504 plan for ADHD

Quick answer

A 504 plan for ADHD is the written record of accommodations a public school gives a student whose attention-deficit/hyperactivity disorder (ADHD) substantially limits a major life activity. Concentrating is one. Between 2011 and 2015 the Office for Civil Rights (OCR) received more than 16,000 disability complaints from elementary and secondary schools, and about 2,000 of them, one in nine, involved a student with ADHD. OCR published a Dear Colleague Letter and resource guide on this one disorder in July 2016. Most of what follows comes out of it. Read what a 504 plan is first if the term is new.

Why ADHD is the classic 504 case

One rule decides most ADHD eligibility arguments. A district cannot count the good effects of medication when it decides whether your child is substantially limited.

The 2008 ADA Amendments Act put medication, coping strategies, and learned behavioral modifications on a list of mitigating measures that get ignored. OCR applies that list to ADHD in plain words. "If a student requires medication to address an impairment, the ameliorative effects of the medication cannot be considered when evaluating the student for a disability."

So the question is what concentrating looks like unmedicated. Not what it looks like at ten in the morning on a stimulant that wears off at two. The Amendments Act also added concentrating, reading, thinking, and functions of the brain to the list of major life activities, so an ADHD case no longer has to be argued through learning.

Four more rules follow from the first one.

• A diagnosis is close to enough. OCR "will presume, unless there is evidence to the contrary, that a student with a diagnosis of ADHD is substantially limited in one or more major life activities."
• Good grades prove nothing by themselves. A student may earn them "only as a result of having extra time on exams, or receiving help at home in completing assignments, or studying for extraordinarily long periods of time." The nightly effort is the evidence.
• Nobody has to stop the medication to be tested. Section 504 "does not require that a student stop taking needed medication in order to receive an evaluation."
• The quiet student counts. OCR says failure to evaluate "may be particularly acute for students with the inattentive-type ADHD," who are "less likely to come to the attention of school district personnel."

Qualifying and getting something are two different results. A student whose medication adequately treats the ADHD may still need no aids or services at all. The district has to evaluate before it says so.

When ADHD points to an IEP instead

Two things have to be true at once for an Individualized Education Program (IEP). Your child fits a category under the Individuals with Disabilities Education Act (IDEA), and your child needs specially designed instruction because of it.

ADHD has a category. It is other health impairment, at 34 C.F.R. § 300.8(c)(9), and the regulation names "attention deficit disorder or attention deficit hyperactivity disorder" among the chronic or acute health problems that count. It was amended in 1999 to add them. The category asks for limited alertness in the educational environment that adversely affects educational performance. OCR notes ADHD can also qualify under the specific learning disability or emotional disturbance categories.

The dividing line is teaching. Specially designed instruction means adapting the content, methodology, or delivery of instruction, at 34 C.F.R. § 300.39. Handing your daughter a printed checklist is access. Teaching her to build one, in a planned sequence, by somebody trained to teach it, is instruction.

OCR blurs that line on purpose. It says some students with ADHD "might require direct instruction," and its example is teaching a student to break a multi-step assignment into parts. A district is not barred from writing that into a 504 plan. What the plan will not carry is the machinery around it.

An IDEA refusal does not end the conversation. Finding a student with ADHD ineligible under IDEA "does not relieve the school district of its obligation to evaluate the student, as appropriate, under Section 504." Ask for both in one letter. IEP vs 504 plan walks the full comparison.

What you give up by settling for the 504 plan is specific. No federally required annual goals. No progress reporting schedule. No evaluation deadline, where IDEA sets 60 days from parental consent at 34 C.F.R. § 300.301(c)(1).

A sample 504 plan for ADHD, ninth grade

Our 504 plan examples page carries a six-line seventh grade ADHD plan. This one is high school and inattentive type, because ninth grade is where six teachers and a real homework load meet a student who never had to plan anything.

The finding reads that ADHD, predominantly inattentive presentation, substantially limits concentrating and thinking. It also records that the student takes a daily stimulant and that the group decided without counting its effects. Ask for that sentence by name, because most plans leave it out.

The group looked at five things. Rating scales from each of the six classroom teachers. Test scores averaging 91 against a homework completion average of 54. A three-week parent log showing two to three hours nightly on work assigned for forty-five minutes. The pediatrician's diagnosis. Four tardies logged between second and third period.

Six accommodations, all of them on one page.

• Every assignment posted in the district learning system by the end of the day it is given, by all six teachers
• A forty-five minute nightly cap per class. Work stopped at the cap is graded on what was finished
• Any assignment over 50 points broken into three checkpoints with separate due dates, set when the work goes out
• Time and a half on tests over 30 minutes, in the testing room off the main office, booked by the counselor the day before
• A five-minute check-in with the case manager at the end of fourth period, running through December
• The late penalty waived up to two school days, twice per quarter per class, on the case manager's documentation

Who does the work. All six teachers post and chunk, and the counselor books the testing room. The case manager runs the check-in and keeps the late-work count. The 504 coordinator emails the plan to all six teachers within five school days, and again after the January schedule change.

