Physical Disabilities, Health Impairments, and AD/HD

1. Physical Disabilities, Health Impairments, and AD/HD A guide for parents and students Presented by Michelle Thomas

2. Epilepsy • Diabetes • Asthma • Cystic Fibrosis • HIV and AIDS • AD/HD Introduction Physical Disabilities Health Impairments • Cerebral Palsy • Spina Bifida • Muscular Dystrophy • Spinal Cord Injuries Case Study • Description • Sample Lesson • Modifications

3. IDEA Definitions (8)Orthopedic impairment means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by a congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures). (9)Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that-- (i) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and (ii) Adversely affects a child's educational performance. (IDEA 2004, 2004)

4. Categories • Skeletal – physical issues with the skeletal system of the body. • Neuromotor – issues with the central nervous system that effects the movement of muscles. Orthopedic Impairments Health Impairments • Chronic or acute health problems.

5. Cerebral Palsy Characteristics • Lack of voluntary muscle control • Poor coordination • Muscle spasticity • Speech and swallowing issues • Weak muscles • Gross and fine motor skill issues • Muscle tightness Causes Brain injury due to: • Viral infection • Birthing issues • Fetal development • Head injury from car accident, fall or child abuse Types • Monoplegia • Hemiplegia • Triplegia • Quadraplegia • Paraplegia • Diplegia • Double hemiplegia (United Cerebral Palsy, 2001)

6. Cerebral Palsy Educational Strategies • Assistive technology for speech • Scribe for writing • Proximity placement of toys and other items • Physical, occupational and speech therapists • Velcro strips • Large desks for wheelchairs • Classroom set up • Tape recorder • Clip boards • Large writing implements • Recorded books Treatments Medications, surgery, and braces are sometimes used to help maintain or improve muscle and nerve coordination. (United Cerebral Palsy, 2001) (Aiello & American Federation of Teachers, 1981)

7. Spina Bifida Characteristics • Muscle weakness • Loss of involuntary and voluntary muscles below affected region • Paralysis • Hydrocephalus • Loss of sensation and feeling below affected region Causes • Birth defect • Genetic • Environmental • Lack of folic acid during first trimester Types • Occult Spinal Dysraphism • Spina Bifida Occulta • Meningocele • Mylomeningocele (Liptak & Spina Bifida Association, 2008)

8. Educational Strategies • Flexibility for surgery and doctor visits • Management of bathroom functions and catheters • Learning issue modifications • Classroom set up • Higher desks for wheelchairs • Physical and Occupational therapists Treatments • Surgery • Regular doctor visits • Shunt Spina Bifida (Liptak & Spina Bifida Association, 2008) (National Dissemination Center for Children with Disabilities [NICHY], n.d.)

9. Muscular Dystrophy Characteristics • Difficulty in mobility • Difficulty in fine motor skills • Difficulty in breathing • Fatigue • Irregular heart beat Causes • Genetic • Viral infection • Bacterial infection • Irregular reaction to medication for infections Types • 40 different diseases • Muscular • Motor Neuron • Metabolic • Peripheral Nerve • Inflammatory • Neuromuscular Junction • Endocrine • Other (Muscular Dystrophy Association, n.d.)

10. Muscular Dystrophy Educational Strategies • Assistive technology and scribes for writing • Physical, occupational and speech therapy • Classroom set up • Higher desks for wheelchairs • Shortened school day • Meaningful interactions • Counseling on end of life issues • Sensitivity to emotional issues • Safe room or person Teatments • Surgery • Drug therapies • Antibiotics (National Institute of Neurological Disorders and Stroke, 2009) (Ainsa, 1981)

11. Spinal Cord Injuries Characteristics • Damage begins at site of injury • Motor impairment • Loss of involuntary muscle response • Sensory deprivation • paralysis Causes • Sudden traumatic blow to the spine • Car accidents • Falls • Sports injuries • Physical abuse Types • Bone fragments • Fractures • Dislocation • Bruises • Tears • Compression • Nerve damage • Sever (National Institute of Neurological Disorders and Stroke, 2010)

12. Spinal Cord Injuries Educational Strategies • Assistive technology and scribes for writing • Physical and occupational therapy • Classroom set up • Higher desks for wheelchairs • Counseling for trauma Treatments • Rehabilitation • Respiratory support • Steroids (National Institute of Neurological Disorders and Stroke, 2010) (Carney & Porter, 2009).

