Physical Disabilities and Other Health Disorders

Cerebral Palsy

Definition: One of a number of neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination but don’t worsen over time.

● Represents a group of chronic conditions that affect muscle coordination and body movement.

● Neuromuscular disorder caused by damage to one or more specific areas of the brain.● Most often occurring in fetal development usually before birth, but may follow shortly

after.

Kids and teens with CP may:

● Have learning disabilities, visual impairments, hearing problems,speech problems, drooling issues, and behavior problems

● Need braces, crutches, or a wheelchair to get around

● Need help moving around in class or reaching things

● Need assistive devices for writing and speaking● Have difficulty sitting still and have uncontrolled

movements● Have difficulty with bladder and bowel control and

may need to use a bathroom frequently● Have seizures● Need occupational therapy (OT), physical therapy

(PT), and speech therapy during the school day

In the Classroom:

Many students with CP can do the same kinds of things that other kids and teens like to do, such as extracurricular activities, phys-ed, playing or listening to music, hanging out with friends, etc. Students with CP, however, may need a little more time to travel between classes and complete activities and tasks.

● Make sure your classroom is easy to get around and free of obstacles.● Students with CP may need to miss class time for doctor visits or to see the school nurse

to take medication. Make sure to give special consideration regarding missed instruction, assignments, and testing. In some cases, arranging for verbal responses in assignments and testing can be a good way to measure learning.

● Educators, parents, doctors, therapists, and the students with CP should work together to develop and maintain the best treatment and education plans.

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● Be prepared for possible medical emergencies by planning ahead with parents in case your students with CP need advanced assistance.

Cystic Fibrosis

Definition: A life-threatening, genetic disease that causes persistent lung infections and progressively limits the ability to breathe.

● A defective gene causes a thick, buildup of mucus in the lungs, pancreas and other organs.

● In the lungs, the mucus clogs the airways and traps bacteria leading to infections, extensive lung damage and eventually, respiratory failure.

● In the pancreas, the mucus prevents the release of digestive enzymes that allow the body to break down food and absorb vital nutrients.

Symptoms:

● Very salty-tasting skin● Persistent coughing, at times with phlegm● Frequent lung infections including

pneumonia or bronchitis● Wheezing or shortness of breath● Poor growth or weight gain in spite of

a good appetite● Frequent greasy, bulky stools or

difficulty with bowel movements● Male infertility

In the Classroom:

● Give a student with CF frequent access to the bathroom

● Not draw attention to the student● Making it easy for the student to drink water at his or her desk or slip out of the

classroom for water.● Encouraging your student to keep a box of tissues to cough into and a trashcan to dispose

of the tissue near their desk.● Allowing the student to clean his or her hands with alcohol-based hand gel at their desk.● Include the student in all games and activities in which he or she is interested.● Keep a 6-foot distance (2 meters) from others with a cold, flu or an infection in all

settings, especially indoors.● Encourage everyone to wash their hands by making soap and water and/or alcohol-based

hand gel readily available in the classroom. ● Encourage students to cover their cough or sneeze with a tissue.

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Spinal Cord Injury

Definition: Damage to the spinal cord that results in a loss of function such as mobility or feeling.

● Injuries happen without any advanced notice.● Generally a result of some normal activity - driving, hiking, skiing, sledding, or diving.● The spinal cord does not need to be severed in order for a loss of functioning to occur.● Trauma can result through extreme extension or flexing from a fall, an automotive

accident, or a sports injury. ● The overall impact of injury on an individual

depends on the site and nature of the insult.○ If the injury occurs in the neck or

upper back, the resulting paralysis and effect are usually extensive.

○ If the injury occurs in the lower back, paralysis is confined to the lower extremities.

○ May result in loss of voluntary bladder and bowel control.

Autonomic dysreflexia, or AD

● AD occurs when a stimulus below the level of the spinal cord injury causes irritation. ● The stimulus sends nerve impulses to the spinal cord. ● When the message wants to travel up the cord to the brain it is blocked because of the

injury.Signs and Symptoms:

● Some students will have a tell tale sign such as white patchy marks or goose bumps.● Sudden onset of headache.● Sweating above the level of injury.● Nasal stuffiness.● Elevated blood pressure (greater than 200/100.)● Flushed (reddened) face.● Red blotches on the skin above the level of the spinal cord injury.● Nausea.● Slow pulse (< 60 beats per minute.)● Cold, clammy skin below level of spinal injury.

