A 504 plan establishes accommodations than can make it easier for a kid with juvenile arthritis (JA) to get through school day. The name refers to Section 504 of the Americans with Disabilities Act of 1974. It requires schools – elementary, secondary, post-secondary and colleges – that receive federal money to create a level playing field for all students to succeed. Part of the way to do that is by accommodating kids with disabilities, a category that includes chronic diseases such as JA.

Accommodations can range from giving kids more time to take tests to letting them use a laptop instead of handwriting answers. Kids with limited mobility may be placed in adaptive PE classes where they can modify exercises; those who need medication during the day can have it dispensed. And most important for kids with JA, a 504 plan can allow them to make up work missed during a flare.

“In general,” says Colleen Ryan, who’s had a plan in place since her daughter Caitlin, now 11, entered first grade, “parents can request anything that would help their own child participate more fully and comfortably – as long as it does not involve additional costs to the school.”

Here’s a sample of 504 accommodations from kids who have JA.

How to Set Up a 504 Plan

Spring: Everybody associates planning for the school year with fall, but Ryan says spring is the ideal time to lay the groundwork. Chances are you’ll already be going to an open house for the upcoming academic year to meet teachers and check out the classrooms. This is a perfect time to introduce yourself to your child’s teacher (or teachers, for older kids) and get a feel for the rooms he’ll be in and the movements he’s going to have to make throughout the day. Ryan suggests scheduling a follow-up meeting with the teacher in the last few days of the school year; they’ll be a little less stressed and have more time to listen.

Fall: The next step in enacting a 504 plan involves a meeting of the district’s Committee for Special Education (CSE), which determines students’ eligibility for the 504 plan and its close cousin, the IEP, which usually applies to kids in special education programs. Every school district has different eligibility criteria, but most require an initial meeting with teacher, school officials, parents, and – ideally – a member of the child’s medical team. Request the 504 plan meeting as early as possible in the school year, says Ryan; districts have 30 days to make a ruling.

Frawley, a former special ed teacher, says the application process for Brendan, who was diagnosed with JA in the fall of his junior year, went smoothly. She presented a letter stating his diagnosis and his physician’s projected outcomes. The doctor also suggested accommodations, such as allowing Brendan to take breaks if schoolwork involved extended note-taking or typing, and providing him with physical therapy every other day.

“You can’t overbuild the 504 plan if you’re starting from scratch,” says Frawley. “Better adding too much than not enough and taking something out if you found you never used it.”

Winter: A mid-year review session can provide parents an opportunity to amend the plan. It’s also useful if a child has new teachers or new classes due to a semester schedule change, or if there have been substantial changes to her medical care plan. Frawley says monthly reviews aren’t uncommon for parents whose kids are newly diagnosed, working out treatment regimens or undergoing extensive medical care such as surgeries.

A Plan for All Seasons

Some items on a 504 plan might be tied to specific times of year. As cold weather approaches, for example kids – especially younger ones – will need more time to get in and out of heavy coats and hats. “I have also heard of parents requesting permission for their child to wear heated gloves or use rice packs that can be warmed in a classroom microwave to soothe inflamed hands during cold weather,” Ryan says.

Cold and flu season raises additional concerns. Ryan suggests asking that a child with a compromised immune system be allowed to keep hand sanitizer at her desk. A 504 plan can require that kids who do get sick be provided notes and allowed to make up missed assignments and tests.

During warm weather, PE classes may move outside. Kids whose medications (NSAIDs, methotrexate) make them sensitive to sunlight, Ryan says, may need to be allowed to wear sun hats and get extra time to apply sunscreen.

Spring brings academic concerns. Older students when who are planning to take college entrance exams such as the SAT or Advanced Placement tests can request accommodations. Frawley says Brendan was allowed to go to another room and write his essay questions on a laptop. The College Board, which oversees the exams, requires separate requests for each; she recommends starting the application process early in the second semester.

Extracurricular Activities

While the 504 plan is for academic considerations, kids who are able to participate in activities that involve actual classes – such as choir or, in some cases, band – can include accommodations in the 504 plan. A choir student, for example, might be allowed to sit during class while other students stand on risers to practice a song.

And while sports may not be the first activity to leap to mind for kids with JA, many do take part in everything from swimming to soccer. Frawley says Brendan played both soccer and baseball before and after his diagnosis. While working out the 504 plan, his physical therapist met with the school’s coaches to work out a modified training plan. If the rest of the team was running laps, Brendan, who had trouble with his knees, was allowed to ride a comparable distance on a stationary bike.