Are schools doing enough for food-allergic kids?

May 11, 2009 Volume 6 Issue 3
  • About one-quarter of parents know of a child with a life-threatening food allergy in their children's school or daycare.
  • About three-quarters of parents who know of a food-allergic child say their children's school/daycare makes accommodations for children with food allergies.
  • About one-half of parents who know of a food-allergic child do not find it inconvenient to make accommodations for children with food allergies.

In recent years, media and medical attention has turned to emerging concerns about life-threatening food allergies in children. What has received comparatively little notice is what actions schools are taking to manage the problem of children’s food allergies.

The C.S. Mott Children’s Hospital National Poll on Children’s Health asked parents with children age 0-13 years about food allergies and what their children’s daycare/preschools and elementary schools are doing to accommodate children with food allergies.

Children with Food Allergies

In this Poll, 3% of parents report having a child in their family who has a life-threatening food allergy.

Among families, 22% of parents with a child in daycare/preschool and 25% of parents with a child in elementary school report knowing a child with a life-threatening food allergy in their children’s school setting.

Accommodations in School Settings

Parents who knew of a child with a life-threatening food allergy were asked whether schools had accommodations for food allergies, including: bans on treats/food brought from home, a posted or required food allergy plan, separate eating areas for children with food allergies, staff training for food allergies, or special classroom assignments.

Overall, 83% of parents report that their children’s daycare or preschool provides one or more accommodations for children with food allergies. 79% of parents report their children’s elementary schools provide accommodations (Table 1).

Bans on treats or food brought from home were the most common accommodation— with nearly two-thirds of parents indicating their children’s daycare or preschool has this policy and one-half indicating their children’s elementary school has this policy (Table 2).

Posted or required food allergy plans and special classroom assignments were more common in daycare/preschool than in elementary settings. Conversely, separate eating areas were more common in elementary school than in daycare/preschool (Table 2).

Staff Training For Food Allergies

About one-half of parents indicate that their children’s daycare, preschool, or elementary school has staff training specifically for food allergies (Table 3).

Acceptability of Accommodations

Among families with food allergic children, one-half of parents believe that others at school accommodate their children’s life-threatening food allergy “very well” and 44% of parents say their children’s food allergy is “somewhat” accommodated.

Nearly one-half of parents without food allergic children say it is “not at all inconvenient” to make accommodations with food or the handling of food at the request of a school or food allergic family. About one-quarter say it is “somewhat inconvenient” and few say that it is “very inconvenient (Figure 1).

Implications

Based on this Poll, children in 3% of US households are affected by life-threatening food allergies. This is consistent with other studies of food allergies. As a result, about one-quarter of parents in the US are aware of food-allergic children in their own children's school settings.

This is the first assessment of parents’ perceptions of school accommodations to the problem of food allergies. Many schools and daycare settings appear to have incorporated one or more food allergy accommodations. Most parents of food-allergic children feel that their children’s schools have at least somewhat accommodated their children’s needs.

But how do the parents without food-allergic children feel? Many such parents feel that the schools’ accommodations have not been inconvenient, or that they have not had to make changes to their usual food routines. Nevertheless, about one-third of parents reported that it was inconvenient to make accommodations for food-allergic children; this raises concerns about potential obstacles to expanding accommodations to other daycares and schools that have not yet adopted them. Further work by advocacy groups and educational information will need to reach out to all community members to improve the perception and impact that food allergies can have on individuals and families.

Increasing staff training may be the greatest opportunity to enhance schools’ response to food-allergic children. School nurses or community health professionals could disseminate messages and training regarding effective food allergy responses. In the past, the burden of enhancing awareness and preparedness at the school level has often fallen on affected families. With food-allergy prevalence at current levels, health care workers and school personnel can be asked to fill this need instead.

At the intersection of health and education, the needs of food-allergic children are leading to fundamental changes at daycares, preschools, and elementary schools. The attitudes of parents without food-allergic children may strongly influence how quickly schools adopt food allergy policies in the future.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc, for C.S. Mott Children’s Hospital via a method used in many published studies. The survey was administered in January 2009 to a randomly selected, stratified group of parents aged 18 and older (n=1,552) from the Knowledge Networks standing panel that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 62% among parent panel members contacted to participate. The margin of sampling error for this sample is plus or minus 3 to 7 percentage points. For results based on subgroups, the margin of error is higher.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Faculty Collaborator: Harvey L. Leo, MD
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH

This Report includes research findings from the C.S. Mott Children's Hospital National Poll on Children's Health, which do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.

