LOW-INCIDENCE LOW-INCIDENCE DISABILITIESDISABILITIES

Jae Hee KimJae Hee KimED 315-01ED 315-01Fall 2013Fall 2013

Instructor: Roland MerarInstructor: Roland Merar

BELLWORKFrank was a very bright, precocious 6-year-old first-grader. He was reading and doing math

above grade level and was socially very mature. He was one of the most popular students in Ms. Bond’s classroom. Over the Christmas holidays, Frank fell out of a tree where he and some friends were playing. He was rushed to the emergency room unconscious. He remained hospitalized for 3 weeks, diagnosed with a closed head injury. Frank was then moved to a residential rehabilitation facility for children with head injuries. He remained in the rehabilitation hospital until April when he was released to home.

Frank’s Parents and the school Agreed that he should repeat first grade because he was having some lingering effects from his head injury. He exhibited problems with memory, had occasional behavior outbursts, did not et along well with his peers, and had lost many of the academic skills he had developed during first grade. Ms. Bond would be his teacher again, since she knew him from the previous year. When school started, Frank was somewhat apprehensive about going. He had difficulty paying attention, displayed some hyperactive behaviors, and had problems with short-term memory skills. His social skills were very immature and he did not have any friends. After 6 weeks, Ms. Bond referred him for special education. After a comprehensive evaluation, Frank was determined eligible for special education services under the category of traumatic brain injury.

Questions to Consider:1. What kind of special skills does Frank’s first-grade classroom teacher need to meet Frank’s

educational and social needs?2. What are Frank’s major problems that need to be addressed if he is to make progress

during the first grade and be prepared for promotion to second grade?3. What can Frank’s teacher do to help him improve his social skills?4. What academic skills are critical for Frank to have for him to be successful in higher

grades?(Pg. 347)

CLASS NORMS

• Be On Time• Be Prepared• Be Attentive• Be Respectful

SLO

After listening to the teachback, you should be able to:

• Define and describe low-incidence disabilities.

• Define and describe students with other health impairments.

• Define and describe students with physical impairments.

ENERGIZER

Try to remember and write down as many words as you can…

ARE YOU READY?

APPLEJEANSCOOLINWORNBLACKAREBOTTOMWHEN

APPLEJEANSCOOLINWORNBLACKAREBOTTOMWHEN

TOO HARD? HOW ABOUT THIS?

APPLEBOTTOMJEANSARECOOLWHEN WORNINBLACK

ARE YOU READY?

WAKEEATUPTHENOHOUSEBARKINGMEUPHELLOIN

HELLOWAKEMEUPEATUPNOBARKINGINTHE HOUSE

LOW-INCIDENCE DISABILTIES

“To classify learners in terms of how many students with any particular disability or combination of disabilities reside in a community.” (NCAC)

NON-DISABILITYNON-DISABILITY

HIGH-INCIDENCEHIGH-INCIDENCE

LOW-INCIDENCELOW-INCIDENCE

HIGH-INCIDENCE DISABILITIES

• Communication disorders (speech and language impairments)

• Specific learning disabilities (including attention deficit hyperactivity disorder [ADHD])

• Mild/moderate mental retardation • Emotional or behavioral disorders

LOW-INCIDENCE DISABILITIES

• Blindness• Low vision• Deafness• Hard-of-hearing• Deaf-blindness• Significant developmental delay• Complex health issues• Serious physical impairment• Multiple disability• Autism

BLIND/LOW-VISION

According to IDEA ’97, Visual impairment including blindness

means an impairment in vision that, even with correction, adversely affects a child’s educational performance. The term includes both partial sight and blindness.

DEAF/HARD-OF-HEARING

According to IDEA ’97,Deafness means a hearing impairment

that is so severe that [a] child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance.

DEAF-BLIND

According to IDEA ’97,Deaf-blindness means concomitant

hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that cannot be accommodated in special education programs solely for children with deafness or children with blindness.

SIGNIFICANT DEVELOPMENTAL DELAY

According to IDEA ’97,Mental retardation means significantly

sub-average general intellectual functioning, existing concurrently with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance.

