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

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

3. 3 Examples of Physical and Health Disabilities

4. 4 Brief History of the Field Early history Early history Middle Ages Middle Ages 1890: First U.S. institution for children with physical disabilities (Industrial School for Crippled and Deformed Children), Boston 1890: First U.S. institution for children with physical disabilities (Industrial School for Crippled and Deformed Children), Boston Emergence of public education Emergence of public education

5. 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) Orthopedic impairments (63,127 children) Multiple disabilities (133,914 children) Multiple disabilities (133,914 children) Traumatic brain injury (23,509 children) Traumatic brain injury (23,509 children) Other health impairments (561,028 children) Other health impairments (561,028 children)

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

7. 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. 8 Spinal Development

9. 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. 10 Students with Traumatic Brain Injury (TBI) Acquired brain injury 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 Added as a separate disability category under IDEA in 1990 Often requires rehabilitative services Often requires rehabilitative services

11. 11 Students with Other Health Impairments (OHI) Major Health Impairments Seizure Disorders 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 Asthma –Medication, avoid triggers

12. 12 Students with Other Health Impairments (OHI), continued Infectious Diseases Acquired immune deficiency syndrome (AIDS) 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. 13 Classroom Suggestions Teacher Actions if a Tonic-Clonic Seizure Occurs: Stay calm Stay calm Move furniture Move furniture Loosen shirt collar Loosen shirt collar Place pillow under head Place pillow under head Turn student on his/her side Turn student on his/her side Call ambulance if first seizure or duration of 5 minutes or more Call ambulance if first seizure or duration of 5 minutes or more Reassure student after seizure, allow to rest Reassure student after seizure, allow to rest

14. 14 Assessment of Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Medical evaluation Medical evaluation –Physician confirms diagnosis of physical or health condition Educational evaluations Educational evaluations –Team determines if the disability negatively impacts educational performance Students with deaf-blindness Students with deaf-blindness –Developmental, rather than standardized, assessments are used

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

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

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

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

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

20. 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. 21 Educational Considerations for Students Who are Deaf-Blind Communication Communication Orientation and mobility Orientation and mobility Collaborative efforts Collaborative efforts

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

23. 23 Transition into Adulthood Career preparation Career preparation College College Technology Technology

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

25. 25 Family Issues Stress coping strategies Stress coping strategies Medical treatments Medical treatments Death issues Death issues

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

27. 27 Technology and Individuals with Physical Disabilities, Health Disabilities, and Related Low-Incidence Disabilities Assistive technology Assistive technology Augmentative communication Augmentative communication Positioning and seating devices Positioning and seating devices Mobility devices Mobility devices Environmental control and assistive technology for daily living Environmental control and assistive technology for daily living Assistive technology for play and recreation Assistive technology for play and recreation

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