Chapter 11

Introduction to Contemporary Special Education: Physical and Health Disabilities

Learning Objectives (1 of 2)

  • Objective 11.1: Describe types of physical and health conditions, their common characteristics, and why the prevalence of those requiring special education services is unknown.

  • Objective 11.2: Discuss how challenges posed by physical and health disabilities can be addressed through adjustments to physical environments in school settings and explain how teachers can meet the unique needs of affected students.

Learning Objectives (2 of 2)

  • Objective 11.3: Provide historical examples of poor treatment towards individuals with physical and health disabilities, note actions that improved their situation, and suggest ways to further enhance their participation in American society.

  • Objective 11.4: Explain how emerging technologies are transforming participation of individuals with physical and health disabilities in schools and everyday life.

Physical and Health Disabilities Described

  • The document explores different physical and health conditions, common characteristics of these disabilities, and why precise prevalence data is often elusive.

Physical and Health Disabilities Defined

  • Physical Disabilities (ID 1EA category): Distinct from health disabilities but often interrelated.

    • May require accommodations, special education services, both, or neither.

    • Must severely affect educational performance to qualify for services.

  • Health Disabilities: Must be chronic or acute; result in limited strength, vitality, or alertness; and adversely affect educational performance.

  • Potential requirements: May miss school or need to engage in distance learning.

Types of Physical and Health Disabilities

Major Physical Disabilities (1 of 2):

  • Reflected in IDEA as “orthopedic impairment”.

  • Severe enough to affect educational performance or access to education.

    • Accommodations may range from environmental changes to special education services.

    • Neuromotor Impairments:

    • Examples include epilepsy, cerebral palsy, spinal cord disorders, muscular dystrophy, polio, multiple sclerosis.

    • Musculoskeletal Conditions:

    • Examples include juvenile arthritis, limb deficiencies, skeletal disorders.

Major Health Disabilities (2 of 2):

  • Classified under IDEA as “other health impairments.”

  • Conditions impact the ability to learn and include:

    • Chronic Illnesses:

    • Examples include asthma, blood disorders, childhood cancer, congenital heart defects, cystic fibrosis, diabetes, sickle cell anemia.

    • Infectious Diseases:

    • Examples include hepatitis B, HIV/AIDS, STORCH infections, tuberculosis.

Characteristics of Disabilities

Common Characteristics (1 of 2):

  • Vary widely based on individual conditions:

    • Cerebral Palsy:

    • Poor muscle tone and motor function issues.

    • Challenges in producing intelligible speech.

    • May co-occur with intellectual disabilities.

    • Sickle Cell Disease:

    • Genetic; prominent among Black individuals.

    • Symptoms: extreme pain, swollen joints, high fever, stroke, increased infection risk, dehydration, leading to frequent school absences.

Common Characteristics (2 of 2):

  • Diabetes:

    • Body fails to produce insulin or inadequately uses it.

    • Rising prevalence; Type 1 is hereditary, Type 2 linked to overweight in youth.

    • Symptoms from blood glucose imbalance may include clumsiness, speech issues, blurred vision, confusion, inattention, headaches, seizures, or unconsciousness.

Prevalence and Placement

Prevalence (1 of 2):

  • Specific prevalence rates are largely unknown due to:

    • Lack of national records for conditions receiving special education services.

    • Many individuals do not need special education services.

    • Some may have concurrent disabilities and may be categorized differently.

    • Statistical data: Less than 0.5% of children with disabilities served are under “orthopedic impairment.” “Other health impairments” category includes ADHD, affecting a larger student population.

Placement (2 of 2):

  • Classroom placements:

    • General education classes for the vast majority of students (58% for those with physical disabilities; over 70% for those with health disabilities).

    • Some students with more severe conditions may receive services in separate schools, residential facilities, homes, or hospitals.

Special Education

  • The discussion revolves around adjustments in school settings to accommodate students with physical and health disabilities.

Challenges and Their Solutions (1 of 2):

Challenges:

  • Limitations in physical abilities (wheelchair or walker usage).

  • Motor function impairments (difficulties with writing, page-turning, speech clarity).

  • Fatigue resulting from exertion in school activities.

  • Poor health or episodic health crises leading to absenteeism.

Challenges and Their Solutions (2 of 2):

Solutions:

  • Adjustments to classroom environments:

    • Accommodate assistive technologies.

    • Universal Design for Learning (UDL) principles.

    • Technologies to support distance learning.

    • Accommodations such as note takers, peer support, specialized services from multidisciplinary teams.

