CHAPTER 12: Understanding Students with Physical Disabilities and Other Health Impairments Exceptional Lives 8th Edition Turnbull, Turnbull, Wehmeyer, and Shogren Developed by Theresa Garfield Dorel Texas A&M University-San Antonio

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

Prevalence of Physical Disabilities Approximately 1% of all students ages three through 21 in special education were classified as having a physical disability.

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

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

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

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

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

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

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

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

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

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

Evaluating Students with Physical Disabilities and Other Health Impairments Neuroimaging Prenatal screening Maternal serum alpha-fetoprotein Fetal surgery

Determining the Nature of Specially Designed Instruction and Services School Function Assessment Examines a range of tasks and activities Examines three areas: Participation Task supports Activity performance

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

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

Including Students with Physical Disabilities and Other Health Impairments Physical Disabilities (Figure 12.4) 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 80-100% of their time Other Health Impairments (Figure 12.5) 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 80-100% of their time NOTE: Percentages have been rounded and collapsed into categories

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