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CHILDREN WITH DISABILITIES AND  

SPECIAL DIETARY RESTRICTIONS

A. Rehabilitation Act of 1973 and the Americans with Disabilities Act

Under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act Amendments Act (ADAAA)  of 2008, “a person with a disability” means any person who has a physical or mental impairment which substantially  limits one or more major life activities or major bodily functions, has a record of such an impairment, or is regarded as  having such an impairment.

Major life activities include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating,  sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking,  communicating, and working. A major life activity also includes the operation of a major bodily function, including but  not limited to, functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain,  respiratory, circulatory, endocrine, and reproductive functions.  

Please refer to these Acts for more information at http://www.dol.gov/oasam/regs/statutes/sec504.htm and  http://www.eeoc.gov/laws/statutes/adaaa.cfm, respectively.  

B. Individuals with Disabilities Education Act

A child with a “disabilityunder Part B of the Individuals with Disabilities Education Act (IDEA) is described as a child  evaluated in accordance with IDEA as having one or more of the recognized thirteen disability categories and who, by  reason thereof, needs special education and related services. The IDEA can be found in its entirety at  http://nichcy.org/wp-content/uploads/docs/IDEA2004regulations.pdf.

The Individualized Education Program (IEP) is a written statement for a child with a disability that is developed,  reviewed, and revised in accordance with the IDEA and its implementing regulations. When nutrition services are  required under a child's IEP, school officials need to make sure that school food service staff is involved early in  decisions regarding special meals. A copy of the completed Dietary Request Form (page 2 of this document) must be  kept on file to support any modifications made to students’ meals, even if they are detailed in the IEP.

C. Medical Practitioner’s Statement for Children with Disabilities

U.S. Department of Agriculture (USDA) regulations 7 CFR Part 15b require substitutions or modifications in school  meals for children whose disabilities restrict their diets. A child with a disability must be provided substitutions in foods when that need is supported by a statement signed by a medical practitioner. The practitioner’s statement must  identify:

the child's disability;  

an explanation of why the disability restricts the child's diet;

the major life activity operation of a major bodily function affected by the disability; and the food or foods to be omitted from the child's diet and the food or choice of foods that must be substituted.

This form may be used to obtain the required information from the medical practitioner.

“Practitioner” is defined by Wisconsin State Statute 118.29(1) (e): “Practitioner” means any physician, dentist,  optometrist, physician assistant, advanced practice nurse prescriber, or podiatrist licensed in any state. Unless the  documentation to support the required dietary accommodation has been signed by one of these practitioners, the  school is not required to accommodate the request.

D. Other Special Dietary Needs

School food service staff may make food substitutions, at their discretion, for individual children who do not have a  disability. The school should have a completed Dietary Request Form (page 2 of this document) on file from any medical authority certifying the student as having a special medical or dietary need. Such determinations are only  made on a case-by-case basis and all accommodations must be made according to USDA’s meal pattern  requirements.

For more information, please see the USDA guidance: Accommodating Children with Special Needs: Guidance for  School Food Service Staff at http://www.fns.usda.gov/cnd/Guidance/special_dietary_needs.pdf.

This institution is an equal opportunity provider.

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Dietary Request Form

Please read page 1 before completing this form.

Student’s Name Student’s PIN/ID Number Age* Name of School* Grade Level* Classroom*

*Please include information that is accurate as of the time of this form’s submission.  

1. Does the child have a disability according to 7 CFR Part 15d that requires accommodation? (Does he/she have “a physical  or mental impairment which substantially limits one or more major life activities”?)

No (Districts have the discretion as to whether non-disability requests will be accommodated.)See Section D, page 1 Yes a) What is the disability? ____________________________________________________ b) What major life activity is affected? ___________________________________________

c) How does the disability restrict the diet? _______________________________________

2. Please complete all of the sections below that are applicable to the child.

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What food(s)/type(s) of food should be omitted? Please be specific.

List foods to be substituted. (Avoid specific brand names, if possible.)

 

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Please describe any modifications necessary to accommodate the child’s needs.

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The child requires that all foods be:

Pureed

Diced/finely ground

Chopped/cut into bite-sized pieces

Liquids should be:

Pudding thick

Honey thick

Nectar thick

Thin/normal consistency

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What food(s)/type(s) of food should be omitted? Please be specific.

List foods to be substituted.

3. Additional comments:

Parent’s Signature Date Parent’s Name (Please Print) Phone Number

Signature Below Required for Disabilities(See section C, page 1)

Medical Practitioner’s Signature & Date

Medical Practitioner’s Name, Title, & Phone Number (Please Print)

Signature Below Required for Non-Disabilities(See Section D, page 1)

Medical Authority’s Signature & Date

Medical Authority’s Name, Title, & Phone Number (Please Print)

This institution is an equal opportunity provider.

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