1. Chapter Thirteen
Individuals with Physical Disabilities, Health Disabilities, and Related Low- Incidence Disabilities

2. Federal Definitions Pertaining to Physical or Health Disabilities and Deaf-Blindness

3. Examples of Physical and Health Disabilities

4. 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
Emergence of public education

5. Prevalence of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities
School-age children receiving special education by disability category (U.S. Department of Education):
Orthopedic impairments (63,127 children)
Multiple disabilities (133,914 children)
Traumatic brain injury (23,509 children)
Other health impairments (561,028 children)

6. Etiology of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities
Genetic and chromosomal defects
Muscular dystrophy, sickle cell anemia, hemophilia, cystic fibrosis, deaf-blindness
Teratogenic causes
Fetal alcohol syndrome, syphilis, rubella, herpes
Prematurity and pregnancy complications
Neurological conditions, cerebral palsy, vision or hearing loss
Acquired causes
Traumatic brain injury (TBI), meningitis

7. Categories of Students with Orthopedic Impairments
Neuromotor impairments
Damage to the brain, spinal cord, or nerves
Cerebral palsy (CP), spina bifida
Degenerative diseases
Affects muscles and motor development
Muscular dystrophy (MD)
Musculoskeletal disorders
Juvenile rheumatoid arthritis (JRA), limb deficiency

8. Spinal Development

9. Definition 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)
Acquired brain injury
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

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
Asthma
Medication, avoid triggers

12. Students with Other Health Impairments (OHI), continued
Infectious Diseases
Acquired immune deficiency syndrome (AIDS)
Human immunodeficiency virus (HIV) destroys immune system
Students with Deaf-Blindness
Students with deaf-blindness may exhibit cognitive deficits (65%), physical impairments (58%), or complex health needs (41%)

13. Classroom Suggestions
Teacher Actions if a Tonic-Clonic Seizure Occurs:
Stay calm
Move furniture
Loosen shirt collar
Place pillow under head
Turn student on his/her side
Call ambulance if first seizure or duration of 5 minutes or more
Reassure student after seizure, allow to rest

14. Educational evaluations
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

15. Where are Students with Physical or Health Disabilities Educated?

16. Where are Students with Physical or Health Disabilities Educated
Where are Students with Physical or Health Disabilities Educated? (continued)

17. Where are Students with Physical or Health Disabilities Educated
Where are Students with Physical or Health Disabilities Educated? (continued)

18. Impact on School Performance
Type of Disability:
Neuromotor impairments
Orthopedic and musculoskeletal impairments
Degenerative and terminal diseases
Sensory impairments
Health impairments
Multiple disabilities

19. Impact on School Performance (continued)
Functional Effects of a Disability:
Atypical movements and motor abilities
Sensory loss
Communication impairments
Fatigue, lack of endurance
Health factors
Experiential deficits
Cognitive impairments, processing deficits

20. Impact on School Performance (continued)
Psychosocial and Environmental Factors:
Motivation
Self-concept
Self-advocacy
Behavioral and Emotional Functioning
Social Environment and Social Competence
Physical and Technological Environments
Learning and Attitudinal Environments

21. Educational Considerations for Students Who are Deaf-Blind
Communication
Orientation and mobility
Collaborative efforts

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

23. Transition into Adulthood
Career preparation
College
Technology

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

25. Family Issues
Stress coping strategies
Medical treatments
Death issues

26. Issues of Diversity Lack of cultural bias in diagnosis
Cultural differences in coping with illness and disability

27. 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

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