Physical Disabilities

PROF.ED 9: INTRO TO SPED TOPIC: PHYSICAL DISABILITIES Physical Disabilities – a child with a physical disability has a problem with the structure or functioning of the body – refer to impairments that are temporary or permanent that: o affect the bones and muscle systems and make mobility and manual dexterity difficult and/or impossible; o cause deformities and/or absence of body organs and systems necessary for mobility; o and affect the nervous system making mobility awkward and uncoordinated. - some children’s physical disabilities or health impairments appear in combination with other disabilities and are often considered to have multiple disabilities  concomitant impairments – combination of which causes such severe educational problems that they cannot be accommodated in SPED programs solely for one of the impairments (Individuals with Disabilities Education Act [IDEA]) CAUSES AND PREVENTION OF PHYSCAL DISABILITIES CAUSES PREVENTION Motor Vehicle Accidents child restraints, safety belts, auto air bags, helmets Water and Diving Accidents diving safety, swimming safety, flotation devices, supervision Gunshot Wounds gun control and weapons training Sports Injuries (boxing, skiing, football) headgear, safe fields and slopes, conditioning/training Child Abuse family support services, parenting training POSSIBLE SIGNS OR CHARACTERISTICS OF PHYSICAL DISABILITIES AND HEALTH IMPAIRMENTS • Limited vitality and energy • Many school absences • Need for physical accommodations to participate in school activities • Physical presence but mental “absence” • Poor motor coordination • Frequent falls • Speech difficult to understand CLASSIFICATION/TYPES 1. Orthopedic Impairment – related to a physical deformity or disability of the skeletal system and associated motor function – affects the bones, joints, limbs and associated muscles of the skeletal system a. Poliomyelitis – “infantile paralysis” b. Osteomyelitis – or tuberculosis of the bones and spine c. Bone Fracture – or breakage in the continuity of the bone results from falls and accidents d. Muscular Dystrophy – a group of long-term diseases that progressively weakens, deteriorates and wastes away the muscles of the body e. Osteogenesis Imperfecta – a rare inherited condition marked by extremely brittle bones. The skeletal system does not grow normally and the bones are easily fractured.

f. Limb Deficiency – refers to the absence or partial loss of an arm or leg. The Greek word “PLEGIA” which means “to strike” is used in combination with the affected limb, that is, arm or leg, to describe the condition. o Quadriplegia – all 4 limbs, both arms and legs, are affected. Movement of the trunk and face may also be impaired. o Paraplegia – motor impairment of the legs only o Hemiplegia – only one side of the body is affected o Diplegia – major involvement of the legs, with less severe involvement of the arms o Monoplegia – only one limb is affected o Triplegia – three limbs are affected o Double Hemiplegia – major involvement of the arms, with less severe involvement of the legs g. Crippling Conditions o Clubfoot – the child is born with 1 or both feet deformed usually with the feet and toes inward, outward or upward often accompanied by webbed toes o Clubhand – same as clubfoot but this time the hands and fingers are deformed o Polydactylism – the child is born with extra toes or fingers o Syndactylism – the fingers or toes or both are webbed like those of fowls, ducks and hens 2. Neurological Impairment - involves the nervous system and affects the ability to move, use, feel, or control certain parts of the body - are problems with the structure or functioning of the central nervous system, including the brain and the spinal cord b. Convulsive Disorders/Epilepsy – a tendency to have recurrent seizures  are sudden, excessive, spontaneous, and abnormal discharge of neurons in the brain accompanied by alteration in motor function, and/or sensory function, and/or consciousness. Types of Seizures 1. Generalized Absence (Petit Mal) – short lapses in consciousness 2. Generalized Tonic-Clonic (Grand Mal) – convulsions and loss of consciousness 3. Complex Partial (Psychomotor) – the result of discharge in a localized area of the brain Causes Primary Epilepsy (Congenital) – usually appear at a young age, occur in families where there is some history of epilepsy, have stereotypical pattern of the seizure, and have a predictable response to specific medication Secondary Epilepsy (Lesional) – may appear at any age and result from accidents or child abuse, metabolic disturbances such as hypoglycemia, brain tumors and abscesses, lesions, brain injury, meningitis, or alcohol or drug withdrawal Treatment Usually involves medication: too much, too little, or the wrong medication can have serious effects. But even at the proper dose, medication has side effects such as drowsiness, lethargy, intellectual dullness, coarsening of facial features, behavioral changes, or sleep disturbances in the child. Another recent treatment for epilepsy is brain surgery, which is gaining in popularity because techniques for finding and removing diseased tissue are improving. The results of surgery are especially promising for infants and young children, whose brains seem to be more able to reorganize after the surgery.

