Lower Incidence Disabilities PP

Chapter 4 Teaching
Students with Lower-
Incidence Disabilities
Presented by:
Mauro Garcia, Amerika Hernandez, Marivel Montes

Physical Disabilities Prevalence
.10% of the school-age population has a
physical disability
.68% of the school-age population has a
physical disability
This accounts for a total of .78%
8.7% of students are served under IDEA

Physical disabilities and other health
impairments definitions and characteristics
Physical disabilities may range from mild to
moderate to severe
They can also range from permanent or life-
threatening
Physical disabilities are often described as either
orthopedic or neuromotor impairments and
IDEA considers neuromotor impairments part of
the orthopedic impairments category

impairments definitions and characteristics cont.
 Orthopedic Impairments – Involve damage to the skeletal
system
 Neuromotor Impairments – Involve damage to the nervous
system
 Quadriplegia – Both arms and legs impaired
 Paraplegia – Legs impaired
 Hemiplegia – Left or right side of the body is impaired
 Diplegia – Both legs are impaired more than the arms

impairments definitions and characteristics cont.
 Other health impairments include physical or medical
conditions resulting from disease or illness.
 School related difficulties due to physical disability and other
health impairments are covered by the provision “Special
Education Services” under IDEA 2004.
 Some students with other health impairments including
asthma, AIDS, tuberculosis, diabetes, drug or alcohol
addiction might not qualify under IDEA but may qualify for
services under Section 504.

Physical and health-related disabilities
 Cerebral Palsy – The most common physical disability. A
neurological disorder that causes permanent disorders of
movement and positions.
 Types of Cerebral Palsy:
Spastic – Characterized by increased muscle tone.
Ataxic – Characterized by lack of coordination in
balance and equilibrium.
Mixed – Shows characteristics of both spastic and
ataxic.

Physical and health-related disabilities cont.
 Spina Bifida – caused during fetal development when the
vertebrae do no properly enclose the spinal cord.
 Possible symptoms may include:
Lack of bladder and bowl movement control
Motor impairment
Loss of sensation to paralysis in lower body
Can cause hydrocephalus (a condition in which
cerebrospinal fluid collects in the brain tissues, if left
untreated can cause swelling, brain damage and result
in intellectual disability, attention and learning problems.

Muscular dystrophy – Refers to a group of diseases
that weaken and progressively destroy muscle
tissue.
Child may appear normal, however at ages 2-6 they
may begin experience motor difficulties.
Ages 10-14 children lose the ability to walk.
Since muscular dystrophy is progressive it is
important to know what difficulties may be
expected in a school year.

Traumatic brain injury – Represents a type of
physical and cognitive disability.
Results from an external injury to the brain.
Injury may result in physical, cognitive, attention,
memory, problem-solving, sensory and
psychosocial difficulties
It is important to teach helmet safety.
Work with students who may have difficulty
coping with the disability.

Epilepsy – Seizures that are caused when abnormal
electrical energy is released in the brain and causes
loss of consciousness and lack of motor control.
About 50% of those with seizure disorders also have
intellectual disabilities.
Can be treated (but not cured) with medications,
special diets, vagus nerve stimulation and surgery.

Arthritis – A disease in which the muscles and joints
are affected.
Can be painful and severely impede mobility
If mobility is hindered children may use canes or
braces while walking
Students may have good days and bad days
Allow for extra rest periods or accommodations
during bad days

 Asthma– Associated with breathing difficulties due to sensitivity
to airborne particles, and can be exacerbated during
exercise.
 These children may require restricted athletic activities,
 Allergies – Condition in which elements in the environment
(mold, pollen, dust, animal dander, carpet fibers) causes
allergic reactions in some individuals.
 Know which students have allergies, most students carry their
own emergency kits with them.

 Diabetes – An inherited condition in which sugar is not
metabolized correctly due to insufficient production of insulin
in the pancreas.
 Individuals with this disability may require special schedules
for administering medication.
 The school nurse can provide relevant information regarding
the disability.
 Fetal Alcohol Syndrome – Results when pregnant mother
consume alcohol that damages the developing fetus.
 Can cause intellectual, learning and physical disabilities.
 May also cause problems with impulsivity and attention.

 Acquired immune deficiency syndrome (AIDS) – Caused by the
human immunodeficiency virus (HIV) which destroys a form of
white blood cells weakening the immune system.
 Children may have developmental delay, cognitive disabilities,
respiratory problems, cardiovascular problems, motor or kidney
functioning.
 Not transmittable through casual contact
 Transferrable through pregnancy, during childbirth, or through
infected breast milk. May also be transmitted through sexual
activity and blood exposure (sharing needles)

Autism
Autism is a disorder characterized by severe impairments of
social, emotional, and intellectual functioning.
Having great difficulty communicating and interacting
with and responding to other groups.
They display stereotypic behavior such as self-
stimulating behaviors such as rocking, and bizarre
speech patterns, as repeating the words of other
people over and over again.
Children with autism are typically identified before the
age of 3 by the parents when they do not respond
positively to being touched or their language does not
develop along the common developmental milestones.
The causes of autism are still unknown.

