Allen Chapter 7

Allen and Cowdery The Exceptional Child: Inclusion in Early Childhood Education, Ninth Edition. © 2022 Cengage. All
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Physical Disabilities and Health Problems
Chapter 7

Chapter Objectives
By the end of this chapter, you should be able to:
7-1 Define and give examples of physical disabilities.
7-2 Recognize the various health problems an early childhood teacher may
encounter.
7-3 Describe the program implications and the role of the early childhood
teacher when working with children with physical disabilities and health
problems.
7-4 Outline practices for completing daily health checks, maintaining health
records, and administering medication.

Categories of Disabilities
Physical Disabilities
Relate to disabilities involving skeleton,
joints, and muscles
• Missing limbs, club feet, congenital hip
dislocations;
• Neurological disorders such as cerebral
palsy;
• Joint contractures caused by fractures, burns,
or amputations
Health Conditions
• Heart conditions
• Epilepsy
• Asthma
• Leukemia
• Diabetes
• Sickle-cell anemia
• HIV/AIDS
• Hemophilia
• Obesity

Physical Disabilities (1 of 3)
Cerebral Palsy
Cerebral palsy—Neurological disorders
resulting in lack of control of muscle
movements
• Spasticity—Muscles do not contract and flex
as they should
Hypotonicity
Hypotonicity—Too little muscle tone, resulting
in an inability to move about or maintain
postural control, a “rag doll” condition
• Athetosis—Fluctuating or uneven muscle tone
• Ataxia—Lack of motor coordination
Classifications based on body parts
• Diplegia—all four extremities
• Hemiplegia—one side of the body
• Paraplegia—legs only
• Quadriplegia—arms, legs, trunk, and head
control

Spinal Cord Injuries
• Spinal cord is injured or severed
• Muscles below the point of damage become
impaired
• Muscles no longer receive messages from
the brain
Spina bifida—imperfect development of the
spinal cord and spinal column during the
first thirty days of fetal development
• Hydrocephalus—Blockage of the circulation
of the spinal fluid in the cranial (brain) cavity
• Incontinence—Lack of control over bladder
and bowel movements
Muscular Dystrophy
Progressive weakening of the muscles
• Duchenne Muscular Dystrophy—affects only
males; weakness begins at hips and shoulders
and moves to arms and legs

Hip Dysplasia
Developmental dislocation of the hip (DDH)
• Hip moves in and out of socket
• More frequently found in girls
• Treated with braces
Juvenile Rheumatoid Arthritis
• Painful inflammation around the joints
• Children should be encouraged to move
• It often disappears by age 18

Program Implications
Despite individual differences among children with physical disabilities, they
have the same basic classroom needs:
• The services of various pediatric professionals working as a team with classroom teachers
• Adaptive equipment designed for each child’s particular disability
• Environmental adaptations to facilitate and support each child’s learning efforts

Team Efforts
• Physical therapists
• Occupational therapists
• If there are language or hearing problems, Speech Language Pathologists
and audiologists may be on the team
• Parents and teachers
• Psychologist if there are behavior problems

Knowledge Check Activity 1
When should a teacher be instructed to arrange for therapeutic activities for a
child with physical disabilities?
a. Under no circumstances should teachers initiate positioning exercises or remedial motor
activities without specific guidance from a certified therapist.
b. Teachers may initiate positioning exercises without specific guidance from a certified
therapist.
c. Teachers may initiate remedial motor activities without specific guidance from a certified
therapist.
d. Teachers may initiate therapeutic activity.

Knowledge Check Activity 1: Answer
When should a teacher be instructed to arrange for therapeutic activities for a
child with physical disabilities?
Answer: a. Under no circumstances should teachers initiate positioning exercises or
remedial motor activities without specific guidance from a certified therapist.
Depending on the therapists’ assessment, individual remediation activities are mapped
out for each child. The classroom teacher should never be expected to put a child
through stressful exercises, nor should teachers initiate any kind of therapeutic activity
without specific instruction and supervision from a certified specialist.