Accommodations for Physical and Health Disabilities (1 of 2)

  • Accessing curriculum may require accommodations under Section 504:

    • Distance education for students unable to attend school.

    • Digital textbooks facilitate accessibility for those with limited mobility.

    • Flexible deadlines, word processing software for writing.

    • Service animals for physical assistance or health alerting.

Accommodations for Physical and Health Disabilities (2 of 2)

Removing Barriers to Physical Environment:

  • Older schools often lack accessibility.

  • Class designs prioritize efficiency over accessibility.

  • Teachers can enhance accessibility through:

    • Hazard removal, creating flexible traffic patterns in the classroom.

    • Flexible seating arrangements, accessible storage for assistive devices, adequate space for wheelchair movement.

    • Visual aids placed at accessible heights for wheelchair users.

Table 11.3: Presentation, Setting, Response, and Scheduling Accommodations for Students

  • Presentation:

    • Digital texts, note takers, positioning tools (e.g., book stands).

  • Setting:

    • Accessible locations, adjustable workstations, distance education settings.

  • Response:

    • Options like working with peers, computer assistance, use of scribes, voice-to-text software.

  • Scheduling:

    • Breaks, extended time allowances, flexible schedule possibilities, shorter assignments.

Early Intervention

  • Newborn Screening:

    • Initiated in the 1960s to identify conditions like PKU, preventing potential intellectual disabilities.

    • Ability to identify numerous conditions early, minimizing effects.

  • Prenatal Screenings:

    • Can allow fetal surgery to rectify or improve conditions pre-birth.

Health Emergencies and Management (1 of 2)

Role of Teachers:

  • Teachers are often the first responders during medical crises at school.

  • Given that school nurses may cover multiple sites, teachers must be knowledgeable of health emergency protocols and aware of students' special health care needs.

Health Emergencies and Management (2 of 2)

Seizures:

  • Varying types and causes; common among students with disabilities.

  • Awareness of increased bullying risks.

  • Teachers should manage seizures sensitively, normalizing the event to encourage peer support.

  • Related Services:

    • Physical and occupational therapy are key for muscle control, mobility, fine motor skills enhancement, and assistive device management.

    • School nurses traditionally assist students with health disabilities.

Transition for Adolescents with Health Disabilities

  • Health transition plans are typically coordinated by school nurses.

  • Teen students should take an active role in their health care, involving:

    • Decision making, self-advocacy, understanding their health conditions, managing medications.

  • Responsibility for personal health care is expected to shift fully by age 18.

Treatment through History

Historical Poor Treatment (1 of 2):

  • 400 BC: Hippocrates’ early attempts at applying scientific methods to treat health conditions.

  • Throughout history, people with disabilities faced stigma, misguided treatment, forms of entertainment exploitation, neglect, or cruelty.

  • Victims among those with disabilities included persecution during the Holocaust.

  • Early 1900s: Many segregated educational institutions provided special therapy equipment but led to isolation.

Historical Poor Treatment (2 of 2):

  • 1960s: Civil rights movements contributed to advocacy for disability rights.

  • 1973: Passage of Section 504 of the Rehabilitation Act, forbidding discrimination against individuals with disabilities.

  • 1990: Implementation of the Americans with Disabilities Act (ADA), mandating removal of physical barriers in public spaces, promoting universal design principles.

Personal Experiences

  • Societal Ideals:

    • Trends valuing youth, beauty, and fitness can marginalize individuals with disabilities, linking physical attractiveness to moral goodness.

    • These values can lead to bullying, exclusion, or neglect of disabled individuals.

Changing Perspectives:

  • Increased visibility leads to awareness, acceptance, and inclusion.

  • Developments:

    • More inclusive playgrounds and peer support initiatives.

    • Positive media representation has increased sympathy and understanding.

Future Perspectives on Healthcare and Technology

Prevention Strategies:

  • Importance of universal health precautions (e.g., hand washing) to protect vulnerable students.

  • Injury prevention and protective device advancements.

  • Use of vaccines and medical care access for mothers and children.

  • Ongoing scientific research into health conditions.

Technology Advances:

  • Prosthetics:

    • Have become increasingly functional; challenges include comfort and cost, leading to user abandonment.

  • Robotics:

    • Includes motorized exoskeletons aiding those with spinal cord injuries.

    • Enhancements in prosthetic functionalities and overall field growth.

Copyright Notice

  • This work is protected under US copyright laws and is intended for educational purposes in teaching and assessing student learning.

  • Unauthorized dissemination or sale is prohibited, as it compromises the integrity of the material provided to instructors.