What the plan does not do is teach this student to plan. It hands her the scaffold six times a day and hopes the habit sticks. If nobody has taught her the skill, the scaffold holds her grades up for two years and then stops working.

Accommodations for ADHD by symptom

Start from the symptom rather than from the district's checkbox list. OCR makes the same point from the other side. "One student may require extra time on an examination, while another may have difficulty with multiple-choice testing and require a different testing format. A third student may not require any academic services, but a behavioral intervention plan."

Sustained attention. Testing in a separate quiet room for anything over 30 minutes. Long work blocks split at a fixed point rather than when the teacher notices. A named seat out of the traffic line by the door.

Working memory. Anything said out loud also written down, same place every time. A second set of materials at home so nothing rides on remembering the binder. Multi-step directions given one step at a time.

Task initiation and time. Deadlines chunked by the teacher who set the assignment. A nightly minute cap instead of a page count. Flexibility on homework deadlines, which is OCR's own example for a student who "consistently forgets his homework because of ADHD."

Restlessness and regulation. A two-minute movement break per period on an agreed signal. A cool-down pass with a named destination and a time limit. A behavior intervention plan, which OCR names as a Section 504 response for a student who needs no academic help at all.

Medication at school. If a prescribed medication has to be taken during the day and your child cannot self-administer it, the district must provide that assistance as part of an appropriate education.

Not every student with ADHD needs the same set of services, or any services at all. The evaluation decides which belong on the page, and a group that writes something shorter has done its job.

What the school must do, and what it can refuse

Six things a district cannot do, each one out of OCR's ADHD guidance.

1. Hand out a standard package. "School districts cannot simply group together a few aids and services and provide them in a blanket fashion to any student with ADHD."
2. Refuse on cost. The team "cannot limit its placement recommendations to those related aids or services that are free or low-cost," and an eligible student gets what the team decides is appropriate "regardless of cost or administrative burden."
3. Treat the plan as optional. OCR has found districts believing the services "are optional, or unnecessary because the student is academically gifted."
4. Make your child ask. "It is not the responsibility of the student with a disability to request FAPE," meaning Free Appropriate Public Education, the name for what the school owes your child.
5. Run interventions first and evaluate later. Response to Intervention and multi-tiered systems of support are fine, but "implementing an intervention strategy and evaluating for a disability do not have to occur sequentially."
6. Demand a doctor's note first. "There is nothing in Section 504 that requires a medical assessment as a precondition." If the district decides it needs one, the district pays.

Now the other side, because a teacher refusing something is not always breaking the law.

A district can decline the accommodation you named. The duty runs to an appropriate education and to a group decision by people who know your child, at 34 C.F.R. § 104.35(c)(3), and not to any line you wrote. It can pick the cheaper of two options that work equally well. After a real evaluation it can also find that your child needs nothing at all. And a teacher can ignore a request you made in the hallway, because the plan is the only thing that binds anyone.

OCR says implementation complaints usually come from staff "being unaware that a plan exists or the plan being so vaguely worded that the parties are unclear."

What to say in the meeting

Bring the homework log. Two or three weeks of start time, stop time, and what was assigned beats any adjective you could use at the table.

When somebody says the grades look fine, the answer is the log rather than an argument. Ask the group to put the hours next to the completion grade. Then ask three questions about every accommodation it agrees to. Who does it. When does it start. How will anyone know in November if it stopped.

A refusal is not a dead end. A district that denies the request, "regardless of the grounds for the denial, must inform the student's parent of its decision and of the parent's procedural safeguard rights."

Where an advocate fits

The ADHD meeting goes wrong in a predictable place. The school lists what it already does for every ninth grader, somebody says the grades are fine, and four vague lines go onto the plan.

An advocate reads the evaluation against the draft, puts the unmedicated-state finding and the homework data into words the district recognizes, and sits next to you while the group works. Advocates are not attorneys. They cannot file a lawsuit or represent you at a due process hearing. Most advocates on our directory charge $75 to $150 per hour, and you can search by state to see who works near you.

What a 504 plan for ADHD cannot do

A 504 plan does not treat ADHD. It buys access to school while treatment happens somewhere else, and no accommodation above changes a symptom.

Three more limits worth carrying into the meeting.

• It does not teach executive function. A group can write direct instruction in, and most will not, because that is IDEA's territory.
• It does not guarantee a review. Section 504 requires periodic reevaluation at 34 C.F.R. § 104.35(d) and sets no interval, so a December date has to be written into the plan or it does not exist.
• It does not follow your child out of high school. Colleges run on Subpart E of the same regulation and there is no 504 plan on the other side.

Most ADHD plans do not fail at the eligibility meeting. They fail in period four in the second week of November, when a substitute has the roster and nobody told her about the check-in.