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Children With Physical Disabilities and other Health Impairments


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Title: Children With Physical Disabilities and other Health Impairments

Children With Physical Disabilities and other
Health Impairments
  • By Kelsey Allen Chelsea Hollinger

Definition and Classifications
  • Children with physical disabilities and other
    health impairments are those whose physical
    limitations or health problems interfere with
    school attendance or learning to such an extent
    that they require special services, training,
    equipment, materials, or facilities (p.399)

Classifications Characteristics
  • Congenital anomalies defects the child is born
  • Acquired disabilities through accident or disease
    (after birth)
  • Can be mild and transitory
  • OR profound and progressive (incapacitation and
    ultimately an early death)
  • Acute illness A serious illness or condition
    that a person can overcome with medical treatment
  • Chronic condition An incurable condition that is
    ongoing and will never resolve itself, even with
    the best treatment
  • Example Cerebral Palsy
  • Episodic A condition that occurs repeatedly but
    with medication and treatment, an individual can
    function normally (does not have to become more
    serious or severe over time)
  • Example Asthma and seizure disorders (epilepsy)
  • Progressive condition that gets worse over a
    period of time
  • Example Muscular Dystrophy

Neuromotor Impairments
  • Neuromotor Impairment- injury to brain or spinal
    cord that affects the ability to move ones body.
  • If a childs nervous system is damaged, most
    commonly they will experience muscular weakness
    or paralysis.
  • Causes and injuries include
  • Traumatic Brain Injury brain damage with an
    identifiable external cause after birth
  • Hypoxia Reduced oxygen to the brain
  • Stroke
  • Infection
  • Metabolic Disorder
  • Toxic Chemicals or drugs

Cerebral Palsy
  • Cerebral palsy is a disorder of movement and
    posture. It is caused by a brain injury that
    occurred before birth, during birth, or during
    the first few years after birth. The injury
    hinders ability of the brain to control muscles
    of the body properly (p.400)
  • It can be considered part of a syndrome that
    includes motor dysfunction, psychological
    dysfunction, seizures, and emotional or
    behavioral disorders due to brain damage.
  • Paralysis, weakness, lack of coordination, and
    other motor dysfunctions are caused because of
    damage before a childs brain matures.
  • There is no cure for cerebral palsy. However,
    with help from new technologies (medical and
    rehabilitation technologies), there is hope for
    overcoming this neurological disorder.
  • Example long-term physical therapy in
    combination with a surgical procedure where
    selected nerve roots are cut below the spinal
    cord that help with spasticity of legs - this can
    create progress with walking.

Causes Types of Cerebral Palsy
  • Anything that can damage the brain before birth
    which includes
  • maternal infections, chronic diseases, physical
    trauma, maternal exposure to toxic substances
    (drugs/alcohol), x-rays, pre-mature birth,
    hypoxia, high fever, infections, poisoning,
    hemorrhaging etc.
  • Types
  • Quadriplegia All 4 limbs involved
  • Paraplegia Only legs involved
  • Spasticity Stiffness of muscles and inaccurate
    voluntary movement
  • Choreoathetoid Abrupt, involuntary movements and
    difficulty maintaining balance
  • Atonic Floppiness, and an overall lack of muscle

Cerebral Palsys Associated Disabilities and
Educational Implications
  • Cerebral Palsy affects an individuals sensory
    abilities, cognitive functions, and emotional
    responsiveness and motor performance.
  • Hearing impairments
  • Visual impairments
  • Perceptual disorders
  • Speech and language problems
  • Emotional/ behavioral disorders/ intellectual
    disability or a combination of these
  • Some children have normal to above-average mental
    capacity or are considered gifted
  • Lower than the average IQ standardized tests
    could play a role
  • Children with cerebral palsy require special
    equipment, procedures, and individualized
  • Teaching a child who has cerebral palsy demands
    knowledge and background in special education and
    experience working with a variety of disabling

Meet Eric...
  • http//

Discussion Time!
  • Turn and talk to your table neighbors about the
    challenges, frustrations, and limitations you
    would personally face if you had this disorder.
  • For example operating a vehicle

