© 2009 The McGraw-Hill Companies, Inc.

Students with Physical or Students with Physical or Health DisabilitiesHealth Disabilities

Chapter 10Chapter 10

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What are the Foundations of What are the Foundations of Physical and Health Disabilities?Physical and Health Disabilities?

350 B.C. - first known description of epilepsy350 B.C. - first known description of epilepsy Cerebral palsy first described in 1800sCerebral palsy first described in 1800s AIDS is one of the most recent health AIDS is one of the most recent health

disabilities.disabilities.

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How are Physical and Health How are Physical and Health Disabilities Defined?Disabilities Defined?

Three categoriesThree categories Other Health ImpairmentOther Health Impairment (OHI) (OHI)

Disorder resulting in limited strength, vitality or alertness with Disorder resulting in limited strength, vitality or alertness with respect to the educational environmentrespect to the educational environment

Orthopedic ImpairmentOrthopedic Impairment (OI) (OI) Disease such as polio, clubfoot, bone tuberculosis, cerebral palsy, Disease such as polio, clubfoot, bone tuberculosis, cerebral palsy,

spina bifida, muscular dystrophy, amputations, fractures, or burns spina bifida, muscular dystrophy, amputations, fractures, or burns that adversely affect educational performancethat adversely affect educational performance

Traumatic Brain InjuryTraumatic Brain Injury (TBI) (TBI) An acquired injury to the brain caused by external physical force, An acquired injury to the brain caused by external physical force,

resulting in total or partial functional disability that adversely resulting in total or partial functional disability that adversely affects educational performance, includes open or closed head affects educational performance, includes open or closed head injuriesinjuries

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What are Examples of What are Examples of Other Health Impairments?Other Health Impairments?

Asthma, AD/HD, diabetes, epilepsy, heart Asthma, AD/HD, diabetes, epilepsy, heart conditions, hemophilia, lead poisoning, conditions, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, leukemia, nephritis, rheumatic fever, Tourette’s Syndrome, sickle cell anemia, etc.Tourette’s Syndrome, sickle cell anemia, etc.

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What is the Prevalence of Physical What is the Prevalence of Physical and Health Disabilities?and Health Disabilities?

Students aged 6-21 Students aged 6-21 About .10% - orthopedic impairmentsAbout .10% - orthopedic impairments About .85% - other health impairments (3About .85% - other health impairments (3 rdrd largest largest

category)category) About .04% - traumatic brain injuryAbout .04% - traumatic brain injury

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What are Some Causes of What are Some Causes of Orthopedic Impairments?Orthopedic Impairments?

Orthopedic Impairments - Causes vary, but some Orthopedic Impairments - Causes vary, but some examples include:examples include: Cerebral PalsyCerebral Palsy

Damage to different parts of the brain that results in problems in Damage to different parts of the brain that results in problems in muscle tone and movement caused by prematurity, intrauterine muscle tone and movement caused by prematurity, intrauterine development, lack of blood flow or oxygen, etc.development, lack of blood flow or oxygen, etc.

Spina BifidaSpina Bifida Congenital disorder resulting when bones surrounding the spinal Congenital disorder resulting when bones surrounding the spinal

cord do not close or grow togethercord do not close or grow together Muscular DystrophyMuscular Dystrophy

Inherited (usually from the mother) or gene mutation causing Inherited (usually from the mother) or gene mutation causing muscle weakeningmuscle weakening

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Types of Cerebral PalsyTypes of Cerebral Palsy and Their Effects (Table 10.1) and Their Effects (Table 10.1)

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What are Some Causes of What are Some Causes of Other Health Impairments?Other Health Impairments?

Other Health Impairments - Many different causes Other Health Impairments - Many different causes and many different disabilities under this category and many different disabilities under this category (including AIDS, asthma, AD/HD, cancer, diabetes, (including AIDS, asthma, AD/HD, cancer, diabetes, sickle cell anemia, epilepsy, etc.)sickle cell anemia, epilepsy, etc.) Epilepsy – Recurrent seizures resulting in problems with Epilepsy – Recurrent seizures resulting in problems with

consciousness, movement, and/or sensation caused by an consciousness, movement, and/or sensation caused by an electrical dysfunction in the brainelectrical dysfunction in the brain

Generalized tonic-clonic seizuresGeneralized tonic-clonic seizures Absence seizuresAbsence seizures Simple partial seizuresSimple partial seizures Complex partial seizuresComplex partial seizures

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What are Some Causes of What are Some Causes of Traumatic Brain Injury?Traumatic Brain Injury?

