative. From there, I continued to advocate and learn as much as I can about food allergies, and I have become a national speaker on the topic. One of the things I will be talking about a little later on today is 504, which is a federal law that requires an organization that gets federal funding to accommodate for disabilities. In many cases, food allergies have been termed a disability. A lot of people frequently hear the word disability and think it has a negative connotation, but just remember that it is a legal term and that it does not mean anything pejorative against your child.

It is just the way the law has phrased it so that you need to use that term in order to get the accommodations you need. Most people in public school will be subject to a 504 plan which offers more protection than just under the ADA, so I would advise everybody to learn about their rights, to know that your child is entitled to accommodations in school. One of the things I tell clients when they are thinking about the beginning of the school year is to go through the day in your mind and try to think about what accommodations you will need along the way. The first thing would be the bus ride. Does your child need access to epinephrine on the bus ride? Then think about when they get to school. Should they maybe wash their hands as soon as they arrived? Should it be an allergy-free or allergy-friendly classroom? Should the snacks in the classroom be allergen-free or should there be a special area in the classroom for snacks to be eaten? Basically, go through the day in your head and think about what accommodations you may need for that. Another thing will be reassessed. Is there someone there who can get the nurse quickly if the child is having a reaction. Is there walkie-talkies or some other cell phone mechanism to get the nurse said the recess monitors do not have to leave your child unattended. Again, think about the day.

Think about things your child would need, and remember that it is a negotiation with the school. You are not always entitled to everything that you want. It is really a negotiation with the school, and we work to try to see what accommodations would be reasonable and needed for your child. Another thing I always tell people is an accommodation is usually a change from the way things are usually done. If the school principal says we always have a pizza party after the first bubble game, to say that an accommodation is a change from what is usually done and you need to change to make sure your child is included. There is the CDC guidelines. There’s a new document that is called FAMS, which is a document that was developed by Dr. Michael Prisoner. It has a lot of best practices. There’s a lot of resources out there. Do some research. Make sure you know what your child needs and be ready to advocate for them and also be ready to negotiate. I always say to parents when you have been dealing with the school, the best thing is to go in with the feeling that you are educating the school about your child. You are not there to insist this is what your child needs. You want to have the attitude of here I am, let me explain to you my child and his or her needs and what happens when they have a reaction. That attitude of trying to educate the school rather than fight with the school is always the best approach. If you want to reach out to lawyers like me or other lawyers that can help you, we work with parents and help get them accommodations all the time. Just know that you do have rights, and again, there is a lot of resources out there, so feel free to reach out and I wish everybody the best of luck going back to school. I know it is a time fraught with lots of concern and worry, but my son is now 25 years old. He is going to school in Canada for his PhD. He still has food allergies, but he has had a good life, and he did it, so you guys can do it, too. Thank you.

Ruthie: Thank you for sharing that and for sharing that about your son. I have a two-year-old daughter. She was diagnosed with wheat, kiwi allergies. I definitely understand the scary part. She is not school-aged yet, but I can imagine that fear. Every interaction, you have to think through what does the day look like. What interactions happen. But for sharing that your son is thriving, is traveling, he has the knowledge, I am thankful for you for kind of setting that foundation for him but also food allergy sufferers to come.

Laurel: One less thing I will share very quickly as there is another side to food allergies. Because he has had food allergies all his life, it has made him very empathetic towards other people, made him grow up quickly. He can advocate for himself, learned to read labels at an early age, so there is some good side. It is not all doom and gloom. It’s like a roller coaster. You have some days that are good and some that are bad, but just know there is life at the end of the tunnel. Thank you.

Ruthie: Thank you for sharing that. I would like to now introduce our second presenter, a board-certified allergist, pediatrician serving as an assistant professor of the division of allergy immunology at Howard University. She specializes in managing allergic and immunologic condition in children and adults with a focus on biologic treatments in chronic, mild, and severe diseases. She is also a national speaker and published author and has contributed to peer-reviewed journals and advisory boards across the country. Thank you for being here today, Dr. Burnett. I will turn it over to you.