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Spinal Cord Injury

In the Classroom:

● Schedule rest breaks throughout the day, if needed. ● Allow students to leave classes early to travel to their next class, allowing them sufficient

time and the ability to move through the halls when they are less crowded.● Provide time in their schedule for catheterization.● Extended time to complete written assignments.● Use of a laptop.● Assistance with getting laptop and/or materials in and out of backpack or bag.● Allowed to have list of keyboard shortcuts on student’s desk.● Preferential seating near door as well as electrical outlets.● Allow student to carry fluids.● A presentation to the student’s classmates should be considered. Ask the student if he

wants to be involved and what type of information he is comfortable having shared with his classmates.

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Asthma

Definition: Chronic lung disease that affects the airways.

● When the airways react to a trigger, they become narrower due to swelling and squeezing of the airways by the small muscles around them. This results in less air getting through to the lungs and less air getting out.

Common triggers:

● Dust mites● Mold● Pollen● Cigarette smoke● Chemical fumes

Symptoms of asthma include acute episodes of:

● Lingering cough after a cold● Persistent cough during the day● Coughing during the night or early in the morning● Coughing, wheezing, chest tightness, or shortness of breath after vigorous physical

activity or activity in cold or windy weather.● Low level of stamina during physical activity or reluctance to participate● Coughing, wheezing, chest tightness, or shortness of breath even though the child is

taking medicine for asthma● Increased use of asthma medicine to relieve coughing, wheezing, chest tightness, or

shortness of breath

In the Classroom:

● Be aware of students with asthma in your class or classes. Understand their triggers and symptoms

● Consult with your school nurse or principal for updated policy and procedures for managing students with chronic asthma.

● Know your role and how to easily access a student’s asthma action plan or have a copy of it in the classroom, maintained in a confidential manner.

● Don’t delay getting medical help for a student with severe or persistent breathing difficulty.

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● Report if a student’s symptoms are interfering with learning or activities with peers.Asthma

● Possible side effects of medicine that warrant referral are nervousness, nausea, jitteriness, hyperactivity, and drowsiness.

● Alert school administrators, school nurses, and parent(s) or guardian(s) of changes in a student’s performance or behavior that might reflect trouble with asthma.

● Encourage the student with asthma to participate fully in physical activities.● Plan field trips and other activities in a way that ensures students with asthma can fully

participate.● Advise the school nurse when you suspect poorly controlled asthma.● Be alert for signs of uncontrolled asthma attack.

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Muscular Dystrophy

Definition: A group of more than 30 genetic diseases that cause progressive weakness and loss of muscle mass.

● may affect the muscles of the hips, legs, arms, and shoulders● causes these individuals to lose the ability to use their arms and legs functionally and

effectively● can also attack the heart, restorting in heart failure ● about 200,000 people are affected● Learning disabilities are more prevalent in some neuromuscular diseases, but most

students with these diseases have the normal range of intelligence.

In the Classroom

● need an individualized education plan (IEP) or 504 education plan● need adaptive or assistive technological devices in the classroom (such as a keyboard for

writing)● use a wheelchair or wear joint braces● use a ventilator for breathing● need additional time to take tests and quizzes● require additional time to get to other classes or use of an elevator● need special considerations about latenesses, absences, shortened school days, and

missed class work and homework due to physical therapy sessions● require tutoring or additional time to make up assignments● need frequent bathroom breaks or visits to the school nurse for medications be at risk of

bullying

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Sickle-cell disease

Definition: a group of inherited red blood cell disorders. This disease affects the structure and functioning of red blood cells.

● The hemoglobin molecule in the red blood cell of individuals with sickle-cell is abnormal because it is vulnerable to structural collapse. This is caused when their blood oxygen level is significantly diminished.

● As the blood oxygen level drops, their blood cells start to form odd shapes. This process is known as sickling.

● The sickle cells begin to build up because of their odd shapes and cause obstructions in the vessels which lead to strokes and other organ damage.

Treatments

● Medications○ antibiotics ○ pain relievers ○ Hydroxyurea

● Blood transfusions● Supplemental oxygen● Stem cell transplants

In the Classroom

● Anemia, may appear pale and have yellow eyes● Vaso-occlusive episodes, these are blockages of the blood vessels. The most common

symptoms are called pain crises, which are unpredictable and typically happen in the bones.

Possible triggers for a pain crisis include:

● - infection● - stress/fatigue● - dehydration● - exposure to cold and very hot temperatures

*Some pain crises happen without a known reason.

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Preventing pain crises● Giving children lots of fluids to drink so they are not thirsty.● Dressing them in a few layers of warm clothing in the winter when they are leaving

home.● Sending an extra sweatshirt and socks to school in case the student becomes wet during

recess or at any time.● Recognizing fever as a sign of infection and having the child seen immediately by a

doctor.● Avoiding vigorous exercise without the ability to take breaks and drink fluids, especially

during hot days.

