Listed below, parents, educators and physicians can find samples and templates of commonly used documents that can aid mitochondrial disease-affected patients and families in advocating their concerns for educational supports. These documents were formulated with the best of intentions; and there may be some areas that do not apply to your child(ren).
Please note that these documents are ONLY templates and that the content of the documents are formatted to facilitate discussions with primary care physicians, specialists, and educators. Use them at office visits or with school personnel to convey your child’s particular needs to have access to learning in the school environment.
It is IMPERATIVE that each of these documents have the required signatures. Eligibility or Individual Health Plan documents need a physician’s signature. IEPs require a minimum of four signatures ( parent, administratrative authority, special education licensed teacher of record and a general education teacher). If the student is eligible for special services such as physical, occupational or speech therapy. If the student is 14 years of age or older, the IEP requires the student’s signature as well. If you have questions, contact MitoAction staff at this email: firstname.lastname@example.org if you have any questions or concerns. These documents have legal significance and opportunity to thrive in the most supportive environment possible, both at home and in their school setting.
MitoAction is committed to helping educators, teachers, and therapists in your community understand how mitochondrial disease might affect your child or teen, and to offer constructive ideas to help modify the school setting to best meet his or her needs.
Tools for School Success
- Sample IEP (Individualized Education Plan)
- Sample Section 504
- Occupational Therapy recommendations
- Daily School Symptoms Checklist
- Technical Assistive Technologies
- Academic Checklist for Strength and Needs when planning Educational goals
- Sample Preschool Developmental Questionnaire
- OHI What is Other Health Impaired?
- Neurological Testing (an explanation)
- Suggested Elementary School Accomodations for the child with Mito
- Suggested Middle & High School Accomodations for the Student with Mito
- Sample of Contents of an IFSP (Individualized Family Service Plan)
- Sample 504 Accommodations
- My Child needs an aide, how do I get one?
- Debilitating Fatigue and School (letter)
- Sample Letter for Schools and IEP Qualification using OHI
- Sample Individual Health Care Plan
- What is an Individualized Health Care Plan?
- What is an extended school year?
- What is a transitional IEP?
- Suggested Protocol to share with a School Nurse