Chapter 12: Physical Disabilities

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Chapter 12 Physical Disabilities
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Orthopedic Disabilities Definition

• A severe orthopedic impairment that adversely
  affects a childs 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).

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Cerebral Palsy

• Results from brain damage and does not get
  progressively more impairing- occurs during
  pregnancy, labor, in infancy, or in early
  childhood
• Nonprogressive and nonhereditary
• Types
• Spastic- most common rigid movements
• Athetoid- abrupt involuntary movements
• Ataxic- unsteadiness, lack of coordination
• Mixed- spastic and athetoid
• Mental retardation occurs in 50- 70 of cases

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Topographical Classification

• Cerebral palsy is classified by type of movement
  and body part affected
• A. Monoplegia one limb
• B. Paraplegia legs only
• C. Hemiplegia one-half of body
• D. Triplegia three limbs (usually two legs and
  one arm)
• E. Quadriplegia all four limbs
• F. Diplegia more affected in the legs than the
  arms
• G. Double Hemiplegia arms more involved than
  the legs

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Spina Bifida

• Malformation of spinal cord during early days of
  pregnancy- spinal column does not completely
  close
• The higher the defect, the more severe the loss
  of function
• Types
• spina bifida occulta- mildest found by x-ray
• meningocele- covering, but not cord, protrudes
  abilities not lost
• myelomeningocele- covering and cord protrude

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Types of Spina Bifida
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• Classroom issues
• shunt must be monitored
• Bladder and bowel control may be limited
• May have sensitivity to temperature, pain, or
  position of legs
• About 75 of kids with spina bifida have normal
  intelligence but some have learning difficulties.
  

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Muscular Dystrophy

• Includes nine hereditary muscle- destroying
  disorders that vary inheritance pattern, age of
  onset, initial muscles attacked, and rate of
  progression
• Duchennes disease- most common
• Scoliosis, a lateral curve of the spine, is
  common in these students.

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Prevalence

• U.S. Department of Education reported that
  schools served 67,442 students, ages 6-21, who
  have physical disabilities in the 1999-2000
  school year.

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Evaluation Process

• Types of evaluation
• Amniocentesis and ultrasonographic imaging of the
  fetus assist physicians in diagnosing
  disabilities before the baby is born.
• Apgar screening- done right after birth and
  checks sucking reflex, convulsions, stiffness or
  an unusual amount of irritability and respiratory
  problems
• Ecological inventory, Electromyography, Muscular
  biopsy, Discrepancy analysis
• Physical therapists- Assessment
• Occupational therapists- upper-body movement fine
  motor, and daily living activity

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Effective Teaching Practices

• Curricular Goals
• Enhance functional mobility
• Increase communication
• Enhance capability to attend to daily living
  skills
• Maintain best physical health
• Achieve self-determination

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Effective Teaching Practices

• Implement Instruction
• Augmentative and alternative communications
  (AAC)- technical and strategies to assist with
  communication
• Medical technology assistance (tracheostomy,
  jejunum tube, colostomy, pulseoximeter)

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Progress in General Curriculum

• Practice Inclusion
• Development programs aimed at integrating
  students with physical disability and their peers
  without disabilities
• Foster Collaboration
• Professional- school-based teams, including
  district resource nurse to oversee multiple
  services
• Family- family and other professionals
  collaborate with teachers and other professionals
• Students and community- a buddy system helps
  the student become an important member of the
  team

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Programs and Practice

• Early Childhood Years- enhances functional
  mobility by utilizing technology tools such as an
  eye-gaze board and a computer
• Middle Years- a buddy system is utilized to
  assist with adaptive equipment
• Secondary Years- Pacific Northwest community
  pairs adult mentors with students to engage in
  learning and recreational activities
• Transition and Postsecondary Years- UC Berkeley
  utilizes trained care attendants to ensure
  accessibility and appropriate education