Chapter Thirteen Individuals with Physical Disabilities, Health Disabilities, and Related Low- Incidence Disabilities

Federal Definitions Pertaining to Physical or Health Disabilities and Deaf-Blindness

Examples of Physical and Health Disabilities

Brief History of the Field Early history Middle Ages 1890: First U.S. institution for children with physical disabilities (Industrial School for Crippled and Deformed Children), Boston Emergence of public education

Prevalence of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities School-age children receiving special education by disability category (U.S. Department of Education): Orthopedic impairments (63,127 children) Multiple disabilities (133,914 children) Traumatic brain injury (23,509 children) Other health impairments (561,028 children)

Etiology of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Genetic and chromosomal defects Muscular dystrophy, sickle cell anemia, hemophilia, cystic fibrosis, deaf-blindness Teratogenic causes Fetal alcohol syndrome, syphilis, rubella, herpes Prematurity and pregnancy complications Neurological conditions, cerebral palsy, vision or hearing loss Acquired causes Traumatic brain injury (TBI), meningitis

Categories of Students with Orthopedic Impairments Neuromotor impairments Damage to the brain, spinal cord, or nerves Cerebral palsy (CP), spina bifida Degenerative diseases Affects muscles and motor development Muscular dystrophy (MD) Musculoskeletal disorders Juvenile rheumatoid arthritis (JRA), limb deficiency

Spinal Development

Definition of Students with Multiple Disabilities Multiple Disabilities is an umbrella term that refers to individuals with concomitant impairments whose needs cannot be met in a special education program designed solely for one impairment. Examples: Intellectual disabilities and spina bifida Cerebral palsy and seizures Muscular dystrophy and behavior disorders

Students with Traumatic Brain Injury (TBI) Acquired brain injury Often mild, varies by area of brain injury May impair cognition and social/behavioral functioning Added as a separate disability category under IDEA in 1990 Often requires rehabilitative services

Students with Other Health Impairments (OHI) Major Health Impairments Seizure Disorders Absence seizures (formerly petit-mal) Loss of consciousness, appears trancelike Complex partial seizure Impaired consciousness, involuntary movements Tonic-clonic seizures (formerly grand-mal) Convulsive seizure, loss of consciousness Asthma Medication, avoid triggers

Students with Other Health Impairments (OHI), continued Infectious Diseases Acquired immune deficiency syndrome (AIDS) Human immunodeficiency virus (HIV) destroys immune system Students with Deaf-Blindness Students with deaf-blindness may exhibit cognitive deficits (65%), physical impairments (58%), or complex health needs (41%)

Classroom Suggestions Teacher Actions if a Tonic-Clonic Seizure Occurs: Stay calm Move furniture Loosen shirt collar Place pillow under head Turn student on his/her side Call ambulance if first seizure or duration of 5 minutes or more Reassure student after seizure, allow to rest

Educational evaluations Assessment of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Medical evaluation Physician confirms diagnosis of physical or health condition Educational evaluations Team determines if the disability negatively impacts educational performance Students with deaf-blindness Developmental, rather than standardized, assessments are used

Where are Students with Physical or Health Disabilities Educated?

Where are Students with Physical or Health Disabilities Educated Where are Students with Physical or Health Disabilities Educated? (continued)

Where are Students with Physical or Health Disabilities Educated Where are Students with Physical or Health Disabilities Educated? (continued)

Impact on School Performance Type of Disability: Neuromotor impairments Orthopedic and musculoskeletal impairments Degenerative and terminal diseases Sensory impairments Health impairments Multiple disabilities

Impact on School Performance (continued) Functional Effects of a Disability: Atypical movements and motor abilities Sensory loss Communication impairments Fatigue, lack of endurance Health factors Experiential deficits Cognitive impairments, processing deficits

Impact on School Performance (continued) Psychosocial and Environmental Factors: Motivation Self-concept Self-advocacy Behavioral and Emotional Functioning Social Environment and Social Competence Physical and Technological Environments Learning and Attitudinal Environments

Educational Considerations for Students Who are Deaf-Blind Communication Orientation and mobility Collaborative efforts

Services for Young Children with Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Collaborative services Motor development Communication development Use of augmentative communication Building of experiences

Transition into Adulthood Career preparation College Technology

Adults with Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Community acceptance and supports Preventative medical care Terminal illnesses

Family Issues Stress coping strategies Medical treatments Death issues

Issues of Diversity Lack of cultural bias in diagnosis Cultural differences in coping with illness and disability

Technology and Individuals with Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Assistive technology Augmentative communication Positioning and seating devices Mobility devices Environmental control and assistive technology for daily living Assistive technology for play and recreation

Trends, Issues, and Controversies Assessing capabilities and needs Specialized technology, adaptations, instructional strategies Appropriate curriculum