Chapter 11 Objectives

1. Other Health Impairments Chapter 11 Objectives At the end of this presentation, you should be able to: • Describe characteristics of other health impairments. • Understand causes of other health impairments. • Describe evaluation processes for students with other health impairments. • Reflect on the importance of inclusion for students with other health impairments. • Understand the curricular and instructional needs. Chapter Objectives

2. Other Health Impairments Understanding Individual Students Who Is Kyle Edwards? • Kyle is a 10-year-old boy with sickle cell disease. • His condition resulted in 10 hospitalizations in his last school year. • Kyle understands what is necessary to do in order to care for his condition. • He has developed friendships with other children with health impairments from his times in the hospital. • Because he also has an adult aunt with sickle cell and has watched her studying to be a teacher, he is determined to stay in school and succeed. • Through teachers involved in a program at the hospital he uses for hospitalizations, he is working to stay on track with his class. Chapter Objectives

3. How Do You Recognize Students with Other Health Impairments? Defining Other Health Impairments How Do You Recognize Students with Other Health Impairments? • IDEA defines as chronic health problems that have an adverse impact on educational performance. • Limited strength, vitality or alertness • Heightened alertness to environmental stimuli • Distinguished from severe and multiple disabilities, physical disabilities, and traumatic brain injuries • May be: • Chronic: develops slowly and has long-lasting symptoms • Acute: develops quickly with intense symptoms that last a relatively short period of time • More than 200 specific health impairments exist. • This chapter focuses on more typical conditions. Describe characteristics of other health impairments.

4. Challenges Facing Children with Health Impairments • Loss of sense of control • Lack of understanding about the condition • Fear, worry, anxiety/stress, anger, guilt • Change in family dynamics • Experience of loss because of how life has changed • Isolation • Medical noncompliance • Depression, withdrawal STARBRIGHT Foundation

5. Challenges Facing Children with Health Impairments • Boredom • Loss of peer interactions • Pain • Decreased self-esteem • Lack of feelings of normalcy • Negative body image • Impact on identity and social interactions, including those at school STARBRIGHT Foundation

6. How Do You Recognize Students with Other Health Impairments? Describing the Characteristics of Sickle Cell Disease • Sickle cell disease • The most common inherited blood condition, affecting about 80,000 Americans • About 1 in 500 African Americans and 1 in 1,000-4,000 Hispanic Americans are born with the condition • Symptoms include hand-foot syndrome, pain, nosebleeds, and anemia • Affects the hemoglobin (red blood cells), causing them to be sickle-shaped rather than rounded • Teachers can help students by: • Avoiding stressors (heat, cold, poor diet, inadequate liquids) • Observing students for symptoms of pain and consider the emotional aspects of dealing with pain Describe characteristics of other health impairments.

7. How Do You Recognize Students with Other Health Impairments? Describing the Characteristics of Epilepsy • Epilepsy • Characterized by seizures (abnormal electrical discharges in the brain) • (see Figure 11-1 on page 316 in text) • Generalized seizures • Tonic-clonic • Absence • Partial seizures • Temporal lobe, also known as psychomotor • Focal motor or focal sensory • Myoclonic • Teachers can help by: • Identifying and eliminating environmental factors that trigger seizures • Provide classmates with factual information on seizures http://www.epilepsy.com/epilepsy/seizure_tonicclonic.html Describe characteristics of other health impairments.

8. How Do You Recognize Students with Other Health Impairments? Describing the Characteristics of Asthma • Asthma • A disease process that is characterized by narrowing of the bronchi (lung passageways) making breathing difficult • Most prevalent chronic illness of children and leading causes of school absences • Prevalence has become epidemic, increasing by 72% from 1982 to 1994 • Symptoms can vary widely • Mild intermittent • Mild persistent • Moderate persistent • Severe persistent • Students may use anti-inflammatories or bronchodilators • Teachers can help by: • Following students’ leads about exercise regimens • Know essential first-aid skills for managing asthma episodes • Follow a student’s action plan for episodes Describe characteristics of other health impairments.

9. How Do You Recognize Students with Other Health Impairments? Describing the Characteristics of Cancer • Cancer • Unrestrained growth of cells in body organs or tissues • Cancer is the primary cause of death in children under age 15. • More than half have leukemia or brain tumors. • Possible treatments include: • Chemotherapy • Radiation • Surgery • A combination of the above • Side effects from treatments may result in learning disabilities. • Teachers can help by: • Including students in activities with their peers as much as possible • Creating a secure environment where the child can succeed, but does not feel as if he/she is being treated differently Describe characteristics of other health impairments.

10. How Do You Recognize Students with Other Health Impairments? Describing the Characteristics of Diabetes • Diabetes • About two out of every 1,000 people under the age of 20 have diabetes • Occurs when the pancreas stops producing or produces too little insulin • Symptoms include: • Increased thirst and urination • Weight loss • Two serious conditions can result: • Hyperglycemia (too much sugar) resulting in ketoacidosis • Hypoglycemia (too little sugar) resulting in insulin shock • Teachers can help by: • Monitoring for symptoms of hyper- or hypoglycemia • Knowing the necessary first aid processes • Allowing students to find methods of monitoring blood sugar that is as unobtrusive as possible Describe characteristics of other health impairments.

11. How Do You Recognize Students with Other Health Impairments? Describing the Characteristics of HIV • Human immunodeficiency virus (HIV) • A retrovirus that causes AIDS • HIV gradually infects and destroys T4 and other immune cells • Causes a person with HIV to be more susceptible to opportunistic infections • HIV is spread through certain body fluids • In the final stages, HIV progresses to acquired immunodeficiency disease (AIDS) • African Americans have the highest risk of HIV transmission; 64% of adolescent AIDS cases in 2000 were African American • Teachers face three issues: • Confidentiality • Preventing transmission (universal precautions) • Understanding how the condition affects learning and behavior Describe characteristics of other health impairments.

