1. Copyright © 2007 Allyn & Bacon Chapter 9 Physical Impairments and Special Health Care Needs This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or in part, of any images; any rental lease, or lending of the program. Introduction to Special Education: Making a Difference 6th Edition

2. Copyright © 2007 Allyn & Bacon Focus Questions How are physical impairment and special health care needs classified and organized? How are physical impairment and special health care needs classified and organized? What are some steps teachers should follow to assist a child who is having a seizure? What are some steps teachers should follow to assist a child who is having a seizure? What are the different types of cerebral palsy? What are the different types of cerebral palsy? How do students with ADHD qualify for special education services? How do students with ADHD qualify for special education services? How can the learning environment be modified to accommodate students with physical impairments and special health care needs? How can the learning environment be modified to accommodate students with physical impairments and special health care needs?

3. Copyright © 2007 Allyn & Bacon Challenge Question What are the barriers to the full inclusion of these individuals in society, and how can they be minimized? What are the barriers to the full inclusion of these individuals in society, and how can they be minimized?

4. Copyright © 2007 Allyn & Bacon History of the Field Treatment dates to prehistoric times, but was often based in superstition and unsafe practices Treatment dates to prehistoric times, but was often based in superstition and unsafe practices Architectural barriers, though improving, are still problems Architectural barriers, though improving, are still problems Brief timeline: Brief timeline: 1861: William Little describes cerebral palsy 1900: First public classes for “crippled” children 1973: Section 504 of the Rehabilitation Act is passed 1977: Section 504 is implemented 1990: The Americans with Disabilities Act is signed into law 1997: IDEA calls out ADHD in other health impairment category

5. Copyright © 2007 Allyn & Bacon Opportunities for a Better Future Incorrect stereotypes about physical impairments are common Incorrect stereotypes about physical impairments are common Physical perfection is often wrongly associated with goodness Physical perfection is often wrongly associated with goodness

6. Copyright © 2007 Allyn & Bacon Thinking about Dilemmas to Solve How can the educational system best respond to their needs How can the educational system best respond to their needs Why some states use separate special education schools for students with physical disabilities while others do not Why some states use separate special education schools for students with physical disabilities while others do not The impact of fully including all medically fragile students in general education classrooms on all of those directly and indirectly involved The impact of fully including all medically fragile students in general education classrooms on all of those directly and indirectly involved The implications of including ADHD as a condition under the health impairments category The implications of including ADHD as a condition under the health impairments category How teachers should be prepared to work with children with these special needs How teachers should be prepared to work with children with these special needs

7. Copyright © 2007 Allyn & Bacon Physical Impairments and Special Health Care Needs Defined Physical impairments Physical impairments IDEA uses the term orthopedic impairments IDEA uses the term orthopedic impairments Children have problems with structure or functioning of their bodies Children have problems with structure or functioning of their bodies Includes impairments caused by: Includes impairments caused by: Congenital anomaly Congenital anomaly Disease Disease Other causes such as cerebral palsy and amputations Other causes such as cerebral palsy and amputations Special health care needs Special health care needs IDEA uses the term other health impairments IDEA describes these students as having: Limited strength Chronic or acute health problems Affected educational performance Can be divided into two categories Neuromotor Muscular/skeletal

8. Copyright © 2007 Allyn & Bacon Physical Impairments Neuromotor impairments Neuromotor impairments Brain and spinal cord damage Brain and spinal cord damage Includes: Includes: Seizure disorders Seizure disorders Cerebral palsy Cerebral palsy Spinal cord disorders Spinal cord disorders Polio Polio Muscular dystrophy Muscular dystrophy Multiple sclerosis Multiple sclerosis Muscular/Skeletal conditions include: Muscular/Skeletal conditions include: Juvenile arthritis Limb deficiencies Skeletal disorders

9. Copyright © 2007 Allyn & Bacon Assisting a Child who is Having a Seizure Create a safe place free from hazards Create a safe place free from hazards Loosen clothing Loosen clothing Protect the head Protect the head Call ambulance for seizures longer than five minutes Call ambulance for seizures longer than five minutes Keep individual calm when they return to consciousness Keep individual calm when they return to consciousness

10. Copyright © 2007 Allyn & Bacon Special Health Care Needs Chronic Illnesses Chronic Illnesses Asthma Asthma Sickle cell anemia Sickle cell anemia Tuberculosis Tuberculosis Childhood cancer Childhood cancer Cystic fibrosis Cystic fibrosis Congenital heart defects Congenital heart defects Blood disorders Blood disorders Diabetes Diabetes Infectious Diseases Infectious Diseases HIV and AIDS Hepatitis B

11. Copyright © 2007 Allyn & Bacon Prevalence In the 2003-2004,school year: In the 2003-2004,school year:.88% of all students were classified as having “other health impairments” ( including students diagnosed with ADHD).88% of all students were classified as having “other health impairments” ( including students diagnosed with ADHD) 13% of all students were classified with physical disabilities 13% of all students were classified with physical disabilities Both categories comprise 1% of all students

12. Copyright © 2007 Allyn & Bacon Prevalence of Some Special Health Care Needs Asthma - 8% to 12% Asthma - 8% to 12% Cerebral palsy - 0.03% Cerebral palsy - 0.03% Epilepsy - <1% Epilepsy - <1% AIDS - < 5% ( in students 13 - 24) AIDS - < 5% ( in students 13 - 24) Sickle Cell Anemia- 8% Sickle Cell Anemia- 8%