b. Cerebral Palsy - characterized by disturbances of voluntary motor functions that may include paralysis, extreme weakness, lack of coordination, involuntary convulsions and other motor disorders - a long term condition resulting from a lesion to the brain or an abnormality of brain growth - can be treated but not cured, not fatal, not contagious, and in most cases not inherited - causes are varied and not nearly known. It is often attributed to the occurrence of injuries, accidents, illnesses that are prenatal (before birth), perinatal (at or near the time of birth) or postnatal (soon after birth)  Congenital cerebral palsy - acquired cerebral palsy is usually the result of brain damage resulting from accidents, brain infections or child abuse - Other disabilities that sometimes accompany cerebral palsy include seizures, sensory deficits such as abnormal sensation and perception, visual impairments, hearing impairments, speech impairments, and learning problems. Although mental retardation is present in some children with cerebral palsy, others function in the normal or higher intellectual range. - An individual’s cerebral palsy is usually described by the type of cerebral palsy and the area of the body affected: o Hypertonia/Spastic – movements are very stiff o Athetoid/Athetosis – a condition characterized by slow, worm-like involuntary, uncontrollable and purposeless movements o Ataxic/Ataxia – a disturbance of balance and equilibrium resulting in a gait like that of a drunken person when walking and may fall easily if not supported - Although cerebral palsy cannot be cured, proper management or treatment can limit further physical damage, increase strength, improve the child’s functional skills, and offer opportunities for increased independence and autonomy. A variety of treatment services are available for children with cerebral palsy. The treatment is usually customized to the needs of the individual. o Some individuals with cerebral palsy have impaired mobility. o Some children with cerebral palsy need surgery to help improve their condition. o Specially designed tools also serve to improve the way children with cerebral palsy accomplish ordinary activities of daily living.

c. Spina Bifida and Myelodysplasia - failure of the spinal column to close properly -

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is a congenital defect in the vertebrae that encloses the spinal cord About 80 – 90% of children born with spina bifida develop hydrocephalus, the accumulation of cerebrospinal fluid in tissues surrounding the brain. This could lead to head enlargement and severe brain damage. Risks includes the possibility of infection and further damage to the delicate nervous system, brain damage such as hydrocephaly and paralysis

Types Spina Bifida Occulta is a defect in which the bony protective arches of the spinal column have failed to develop. The spinal cord and its covering (meninges  membranes that cover the spinal cord and brain) are protected, if at all, only by skin. Spina Bifida Meningocele is the most serious, involving not only a defect in the spinal column but also some protrusion of the meninges. Meningocele indicates a skin sack protruding on the back containing some of the cord covering but not the cord.

Spina Bifida Myelomeningocele is the most serious form of spina bifida because the back, the meninges, and the actual spinal cord are involved. Myelomeningocele indicates a skin sack protruding on the back containing a portion of the spinal cord and its covering that have escaped through a defect in the bony spinal column.

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The causes of these spinal canal defects are not yet clear, although the presence of a virus or an unknown environmental toxin during early fetal development and genetic factors have been suggested. The defect occurs very early in the development of a fetus, between the 20th and 30th day of fetal development, before a woman even knows she is pregnant Today, infants born with spinal column defects generally have surgery to repair the back to avoid infection. If the infection is not treated or if the infant contracts meningitis, the effects can be devastating and can include mental retardation. Surgical closure of the defect allows the infant’s motor, sensory, and intellectual functioning to be preserved and a suitable environment for the child’s neural tissue development to continue. Medical procedures for these children include insertion of a shunt (a tube to drain excess spinal fluid from the brain into a body cavity such as the abdomen) to drain excess spinal fluid from the child’s brain. The use of the shunt can prevent the brain damage that results when the brain ventricles fill up with the fluid and expand, stretching the child’s head outward and squeezing and compressing the brain and nerves. Without treatment, the future for a child with a major spinal cord defect can be bleak. With treatment, however, the child’s prognosis is excellent.

Spinal Cord Injuries Results of accidents. Injury to the spinal column is generally described by letters and numbers indicating the site of the damage.

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d. Traumatic Brain Injury commonly caused by injuries to the head as results from automobile, motorcycle and bicycle accidents, falls, assaults, gunshot wounds and child abuse is severe trauma to the head that results in lingering physical and cognitive impairments “An acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problemsolving; sensory, perceptual and motor abilities; psychosocial behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or brain injuries induced by birth trauma.” (IDEA) number-one killer of people under 34

Causes - motor vehicle accidents - alcohol - drug abuse - child abuse Includes - long term problems o cognition problems

behavioral problems  poor judgment  over-activity  aggression  destructiveness  impulsivity o psychosocial problems o sensory o motor problems  paralysis  poor balance  poor coordination o language impairments chronic fatigue pain epilepsy memory impairments poor ability to organize o

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For teachers to enhance these students’ ability to succeed - retrain and teach cognitive skills - consider whether the student is thinking and processing appropriately - check on any prerequisite cognitive skills - provide frequent feedback - refocus student’s attention if necessary - repeat and review - provide examples and models - give simple and frequent instructions, both verbal and written - provide enough time to respond - use computers, especially for drill and practice