Orthopedic Impairments

Orthopedic Impairments Ebonie Prather, Jessica Gibbs, Clifford Young, Rachel Hopkins

What is an Orthopedic Impairment? • Any condition that interferes with the health or normal functioning of bones, joints, or muscles. • The term is very broad making it difficult to identify many of the general characteristics. • Orthopedic impairments are often referred to as physical disabilities.

What is an Orthopedic Impairment? • According to the NAPCSE, the term includes: • impairments due to the effects of a congenital anomaly. (e.g., clubfoot, absence of some member, etc.) • impairments due to the effects of disease (e.g., poliomyelitis, bone tuberculosis, etc.) • impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures)

Types of Orthopedic Impairments • The three most common types of orthopedic impairments: • Cerebral Palsy • Muscular Dystrophy • Spinal cord injuries

Types of Orthopedic Impairments • Cerebral Palsy • The largest group of students with orthopedic impairments. • Occurs because of injury to the brain before, during, or after birth and results in poor motor coordination and abnormal motor patterns.

Types of Orthopedic Impairments • Muscular Dystrophy • A group of diseases that weakens the muscles. • Students often have difficulty walking or actively moving about. • Spinal Cord Injuries • Occurs when the spinal cord is severely damaged or severed, usually resulting in partial or extensive paralysis, i.e. spina bifida.

Causes of Orthopedic Impairment • Some students may be born and/or have an accident that results in diseases and defects of the muscles and bones. • Car accidents, sports-related injuries, and premature birth may result in broken bones and burns, which damages more than just muscle and bone.

Causes of Orthopedic Impairment • Aside from birth defects, living conditions play a large role in orthopedic impairments. • Club foot, an orthopedic impairment, is caused by malnutrition. • Other effects of malnutrition are bone softness and bone deformity. • Lack of medical care and hygiene can further increase the risk of orthopedic impairments.

Orthopedic Impairments in IDEA • Students classified under the OI category of IDEA: • severe orthopedic impairments • The impairment must affect their educational performance to the degree that the child requires special education. • Children served in a special education program for orthopedic impairments: • Usually function no lower than criteria outlined for mild intellectual disabilities programs.

Orthopedic Impairments in IDEA • Students with orthopedic impairments only accounted for about 1.25% of all students receiving IDEA services.

Preventing Orthopedic Impairment • Focus on well-balanced diets • Be aware of cleanliness • Seek proper medical care • Provide proper nutrition for strong bones • Monitor births to avoid complications • Administer vaccines to prevent diseases that increase the chance of OI

Accommodations for Orthopedic Impairments • Accommodations depend on the individual needs of the student. • “Most” students with orthopedic impairments have no sign of cognitive impairments. • Teachers should try to include the student in the general curriculum as much as possible.

Accommodations Students may need: • Extra time to get from one class to another • Extended test taking time • Extended time on writing assignments due to slow writing speed • Accessible parking close to building • A course waiver or substitution for qualified students

More Accommodations • Adjustable table and lab work stations • Accessible seating arrangements within the classroom • Note takers or use of tape recorders • Photocopying of notes if the impairment disables the act of writing

Tips and Strategies • Not all orthopedic impairments are constant and unchanging • Some students may experience relapses and require bed rest or hospitalization. • Students may need extra time to make up missed work.

Tips and Strategies A student with an upper body orthopedic impairment may not be able to raise his/her hand. A student with an orthopedic impairment may be wheelchair bound • Make eye contact with these students and be sure to call on them when they indicate they want to participate in class discussions. • Take a seat when conversing with a wheelchair bound student so he or she does not have to peer upwards.

Assistive Technology • The use of assistive technology may be appropriate depending on the impairment.

Devices Used to Access Information • Speech recognition software • Screen reading software

Devices Used for Mobility • Canes • Wheelchairs • Walkers • Specialized exercise equipment • Crutches • Chairs, desks, and tables for proper posture development

Journal Articles • The following is a sample of journal articles that will hopefully provide support for parents, teachers and students.

Peer Relations and Friendship in Physically Disabled Children by K. Mulderij • A child’s ability to show initiative, degree of mobility, and physical attractiveness play a role in establishing friendships. • When a child suffers from a lack of mobility, family members often have to actively seek friends for the child. • Children who have the ability to show initiative have an advantage in establishing friendships. • Educators can use the information presented in the article as a means of understanding the dynamics of peer relationships, and to facilitate the development of friendships between physically disabled students and their classmates. • Several recommendations are made for parents of physically disabled children and teachers of physically disabled students to assist in the friendship establishment process. • Ebonie Prather • Mulderij, K. (1997). Peer relations and friendship in physically disabled children. Child: Care, Health and Development, 23(5), 379-389. Retrieved October 12, 2010, from Ebscohost Database.

Students with Physical Disabilities and Health Impairments revised by John Venn • This article focuses on the difficulties that students with Orthopedic Impairments may face in school, and how to prevent them. • Working in teams is the best way to create a plan for these students because several perspectives are represented. • The article lists several modifications, some technological and some environmental, that teachers may choose to implement so that their students are provided with the best opportunities available. • Clifford Young • John Venn (1983). Students with Disabilities and Health Impairments. Retrieved October 8, 2010 from: http://library.adoption.com/articles/students-with-physical-disabilities-and-health- impairments.html

Research Into the Lifeworld of Physically Disabled Children by Karel J. Mulderij • The article is taken from the perspective of students with physical disabilities, and details multiple types of “bodies” then summarizes the view of the children when another person stares at them, and also interactions with peers. • The article is a great resource for teachers to use as a reminder of what the student sees and how to interact with that student. • Rachel Hopkins • Mulderij, K. J. . (1996). Research into the lifeworld of physically disabled children. Child: Care, Health, and Development, 22(5), 311-322. http://onlinelibrary.wiley.com.libez.lib.georgiasouthern.edu/doi/10.1111/j.1365-2214.1996.tb00433.x/pdf

