1. Understanding Students with Physical Disabilities and Other Health Impairments

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
The term may also be used to include with:
Severe and multiple disabilities
Traumatic brain injury
Focus on two types of physical disabilities:
Cerebral palsy
Spina bifida

3. Characteristics of Cerebral Palsy
A disorder of movement or posture due to damage in the brain
Multiple Types
Spastic
Dyskinetic
Athetoid
Ataxic
Mixed
Causes
Prenatal
Perinatal
Postnatal
Other associated conditions
Possible intellectual disability
Speech/language problems
Vision impairments
Seizures

4. Characteristics of Spina Bifida
Malformation of the spinal cord
Three common forms
Spina bifida occulta
Meningocele
Myelomeningocele
Causes
Occurs in early pregnancy due to environmental and genetic factors
Mothers using regular supplements containing folic acid reduce their risk
Other associated conditions
Usually does not affect intelligence
Depending on location of the defect, may cause incontinence or other urinary and bowel problems

5. 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.

6. Prevalence of Other Health Impairments
In 2006, 595, 073 students (0.99%) of the ages 6 to 21 served under IDEA
Of all students, 10 to 30% will experience a childhood chronic illness lasting three months or longer
More than 200 specific health impairments exist

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

8. Characteristics of Epilepsy
Conditions associated with epilepsy
Most children have lower IQ and academic achievement
They are at risk for being diagnosed with AD/HD
Adolescents with epilepsy are reported to have higher levels of depression
Causes
Approximately 40% of individuals with epilepsy have a genetic contribution
Environmental factors include: prenatal brain infections, birth trauma, and poisoning, stress, fatigue sleep deprivation
In three-fourths of individuals with epilepsy, the cause is unknown

9. Characteristics of Asthma
Most prevalent chronic illness of children and leading cause of school absences
Symptoms can vary widely
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent

10. 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
Something asthma is an inherited condition

11. Determining the Presence of Physical Disabilities and Other Health Impairments
Neuroimaging
Prenatal screening
Maternal serum alpha-fetoprotein
Fetal surgery

12. Determining the Nature of Specially Designed Instruction and Services
School Function Assessment
Participation
Task supports
Activity performance

13. 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 (Figure 12.7)

14. Determining Supplementary Aids and Services
Adaptive Switches
Pressure
Timed
Pneumatic or puffing switches
Movements
Sound
Electronic Wheelchairs
Transporting the chair
Adjusting the size
Recharging the batteries
Selecting the navigation tools
Assure safety

15. Planning for Universal Design for Learning
Electronic Text
Use word processing programs
Use presentation software
Embedded links
Access existing electronic text
Download digital talking book player

16. Planning for Other Educational Needs
Adaptive PE
Allows for students with disabilities to participate in a typical sport or physical activity
Modified equipment
Beeping ball for student with visual impairment

17. 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

18. 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

19. 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 student with disabilities

20. Measure Students’ Progress
Using Computers for Curriculum-Based Measurements
Measurement in Adaptive Physical Education
Cardiovascular function
Body composition
Muscle strength and endurance
Muscle and joint flexibility
Mobility

21. Making Accommodations for Assessment
Computer-based assessment
Frequent breaks
Scribe
Physical access to testing environment
Security concerns, test materials, and environmental controls