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

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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  Early 1900s: emergence of public education 4

Prevalence of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities School-age children receiving special education by disability during the school year:  Orthopedic impairments (62,371 children)  Traumatic brain injury (24,866 children)  Other health impairments (648,398 children)  Multiple disabilities (124,073 children)  Deaf-blindness (1,745 children) The first four categories represent approximately 15% of students receiving a special education with a range of.42% (TBI) to 11.0% (OHI). 5

Etiology of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Chromosomal and genetic causes  Muscular dystrophy, sickle cell anemia, hemophilia, cystic fibrosis  CHARGE Association (syndrome) and Usher syndrome are the two examples of genetic causes of deaf- blindness Teratogenic causes  TORCH – toxoplasmosis, other, rubella, cytomegalovirus, and herpes. Prematurity and pregnancy complications  Neurological conditions, cerebral palsy, vision or hearing loss, intellectual disability Acquired causes  Traumatic brain injury (TBI), child abuse, environmental toxins 6

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Categories of Students with Orthopedic Impairments  Neuromotor impairments Cerebral palsy (CP) Four most common forms: spastic, athetoid, ataxic, and mixed Classified according to which limbs are affected Spina biffida  Degenerative diseases Duchenne Muscular Dystrophy (MD)  Orthopedic and Musculoskeletal disorders Juvenile rheumatoid arthritis (JRA) limb deficiency Watch a wheelchair dance competition in this videowheelchair dance competition 8

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Characteristics 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 10

Students with Traumatic Brain Injury (TBI) Traumatic brain injury:  Temporary or permanent injury to the brain  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 Watch this video to learn about living with a TBIliving with a TBI 11

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 12

Students with Other Health Impairments (OHI) Major Health Impairments (continued)  Asthma Infectious Diseases Acquired immune deficiency syndrome (AIDS)  Human immunodeficiency virus (HIV) destroys immune system 13

Students with Deaf-Blindness Students with deaf-blindness represent an extremely heterogeneous population. Students with deaf-blindness may exhibit cognitive deficits, physical impairments, and complex health needs Additional considerations Speech and language development Social and behavior skills 14

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 in conjunction with informal observations 15

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Impact on School Performance School performance of individuals with physical or health disabilities is impacted by the type of disability and its functional effects, in addition to psychosocial and environmental factors. 17

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Educational Considerations for Students with Physical or Health Difficulties  Physical/health monitoring  Modifications and adaptations of instruction, assessment, communication, physical environment, class participation, and use of assistive technology  Specialized instructional strategies  Specialized expanded curriculum areas 19

Educational Considerations for Students Who are Deaf-Blind  Communication  Orientation and mobility  Collaborative efforts 20

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Services for Young Children with Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Early intervention services address:  Collaborative services  Motor development  Communication development  Use of augmentative communication  Building of experiences 22

Transition into Adulthood Transition planning typically addresses:  Career planning  Post-secondary education  Employment opportunities  Daily living skills  Independent living  Use of technology 23

Adults with Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities  Community acceptance and supports  Preventative medical care  Medical and technological support  Terminal illnesses 24

Family Issues  Coping with stress  Daily living activities  Medical interventions  Terminal illness 25

Issues of Diversity Physical, health, and related low-incidence disabilities occur in individuals from all backgrounds, cultures, and economic levels.  Lack of cultural bias in diagnosis  Cultural differences in coping with illness and disability 26

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 27

Trends, Issues, and Controversies  Assessing capabilities and needs  Specialized technology, adaptations, instructional strategies  Appropriate curriculum 28