Daycares and schools
When an HIV-positive child is enrolled in daycare or school, there are many
different issues to take into consideration. Due to
confidentiality, you cannot disclose the child's HIV infection to the
care provider unless you have completed an adoption of the child.
In cases where confidentiality is an issue, although you cannot
disclose what illness the child has, you can explain to the school or
daycare that certain precautions need to be taken to protect the health
of the child. Some school districts put 'health plans' into place
which do not necessarily disclose a child's diagnosis but address the
ramifications of the illness.
For example, children with HIV are more susceptible to common
illnesses, and certain illnesses can be life-threatening. If
available in your district, you will want the child to have a health
plan that addresses what will happen should there be an outbreak of
chicken pox, the flu, or any other potentially threatening illness.
You will want to request that you be notified by the school when there
is an outbreak, and at that time you and the school would decide
whether it requires the child to stay home until the outbreak dies
down.
Additionally, children with HIV sometimes tire easily and do not have
the stamina to keep up with physical activities such as gym or a field
trip which will include a lot of walking. You will definitely
want to request that the child be allowed to rest if needed.
Although a child might abuse this request, should there be a problem
you can modify the plan accordingly.
You may also want to request to be notified any time the child is
complaining of physical illness. Most schools do not contact
parents unless the child has a fever.
You will want to be inquire as to whether the child's school is aware
of and practices universal precautions. As mentioned previously,
universal precautions should be implemented in most schools and
daycares. Without disclosing the child's HIV, it is OK to gently
remind the school that universal precautions should be used with all
children. To prevent the spread of illness from other children to
the HIV-positive child, you also will want to remind the school that
all guidelines in regards to hygiene should be taken in any room your
child is in.
Due to treatment requirements and the effect of HIV on a child's
health, chances are the HIV-positive child will miss a lot of school.
In some cases, a child will be classified as special education and have
an IEP which outlines what the school will do in order to ensure the
child progresses despite his/her disability. You will want to be
actively involved in advocating for the child's education during the
yearly IEP meetings and evaluations. Some school districts will
provide a tutor if the child misses a certain number of days.
There is the possibility that the school will not understand why the
child is gone so often. Children with HIV often do not look sick.
Even those with minimal complications of HIV can miss school quite
often. It seems that even those who are aware of a child's HIV
status want to believe that the child is 'normal' and should not be
given special treatment due to the HIV infection. It's not always
easy to deal with people who don't want to accept that, despite signs
of good health, an HIV-positive child is not like all other children
and the 'good' health cannot be taken for granted. You will find
this perception not only with school officials, but probably also among
the various DHS workers and those associated with DHS. Everyone
desires to make things as simple as possible; it's your
responsibility to the child to continuously remind people that HIV is a
serious disease and the child with HIV, healthy-looking or not, is at
tremendous risk whenever exposed to illness or pushed beyond their
limits.
For adoptive parents, you will need to decide whether or not your
child's daycare or school needs to know about the child's HIV
infection. In the mid-1980s, there were many cases of children
being excluded from school based on their HIV status. Nowadays,
this type of exclusion is prohibited by law. However, this does
not guarantee that people in contact with your HIV-positive child will
be educated. If your child has a health plan on file with the
school district, you may find that there is no imperative reason why
the school needs to know the HIV diagnosis. When a child is old
enough to disclose the information on his/her own, you and the child
can develop a 'plan' for the child to come to you and then you can
together decide who should know and when.
© 2003 Sarah P. All rights
reserved.
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