12. How Do You Recognize Students with Other Health Impairments? Identifying the Causes and Prevalence • Causes • Infections • Genetic factors • Environmental factors • Prenatal and perinatal influences • Postnatal influences • Prevalence • In 1999-2000, school served 197,761 students as other health impaired (about 0.54% of the school-age population) • There has been a 351% increase since 1990-91, primarily due to the inclusion of students with AD/HD in this category Understand the causes of other health impairments.

13. How Do You Evaluate Students with Other Health Impairments? Determining the Presence Figure 11-4 Describe evaluation processes for students with other health impairments.

14. How Do You Evaluate Students with Other Health Impairments? Determining the Nature and Extent of Services • Students whose health condition adversely impacts their educational performance are entitled to an IEP. • If there is no adverse impact, they may still be entitled to a 504 plan for health services and any needed accommodations. • The school nurse is an important member in the planning of either document. • Students should also have health care plans, specifying procedures for medications or treatments, making up work missed during absences, and plans for medical emergencies. • Related services may also include school health care services. • These must be able to be administered by the nurse or other trained school personnel. • IEP’s may also contain respite care for family members. Describe evaluation processes for students with other health impairments.

15. How Do You Assure Progress in the General Curriculum? Including Students Figure 11-5 Reflect on the importance of inclusion for students with other health impairments.

16. How Do You Assure Progress in the General Curriculum? Planning Universally Designed Learning • Adapting instruction • Teachers should ask three questions: • What are the most important academic standards the student needs to meet? • How can I ensure the student attains those standards efficiently? • How can I motivate the student to attain those standards? • Adapting evaluation • Frequent student absences require teachers to determine an efficient way of determining if the student has mastered the essential standards. • Reducing the work needed on assignments or tests • Alternative assessments, such as portfolios or journaling, which may also leave a legacy for the student Understand the curricular and instructional needs.

17. How Do You Assure Progress in The General Curriculum? Collaborating to Meet Students’ Needs • Students may need ongoing support from educators and others in order to cope. • Teachers need preparation in the event of a student’s death. • Teachers face their own grief, and must also help families and other students • Teachers need to be able to seek additional support from others • Students may also lose friends they have made in the course of their illnesses Understand the curricular and instructional needs.

18. What Can You Learn from Others Who Teach Students with Other Health Impairments? Early Childhood What Can You Learn from Others Who Teach Students with Other Health Impairments? The Early Childhood Years • Kids on the Block • Shares stories of children with health impairments through puppet shows • Children can ask puppets questions after the presentation, and the puppets answer them. • There is an additional curriculum about sensitivity to differences with the scripts. • The shows discuss the different terms that are more appropriate to use in discussing health impairments. Understand students with other health impairments.

19. What Can You Learn from Others Who Teach Students with Other Health Impairments? Elementary The Elementary Years • Class Act • A school program available at the University of South Alabama’s Children’s Hospital • Assignments are sent in from the students’ home schools and attendance at Class Act counts as school attendance • Class Act employs both a teacher and a child life specialist • Goals are to prevent student retention and reduce stress, anxiety, and fear of medical procedures Understand students with other health impairments.

20. What Can You Learn from Others Who Teach Students with Other Health Impairments? Middle/Secondary The Middle/Secondary Years • Meeting the Challenge • A program that encourages teens to express their feelings about having health impairments • It teaches five levels of interpersonal skills • Self-awareness • Social imitation and conversational skills • Assertion or direct communication • Empathy or active listening • Conflict resolution and problem solving • Helps students identify maladaptive reactions to situations specific to their health impairment Understand students with other health impairments.

21. What Can You Learn from Others Who Teach Students with Other Health Impairments? Transitional and Post Secondary The Transitional and Post-Secondary Years • HIV University • Started as a support group among women with HIV who wanted to learn how to live with their condition • Their school developed four programs that: • Provided emotional support • Eliminated barriers to participation (such as child care or language barriers) • Emphasized group problem solving • Provided classes on topics relevant to living with HIV Understand students with other health impairments.

22. Case Study Analysis • Considering Kyle Edwards situation, design a plan to correspond with the medical teaching staff. • If you were teaching Kyle in a medical facility, how could you meet Kyle’s educational needs if information was not provided by the school? • Plan a meeting agenda to discuss Kyle’s progress and how he is doing in comparison to his fourth-grade peers. • How can you as the classroom teacher ensure Kyle’s progress despite his medical needs and his frequent absences • How is Kyle’s situation similar to students with other types of health impairments? • How is he the same as his peers?

23. A Vision for Kyle’s Future • Kyle’s grandmother hopes for a cure for sickle cell. • She wants him to go to college and be a doctor. • Kyle wants to be an athlete, or perhaps an author of children’ books. • He also may consider becoming a doctor so he can find a cure for sickle cell himself.

24. Into Practice - Strategies for Kyle’s Transition to School • Create a class unit about children with special needs. • Write movie reviews or TV reviews to send. • Send information about a new video or computer game, with secret codes. • Share comic books and follow up with a call. • Use e-mail to create buddy lists. • Create a website/chat room/info-board. • Make an audiotape or video. • Schedule phone calls, visits, special events. • Arrange for mail, [e-mail, and/or fax] deliveries every day, [including class assignments].

25. Into Practice • If Kyle Bessell were in your classroom next year, which of these strategies do you think would be most helpful for meeting his needs? • Which strategies do you believe will be most challenging to implement for him or other students? Why? How could you meet these challenges? • How could you incorporate some of these strategies to help students keep up academically?