Physical Disabilities, Health

Impairments, and AD/HD

A guide for parents and

students

Presented by Michelle Thomas

Health Impairments

Case Study

Physical Disabilities

Introduction

• Cerebral Palsy

• Spina Bifida

• Spinal Cord Injuries

• Muscular Dystrophy

• Epilepsy • Diabetes

• Asthma • Cystic Fibrosis

• HIV and AIDS • AD/HD

• Description • Sample Lesson • 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.(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.

Health Impairments

• Chronic or acute health problems.

Cerebral Palsy

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

Characteristics• Lack of voluntary

muscle control• Poor coordination• Muscle spasticity• Speech and

swallowing issues• Weak muscles• Gross and fine motor

skill issues• Muscle tightness

(United Cerebral Palsy, 2001)

Cerebral Palsy

Treatments

Medications, surgery, and braces are sometimes used to help maintain or improve muscle and nerve coordination.

(United Cerebral Palsy, 2001)

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

(Aiello & American Federation of Teachers, 1981)

Spina Bifida

Causes• Birth defect• Genetic• Environmental• Lack of folic acid

during first trimester

Types• Occult Spinal

Dysraphism• Spina Bifida

Occulta• Meningocele• Mylomeningocele

Characteristics• Muscle weakness• Loss of involuntary and

voluntary muscles below affected region

• Paralysis• Hydrocephalus• Loss of sensation and

feeling below affected region

(Liptak & Spina Bifida Association, 2008)

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)

(National Dissemination Center for Children with Disabilities [NICHY], n.d.)

Muscular Dystrophy

Types• 40 different diseases

– Muscular

– Motor Neuron

– Metabolic

– Peripheral Nerve

– Inflammatory

– Neuromuscular Junction

– Endocrine

– Other

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

(Muscular Dystrophy Association, n.d.)

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

(National Institute of Neurological Disorders

and Stroke, 2009)

Teatments• Surgery• Drug therapies• Antibiotics

(Ainsa, 1981)

Spinal Cord Injuries

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

Characteristics• Damage begins at site of

injury– Motor impairment

– Loss of involuntary muscle response

– Sensory deprivation

– paralysis

(National Institute of Neurological Disorders and Stroke, 2010)

Spinal Cord Injuries

Treatments• Rehabilitation• Respiratory support• Steroids

(National Institute of Neurological Disorders

and Stroke, 2010)

Educational Strategies• Assistive technology and scribes for writing• Physical and occupational therapy• Classroom set up• Higher desks for wheelchairs• Counseling for trauma

(Carney & Porter, 2009).

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

(Epilepsy Foundation, n.d.)

(Epilepsy Foundation, n.d.)

(Heward, 2009) (Heward, 2009)

(Heward, 2009)

Diabetes

Causes• Genetics,

metabolism, and environment

• Hyperglycemia• Hypoglycemia

Types• Type 1

– Lack of insulin production

• Type 2– Resistance to

insulin

Characteristics• Thirst• Lack of energy• Headaches• Weight loss• Slow healing of cuts• Frequent urination

Treatments• Medication• Diet• Exercise

Educational Strategies• Recognize symptoms• Have candy or juice in close proximity• Prompting for medication

(Heward, 2009)

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

Treatments• Medication• Counseling

Educational Strategies• Modifying curriculum for frequent absence• Homebound instruction• Avoiding triggers

(Heward, 2009)

Cystic Fibrosis

Causes• Genetic Disease

– Causes over production of mucus on membranes

TypesThere are no

specific types.

Characteristics• Difficulty breathing• Heart disease• Malnutrition• Poor development• Poor digestion

Treatments• Enzyme supplements• Mucus thinners• Antibiotics• Anti-inflammatory

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 (Cystic Fibrosis Foundation, 2009)

(Heward, 2009)

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

(Heward, 2009)

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

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

Teacher brought up

concerns at first parent meeting. The group decided to do

an informal observation of the

student.

Student is diagnosed with AD/HD with the

help of her doctor and the informal observation tool.

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.

Modifications

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.

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.

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

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