SIGNIFICANT PHYSICAL DISABILITIES

According to IDEA ’97,  Orthopedic impairment means a severe

orthopedic impairment that adversely affects a child’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, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

SIGNIFICANT MULTIPLE DISABILITIES

According to IDEA ’97, Multiple disabilities means concomitant

impairments (such as mental retardation-blindness, mental retardation-orthopedic impairment, etc.), the combination of which causes such severe educational needs that they cannot be accommodated in special education programs solely for one of the impairments. The term does not include deaf-blindness.

AUTISTIC SPECTRUMAccording to IDEA ’97, Autism means a developmental disability significantly

affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in paragraph (b)(4) of this section.

A child who manifests the characteristics of “autism” after age 3 could be diagnosed as having “autism” if the criteria in paragraph (c)(1)(i) of this section are satisfied.

OTHER HEALTH IMPAIRMENTS

According to IDEA ’04, Other health impairments means having

limited strength, vitality or alertness, due to chronic or acute health problems such as a heart condition, tuberculosis, rheumatic fever, nephritis, asthma, sickle cell anemia, hemophilia, epilepsy, lead poisoning, leukemia, or diabetes that adversely affects a child’s educational performance.”

ASTHMA• “Asthma is the result of the body’s antibodies

reacting to antigens and causing swelling mucus secretion, and muscle tightening in the lungs.” (pg. 350)

• May cause:– Repetitive episodes of coughing, shortness of

breath, and wheezing• Triggers:– Dust– Cigarette smoke– Mold– Dust mites– Animal dander

ASTHMA• Tips for Teachers:

– Consult with principal and school nurse for policies and procedures for dealing with students who have chronic health problems, such as asthma.

– Understand your role in implementing a student’s asthma action plan, including knowing when to seek medical assistance for children.

– Develop and implement a procedure for students to complete missed school work.

– Monitor students to ensure that their asthma is not interfering with school work; report such events to parents and school health professionals.

– Inform school administrators, nurses, and parents if student’s behavior or academic performance changes.

– Encourage students to participate in physical activities and field trips.– Be aware of signs of uncontrolled asthma– Inform school nurse in situations where asthma is not controlled

properly.– Understand asthma triggers and attempt to minimize them in the

classroom.– Understand warning signs of an asthma episode and what actions

should be taken.

CHILDHOOD CANCER

• Leukemia• Brain cancer/tumors of the central nervous system

CHILDHOOD CANCER

• Tips for Teachers:– Maintain communication between school and family.– Encourage the student to attend classes when possible.– Learn about the child’s diagnosis.– Learn about the treatment the child is receiving and any

possible side effects to the treatment.– Encourage the student to continue to complete school

work.– Provide supports and accommodations for the student.– Determine if the child should receive IDEA or 504

supports– Understand that the student may display learning

problems not displayed before the diagnosis.

CYSTIC FIBROSIS

• Cystic fibrosis is an inherited, fatal disease that results in an abnormal amount of mucus throughout the body, most often affecting the lungs and digestive tract. This results in the blockage of air sacs in the lungs, causing air to be trapped in the lungs, which then overinflate and collapse.

CYSTIC FIBROSIS• Tips for Teachers:

– Prepare students in class for the realities of this disease (e.g., coughing, non-contagious sputum, gas).

– Learn how to clear a student’s lungs and air passages, as such assistance may be needed after certain activities.

– Know the medications a student must take and be able to administer them (e.g., enzymes, vitamins).

– Consider restricting certain physical activities.– Inquire about he therapies being used with the student.– Support the implementation of special diets if needed.– Provide opportunities for students to talk about their concerns,

fears, and feelings.– Ensure that the student is included in all class activities to

whatever extent is possible.– Prepare students for the eventual outcome of the disease by

discussing death and dying.

DUAL-SENSORY IMPAIRMENT

• Tips for Teachers:– Use an ecological approach to assessment and skill

selection to emphasize functional needs of students.– Use a variety of prompts, cues, and reinforcement

strategies in a systematic instructional pattern.– Use time-delay prompting, increasing the time between

prompts.– Use groups and cooperative learning strategies– Implement environmental adaptations, such as

enlarging materials, using contrasting materials, altering seating arrangements, and reducing extraneous noises to maximize the residual hearing and vision of the student.

DIABETES

• Diabetes is a metabolic disorder in which the pancreas cannot produce sufficient insulin to process food.

• 2 Types:– Type II: Able to produce some insulin.– Type: I: Occurs in children. Not able to

produce insulin. Need insulin added in the body daily.