13. Characteristics • Multiple seizures • Drop toys • Eyes flutter • Sudden jerking motion • Unresponsive • Loss of consciousness Educational Strategies • Avoid triggers • Aura identification and self-removal • Understanding of medication side-effects that can impact learning Causes • Head injuries • Anoxia at birth • Tumors • Genetics • Viral or bacterial infection Treatments • Medication • Surgery • Diet Types • Generalized • Complex partial • Simple Partial • Absence Epilepsy (Heward, 2009) (Epilepsy Foundation, n.d.) (Heward, 2009) (Epilepsy Foundation, n.d.) (Heward, 2009)

14. Educational Strategies • Recognize symptoms • Have candy or juice in close proximity • Prompting for medication Treatments • Medication • Diet • Exercise Diabetes Characteristics • Thirst • Lack of energy • Headaches • Weight loss • Slow healing of cuts • Frequent urination Causes • Genetics, metabolism, and environment • Hyperglycemia • Hypoglycemia Types • Type 1 • Lack of insulin production • Type 2 • Resistance to insulin (Heward, 2009)

15. Characteristics • Wheezing • Coughing • Difficulty with breathing Educational Strategies • Modifying curriculum for frequent absence • Homebound instruction • Avoiding triggers Causes • Chronic lung disease • Allergy • Air pollutants • Stress • Exercise Treatments • Medication • Counseling Types -Described by the causes of the onset of an asthma attack. Asthma (Heward, 2009)

16. Characteristics • Difficulty breathing • Heart disease • Malnutrition • Poor development • Poor digestion Causes • Genetic Disease • Causes over production of mucus on membranes Types There are no specific types. Cystic Fibrosis Educational Strategies • Modifying curriculum for missed class time for medical treatments • Learning issue modifications • Ensure caloric intake is high at lunch and with frequent snacks Treatments • Enzyme supplements • Mucus thinners • Antibiotics • Anti-inflammatory (Cystic Fibrosis Foundation, 2009) (Heward, 2009)

17. Characteristics • Suppressed immune system • Frequent illness • Weigh loss • Developmental delays Educational Strategies • Alleviation of fear by educating peers • Learning issue modifications • Modifications to curriculum due to missed class time for illness • Counseling Causes • Viral infection • Virus is transmitted by body fluids Treatments • Medication • No cure, but new drug therapies are being developed Types • HIV • AIDS HIV and AIDS (Heward, 2009)

18. Characteristics • Inability to stay on task • Impulsive behavior • Fidgeting • Lack of self-control • Poor organization • Easily distracted Educational Strategies • Seating placement • Prompting signals for attention specific items • Self monitoring behavior and activities Causes • Unsure • Genetics • Neurological • Environmental Treatments • Medication • Behavior plans • Counseling Types • Attention Deficit Disorder • Attention Deficit Hyperactive Disorder AD/HD (Heward, 2009)

19. Case Study Sally 11 y/o Struggling with transition to 6th grade Disruptive in class & does not turn in homework Student is diagnosed with AD/HD with the help of her doctor and the informal observation tool. Teacher brought up concerns at first parent meeting. The group decided to do an informal observation of the student.

20. Lesson Plan

21. Modifications Assessment: The teacher introduces the lesson by asking students if anyone can spell the word two. She then spells it on the board and asks if anyone knows the meaning of the word. She then asks them if they can think of another way to spell the word. Then she asks if they can think of other words that sound the same, but spelled differently. Modifications: The teacher uses a cue to let Sally know she is going to ask her a question. The pre-arranged cue is for the teacher to walk in front of Sally’s desk and touch the corner of it as she passes by. This way she is bringing Sally’s attention back to the classroom and the task at hand. The Lesson: After the introduction, the teacher will list 15 pairs of homophones on the blackboard. The students will work with partners today and will use multiple sources to discover the meaning of the words identified with each spelling. They are then asked to draw a picture and write a sentence on their worksheet to be shared with the classroom and placed in a classroom book of homophones that will be photocopied and given to each student the following day. The last 15 minutes of class will be devoted to each set of partners sharing the information they have gathered on their homophone pairs. Modifications: Sally is paired with a student who helps keep her on task. The teacher checks in with her group first, making sure Sally understands the assignment. She helps the group map out a plan of attack on how to find the information and in what order they should approach their task. Finally, after checking in with other students, the teacher returns to Sally and her partner to ensure they are on task with the assignment. Additionally she asks Sally to explain to her the definitions for each word to ensure that Sally is participating and understands the meaning of the words she is writing.

