Juvenile AS and School Accommodations

Reviewed by: HU Medical Review Board | Last reviewed: February 2019 | Last updated: November 2020

When ankylosing spondylitis (AS) occurs in children or adolescents, it is called juvenile ankylosing spondylitis (JAS). JAS can cause pain, inflammation, and stiffness in affected joints. While some of the pain and stiffness of JAS improves with activity, other pains worsen with activity, including pain in the knees, heels, or bottom of the feet. Children with JAS may also experience abdominal symptoms, such as diarrhea, and eye problems, such as eye pain, redness, and sensitivity to light.1

Having JAS causes extra challenges for kids in school, as their condition may make it harder to focus or abide by school constraints. To help young people with JAS succeed in school, parents may want to ask for a 504 plan or an Individualized Education Program (IEP).

What is a 504 plan?

A 504 plan (named for Section 504 of the Rehabilitation Act of 1973) establishes accommodations, support, or services that will be provided by public schools to ensure a child with physical or mental impairments is treated fairly. The goal of 504 plans is for students to be educated in regular classrooms.2

Who qualifies for a 504 plan?

504 plans are applicable to children who have physical or mental impairments that limit their abilities to2:

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

JAS can impact a child’s mobility. It may also interfere with sleep, as it can be difficult to find a comfortable position and staying inactive during the night makes pain and stiffness worse. Mornings can be a challenge as the pain and stiffness of JAS tend to be worse after a night’s sleep. If a child’s shoulders, wrists, or hands are impacted by JAS, they may have difficulty carrying books or writing. Many accommodations can be made to help address these challenges.

What types of accommodations are included in a 504 plan?

A 504 plan can have a variety of accommodations, including2,3:

  • Allowing a student to make up missed schoolwork or tests due to medical appointments
  • Breaks for stretching and movement
  • Snacks or water at the desk if needed to be taken with medication
  • Extended time for tests or homework
  • Verbal testing (rather than required writing)
  • Approval to visit the nurse’s office as needed

What is an Individualized Education Program (IEP)?

An IEP is a program in public schools that spells out any special support that is needed to help a child who is struggling with school.4

Who qualifies for an IEP?

An IEP may be implemented for kids who are having difficulties in school due to a variety of challenges, including4:

  • Learning disabilities
  • Physical disabilities
  • Cognitive challenges
  • Emotional disorders

A child with JAS could qualify for both a 504 plan and an IEP. However, because an IEP can include accommodations that would be covered in a 504 plan, it may only be necessary to have an IEP plan.5

What is covered in an IEP?

In addition to physical accommodations and assistive technology, an IEP is designed around the child’s present level of performance and enables individualized instruction and other services, such as occupational therapy.6

Helping your child succeed

Parents play an important role in ensuring their children get the support they need at school. After a child is diagnosed with JAS, parents should reach out to their child’s teacher and school counselor and ask about a 504 plan or IEP.

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