1. 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

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

4. 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

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

6. 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

7. 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

8. 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

9. 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

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

11. 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

12. 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

13. 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

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

15. 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

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. 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 % 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 % of their time
NOTE: Percentages have been rounded and collapsed into categories

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