Assistive devices and cerebral palsy: the use of assistive devices at school by children with cerebral palsyBy I-C. Huang, D. Sugden and S. Beveridge • This article reminds parents and teachers that one of the most important opinions, that is often overlooked, regarding assistive technology is the opinion of students using the technology. • The study discovered that effectiveness of technology depends on several factors, including: children’s willingness, teacher’s attitudes and parents’ support. • Also, this study pointed out that assistive technology is used quite often in school and hardly ever at home. • Keep in mind children experience things differently than adults! • Jessica Gibbs • Child: care, health, development. Retrieved October 20, 2010 from:C:\Users\default.tald2374124x001\Documents\AssistiveDevices.pdf

Resources The following is a small sample of websites, journal articles and books that teachers, parents and students may find helpful.

National Resources • National Association of Parents with Children in Special Education: • http://www.napcse.org/exceptionalchildren/orthopedicimpairments.php • Dssc.org provides links to other resources that cover lesson plans, IEPs and benefits for disabilities: • http://www.dssc.org/ • National Public Website on Assistive Technology: • http://assistivetech.net/webresources/techActProjects.php • Assistive Technology: A Resource for School, Work, and Community [Paperback] Karen F. Flippo (Author), Katherine J. Inge (Editor)

National Resources for Specific Orthopedic Impairments • United Cerebral Palsy: • http://www.ucp.org/ucp_channel.cfm/1/12 • Kids Health from Nemours (Particularly helpful because it offers information in Spanish as well): • http://kidshealth.org/parent/medical/brain/cerebral_palsy.html • Muscular Dystrophy Association: • http://www.mda.org/ • Spinal Cord Injury and Disease Resources (Index of articles for students, parents and teachers): • http://www.makoa.org/sci.htm

State Resources • Georgia State Resource Guide: http://www.ucp.org/uploads/georgia_state_resources.pdf • Housing: p 40 • Employment: p 21 • Assistive Technology: p 4 • Center for an Educated Georgia: http://educatedgeorgia.org/forparents-q10185-c5-Georgia_Special_Needs_Scholarship_SB_10.aspx • This scholarship provides around $6,000 to students with disabilities so that educational programs may be tailored to fit their individual needs.

State Resources for Specific Orthopedic Impairment • United Cerebral Palsy of Georgia: • http://www.ucp.org/ucp_local.cfm/63 • FOCUS Extraordinary Families Kool Kidz: • http://www.focus-ga.org/ • Georgia State Resources: • http://www.ucp.org/uploads/georgia_state_resources.pdf • Page 16 provides information specifically for Spinal Cord Injuries

Local Resource • Bulloch County Schools—Special Education • http://www.bulloch.k12.ga.us/cms/page_view?d=x&piid=&vpid=1280193940853 • Provides therapies and services available in the Bulloch County school system • The Special Olympics • http://www.specialolympics.org/Locations/Special_Olympics_NA_Georgia.aspx • Statesboro hosts Special Olympic events annually (volunteers, coachers and spectators gather to support local individuals with special needs)

Quiz time . . . and now you can test your knowledge of Orthopedic Impairments with a quiz!

1. There are no local resources in Bulloch County for Children with Orthopedic Impairments. • True • False

1. There are no local resources in Bulloch County for Children with Orthopedic Impairments. • True • False I’m sorry that answer is incorrect  Try Again

1. There are no local resources in Bulloch County for Children with Orthopedic Impairments. • True • False Congratulations! That answer is correct! Next Question

2. What does the Georgia State Resource guide not provide information about? • Housing • Employment • Transportation • Assistive Technology

2. What does the Georgia State Resource guide not provide information about? Housing I’m sorry that answer is incorrect  Try Again

2. What does the Georgia State Resource guide not provide information about? Employment I’m sorry that answer is incorrect  Try Again

2. What does the Georgia State Resource guide not provide information about? Transportation Congratulations!!! That answer is correct! Next Question

2. What does the Georgia State Resource guide not provide information about? Assistive Technology I’m sorry that answer is incorrect  Try Again

3. What is NOT a birth defect that results in orthopedic impairments? • Muscular Dystrophy • Spina Bifida • Cerebral Palsy • Autism

3. What is NOT a birth defect that results in orthopedic impairments? Muscular Dystrophy I’m sorry that answer is incorrect  Try Again

3. What is NOT a birth defect that results in orthopedic impairments? Spina Bifida I’m sorry that answer is incorrect  Try Again

3. What is NOT a birth defect that results in orthopedic impairments? Cerebral Palsy I’m sorry that answer is incorrect  Try Again

3. What is NOT a birth defect that results in orthopedic impairments? Autism Congratulations!!! That answer is correct! Next Question

4. Malnutrition causes orthopedic impairments. • True • False

4. Malnutrition causes orthopedic impairments. I’m sorry that answer is incorrect Try Again • False

4. Malnutrition causes orthopedic impairments. • True Congratulations!!! This answer is correct! Next Question

5. What is an Orthopedic Impairment? • Significant limitations in intellectual functioning • Limited strength, vitality, or alertness as a result of chronic or acute health problems • Any condition that interferes with the health or normal functioning of bones, joints, or muscles • An acquired injury to the brain caused by an external force

5. What is an Orthopedic Impairment? Significant limitations in intellectual functioning I’m sorry that answer is incorrect  Try Again

5. What is an Orthopedic Impairment? Limited strength, vitality, or alertness as a result of chronic or acute health problems I’m sorry that answer is incorrect  Try Again

Orthopedic Impairments