Orthopedic Impairment

Orthopedic Impairment

Definition: Orthopedic impairment is defined as a severe orthopedic 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).

Characteristics of Students who have Orthopedic Impairment:

·         Learning, perceptual, or sensory problems

·         May impede speech production

·         Impede expressive language of the child

Characteristics based on 3 Categories of Orthopedic Impairments:

Neuromotor Impairments: an abnormality of, or damage to, the brain, spinal cord, or nervous system that sends impulses to the muscles of the body. These impairments are acquired at or before birth, and often result in complex motor problems that can affect several body systems.

·         Limited limb movement

·         Loss of urinary control

·         Loss of proper alignment of spine

Two most common are Spina Bifida and Cerebral Palsy

1.      Spina Bifida: is a developmental defect of the spinal column. It may or may not affect intellectual functioning. Spina bifida occulta is a mild condition while spina bifida cystica is more serious.

·         Involves some paralysis

2.       Cerebral Palsy : refers to several nonprogressive disorders of voluntary movement or posture that are caused by malfunction of or damage to the developing brain that occurs before or during birth or within the first few years of life. Individuals with cerebral palsy have abnormal, involuntary, and/or uncoordinated motor movements.

The four most common types of cerebral palsy include:

·         Spastic (very tight muscles occurring in one or more muscle groups that result in stiff, uncoordinated movements)

·         Athetoid (movements are contorted, abnormal, and purposeless)

·         Ataxic (poor balance and equilibrium in addition to uncoordinated voluntary movement)

·         Mixed (any combination of the types)

Degenerative Diseases:  are composed of various diseases that affect motor development. The most common is muscular dystrophy.

·         Muscular dystrophy: group of inherited diseases characterized by progressive muscle weakness

Musculoskeletal Disorders: are composed of various conditions that can result in various levels of physical limitations

·         juvenile rheumatoid arthritis

·         limb deficiency

Teaching Tips

• Special seating arrangements to develop useful posture and movements
• Instruction focused on development of gross and fine motor skills
• Securing suitable augmentative communication and other assistive devices
• Awareness of medical condition and its effect on the student (such as getting tired quickly)
• Educate everyone in the school community on a student’s disability
• Have parent/student/resource staff conferences to ensure classroom is accommodating for each child’s IEP

Due to the various levels of severity of orthopedic impairment, multiple types of assistive technology may be used

·         speech recognition software

·         screen reading software

·         augmentative and alternative communication devices (such as communication boards)

·         academic software packages for students with disabilities

Learning Tools

• Physical Therapists who work on gross motor skills (focusing on the legs, back, neck and torso)
• Occupational Therapists who work on fine motor skills (focusing on the arms and hands as well as daily living activities such as dressing and bathing)
• Speech-Language Pathologists who work with the student on problems with speech and language
• Adapted Physical Education Teachers, who are specially trained PE teachers who work along with the OT and PT to develop an exercise program to help students with disabilities
• Other Therapists (Massage Therapists, Music Therapists, etc.)

Additional Resources

·         Project Ideal: http://www.projectidealonline.org/orthopedicImpairments.php

·         Bright Hub Education: http://www.brighthubeducation.com

·         National Center on Accessible Instructional Materialshttp://aim.cast.org/learn/disabilityspecific/physical

United Cerebral Palsy: http://www.ucp.org/

Multiple Disability

October 16, 2012

“It should be noted however, that these students can also have average or even above-average intelligence”

Resources:   United Cerebral Palsy Association – www.ucp.org   Utah Center for Assistive Technology – ucat.usor.utah.gov   Assistiveware – www.assistiveware.com   Project Ideal - http://projectidealonline.org/multipleDisabilities.php   National Dissemination Center for Children with Disabilities http://nichcy.org/disability/specific/multiple

Multiple Disabilities

Encompasses a combination of conditions that may impact a student’s ability to learn and achieve success in an academic setting.  o   Students with severe disabilities are typically included under this terminology. o   This disability category includes those students with the most severe physical, cognitive, and communicative impairments.  o   The common connection isn’t that they have two or more co-existing impairments, but that they generally need extensive support across any number of skill areas.

Characteristics - Six Categories that impact their learning:

Intellectual functioning-  Most have severe impairments   Adaptive skills-  Especially self-care and social skills Programs should include self-care and self-advocacy components (essential for their inclusion in the community)

Motor development- Significant delays in fine and gross motor skills Physical Therapy w/ orthopedic supports to improve deficits in motor Sensory impairments- Hearing and visual impairments are common Having a clear understanding of their sensory impairments will

help develop appropriate instructional programs.

