Early Childhood Education Linkage System/ Healthy Child Care Pennsylvania PA Chapter, American Academy of Pediatrics Rose Tree Corporate Center II, Suite 3007 1400 N. Providence Road Media, PA 19063 Phone: 484-444-3003; Fax: 484-446-3255; e-mail: ecels@paaap.org Website: www.paaap.org September 2014 Dear Early Learning Practitioner, Thank you for your interest in the Food Allergy Self-Learning Module. Food allergy affects approximately 4 – 8 % of children in the United States. That is 1 in every 13 children. Food Allergy is on the rise. A study released in 2013 by the Centers for Disease Control and Prevention reported that food allergies among children increased approximately 50% between 1997 and 2011. Why this has happened is not clear. The Core Knowledge Competencies and objectives of this module are that users will be able to:

• K7.1 C1 Identify the sources of health, safety, and nutrition standards and regulations that apply to the early childhood or school-age program.*

• K7.5 C1 List health care prevention practices and discuss accepted measures for

managing acute and chronic illnesses in children.*

• K7.5 C2 Demonstrate the use of preventive practices and management of acute and chronic illnesses in children.*

• K7.6 C1 Identify and describe all elements that should be contained in children’s health

records.

*Appendices of the PA Core Knowledge Competencies document offer additional information on definitions, including a further detailing of competencies indicated by an asterisk (*), and an alignment of the CKC to other commonly-used documents. (From PA Core Knowledge Competencies accessed online on 5/1/14 at http://www.pakeys.org.)

Objectives

• Identify the basic types of food allergy and allergens in foods. • List at least 4 of the 8 foods which cause 90% of food allergies. • State ways to prevent the accidental ingestion/contact of prohibited foods in early

learning and school-age programs. • Point out risks which can affect children with food allergies. • Demonstrate how to read a label to decrease risks to children with food allergies. • Select an Emergency Plan and policies for handling food allergy incidents and medication

storage. • Identify plans for change and then implement the plans.

This module meets PA Keystone STAR 2 Performance Standard requirement for two (2) hours of annual professional development for health and safety. To receive state-approved professional development credit: ECELS/Healthy Child Care PA; PA Chapter, American Academy of Pediatrics 9/2014 – Food Allergy Page 1

1. Review the Self-Assessment: Before you complete the Learning Activities for the module, take a look at what you need to submit for review to obtain professional development credit. The Self-Assessment includes three parts: Multiple Choice Questions, Implementation Questions, and a Label Reading Activity. Knowing what you will be asked to submit for review may help you find the necessary information as you do the Learning Activities. The Self-Assessment must be completed independently and submitted by each practitioner requesting credit. PA child care practitioners may submit the Self-Assessment for review for credit using the electronic response form at https://www.surveymonkey.com/s/DDRZ2PS

2. If you prefer, you may copy and print out the Self-Assessment, then complete and submit it either by scanning and attaching it to an e-mail, or by sending the original of your work by surface mail to ECELS at the address on the top of this letter.

3. Follow the instructions in the “Important Reminders” box next to the list of self-learning modules on this webpage. These instructions include the steps to register your credit and mark your assignment complete in the PA Key Professional Development Registry. Review the document “Using the Professional Development Registry” posted in the “Important Reminders” box. If a review fee is required for this module at the time you submit it, ECELS must receive the per person payment before ECELS staff will review the work you submit for credit. When you have successfully completed the three parts of the Self-Learning Module Self-Assessment, ECELS will notify you by e-mail that your credit has been approved. Remember that you must follow the steps required to document your work in the PA Key Professional Development Registry to receive credit in the PA Key system. After ECELS approves your credit, you will be able to complete an Evaluation Form for the PA Key Registry. Contact ECELS if you have questions. After ECELS approves your credit, you will be able to complete the Evaluation Form. Then the PA Key will record your credit and notify you that your credit has been awarded. In the My Learning Path Tab, select My Transcript to view a detailed history of the Courses you have completed.

4. Complete the Learning Activities If you need help with this module, or have questions about the material or the review process, call the ECELS office 1-800-243-2357 toll free in PA or 484-446-3003 or email ecels@paaap.org.

Sincerely, Susan Aronson, MD, FAAP Nancy Alleman, BSN, RN, CRNP, CSN ECELS Pediatric Advisor ECELS Lead T/TA Coordinator

Costs for the development and 2014 update of this module have been underwritten by Pennsylvania’s Office of Child Development and Early Learning.