Dr. Burnett: — Dr. Burnette: Thank you and thank you for such a wonderful introduction. Please let me know if you cannot hear me. The goals and objectives for our webinar today — and thank you so much for who is joining us on this conference call today. One of the goals for today is to understand anaphylaxis and to be able to recognize the signs and symptoms and to kind of guide us into how we quickly can respond to severe allergic reactions. Also, number two, no — know the tools. Review the available epinephrine devices and the best practices for carrying those devices and storing those devices, particularly at school or during school activities.

Third, how do we talk to families? How do we talk to caregivers, staff in the school, nurses in the school in terms of preparedness? Just like Laurel introduced, we will talk about the key elements of a pliable flow plan and also anaphylaxis plan so we can keep children safe when they go back to school. Number four, we want to talk about building a supportive community. There is an upside to this conversation, and that is really how we can discover ways to partner with each other. Parents with the school staff, with other classmates in the class to hopefully raise awareness, but also to reduce the stigma. How many people actually have food allergies? From the Allergy & Asthma Network data, approximately 20 million Americans. That accounts for about 60 million adults and 4 million children according to the 2021 data collected from the U.S. CDC.

What is anaphylaxis? This, for understandable reasons, get confused out there. In the caregiver setting and the school setting, but in layman’s terms, it is basically described as a serious or severe allergic reaction. Some children are allergic to things like foods, medications, insect stings, latex. All of these things are considered to be allergens. If a child touches or eats something they are allergic to, they may have mild symptoms, but sometimes there’s symptoms can be moderate or severe. Some of the things we look for allergic reactions are things like hives or generalized welts are reactions on the skin. They can be very itchy. We also look for things like trouble breathing. If the symptoms are present, and it is after a known trigger like a food or medication or insect sting, that is something that does require to be treated fairly immediately. Each allergic reaction can be different from the other, even within one respective individual . Sometimes allergy symptoms are mild. Other times, symptoms can be severe and can result in a serious or severe allergic reaction which is defined as anaphylaxis. Anaphylaxis can even be life-threatening, and a scary as it sounds, it is important to understand that. And anaphylaxis, if not treated right away, can worsen.

It can also involve multiple organ systems of the body. Skin can be involved. The upper respiratory tract and the sinuses. The lower respiratory tract and the lungs. The G.I. tract and the gut. And the cardiovascular system. Oftentimes, it is important to understand that it can be mild, it can be moderate, it can be severe, but anaphylaxis generally speaking involves multiple organ systems and potentially if not treated immediately and appropriately can result in serious detriment. Symptoms, again, can include skin symptoms, cutaneous symptoms, which can be skin rashes, itching, and hives. They can be spots in local areas but generally are widespread. Swelling can happen as well in the lips, tongue, or throat. Individuals can have a hard time breathing. They can start wheezing. They can have chest or throat tightness. Stomach pain can ensue. Nausea. Repetitive vomiting, even diarrhea, and even individuals can feel faint. They can feel dizzy, or even impending doom like something bad is about to happen. The best way to manage anaphylaxis is epinephrine as the first line most important treatment for anaphylaxis.

It is important to carry at least two doses of epinephrine because a second dose may be needed if symptoms are not improving or getting worse after the first dose. Calling 911 if symptoms do not approve — improve right away. Nasal issues such as obstruction of the nose. Some people have nasal polyps in the nose which may affect absorption of epinephrine. Side effects may include fast heartbeat, sweating, or headache after using epinephrine. What devices are available? Let’s talk about the numerous devices that may be familiar to you. You may have one of these. Some may not be familiar to you. I think most people know EpiPen or EpiPen Junior. Some people know of EQ, which is a device that speaks to you. One of the newer devices is nasal epinephrine. Then there are some epinephrine injectable devices that are shown here on the slide by different manufacturers. There’s epinephrine devices that are a generic type of epinephrine device. Here’s the variety of devices that can be used for individuals that are pediatric patients and even for adults. The standard pediatric dose would be such as an EpiPen Junior or nepi 1 dose. An idol device would be for patients that — I should say for adults above 30 kg. I think I said that wrong. A pediatric device is anywhere from 15 to 30 kg.

