From the Allergic Living archives. First published in the magazine in 2009.
Alarm bells went off for Sarah Cameron* that day in 2008 when her 8-year-old daughter came home from school in a state of high agitation. There had been an incident during lunch break. The girl recounted how one of two Grade 6 monitors supervising the kids in her classroom had ordered her to sit at a desk out in the hallway, and to eat there by herself.
She was indignant and didn’t know what she’d done wrong. “They can’t treat me this way,” she said.
Her mother wasn’t pleased to hear of a student disciplining another student, but she had a more immediate concern. Her severely peanut-allergic daughter had been alone while eating.
“Where was your EpiPen?” Cameron asked. The reply: “In my backpack.” And where was that? “In the classroom.”
“If she’d had a reaction in the hall, no one would have been there to help her,” says Cameron. The previous fall, Cameron first learned that adults weren’t supervising the lunch breaks at the Ottawa public school. Instead, pairs of Grade 5 or 6 students oversaw the younger children as they ate at their desks. In case of an emergency, these monitors would have to run and seek out an adult.
Thousands of miles west, in Victoria, B.C., Caroline Posynick can relate. She became a convert to allergy advocacy in 2006 over the issue of student lunch-monitoring.
She had been blissfully unaware that, in a school that ran from kindergarten through Grade 7, lunch for younger grade children was supervised by kids from the eldest grade. She also didn’t realize that the teacher had decided to keep her son Griffin safe by isolating the 7-year-old at the crafts table.
On Valentine’s Day in 2006, “my son was sitting at this special table. A kid who was really, really active got up and put some peanut butter on his finger and then put it on Griffin’s arm,” Posynick says. “He wanted to see what would happen. This occurred with kids watching kids, so they couldn’t stop it.”
There was panic in the room, Griffin froze, and the monitors hustled him off to the teachers’ staff room to get his arm washed.
When Posynick and her husband got to the school they found Griffin with a huge hive on his arm. Benadryl was enough to handle the contact reaction. But the boy’s sense of upset did not go away nearly as quickly.
Incidents with lunch supervision are not hard to find among the parents of food-allergic children. They illustrate that, for all of the advances such as Sabrina’s Law in Ontario (an act to protect anaphylactic pupils) or B.C.’s ministerial framework on anaphylaxis, and for all the allergic community’s advocacy on risk reduction and readiness for emergencies, gaps remain in the protection of food-allergic children.
Within Canada’s public elementary schools, there’s a patchwork of student monitors and adult lunch supervisors, but even with the latter, the person in sight line of the child may not be trained on giving an epinephrine auto-injector. Who’s watching the kids depends on a school board’s policy and then, in turn, on how an individual principal handles (and applies budget to) lunch supervision at his or her school.
For instance, in Vancouver, the norm today is paid lunch assistants, but a ferry ride away in Victoria, students not old enough to babysit frequently patrol lunch in the class.
In 2005, Anaphylaxis Canada did a survey of its online registry about allergy policies in Canadian schools. Of the 678 parents who responded about their child’s public elementary school, 28 per cent said the school relied on student lunch monitors, 43 per cent said school staff supervised (sometimes in combination with students) and 33 per cent had paid lunch supervisors. At some schools, there were also a small percentage of parent volunteers assisting.
Most public elementary students (73 per cent) ate lunch in their class as schools often lacked the space for lunchrooms. “You do have to consider what the principals are dealing with,” notes Laurie Harada, executive director of Anaphylaxis Canada. “They’ve had cutbacks, the best that many principals can do is to have someone to wander the halls and poke their head in and monitor the kids.” That said, she adds: “too much of this is ad hoc, and schools need to think through this.”
U.S. ‘All Over the Map’
In the United States, student lunch volunteers are less the issue, but again – despite a growing number of anaphylaxis laws among the states, there are gaps. Lunch is usually eaten in a cafeteria or lunchroom, making it possible for fewer adult eyes to survey a larger group of kids.
Yet anaphylaxis prevention practices and auto-injector training can vary from district to district, and cafeteria to cafeteria.
Lunch supervision “is an all over the map situation in the U.S.,” says Deb Scherrer, vice president of education for the Virginia-based Food Allergy & Anaphylaxis Network. “Sometimes it’s a teacher, sometimes it’s a food service worker, sometimes it’s a parent – it may be paid staff or volunteer.”
*Name changed by request.
But in her discussions with literally thousands of parents of food-allergic kids, “I haven’t heard of situations where a child supervising lunch.”