Important to Know● Learn about SCD and how it has affected your student.● Provide makeup work for students who have missed days from school due to illness.● Have free and open communication with the student’s parents so you can work as a team

to optimize performance.● Dispel any myths or rumours about your student that may be in the classroom, such as

reasons for the student’s eyes being yellow, or the disorder being contagious.

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Spina Bifida

Definition: SB or Myelodysplasia is a collective term for malformations of the spinal cord and is the most common neural tube deficit.

● SB is characterized by an abnormal opening in the spinal column.● It originates in the first days of pregnancy, often before the mother even knows she is

expecting.● It may or may not influence the individual's intellectual functioning.

There are 2 classifications of SB● Spina Bifida Occulta (milder of the two)

○ Most people are unaware of its presence and has little if any impact ● Spina Bifida Cystica.

○ Malformation of the spinal column in which a tumor like sac herniates through an opening or cleft on the infant's back.

○ Cystica comes in two prominent forms SB Meningocele and SB Myelomeningocele.

Spina Bifida Meningocele ● The sac contains spinal fluid

but no nerve tissue.

Spina Bifida Myelomeningocele● The sac contains spinal fluid.● The sac contains nerve tissue.● Most serious type of NTD● Results in paralysis or legs and lower body,

inability to control bladder or bowel voluntarily, and the presence of other orthopedic problems.

School● Many children with spina bifida do well in school. But some can experience difficulties

at school, especially children with shunts that are used to treat hydrocephalus (often called water on the brain).

● These children often have problems with learning. ○ They might have difficulty paying attention or work slowly, be restless, or lose

things.○ They also might have trouble making decisions.

● An Individualized Education Plan is important because it will help children develop skills at school.

● If a child does not qualify for an IEP, parents can request a 504 Plan be developed for their child at school.

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Diabetes

Definition: A developmental or hereditary disorder characterized by inadequate secretion of insulin.

● Insulin is a hormone the pancreas produces that converts glucose(sugar) into energy.● Two types of Diabetes

○ insulin dependant or type 1, juvenile diabetes○ non-insulin dependant or type 2, adult onset

Symptoms of high blood sugar

● extreme hunger● excessive thirst● frequent urination● fruity breath● lethargic ● extreme weight loss● nausea

Symptoms of low blood sugar

● shakes - Sweating● hunger - Trouble thinking● sweating - Fatigue ● pale skin

In the Classroom

● Blood sugar testers● Different forms of medicine

○ pumps○ insulin pen○ syringe and a vial of insulin

● Snacks or glucose tablets to help raise a low blood sugar● If a child goes into a diabetic shock or comma know what steps need to be taken

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Traumatic Brain Injury

Definition: Acquired injury to the brain caused by external influences either striking the head or piercing the skull and damaging the brain directly.

Symptoms of TBI: Physical changes:

● Tiredness● Lack of interest● Headaches● Awkward movements● Slowed reactions● Heightened sensitivity to light or noise.

Cognitive (thinking) changes:● Forgetfulness● Difficulty learning new material● Word-finding difficulties● Problems with organizing materials; easily distracted.

Behavioral changes:● Irritability● Inability to deal with unexpected event.

Emotional changes: ● Unable to deal with minor changes in the environment or daily routine● Little or no expressed emotion● Depression.

In the classroom

● Find out as much as you can about the child’s injury and his or her present needs.● Give the student more time to finish schoolwork and tests.● Give directions one step at a time. For tasks with many steps, it helps to give the

student written directions.● Show the student how to perform new tasks, and give examples to go with new ideas

and concepts.● Have consistent routines., and if the routine is going to change, let the student know

ahead of time.● Check to make sure that the student has actually learned the new skill, and give the

student lots of opportunities to practice the new skill.● Show the student how to use an assignment book and a daily schedule.● Let the student rest as needed.● Reduce distractions.● Keep in touch with the student’s parents to share information about how the student is

doing at home and at school.● Be flexible about expectations, and be patient to maximize the student’s chances for

success.

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Seizure Disorders (Epilepsy)

Definition: A brain disorder in which clusters of neurons in the brain sometimes signal abnormally

Symptoms: Strange sensations, emotions, behavior and seizures

Types of Seizures: Tonic/Clonic (Grand Mal)

● Affect the entire brain● in two phases

○ Tonic phase characterized by stiffening of body○ Clonic phase characterized by repeated muscle contractions and relaxations.

● Preceded by an “Aura”, in which the individual senses a unique scent, sound odor or physical sensation just prior to the seizure. Sometimes signaled by a cry or similar sound.