Seizure Disorder (Epilepsy)
  • Seizure when an abnormal discharge of electrical
    energy occurs in certain brain cell. The
    irregular discharge spreads to surrounding cells
    which may cause lack of consciousness,
    involuntary movements, and/or abnormal sensory
  • 1 in 10 children have seizures at one time (high
    fever or serious illness) but this is NOT
  • Epilepsy chronic neurological condition that is
    recurrent and caused by damage to the brain
  • Most known common causes include hypoxia, low
    blood sugar, infections, and physical trauma
  • Epilepsy may be progressive (damaging the
    brain/disrupting its functioning in such a way
    that having a seizure increases the probability
    of having another)

Best Way To Classify Seizures
  • Duration can range from a few seconds to several
  • Frequency can occur as frequently as every few
    minutes to once a year
  • Onset set off by identifiable stimuli, unrelated
    to the environment, totally unexpected, or be
    triggered by internal sensations.
  • Movements can cause major convulsive movements
    or only minor motor symptoms
  • Example Flopping body or eye blinks
  • Causes high fever, poisoning, trauma, and
    unknown causes
  • Associated Disabilities can be associated with
    other disabilities that could be a related
    medical problem
  • Control can be controlled or partially
    controlled by drugs

Seizure Disorder Information
  • Half of people with epilepsy have average or
    higher intelligence (same for general population)
  • Among children with seizure disorders (without
    intellectual disabilities), learning disabilities
    tends to be higher
  • Helpful Tips
  • educate the population about epilepsy and that it
    can be handled
  • be prepared to manage someone who has seizures
  • keep record
  • know how to help and seek medical assistance
  • These children may have behavioral disorders from
    brain function or as a side effect from
  • These children are associated with having
    problems with executive function, adaptive
    behavior, low IQ, psychological difficulties, and
    low family income

Spina Bifida
  • Spina Bifida- A congenital midline defect that
    results from failure of the bony spinal column to
    close completely and occurs anywhere down the
    spine from the head to the lower back.
  • Often results in paralysis of the legs, anal
    region, and bladder sphincters because nerve
    impulses cannot travel past the defected area
  • Similar defects include cleft lip and a cleft
    palate that occur during the early fetal
    development stage where the two halves of the
    embryo grow together at the midline. The
    incomplete fusing results in congenital midline
    defects just like spina bifida.
  • Surgery can be performed in early infancy to
    close the spinal opening, but this does not fix
    nerve damage
  • Spina Bifida one of the most common birth defects

Spinal Cord Injuries
  • Most spinal cord injuries resulting from
    accidents after birth are also a major cause of
    paralysis (p.404)
  • An individual must adjust to their acquired
    disability in contrast to developing normally by
  • Using wheelchairs, braces, or learning to walk
    independently again (extremely varying because
    those with paralysis have varying extents).
  • Spinal cord injuries can also result in
  • Lack of sensation in skin can lead to burns,
    abrasions, and sores
  • Lack of bowel and bladder control requiring

Orthopedic Musculoskeletal Disorders
  • Two of the most common musculoskeletal conditions
    affecting youth muscular dystrophy and juvenile
    rheumatoid arthritis
  • Muscular dystrophy a hereditary disease that is
    characterized by progressive weakness cause by
    degeneration of muscle fibers
  • No cure, advances in pharmacology
  • Juvenile rheumatoid arthritis potentially
    debilitating disease in which the muscles and
    joints are affected
  • Cause and cure are unknown
  • Very painful and often accompanied by fever,
    respiratory problems, heart problems, eye
  • Scoliosis Spinal curvature
  • Missing or malformed limbs intelligence is
    unaffected unless additional disabilities are
  • Placing the student in a special education
    setting is beneficial for improving mobility,
    ensuring proper posture and positioning,
    providing education during home confinement time,
    and for making the educational experience as
    normal as possible.

OTHER conditions that affect a childs HEALTH or
  • A wide array of diseases affect a childs health
    and/or physical abilities including
    physiological disorders, congenital
    malformations, and injuries that can affect
    student health and physical abilities which
    creates a need for special education. Also,
    obesity, diabetes, asthma.
  • Asthma- increasingly common lung disease
    characterized by episodic inflammation or
    obstruction of the air ways making it hard to
    breatherestricting activities
  • Accidents- many children are hurt in accidents
    each year resulting in traumatic brain injury,
    spinal cord injuries, and short term hindrances
    such as broken bones
  • AIDS- often acquire neurological symptoms,
    including intellectual disabilities, cerebral
    palsy, seizures, and emotional or behavioral
  • Fetal alcohol syndrome- disabilities acquired
    during pregnancy because of drinking of
    mothersresults in distinct physical and
    developmental abnormalities, many need early
    intervention and help throughout