A recent University of Michigan poll found 79 per cent of parents of food-allergic elementary pupils reporting some accommodations for their allergies, but a designated eating area (within a lunchroom) for those with allergies was only reported in 28 per cent of the schools.
Scherrer says FAAN hasn’t gathered information on the specific topic of lunch aides and their training, and Allergic Living’s inquiries prompted her to suggest that the organization may look into this important area.
During its research, Allergic Living heard from parents across the continent. Some U.S. parents mentioned parent lunchtime volunteers and expressed concerns that they don’t know enough about anaphylaxis.
One Pennsylvania mother, whose child has multiple allergies including milk, wheat, peanuts and tree nuts, said the paid lunch aides at her son’s school were not trained on anaphylaxis or use of an auto-injector and, “even if they were, I don’t think the school administrators would have trusted them enough to keep an eye on my son.”
Complicating life, despite this mom’s repeated training, her son has been inclined to take risks, such as eating a candy he “thought” was safe. The solution she turned to was to get her son qualified under Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination on the basis of disability. In cases of food allergy, that designation is only permitted for those whom a physician has assessed as at risk of severe anaphylactic reaction.
To accommodate this boy under his 504 plan, the school assigned a specials needs assistant (who works with children with all manner of disabilities) to watch him as he ate. To the Pennsylvania mother’s great relief: “she got the whole allergy thing right away.”
But getting a 504 designation can be difficult. Allergic Living heard from one Missouri woman whose family is in a messy wrangle over the local school district’s refusal to view her daughter’s severe food allergies as a disability and make accommodations. While the whole topic of “allergy as disability” is controversial, it has been one means of securing allergy provisions. T
o get a sense of how heated this topic gets, the Missouri woman stressed: “I do not want to publish anything specifically about our school district situation. I will not give them anything that they can come back and sue us with.”
It’s tough to find common ground with school administrators once relations are strained. But it’s certainly wise to find out who is watching lunchtime and snacking at recess, especially when dealing with young children. Harada recommends including a few questions about who’s in charge of kids at lunch during start-of-school-year talks about your child’s anaphylaxis plan.
Don’t simply assume that lunch supervisors with food allergy training are covered under a school’s allergen prevention measures. Even in Ontario, which introduced the precedent-setting Sabrina’s Law to protect anaphylactic students, a Ministry of Education spokesman stresses that, “supervisory duties are assigned by the principal to meet the needs of a school.”
At the local level, there can be big differences. In Canada, there are two categories of student monitor systems, those in which one or two teachers or paid staff circulate among the classes in the hallway and those in which monitors are simply instructed to find a teacher or staffer in the office.
When it comes to adult supervision, a minority of districts have teachers minding lunch. With budget cuts and restricted supervision minutes in teacher contracts, this is often not possible. Other options are parent volunteers or paid, part-time lunch aides.
A drawback to the latter, as the Pennsylvania mom mentions, is the variance in the ability to grasp or contend with anaphylactic emergencies. One option that appears to be popular among both parents and principals is extending the duties of education assistants (or special needs aides) to cover lunch supervision.
In Ottawa, members of the Ottawa Anaphylaxis Support Group would be thrilled to have EAs keeping an eye on meals. On behalf of OASG, parent Scott McKenzie presented concerns to the Ottawa-Carleton District School Board about anaphylaxis procedures, stressing the safety issues with student lunch monitors.
The board conducted a review of several jurisdictions, and found EAs definitely a popular, if somewhat pricey option. This fall, the board will consider recommendations from this review.
McKenzie says something has to give on the subject. He and his wife have two daughters, the younger of whom, Taya, has multiple allergies including peanuts, nuts, dairy and eggs. At lunch one day, another child’s parent brought in a cake, and the monitors dished it out. Fortunately, 7-year-old Taya turned down her slice – saying she didn’t know what was in it.
“This seems like an accident waiting to happen,” says McKenzie of the level of supervision. “There is going to an accident with food, the monitors aren’t going to know what to do. Then people are going to say [to the school]: ‘how could you have let this happen?’”
It is the informed parents, like him, like Cameron, Posynick and the Pennsylvania mom who are trying to prevent “that” from happening. Through her lobbying efforts, Posynick was able to get adult lunch supervision for his son.
But it took being “a squeaky wheel” she says, reminding that you can’t assume; you need to ask for the facts before the kids pull out their lunchboxes.
With files from Colleen Seto
See Fall 2010 update on Ottawa school board policy .
Also featured in Fall 09 issue: related article on school lunch supervising policies in several cities.
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