Physically or Otherwise Health Impaired

(POHI)

General Description of Population

A physical or other health impairment which adversely affects a student's educational performance. The term includes impairments caused by congenital anomaly (e.g.,
clubfoot, absence of some member, etc.), impairments caused by disease (e.g.,
poliomyelitis, tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy,
amputation, and fractures or burns which cause contractures). 121a.5 (b) (6)
Other health impaired means limited strength, vitality or alertness, due to chronic or
acute health problems such as heart condition, tuberculosis, rheumatic fever, nephritis,
asthma, sickle cell anemia, hemophilia, epilepsy, lead poisoning, leukemia, or diabetes,
which adversely affects a student's educational performance. 121a.5 (b) (7)

Common Characteristics
mild, moderate and severe physical needs
perceptual problems
distractibility
needs assistance with problem solving
poor fine motor coordination
poor gross motor skills
physical limitation of limbs
in some cases, learning disabilities,
common emotional difficulties,
attention deficit disorders
medical/health problems
vision problems
speech impairments
mental impairments
poor organization skills

Physically or Otherwise Health Impaired

Common Characteristics (continued)

Mild
75 to 100 percent personally independent
able to walk without appliances
possibly one to three limbs involved mildly
able to attend regular school environment with minimal support
may have mild perceptual problems which will need classroom adjustments
may observe some inability to organize
works slower than most of class

Moderate
50 to 90 percent personally independent
able to walk but usually wears some type of appliance, either a brace or a splint
may have more severity in lower extremities and one upper extremity
spasticity or flaccidity is present
perceptual problems may be present and will need remediation or adaptation in
classroom
organizational skills impaired
fine motor problems apparent (written communication skills labored or slow)
electronic equipment enhances performance

Severe
100 percent dependent in daily living skills
verbal/written output impaired
wheelchair user
poor to no hand function
needs adaptive appliances to function
needs supportive services for management of needs
environmental adaptations necessary
electronic equipment necessary for written/verbal output

Instructional Strategies-General
present material in small amounts
use clear worksheets
do not over clutter blackboards
check knowledge through verbal responses
sometimes assignments that require minimum lighting are helpful

Physically or Otherwise Health Impaired

Instructional Strategies-General (continued)

dispel old fears of working with students with challenging conditions through self
education
be flexible and creative
utilize support staff
expect all you candon't pity
modify assignments only as needed
use dark lined dittos
provide enough space for answers
seat students in front
provide peer tutors or helpers
arrange room to accommodate student's equipment
look at alternatives for excessive writing
facilitate cooperative learning situations
set reasonable expectations
clarify why the POHI student is being mainstreamed
promote neatness
establish good channels of communication within the building
mark or circle correct answers on worksheets works better than filling in blanks
provide repetition
give visual focus
break all tasks into small parts
provide extra time for assignments
assist with organization of materials and lesson
reduce homework amount taking into consideration students physical ability to
complete it in a timely fashion

Mild

reduce work loads/ volume of work required

utilize equipment that may be needed for his/her efficiency; large print, proper
pencil, typewriter or computer
suggest the student carry a calendar/pad for organizing needed notes/schedules
provide possible extra study opportunity to catch up on needed assignments

Physically or Otherwise Health Impaired

Instructional Strategies-Moderate

Moderate
may need special pencil or handwriting device
fine motor problems may require some assistance, such as putting on outer
clothing and toileting
write clearly on the blackboard
place student for visual access to blackboard
use clipboards to control paper
use notebooks
instructions should be clear and concise
be cautious about using time limits

Severe

use typewriters and/or computers

use communication devices
use tape recorders
provide unlimited time to perform
provide support for toileting
technical help when adapting classroom environment
help with proper positioning
adaptations to textbook; such as large print* positioning textbook; bookstand
devise some method of carrying books/materials
give uncluttered presentation of materials
provide repetition

Additional Instructional Considerations

maintain a communication link with all individuals involved with the student
parent(s), doctors, instructional assistants, therapists, special and general
education teachersto assure appropriate and coordinated instruction
agree on a schedule for support staff services that minimally infringes on basic
instruction
make appropriate arrangements to accommodate the student's schedule in regards
to personal needscatheterization, availability of instructional assistant or nurse,
and toileting with dignity, i.e., private and as independent as possible
have a clear understanding of the medication needs of the student, type of
medication, when it is administered, who administers it, and its effect on the
student

Physically or Otherwise Health Impaired

Behavioral Strategies
expect students to reach all classroom goals
make classroom rules appropriate
make adaptations for physical management not for behavioral expectation
do not become over-protective
promote student independence and responsibility for own behavior
provide positive reinforcement
establish behavior management programs
provide verbal repetition/description
communicate with students to encourage their sharing feelings

Support Staff
Internist
Neurologist
Occupational Therapist
Orthopedic Surgeon
Pediatrician
Physical Therapist
School Nurse
Teacher Assistants
Teacher Consultant
Teacher Consultant for POHI
Teacher Consultant for Visual Impaired
Teacher of POHI
Teacher of Speech and Language Impaired

Primary Resource of Information taken from: Vocational Study of Physically or Otherwise Health Impaired Post
Graduate Students Who Attended Lansing School District Program Between 1940-1986. By Ruby Frazier, O.T.R.
Western Michigan University 1987.