The rate at which Minnesota students receive accommodations for conditions like ADHD, anxiety, depression and others has increased by about ten-fold in two decades, according to data from the Minnesota Department of Education.

In 2000, about 2 out of every 1,000 students enrolled in Minnesota public schools had “504 plans,” which provide for things things like extra time on tests or extended deadlines on assignments. In 2019, that number was 16 out of every 1,000 students, a MinnPost analysis of MDE data shows.

But the data also show 504 plans aren’t up everywhere: they’re most prevalent in some of Minnesota’s wealthier school districts.

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Section 504

504 plans are named after a section of federal law — Section 504 of the 1973 federal Rehabilitation Act — which prohibits discrimination against students based on a disability in school districts that receive federal funding. The law doesn’t define disability strictly, instead focusing on its effects.

“The criteria in the law is that it has to be a physical or mental impairment that substantially limits a major life activity,” said Daron Korte, assistant Minnesota Department of Education Commissioner overseeing special education, compliance and assistance, rulemaking, and health, nutrition and youth development.

Common conditions for which students receive 504s include ADHD, depression, traumatic brain injury, broken limbs and heart defects. Generally, Korte said, it’s disabilities that don’t rise to the level of meeting a disability criteria under IDEA, the Individuals with Disabilities Education Act, for which a student would typically receive special education services under an individualized education plan, or IEP (though students may have services under both plans).

Unlike IEPs, which might require specialized instruction, “504 plans are accommodation-only. They’re not modification and that’s an important difference. An accommodation is anything that doesn’t change the rigor or the standard,” said Christine Peper, mentor manager and faculty member at the Learning Disabilities Association of Minnesota.

Also worth noting, said Korte, is that 504 plans may be underreported because, unlike IEP plans, they’re not attached to federal funding, so there’s no monetary incentive for districts to accurately report data.

Plan initiation

There isn’t one protocol for initiating 504 plans: sometimes it’s the district that starts the process, when teachers notice a student is struggling and look into accommodations. But often it’s parents, who are concerned their kid is having trouble in school and hope to find a way to help.

Parents can request districts do an assessment for a 504 plan. In an assessment, districts typically look into grades, class performance and test scores to see if there’s a pattern where the student is struggling that might merit accommodations.

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504 plans don’t require a medical diagnosis, but medical evaluations are often used to determine whether students should have 504 accommodations and what types of accommodations might be applicable.

Accommodations vary by school and condition: a student with ADHD might be given extra time on tests. A student whose mobility makes it harder to get to class on time might get more passing time in the hallway. A student with depression might get extended assignment deadlines.

Behind the numbers

There are a few reasons experts say the number of 504s in Minnesota are up.

A 2008 amendment to the Americans With Disabilities Act expanded the scope of 504 eligibility, more broadly defining what qualifies as a disability under the law.

But the numbers started to rise before that change was made, something some see as a result of growing awareness and communication about conditions that hinder students’ academic progress — particularly mental health diagnoses, and the resources available to students.

504 plans per 1,000 students in Minnesota Public Schools Source: Minnesota Department of Education

“I think there definitely is more awareness, especially of ADHD, said Julie McMonagle, a social worker at Gillette Children’s Specialty Healthcare. These days, McMonagle works most often with students who receive accommodations for physical conditions, ranging from cerebral palsy to orthopedic conditions and epilepsy.

But, she said, “when I was in the schools, (ADHD) was our most common 504, and I think there definitely has been an increase in that diagnosis and then the awareness that accommodations are available and needed for that diagnosis,” she said.

Mary Beth Kelley, program manager and developer at the Learning Disabilities Association of Minnesota, said heightened anxiety in school environments could be causing more underlying conditions, too.

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“I was in a school yesterday where we had a lockdown drill. To be honest, the intruder lockdown drill created a lot of anxiety — the fact that we even have to do those in schools and the reality that there might be a shooting makes kids very anxious,” she said.

With increasing use of parent websites and forums online, it’s easier for parents who are concerned about their kids to access advice, too. “Parents have become more educated about what is out there to help their child. There has also been the emergence of various parent advocacy groups that put stuff on the Internet that parents can follow,” said Michael Zaccariello, a psychologist at the Mayo Clinic.

Disparities in 504s

But the increase in awareness hasn’t happened everywhere, and disparities in 504 plan rates exist at both the state and national level.

The three Minnesota school districts with the highest share of students with 504 plans are some of the state’s wealthiest, on average: First is Mahtomedi, where about 6 percent of students have 504 plans, and next are Orono and Minnetonka, where 5 percent have 504 plans. MDE data show that less than 10 percent of students in those districts qualify for free or reduced-priced lunch, a measure used as a proxy for poverty. (A spokesperson for Mahtomedi Public Schools said an increase in 504s is partly due to more broadly-defined disabilities under the revised ADA.)

In Minneapolis, where 60 percent of students qualify for free or reduced-price lunch, about 3 percent students of had 504s, according to state data.

88 percent of Minnesota students who have 504 plans are white, compared to 66 percent of students who are enrolled in Minnesota public schools.

A New York Times investigation found that nationally, students in wealthier school districts were more likely to have 504 plans than students in poorer districts. The investigation followed the accusation that William Singer, a consultant at the center of the college admissions scandal in which students from wealthy families were accused of gaming the system to get into college, was using 504 designations as a way to help students get extra test-taking time.

Because 504 plans are often found at higher concentrations in richer districts, they’re sometimes criticized as being misused to give students who are already at an advantage an even greater edge on things like standardized tests that can determine college and job placement in their futures.

The Times talked to high school counselors in affluent districts who said some parents would pay up to $10,000 for evaluations that weren’t covered by insurance, a phenomenon the counselors called “diagnosis shopping.”

But more than that, the Times found disparities in access across districts. “What we found was less a story of fraud than one of everyday inequality. Although some unknown number of 504 disability cases are likely misdiagnoses of students whose parents are particularly aggressive or anxious about academic competition, the majority of these wealth-related disparities are due to unequal access to psychological services,” their report found.

Kelley said in addition to disparities in access, there’s disparities in knowledge that the plans even exist at all.

“It’s hit or miss. There are some schools where I think they know about the resources and know how to access the resources, and there are other places that don’t seem to know,” she said.