Health care needs- Medical procedures, medical aids, medications

Communication skills- Challenges requiring augmentative and alternative communication

Teaching Strategies:

Planning process: a multidisciplinary process (parents, teachers, physical therapist, assistive technology teachers, and any additional support staff).   Determining the students strengths and desires   Determine what Resources and support will be needed   Develop an IEP   Integrate students with multiple disabilities with other peers.  Part of the

learning process is social development. Peer tutoring – Must be reciprocal.  Student with MD should be able to provide something to the tutoring process, even if it is simply social behavior.   Assistive technology – is an effective tool for students with MD in overcoming functional and communicative limitations.   Augmentative and Alternative Communication –is any

instructional device, technique, or system that serves to support and bolster communication

GOAL: AAC devices allow students with MD to share countless emotional and social benefits that can come from a reciprocal interaction with another person.

 

Tangible and tactile symbol systems:

Choice boards

Object prompts & symbols

Physical modeling & prompting

Computer or microswitch technology

Intellectual Disability

Intellectual Disability

 

Definition in IDEA: “…significantly subaverage general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance.” [34 CFR §300.8(c)(6)]

 

In 2010, President Obama signed Rosa’s Law, which replaced the stigmatizing label “Mental Retardation” with the more acceptable term “Intellectual Disability”

IDs are the most common form of developmental disability

 1-3% of America’s general population and 10% of students requiring SPED have an ID

 

Causes: Genetic conditions (e.g. Down syndrome, Fragile X syndrome, Williams syndrome), problems during pregnancy (e.g. mother who used alcohol during pregnancy, improper cell division), problems at birth (e.g. lack of oxygen), and health problems (e.g. malnutrition, lack of appropriate medical care, contact with poisons, and diseases like whooping cough, meningitis, or the measles)

 

Characteristics:

·         Variety of physical markers depending on cause of the disability

·         Below average intelligence ranging in incidence rate and severity

o   For a mild diagnosis, students’ IQ scores will be between 70-75 or below

o   For a moderate to severe diagnosis, students’ IQ scores will be approximately 55 or below

·         Slower learning rate and greater difficulty retaining information

·         May reach a point where learning levels off

·         Difficulty generalizing skills learned in one context to another

·         Trouble solving problems/thinking logically

·         Difficulty with social and daily living skills

·         Developmental delays

 

Suggested Teaching Strategies:

·         Treat students appropriately according to their chronological age

·         Carefully follow the strategies outlined in the student’s IEP

·         Break large concepts down into smaller steps and include breaks

·         Teach one subject or idea at a time

·         Supply manipulatives to concretely represent concepts

·         Provide opportunities for continued practice in a variety of settings

·         Teach social and daily living skills

·         Match expectations to instruction (i.e. accommodations and modifications)

·         Use peer-tutoring, inclusive methods, and family involvement

 

Additional Resources:

 

The Arc

http://www.thearc.org/page.aspx?pid+2335

The Arc is a community-based organization that advocates and serves those with intellectual and developmental disabilities and their families. The site includes various fact sheets on intellectual disabilities detailing everything from the causes of these disabilities to criminal justice issues regarding these disabilities.

 

The Utah Association for Intellectual Disabilities (UIAD)

http://www.uaidutah.org/home

The UIAD is a relatively new non-profit organization that formed in 2008 after The Arc of Utah closed due to financial reasons. UIAD took over some of the services the local Arc chapter provided, including the “Holiday Gift Box Program, Bridge to the Future, Connections to Computers, and socialization projects.” The Bridge to the Future is a particularly beneficial resource for parents and educators alike, outlining the services a person with an intellectual disability may require throughout stages of his or her life. People interested in supporting UIAD’s mission are welcome to volunteer.

 

Project Ideal

http://www.projectidealonline.org/index.php

Project Ideal is part of a teacher preparation program meant to prepare teachers to work with students with disabilities.  It provides helpful resources such as tips for classroom management and managing student behavior along with descriptions of disability categories and disability law.

 

The U.S. Equal Employment Opportunity Commission

http://www.eeoc.gov/facts/intellectual_disabilities.html

The EEOC provides information on employment opportunities and the rights of workers with intellectual disabilities.  EEOC is an important resource for educators to gain knowledge on how to prepare students with disabilities for future jobs and opportunities.  This resource would be especially applicable for secondary teachers.

 

American Association on Intellectual and Developmental Disabilities (AAIDD)

http://www.aamr.org/index.cfm

The AAIDD offers links to national disability organizations focusing on specific disabilities.