Special Education: Contemporary Perspectives for School Professionals Fourth Edition. Marilyn Friend. Kerri Martin, Contributor

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1 Special Education: Contemporary Perspectives for School Professionals Fourth Edition By Marilyn Friend Kerri Martin, Contributor 0 Special Education: Contemporary Perspectives for School Professionals, 4 th ed, Marilyn Friend

2 Students with Orthopedic Impairments, Traumatic Brain Injury, and Other Health Impairments Chapter 13 1

3 Objectives Outline the development of understanding and services for physical and health disabilities Define orthopedic impairments, other health impairments, and traumatic brain injuries, and explain their prevalence and causes Describe characteristics of these individuals Explain how physical and health disabilities are identified Outline how students with physical and health disabilities receive their education Describe recommended educational practices for students with physical and health disabilities Explain the perspectives and concerns of parents and families Identify trends and issues influencing the field 2

4 Development of the Field of Physical and Health Disabilities Time Period People/Group Event 1600s Medical Concept of contagious infection 1800s Country Institutionalization common 1917 (WWI) Soldiers Laws enacted to assist wounded to learn job skills 1938 President F.D.R. Establishes what is now the March of Dimes 1950s Hospitals 50% of premature babies die 1955 Medical Polio vaccine 1980s-1990s Supreme Court Rulings establish certain procedures as related services 3 Book title, #

5 Key Concepts for Understanding Physical and Health Disabilities Chronic exists all the time, little change, no cure (e.g., cerebral palsy) Acute serious, but there is treatment, possibly cure (e.g., childhood cancers) Progressive gets worse over time, may lead to death (e.g., muscular dystrophy) Episodic occur with intensity but at times are dormant (e.g., epilepsy) Congenital present at birth (genetic or environmental) Acquired occurs during or shortly after birth (accident, illness, environmental) 4 Book title

6 IDEA Definition of Orthopedic Impairments a severe impairment that adversely affects a child s educational performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures). (IDEA 20 U.S.C [2004], 20 C.F.R [c][8]) 5

7 Terms That Refer to the Parts of the Body Affected Monoplegia only one limb is affected Hemiplegia one side of the body is affected Paraplegia only legs are affected Tetraplegia (formerly called quadriplegia) involves all limbs and trunk of the body Diplegia both legs or both arms are affected 6

8 Neurological Disorders Cerebral palsy Spastic Athetoid Ataxic Mixed Spina bifida spina bifida occulta Meningocele Myelomeningocele Spinal cord injury 7

9 Musculoskeletal Disorders Duchenne muscular dystrophy Juvenile rheumatoid arthritis 8

10 IDEA Definition of Traumatic Brain Injury an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma. (IDEA 20 U.S.C [2004], 20 C.F.R [c][12]) 9

11 Types of Traumatic Brain Injury Closed head injury no physical injury to the skull Open head injury skull is fractured and membrane surrounding the brain is penetrated 10

12 Effects of Traumatic Brain Injury Cognitive skills Processing ability Language Academic achievement Emotions Behavior 11

13 Prevalence and Causes Most common cause of death and disability under age 21 Highest risk: ages 0-4 and Boys:girls 2:1 Car/motorcycle accidents (20% of TBI) Falls (28%; 50% ages 0-11) Assaults (e.g., guns; 11%) Struck by/against (e.g., shaken baby syndrome; 19%) 12

14 IDEA Definition of Other Health Impairment 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, and sickle cell anemia; and ii. Adversely affects a child s educational performance. (IDEA 20 U.S.C [2004], 20 C.F.R [c][9]) 13

15 Other Health Impairments Asthma Epilepsy (see next slide) HIV and AIDS Cancer Sickle cell disease Diabetes 14

16 Epilepsy = Seizure Disorder Partial seizures Simple partial seizures Complex partial seizures Generalized seizures Tonic-clonic seizure (formerly, grand mal) Aura, loses consciousness, falls, arms and legs jerk Absence seizure (formerly, petite mal) Atonic and tonic seizures (remains conscious) Myoclonic 15

17 Prevalence and Causes Condition Prevalence Causes Asthma Epilepsy HIV and AIDS Most common chronic illness in children; 7.1 million No central numbers kept; African Americans from low SES greater risk; more boys Unclear; 21% of those infected do not know Hereditary or triggered by allergens Central nervous system problem; 70% no known cause; head injury Virus Cancer 16/100,000 children Most unknown; some genetic Sickle Cell Disease Diabetes 1/500 African American newborns (1/12 carries) Type I: uncommon Type II: quadrupled in 15 yrs. Recessive gene Metabolic disorder; Type II is preventable 16

18 Characteristics of Individuals with Physical and Health Disabilities Cognitive and academic varies widely Behavior, Emotional, and Social Behavior problems may be present (especially TBI) Positive Behavior Supports and FBA needed Student may have poor self-esteem, anger at situation May need help relating to peers, access to peers Physical and medical teachers must learn about each student s conditions, risks and needs 17

19 Assessment Medical condition and physical functioning Intellectual functioning Academic achievement, language, and related areas Behavior 18

20 Eligibility An IEP is planned and implemented when the student s disability has a significant, negative effect on educational performance A 504 Plan may be used when a condition exists but a student s educational performance receives no negative effects 19

21 Early Childhood Education Infants/toddlers services at home Preschoolers in-home, center-based, or preschool programs Services focus on family relationships as well as treatment for the child Early interventionists help family locate and access needed resources 20

22 Elementary and Secondary School Services Primarily in general education classrooms: Slightly more than half of students with physical disabilities and health impairments; slightly fewer students with traumatic brain injury Many students receive services in special education classrooms, residential facilities, at home, or in hospitals 21

23 Inclusive Practices What are the goals and objectives for the student within the context of the general curriculum? To what extent can appropriate supports and services be provided to ensure that the student progresses on IEP goals and objectives? Do any of the student s needs make education in the general education setting inappropriate (e.g., aggressive behavior or issues related to medical needs, such as unusual allergies)? One other factor to consider in making a placement decision is student voice 22

24 Transition and Adulthood Postsecondary education Practical matters of adulthood Transportation Personal assistance Living arrangements Medical bills Assistive technology Career choices 23

25 Recommended Educational Practices Access to education Aids for posture and mobility Aids for communication Aids for learning Related services Factors related to illness, injury, condition, or disorder School re-entry Responding to emergencies 24

26 Perspectives of Parents and Families Initial thoughts of daily survival Get accustomed to procedures and routines Educate themselves Advocate for their child Deal with sibling needs Help from school professionals is valued 25

27 Trends and Issues Professional preparation Physical and health monitoring Adapted assessment Modifications and assistive technology Specialized instruction Disability-specific curricula Ensuring and affective learning environment Access to technology 26 Book title, #e Author Name 2013 Pearson Education, Inc. All rights reserved.

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