1. Please provide information on each child age 17 or younger in your household for which you are the parent, step parent or guardian:

Child Age (begin with oldest child) Gender In general, how would you rate this child's health? Does this child have a regular health care provider? Does this child have asthma?
1  
  • M
  • F
  • Excellent
  • Very Good
  • Good
  • Fair
  • Poor
  • Yes
  • No
  • Yes
  • No
2  
  • M
  • F
  • Excellent
  • Very Good
  • Good
  • Fair
  • Poor
  • Yes
  • No
  • Yes
  • No

 

This next set of questions is about food allergies.

2. Please indicate the type of school your child(ren) attend and if they have a food allergy?

Populate row(s) in this column with child gender and age from Q1 2a. What type of school does this child attend? 2b. Does this child have a life-threatening food allergy?
 
  • Daycare/Preschool
  • Public school
  • Private school
  • Home school
  • Does not attend school
  • Other [write-in]
  • Yes
  • No
 
  • Daycare/Preschool
  • Public school
  • Private school
  • Home school
  • Does not attend school
  • Other [write-in]
  • Yes
  • No

[If Q2b = Yes then Q2d.]
[If more than one child with life-threatening food allergy, then insert a Q2d for each child with a food allergy]

2d. How do you know that your [insert age of child]-year-old’s food allergy is life-threatening?

  • S/he developed immediate (within 1 hour) hives, rashes, vomiting, coughing, wheezing, or itchiness
    • Yes
    • No
  • S/he had allergy testing (Skin Prick Testing)
    • Yes
    • No
  • S/he had blood work that suggested an allergy
    • Yes
    • No
  • The doctor recommended having an EpiPen/Twinject or other rescue medication
    • Yes
    • No

[If Q2a=daycare/preschool, then Q3a]

3a. Do you know of a child with a life-threatening food allergy in your child’s daycare/preschool?
(Do not include your own child(ren) if they have a life-threatening food allergy.)

  • Yes
  • No

[If Q2a=public school or private school, then Q3b]

3b. Do you know of a child with a life-threatening food allergy in your child(ren)’s school?
(Do not include your own child(ren) if they have a life-threatening food allergy.)

  • Yes
  • No

[If Q2a=daycare/preschool, then Q4a]

4a. Does your child’s daycare/preschool have any of the following because of food allergies?

  • Separate eating areas or accommodations
    • Yes
    • No
    • Don’t know
  • Special class/room assignment due to allergy
    • Yes
    • No
    • Don’t know
  • Ban on treats or foods brought from home
    • Yes
    • No
    • Don’t know
  • Training of staff in food allergies
    • Yes
    • No
    • Don’t know
  • Posted or required food allergy plan
    • Yes
    • No
    • Don’t know

[If Q2a=public school or private school and child age = 5-13, then Q4b]

4b. Does your [insert age of youngest child 5-13]-year old child’s school have any of the following because of food allergies?

  • Separate eating areas or accommodations
    • Yes
    • No
    • Don’t know
  • Special class/room assignment due to allergy
    • Yes
    • No
    • Don’t know
  • Ban on treats or foods brought from home
    • Yes
    • No
    • Don’t know
  • Training of staff in food allergies
    • Yes
    • No
    • Don’t know
  • Posted or required food allergy plan
    • Yes
    • No
    • Don’t know

[If Q2b= yes and Q2a = private or public school then Q5]
[If a parent has more than one-child with a life threatening allergy, repeat this question and insert the age of the next child with a life-threatening food allergy]

5.  How well have parents and other children at your child’s school accommodated your [age of child with life threatening food allergy]-year old child’s life-threatening food allergy?

  • Very well
  • Somewhat
  • Not very well
  • Not at all

[If Q2b= Yes and Q2a = daycare/preschool then Q5a]

5a. How well have parents and other children at your child’s daycare/preschool accommodated your child’s life-threatening food allergy?

  • Very well
  • Somewhat
  • Not at all

[For ALL PARENTS, except those where Q5b = yes]

5b. How inconvenient is it for you to make changes with food or the handling of food at the request of a school, community event, or food allergic family?

  • Very inconvenient
  • Somewhat inconvenient
  • Not at all inconvenient
  • Have not had to make any changes

Participants were also asked demographic questions on age, gender, health status, annual household income, education, race/ ethnicity and health insurance status.

All information is the sole property of the University of Michigan CS Mott Children's Hospital National Poll on Children's Health.  It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Faculty Collaborator: Harvey Leo, MD
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MS

Click on an image to download the full-size version

Parent report of accommodations for food allergies in schools
Specific accommodations for food allergies in schools
Staff training for food allergies
Parent report of inconvenience with making accommodations for food allergies

Contributing Faculty

Harvey L. Leo, M.D.

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