The document defines orthopedic impairment as a physical disability that negatively impacts educational performance, including congenital anomalies, diseases, and injuries causing limited movement. Students with orthopedic impairments may have learning, sensory, speech, or language problems. There are three categories: neuromotor impairments involving the brain or nervous system like cerebral palsy and spina bifida; degenerative diseases like muscular dystrophy; and musculoskeletal disorders like arthritis. Teachers should provide specialized seating, focus on motor skills, and ensure assistive technology and accommodations for each student's needs according to their IEP. Physical, occupational, and speech therapists can help address motor, functional, and communication challenges.

1. 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

2. 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 Materials
http://aim.cast.org/learn/disabilityspecific/physical
United Cerebral Palsy: http://www.ucp.org/