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WHAT ARE THE FOUNDATIONS OF PHYSICAL AND HEALTH DISABILITIES?

History

• The histories of the medical conditions that comprise physical and health disabilities are all different. (p. 324)
• Some disabilities, such as cerebral palsy, have a long history whereas others, such as AIDS, are relatively recent conditions. (p. 324-25)

Definitions

• Physical and health disabilities include three categories under IDEA 04: orthopedic impairments, other health impairments, and traumatic brain injury. Each has its own definition. (p. 325)
• To receive services under IDEA 04, the physical or health impairment must adversely affect educational performance. (p. 325)

Prevalence

• The actual prevalence of physical and health disabilities varies as a function of the medical condition; slightly fewer than 1% of the school age population receives services under IDEA 04 through the OI, OHI, and TBI categories. (p. 325)

WHAT ARE THE CAUSES AND CHARACTERISTICS OF PHYSICAL AND HEALTH DISABILITIES?

• Cerebral palsy is caused by brain damage before, during, or shortly after birth that affects muscle tone, movement, and motor development. (p. 327-28)
• The exact cause of spina bifida, a condition that can damage the spinal cord, is still not known. (p. 328-29)
• The most common form of muscular dystrophy, Duchenne, is a genetic disorder characterized by progressive muscle weakness. (p. 329-30)
• A person with epilepsy has recurrent seizures (problems with consciousness, movement and/or sensation) caused by an abnormal electrical discharge in the brain. (p. 330-31)
• Asthma is a respiratory condition that results in breathing difficulties. (p. 331)
• Cystic fibrosis is an autosomal recessive disorder primarily resulting in lung problems due to a build up of mucus. (p. 332)
• Diabetes, a condition resulting in high blood sugar, appears to have a genetic basis that is triggered by environmental factors such as diet. (p. 332-33)
• Acquired autoimmunodeficiency syndrome, which can lead to chronic illnesses and even death, is caused by a virus. (p. 333-34)
• Traumatic brain injury, one caused by an external force, can result in many characteristics depending on the type and location of the injury. (p. 334-36)

HOW ARE STUDENTS WITH PHYSICAL OR HEALTH DISABILITEIS IDENTIFIED?

• Many physical and health disabilities can be identified prenatally using techniques such as amniocentesis and chorionic villus sampling. (p. 337)
• Some physical disabilities, such as cerebral palsy and most forms of spina bifida, are identified by noting observable physical characteristics. (p. 337)
• The identification of Duchenne muscular dystrophy might involve laboratory tests as well as medical procedures such as muscle biopsies. (p. 337)
• Epilepsy is usually diagnosed using an electroencephalograph (EEG) and brain imaging techniques such as computerized axial tomography (CAT scan). (p. 336-37)
• A physical exam that includes procedures that evaluate a person's lung functioning are used to diagnose asthma. (p. 338)
• Traumatic brain injury is identified using various brain imaging techniques to determine severity and location of the injury. The Glasgow Coma Scale is used to indicate the degree of damage. (p. 338)

WHAT AND HOW DO I TEACH STUDENTS WITH PHYSICAL AND HEALTH DISABILITIES?

Instructional Content

• Most students with physical or health disabilities will participate in the general education curriculum. Access to the general education curriculum can be accomplished, in part, through universal design. (p. 339-40)
• Students may need to learn special health care content to manage their own conditions as much as possible. (p. 340-41)
• Students may need an emphasis on life skills to accomplish daily activities and routines in life. (p. 341)
• Students, especially those with TBI, may need social skills to assist them in developing and maintaining relationships with peers and adults. (p. 341)
• Self-determination skills may be needed by students to develop independence and self-advocacy. (p. 341)
• Transition planning and programming can involve movement from a community setting, (such as a hospital) back to school, and vice versa or the transition from school to adult living. (p. 342)

Instructional Procedures

• Individualized Health (care) Plans are developed to provide information about a student's health status, health care procedures, and physical management. (p. 343-44)
• The use of strategies for behavioral and social skill development are particularly important for students with TBI who may experience personality changes following their injuries. (p. 344-45)
• Cognitive strategies can be used to assist students in developing thought patterns and decision-making processes that help them problem-solve in social situations. (p. 345)
• Parents often need special support in both understanding and working with their child with a physical or health disability. (p. 345)

WHAT ARE OTHER INSTRUCTIONAL CONSIDERATIONS FOR TEACHING STUDENTS WITH PHYSICAL OR HEALTH DISABILITIES?

Instructional Environment

• A continuum of services is needed. Because of the nature of physical and health disabilities, instruction may occur in a variety of settings including schools, home, hospital, and rehabilitation facilities among others. (p. 346)
• Coordination of educational and related services is a major area of concern for parents and students. (p. 346)
• Classroom arrangements involve consideration of various types of barriers, portability of materials, accessibility, competing educational philosophies, and appropriate staff training. (p. 346-47)
• Distance learning is one means by which students who are unable to attend school can still be provided access to education and interactions with peers and teachers. (p. 347)

Instructional Technology

• Students should be individually assessed to determine what types of technology can best be used to meet their unique needs. (p. 348)
• Adaptive equipment can be helpful in the physical management of students and in assisting with self-help and other skills. (p. 348-50)
• Alternative and augmentative communication systems may be needed for students who are unable to speak, so that others can understand their messages. (p. 349-50)
• Assistive technology, such as computer hardware and software, can be used to increase accessibility to materials and learning activities. (p. 350-52)

WHAT ARE SOME CONSIDERATIONS FOR THE GENERAL EDUCATION TEACHER?

• The need to work collaboratively with special education teachers and related services personnel is very important as well as learning the use of adaptive equipment and assistive technology. (p. 352)
• Teachers need to consider making the environment safe and accessible. (p. 353)
• Instructional adaptations to schedules, seating arrangements, and materials may be necessary. (p. 353)
• Support in emotional and social development can facilitate the inclusion of students with physical and health disabilities. (p. 353)