Autism Cont.
Related diagnostic categories that are now under a broader term,
autistic spectrum disorders include autistic disorder, Rett’s
disorder, childhood disintegrative disorder, Asperger syndrome,
and pervasive developmental disorder.
 Current diagnoses indicate that individuals with autism may
function along a continuum of severe to mild disabilities.
 Individuals with severe autism may have limited to no expressive
and receptive language.
 While individuals with milder forms of autism may have developed
more sophisticated communication.
 Communication and social competence are typically the two
greatest challenges that vary among individuals with autism.

Strategies For Making Classroom
Adaptations for Students with Autism
 Individuals with severe forms of autism may function similarly
to those individuals with severe disabilities, and it is
recommended that you employ the suggested adaptations
for individuals with severe disabilities.
 Individuals with milder forms of autism, consider using
modifications recommended for students with mild disabilities,
including learning disabilities and behavior disorders.
 Work closely with both special education teachers and
parents. This partnership ensures that IEP goals and objectives
are being addressed, and you have assistance in interacting
with students.

Establish Effective Communication
Discuss the best communication patterns and design
communication strategies with special education teachers,
parents and peers.
 Strategies- sign language or Augmentative and Alternative
Communication (AAC) methods.
 Scenario- describes a young boy, Tony with autism who does
not have language, but does communicate with an AAC
procedure referred to as the Picture Exchange
Communication System (PECS.)

Use Direct Instruction and Applied
Behavior Analysis
 Direct instruction is when instruction is carefully sequenced
according to students needs.
 Example- if a student had no expressive language, training might begin
with the teacher providing reinforcement for imitating sounds such as
“aaa,” followed by imitating words (e.g., “hat”), followed by responding to
simple directions, (“Point to the hat”), followed by word production (“What
is this?”[Teacher points to a hat]).
 Throughout this development , the teacher would provide clear feedback
and reinforcement for attending and for correct responding.

Use Direct Instruction and Applied
Behavior Analysis
 Applied behavior analysis involves the use of
reinforcement (e.g., praise) for displaying appropriate
behaviors (e.g., sitting) and carefully recording students
behaviors on charts that are used in decision making.
 Teachers may also document the past history as well as
observed consequences of specific behaviors (e.g.,
screaming), and then arrange the environment and
environmental consequences to minimize inappropriate
behaviors.

Develop Social Competence
A teacher may find it easy to become over whelmed by the students
challenging behaviors if they do not design behavior plans with the
students IEP team and implement these plans thoroughly.
Ex.
 Teach students to wait their turn.
 To use socially appropriate behaviors throughout the school day to
help promote generalization of appropriate social behavior.
 Develop behavior management plans based on an analysis of
students’ preferences and classroom dynamics.
 Create a learning environment in which the student with autism feels
comfortable including a predictable schedule of daily activities, and
classroom routines.

Cont. Develop Social Competence
One technique for improving social behavior is the use
of social stories.
 Social stories use simple sentences and pictures to
demonstrate the desired social behavior, feelings, and
reactions of others, such as “when I return my tray after I
have finished eating, my teacher is happy.”
 Establish and maintain effective communication with
all individuals who are in contact with students with
autism.

Severe and Multiple Disabilities
PREVALANCE, DEFINITIONS, AND CHARACTERISTICS
 Many individuals with severe disabilities have severe and
profound mental retardation/intellectual disability.
 Some with moderate mental retardation may also be
included in this group.
 The American Association on Intellectual and Developmental
Disabilities (AAIDD, formerly American Association on Mental
Retardation, or AAMR) proposed a classification system for
intellectual disability based upon level of support needed,
with severe and profound retardation requiring more
extensive and pervasive support.

Cont. Severe and Multiple Disabilities
 Multiple disabilities refers to the presence of two or more
impairments that significantly influence an individual’s
ability to learn and function without adaptations, and
that cannot be accommodated in special education
programs devoted to only one of the impairments.
 A major disability with minor impairments or secondary
conditions is not considered multiple disabilities; at least
two separate categories of impairments must be
present.

Educational Placement Considerations
 The best educational placement and the design of effective
instruction for students with severe and multiple disabilities are
usually determined by the case conference team.
 The priorities vary depending on the age, severity level, and needs
of the individual. Priorities come from family, medical, school, etc.
and are designed to match each student’s needs and strengths.
 Students with severe and multiple disabilities generally have severe
cognitive and adaptive behavior difficulties and require instruction
in self-help skills, communication skills, living skills, etc.
 The creation of peer-support networks, friendship circles, social
circles, etc.; is strongly advocated for individuals with severe
disabilities.