13. Copyright © 2007 Allyn & Bacon Causes and Prevention Causes Causes Allergies and infections Allergies and infections Heredity Heredity Accidents and injuries Accidents and injuries Multiple factors Multiple factors “unknown” “unknown” Prevention Prevention Good prenatal care Good prenatal care Universal immunization Universal immunization Avoiding injuries Avoiding injuries Medical treatment or management Medical treatment or management Teachers can help by: Teachers can help by: Referring sick children to school nurse and parents Keeping play areas and objects disinfected Having students wash their hands frequently Using disposable gloves when cleaning up an accident Keeping classrooms free of pollutants

14. Copyright © 2007 Allyn & Bacon Environmental Modifications Modifications vary widely and are based upon the needs of the student Modifications vary widely and are based upon the needs of the student Modifications may be required continuously or intermittently Modifications may be required continuously or intermittently The degree of modification required may range from none to home bound or hospital bound instruction. The degree of modification required may range from none to home bound or hospital bound instruction.

15. Copyright © 2007 Allyn & Bacon Testing Accommodations Accommodations Accommodations Scheduling - providing extra time Scheduling - providing extra time Setting - distraction free setting Setting - distraction free setting Directions - reading directions aloud / simplifying directions Directions - reading directions aloud / simplifying directions Assisting during testing - reading each item Assisting during testing - reading each item

16. Copyright © 2007 Allyn & Bacon Early Childhood Education Focus on the development of motor responses Focus on the development of motor responses Body awareness, motor planning and mobility skills set the stage for independence Body awareness, motor planning and mobility skills set the stage for independence Communication skills must be encouraged Communication skills must be encouraged Multi-disciplinary team members ensure development of an effective program Multi-disciplinary team members ensure development of an effective program Students need to be positioned properly Students need to be positioned properly

17. Copyright © 2007 Allyn & Bacon Elementary Through High School School children may require special features and instructional accommodations such as: School children may require special features and instructional accommodations such as: Adjusted schedules and extra time Accessible physical and learning environments Planning for health care in the classroom Creative solutions to lessen impact of absences Goals that foster independence Assistive technology

18. Copyright © 2007 Allyn & Bacon Collaboration for Inclusion Accessibility is important at school, home, and in the community Accessibility is important at school, home, and in the community Remove physical barriers Remove physical barriers Eliminate social barriers Eliminate social barriers Participate in extra curricular activities Participate in extra curricular activities Inclusion in sports and leisure time activities Inclusion in sports and leisure time activities Coordination and collaboration with multidisciplinary team members is crucial Coordination and collaboration with multidisciplinary team members is crucial More students with physical disabilities (46%) and those with special health care needs (44%) are receiving their education primarily in the general education class More students with physical disabilities (46%) and those with special health care needs (44%) are receiving their education primarily in the general education class Teachers are being called on to resume more medical management responsibilities due to: Teachers are being called on to resume more medical management responsibilities due to: Shortage of nurses Courts expansion of duties Local education budget cuts

19. Copyright © 2007 Allyn & Bacon Transition Through Adulthood Students attaining a high school diploma Students attaining a high school diploma Physical disabilities - 63% Physical disabilities - 63% Special health care needs – 67% Special health care needs – 67% Independent living is the goal for many people Independent living is the goal for many people Transition programs in school can be helpful Transition programs in school can be helpful Barriers to full participation include: Barriers to full participation include: Coping with inaccessible environments Dealing with bias, rejection, and discrimination Difficulties living independently Difficulties finding jobs Social rejection by people without disabilities

20. Copyright © 2007 Allyn & Bacon Families A child’s chronic illness can affect families in ways such as: A child’s chronic illness can affect families in ways such as: Fatigue Fatigue Low vitality Low vitality Restricted social lives Restricted social lives Preoccupation with decisions related to the child’s illness Preoccupation with decisions related to the child’s illness Some families find that seeking out others with similar problems is helpful Some families find that seeking out others with similar problems is helpful

21. Copyright © 2007 Allyn & Bacon Technology Assistive technology Assistive technology Help with independent living Help with independent living IDEA and courts have clarified its role as a related service IDEA and courts have clarified its role as a related service IDEA does not cover medical services provided by physicians IDEA does not cover medical services provided by physicians Includes high-tech devices such as computers and wheelchairs Includes high-tech devices such as computers and wheelchairs Includes low-tech devices such as communication booklets Includes low-tech devices such as communication booklets Individualizing and creativity are important Individualizing and creativity are important Cutting edge technology includes: Cutting edge technology includes: Rehabilitation engineering including bionics and robotics Rehabilitation engineering including bionics and robotics Gait training laboratories Gait training laboratories Voice activated systems Voice activated systems

22. Copyright © 2007 Allyn & Bacon Challenge Question What are the barriers to the full participation of these individuals in society, and how can they be minimized? What are the barriers to the full participation of these individuals in society, and how can they be minimized? Barriers include: Barriers include: Inaccessible environments Inaccessible environments Bias, rejection, and discrimination Bias, rejection, and discrimination Difficulties living independently Difficulties living independently Difficulties finding jobs Difficulties finding jobs Social rejection by people without disabilities Social rejection by people without disabilities Students require: Students require: Accessible physical and learning environments Accessible physical and learning environments Acceptance and understanding Acceptance and understanding Goals that foster independence Goals that foster independence Accommodations for learning, physical, and health needs Accommodations for learning, physical, and health needs Special teaching, scheduling, counseling, therapies, equipment, and technology Special teaching, scheduling, counseling, therapies, equipment, and technology