An idol device is 30 kg and over — an adult device. There is a smaller device for infants who are down to the age of seven and a half kilograms . There are different devices, different age ranges, but as you can see here, the milligrams are here along with the weight category. Managing food allergy in schools comes with guidance actually published by the CDC. This publication was from 2013, and it still actually applies to today. Some practical things for the school staff to follow are listed here. School nurses, school staff, parents and guardians can use this as a great resource from the CDC in terms of practical things in terms of how to respond to allergy in a school setting, how to respond to an emergency, what we can learn about 504 plan or ADA, state laws, etc. How to administer epinephrine with an autoinjector or with a knee is a device, how to help children treat their own episodes if they are able to do so, and the importance of really giving emotional support and other services to students who have severe allergies or anaphylaxis. Some common risk factors and triggers can be found on the CDC information points, but really, this is a common tool used to give guidance to parents and school staff.

Every school should have a food allergy management and prevention plan. I believe, Laurel, you may have mentioned this. FAMP. It sets clear rules for keeping students safe. Each child with an allergic reaction should have a written plan. Usually it is a 504 plan in a public school setting. It should include steps to help your children join school activities in a safe way. It can also include an anaphylaxis management plan or emergency care plan so that if they do experience a super — severe allergic reaction there are steps in place to talk about medication and what to do. Food allergies may count on some instances as a disability so children cannot be left out of things like field trips are class parties or activities. How do schools manage food allergies? There are some steps to take. Planning and coordination of care, educating staff, students, and families, and providing a safe environment, and having a prompt emergency response.

The important thing is working as a team and working together. Schools need a doctor’s note to confirm that the student has a food allergy so the parent can work with the doctor, the physician to line that up in place with an anaphylaxis or food allergy plan. Staff, families, and cafeteria teams must also work together to keep children safe. Also making sure the school has the medication needed to manage that allergy should that allergic reaction occurred in the school environment, and even with good planning, schools must just be ready to handle an emergency. Teachers and staff must also know how to manage allergy symptoms, allergic reactions, and anaphylaxis, know how to help, no how to call 911 or EMS should not be needed as well and everyone should really learn that emergency care plan for that individual child in the school. Schools should teach students and families how to stay safe, and school rules should also help stop allergic reactions before they happen, be ready in case of anaphylactic reactions occurring. Laurel touched on this briefly — some steps can be put into place so the child can avoid allergens in class activities and celebrations. They can use non-food rewards if they are rewards given in class.

Keeping that epinephrine always accessible, training staff on how to use it, providing allergy-friendly seating that is not cumbersome for the staff or the teacher. Teaching label reading to students. Laurel said her child is now a grown adult. Learned early. Preventing cross-contamination with food handling and storage. Support safe snacks. And informing about substitutes — informing any substitutes in the classroom about that particular child’ food allergy. Reducing exposure risk in the cafeteria looks similar to what it does in the classroom but can include additional measures like washing hands, including the tables, before and after meals, using allergy-friendly seating if it is needed, identifying students with allergies discreetly and safely, and FER PA-compliant measures can be added to the cafeteria. Sharing a checking food labels and ingredients every single time, using allergy-safe prep areas and keeping food labels for at least 24 hours in case the child does have an allergic reaction and report any mistakes or cross-contamination immediately to the appropriate person. Risks during field trips, PE, and anything beyond that. Including children in these activities is really important. They should not be left out of field trips and PE.