DIABETES

• Symptoms:– Increased thirst, appetite, and urination–Weight loss– Fatigue– Irritability

DIABETES• Tips for Teachers:

– Attend diabetes education training programs.– Become familiar with student’s healthcare plan for management of diabetes at

school and school-sponsored events.– Become aware of how to handle emergency situations for individual students.– Be alert to recognize signs and symptoms of hypoglycemia and

hyperglycemia.– Encourage the students with diabetes to participate fully in school activities

and events.– Prepare substitute teachers to handle emergencies or know whom to notify in

case of emergencies.– Provide accommodations for educational issues related to hyperglycemia and

hypoglycemia, as those conditions can impair thinking for several hours.– Communicate appropriate events to the school nurse, school, counselor, and

parents.– Help the other students in the class empathize with the child who has diabetes

while respecting the child’s needs for privacy.

EPILEPSY• Epilepsy is a neurological disorder

that results in individuals having seizures.

EPILEPSY• First-Aid:

1. Record date and time the seizure started

2. Behaviors before the seizure3. Body parts involved in the seizure4. Ending time and recovery period5. Behaviors during the recovery period

HIV & AIDS• “Human immunodeficiency virus (HIV)

occurs when the virus attacks the body’s immune system, leaving an indivual vulnerable to infections or cancers. In its later stages, HIV infection becomes acquired immunodeficiency syndrome (AIDS).” (pg. 357)

• “Transmitted through the exchange of blood, semen, or other body fluids” (pg. 357)

HIV & AIDS• Tips for Teachers:

– Follow the guidelines (universal precautions) developed by the CDC and the Food and Drug Administration for working with HIV-infected individuals.

– Ask the student’s parents or physician whether there are any special procedures that must be followed.

– Discuss HIV/AIDS with the entire class that a student’s skills and abilities will change over time if he or she is infected with HIV/AIDS.

– Prepare for the fact that the student may die, especially if AIDS is present.

– Ensure that the student with HIV/AIDS is included in all aspects of classroom activities.

– Be sensitive to the stress that the student’s family is undergoing.

– Help the other students in the class empathize with the child who has diabetes while respecting the child’s needs for privacy.

TOURETTE SYNDROME• “Tourette Syndrome (TS) is a neurological disorder that results in multiple motor and

verbal tics.” (pg. 358)• Types of tics:

• Clearing of throat• Coughing• Stuttering• Repeating words or phrases• Shouting• Grunting• Spitting• Barking or other animal noises• Blinking eyes• Rolling eyes• Moving jaw• Rocking back and forth• Making facial grimaces/movements/twitches• Biting nails and lip• Picking at skin and pinching• Flailing arms

TOURETTE SYNDROME

• Impact:– Incomplete work– Illegible or poor quality of work– Inattention– Disorganization– Difficulty understanding and following

directions

TOURETTE SYNDROME

• Tips for Teachers:– Be understanding– Monitor medication– Participate as a member of the

interdisciplinary team

PHYSICAL IMPAIRMENTS

• “Disabilities related to physical impairments are placed under the umbrella category of orthopedic impairments in IDEA.” (pg. 359)

AMPUTATIONS

• “An amputation is the partial or total absence of an arm or a leg. Amputations can be congential, present at birth, or acquired after birth.” (pg. 359)

AMPUTATIONS

• Interventions:– Accessibility • Classrooms• Playgrounds• Gyms• Cafeterias• Others

– Alternative ways to submit work– Address emotional & social issues

CEREBRAL PALSY

• “Cerebral Palsy (CP) is a disorder of movement or posture.” (pg. 361)

• Other Characteristics:– Oral language problems– Learning difficulties

CEREBRAL PALSY• Tips for Teachers:

– Create a supportive classroom environment that encourages participation in every facet of the school day.

– Allow extra time for students to move from one location to another

– Ask students to repreat verbalizations that may be hard to understand because of their speech patterns

– Provide many real-life activities– Learn the correct way for the student to sit upright in a chair or

wheelchair and any special adaptive pieces that may accompany it.

– Encourage students to use computers that are equipped with expanded keyboards if necessary or other portable writing aids for taking notes or generating written products.

