Inclusive practice for children with allergies

Issue: Volume 100, Number 15

Posted: 24 November 2021
Reference #: 1HARWX

As allergies become increasingly common, Education Gazette explores how inclusive practice can lower the barriers to learning for children and young people with allergies, particularly to food, and support their wellbeing.

allergies

The prevalence of allergies is increasing, and nobody is quite sure why. But schools like Auckland’s Balmoral School are showing how students with food allergies can enjoy the full benefits of education like anybody else.

According to Allergy New Zealand, allergies affect 30 to 50 percent of the population in Aotearoa. 

The most common are caused by airborne allergens such as pollen and house dust mites. However, food allergy has become a common condition in childhood, affecting one in 10 children under five years old, and around five percent of children of school age.

Different allergens will cause different kinds of allergic reactions. The most common allergic conditions are hay fever, asthma and skin problems, such as eczema, rashes and hives.

However, some allergens such as food, or bee or wasp stings can cause severe, life-threatening reactions known as anaphylaxis. Reactions can happen in minutes and need urgent medical care.

Co-operation is key

Balmoral School principal Malcolm Milner says that with appropriate planning and action, allergies need not be a barrier to enjoying the full benefits of schooling. 

“I don’t think you can separate inclusion out of anything. Every child wants a sense of belonging – staff do too. We value diversity – it’s the third word in our mission statement.”

The statement reads: “To value diversity and to develop curious, confident and connected learners.”

Malcolm stresses the need for co-operation in the school when it comes to allergies. The school’s Board of Trustees works with staff to create plans. The good relationships that exist between staff, parents and the Board are the foundation of developing understanding and collaboration around allergy management. 

Malcolm recalls a parent joining a school camp with the task of specifically managing the food for four allergy sufferers. With that taken care of, the pressure was off the staff and the students could enjoy the trip alongside their peers.

Students are also encouraged to have some agency themselves. Developing independence in managing their health conditions is something that can happen over time with the support of the school and home team.

“We want them to be fully functional people, not have everybody else managing things for them. That’s the long game.”

Plans and action

The school’s enrolment officer Janet Gould says their commitment to inclusion begins when a student first joins the school. 

In particular, they need to know how many students may be at risk of anaphylaxis – a severe, potentially life-threatening allergic reaction.

In a roll of 820, Balmoral School currently has 22 allergy sufferers at risk of anaphylaxis, and around 40-50 more students with allergies of some kind. 

The students at risk of anaphylaxis must have an action plan, which is developed by a medical professional. It is widely distributed and follows the child as needed, including on school trips. 

“It’s all about making sure,” Janet says. “It’s about being aware. You must have a plan and stick to it. Everybody should be on board.”

Those students also come with an EpiPen, which parents or whānau supply.

An EpiPen is an auto-injector device that has a pre-filled syringe fitted with a needle and contains a single dose of adrenaline. It is used in an emergency to quickly treat anaphylaxis.

The school has had around three episodes of anaphylaxis in the last 10 years. 

If something does go wrong, the first action is to call an ambulance, says Janet. They are then usually advised to use the EpiPen.

But prevention is key, and the school has relevant policies in place, Malcolm says. Children are not allowed to share food, for example. But certain foods are not banned, which is consistent with advice from allergy experts. 

“It would be too difficult to monitor anyway,” he says.

Allergies in New Zealand schools

Balmoral School’s approach to allergies mirrors advice from Allergy New Zealand.

Advisor Penny Jorgensen agrees there is no reason why allergy sufferers should be excluded from enjoying regular class practice. But there are steps that should be followed.

Penny says it’s important for the school to understand food allergies and for them to raise awareness of these in the school environment and in communities. So, when something arises, it is not unexpected.

There are three main steps for schools to follow, she says:

  • The first step is to be prepared for anaphylaxis, including appropriate training.
  • The second step is prevention and risk minimisation.
  • The third step is to raise awareness and support for students.

Penny says awareness of allergies has improved in recent times, but there is still some way to go.

One common concern from parents is a lack of preparedness around school camps. 

“We’ve had parents having to get into fairly remote locations to try and get their child out of there because they can’t eat food,” says Penny.

Another concern is that allergies can lead to bullying, with those suffering becoming easy targets. 

A worrying trend and concern is the prevalence of allergies in Pasifika and Asian populations and the number of hospital admissions for food-triggered anaphylaxis among those groups is also higher.

The reasons are unclear, and the causes of allergies and reasons for an increase are not known, says Penny. 

Simple precautions make a big difference

Penny says parents are often keen to know how a school manages allergies, and that it is a good idea if schools have policies and procedures written up, so they are easily accessible, and visible to their school community. 

The enrolment process should also help identify at-risk students and have plans to follow up on that, such as medicine management and individual health care plans which are developed in collaboration with parents.

There should also be more general policies like not sharing food.  Penny says it would make a big difference if food could be kept out of classrooms in general and particularly where there is a child with food allergy – this would reduce stress and anxiety on the child and family, as well as making it easier on teachers and the school. 

She is aware some schools arrange a separate place for a class that includes a child with food allergies, to eat lunch, such as the school hall or even sharing with another class. Secondary schools should also look at keeping food out of technical and specialist classes which students with food allergies will need to use as well. 

There are some other simple actions that anyone can take. For example, Penny says children can be encouraged to wash their hands after eating, as well as before, and to dispose of their lunch rubbish properly, before going to play. These are good hygiene practices anyway. 

“Anaphylaxis is preventable. It doesn’t necessarily require extraordinary measures. A child with a food allergy also has to learn to manage as well. By the time they get to secondary school they need to be able to manage certain things themselves. But it helps if everyone understands and supports them.” 

For more information, teachers and school staff can email allergy@allergy.org.nz or call 0800 34 0800.

Guidelines for educators

Te Kete Ipurangi(external link) has a useful guide to allergies and learning, including health and safety policies and procedures. 

Allergy New Zealand(external link) has a set of guidelines for early learning services and schools. An updated version is due to be released early next year.

BY Education Gazette editors
Education Gazette | Tukutuku Kōrero, reporter@edgazette.govt.nz

Posted: 11:28 AM, 24 November 2021

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