orthopedic impairment

Orthopedic Impairments

Under federal law (IDEA), an orthopedic impairment means a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments due to the effects of congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments due to the effects of disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

An orthopedic impairment involves the skeletal system-bones, joints, limbs, and associated muscles. A neuromotor impairment involves the central nervous system, affecting the ability to move, use, feel, or control certain parts of the body. Although orthopedic and neurological impairments are two distinct and separate types of disabilities, they may cause similar limitations in movement. Many of the same educational, therapeutic, and recreational activities are likely to be appropriate for students with orthopedic and neurological impairments. And there is a close relationship between the two types: for example, a child who is unable to move his legs because of damage to the central nervous system (neuromotor impairment) may also develop disorders in the bones and muscles of the legs (orthopedic impairment), especially if he does not receive proper therapy and equipment

Students may be born with or acquire problem with their bones, their joints and/or their muscles. Orthopedic problems may result from deformities, diseases, injuries, or surgeries. Problems a child might be born with include cerebral palsy, Osteogenisis Imperfecta, joint deformities or muscular dystrophy. Injuries or surgeries may result in the loss of a bone and/or muscle tissue and may include the amputation of a limb. Burns and broken bones can also result in damage to both bones and muscles.

Teaching and modifications

As with most students with disabilities, the classroom accommodations for students with orthopedic impairments will vary dependent on the individual needs of the student. Since many students with orthopedic impairments have no cognitive impairments, I collaborate with the special educator to include the student in the general curriculum as much as possible.
In order for the student to access the general curriculum, the student may require these accommodations:

Special seating arrangements to develop useful posture and movements

Instruction focused on development of gross and fine motor skills

Securing suitable augmentative communication and other assistive devices

Awareness of medical condition and its affect on the student (such as getting tired quickly)

Because of the multi-faceted nature of orthopedic impairments, other specialists may be involved in developing and implementing an appropriate educational program for the student. These specialists can 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 problems with speech and language

Adapted Physical Education Teachers, who are specially trained PE teachers who work along with the OT and PT to develop an exercise program to help students with disabilities

Other Therapists (Massage Therapists, Music Therapists, etc.)

In my preschool classroom I would use the buddy system to encourage social skills as well as create empathy with all my students. Wheelchair bound students can participate in many sports activities such as baseball, basketball, relays, and bowling to name a few. Actually, if a game cannot be modified to include all students in some manner, then it will not be used as part of my curriculum. We have made bats for hitting with extra wide handles and shorter basketball goals. We adapt obstacle courses for any means of mobility. The idea is to have fun while being included.

Assistive Technology

Due to the various levels of severity of orthopedic impairment, multiple types of assistive technology may be used. As with any student with a disability, the assistive technology would need to address a need of the student to be able to access the educational curriculum. For students with orthopedic impairments, these fall into these categories:

Devices to Access Information:
These assistive technology devices focus on aiding the student to access the educational material. These devices include:
speech recognition software
screen reading software
augmentative and alternative communication devices (such as communication boards)
academic software packages for students with disabilities

Devices for Positioning and Mobility:
These assistive technology devices focus on helping the student participate in educational activities. These devices include:
canes
crutches
wheelchairs
specialized exercise equipment
specialized chairs, desks, and tables for proper posture development




Following are examples of computer input, output, and documentation accommodations for individuals who have mobility or orthopedic impairments:

Input
Accessible on/off switches.
Flexible positioning or mounting of keyboards, monitors, etc.
Software utilities that consolidate multiple or sequential keystrokes.
Mouth sticks, head sticks, or other pointing devices.
Keyguards.
Modified keyboards (e.g., expanded, mini, or one-handed).
Trackballs or other input devices provide an alternative to a mouse.
Keyboard emulation with specialized switches that allow the use of scanning or Morse code input.
Speech input.
Word prediction software.

Output
Speech output.
General assistance may be needed to access printed materials.





Annotations
http://www.naset.org/orthopedicimpairment2.0.html
http://www.napcse.org/exceptionalchildren/orthopedicimpairments.php
http://www.projectidealonline.org/orthopedicImpairments.php good assistive technology section
http://specialed.about.com/od/disabilities/Disabilities_in_Special_Education.htm list of disabilities and resources
http://www.specialchild.com/archives/dz-005.html excellent website on spina bifida