– Consult physical and occupational therapists to understand correct positioning,

MUSCULAR DYSTROPHY

• Muscular dystrophy (MD) is a genetic disorder that gradually weakens the body's muscles. It's caused by incorrect or missing genetic information that prevents the body from making the proteins needed to build and maintain healthy muscles.

• A child who is diagnosed with MD gradually loses the ability to do things like walk, sit upright, breathe easily, and move the arms and hands. This increasing weakness can lead to other health problems.

MUSCULAR DYSTROPHY• Tips for Teachers:

– Be prepared to help the student deal with the loss of various functions

– Involve the student in as many classroom activities as possible– Using assistive techniques that do not hurt the indivual; help

the student as needed in climbing stairs or in getting up from the floor.

– Understand the functions and components of wheelchairs.– Monitor the administration of required medications.– Monitor the amount of time the student is allowed to stand

during the day.– Be familiar with different types of braces (e.g., short leg,

molded ankle-foot) students might use.– Prepare other students in class for the realities of the disease.

SPINA BIFIDA

• “Spina bifida is a neural tube defect characterized by bones in the spinal column (vertebrae) not connecting properly.” (pg. 363)

• Types:– Occult spinal dysraphism, spina bifida

occulta, meningocele, and myelomeningocele

SPINA BIFIDA • Myelomeningocele (sounds like: my-low-ma-nin-jo-seal;

When people talk about spina bifida, most often they are referring to myelomeningocele. Myelomeningocele is the most serious type of spina bifida. With this condition, a sac of fluid comes through an opening in the baby’s back. Part of the spinal cord and nerves are in this sac and are damaged. This type of spina bifida causes moderate to severe disabilities, such as problems affecting how the person goes to the bathroom, loss of feeling in the person’s legs or feet, and not being able to move the legs.

• Meningocele (sounds like: ma-nin-jo-seal) Another type of spina bifida is meningocele. With meningocele a sac of fluid comes through an opening in the baby’s back. But, the spinal cord is not in this sac. There is usually little or no nerve damage. This type of spina bifida can cause minor disabilities.

• Spina Bifida Occulta (sounds like: o-cult-tuh; Spina bifida occulta is the mildest type of spina bifida. It is sometimes called “hidden” spina bifida. With it, there is a small gap in the spine, but no opening or sac on the back. The spinal cord and the nerves usually are normal. Many times, spina bifida occulta is not discovered until late childhood or adulthood. This type of spina bifida usually does not cause any disabilities.

SPINA BIFIDA

SPINA BIFIDA • Tips for Teachers:

– Inquire about any acute medical needs the student may have.

– Learn about the various adaptive equipment a student may be using

– Maintain an environment that assists the student who is using crutches by keeping floors from getting wet and removing loose floor coverings.

– Understand the use of a wheelchair as well as its major parts

– Learn how to position these students to develop strength and to keep sores from developing in parts of their bodies that bear their weight or that receive pressure from orthotic devices they are using. Because they do not have sensation, they may not notice the sores themselves.

SPINA BIFIDA • Tips for Teachers:

– Understand the process of clean intermittent bladder catheterization (CIC), as some students will be performing this process to become continent and avoid urinary tract infections. The process involves insertion of a clean catheter through the urethra and into the bladder, must be done four times a day.

– Be ready deal with the occasional incontinence of students. Assure the student with spina bifida that this is not a problem and discuss this situation with other class members.

– Learn how to deal with the special circumstances associated with students who use wheelchairs and have seizures.

– Ensure full participation of the student in all classroom activities.– Help the students with spina bifida develop a healthy, positive self-

concept.– Notify parents if there are unusual changes in the student’s behavior or

personality or if the student has various physical complaints such as headaches or double vision— may be due to increased pressure on the brain.

TRAUMATIC BRAIN INJURY

• “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.”

TRAUMATIC BRAIN INJURY

• Implications:– Difficulty with logic, thinking, and reasoning– Slower to respond, react, and complete activities

and tasks– Difficulty focusing attention– Physical limitations– Inappropriate social behaviors– Difficulty remembering– Frequently puzzled or challenged by grade level

work– Difficulty thinking– Speech and language deficits

ACTIVITY

1. Select one low-incident disability.2. Provide a concise description. 3. Explain how you would make

adjustments in the classroom to accommodate students with the disability.

4. Present.(pgs. 347-366)

ASSESSMENT

What did you learn today?

THANK YOU