Orthopedic

Impairment
By Taryn Johnston, Taylor Marlow, & Jessica Zimmer
 Discussion
What do you know about orthopedic impairments?

Have you ever had a student with an orthopedic

impairment in your class? What accommodations were
made for that student?
https://www.ted.com/talks/aimee_mullins_prosthetic_aesthetics#t-6197
 Federal Definition
Orthopedic impairment means a severe orthopedic impairment that
adversely affects a child's educational performance. The term
includes impairments caused by a congenital anomaly, impairments
caused by disease (e.g., poliomyelitis, bone tuberculosis), and
impairments from other causes (e.g., cerebral palsy, amputations,
and fractures or burns that cause contractures).
http://idea-b.ed.gov/explore/view/p/,root,regs,300,A,300.8,c,.html
 Characteristics
Specific characteristics of an Three Main Areas
individual with an orthopedic
impairment will depend on both
1. Neuromotor impairments
the specific disease and its
2. Degenerative diseases
severity.
3. Musculoskeletal disorders
 Three Main Areas - Area ONE
Neuromotor Impairments
Abnormality or damage to the brain, spinal cord, or nervous system that sends
impulses to the muscles of the body
Acquired at birth or prior to birth
Often results in complex motor challenges that can affect multiple systems in
the body
Motor problems can include limited limb movement, loss of urinary control, and
loss of proper alignment of the spine.
Cerebral palsy and spina bifida are the two most common types of neuromotor
impairments.
 Cerebral Palsy
Refers to several non-progressive disorders of voluntary movement or posture that
are caused by malfunction of or damage to the developing brain that occurs before
or during birth or within the first few years of life.
The four most common types:
a. Spastic - very tight muscles occurring in one or more muscle groups that
result in stiff, uncoordinated movements
b. Athetoid - movements are contorted, abnormal, and purposeless
c. Ataxic - poor balance and equilibrium in addition to uncoordinated voluntary
movement
d. Mixed - any combination of the types
 Cerebral Palsy Continued...
Arms and legs are affected.
Major classifications include:
Hemiplegia (left or right side)
Diplegia (legs affected more
than arms)
Paraplegia (only legs)
Quadriplegia (all four limbs)
http://mucerebralpalsy.weebly.com/modifications--accommodations.html
 Spina Bifida
There is a developmental defect of the
spinal column.
Characterized by an abnormal opening in
the spinal column and frequently involves
some paralysis, which may or may not affect
intellectual functioning.
Classified as either spina bifida occulta or
spina bifida cystica
Spina bifida occulta is mild
http://www.ohio.com/news/local/student-with-spina-bifida-takes-the-longest-w
Spina bifida cystica is severe
alk-of-his-life-across-graduation-stage-1.769466
 Three Main Areas - Area TWO
Degenerative Diseases
Composed of several diseases that affect motor development.
The most common degenerative disease found within school populations is
muscular dystrophy:
A group of inherited diseases, which include progressive muscle
weakness from degeneration of muscle fibers.
 Three Main Areas - Area THREE
Musculoskeletal Disorders
Composed of various conditions that can result in several different levels
of physical limitations
Examples of musculoskeletal disorders include:
Juvenile rheumatoid arthritis
Limb deficiency
Severe burns
Amputations
 Prevalence
In 2013, 56,000 out of 6,464,000 people from 3-21 years old had an
orthopedic impairment
This has decreased each year since 2001
Roughly 1.1% of students receiving special education services are
classified with orthopedic impairment
 modifications, accommodations, and adaptations
General Accommodations:
Create a classroom layout that is open and
has unrestricted pathways.
Be familiar with the building's emergency
evacuation plan to assure that it is
manageable for all students.
Place supplies and equipment in accessible
locations.
If needed, allow students more time to
complete activities.
Lower chalkboard, whiteboard, or screen
for information to be accessed by all.
Provide various methods of assessment.
Emotional Needs:
Familiarize yourself with their specific disability
in order to provide the best accommodations
and resources.
Focus on the students abilities, not their
disabilities.
Include all students in group projects,
interactions, and discussions.
Treat students with disabilities as equal
partners within groups with peers.
Create an inclusive classroom setting.
Be understanding and accommodating to meet
the physical, emotional, and academic needs of
your student.
Assistive Measures for Communication and Information Access:
Speech recognition software
Screen reading software
Augmentative and alternative communication devices (such as communication boards)

Physical Modifications for Positioning and Mobility:

Canes
Walkers
Wheelchairs
Prosthetics
Specialized exercise equipment
Specialized seating arrangements, chairs, desks, and tables for proper posture development
Modified writing aids
Instruction focused on development of gross and fine motor skills
Awareness of medical condition and its effect on the student (getting tired quickly)
 Additional Support
Other specialists that may be involved in developing and implementing
an appropriate educational program for the student include:

Physical Therapists who work on gross motor skills (focusing on the legs, back, neck and
torso).
Occupational Therapists who work on fine motor skills (focusing on the arms and hands as
well as daily living activities such as dressing and bathing).
Speech-Language Pathologists who work with the student on supporting their speech and
language.
Adapted Physical Education Teachers, who are specially trained PE teachers that work along
with the OT and PT to develop an exercise program to help students with disabilities.
 Common Misconceptions
The most common misconception about students with Orthopedic Impairments is that they are less
intelligent than the general population.

