Physical Disabilities, Health Impairments, and AD/HD Thank everyone for coming Introduce self Ensure everyone got packet of slides for note taking A guide for parents and students Presented by Michelle Thomas

Physical Disabilities Introduction Physical Disabilities Health Impairments Epilepsy Diabetes Asthma Cystic Fibrosis HIV and AIDS AD/HD Cerebral Palsy Spina Bifida Muscular Dystrophy Quick overview of today’s presentation Difference between Health and Physical Physical is usually visible Health is not Spinal Cord Injuries Case Study Sample Lesson Description Modifications

IDEA Definitions (8) Orthopedic impairment means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures). (9) 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. Review definition Point out differences Orthopedic is physical Health is illness Similarities Negative impact on education (IDEA 2004, 2004)

Categories Orthopedic Impairments Skeletal – physical issues with the skeletal system of the body. Neuromotor – issues with the central nervous system that effects the movement of muscles. Specifics on orthopedic 2 types Outcomes similar Another look at health Chronic or acute Long or short term Health Impairments Chronic or acute health problems.

(United Cerebral Palsy, 2001) Characteristics Lack of voluntary muscle control Poor coordination Muscle spasticity Speech and swallowing issues Weak muscles Gross and fine motor skill issues Muscle tightness Causes Brain injury due to: Viral infection Birthing issues Fetal development Head injury from car accident, fall or child abuse Types Monoplegia Hemiplegia Triplegia Quadraplegia Paraplegia Diplegia Double hemiplegia Disorder of voluntary movement and posture both hyper and hypo tonia Plegia – paralysis Mono - 1 limb Hermi – 2 limb on same side Tri – 3 limbs Quad – 4 limbs Para – both legs Di – mostly legs, but some arms Double hemi – mostly arms, but some legs (United Cerebral Palsy, 2001)

Educational Strategies Cerebral Palsy Educational Strategies Assistive technology for speech Scribe for writing Proximity placement of toys and other items Physical, occupational and speech therapists Velcro strips Large desks for wheelchairs Classroom set up Tape recorder Clip boards Large writing implements Recorded books Treatments Medications, surgery, and braces are sometimes used to help maintain or improve muscle and nerve coordination. (United Cerebral Palsy, 2001) Ed strategies Build a team Velcro for grasping and holding onto things Note mod of space for wheelchair Large diameter assists in grasping (Aiello & American Federation of Teachers, 1981)

(Liptak & Spina Bifida Association, 2008) Characteristics Muscle weakness Loss of involuntary and voluntary muscles below affected region Paralysis Hydrocephalus Loss of sensation and feeling below affected region Causes Birth defect Genetic Environmental Lack of folic acid during first trimester Types Occult Spinal Dysraphism Spina Bifida Occulta Meningocele Mylomeningocele Split Spine – disorder of spinal cord exposure Hydrocephalus – fluid on the brain Pressure Effect brain development/function Types Dysraphism – physical outward sign on a baby Dimple, red spot, hair, or lumps Occulta – few malformations Meningo – bulging sac with fluid and cord Myelo – cord and nerves exposed and protrude (Liptak & Spina Bifida Association, 2008)

Educational Strategies Spina Bifida Treatments Surgery Regular doctor visits Shunt Educational Strategies Flexibility for surgery and doctor visits Management of bathroom functions and catheters Learning issue modifications Classroom set up Higher desks for wheelchairs Physical and Occupational therapists (Liptak & Spina Bifida Association, 2008) Ed Strats Packets for home modifications for LD from Hydrocephalus Setup room for wheelchair Collaboration (National Dissemination Center for Children with Disabilities [NICHY], n.d.)

(Muscular Dystrophy Association, n.d.) Characteristics Difficulty in mobility Difficulty in fine motor skills Difficulty in breathing Fatigue Irregular heart beat Causes Genetic Viral infection Bacterial infection Irregular reaction to medication for infections Types 40 different diseases Muscular Motor Neuron Metabolic Peripheral Nerve Inflammatory Neuromuscular Junction Endocrine Other Disorder – progressive muscle atrophy Often ends in death by respiratory or cardio failure Duchenne is most common – most severe (Muscular Dystrophy Association, n.d.)