Adaptive Equipment
Mobility devices—braces, walkers, wheelchairs
Positioning devices—wedge mats, bolsters, prone boards

Universal Design For Learning
• Recognizing that a one-size-fits-all approach to education does not work
• Understanding the need to design curricula to meet the needs of all
classroom learners
• Believing that all children who attend early education programs will be
successful in their development and learning
• The “Why”, “What”, and “How” of learning

Classroom and Material Adaptation (1 of 3)
Creative/Art Area
• Large pencils, crayons, and markers or adapted with a ball
• Paper taped to table to avoid slipping
Fine Motor Area
• Wall-mounted manipulatives including puzzles with Velcro on back of pieces, Lego boards,
pegboards

Snack Area
• Built-up spoon handles
• Suction cups or skid-resistant shelf paper
Outdoor Play Area
• Swings adapted with safety harnesses
• Pedal and wheel toys adapted with foot block and Velcro
• Ground surface soft and resilient

Overall Classroom
• Wide aisles and space to turn around and maneuver wheelchairs or walkers
• Activities and materials accessible for all students to participate independently
• Handrails and ramps where needed
• Low shelves
• Clearly defined play spaces

Case Study
Clarissa is a very petite four-year-old with severe language delays as well as
physical disabilities. The physical delays, in combination with her small stature
(she is closer to the size of a two-year-old), present many challenges in her
child care classroom.
The physical environment alone, including the toilets, sinks, and chairs, are all
oversized for her.
a. What might her teacher do to modify both the physical environment and classroom
curriculum to help Clarissa feel safe and be successful in her development and
learning?

Health Problems (1 of 4)
Asthma—During an attack, a child cannot get a full breath of air, lips and nails
may turn blue. If a child cannot get relief from medication, emergency help
needs to be called.
Cystic fibrosis—Excessive mucus, chronic cough, progressive lung damage,
and inability to absorb fats and proteins. Children also tend to have frequent,
foul smelling bowel movements and unusually salty perspiration.
Hemophilia—Blood does not clot normally, causing serious internal bleeding.
Leukemia—Most common type of childhood cancer.

Sickle-cell anemia—Autosomal recessive disorder. Red blood cells are sickled
in shape instead of round, making it difficult for them to pass through the
bloodstream.
• Overall fatigue is one of the chronic problems.
• It is found only in African American children.
Heart problems—Children with heart problems should be encouraged to move
but should not participate in anything too physically demanding.
• Monitor their skin color for a blue tone.
• Let the children tell you when they are too tired to continue.

Diabetes—Body does not produce or properly use insulin, a hormone that is
needed to convert sugar, starches, and other food into energy needed for daily
life.
• Type 1 diabetes is caused by an autoimmune disorder. The body does not make enough
beta cells to fight off infections.
• Type 2 diabetes is more common.
Hypoglycemia and hyperglycemia are the result
• Hypoglycemia is excessively low levels of sugar in the blood.
• Hyperglycemia is too much sugar in the blood.

Seizure Disorders—Caused by a disturbance of the brain’s electrical activity
• Febrile seizures—Brought on by a fast-rising fever
• Generalized tonic-clonic seizures (grand mal)—Causes children to lose consciousness and
fall to the floor with violently jerking movements
• Absence seizures (petit mal)—Generalized seizures with momentary loss of consciousness
that may occur many times a day
• Partial psychomotor seizures—Often appear like a tantrum and the child is unaware of the
behavior. Becomes stereotypic for that child

What To Do During A Seizure (1 of 2)
1. Remain calm. Children will react the same way teachers do. The seizure
itself is painless.
2. Do not try to restrain the child. Nothing can be done to stop a seizure once
it has begun. It must run its course.
3. Clear the space around the child so that no injury from hard objects occurs
and there is no interference with the child’s movements.
4. Do not try to force anything between the teeth.