Strategies For
Making Classroom adaptations
for students with severe and multiple disabilities
 Establish good working relationships with these partners (physical
therapists, paraprofessionals, etc.) and arrange the classroom for easy
access by these specialist.
 Specialist may include their activities along with general education
instruction.
 Ex. Specialist can assist with positioning and grasping techniques during classes
involving art activities or computer applications.
 Arrange a special place where specialist may work with the students
with severe disabilities within the general classroom that does not draw
unnecessary attention nor distracts the rest of class.

Establish Good Working Relationships
with Paraprofessionals
Paraprofessionals (Para educators) are often assigned to accompany
students with severe disabilities in the general education classrooms.
 Teachers are used to being alone in the classroom and having
another adult in there may require some adjustment, but there are
many benefits to them being in the classroom.
 Adapting materials under the direction of the teacher or special
education teacher
 Assisting teachers during a classroom presentation
 Grading papers and assisting with recordkeeping
Be careful that paraprofessionals assist students with disabilities without
preventing their access to other students or teachers.

Increase Disability Awareness
Prepare your students for the arrival of a student with severe or multiple
disabilities.
 One method of presenting information is to have guest
speakers (special education teachers, parents, local disability
organizations) to present information on specific disability-
related issues.
Paula Billingsley, a first-grade teacher described how her class were
willing to learn and ask questions about their classmate Liza who had a
disability. They wanted to know how she learned and how they could
help her. Mrs. Billingsley was amazed how her students showed a
genuine interest and were not judgmental towards Liza.

Conceptualize Inclusive Instruction
Design instruction that includes students with severe disabilities into
general education classes.
 Concentrate on activities where all students can engage,
without modification, for example homeroom or music.
 Use multilevel curriculum instruction, for example have student in
a wheelchair work on control of different muscles while the rest
of the class does exercises on floor mats during physical
education class.
 Engage in curriculum overlapping, for example, having the
student work on communication skills in the context of working
on another academic area, such as mathematics.

Monitor Special Health-Care Needs
Good communication with parents and health
care provider for instruction on;
Medication schedules
Precautions
Emergency plans for medical or other
emergency situations.
Medical equipment and tubing(feeding
tubes, etc.)

Make Classroom Adaptations
Students with severe disabilities may have coexisting
physical disabilities. Adaptations to the physical
environment and instructional materials may be similar
for the students with physical disabilities.
 Primary adaptations that involve alternative and
augmentative communication, additional time to
complete activities, and creating activities that appear
instructionally relevant and meaningful for students.

Cont. Make Classroom Adaptations
 Make certain you are familiar with all IEP objectives for
students with severe (or any other) disabilities. Objectives
should be stated in a way that progress can be directly
observed and recorded.
 Example, if one of a student’s objectives involves
interacting more positively with other students, know
exactly what is meant by positive interaction (e.g., more
eye contact, friendly expression, etc.)

Visual Impairment Prevalence
.04% Individuals with vision impairments. They
make up one of the smallest disability areas of
the school-age population
 .4% of the students served under IDEA have a
visual disability.

Visual Impairment Definitions, and
Characteristics.
 The federal definition is “an impairment in vision that even
with correction, adversely affects a child’s educational
performance. The term includes both partial sight and
blindness.”
 The legal definition includes acuity assessment information.
 Visual acuity: If it is 20/200 or less even with corrective
lenses they are considered legally blind; Partially sighted if
their visual acuity is 20/70.
 Braille system: A system that uses raised dots that are read
with fingertips.
 Individuals who have such limited vision that they are
referred to as totally blind learn to use the Braille system.

Complications of visual impairment
 Visual impairment can be present at birth or
acquired later in life. Common causes of visual
impairments include;
 Glaucoma-excessive pressure on the eyeball
 Cataracts-clouding of the lens
 Diabetic retinopathy-lack of blood to the retina
 Coloboma-parts of the retina improperly formed
 Retinitis pigmentosa-degeneration of the retina
 Retinopathy of prematurity-excessive oxygen to
premature infants

Visual Impairment Compensation
 Students with severe visual impairments may rely on tactile
and auditory senses rather than the visual sense, they need
to hold and feel 3-dimensional objects to obtain a sense of
phenomena.
 If entire objects are held at once, students obtain
complete synthetic touch.
 If objects are too large to be held, different segments must
be touched sequentially. Using analytic touch, segments
touch must be recombined mentally to form “the whole.”