Traumatic Brain Injury - An acquired head Traumatic Brain Injury - An acquired head injury caused by external force that adversely injury caused by external force that adversely affects educational performanceaffects educational performance Often caused by car accidents, falls, violence-Often caused by car accidents, falls, violence-

related injuries, and sports injuriesrelated injuries, and sports injuries Open head injury - skull is penetrated and brain Open head injury - skull is penetrated and brain

exposedexposed Closed head injury - no penetration but serious Closed head injury - no penetration but serious

consequencesconsequences

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What are Some Common What are Some Common Characteristics of Students with Characteristics of Students with Physical and Health Disabilities?Physical and Health Disabilities?

Other Health ImpairmentsOther Health Impairments Characteristics vary depending on the specific Characteristics vary depending on the specific

condition.condition. Orthopedic ImpairmentsOrthopedic Impairments

Motor coordination, balance, and coordination Motor coordination, balance, and coordination Traumatic Brain InjuryTraumatic Brain Injury

Problems with coordination, walking, vision, Problems with coordination, walking, vision, speaking, hearing, stamina, paralysis, seizures, speaking, hearing, stamina, paralysis, seizures, emotional and cognitive difficultiesemotional and cognitive difficulties

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How are Students Identified with How are Students Identified with Physical or Health Disabilities?Physical or Health Disabilities?

Identification is usually completed through Identification is usually completed through medical diagnostic procedures including medical diagnostic procedures including amniocentesis, chorionic villus sampling, amniocentesis, chorionic villus sampling, ultrasound, CT scans, EEGs, PET scans, CAT ultrasound, CT scans, EEGs, PET scans, CAT scans, standardized assessment such as the scans, standardized assessment such as the Glasgow Coma ScaleGlasgow Coma Scale, etc., etc.

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What Should I Teach Students with What Should I Teach Students with Physical or Health Disabilities?Physical or Health Disabilities?

General curriculum should be accessible for many General curriculum should be accessible for many students through use of universal design principles.students through use of universal design principles.

Content to address their specific needsContent to address their specific needs Life skills, social skills, self-determination skills Life skills, social skills, self-determination skills

development, and transition to adult livingdevelopment, and transition to adult living Use of assistive technology such as teleconferences and Use of assistive technology such as teleconferences and

distance education, if the child is hospitalized, can support distance education, if the child is hospitalized, can support access to the general education curriculum.access to the general education curriculum.

Adjust the curriculum to meet the student’s needs.Adjust the curriculum to meet the student’s needs. Teach special healthcare skills.Teach special healthcare skills.

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How Should I Teach Children with How Should I Teach Children with Physical or Health Disabilities?Physical or Health Disabilities?

Individualized Health Plans (IHP)Individualized Health Plans (IHP) Communication, medications, lifting, positioning, Communication, medications, lifting, positioning,

mobility, eating and feeding, toileting, mobility, eating and feeding, toileting, catheterization, respiratory management, ventilator catheterization, respiratory management, ventilator managementmanagement

Proper positioning of studentProper positioning of student Behavioral/social skill supportBehavioral/social skill support Support for parents/siblingsSupport for parents/siblings

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What are Considerations for the What are Considerations for the Instructional Environment?Instructional Environment?

Adapt the environment based on specific needs of Adapt the environment based on specific needs of individual students. Education may take place at individual students. Education may take place at schools, hospitals, rehabilitation facilities, and homes.schools, hospitals, rehabilitation facilities, and homes.

Provide related services as needed and train staff to Provide related services as needed and train staff to deliver special services that may be needed.deliver special services that may be needed.

Adjust placement as child’s needs change.Adjust placement as child’s needs change. Consider the whole continuum of services for Consider the whole continuum of services for

placement. Make materials portable and accessible. placement. Make materials portable and accessible. Make environments accessible.Make environments accessible.

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What Types of Instructional What Types of Instructional Technology Can be Used?Technology Can be Used?

Decisions must be based on individual needs and Decisions must be based on individual needs and assistive technology assessment.assistive technology assessment.

Assistive technology could includeAssistive technology could include Wheelchairs, specialized keyboards, adaptive devices such Wheelchairs, specialized keyboards, adaptive devices such

as wedges, braces, prostheses, self-help skills equipment, as wedges, braces, prostheses, self-help skills equipment, alternative/augmentative communication devices, alternative/augmentative communication devices, specialized computer programs and monitors, switches, etc.specialized computer programs and monitors, switches, etc.

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What are Some Considerations for the What are Some Considerations for the General Education Teacher?General Education Teacher?

Work with medical and related services personnel to provide Work with medical and related services personnel to provide appropriate services.appropriate services.

Make the physical environment safe.Make the physical environment safe. Adjust assistive technology.Adjust assistive technology. Schedule instructional times to meet medical and related Schedule instructional times to meet medical and related

services needs.services needs. Plan accessible seating arrangements.Plan accessible seating arrangements. Adapt materials.Adapt materials. Ensure students take part in extracurricular activities.Ensure students take part in extracurricular activities. Help students develop friendships.Help students develop friendships.