Educational Strategies Muscular Dystrophy Educational Strategies Assistive technology and scribes for writing Physical, occupational and speech therapy Classroom set up Higher desks for wheelchairs Shortened school day Meaningful interactions Counseling on end of life issues Sensitivity to emotional issues Safe room or person Teatments Surgery Drug therapies Antibiotics (National Institute of Neurological Disorders and Stroke, 2009) Ed strat Physical disability Collaboration team Classroom set up – wheelchairs May be sensitive to end of life issues May need special place when upset (Ainsa, 1981)

(National Institute of Neurological Disorders and Stroke, 2010) Spinal Cord Injuries Characteristics Damage begins at site of injury Motor impairment Loss of involuntary muscle response Sensory deprivation paralysis Causes Sudden traumatic blow to the spine Car accidents Falls Sports injuries Physical abuse Types Bone fragments Fractures Dislocation Bruises Tears Compression Nerve damage Sever Happens at any stage of life Severs are rare (National Institute of Neurological Disorders and Stroke, 2010)

Educational Strategies Spinal Cord Injuries Educational Strategies Assistive technology and scribes for writing Physical and occupational therapy Classroom set up Higher desks for wheelchairs Counseling for trauma Treatments Rehabilitation Respiratory support Steroids (National Institute of Neurological Disorders and Stroke, 2010) (Carney & Porter, 2009). May have social/emotional issues from trauma Age of onset has impact Similar strategies can be used for all physical disabilities

Educational Strategies Epilepsy Causes Head injuries Anoxia at birth Tumors Genetics Viral or bacterial infection Types Generalized Complex partial Simple Partial Absence Characteristics Multiple seizures Drop toys Eyes flutter Sudden jerking motion Unresponsive Loss of consciousness Treatments Medication Surgery Diet Educational Strategies Avoid triggers Aura identification and self-removal Understanding of medication side-effects that can impact learning (Heward, 2009) (Epilepsy Foundation, n.d.) (Heward, 2009) Health issues Chronic versus acute Length of time and age of onset affect Not always noticeable Types Generalized –Most noticeable Loss of consciousness Complex Partial –unaware of their behavior Simple Partial – sudden jerking – happens less often Absence –frequent occurring – student often doesn’t remember Self management important Aura gives sense of control (Epilepsy Foundation, n.d.) (Heward, 2009)

Educational Strategies Diabetes Characteristics Thirst Lack of energy Headaches Weight loss Slow healing of cuts Frequent urination Causes Genetics, metabolism, and environment Hyperglycemia Hypoglycemia Types Type 1 Lack of insulin production Type 2 Resistance to insulin Self-regulation important to learn If goes undiagnosed, can be fatal Type 1 birth Type 2 acquired – usually adult, but obesity rates make it more common Treatments Medication Diet Exercise Educational Strategies Recognize symptoms Have candy or juice in close proximity Prompting for medication (Heward, 2009)

Educational Strategies Asthma Causes Chronic lung disease Allergy Air pollutants Stress Exercise Types -Described by the causes of the onset of an asthma attack. Characteristics Wheezing Coughing Difficulty with breathing Can be stress induced Number 1 reason for kids missing school Treatments Medication Counseling Educational Strategies Modifying curriculum for frequent absence Homebound instruction Avoiding triggers (Heward, 2009)

Educational Strategies Cystic Fibrosis Causes Genetic Disease Causes over production of mucus on membranes Types There are no specific types. Characteristics Difficulty breathing Heart disease Malnutrition Poor development Poor digestion Educational Strategies Modifying curriculum for missed class time for medical treatments Learning issue modifications Ensure caloric intake is high at lunch and with frequent snacks Treatments Enzyme supplements Mucus thinners Antibiotics Anti-inflammatory Can live a successful and high quality of life (Cystic Fibrosis Foundation, 2009) (Heward, 2009)

