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Alternative Education: Home and Hospital Teaching

Alternative Education: Home and Hospital Teaching

By Lee Vander Loop
CP Family Network Editor

When a child with cerebral palsy is unable to attend school, parents may opt to have the school come to them. By law, Home and Hospital Teaching (HHT) is a program that must be offered to students who are unable to attend a regular school program due to a physical or emotional condition. Normally, these programs are offered for a short period of time, but in some cases are appropriate for long term education.

Our Story

My daughter, Danielle, had been in the school system for about two years before it became obvious that her severe cerebral palsy was not conducive to a traditional classroom environment. Her health was being compromised and her educational needs were not being met.

My reluctance to send Danielle to traditional school began when the transportation department required that a licensed medical professional accompany my daughter during her transit to school. This forced us to use the few hours of nursing services available to us for school transport.

The nurses that accompanied Danielle to school reported that she was excluded from nearly all classroom activities due to her condition. It was difficult to control her environment during transport and while she was at school, resulting in frequent episodes of hypothermia and hypothermic comas. Danielle’s nurses had to go to extraordinary measures to try to keep her warm and stable. She would spend the day in the classroom, in her snowsuit, with blankets piled high in front of a space heater in a hypothermic coma.

I knew I needed to take action when the school nurse, who had 20 years experience, commented that my daughter’s medical condition made her nervous. At that point, I insisted on a meeting with the principal, teachers, nurses and appropriate staff to demand home/hospital teaching for my daughter.

The meeting was successful and productive. After I obtained the necessary documentation from the school and my daughter’s doctor, Danielle was placed in the home/hospital program. She remained in the program for the duration of her academic years. It was the best decision I could have made. At home, I was able to control my daughter’s environment, thereby alleviating many of the situations that were affecting her in the classroom. The teacher came to the house six hours a week and was able to work with my daughter and accomplish her academic goals.

How the Home/Hospital Teaching Program Works

Students in a full day program typically receive six hours of instruction weekly. Students in a half day program receive three hours of instruction weekly. Instruction takes place either at the home, library, or other public facility. A responsible adult, 21 years of age or older, is required to be present during instruction time in the home.


A student is eligible for the HHT program if:

  • The student must be a county resident and enrolled in grade pre-k to 12 in a public or non public school.
  • Student has an anticipated absence of four weeks or more from regular school due to a physical or emotional condition.
  • A physician or psychologist/psychiatrist verifies in writing the student’s diagnosis and need for home and hospital teaching services.
  • A completed application is on file at the home and hospital teaching office.
  • The referring physician or psychologist remains responsible for the continuing of treatment or supervision during the time the student is out of school.

Continuation of services is always subject to review and requires re-verification by physician/psychologist/psychiatrist.

Parental Responsibilities:

  • Acquire and submit required documentation.
  • Make sure a responsible adult (21 years of age or older) is present when instruction takes place in the home.
  • Provide a quiet, well-lit, smoke-free learning environment. (Instruction usually takes place at student’s home but when circumstances warrant, instruction may take place at an alternative site.
  • Provide transportation to and from alternative instruction site.
  • See that the child is dressed and ready to begin instruction when the teacher arrives.
  • Agree to keep all instruction appointments. In case of emergency, agree to notify the teacher of a cancellation in a timely manner.

School of Enrollment Responsibilities:

  • Continues to enroll child in school for duration of HHT.
  • Marks student absent from school with reason of home and hospital teaching.
  • Verifies student’s course schedule with the HHT teaching office.
  • Provides the HHT teacher with textbooks, course outlines, and current instruction information.
  • Provides the HHT teacher with any adaptive, augmentive equipment needed.
  • Collaboration with the HHT teacher to ensure the student receives current course work.

Home and Hospital Teacher Responsibilities:

  • Provides instruction as assigned by the HHT office.
  • Obtains signature of supervising adult in the home biweekly to verify date and time teaching took place in the home.
  • Contacts requesting family within 24 hours of accepting assignment to schedule teaching time.
  • Obtains instructional materials and communicates with course classroom teacher.
  • Plans course lessons according to curriculum guides, grades student work performance, and assesses student progress.
  • Monitors confidentiality of student information.
  • Submits final grade report to HHT office, school, and parents when student withdraws and/or at the end of the marking period.
  • Reports student cancellations and no-shows to HHT office within 24 hours of occurrence.

HHT Office Responsibilities:

  • Coordinates instructional services for homebound student.
  • Assigns teachers to instruct students.
  • Processes applications for HHT service.
  • Collaborates with parents, schools and others to support needs of student.


Additional Resources

Visit our Facebook page to talk to other parents of cerebral palsy children about the education challenges they face and how they’ve conquered them. For more information about cerebral palsy symptoms, causes and treatments, visit www.cpfamilynetwork.org.

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3 Responses to “Alternative Education: Home and Hospital Teaching”

  1. Tenia Johnson says:

    This is a very, very interesting article. I have a son with Cerebral palsy, and he is immobile, and nonverbal. With school just begining again I’m having a hard time like I do every year with letting him go and having to be with strangers all day.

  2. Christina Dalton says:

    I’m so happy to have read this article. This type of schooling is what feel will be best for our son next year. He is 5, has cerebral palsy, is immobile & nonverbal. We had already been struggling with the school issue but were very relieved when we first learned of this home schooling option. Its so nice to read someone’s story who has done this. Thank you!!

  3. Dodie Carlton says:

    Hi. I am going to reply as both a teacher of students with moderate to severe disabilities (including cerebral palsy) and a mother of a son with autism. First as a parent, I’m glad you found that the home/hospital program worked for your daughter. As a teacher, I want to apologize for her being excluded from most classroom activities. For the past 2 years, I had a student who travel with an LVN on a half day schedule because of her fragile medical condition. I made it a point to involve the student as much as possible because she was one of my students, and I want her to be included. If there was a lot of commotion and/or noise (those things make the student nervous and could lead to seizures) her nurse would take her for a walk around the school and take her to the bathroom to wash her hands which would make her calm.