ECELS/Healthy Child Care PA; PA Chapter, American Academy of Pediatrics 9/2014 – Food Allergy Page 2

Learning Activities

The information in the documents and videos are from reliable sources of information that you should know about. The materials you are to review for this Self-Learning Module provide up-to-date information about food allergies in different ways. View all of the listed materials. Note which of them you think will be most useful for you to share with families and with staff members involved with child care programs. 1. Follow the instructions to find and read the handouts and information on the Food

Allergy Research and Education (FARE) website: www.foodallergy.org listed below:

Select the Tools and Resources tab, then select the option “Most Popular Resources”. In the section headed “About Food Allergies” look for and read:

a. Food Allergy Facts and Statistics

Go back to the Tools and Resources tab, then in the section headed “Health Care Providers” look for the brochure for parents

b. Does Your Child Have a Food Allergy? (in English or in Spanish) Go back to the Tools and Resources tab, select “Child Care Facilities”. Look for and review:

c. Food Allergy and Anaphylaxis Emergency Care Plan

Any child with a food allergy who attends your program must have a Food Allergy and Anaphylaxis Emergency Care Plan. This Care Plan is completed by a child’s health professional and parent. Any medication(s) that the child might need must be kept at all times with the teacher/caregiver responsible for providing that child’s care. Consider keeping the medication in a fanny pack to be worn by the teacher who is responsible for the child. Then the medication can be passed easily to another teacher/caregiver if the primary caregiver needs to be away from the location where the child is in care.

d. Field Trips Tips

e. Cleaning Methods

f. How to Read a Label (You will use this information to complete the Label Reading Activity that is part of this self-learning module.)

g. Americans with Disabilities Act

h. How a Child Might Describe a Reaction

2. Explore the U.S. Food and Drug Administration (FDA) website at www.fda.gov Enter

“Food Allergies – What You Need to Know” in the search box. Review the eight (8) major food allergens. Read information about food labels and symptoms of food allergies. Watch the brief video found at the bottom of the home page: Food Allergies: Reducing the Risk.

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3. View the 8 minute food allergy training video for child care centers Managing Food Allergies in Child Care Centers - video. If the direct link doesn’t work for you, go to www.nfsmi.org Enter “food allergy resources” in the search box, then select the same words in the list of results from your search. Click on and watch the video.

The National Food Service Management Institute (NFSMI), in partnership with the United States Department of Agriculture (USDA), has developed food allergy professional development videos for schools and child care centers. The video tells ways staff who prepare and serve food can prevent and manage food allergies.

4. Review the 2013 Centers for Disease Control and Prevention (CDC) publication

Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Centers at http://www.cdc.gov/healthyyouth/foodallergies/pdf/13_243135_A_Food_Allergy_Web_508.pdf. If the direct link doesn’t work for you, go to www.cdc.gov. Enter “voluntary guidelines for managing food allergies in schools” into the search box. It is a 10.93 MB downloadable book worth having in your collection of resources. Begin with the Table of Contents to become familiar with the materials in this rich resource. Look at what interests you. At the least, review the following sections:

a. About Food Allergies, pages 17 – 21

b. Table 1: Recommended Practices for Reducing the Risk of Exposure to Food Allergens and Responding to Food Allergies in Schools and Early Childhood Education Programs, pages 41 – 43

c. Food Allergy Management and Prevention Checklist, page 44

d. Section 4. Putting Guidelines into Practice for Early Childhood and

Education Administration and Staff, pages 77 – 85

5. Read Caring for Our Children, 3rd Ed. Standard 4.2.0.10: Care for Children with Food Allergies: http://cfoc.nrckids.org/StandardView/4.2.0.10

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Self-Assessment

Directions: This Self-Assessment consists of three parts: Multiple Choice Responses, Implementation Questions, and a Label Reading Activity. ECELS encourages you to submit your completed self-assessment using the online version at https://www.surveymonkey.com/s/DDRZ2PS . If you prefer, you may copy and print out the Self-Assessment, then complete and submit it either by scanning and attaching it to an e-mail, or by sending the original of your work by surface mail to ECELS at the address on the top of this letter. You may photocopy the Self-Assessment, Implementation Questions, and Label Reading Activity for individual staff members if more than one is seeking credit for completion of the Self-Learning Module. ECELS encourages discussion among the staff members about the content of self-learning modules. However, each person must respond to the multiple-choice questions individually and to the write-in questions using her/his own words.

Early Learning Practitioner Name: _______________________________________________________

Home Address: Street/City ______________________________________________________________

County ___________________ State________ Zip Code__________ Home Phone: (______) ________

Email Address ________________________________________________________________________

PA Keys Registry ID Number ___ ___ ___ ___ ___ ___ (For PA Key credit) Date of Birth ________

Early Learning Program Name: _______________________________________________________

Early Learning Program Phone #: (______) ___________________

Multiple Choice Questions Please select the one BEST answer. 1. Which of the following is true about food allergies?

a. Food allergies cause hyperactivity. b. Food allergy is an interaction between a food and an overly sensitive immune

system. c. Food allergies are the result of a weakened immune system. d. Food allergies cause a rash in most children diagnosed with a food allergy.

