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  • Robert Lusk

Iowa’s Supreme Court Weighs In on Doctor’s Notes for ABA Therapy



If a school district receives a doctor’s note prescribing ABA therapy, is it required to release a student during the school day? The Iowa Supreme Court recently considered and resolved this issue in a case called Hills & Dales Child Development Center v Iowa Dept. of Ed., et al., 80 IDELR 79 (December 30, 2021).


In Hills & Dale, the plaintiff, a certified provider of ABA therapy under Iowa law, argued that Iowa school districts were legally required to comply with a doctors’ notes excusing students from school to attend ABA therapy. The court noted it had no issue with ABA therapy. However, a school district’s obligation to provide an IDEA-eligible student with FAPE superseded any duty it might have to release a student for ABA therapy prescribed by a doctor. Therefore, unless ABA therapy was necessary to provide FAPE, a school district had no obligation to release a student to receive such therapy. To the contrary the court pointed out, releasing a student from too much school for anything, including ABA therapy, might, in some cases, deny the student FAPE. The court further explained, pursuant to US Supreme Court decisions interpreting IDEA (e.g., Garret F.), ABA therapy was a “related service” and not a medical intervention.


Hills & Dales, thus, reinforced the position most Michigan school districts have taken on this issue. Unfortunately, it also highlighted the conundrum school districts face when parents insist on taking advantage of ABA therapy during the school day: Should a school district actively oppose a parent’s preference for ABA therapy over FAPE as described in the IEP? Or, put differently, in those cases where a parent insists on taking a student out of school for ABA therapy that is not necessary to provide FAPE, should a school district consider those absence unexcused or even evidence of truancy. These questions pose a real dilemma as nothing prevents parents from later claiming the school district’s permissiveness caused a denial of FAPE.


There are several ways to resolve this dilemma. The school district may, for example, persuade the parent that ABA is not appropriate for a particular child. The IEP team might also reconsider whether ABA is necessary for the student to receive FAPE. Alternatively, the school district might consider mediation and, perhaps, enter into a mediation agreement that prevents the parent from later claiming a denial of FAPE. And, of course, the school district may simply treat the parent and student like any other who misses too much school. However, Hills & Dale suggests a school district accepts a liability risk when it simply looks the other way at the expense of the student’s right to FAPE.