Why is this FALSE?

Many students with orthopedic impairments have no cognitive, learning, perceptual, language, or
sensory issues. For example, Cerebral Palsy does not itself affect a persons intelligence.
However, at times a person may have Cerebral Palsy and another disability such as a
Developmental Disability that affects the way his or her brain functions. Individuals who have
neuromotor impairments also have a higher incidence of additional impairments, especially when
there has been brain involvement.

For most students with orthopedic impairments, the impact on learning is focused on accommodations
necessary for students to have equal access to academic instruction.
 Common Misconceptions Cont.
Students with orthopedic impairments will not be able to live on their own.

Why is this FALSE?

A majority of people with orthopedic impairments live on their own, however there are some
cases where adaptations or made or attendants are hired.

An additional misconception is that physical and/or occupational therapy can cure orthopedic
impairments.

Why is this FALSE?

Therapy can increase a students range of motion and ability to complete different gross and
fine motor tasks, however the student may continue to have the same medical diagnosis and
physical disability.
 Tips, Strategies, and Parent Perspective
Parents, know your childs rights!
Communication between schools and parents is key!

The Individuals with Disabilities Education Act (IDEA) requires schools to provide accessible
transportation to and from school as well as within and in between school buildings.

Parents should also be aware that individualized education plans (IEPs) are available to their
students that can indicate that a students schedule should be arranged to eliminate excessive
walking back and forth between classes. In addition, students can have access to the schools
elevator to allow them to travel safely between floors.

Orthopedic Impairments is a friendly website aiming to inform, educate, and provide resources for
parents and teachers of students with orthopedic impairments.
(http://orthopedicimpairments.weebly.com/)
 Community Resources
Council for Exceptional Children - Division for Physical, Health, & Multiple Disabilities
Advocates for quality education for all individuals with physical disabilities, multiple disabilities, and special health
care needs served in schools, hospitals, or home settings.

Mobility International, USA

A London-based organization that aims to integrate people with disabilities into international educational exchange
programs and travel.

Life Rolls On
An organization dedicated to improving the quality of life for young people affected by spinal cord injuries and
utilizes action sports as a platform to inspire infinite possibilities despite paralysis.

National Multiple Sclerosis Society

A non-profit organization that offers programs and services including local referrals, information and education,
professional and peer counseling, self-help groups, equipment assistance, and more.
 More Community Resources
Arizona Spinal Cord Injury Association
Provides information and support for people with spinal cord injuries. Offers support groups, social and
recreational programs, skill classes, and peer mentoring. Also provides local transportation, and day and overnight
trips for people in wheelchairs.

Muscular Dystrophy Association - Arizona

Provides diagnosis and follow-up outpatient medical care to anyone suspected of having a neuromuscular disease.
Services include genetic counseling; physical, speech, occupational, and respiratory therapies. Offers wheelchairs
and other adaptive equipment and works to increase awareness of neuromuscular disease. Also provides summer
camps for youth and support groups.

National Association of Special Education Teachers, NASET

Provides specific information and resources to educate teachers on different types of orthopedic impairments.
 Reflection
What have you learned about orthopedic impairments?
What are some ways you can accommodate these students in
your classroom?
 References
http://idea-b.ed.gov/explore/view/p/,root,regs,300,A,300.8,c,.html

http://education.ohio.gov/Topics/Special-Education/Students-with-Disabilities/Orthopedic-Impairment

https://nces.ed.gov/fastfacts/display.asp?id=64

http://www.brighthubeducation.com/special-ed-physical-disabilities/71266-common-classroom-modifications-for-students-with-orthopedic-i
mpairments/

http://www.projectidealonline.org/v/orthopedic-impairments/

http://www.partnership.vcu.edu/centerfordisabilityleadership/downloadables/myths-and-misconceptionsanswers.pdf

http://www.special-education-degree.net/the-best-websites-for-parents-of-special-needs-children/

https://sites.google.com/a/ucdavis.edu/teaching-students-with-disabilities/home/idea-disabilities/orthopedic-impairment

https://www.naset.org/orthopedicimpairment2.0.html