Checking locations for allergy safety, identifying needs in advance for things like bus rides, packing food to avoid cross-contamination, and limiting food on buses. Carrying epinephrine safety — safely at school is also really important. Carrying two doses of epinephrine at all times is really important in case a second dose is needed , and if that epinephrine device needs an insulated label case, that should also be thought about in advance, avoiding extreme temperatures with epinephrine autoinjector’s, keeping it between 60 and 70° Fahrenheit for 20 to 25° Celsius is the optimal temperature for any epinephrine device. I will say that for nasal epinephrine, it can withstand high temperatures up to 122° Fahrenheit for a few days, and that is specific only to the nasal epinephrine device. Keep it accessible. Schools have ways of doing this so anyone who is able to treat and manage anaphylaxis can easily put their hands on the epinephrine device itself. Consider self carry if it is deemed appropriate for that child.

That would need a Dr.’s note. Make sure that school staff are informed at all times. Storing epinephrine safely at school — again, epinephrine should be accessible. It should be secure but unlocked because you don’t want it to be locked and someone cannot get to it in a quick way when someone is having a severe allergic reaction. Some of those locations are deemed by the school itself, but it can be a nurse’s office. It can potentially be a nurse’s office if it is deemed to be secure and accessible. Following school policies for locked versus unlocked storage is key. Carrying epinephrine during activities like Jim and field trips with a trained staff member should also be arranged — during activities like gym and field trips. And expiration and condition of that device should be routinely checked and monitored. Replacing or disposing properly of an old epinephrine device or used epinephrine device per the school or local guidelines. What is a section 504 plan? I will not belabor this too much because Laurel did such a phenomenal job talking to us from that legal standpoint. It is a legal care plan between families and schools uploading — outlining how schools support students, and it is based on federal disability law and it shows that there is a safe learning environment and equal access to education for students who have severe allergies.

It covers classroom, cafeteria, emergencies, and staff training. Again, like Laura said, not all children with allergies qualified. The school must be evaluated for eligibility and provide medical documents showing that the allergy limits a major life activity like eating or breathing. You may ask yourself, how do I start that process? It is important to request that for your child. You can also do things like director the principal and a 504 coordinator about the child’s food allergy, asking for an evaluation, and if eligible, set up a meeting to create a plan. Do this early, like Laurel said, before school starts to keep your child safe at school. What should that plan include? It should include things like signs and symptoms of an allergic reaction. It should list all of the food allergies of that child or any other severe allergies that may lead to anaphylaxis such as latex or occasions are stinging insects, and it should include an anaphylaxis action plan which lists out all of the child’s medications.

This is that example published by the American Academy of pediatrics of what an allergy and anaphylaxis emergency care plan looks like with the name, date of birth, age and weight of the child, some important things to note in terms of signs and symptoms to look for. For severe allergy anaphylaxis and when you get epinephrine and also for mild allergic reactions and what to do for that as well and the signature of the physician and the epinephrine device they have . What accommodations should I ask for in a 501 plan, you may be asking yourself. One of the things Laurel mentioned earlier is using nonfood rewards and cleaning up after eating, using safe food in art in class projects, keeping safe snacks and lunch at school for the child, letting kids carry allergy medicine if they know how to use it and are properly trained and planning for trips, bus rides, and class parties. How do you create that? The plan should address a couple of things. One is the responsibility. Who will be responsible for what? The child, the parent, the staff, the nurse, the training? What training will be required? The services. What special services, if any, will the school provide to keep your child’s environment safe, and will they give your child the medicine? Will they change the classroom environment? Will they make menu changes? The policies — what policies need to be in place to keep your child’s environment safe in a school setting and the emergency response. What is the emergency treatment plan if your child has an allergic reaction at school? By the way, 504 plans and college students — there’s some caveats here.