What To Do During A Seizure (2 of 2)
5. Loosen tight clothing, especially at the neck; turn the child’s head to the
side; wipe away discharge from the mouth and nose to aid breathing.
6. When the seizure is over, allow the child to rest.
7. Generally, it is not necessary to call for medical assistance unless the child
does not have a known history of seizures or if the seizure lasts for more
than 3 to 4 minutes or is followed by another seizure. Parents often provide
specific guidelines for handling their child’s seizures based on input from
their pediatrician.
8. The child’s parents should always be informed of a seizure. Teachers and
parents plan together how future seizures are best handled for that
particular child.

Guidelines to Promote Healthy Eating and Physical
Activity (1 of 2)
1. Use a coordinated approach to develop, implement, and evaluate healthy eating
and physical activity policies and practices.
2. Establish school environments that support healthy eating and physical activity.
3. Provide a quality school meal program and ensure that students have only
appealing, healthy food and beverage choices offered outside of the school meal
program.
4. Implement a comprehensive physical activity program with quality physical
education as the cornerstone.
5. Implement health education that provides students with the knowledge, attitudes,
skills, and experiences needed for lifelong healthy eating and physical activity.

Guidelines to Promote Healthy Eating and Physical
Activity (2 of 2)
6. Provide students with health, mental health, and social services to address
healthy eating, physical activity, and related chronic disease prevention.
7. Partner with families and community members in the development and
implementation of healthy eating and physical activity policies, practices, and
programs.
8. Provide a school employee wellness program that includes healthy eating and
physical activity services for all school staff members.
9. Employ qualified persons and provide professional development opportunities for
physical education, health education, nutrition services, and health, mental health,
and social services staff members, as well as staff members who supervise
recess, cafeteria time, and out-of-school time.

Health Problems and Classroom Practices (1 of 3)
• Teachers should be informed of all health issues related to the child that
may impact educational performance.
• Become educated on the illness, prevention, and care.
• NAEYC Healthy Young Children (Aronson, 2012) is a resource that
provides further information as well as forms and checklists to use when
planning and implementing health programs at a center or school

Daily Health Check—Should be completed in a relaxed manner that is
respectful of the child and the family’s culture. Should include a quick visual
head-to-toe inspection to look for symptoms of illness, injury, or changes in the
child that would suggest that something is out of the ordinary
Health Records—Emergency contact information for family and health care
providers, medical history, immunizations, assessments and testing, notations,
etc.
Administering Medication—Varies from state to state, but most require child’s
name, physician’s name and phone number, name of the medicine, dosage
information, and schedule

Emergency Considerations—All programs serving children are required to
have detailed plans for emergency situations in general
• Confer with parents and doctors to plan for a health crisis.
• Understand the cause of a crisis and frequency with which it is likely to occur.
• Learn how a child may behave before and after a crisis.
• Know what to do during and after the crisis and understand when to call for additional help.
Confidentiality—Staff should be trained in requirements and understand
importance of working with families.

Knowledge Check Activity 2
Who specifies that medication bottles are required to bear specific details and
packaged according to safety regulations?
a. Teacher
b. Parent
c. State
d. NAEYC

Knowledge Check Activity 2: Answer
Who specifies that medication bottles are required to bear specific details and
packaged according to safety regulations?
Answer: c. State.
In many states, the law or licensing agency requires that medication given in the early
childhood center be administered only on written order from a physician. Most states
require that the package or bottle containing the medication be a child-resistant
container and clearly labeled.

Summary
Now that the lesson has ended, you should have learned how to:
• Define and give examples of physical disabilities.
• Recognize the various health problems an early childhood teacher may encounter.
• Describe the program implications and the role of the early childhood teacher when working
with children with physical disabilities and health problems.
• Outline practices for completing daily health checks, maintaining health records, and
administering medication.

Allen Chapter 7

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