Educational Strategies HIV and AIDS Causes Viral infection Virus is transmitted by body fluids Types HIV AIDS Characteristics Suppressed immune system Frequent illness Weigh loss Developmental delays Treatments Medication No cure, but new drug therapies are being developed Educational Strategies Alleviation of fear by educating peers Learning issue modifications Modifications to curriculum due to missed class time for illness Counseling Lots of misinformation Body fluids does not mean anything from the mouth, except blood. (Heward, 2009)

Educational Strategies AD/HD Causes Unsure Genetics Neurological Environmental Types Attention Deficit Disorder Attention Deficit Hyperactive Disorder Characteristics Inability to stay on task Impulsive behavior Fidgeting Lack of self-control Poor organization Easily distracted Environmental Sometimes not diagnosed until older Treatments Medication Behavior plans Counseling Educational Strategies Seating placement Prompting signals for attention specific items Self monitoring behavior and activities (Heward, 2009)

Case Study Sally 11 y/o Struggling with transition to 6th grade Disruptive in class & does not turn in homework Student is diagnosed with AD/HD with the help of her doctor and the informal observation tool. Teacher brought up concerns at first parent meeting. The group decided to do an informal observation of the student. Sally – name changed Identification process, includes supportive environment which delayed ID

Lesson Plan Read over lesson plan. Content Language Arts – Spelling and defining homophones Standards Colorado Standards for Reading and Writing 3. Students write and speak using conventional grammar, usage, sentence structure, punctuation, capitalization, and spelling. 4. Students apply thinking skills to their reading, writing, speaking, listening, and viewing. 5. Students read to locate, select, and make use of relevant information from a variety of media, reference, and technological sources. (Colorado Department of Education, 1995, p.3) Software Title Internet Explorer Learner Assessment The teacher introduces the lesson by asking students if anyone can spell the word two. She then spells it on the board and asks if anyone knows the meaning of the word. She then asks them if they can think of another way to spell the word. Then she asks if they can think of other words that sound the same, but spelled differently. Level of Technology Use Students use the computer often in the classroom. They are familiar with finding research tools both online and within the classroom. Pre/Lesson After the introduction, the teacher will list 15 pairs of homophones on the blackboard. The students will work with partners today and will use multiple sources to discover the meaning of the words identified with each spelling. They are then asked to draw a picture and write a sentence on their worksheet to be shared with the classroom and placed in a classroom book of homophones that will be photocopied and given to each student the following day. The last 15 minutes of class will be devoted to each set of partners sharing the information they have gathered on their homophone pairs. Lesson Goals The student will recognize that sometimes words have different spellings. The student will identify the meaning of common homophones. The student will apply each word correctly in a sentence. The student will utilize strategies of context and visual cues to assist them in learning the meaning of the word along with its correct spelling. Read over lesson plan.

Modifications Assessment: The teacher introduces the lesson by asking students if anyone can spell the word two. She then spells it on the board and asks if anyone knows the meaning of the word. She then asks them if they can think of another way to spell the word. Then she asks if they can think of other words that sound the same, but spelled differently. Modifications: The teacher uses a cue to let Sally know she is going to ask her a question. The pre-arranged cue is for the teacher to walk in front of Sally’s desk and touch the corner of it as she passes by. This way she is bringing Sally’s attention back to the classroom and the task at hand. The Lesson: After the introduction, the teacher will list 15 pairs of homophones on the blackboard. The students will work with partners today and will use multiple sources to discover the meaning of the words identified with each spelling. They are then asked to draw a picture and write a sentence on their worksheet to be shared with the classroom and placed in a classroom book of homophones that will be photocopied and given to each student the following day. The last 15 minutes of class will be devoted to each set of partners sharing the information they have gathered on their homophone pairs. Modifications: Sally is paired with a student who helps keep her on task. The teacher checks in with her group first, making sure Sally understands the assignment. She helps the group map out a plan of attack on how to find the information and in what order they should approach their task. Finally, after checking in with other students, the teacher returns to Sally and her partner to ensure they are on task with the assignment. Additionally she asks Sally to explain to her the definitions for each word to ensure that Sally is participating and understands the meaning of the words she is writing. Discuss modifications and the reason behind them. Cueing Allows to student to refocus attention Pairing Use of strengths to overcome weakness Understanding To help with focus on task and understanding of task Participation and understanding Another check for on task and ensure understanding of information