Colleges that got money from the government must follow laws like section 504 and the ADA, but they do not have to follow 504 plans the same way K-12 schools have to follow. If a request would change their program too much or potentially cost too much, they can say no in some instances. Allergy safety for the new school year. It is important to collaborate, educate, and communicate. Collaboration training is key. The 1, 2, 3, 4’s of collaboration — making a safety plan with teachers. What to do in an emergency is really important with collaborating. Training staff, making sure teachers and adults in that school setting know the signs should they need to. Know where the medication is located in the school. All staff you know where epinephrine is and how to give it fast, and be ready for an emergency. Have a step-by-step plan of how to use medication, call 911, and get help. In the education environment that is classmate-focused, believe it or not, raising awareness of other classmates can be key, making plans for sharing info, especially during allergy awareness month in May. Teaching others by using posters, flyers, social media, sharing allergy facts can be fun, informative, and educational. Some schools can teach allergy safety in their classroom setting for other students to learn more.

Showing kids how to help. Don’t share food with someone who has a severe allergic reaction, watching hands after eating, knowing the signs of an allergic reaction, get an adult right away, learning how to use epinephrine, and picking fun and non-food activities for those kids who have food allergies. Communication. Removing those stigmas, including children with food allergies enter the school field trips and bus rides and things that other students are doing. So just talking about it, being open about it helps kids feel safe about talking about allergies with family and friends and so that it is not a stigma for them. Making it normal, normalizing this, teaching that food allergies are very common and nothing to be ashamed of. Working as a team so that kids feel everyone is involved in keeping them and their allergies safe, building confidence, teaching kids with allergies how to speak up and stay safe. I think Laurel said that is what her child learned to do very early on. Being inclusive, howling that having Allard — being inclusive, having allergy-safe areas in the classroom. Cleaning hands well before and after meals, and celebrating in a way that includes everyone.

Removing the bullying, making sure that teasing or bullying about food allergies is just not allowed in a school setting. Finding that good support, helping kids connect with friends and groups of students that can help promote awareness and education and understanding about food allergies. I love a back-to-school checklist. Here is one that is published by the allergy and asthma network that talks about things you can do before the school year begins like right now and when school starts, so key things you can do right now is making that important — making that appointment with your health care provider. Getting that allergy action plan. Talking about if you need a 504 plan in place, talking about what you will do if your child has a life-threatening allergic reaction. Making sure that prescription for epinephrine is up-to-date. Making sure they have everything they need so when they go back to school in the fall, they are ready to go, and when school starts, again, talking to the school nurse or administrative about what to do if life-threatening anaphylaxis takes place.

Making sure allergy anaphylaxis medication forms are in the hands of the staff they need to be in and I would take checking throughout the year and encouraging your child to participate in all activities. The take-home message is here and hopefully this has been informative for everyone in the webinar today. The take-home message is just to have an emergency care plan in place. This may include a section 504 plan and a food allergy and anaphylaxis care plan. This may involve communicating with your provider, your physician, your school nurse, your teacher, your staff, and even other administrators during the school. Keeping in caring for epinephrine correctly during the school year will be chief in ensuring efficacy in a life-threatening situation. Implementing initiatives and fostering a healthy culture of understanding, inclusivity, schools and communities can significantly reduce the risk of stigma that we really don’t want to be associated with food allergies. It can create a safer and more supportive environment for the child who has food allergies and for everyone else as well. We really thank you for your time and attention for today’s webinar, and I would like to hand it back over to Ruthie for the Q&A session.

Ruthie: Thank you so much. It was super insightful pier and myself as a parent — as I mentioned, my daughter is 2. We are not school-aged yet, but there is a question in the chat about 504 plans carrying over into afterschool programs or even day cares. We will start with that question. How should a parent or caregiver prepare for that. Laurel, feel free to chime in to any of these areas. You are both experts. How would a parent address 504 plans in afterschool daycare?

Dr. Burnette: Laurel, do you want to step in and give your thoughts?