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2. A child might describe a food allergy reaction by saying:

a. “My mouth itches.” b. “My lips feel tight.” c. “My tongue is cold.” d. a and b

3. It is important to teach all children about food allergies because it informs them why children with food allergies cannot eat certain foods, and discourages food trading. a. True b. False

4. Which of the following lists of foods account for about 90% of allergic reactions in children: a. Rice, milk, strawberries, eggs and kidney beans b. Wheat, eggs, peanuts, tomatoes and milk c. Peanuts, tree nuts, eggs, strawberries and milk d. Milk, eggs, peanuts, soy, wheat, tree nuts, shellfish and fish

5. Who is likely to experience anaphylaxis from an allergic reaction to food is predictable. a. True b. False

6. The most important and immediate drug(s) for an anaphylactic reaction is:

a. Ibuprofen b. Epinephrine c. Penicillin d. a and b

7. Early learning and school-age programs can protect against liability and provide a safe environment for children with food allergies by: a. Educating staff b. Educating the child with the food allergy c. Implementing a written food allergy management plan d. All of the above

8. Anaphylaxis is a severe reaction resulting in several body systems reacting at once: lungs (breathing difficulties), skin (hives), and stomach (nausea and vomiting). a. True b. False

9. When food is prepared onsite at a program, the following recommendations help

protect a child with a food allergy: a. Prepare allergy-free meals first, cover them, set them aside, and proceed to cook

other foods. b. Wipe food preparation surfaces with a wet cloth before starting food preparation. c. Purchase an extra heavy duty plastic cutting board to use only for allergy-free

foods or use a disposable plate. d. a and c

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10. The following recommendations protect a child with a food allergy in early learning

and school-age programs: a. Staff read ingredient statements (labels) each time before giving the child any

food. b. Children with food allergies are not allowed to participate in activities that involve

foods such as crafts, cooking or science. c. Everyone is required to perform hand washing with soap and water is required

before and after food handling. d. a and c

11. Early learning and school-age practitioners can plan activities and celebrations to protect children with food allergies by using: a. Non-food items such as colored pencils or stickers. b. Games, songs, and activities. c. Food items sent to the program that are purchased at a store and contain a list of

ingredients. d. All of the above.

Food Allergy Implementation Questions

1. Refer to the video from the National Food Service Management Institute: Managing Food Allergies in Child Care Centers. What are at least 3 ways that staff members who prepare and serve food work together to prevent food allergy reactions? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 2. How will you use the information about food allergy in your daily practices? What do you plan to change? List at least three (3) of your plans. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 3. What are the eight (8) foods that account for 90% of all food allergy reactions?

1) __________________ 5) __________________

2) __________________ 6) __________________

3) __________________ 7) __________________

4) __________________ 8) __________________

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4. What information from the Centers for Disease Control’s (CDC) publication Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Centers was particularly informative? List at least 2.

______________________________________________________________________ 5. Do your program’s policies need to be revised based on the information presented in

this module? If so, what is the plan to revise them? ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 6. Do you have a Food Allergy Action Plan for each student with food allergies?

Yes No If not, how will your staff be prepared to care for the child with food allergies?

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 7. Does your emergency plan/shelter-in-place emergency plan address the special

needs of children with food allergies? Yes No If not, what improvements will you make to your plan? See Managing Students with Food Allergy During a Shelter-in-Place Emergency handout for suggestions.

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ 8. Does anyone in your program have an EpiPen Jr®. / EpiPen® or other epinephrine

auto-injector? Yes No What is the expiration date on each EpiPen Jr®./EpiPen® now in your facility? ______________________________________________________________________________________________________________________________________

Food Allergy Label Reading Activity Use the resource Tips for Avoiding Your Allergen to complete this Activity. Find the resource at the Food Allergy Research and Education (FARE) website: www.foodallergy.org. Select the Tools and Resources tab, then click on the option “Child Care Facilities”. Select How to Read a Label. Review the five food labels. Decide which foods each child can eat. The following children in your program have these food allergies: Chris has a soy allergy. Alex has a milk allergy. Rachel has a wheat allergy.

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Label Reading Activity (continued) GRAHAM CRACKER VEGETABLE AND NOODLE SOUP

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Label Reading Activity (continued)

MACARONI AND CHEESE SPAGHETTI AND SAUCE ECELS/Healthy Child Care PA; PA Chapter, American Academy of Pediatrics 9/2014 – Food Allergy Page 10

Which foods can Chris eat? (soy allergy)___________________________________________________________________ ___________________________________________________ Which foods can Alex eat? (milk allergy)____________________________________________________________________ ____________________________________________________ Which foods can Rachel eat? (wheat allergy) __________________________________________________________________ ______________________________________________________________________________

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