Making classroom adaptations for
students with visual impairments
 Classroom Management:
 Ensure that your classroom has clear, open
walkways.
 Devise and teach classroom procedures for
responding to emergency situations, including fire
and tornado drills.
 Assign peers to assist students with visual
impairments during emergency evacuations.
 Develop safety guidelines for using objects that are
potentially harmful to students with visual
impairments.

students with visual impairments cont.
ADAPT THE PHYSICAL ENVIRONMENT:
Keep aisles clear, wide, and open.
Extra space will be necessary to accommodate
equipment for braille and reading enlarged print
materials.
Notify students if any changes are made.

ADAPT INSTRUCTIONAL MATERIALS:
Enlarge and enhance printed material
Increase visibility of materials
Convert print to braille formats
Use oral output devices which produce speech
Use tactile and three-dimensional models

Tools for students with visual
impairments
Low Vision
Blindness
Freedom Scientific

 ADAPT INSTRUCTION:
 Be explicit when giving oral presentations. Avoid vague
phrases such as over here, almost, this, and that. Instead use
specific language such as above your head, on your right,
and the beaker in my hand.
 When addressing students with visual impairments, always
state their name first, so they know you are speaking to them,
and speak in normal tone of voice.
 Provide sufficient time for students with visual impairments to
complete class activities, allow sufficient time to complete
tests, and extra time required to transcribe responses.

Hearing Impairment Prevalence
.11%- Individuals with hearing
impairments in the school-age
population.
1.2%- Students served under IDEA

Hearing Impairments definitions, and
characteristics
 Can range in severity from mild to moderate to
severe to profound
 Meaning a person with a mild hearing impairment
can use a hearing aid to hear speech tones while a
profound case can not hear even with the use of
hearing aids.
 Prelingual: Children who are born with deafness
have congenital hearing losses and more difficulty
with language development than those who
acquire deafness after age 2 (postlingual).

Complications of hearing impairment
Causes of hearing impairments include heredity,
prenatal infections such as;
Maternal rubella
Ear infections
Meningitis
Head trauma
Prematurity
Oxygen deprivation during birth.

Complications of hearing impairments cont.
 Impairments can be conductive, meaning the outer or middle ear
along the passageway is damaged; sensorineural, referring to
inner-ear damage; or they can be combination of the two.
 Children with hearing impairments have developmental lags due
to difficulty in processing language.
 Mild losses: may miss up to 50% of classroom discussion if voices are
faint or faces cannot be seen.
 Moderate losses: can understand only loud speech, limited
vocabularies.
 Severe loses: may be able to hear loud voices whiting 1 foot from
the ear, likely to impaired.
 Profound losses: may hear some loud sounds, likely to sense
vibrations, rely on vision rather than hearing primary vehicle for
communication.

Hearing impairment compensation
Signing systems available:
American Sign Language (ASL) – A visual, spatial
language.
Finger-spelling – Used mostly for unfamiliar words
like names. Teachers also use this to communicate
with students with hearing impairments.
Signing Exact English – A system that employs
components of ASL, but uses correct English for
the learning of reading, writing and literacy skills in
English for students who are deaf.

American Sign Language &
Fingerspelling

Making Classroom Adaptations For
Students With Hearing Impairments
Classroom management:
Establish classroom emergency procedures for use
during fire and tornado drills.
Many fire alarms can be equipped with a light
that flashes when it rings.
Assign a peer assistant who can pass along
information that comes from the announcement
system and to help during emergency situations.

Making Classroom Adaptations For Students
With Hearing Impairments cont.
ADAPT THE PHYSICAL ENVIRONMENT:
Seat students close enough to the front to
maximize their hearing and enable them to read
speech.
Be able to turn to face other students while
speaking, loud or irritating noises should be
avoided.
Choose a room with carpeting and located away
from noisy school areas.

 ADAPT INSTRUCTIONAL MATERIALS:
 Use technology including hearing aids.
 When appropriate use sound systems, microphone when
speaking in class discussion so they can be heard,
 Audio enhancement to improve the volume and clarity
 Use visuals such as illustrations/pictures to introduce
vocabulary and concepts
 Use language cards that contain vocabulary words
 Encourage students to maintain personal dictionaries of
their language cards.

Tools for students with hearing
impairments
Speech to text software
Hearing Aids
Captioning Software
Language Cards

 ADAPT INSTRUCTION: Create authentic experiences by
connecting new language and knowledge to real-world
experiences.
 Use hands signals or devise a signaling system to denote
transitions
 Allow students with hearing impairments or interpreters to review
questions, answers, and concepts.
 Use a “listen, then look, then listen” sequence of instruction, so
students can focus on your face as you speak, then focus on the
other aspects of the lesson separately, then focus on your face
again.
 Testing and evaluation modifications for students with hearing
impairments might include providing individual testing times in
separate rooms and extending time limit as necessary.

Lower Incidence Disabilities PP

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