Back to School Safety for Students with Adrenal Insufficiency

Helping Students Thrive While Staying Safe

For families of children with adrenal insufficiency, whether caused by hypothalamic-pituitary tumors, surgery, or other conditions, the back to school season can bring mixed emotions. There is excitement for new learning and friendships, but also worry about how a child’s medical needs will be understood and managed in a busy school environment.

Adrenal insufficiency means the body cannot produce enough cortisol, a hormone vital for responding to stress, illness, or injury. For students, this makes everyday events such as a fever, stomach bug, or even intense physical activity potentially dangerous if not managed quickly and correctly.

Here’s how families, schools, and caregivers can work together to ensure a safe and successful school year.

1. Share a Clear Emergency Care Plan

• Provide the school with a written adrenal crisis action plan from your child’s endocrinologist.
• Include signs of adrenal crisis such as fatigue, confusion, vomiting, dizziness, or loss of consciousness.
• Add instructions for stress dosing oral steroids and guidance on when and how to administer emergency hydrocortisone, whether by injection or orally as prescribed.
• Make sure this plan is shared with teachers, the school nurse, coaches, and staff.

2. Train Key Staff on Emergency Response

• Arrange a brief training before or at the start of the school year for staff who interact daily with your child.
• Practice using an emergency hydrocortisone kit so staff feel confident acting quickly.

Tip – save expired solu cortef vials and demonstrate drawing up medication and injecting it with lemons or oranges.

3. Ensure Quick Access to Medication

• Store emergency medication in multiple accessible locations such as the nurse’s office and your child’s classroom.
• If your child is old enough and has been trained, consider self carry options if allowed by school policy.
• If requesting refills or additional Solu-Cortef injection vials for school, confirm that you receive the Act-O-Vial version. This version contains both the medication and diluent in one vial, making it faster and easier to prepare in an emergency.

4. Prepare for Sick Days and Physical Activity

• Communicate how illness or strenuous exercise might require stress dosing.
• For field trips or sports, confirm who will carry the emergency kit and be responsible for administering medication if needed.

5. Empower Your Child

• Even younger students can learn to recognize when they do not feel right and alert an adult.
• Teach them simple, age appropriate language to explain adrenal insufficiency to peers and staff.

6. Understand Your Child’s Legal Rights

• Under federal law, all students are entitled to a Free and Appropriate Public Education (FAPE).
• Section 504 of the Rehabilitation Act and the Americans with Disabilities Act require schools to make reasonable accommodations for students with medical conditions, which can include having a school nurse or trained staff available to give medication in an emergency.
• A 504 Plan can outline your child’s specific medical needs, emergency procedures, and classroom supports. This plan is legally binding and ensures that your child’s health needs are met during the school day.

7. Keep Communication Open

• Schedule regular check ins with teachers and the nurse to review any concerns.
• Update the school immediately if there is a change in medication or care instructions.

A Final Word

School should be a place where every child, including those managing adrenal insufficiency, can feel safe, supported, and ready to learn. With preparation, collaboration, awareness, and a clear understanding of legal protections, families and schools can create an environment that allows students not just to survive but to thrive.

To get more education on adrenal insufficiency, other hypothalamic-pituitary conditions, and advocacy strategies — and to connect with other families who understand your journey — register for the Bi-Annual Pituitary Brain Tumor Family Conference in Philadelphia on November 15th & 16th. It’s a unique opportunity to learn from experts, share experiences, and build lasting connections within the community.

More about Adrenal Insufficiency

Learn more about adrenal insufficiency in craniopharyngioma survivors.