1. Chapter 12
Understanding Students with Physical Disabilities and Other Health Impairments
Each Power Point presentation can be viewed as transparencies or computer presentations. There are discussion questions and links to websites imbedded in each Power Point presentation to assist instructors and students. Please refer to the Instructors Manual for the complete list of ancillaries that support each chapter. The DVD and Companion Website all have video clips and other materials for an enriching multimedia instructional experience.

2. Defining Physical Disabilities
IDEA uses the term orthopedic impairments, but educators typically use the term physical disabilities.
Typically refers to a large group of students who experience conditions that are very different from each other but usually include mobility issues
The term may also be used to include students with:
Severe and multiple disabilities
Traumatic brain injury
Focus on two types of physical disabilities:
Cerebral palsy
Spina bifida

3. Characteristics of Cerebral Palsy
A disorder of muscle control due to damage in the brain
Multiple types
Spastic
Dyskinetic
Athetoid
Ataxic
Mixed
Topographical Classification System
Monoplegia
Paraplegia
Hemiplegia
Triplegia
Quadriplegia
Diplegia
Double hemiplegia

4. Characteristics of Cerebral Palsy
Causes
Prenatal
Perinatal
Postnatal
Other associated conditions
Possible intellectual disability
Speech/language problems
Vision impairments
Seizures

5. Characteristics of Spina Bifida
Malformation of the spinal cord prior to birth
Three common forms
Spina bifida occulta
Meningocele
Myelomeningocele
Causes
Occurs in early pregnancy due to environmental and genetic factors
Maternal exposure to certain acne medications
Excessive use of saunas (hyperthermia)
Prenatal diabetes
Mothers using regular supplements containing folic acid reduce their risk

6. Characteristics of Spina Bifida
Other associated conditions:
Approximately 75% of persons with Spina Bifida have average intelligence, however, may struggle with attention, memory, and executive functioning
Depending on location of defect, may cause
incontinence or other urinary and bowel problems
Children and youth may also experience challenges in social development

7. Defining Other Health Impairments
IDEA defines as chronic health problems those that have an adverse impact on educational performance.
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

8. Prevalence of Other Health Impairments
In 2008, 11% of students receiving services under IDEA (ages 6-21), were classified as OHI
This includes AD/HD
Of all students, 10–30% will experience a childhood chronic illness lasting three months or longer
More than 200 specific health impairments exist

9. Characteristics of Epilepsy
Characterized by seizures (abnormal electrical discharges in the brain)
Generalized seizures
Tonic-clonic
Absence
Partial seizures
Simple partial
Complex partial

10. Characteristics of Epilepsy
Conditions associated with epilepsy
Approximately 75% of individuals with epilepsy have normal intelligence
They are at risk for being diagnosed with learning disabilities
Research also indicates a higher prevalence of emotional disorders
Causes
Approximately 40% of individuals with epilepsy have a genetic contribution
Environmental factors include: Prenatal brain infections, birth trauma, poisoning, stress, fatigue, and sleep deprivation
In three-fourths of individuals with epilepsy, the cause is unknown

11. Characteristics of Asthma
Lung condition characterized by airway obstruction, inflammation, and hyperirritability of the bronchial tubes
Most prevalent chronic illness of children
Symptoms can vary widely
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent

12. Characteristics of Asthma
Conditions associated with asthma
Fatigue from waking during the night because of breathing difficulties
Absences from school due to symptoms
Fatigue and school absenteeism are associated with lower academic performance
Causes
Asthma symptoms are triggered by food, exercise, cold air, respiratory infections, and environmental allergens, including cigarette smoke, dust, mold, gases, and chemicals
Sometimes asthma is an inherited condition

13. Partnering for Special Education and Related Services
Health condition must adversely impact educational performance for an IEP
Otherwise, develop a 504 plan
Components of the health care plan (Box 12.3)

14. Determining Supplementary Aids and Services
Electronic Wheelchairs
Transporting the chair
Adjusting the size
Maintenance
Recharging the batteries
Selecting the navigation tools
Assuring safety
Brake system
Adaptive Switches
Pressure
Timed
Pneumatic or puffing switches
Movements
Sound

15. Planning for Other Educational Needs
Adaptive PE
Allows for student with disabilities to participate in a typical sport or physical activity
Modified equipment
Beeping ball for student with visual impairment

16. Effective Instructional Strategies: Early Childhood Students
Token economies
Not age- or disability-specific
Relates to errorless learning and using prompts for modifying the “three-term contingency” sequence (discriminative stimulus, response, and reinforcing stimulus)
Another way to modify the three-term contingency is by changing aspects of the reinforcing stimulus (e.g., altering the schedule on which a reinforcer is delivered)
Token economies use reinforcers

17. Effective Instructional Strategies: Elementary and Middle School Students
Self-awareness
Middle school is difficult for most children, and a disability or illness only adds to the stress
The term self-awareness refers to one’s understanding of oneself as a unique individual and is often used in conjunction with the notions of self-understanding and self-knowledge
This includes the process referred to as disability awareness, which involves the capacity of an individual to appraise his or her own abilities as a function of a specific disabling condition

18. Effective Instructional Strategies: Secondary and Transition Students
Driver’s Ed
A driver’s license is the key to freedom and independence
Having a driver’s license impacts a student’s social activity
Schools need modified vehicles for students with disabilities

19. Including Students with Physical Disabilities and Other Health Impairments
Physical Disabilities (Figure 12.6)
7% in a separate setting
25% in a regular class 0-39% of their time
17% in a regular class 40-79% of their time
52% in a regular class % of their time
Other Health Impairments (Figure 12.7)
4% in a separate setting
11% in a regular class 0-39% of their time
24% in a regular class 40-79% of their time
60% in a regular class % of their time
NOTE: Percentages have been rounded and collapsed into categories

20. Making Accommodations for Assessment
Computer-Based Assessment
Frequent Breaks
Scribe
Physical access to testing environment
Security concerns, test materials, and environmental controls