[parent name] 
[address] 
[phone and email] 
[date] 
[school counselor or 504 team leader] 
[school name and address] 
Dear [school counselor or 504 team leader]; 
This letter is regarding [Child]’s planned 504 eligibility meeting. I have forwarded a letter from [Child]’s psychiatrist, [Doctor’s name], documenting their diagnoses. In addition, I would also like to provide some additional context and describe some of the ways in which [Child]’s conditions impair their learning and activities. 
One of the main ways in which [Child]’s conditions affect their everyday life is through misophonia. Misophonia (literally “hatred of sound”) describes an affective sound-processing disorder characterized by strong negative emotions (anger and anxiety) in response to everyday sounds, such as those generated by other people eating, drinking, chewing, and breathing. [Child] finds these sounds -- i.e. “triggers” -- intolerable, and when [Child] hears people eating, drinking, and chewing -- and at times, coughing, whistling, and even breathing -- [Child] instantaneously becomes profoundly agitated, anxious, or angry, and experiences an irresistible urge to flee. 
This is not mere irritation or annoyance: [Child] has described the experience of hearing people eat, chew, or swallow as “unbearable,” “agony” and “torture.” 
[Child]’s misophonia affects just about everything in their life. At home, [Child] takes most meals in their bedroom and almost always checks to see if someone is eating before venturing out of their room into common areas of the house. We have not shared a meal as a family in almost two years. 
At summer camp this past summer, [Child] ate in a separate area from the rest of the campers, while everyone else ate in a shared dining hall. On a couple of different occasions, when [Child] was unable to avoid being around other campers who were snacking, [Child] had full-blown panic attacks. 
[Child] finds it consistently challenging to attend birthday parties, bar and bat mitzvahs, religious services, holiday celebrations, fairs and festivals, family events, and occasions of all sorts. [Child] manages to go to shops or stores or friends’ houses only with significant pre-planning and with the use of assistive devices such as noise-cancelling headphones with music.
Since returning to school this fall, [Child] has found getting through the school day deeply challenging. On a typical day, in order to manage triggering situations, [Child] leaves class at least half a dozen times -- or more -- and wears headphones in the hallway between classes and at other transition times. [Child] avoids extracurricular activities taking place after-school or during lunch because of the likelihood that other students will be eating during those times. Just yesterday, [Child] informed me that they could not attend the school dance for the same reason. 
As [Child]’s teachers can attest, [Child] wants to be in school, is eager to succeed, and is a conscientious, engaged student. Just as importantly, [Child] is social and extraverted, and is eager to connect with other students. 
I share this in order to underscore that [Child] does not want to miss class, and certainly does not want to miss lunch or other unstructured and social times of the day. 
However, it’s often impossible for [Child] to sit in class when another student is, say eating leftover Halloween candy; or to be in the cafeteria during lunchtime. Sometimes just the fear of these is crippling enough to interfere with [Child]’s day. At other times, [Child] may be caught unaware and have to immediately react to an unplanned-for trigger. 
[Child] has managed relatively well so far this year due in large part to your ongoing support, [school counselor or 504 team leader], and due to the kindness and flexibility of [Child]’s teachers. Generally speaking, [Child]’s teachers have accommodated most of [Child]’s requests to avoid or manage triggers -- without which [Child] would not have been able to remain enrolled at [Middle School] this fall. 
Misophonia substantially limits [Child]’s ability to learn, to socialize, and to engage in a great many everyday activities -- and these experiences represent just one set of [Child]’s challenges. [Child]’s learning is further limited by other aspects of their ADHD and anxiety disorders. [Child] has trouble independently focusing and sustaining their attention, as well as listening when spoken to. [Child] also presents with forgetfulness, procrastination, distractibility, losing items, and trouble organizing tasks. 
Accordingly, we should develop and implement a comprehensive, robust 504 plan that enables [Child] to move freely about their school day. Just as a student with a physical disability should be secure in the knowledge that they will be able to move about the school building unencumbered, so too does [Child] deserve to know that they are welcome throughout the school’s physical and communal spaces. This means, at a minimum, that [Child] must never be penalized for managing triggering situations. And ideally, school spaces and activities should have quiet rooms and spaces where no eating is allowed. 
I hope this letter is useful as the 504 team considers [Child]’s disabilities and how to best provide [Child] with full and unfettered access to the widest possible range of educational experiences at [Middle School.] I am also happy to answer any questions you may have. Thank you so much for your support and assistance.