Asthma – Other Health Impairment (OHI) Melissa wolff Dallas Baptist University SPED 4310 – Summer 2016

What is asthma? Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children. MS Clip art

About asthma People who have asthma have inflamed airways. The inflammation makes the airways swollen and very sensitive. When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed.

About asthma Sometimes asthma symptoms are mild and go away on their own or after minimal treatment with asthma medicine. Other times, symptoms continue to get worse. When symptoms get more intense, that is an asthma attack. Asthma attacks also are called flare-ups or exacerbations. Treating symptoms when you first notice them is important. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can be fatal.

How does asthma affect children in school? Physical: Shortness of breath Chest tightness or pain Audible whistling or wheezing sound Bouts of coughing or wheezing that are worsened by a respiratory virus Social/Emotional: Children may feel left out if they can't participate in outdoor activities May be embarrassed if they have to use an inhaler Depression Anger Frustration Cognitive:  Asthma should have no effect on cognitive abilities Happens in people with all intelligences MS Clip art

What can the teacher do? Teachers need be aware of the signs and symptoms of asthma related problems and have a plan in place in case something happens at school. Severe asthma attacks may need a trip to the emergency room and can cause death if untreated. Teachers should help to encourage children who have asthma to realize the things they can do and not what they can't do. It's also very important to consider asthma when planning outdoor activities, recess, lessons, lunches, and even the markers they use in their classroom (i.e.: the REALLY strong smelling ones). (Asthma in Schools…, 2016) Aside from being aware of the condition, no major strategies or classroom changes should be needed.

What should parents do? Make sure to contact school health services and let them know about your child's asthma. This provides you with the opportunity to get to know the school nurse and any other health services staff. By law, the school needs your permission to communicate student health information to your child's healthcare provider. Make sure permission is granted, that way if prescriptions change, or if your child has an asthma emergency, everyone on "the team" can be kept informed. Be sure your child has a recent Asthma Action Plan on file at the school. Ensure that your child has immediate access to quick-relief medicine in case your child has an asthma flare-up while at school. Contact the school health services staff to find out more about your school's policy and practice. Include discussion about your child's asthma management during parent/teacher meetings or conferences

Other Health Impairment “Other Health Impairment” is one of the 14 categories of disability listed in our nation’s special education law, the Individuals with Disabilities Education Act (IDEA). Under IDEA, a child who has an “other health impairment” is very likely to be eligible for special services to help the child address his or her educational, developmental, and functional needs resulting from the disability. (Other Health Impairment, 2016).

IDEA’s Definition of OHI IDEA states that: Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that— (i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and (ii) Adversely affects a child’s educational performance. (Turnbull, 2016)

Special Education Students with asthma may qualify for special education services under IDEA’s definition of Other Health Impairments. The law was enacted in 1975 and called the Individuals with Disabilities Education Act. Once the student is identified as having a special need, they will begin the special education process. Should the student qualify, he or she would have an Individualized Education Plan (IEP) created with accommodations to help the student with an appropriate education in school. Not all students will meet the qualifications of special education; however, they may qualify for a Section 504 plan. MS Clip art

What is a 504 plan? This type of plan falls under Section 504 of the Rehabilitation Act of 1973. This is the part of the federal civil rights law that prohibits discrimination against public school students with disabilities. Much like an IEP, a 504 plan can help students with disabilities learn and participate in the general education curriculum. A 504 plan outlines how a child’s specific needs are met with accommodations and other services. A student with a 504 plan usually spends the entire school day in a general education classroom. And typically, children who need modifications would have an IEP, not a 504 plan.

Section 504 Criteria 504 plans are for K–12 public school students with disabilities. Section 504 defines “disability” in very broad terms. That’s why children who aren’t eligible for an IEP may qualify for a 504 plan. Section 504 defines a person with a disability as someone who: Has a physical or mental impairment that “substantially” limits one or more major life activity (such as reading or concentrating). Has a record of the impairment. Is regarded as having an impairment, or a significant difficulty that isn’t temporary. For example, a broken leg isn’t an impairment, but a chronic condition, like a food allergy, might be. (Understanding 504 Plans, 2014) A Section 504 evaluation may include documentation of a disability, observations from teachers and parents, and an academic record.

IEPs/504 – Possible Accommodations Provide rest periods. Train appropriate school personnel to properly dispense medication and monitor for side effects (as needed). Develop health care and emergency plans (such as what to do when a child does not respond to medical Assist with inhalant therapy. Adjust schedule for administration of medications. Allow time to make up work when absent for medical reasons. Provide the child with peers who can carry books and other supplies as needed. Adapt activity level for recess, physical education, and other times as needed. Minimize allergens (such as perfume, cologne, lotions, paint) in the child's vicinity.

Christ-like Values and Reflection As and educator and future counselor, I believe students in our schools with asthma need love, compassion and understanding. Asthma is not something they choose to have, and they need to know that we support them and their disability. Students with asthma may have psychological needs as well as physical needs that we need to be supportive of too. One of the main reasons I chose this disability is because I have asthma. I was diagnosed with it when I was a senior in high school I know how scary it can be not to be able to breathe. I have had most of my symptoms as an adult. My brother also had asthma as a child and was hospitalized a few times because of it. This disability can cause students to miss a lot of school and feel really left out of many activities. I had no idea until recently that this was considered as a disability that would qualify for SPED or 504. Even if students do not qualify for one of these, it is important as educators that we remember how they feel mentally and physically.

References Other Health Impairment. (2016) Center for Parent Information and Resources. Retrieved from http://www.parentcenterhub.org/repository/ohi/ What Is Asthma? (2014, Aug 14)  National Heart, Lung and Blood Institute. US Department of Health and Human Services. Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/asthma Asthma in Schools: The Basics for Parents. (2016) American Lung Association. Retrieved from http://www.lung.org/lung-health-and-diseases/lung-disease- lookup/asthma/living-with-asthma/creating-asthma-friendly- environments/asthma-in-schools Sample 504 Accommodations. (2016) SpringerReference.  Retrieved from http://www.tusd1.org/ Understanding 504 Plans. (2014, June 3) Understood.org. Retrieved from https://www.understood.org/en/school-learning/special-services/504- plan/understanding-504-plans>.

References Turnbull, A., Turnbull, R., Wehmeyer, M., Shogren, K., (2016). Exceptional Lives: Special Education in Today’s Schools (Eighth Edition). United States: Pearson. Asthma – Children. (2016) Aspirus. Retrieved from http://www.aspirus.org/Main/Health-Information/Asthma-children- 6241.aspx (image)