● Tonic begins with loss of consciousness, where the individual falls to the ground, after which the individual’s trunk and head becomes rigid. The clonic phase then follows

○ Involuntary muscle contractions○ Irregular breathing○ Blueness in face and lips○ Increased salivation○ Loss of bladder and bowel control○ Perspiration

● Nature, scope, frequency and duration varies from person to person

○ can be 1 minute, can be 20 minutes○ Greatest danger to the person is injuring

themselves from falling or hitting something during the seizure

● Person will generally feel tired and confused after a seizureAbsence (Petit Mal)

● Brief, sudden lapse of consciousness○ More common in children than adults○ May look like they’re staring into space for a few seconds

● Brain ceases normal function temporarily● Young people with this type of disorder may experience these seizures often as 100 times

a day● May look like daydreaming● Can greatly hamper education● Treatment and control generally achieved through prescription meds

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In the Classroom:● Computers and lights

○ 5% of Epilepsy cases are photosensitive○ Computers and TVs with flat screens don’t flicker naturally, so they’re less likely

to cause a photosensitive seizure○ Can also be caused by patterns, flickering lights in the classroom, and patterns

made by sunlight shining through window blinds● Testing

○ Depends on what triggers epileptic episodes○ stress can cause seizures in some○ Time of day

● Practical activities and lessons○ Teachers need to know what to do if a seizure happens○ DON’T exclude the child just because of epilepsy○ Do a risk assessment

Risk Assessment:● What are the safety risks to all children involved in the activity?● What happens to this specific child during seizures?● Do they have a warning? If so, what is it?● What would make this activity safer for them?

Discuss any concerns with them, their parents, and their IEP team. Get ideas from everyone about making the activity a safe and fun experience for them.

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HIV/AIDS

Definition: A Virus transferred through contact with bodily fluids that weakens the immune system.

Symptoms: Many who contract the disease later in life do not show symptoms at all. 1 in 5 people with HIV don’t know they are infected.

● Can prevent normal growth in children○ Don’t make appropriate weight gains○ slow to achieve motor milestones (crawling, walking, etc.)○ Neurological damage (similar to symptoms of cerebral palsy, seizure disorders,

etc.)● Children infected with HIV/AIDS are more susceptible to disease

○ Opportunistic infections: bacteria that wouldn’t ordinarily cause illness in humans unless the immune system is compromised

In the classroom

● Your biggest enemy will be prejudice, from classmates and parents afraid their child will be infected

● Classroom adjustment for children with developmental disabilities and neurological disabilities will work for children who have those symptoms

● Many people with HIV/AIDS don’t even know it

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Work Cited

"Cerebral Palsy Special Needs Factsheet." KidsHealth - the Web's Most Visited Site about Children's Health. Ed. Mary L. Gavin. The Nemours Foundation, 01 Aug. 2013. Web. 02 Dec. 2015. http://kidshealth.org/parent/classroom/factsheet/cp-factsheet.html

"NINDS Cerebral Palsy Information Page." Cerebral Palsy Information Page: National Institute of Neurological Disorders and Stroke (NINDS). N.p., n.d. Web. 02 Dec. 2015.http://www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy.htm

"About Cystic Fibrosis." About Cystic Fibrosis. N.p., n.d. Web. 02 Dec. 2015.https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/https://www.cff.org/Living-with-CF/CF-and-School/For-Teachers/

"Spinal Cord Injury and Paralysis." Spinal Cord Injury and Paralysis. N.p., n.d. Web. 02 Dec. 2015.http://www.kennedykrieger.org/patient-care/diagnoses-disorders/spinal-cord-injury-and-paralysishttps://www.kennedykrieger.org/sites/kki2.com/files/guide_for_school_personnel_working_with_students_with_spinal_cord_injuries_1.pdf

"What Is Asthma?" - NHLBI, NIH. N.p., n.d. Web. 02 Dec. 2015.http://www.nhlbi.nih.gov/files/docs/resources/lung/asth_sch.pdfhttp://www.nhlbi.nih.gov/health/health-topics/topics/asthma

Interview. Muscular Dystrophy. Nemours, n.d. Web. http://kidshealth.org/parent/classroom/factsheet/MD-factsheet.html>.

"Sickle Cell Disease: A Practical Guide for Teachers." Sickle Cell Disease: A Teacher's Guide - AboutKidsHealth. About Kids Healt, n.d. Web. 03 Dec. 2015.

"Diabetes Care." Care of Children With Diabetes in the School and Day Care Setting. American Diabetes Associaton, n.d. Web. 03 Dec. 2015.

“Do Provide Emotional Support and Reassurance for Grand Mal Seizures” seizures.dolyan.comhttp://seizures.dolyan.com/emotional-support-and-reassurance-for-grand-mal-seizures/

“Teaching Children with Epilepsy” Epilepsy Societyhttp://www.epilepsysociety.org.uk/teaching-children-epilepsy#.VmBcQPmrSUl

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