Photo courtesy University of Michigan Transportation Research Institute

Photo courtesy University of Michigan Transportation Research Institute

The American Academy of Pediatrics (AAP) has released a policy statement that provides updated guidance on protecting students with special healthcare needs.

Published in the May 2018 issue of the journal Pediatrics, “School Bus Transportation of Children With Special Health Care Needs,” by Joseph O’Neil and Benjamin D. Hoffman of the AAP Council on Injury, Violence, and Poison Prevention, gives guidance for planning safe transportation for students with special needs, and offers recommendations and considerations to the student’s primary care provider for safe transportation.

The statement notes the importance of discussing transportation issues and documenting appropriate transportation plans during the student’s annual Individualized Education Program meeting. The statement advises that all parties involved in the education and care of the student should be included to provide optimal input into the transportation process. Routes, proximity to first responders, and emergency plans should be discussed with school administrators, transportation directors, and the bus driver, in collaboration with the student, family, school nurse, primary care provider (if possible), teacher, and aides.

“Transportation staff who work with children with special needs can effectively conduct their daily responsibilities when provided with appropriate, documented training from the team of professionals,” the authors note in the introduction to the statement.

All students should be transported safely to school in accordance with best practice guidelines, the statement advises. For example, any student who can transfer from a wheelchair should be transported in a school bus seat, because the best seating system is the school bus seat with a harness system that is appropriate for size and physical/developmental condition.

For children who are too heavy to be transferred or who cannot otherwise do so, a transit-ready wheelchair that meets WC 19 standards may be used correctly anchored to the school bus, according to the statement. The student should be restrained appropriately in the wheelchair with a postural support, if needed, and a bus-mounted lap-shoulder belt appropriately applied. Transit option wheelchairs are crash tested, and these seats meet voluntary standards for safety.

Any equipment needed to safely transport the student should be stored during transport in a manner consistent with the wheelchair manufacturer and the bus manufacturer and school district rules and regulations. Lap tables should be removed from the chair and stored properly, since they could injure a student during a crash.

Additional details in the considerations listed in the statement include providing a school nurse or trained aide when medically necessary to attend to health-related problems; being aware of the local and state regulations and the local school limitations and resources for administering rescue medications; and procedures that caregivers should follow to prevent infections when providing direct care for students with tracheostomy and gastrostomy tubes.

A copy of the policy statement can be downloaded here.

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