Students with Physical or Health Disabilities

1. Students with Physical or Health Disabilities Chapter 10

2. What are the Foundations of Physical and Health Disabilities? • 350 B.C. - first known description of epilepsy • Cerebral palsy first described in 1800s • AIDS is one of the most recent health disabilities.

3. How are Physical and Health Disabilities Defined? • Three categories • Other Health Impairment (OHI) • Disorder resulting in limited strength, vitality or alertness with respect to the educational environment • Orthopedic Impairment (OI) • Disease such as polio, clubfoot, bone tuberculosis, cerebral palsy, spina bifida, muscular dystrophy, amputations, fractures, or burns that adversely affect educational performance • Traumatic Brain Injury (TBI) • An acquired injury to the brain caused by external physical force, resulting in total or partial functional disability that adversely affects educational performance, includes open or closed head injuries

4. What are Examples of Other Health Impairments? • Asthma, AD/HD, diabetes, epilepsy, heart conditions, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, Tourette’s Syndrome, sickle cell anemia, etc.

5. What is the Prevalence of Physical and Health Disabilities? • Students aged 6-21 • About .10% - orthopedic impairments • About .85% - other health impairments (3rd largest category) • About .04% - traumatic brain injury

6. What are Some Causes of Orthopedic Impairments? • Orthopedic Impairments - Causes vary, but some examples include: • Cerebral Palsy • Damage to different parts of the brain that results in problems in muscle tone and movement caused by prematurity, intrauterine development, lack of blood flow or oxygen, etc. • Spina Bifida • Congenital disorder resulting when bones surrounding the spinal cord do not close or grow together • Muscular Dystrophy • Inherited (usually from the mother) or gene mutation causing muscle weakening

7. Types of Cerebral Palsy and Their Effects (Table 10.1)

8. What are Some Causes of Other Health Impairments? • Other Health Impairments - Many different causes and many different disabilities under this category (including AIDS, asthma, AD/HD, cancer, diabetes, sickle cell anemia, epilepsy, etc.) • Epilepsy – Recurrent seizures resulting in problems with consciousness, movement, and/or sensation caused by an electrical dysfunction in the brain • Generalized tonic-clonic seizures • Absence seizures • Simple partial seizures • Complex partial seizures

9. What are Some Causes of Traumatic Brain Injury? • Traumatic Brain Injury - An acquired head injury caused by external force that adversely affects educational performance • Often caused by car accidents, falls, violence-related injuries, and sports injuries • Open head injury - skull is penetrated and brain exposed • Closed head injury - no penetration but serious consequences

10. What are Some Common Characteristics of Students with Physical and Health Disabilities? • Other Health Impairments • Characteristics vary depending on the specific condition. • Orthopedic Impairments • Motor coordination, balance, and coordination Traumatic Brain Injury • Problems with coordination, walking, vision, speaking, hearing, stamina, paralysis, seizures, emotional and cognitive difficulties

11. How are Students Identified with Physical or Health Disabilities? • Identification is usually completed through medical diagnostic procedures including amniocentesis, chorionic villus sampling, ultrasound, CT scans, EEGs, PET scans, CAT scans, standardized assessment such as the Glasgow Coma Scale, etc.

12. What Should I Teach Students with Physical or Health Disabilities? • General curriculum should be accessible for many students through use of universal design principles. • Content to address their specific needs • Life skills, social skills, self-determination skills development, and transition to adult living • Use of assistive technology such as teleconferences and distance education, if the child is hospitalized, can support access to the general education curriculum. • Adjust the curriculum to meet the student’s needs. • Teach special healthcare skills.

13. How Should I Teach Children with Physical or Health Disabilities? • Individualized Health Plans (IHP) • Communication, medications, lifting, positioning, mobility, eating and feeding, toileting, catheterization, respiratory management, ventilator management • Proper positioning of student • Behavioral/social skill support • Support for parents/siblings

14. What are Considerations for the Instructional Environment? • Adapt the environment based on specific needs of individual students. Education may take place at schools, hospitals, rehabilitation facilities, and homes. • Provide related services as needed and train staff to deliver special services that may be needed. • Adjust placement as child’s needs change. • Consider the whole continuum of services for placement. Make materials portable and accessible. Make environments accessible.

15. What Types of Instructional Technology Can be Used? • Decisions must be based on individual needs and assistive technology assessment. • Assistive technology could include • Wheelchairs, specialized keyboards, adaptive devices such as wedges, braces, prostheses, self-help skills equipment, alternative/augmentative communication devices, specialized computer programs and monitors, switches, etc.

16. What are Some Considerations for the General Education Teacher? • Work with medical and related services personnel to provide appropriate services. • Make the physical environment safe. • Adjust assistive technology. • Schedule instructional times to meet medical and related services needs. • Plan accessible seating arrangements. • Adapt materials. • Ensure students take part in extracurricular activities. • Help students develop friendships.