Children with Disabilities

'Individualized Planning for Health' [Background Information] in Essential Principles for Care

A cornerstone of Head Start health services is planning to meet the needs of the individual child. In this fact sheet, health managers, disability coordinators, program staff, and community health providers will find a summary description of Head Start's concept of individualized health planning. 

The following is an excerpt from Training Guides for the Head Start Learning Community: Caring for Children with Chronic Conditions

Head Start aims to individualize services for all children and families from comprehensive screening to individual planning and ongoing assessment. Individualizing means ... "recognizing the characteristics that make each child unique and planning a program that responds to these differences. Individualizing allows families and staff to respond to each child's built-in time clock for development, as well as culture, family, home language, life experiences, strengths, needs, skills, and abilities.**" 

Head Start can best meet the needs of children with chronic conditions by following a systematic process of Individualized Health Planning. For children who are eligible for an Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP), the IEP or IFSP may or may not include planning for the child's health care needs. In addition, many children with special health needs who are not eligible for an IEP or IFSP would, in fact, benefit from individualized health planning. They might be eligible for case management services under Section 504 of the Rehabilitation Act, "Crippled Children's Services," EPSDT, or other programs. 

Individualized health planning for children with chronic conditions involves close communication and collaboration among parents, Head Start staff, and service providers. It is a process of collecting all the necessary information from screening and evaluations, developing plans for the child's routine and emergency care, conducting ongoing assessment, and revising the plans as needed. The plan should be documented in writing to serve as a clear guide for Head Start staff, parents, and health care providers on meeting the child's health needs. 

The Individualized Health Plan is not specifically required by the Head Start Program Performance Standards. However, the process of developing Individualized Health Plans is an effective tool to facilitate Head Start's goal of individualizing the care of all children, including those with chronic conditions. 

Who Should Have an Individualized Health Plan? 

Children who would benefit from an Individualized Health Plan include any child who: 

– requires adaptations in daily activities because of a medical condition; daily activities to be considered include feeding, playing, sleeping, toileting 

– needs medication regularly 

– requires a specialized emergency plan 

The decision to develop an Individualized Health Plan for a child should be made collaboratively by the parent, health specialists, and classroom teacher.

What Are the Benefits of an Individualized Health Plan? 

Health Promotion and Prevention of Complications: 

Children with chronic conditions remain healthiest when all possible measures are taken to promote their general health and manage the chronic condition closely. These steps are very effective in preventing complications of chronic conditions. For example, for a child with diabetes, it is better to closely monitor her diet and blood sugar levels than to cope with a medical emergency resulting from too low or too high blood sugar levels.

Communication and Collaboration: 

Optimal health care for children with chronic conditions requires close communication and coordination among families, Head Start, and health care providers. A systematic process of developing and following the Individualized Health Plan helps clarify the roles and responsibilities of all caregivers and facilitates collaboration. 

Training and Skills: 

An Individualized Health Plan identifies the specific procedures needed to care for a child with chronic conditions. Head Start management can use the Individualized Health Plan to identify what specific training and supervision must be available for caregivers. 


With an Individualized Health Plan, families and Head Start staff can feel confident that they are doing everything possible to keep the child healthy on a routine and daily basis. Also, if health problems or emergencies occur, they can feel confident that they are prepared to manage them in the best way possible. Children with special medical needs feel more secure and able to learn when their caregivers know what to do. 

Protection from Liability: 

Individualized health planning, staff training, and supervision can improve the care of children with chronic conditions and reduce the chance of medical complications. In the event of complications, the Individualized Health Plan may help provide legal protection for program staff by specifying procedures and clarifying responsibilities. 

What Should be Included in an Individualized Health Plan? 

Caring for children with chronic conditions is a serious responsibility. Staff are commonly concerned about meeting the child's daily care needs: "How can I be sure to give him his medicine at the right time? Do we have enough staff to do his tracheostomy care while also supervising the other children? Will I have all his asthma supplies on the field trip?" Staff are also commonly concerned about emergencies: "What if I give her the wrong amount of medicine? What if she stops breathing? What if I can't reach her father on the phone?" The Individualized Health Plan should include the information necessary to respond to the most likely "what-ifs." 

Many people are afraid to care for children with chronic conditions. It can raise anxieties to discuss and plan for the "what-if" situations. It is important to remember that anticipating and planning for a situation doesn't make it happen; it just allows you to be prepared if it does. 

At minimum, an Individualized Health Plan should be a guide to: 

– what accommodations in daily programming are needed, including meals and snacks, playing, sleeping, and toileting 

– when and how to give medication, and who may give it 

– when and how to perform any required medical procedures, and who may perform them 

– what procedures to follow in the event of a medical emergency 

The Individualized Health Plan should be developed with the participation of families, medical professionals, classroom staff, and relevant members of the Head Start management team (e.g., health, disabilities, nutrition, and education specialists). All parties should sign the form as an indication of agreement with and commitment to plan.

** From Individualizing: A Plan for success, an Education series guide from Training Guides for the Head Start Learning Community. Department of Health and Human Services, Administration for Children, Youth and Families, Head Start Publications Center, Washington, D.C., 1997.