Psychological and Behavioral Characteristics
  • Academic achievement
  • Erratic school attendance due to hospitalization
    and doctors visits
  • Widely varied of severity of conditions
  • Some require special teaching methods because of
    intellectual or sensory impairments, and some do
    well in general education
  • May be deprived of regular education experience
    because they are not able to manipulate
    educational materials and respond to tasks the
    way most students do

Personality Characteristics
  • Varied in personality type just as much as
    non-disabled children
  • Public reactions if the public is fearful or
    rejecting the child may spend time trying to hide
    their disability, if it is pitiful and helpless
    the child will be dependent, if they see them as
    limited but otherwise normal the youth will
    become less dependent and productive members of
  • Children and families reaction largely a
    reflection of how those respond to them,
    realistic self-perceptions and set realistic
    goals to the extent that those are honest with

Where are children with physical disabilities
  • - 53.3 of those with orthopedic, other health
    impairments, and traumatic brain injury spend
    less than 21 of the day outside the general
    education class room.
  • - 21.3 spend 21-60 of the day outside the
    general education classroom.
  • - 18.6 spend more than 60 outside the general
    education classroom.
  • - 4 are served in a separate school.
  • - .3 are served in separate facility.
  • - 1.4 are in homebound or hospital placement

Prosthetics, Orthotics, and Adaptive Devices
  • Prosthesis artificial replacement for missing
    body part
  • Example artificial body part like an arm
  • Orthosis a device that enhances the partial
    function of a part of a persons body
  • Example Wheelchair or a brace
  • Adaptive Devices used for daily living that
    helps make adaptions for ordinary devices used
    throughout the home, office, school, etc.
  • Example a device to aid in bathing
  • Technology has been an essential tool in making
    all types of assistive devices much stronger,
    safer, and efficient (metallurgy and plastics)

Two Important Points...
  • 1. Residual function is often important even
    when a prosthesis, orthosis, or adaptive device
    is not used (p.411)
  • The child needs to learn use the device
  • 2. Spectacular technological developments often
    have very limited meaning for the immediate needs
    of the majority of individuals with physical
    disabilities (p.411)
  • The cost of new technological devices in aiding
    those with a physical disability is very
    expensive and offered to a small group of

Educational Considerations
  • We forget, though, that many people with
    physical disabilities can learn to do many or all
    of the things that most non-disabled people do,
    although sometimes they must perform these tasks
    in different ways (p.412)

Educational Considerations
  • Adapted physical education is now a special
    educational feature of all school programs that
    make appropriate adaptions for students with
    disabilities (p.412)
  • It is SO important to educate the non-disabled
    community about physical disabilities.
  • Design adaptions in buildings, furniture,
    household appliances, and clothing can make it
    possible for someone with a physical disability
    to function as efficiently as a person without
    disabilities in a home, school, or community
  • Its critical to understand the environmental and
    psychological factors that affects classroom
    performance and behavior.

Individualized Planning
  • Individualized education plans or IEPs are
    specific with minute details about the childs
  • Instructional goals and objectives
  • Many children under the age of three who need
    special education and/or related services have a
    physical disability.
  • Children under three years old who have a
    physical disability are required, by federal law,
    to have am individualized family service plan
    (IFSP) to accommodate their needs.

Educational Placement
  • Many different educational setting options
    available - it mainly depend on the severity of
    the childs disability and what type of daily
    care they require.
  • Example childs classroom located in a hospital,
    a homebound instructor for those students who can
    not leave their house will receive educational
    instruction until they are able to return to the
    general education setting.
  • Most children today are integrated into public
    schools because of the
  • advanced treatment, new development in
    bioengineering, greater mobility and functional
    movement, decrease in architectural barriers and
    transportation problems, and public education for
    all children.

Educational Goals and Curricula
  • The individuals limitations vary greatly.
    THEREFORE, curriculum can be tailored
    specifically for a student with a physical
    disability of other health impairment.
  • Goals and curriculum must base their assessments
    off of intellectual, physical, sensory, and
    emotional characteristics of the student
  • A severe and chronic disability that limits
    mobility has two implications
  • The child may be deprived of experiences that a
    non-disabled child has
  • The child may not be able to manipulate materials
    and respond to educational tasks the way the
    other general education students do
  • Students who need mechanical devices to perform
  • Severe or profound students participate in
    everyday community environment goals and
    functional lessons for daily life.