22. Resources For more information, please visit these sources: Cerebral Palsy * United Cerebral Palsy Organization * http://www.UCP.org Spina Bifida * Spina Bifida Association * http://spinabifidaassociation.org Muscular Dystrophy * Muscular Dystrophy Association * http://www.mda.org Epilepsy * Epilepsy Foundation * http://www.epilepsyfoundation.org Cystic Fibrosis * Cystic Fibrosis Foundation * http://www.cff.org Diabetes * American Diabetes Association * http://www.diabetes.org HIV/AIDS * AIDS Healthcare Foundation * http://www.aidshealth.org AD/HD * Attention Deficit Disorder Association * http://www.add.org General information National Institute of Neurological Disorders and Stroke * http://www.ninds.nih.gov National Dissemination Center for Children with Disabilities * http://www.nichy.org U.S. Department of Education – IDEA 2004 * http://idea.ed.gov

23. References Aiello, B., & American Federation of Teachers, W. (1981). The Child With Cerebral Palsy in the Regular Class. Retrieved from ERIC database. Ainsa, T. (1981). Teaching the terminally ill child. Education, 101(4), 397. Retrieved from Academic Search Premier database. Carney, J., & Porter, P. (2009). School reentry for children with acquired central nervous systems injuries. Developmental Disabilities Research Reviews, 15(2), 152-158. doi:10.1002/ddrr.57. Colorado Department of Education. (1995). Colorado model content standards for reading and writing. Retrieved February 28, 2010, from http://www.cde.state.co.us/cdeassess/documents/OSA/standards/reading.pdf Cystic Fibrosis Foundation. (2009). Frequently asked questions. Retrieved February 28, 2010, from http://www.cff.org/AboutCF/Faqs/ Epilepsy Foundation. (n.d.). Epilespy: Frequently asked questions. Retrieved February 28, 2010, from http://www.epilepsyfoundation.org/answerplace/faq.cfm Heward, W. L. (2009). Exceptional children: An introduction to special education (9th ed.). Upper Saddle River, NJ: Merrill.

24. References Individuals with Disabilities Education Improvement Act of 2004, H.R. 1350 (2004). Liptak, G. S., & Spina Bifida Association (2008). Spina bifida low lit. Retrieved February 24, 2010, from http://www.spinabifidaassociation.org/atf/cf/%7BEED435C8-F1A0-4A16-B4D8-A713BBCD9CE4%7D/Spina%20Bifida%20low%20litJune%202008.doc Muscular Dystrophy Association. (n.d.). Diseases in the MDA program. Retrieved February 28, 2010, from http://www.mda.org/disease/40list.html National Dissemination Center for Children with Disabilities. (n.d.). Spina Bifida. Retrieved February 24, 2010, from http://www.nichcy.org/Disabilities/Specific/pages/SpinaBifida.aspx#CharacteristicsSB.aspx National Institute of Neurological Disorders and Stroke. (2009). NINDS muscular dystrophy information page. Retrieved February 28, 2010, from http://www.ninds.nih.gov/disorders/md/md.htm National Institute of Neurological Disorders and Stroke. (2010). NINDS spinal cord injury information page. Retrieved February 28, 2010, from http://www.ninds.nih.gov/disorders/sci/sci.htm United Cerebral Palsy. (2001). Vocabulary tips: Cerebral Palsy- facts & figures. Retrieved February 24, 2010, from http://www.ucp.org/ucp_generaldoc.cfm/1/9/37/37-37/447#what