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.

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

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 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

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

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)

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

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

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

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

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 80-100% 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 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