Links with Other Disabilities
  • Most children with physical disabilities need
    services from a physical therapist and an
    occupational therapist
  • Professionals can help give the teacher
    suggestions about how to help the child
    physically, emotionally, and academically.
  • The teacher should always be aware of the childs
    handling and positioning to minimize risk and
    maximize independent movement to enhance learning
  • Teacher should be familiar with prosthetics and
  • Specialist can help instruct the teacher with the
    operation and function of said devices
  • Cooperation with a psychologist and social
    workers to prevent lapses in the childs
  • Speech language therapist
  • Example Cerebral Palsy

Early Intervention
  • Biggest Concerns
  • Early identification and intervention
  • Development of communication
  • Handling how the child is picked up, carried,
    held, and assisted
  • Positioning providing support for the childs
    body and arranging instructional or play
    materials in certain ways.
  • teacher must know how to teach gross motor
    responses and how abnormal reflexes can interfere
    with learning basic motor skills

  • Transitions are generally a difficult time for
    those individuals who are affected with a
    physically disability of health impairment
  • Two areas of concern for transition that stand
    out clearly for adolescents and young adults with
    disabilities are
  • Careers
  • Sociosexuality
  • This individuals begin wanting to experiment with
    jobs, make social relations, and address their
    sexuality and serious ways
  • These individuals often have a hard time dealing
    with developmental issues and if they will be
    accepted in society
  • They ask themselves questions like
  • Can I become independent?
  • Can I hold a well paying job?
  • Will anyone find me physically attractive?
  • What I make close friends and long lasting

Choosing a Career
  • One of the greatest problems in dealing with
    adolescents who have physical disabilities is
    helping them to attain a realistic employment
    outlook (p.420)
  • Characteristics, other than their physical
    disability, that are important to assess
    intelligence, emotions, highly motivated, work
    habits, etc
  • Supported Employment a person with a severe
    disability works in a regular work setting. They
    become a regular employee, perform valued
    function, and receives a fair wage.
  • Ex Greeter at a store. They may need training in
    how to properly greet a person.
  • Technology is creating more jobs for those who
    are disabled

  • People who were not typical physically,
    especially if they had limited mobility, were
    thought of as having no sex appeal for anyone and
    as having little or no ability or right to
    function sexually (p.422)
  • This attitude towards sexuality for those who are
    disabled has changed
  • People with disabilities have rights to take
    family life education, sex education, full range
    of human relationships and sexual expression
  • It is not realistic to expect people with
    physical disabilities to keep all of their
    relationships platonic
  • When teaching students who have physical
    disabilities and health impairments, it is the
    teachers duty to provide alternative means of
    sexual stimulation and about accepting sexual
    practices and relationships that are different
    from the norm

  • Local
  • http//
  • This website is scholarly based. It contains a
    vast number of scholarships for students with
    physical disabilities.
  • http//
  • This website is composed of newsletters and
    various websites that contain general information
    for the public. The community could benefit from
    gaining knowledge from the National Center on
    Health, Physical Activity, and Disability.
  • Parents
  • https//
  • This is a website for parents with articles and
    videos about disabilities. The website also
    offers tutor and specialist links for parents to
    help their children in educational need.
  • http//
  • This website is an informational website with
    definitions of different physical disabilities
    and also different pathologists. Parents could
    benefit from reading this site to gain knowledge
    on their childs disability and also possible
    specialist help.
  • http//
  • http//
  • This website has games and resources for
    children. The website has games on all grade
    level so students can have resources that fit
    their needs best.

  • Teachers
  • This article is an article for teachers of
    students with physical disabilities. It has in
    class, transition ideas, and other classroom
    management ideas.
  • http//
  • The scholastic website has teacher ideas for
    working with physically disabled children. It has
    ideas for encouragement, focus on abilities, and
    specific skills and challenges.
  • Students
  • http//
  • This website has games and resources for
    children. The website has games on all grade
    level so students can have resources that fit
    their needs best.
  • http//
  • Students can go to this website to find out more
    information about joining sports teams that offer
    programs for disabled children.