Laurel: Sure. If it is a program associated with the school, then 504 applies, but if it is a private program, the ADA may still apply, so you may still be able to get accommodations for an afterschool program even if it is separate from the school. Another big topic people talk about is PTO, if PTO things must be accommodated. There is actually a test records used to determine if a PTO activity is considered part of the school day. You look at things like does the school advertise a PTO event? Do they use the school facilities at a discount or for free? If a PTO event meets the criteria, then it must also be accommodated under a 504 plan.

Dr. Burnette: PTO is parent teacher organizations?

Laurel: Yes.

Ruthie: Any thoughts on that?

Dr. Burnette: I think the specifics in any type of private setting, particularly at a cap type of setting, I would agree. You just have to check and see what their policies are, state laws. Again, ADA can be brought into the fold with those conversations, particularly the students who really have unique and special needs for their own particular food allergy situation.

Ruthie: There is another question in the chat regarding what are the most important key points as far as getting a 504 plan implemented?

Dr. Burnette: The application process, is that what it is referring to?

I believe so.

Ruthie: I believe so, if you want to talk about the application and then Laurel can talk about her lived experiences but also her knowledge base.

Dr. Burnette: It does have to be requested. It is not automatically replaced on a child. It may require the school principal or whoever the staff administrator person is which could be the 50 four coordinator, to talk about the child’s situation. It will most likely be a meeting that needs to be set up and most likely a form to fill out. It likely will inform the diagnosis and allergy and food action plan provided by the physician or health care provider.

Laurel: There is what is called child find, so a school does have an affirmative obligation to find children they think would qualify for a 50 four plan, so the burden really is on the school to reach out to the parents. But what happens is the schools don’t do that, so parents end up having to do it anyway, but legally, schools do have to reach out and find students who might be eligible.

if they give the school nurse and epinephrine device, is that one of the ways they can find a child, so to speak?

That should trigger the administration to say, oh, we have a child who needs a 504 plan.

Ruthie: That is learning for all of us trying to navigate this, especially at — as the school year approaches. Question four Laurel regarding how did you address, how have you addressed, how do you recommend addressing either bullying or anticipating bullying under the 504 safety section?

Laurel: That can be addressed in a 504, but schools should have their own independent bullying policy that would apply. One of the things I recommend for children in younger grades, for instance, is teaching other children about food allergies. Maybe having in health class a section about bullying and food allergies. The more I think kids are educated about it and understand it, the more compassion they will have. But, yes, the 504 can address bullying. You can say if your child is being bullied, they have the right to get up and talk to an adult or other things, but the school itself should also have a robust bullying policy.

Ruthie: Thank you for that. There’s another question regarding the transferability. You both touched on this briefly, but if the child is moving from elementary to middle school, middle school to high school — how does that work as far as making sure that 504 accommodation transfers with the child?

Dr. Burnette: Some schools are tethered together in terms of the same school policies, but I would assume if these are totally separate schools, they would have to — most likely, if it is a totally separate institution, they would have to probably follow the same steps again, I am assuming. Laurel, what are your thoughts?

Laurel: Going to another school, the 504 stays in place until another one is implemented. If you are going, let us say, from middle school to high school and the school year starts and you have not had a chance to have a 504 meeting, the old 504 does transfer over, but the school does have an obligation to have another meeting and to sit down and go over the accommodations. I think somebody said in the chat the difference between elementary and middle and high school. Obviously, your child’s needs will change as they get older. In the earlier grades, you might be concerned about everybody touching everything and peanut butter smearing on people. When your child gets older, you may not have to worry as much about that. They may be able to sit at a regular table rather than an allergen-free table, so the accommodations will change as the child grows.

Dr. Burnette: And the allergy action plan would change, especially if they are able to carry and epinephrine device, but what if they are changing schools altogether?

Laurel: Same thing. 504 applies.

Dr. Burnette: So even if it is a whole different school, it should stay in place?

It does.

Dr. Burnette: That is actually good to know. It is less work for the families.

