At the end of this presentation, you should be able to:

1. Physical Disabilities Chapter 12 Objectives At the end of this presentation, you should be able to: • Understand the prevalence of physical disabilities. • Describe how students with physical disabilities can be evaluated. • Reflect on the assistive technologies available to support communication and mobility. • Understand how students with disabilities can be included in the general education curriculum. Chapter objectives

2. Physical Disabilities Understanding Individual Students Who Is Rommel Nanasca? • He is an 18-year-old boy in a gifted and talented education program. • He needs to use special devices to help him breathe and receive nutrients. • He has a condition called spinal muscular atrophy, as does his younger brother. • He experienced a life-threatening episode while at school, which led his family and school team to develop health and emergency procedures so he can fully participate in the general curriculum at school.

3. How Do You Recognize Students with Physical Disabilities? Defining Physical Disabilities • IDEA uses the term orthopedic impairments, but educators typically use the term physical disabilities. • Typically refers to a large group of students who are very different from each other • The term may be used to also include students with: • Severe and multiple disabilities • Other health impairments • Traumatic brain injury • This chapter focuses on three types of physical disabilities: • Cerebral palsy • Spina bifida • Spinal muscular atrophy (a type of muscular dystrophy) Understand the prevalence of physical disabilities.

4. Physical Disabilities

5. Physical Disability Simulation • Diminished strength • Poor endurance • Limited mobility

6. How Do You Recognize Students with Physical Disabilities? Describing the Characteristics • Cerebral palsy • A disorder of movement or posture, due to damage in the brain • Four types • Spastic • Athetoid • Ataxic • Mixed • Causes • Prenatal • Perinatal • Postnatal • Other associated conditions • Possible mental retardation • Speech and communication problems Understand the prevalence of physical disabilities.

7. How Do You Recognize Students with Physical Disabilities? Describing the Characteristics • Spina bifida • Malformation of the spinal cord • Three common forms (see p. 347) • Spina bifida occulta • Meningocele • Myelomeningocele • Causes • Occurs in early pregnancy • Mothers using regular supplements containing folic acid reduce their risk of having a child with spina bifida. • Other associated conditions • Usually does not affect intelligence • Depending on location of defect, may cause incontinence or other urinary and bowel problems Understand the prevalence of physical disabilities.

8. How Do You Recognize Students with Physical Disabilities? Describing the Characteristics • Muscular dystrophy • A group of nine hereditary muscle-destroying disorders • One type is spinal muscular atrophy • Instead of destroying muscles, specialized nerve cells called motor neurons are attacked. • Can result in paraplegia • Causes • Autosomal recessive disease; both parents must carry the gene responsible • Can affect both males and females • Other associated conditions • Scoliosis Understand the prevalence of physical disabilities.

9. How Do You Recognize Students with Physical Disabilities? Describing the Characteristics • Prevalence of physical disabilities • Difficult to determine since physical disabilities may occur with other disabilities • In 1999-2000, about 0.11 percent of all students receiving special education services were in this category. • Preventing physical disabilities • There are many different approaches. • A state-of-the-art approach involves surgery on a fetus while still in the uterus of the mother. Understand the prevalence of physical disabilities.

10. How Do You Evaluate Students with Physical Disabilities? Determining the Presence How Do You Evaluate Students with Physical Disabilities? • Prior to birth • Amniocentesis • Ultrasonographic fetal imaging • After birth • Apgar screening • Activity (muscle tone) • Pulse (heart rate) • Grimace (reflex response) • Appearance (color) • Respiration (breathing) • May be diagnosed after birth if the child fails to develop as expected • Additional specialist on an evaluation team may include: • Physicians • Occupational and physical therapists • Nurses • Adaptive physical education specialists Describe how students with physical disabilities can be evaluated.

11. How Do You Evaluate Students with Physical Disabilities? Determining the Presence Figure 12-4 Describe how students with physical disabilities can be evaluated.

12. How Do You Evaluate Students with Physical Disabilities? Determining the Nature and Extent of Services • Accessibility to physical environments • Access to the general curriculum • Participation in extracurricular and other school activities • Occupational therapists are often valuable • Movement patterns • Posturing • Use of necessary adaptive devices • Ecological inventory • Identifying important environments for participation • Identifying subenvironments • Identifying skills possessed, skills needed, and supports available and needed • Continued monitoring Describe how students with physical disabilities can be evaluated.

