This document discusses physical and health disabilities in students. It begins by outlining the history and definitions of various physical and health impairments such as cerebral palsy, AIDS, orthopedic impairments, other health impairments, and traumatic brain injury. It then discusses the prevalence of these disabilities in students aged 6-21 and common characteristics. Causes, identification procedures, considerations for instruction and accommodations are also outlined. The document provides guidance for teachers on adapting their instruction and environment to meet the needs of students with physical or health disabilities.

1. © 2009 The McGraw-Hill Companies, Inc.
Students with Physical orStudents with Physical or
Health DisabilitiesHealth Disabilities
Chapter 10Chapter 10

2. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are the Foundations ofWhat are the Foundations of
Physical and Health Disabilities?Physical and Health Disabilities?
 350 B.C. - first known description of epilepsy350 B.C. - first known description of epilepsy
 Cerebral palsy first described in 1800sCerebral palsy first described in 1800s
 AIDS is one of the most recent healthAIDS is one of the most recent health
disabilities.disabilities.

3. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
How are Physical and HealthHow are Physical and Health
Disabilities Defined?Disabilities Defined?
 Three categoriesThree categories
 Other Health ImpairmentOther Health Impairment (OHI)(OHI)
 Disorder resulting in limited strength, vitality or alertness withDisorder resulting in limited strength, vitality or alertness with
respect to the educational environmentrespect to the educational environment
 Orthopedic ImpairmentOrthopedic Impairment (OI)(OI)
 Disease such as polio, clubfoot, bone tuberculosis, cerebral palsy,Disease such as polio, clubfoot, bone tuberculosis, cerebral palsy,
spina bifida, muscular dystrophy, amputations, fractures, or burnsspina bifida, muscular dystrophy, amputations, fractures, or burns
that adversely affect educational performancethat adversely affect educational performance
 Traumatic Brain InjuryTraumatic Brain Injury (TBI)(TBI)
 An acquired injury to the brain caused by external physical force,An acquired injury to the brain caused by external physical force,
resulting in total or partial functional disability that adverselyresulting in total or partial functional disability that adversely
affects educational performance, includes open or closed headaffects educational performance, includes open or closed head
injuriesinjuries

4. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are Examples ofWhat are Examples of
Other Health Impairments?Other Health Impairments?
 Asthma, AD/HD, diabetes, epilepsy, heartAsthma, AD/HD, diabetes, epilepsy, heart
conditions, hemophilia, lead poisoning,conditions, hemophilia, lead poisoning,
leukemia, nephritis, rheumatic fever,leukemia, nephritis, rheumatic fever,
Tourette’s Syndrome, sickle cell anemia, etc.Tourette’s Syndrome, sickle cell anemia, etc.

5. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What is the Prevalence of PhysicalWhat is the Prevalence of Physical
and Health Disabilities?and Health Disabilities?
 Students aged 6-21Students aged 6-21
 About .10% - orthopedic impairmentsAbout .10% - orthopedic impairments
 About .85% - other health impairments (3About .85% - other health impairments (3rdrd
largestlargest
category)category)
 About .04% - traumatic brain injuryAbout .04% - traumatic brain injury

6. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are Some Causes ofWhat are Some Causes of
Orthopedic Impairments?Orthopedic Impairments?
 Orthopedic Impairments - Causes vary, but someOrthopedic Impairments - Causes vary, but some
examples include:examples include:
 Cerebral PalsyCerebral Palsy
 Damage to different parts of the brain that results in problems inDamage to different parts of the brain that results in problems in
muscle tone and movement caused by prematurity, intrauterinemuscle tone and movement caused by prematurity, intrauterine
development, lack of blood flow or oxygen, etc.development, lack of blood flow or oxygen, etc.
 Spina BifidaSpina Bifida
 Congenital disorder resulting when bones surrounding the spinalCongenital disorder resulting when bones surrounding the spinal
cord do not close or grow togethercord do not close or grow together
 Muscular DystrophyMuscular Dystrophy
 Inherited (usually from the mother) or gene mutation causingInherited (usually from the mother) or gene mutation causing
muscle weakeningmuscle weakening

7. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
Types of Cerebral PalsyTypes of Cerebral Palsy
and Their Effects (Table 10.1)and Their Effects (Table 10.1)

8. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are Some Causes ofWhat are Some Causes of
Other Health Impairments?Other Health Impairments?
 Other Health Impairments - Many different causesOther Health Impairments - Many different causes
and many different disabilities under this categoryand many different disabilities under this category
(including AIDS, asthma, AD/HD, cancer, diabetes,(including AIDS, asthma, AD/HD, cancer, diabetes,
sickle cell anemia, epilepsy, etc.)sickle cell anemia, epilepsy, etc.)
 Epilepsy – Recurrent seizures resulting in problems withEpilepsy – Recurrent seizures resulting in problems with
consciousness, movement, and/or sensation caused by anconsciousness, movement, and/or sensation caused by an
electrical dysfunction in the brainelectrical dysfunction in the brain
 Generalized tonic-clonic seizuresGeneralized tonic-clonic seizures
 Absence seizuresAbsence seizures
 Simple partial seizuresSimple partial seizures
 Complex partial seizuresComplex partial seizures

9. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are Some Causes ofWhat are Some Causes of
Traumatic Brain Injury?Traumatic Brain Injury?
 Traumatic Brain Injury - An acquired headTraumatic Brain Injury - An acquired head
injury caused by external force that adverselyinjury caused by external force that adversely
affects educational performanceaffects educational performance
 Often caused by car accidents, falls, violence-Often caused by car accidents, falls, violence-
related injuries, and sports injuriesrelated injuries, and sports injuries
 Open head injury - skull is penetrated and brainOpen head injury - skull is penetrated and brain
exposedexposed
 Closed head injury - no penetration but seriousClosed head injury - no penetration but serious
consequencesconsequences

10. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are Some CommonWhat are Some Common
Characteristics of Students withCharacteristics of Students with
Physical and Health Disabilities?Physical and Health Disabilities?
 Other Health ImpairmentsOther Health Impairments
 Characteristics vary depending on the specificCharacteristics vary depending on the specific
condition.condition.
 Orthopedic ImpairmentsOrthopedic Impairments
 Motor coordination, balance, and coordinationMotor coordination, balance, and coordination
Traumatic Brain InjuryTraumatic Brain Injury
 Problems with coordination, walking, vision,Problems with coordination, walking, vision,
speaking, hearing, stamina, paralysis, seizures,speaking, hearing, stamina, paralysis, seizures,
emotional and cognitive difficultiesemotional and cognitive difficulties

11. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
How are Students Identified withHow are Students Identified with
Physical or Health Disabilities?Physical or Health Disabilities?
 Identification is usually completed throughIdentification is usually completed through
medical diagnostic procedures includingmedical diagnostic procedures including
amniocentesis, chorionic villus sampling,amniocentesis, chorionic villus sampling,
ultrasound, CT scans, EEGs, PET scans, CATultrasound, CT scans, EEGs, PET scans, CAT
scans, standardized assessment such as thescans, standardized assessment such as the
Glasgow Coma ScaleGlasgow Coma Scale, etc., etc.

12. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What Should I Teach Students withWhat Should I Teach Students with
Physical or Health Disabilities?Physical or Health Disabilities?
 General curriculum should be accessible for manyGeneral curriculum should be accessible for many
students through use of universal design principles.students through use of universal design principles.
 Content to address their specific needsContent to address their specific needs
 Life skills, social skills, self-determination skillsLife skills, social skills, self-determination skills
development, and transition to adult livingdevelopment, and transition to adult living
 Use of assistive technology such as teleconferences andUse of assistive technology such as teleconferences and
distance education, if the child is hospitalized, can supportdistance education, if the child is hospitalized, can support
access to the general education curriculum.access to the general education curriculum.
 Adjust the curriculum to meet the student’s needs.Adjust the curriculum to meet the student’s needs.
 Teach special healthcare skills.Teach special healthcare skills.

13. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
How Should I Teach Children withHow Should I Teach Children with
Physical or Health Disabilities?Physical or Health Disabilities?
 Individualized Health Plans (IHP)Individualized Health Plans (IHP)
 Communication, medications, lifting, positioning,Communication, medications, lifting, positioning,
mobility, eating and feeding, toileting,mobility, eating and feeding, toileting,
catheterization, respiratory management, ventilatorcatheterization, respiratory management, ventilator
managementmanagement
 Proper positioning of studentProper positioning of student
 Behavioral/social skill supportBehavioral/social skill support
 Support for parents/siblingsSupport for parents/siblings

14. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are Considerations for theWhat are Considerations for the
Instructional Environment?Instructional Environment?
 Adapt the environment based on specific needs ofAdapt the environment based on specific needs of
individual students. Education may take place atindividual students. Education may take place at
schools, hospitals, rehabilitation facilities, and homes.schools, hospitals, rehabilitation facilities, and homes.
 Provide related services as needed and train staff toProvide related services as needed and train staff to
deliver special services that may be needed.deliver special services that may be needed.
 Adjust placement as child’s needs change.Adjust placement as child’s needs change.
 Consider the whole continuum of services forConsider the whole continuum of services for
placement. Make materials portable and accessible.placement. Make materials portable and accessible.
Make environments accessible.Make environments accessible.

15. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What Types of InstructionalWhat Types of Instructional
Technology Can be Used?Technology Can be Used?
 Decisions must be based on individual needs andDecisions must be based on individual needs and
assistive technology assessment.assistive technology assessment.
 Assistive technology could includeAssistive technology could include
 Wheelchairs, specialized keyboards, adaptive devices suchWheelchairs, specialized keyboards, adaptive devices such
as wedges, braces, prostheses, self-help skills equipment,as wedges, braces, prostheses, self-help skills equipment,
alternative/augmentative communication devices,alternative/augmentative communication devices,
specialized computer programs and monitors, switches, etc.specialized computer programs and monitors, switches, etc.

16. Taylor/Smiley/Richards,
Exceptional Students © 2009 The McGraw-Hill Companies, Inc.
What are Some Considerations for theWhat are Some Considerations for the
General Education Teacher?General Education Teacher?
 Work with medical and related services personnel to provideWork with medical and related services personnel to provide
appropriate services.appropriate services.
 Make the physical environment safe.Make the physical environment safe.
 Adjust assistive technology.Adjust assistive technology.
 Schedule instructional times to meet medical and relatedSchedule instructional times to meet medical and related
services needs.services needs.
 Plan accessible seating arrangements.Plan accessible seating arrangements.
 Adapt materials.Adapt materials.
 Ensure students take part in extracurricular activities.Ensure students take part in extracurricular activities.
 Help students develop friendships.Help students develop friendships.