Ruthie: We will take a couple more questions before we wrap up today. One is still related to food allergies but more so in the realm of travel and food allergies. Laurel, do you have any thoughts around this? With your son, did you do a lot of traveling with your son?

Laurel: The main thing is flying that I think people are afraid of because you are in a confined space. Unfortunately, there are not many protections for people with flying. The Americans With Disabilities Act does not apply when you are on a plane. There’s another law, open air carriers access act, which does protect people with disabilities, but it is a lot less robust than the APA, and usually, parents cannot sue under the air Carrier Access act . Also, there are provisions in the budget for the Detroit — Department of Transportation that says peanut bands — peanut than — peanut bans and buffer zones cannot be implemented. But you do have the right to pre-board and wipe down the surface where you sit down, and I recommend everybody do that. There was an independent study where they found something like 60% of airline trays had Mercer — had MRSA on them, so it is a good idea for everyone to wipe here the problem now is people saying I have an allergy and the pilot saying OK, you are not allowed to fly now. You are too much of a risk. That should not be happening, but that has been happening lately, so that is my next case is somebody who has been denied flying for their food allergy. They don’t do that for other people. They don’t say if you have a heart condition, you might have a heart attack, so you cannot fly.

All of the airlines have different policies?

they do, yeah. You have to talk to the airline. Another thing is the Department of Transportation. If you have a problem, let’s say they don’t accommodate you on a flight and you file a complaint with the Department of Transportation, which is pretty much the only recourse, the Department of Transportation keeps track of those complaints, and there is a website. You may have to search for it, but the Department of Transportation keeps track of complaints for all the airlines and one of the categories is allergies, so you can kind of look and say, Gee, this airline has had 100 allergy complaints in the last year where is this one has had only two. You can say maybe this airline is better for allergies than this one because they have fewer complaints. That’s just a little trick I tell people, and it is all public information. The Department of Transportation.

Ruthie: We will take one more question, and I will kinda pose it to both of you. Whoever would like to answer or if you would both like to answer. It is regarding if you have any suggestions regarding emergency plans for young children that cannot self carry who are bus riders and to that same note, what is an appropriate age recommended to self carry epi-pens?

Dr. Burnette: Well, I don’t know the bus laws. Maybe you can help with where a device would be in a secure location on a child’ a school bus, but the age question will vary on the child and the level of functioning of the child. That would be based on probably more so parent/physician type of interactions. And obviously, when someone gets a prescription for an epinephrine device, they are trained on how to use that device. It would be after that child is trained and competent and is ready, is what I like to call it. They may be trained, they may be competent — Ruthie: We lost her audio, Dr. Burnette. — we lost your audio. Do you want to talk, Laurel, while she gets back?

Laurel: Under a 504 plan, they do have to accommodate for that. Some states require that bus drivers be trained in the use of epinephrine. In Massachusetts, there was a recent law that people who get their bus license I think from 2010 on have to be trained in epi-pen administration, but a big issue that I hear from schools is they will say, we have a separate contract. It is a third party bus company, and we cannot tell them what to do. Number one, yes, you can. You can tell them what to do. Second, if you cannot tell them what to do, then have an aide or a teacher or somebody there who is able to give epinephrine because the school is obligated to make sure that that ride is safe for your child.

Ruthie: Thank you. Thank you so much, for both of you. It truthfully has been a great presentation. We had a lot of great questions coming in. If you joined late, you’re still here, just know that this webinar was recorded. A lot of the questions came through at the end had previously been addressed, so please refer back to that recording. It should be available on our website in a matter of days. Zoom will also email you with a link to the recording and evaluation. We do want to mention that we have an upcoming webinar next month on August 26 at 4:00 p.m. Eastern, understanding and managing contact dermatitis. Definitely register for that. A big thank you to Dr. Burnette and to Laurel for being here today for imposing your wisdom and answering your questions. And a big thank you from the Allergy & Asthma Network and to ARS for cosponsoring. Thank you both.