13. How Do You Assure Progress in the General Curriculum? Including Students Figure 12-5

14. How Do You Assure Progress in the General Curriculum? Planning Universally Designed Learning • Adapting instruction and evaluation for mobility impairments • Assistive technology • High-tech devices • Medium-tech devices • Low-tech devices • Use of adaptive equipment requires training for students • Standard computers can be adapted for use • Adapting instruction and evaluation for communication impairments • Augmentative and alternative communication (AAC) • Symbols • Displays • Selection options • Output Reflect on the assistive technologies available to support communication and mobility.

15. Categories of Assistive Technology • Aids for Daily Living: Self help aids for use in activities such as eating, bathing, cooking, dressing, toileting, home maintenance, etc. • Augmentative or Alternative Communication (AAC): Electronic and non-electronic devices that provide a means for expressive and receptive communication for persons with limited or no speech. • Computer Access: Input and output devices (voice, Braille), alternate access aids (headsticks, light pointers), modified or alternate keyboards, switches, special software, etc. that enable persons with disabilities to use a computer. This category includes speech recognition software.

16. Categories of Assistive Technology • Environmental Control Systems: Primarily electronic systems that enable someone with limited mobility to control various appliances, electronic aids, security systems, etc. in their room, home or other surroundings. • Home/Worksite Modifications: Structural adaptations, fabrications in the home, worksite or other area (ramps, lifts, bathroom changes) that remove or reduce physical barriers for an individual with a disability. • Prosthetics and Orthotics: Replacement, substitution or augmentation of missing or malfunctioning body parts with artificial limbs or other orthotic aids (splints, braces, etc.). There are also prosthetics to assist with cognitive limitations or deficits, including audio tapes or pagers (that function as prompts or reminders).

17. Categories of Assistive Technology • Seating and Positioning: Accommodations to a wheelchair or other seating system to provide greater body stability, trunk/head support and an upright posture, and reduction of pressure on the skin surface (cushions, contour seats, lumbar). • Service Animals: The Americans with Disabilities Act defines a service animal as any guide dog (for visually impaired and blind individuals), signal dog (for hearing impaired or Deaf individuals), or other animal individually trained to provide assistance to an individual with a disability.

18. Categories of Assistive Technology • Aids for Vision Impaired: Aids for specific populations including magnifiers, Braille or speech output devices, large print screens, closed circuit television for magnifying documents, etc. • Aids for Hearing Impaired: Aids for specific populations including assistive listening devices (infrared, FM loop systems), hearing aids, TTYs, visual and tactile alerting systems, etc. • Wheelchairs/Mobility Aids: Manual and electric wheelchairs, mobile bases for custom chairs, walkers, three-wheel scooters and other utility vehicles for increasing personal mobility. • Vehicle Modifications: Adaptive driving aids, hand controls, wheelchair and other lifts, modified vans, or other motor vehicles used for personal transportation.

19. What Can You Learn from Others Who Teach Students with Physical Disabilities? Early Childhood What Can You Learn From Others Who Teach Students with Physical Disabilities? Early Childhood Years • Self-determination through technology • Using technology allows children with physical disabilities to communicate with same-age peers without disabilities. • Can use an eye-gaze board as a low-tech tool • Other devices may be used for communication, such as the computer for activities or an electronic speech aid. Understand how students with disabilities can be included in the general education curriculum.

20. What Can You Learn from Others Who Teach Students with Physical Disabilities? Elementary Elementary Years • In the gym with assistive technology • Students can participate in physical education lessons in the general education curriculum through the use of adaptive physical education activities. • Helps build students’ self-esteem Understand how students with disabilities can be included in the general education curriculum.

21. What Can You Learn from Others Who Teach Students with Physical Disabilities? Middle and Secondary Middle and Secondary Years • Centers for Independent Living • These centers are available in communities nationwide. • Adults with disabilities can act as mentors for younger persons with disabilities. • Mentorships allow students to learn how to handle various challenging situations in community life. • Allows students to develop self-efficacy Understand how students with disabilities can be included in the general education curriculum.

22. What Can You Learn from Others Who Teach Students with Physical Disabilities? Transitional and Post Secondary Transitional and Post-Secondary Years • Self-determination in higher education • Peer-mentoring programs are effective. • University of California at San Diego provides mentoring along with other services through its Office for Students with Disabilities. • Weekly meeting sessions allow students to provide emotional support and provide information about college life. Understand how students with disabilities can be included in the general education curriculum.

23. A Vision for Rommel’s Future A Vision for Rommel’s Future • Rommel’s disabilities change constantly, but technology continues to change and grow as well. • He has a strong spirit and quick mind, as well as strong family and professional support. • Rommel wants to be able to attend college in the future, possibly at UCSD, where his sister attends.