Juvenile Spondyloarthritis and School Accommodations

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Juvenile spondyloarthritis (JSpA) is the medical term for a group of diseases that cause specific types of arthritis in children before the age of 16. These diseases may continue to affect children into adulthood. JSpA includes:1

  • Enthesitis-related arthritis
  • Undifferentiated spondyloarthritis
  • Juvenile ankylosing spondylitis
  • Psoriatic arthritis
  • Reactive arthritis
  • Enteropathic arthritis

JSpA causes pain, inflammation, and stiffness in affected joints. While some of the pain and stiffness of JSpA improve with activity, other pains might worsen with activity. Children with JSpA may also have gut symptoms such as diarrhea. Eye problems may also occur. These include pain, redness, and not being able to stand bright light (photosensitivity).2

Because of these symptoms, kids with JSpA often have challenges in school. They might have trouble focusing or following school rules. To help them succeed, parents can ask for a 504 plan or an Individualized Education Program (IEP) from the school.3

What is a 504 plan?

A 504 plan is a legal document. It is a way to make sure that children with physical or mental impairments are treated fairly in public schools. The goal of 504 plans is for students to be educated in regular classrooms.3,4

Who qualifies for a 504 plan?

A student must meet specific criteria to qualify for a 504 plan. In general, these are focused on whether the condition causes “substantial academic or functional limitations.” This means that the child must have a documented need for special accommodations to ensure their success in school.3,4

504 plans apply to children who have physical or mental impairments that limit their abilities to:3,4

  • Walk, breathe, eat, or sleep
  • Communicate, see, hear, or speak
  • Read, concentrate, think, or learn
  • Stand, bend, lift, or work

JSpA can make it hard to move around. It also may make it hard to find a comfortable sleeping position. And staying still during the night can make pain and stiffness worse, so mornings are often a struggle. As a result, it may be hard for a child with JSpA to carry books, write, or keep up with their schoolwork. But school accommodations can help make these things easier.3

What types of accommodations are included in a 504 plan?

A 504 plan is customized to each child in need. Some accommodations might include:3-5

  • Reduced physical activity requirements for PE or after-school activities
  • Extra time to complete assignments and tests
  • Limits on the amount of homework required
  • Verbal testing instead of writing
  • Modified seating, including comfortable furniture such as beanbags
  • Adaptive equipment like standing desks
  • Access to restroom breaks during class
  • Ability to take breaks in a quiet area
  • Options for alternative activities such as yoga or meditation

What is an Individualized Education Program (IEP)?

An Individualized Education Program (IEP) is a legal document that outlines the special education services for students in need of extra help to thrive in school. An IEP serves as a map that guides instruction, support, and services for the child. IEPs are created for eligible kids who attend public schools, including charter schools.3,6

Who qualifies for an IEP?

A child can qualify for an IEP when they are struggling in school due to a variety of challenges, including:3,6

  • Learning disabilities
  • Physical disabilities
  • Cognitive challenges
  • Emotional disorders
  • Speech, language, hearing, and visual impairments

There are 13 categories of conditions and factors that could qualify a child for an IEP. An IEP typically includes an assessment of the student’s current abilities and access to services. It also includes supports that will be provided and a plan for how to measure progress.3,6,7

A child with JSpA could qualify for both a 504 plan and an IEP. However, an IEP can include accommodations covered in a 504 plan. This means it may only be necessary to have an IEP.3,6,7

What is covered in an IEP?

IEPs are based on the child's current level of performance. This allows schools to provide custom instruction and other needed services, such as assistive devices and occupational therapy.3,6

Helping your child succeed

Parents can work with their children's schools to create a plan that meets their child's needs. Whether through a 504 plan or an IEP, these accommodations can make all the difference in helping children with JSpA succeed in school.3

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