Health Manager Orientation Guide

Common Special Health Care Needs

Common special health care needs in Head Start programs include asthma, severe allergies, seizures, and Type 1 diabetes. Health managers who are familiar with these conditions can assist programs with planning, supporting, and individualizing services for children.

Head Start children also have other health concerns, including oral health, mental health, behavioral health, and nutrition concerns. Some children have more complex medical conditions. The health manager will often need more support to plan for caring for children with complex conditions.


Young boy being assisted by an adult on how to use an asthma inhaler.Asthma is a disease that affects the small airways in the lungs. It causes wheezing, breathlessness, chest tightness, and nighttime or early morning coughing. It is a leading chronic health condition for children and a leading cause of school absenteeism. Fortunately, when managed well, asthma symptoms can be controlled with medication and by avoiding triggers that can cause symptoms.

Each child’s asthma can be different, with distinct triggers, symptoms, and treatment plans. It is important to identify triggers and mitigate or eliminate them in the home and program setting to help control asthma symptoms. It’s also critical for staff to understand triggers, early warning signs, when to administer medication, the expected response to the medication, and what to do if the child does not improve. Staff must know what information about the child to communicate to families, such as coughing and resting frequently during play, coughing during nap times, or signs of an early upper respiratory infection.

There are two main categories of asthma medications:

  • Rescue medications, taken as needed for an asthma attack or episode
  • Long-term controller medications taken regularly — usually daily and often administered at home — for persistent asthma to prevent symptoms or episodes

Staff should receive training on where medications are stored, if an inhaler needs to be primed before use, and routinely check expiration dates of medication.

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A young boy with a rash on his face most likely from an allergic reaction.Allergies are caused by an overactive immune system that reacts to certain triggers (called allergens), such as grass, pollen, pet fur, or a specific food. Allergies generally fall into two categories:

  • Environmental allergies (e.g., pollen, mold, pets, dust mites) that cause a variety of symptoms
  • Life-threatening allergies (e.g., food, insect venom, medications) that can cause the airway to close (anaphylaxis)

Staff need to know how to prevent exposure to allergens and how to recognize signs of an reaction. They must also know how to respond to an allergic reaction, including when to administer emergency medications. Staff need to be familiar with procedures for taking emergency medications to outdoor play areas, on field trips, and when evacuating for emergencies.

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Seizures involve sudden, temporary bursts of electrical activity in the brain that change or disrupt the way messages are sent between brain cells. These electrical bursts can cause involuntary changes in body movement or function, sensation, behavior, or awareness. Every brain has the potential to seize. A seizure is an event and can be a symptom of other medical problems.

Sometimes seizures are caused by a neurological disease called epilepsy. A person with epilepsy is at higher risk for having recurrent or more seizures. Sometimes, “seizure disorder” is used to describe epilepsy.

Staff may need special first aid training in managing a seizure. Health managers can work with staff to address their concerns about how to care for a child with seizures. Staff should be trained to know how to time how long a seizure lasts, when to call 911, and when to administer medication.

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Diabetes mellitus is a chronic medical condition that causes problems with the body’s ability to change food — especially sugars (carbohydrates) — into fuel for the body. When a person has diabetes, their pancreas does not produce enough of a hormone called insulin. This stops the body from being able to use sugar, which then builds up in the bloodstream. When diabetes is not managed, high blood glucose can damage the heart, blood vessels, kidneys, eyes, and nervous system over many years. The most common form of diabetes in young children is Type 1 diabetes (T1D). Individuals with T1D require the administration of insulin and regular blood sugar monitoring.

Although there is no cure for diabetes, children with this disease can lead normal lives if it’s kept under control. Staff who care for children with diabetes can help manage the disease through blood sugar monitoring, giving treatment such as insulin injections or through an insulin pump, and understanding emergency situations. Keeping blood sugars in a normal range is important and lowers the risk of long-term health problems. A healthy diet and at least 30 minutes of exercise a day can help children manage their disease, too.

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