Resources For more information, please visit these sources: Cerebral Palsy * United Cerebral Palsy Organization * http://www.UCP.org Spina Bifida * Spina Bifida Association * http://spinabifidaassociation.org Muscular Dystrophy * Muscular Dystrophy Association * http://www.mda.org Epilepsy * Epilepsy Foundation * http://www.epilepsyfoundation.org Cystic Fibrosis * Cystic Fibrosis Foundation * http://www.cff.org Diabetes * American Diabetes Association * http://www.diabetes.org HIV/AIDS * AIDS Healthcare Foundation * http://www.aidshealth.org AD/HD * Attention Deficit Disorder Association * http://www.add.org General information National Institute of Neurological Disorders and Stroke * http://www.ninds.nih.gov National Dissemination Center for Children with Disabilities * http://www.nichy.org U.S. Department of Education – IDEA 2004 * http://idea.ed.gov Many resources available Local chapters Support groups Newsletters Research Covered lots of material Short question time or even better, have panel or people representing organizations available to talk to. Thank you for coming

References Aiello, B., & American Federation of Teachers, W. (1981). The Child With Cerebral Palsy in the Regular Class. Retrieved from ERIC database. Ainsa, T. (1981). Teaching the terminally ill child. Education, 101(4), 397. Retrieved from Academic Search Premier database. Carney, J., & Porter, P. (2009). School reentry for children with acquired central nervous systems injuries. Developmental Disabilities Research Reviews, 15(2), 152-158. doi:10.1002/ddrr.57. Colorado Department of Education. (1995). Colorado model content standards for reading and writing. Retrieved February 28, 2010, from http://www.cde.state.co.us/cdeassess/documents/OSA/standards/reading.pdf Cystic Fibrosis Foundation. (2009). Frequently asked questions. Retrieved February 28, 2010, from http://www.cff.org/AboutCF/Faqs/ Epilepsy Foundation. (n.d.). Epilespy: Frequently asked questions. Retrieved February 28, 2010, from http://www.epilepsyfoundation.org/answerplace/faq.cfm Heward, W. L. (2009). Exceptional children: An introduction to special education (9th ed.). Upper Saddle River, NJ: Merrill.

References Individuals with Disabilities Education Improvement Act of 2004, H.R. 1350 (2004). Liptak, G. S., & Spina Bifida Association (2008). Spina bifida low lit. Retrieved February 24, 2010, from http://www.spinabifidaassociation.org/atf/cf/%7BEED435C8-F1A0-4A16-B4D8-A713BBCD9CE4%7D/Spina%20Bifida%20low%20litJune%202008.doc Muscular Dystrophy Association. (n.d.). Diseases in the MDA program. Retrieved February 28, 2010, from http://www.mda.org/disease/40list.html National Dissemination Center for Children with Disabilities. (n.d.). Spina Bifida. Retrieved February 24, 2010, from http://www.nichcy.org/Disabilities/Specific/pages/SpinaBifida.aspx#CharacteristicsSB.aspx National Institute of Neurological Disorders and Stroke. (2009). NINDS muscular dystrophy information page. Retrieved February 28, 2010, from http://www.ninds.nih.gov/disorders/md/md.htm National Institute of Neurological Disorders and Stroke. (2010). NINDS spinal cord injury information page. Retrieved February 28, 2010, from http://www.ninds.nih.gov/disorders/sci/sci.htm United Cerebral Palsy. (2001). Vocabulary tips: Cerebral Palsy- facts & figures. Retrieved February 24, 2010, from http://www.ucp.org/ucp_generaldoc.cfm/1/9/37/37-37/447#what