STUDENTS WITH PHYSICAL DISABILITIES

Physical impairments vary greatly. The following are brief descriptions of some of the most common physical disabilities. 

Cerebral Palsy (CP) is defined as damage to the motor areas of the brain prior to brain maturity (in most cases, this occurs before, during or shortly after birth). There are 400,000 - 700,000 individuals in the U .S. with CP. The most common types are spastic, where the muscles are tense and contracted and voluntary movement is very difficult where there is constant, uncontrolled motion. Most cases are combinations of the two types. 

Educational implications:

• A student with CP may have some degree of difficulty when speaking. If you are not sure what a

     student has said, repeat it back to the student for confirmation.

• Sensory, perceptual and motor deficits may sometimes affect CP individuals and add to learning problems.  However, do not underestimate the cognitive abilities of CP students.
• Some students with CP may write slowly and lack precision in movements. They need to tape record lectures or use note providers and require assistance in taking exams.
• CP students may benefit from notetakers, laptop, in-class aids and testing facilitation with scribes.

Spinal Cord Injury can result in paralysis or paresis (weakening). The extent of paralysis/paresis and the parts of the body affected are determined by how high or low on the spine the damage occurs and the type of damage to the cord.

Quadriplegia involves all four limbs and is caused by injury to the cervical (upper) region of the spine; paraplegia involves only the lower extrem1ties. There are 150,000 to 175,000 people with spinal cord injuries in the U .S.

Educational implications:

• The student may have paralysis and loss of sensation below the point of injury.
• Absence from school may result from urinary tract infections, respiratory problems and tissue breakdown (bed sores) caused by constant pressure and poor circulation.
• The physical abilities of a person with a spinal cord injury depend on the location and extent of the break in the spinal cord.

• These students may benefit from notetakers, in-class aids and testing facilitation with scribes.
• Isolation or loss of companionship may impact emotional development.
• Loss of hope may cause depression and lack of initiative to finish school.

Acquired Brain Impairment (ABI) is a term used to describe a huge array of injuries, including concussion, brain stem injury, closed head injury, cerebral hemorrhage, depressed skull fracture, foreign object (e.g., bullet), anoxia, and post-operative infections. Head injury and also stroke often results in paralysis and paresis, but there can be a variety of other effects as well. Currently about 1 in every 250 Americans suffer from effects of head injuries, and over 2,000,000 people in the U.S. have suffered strokes.

Educational implications:

• Paralysis or weakness may be present on one or both sides of the body. Fine and/or gross motor functioning may also be involved.
• Perception, memory, thinking, and reasoning may become confused.
• Speech may be faltering, slow, and deliberate.
• Irritability, rapid mood shifts, or a decrease in inhibitory controls may be present.
• Unrealistic ideas of present ability vs. past ability require gentle guidance to plan appropriately.

Arthritis is defined as pain in joints, usually reducing range of motion and causing weakness. Rheumatoid arthritis is a chronic syndrome. Osteo-arthritis is a degenerative joint disease. About 1% of the U.S. population (or 2.4 million people) is affected by arthritis.

Educational implications:

§        Some students must endure periodic pain, stiffness, fever, and depression.

§        Students may be bedridden for short periods as a result of arthritic "flare-up".

§        Student may be require adaptive PE

§        Students may benefit from note providers, in-class aids and testing facilitation with scribes.

if writing is too difficult for them.

Multiple Sclerosis (MS) is defined as a progressive disease of the central nervous system characterized by the destruction of the insulating material covering nerve fibers. The problems these individuals experience include poor muscle control, weakness and fatigue, difficulty walking, talking, seeing, sensing or grasping

objects. It is estimated that about 300,000 in the U.S. suffer from this disease.

Educational implications:

• The student's physical condition may vary greatly.
• The student may require the services of note providers, readers and/or examination assistance. Vision may be impaired.
• The student should avoid overwork and fatigue.

Epilepsy is not a specific disease. Some students identify a seizure disorder as their primary disability, but quite often, it is secondary to another condition.  Medication varies a great deal from individual to individual. Most people can find a medication to help control or lessen seizures, but the medication may cause

them to talk or think more slowly and may influence their coordination or balance. The student should discuss with you privately any effects of medication or accommodations that may be necessary. Listed below is a brief first aid procedure for you to follow if a student should have a tonic-clonic seizure (formerly known as Grand Mal) in your presence.

Educational Implications:

• Remain calm. Students will assume the same emotional reaction as the teacher.
• Do not try to restrain the person. There is nothing you can do to stop a seizure once it has begun.
• Clear the area around the individual so that she/he does not injure her/himself on hard or sharp objects. Try not to interfere with movements in any way.
• Persons who are subject to epilepsy usually take medications. Drowsiness or lack of concentration is often a side effect.
• Do not force anything between the teeth or give him/her anything to drink.
• It is generally not necessary to consider this a medical emergency unless the seizure lasts more than about ten minutes or is followed almost immediately by another major seizure. If assistance is needed call 9-911 in the case of a medical emergency.
• When the seizure is over, let the person rest he or she considers it necessary.

Muscular Dystrophy(MD) is a hereditary, progressive condition resulting in

muscular weakness and loss of control, contractions and difficulty in walking and breathing. About 10,000 new cases are reported per year.

Educational implications:

• The student will have difficulty in grasping heavy objects.
• Writing will probably be slow and laborious.
• The student may require the services of note providers or scribes for tests.

Functional and Educational Limitations From Physical Impairments

Problems faced by individuals with physical impairments include poor muscle control, weakness and fatigue, difficulty talking, seeing, sensing or grasping (due to pain or weakness), difficulty reaching things, and difficulty doing complex or compound manipulations (push and turn).

Individuals with spinal cord injuries may be unable to use their limbs and may use an attendant or classroom aide for manipulation assistance. Individuals with movement impairments may have difficulty with programs, which require a response in a specified period of time, especially if it is short.

Access is one of the major concerns for the student who uses a wheelchair or  crutches. The student must learn routes, which do not present barriers to their access, to and from classes and across campus. A barrier may be a stair, a curb, a narrow walkway, a heavy door, a manually opening door, an elevator door that has no delay mechanism or one that is too fast, or a vehicle blocking a curb cut.

Faculty should be aware that mobility impaired students sometimes encounter situations that may cause them to be late or absent from class. They may require more travel time between classes. They are dependent on indirect but accessible travel routes. Your understanding and willingness to make allowances when the circumstances arise is appreciated.

Classrooms and all course equipment must be accessible to these students. If any course includes travel to other locations, that location must also be accessible. It is difficult to make generalizations about the classroom needs of students who use wheelchairs or crutches. The student should make an appointment with you to discuss possible accommodations privately.

Additional guidelines to consider while working with mobility impaired student:

• Most students who use wheelchairs will ask for assistance if they need it. Do not automatically assume that assistance is required. Offer assistance if you wish, but do not insist, and accept a "No, thank you" graciously.
• A wheel chair is part of the person's body space. Do not automatically hang or lean on the chair. It is similar to hanging or leaning on the person.
• Students are not "confined" to wheelchairs. They often transfer to automobiles or furniture. Some people who use wheelchairs can walk with the aid of canes, braces, crutches or walkers. Using a wheelchair may be a means to conserve energy or move about more quickly.
• Just because a student may not appear to have a physical disability, don't disregard his/her needs. Often people with internal problems need more accommodations and are in discomfort.
• If a classroom or faculty office is inaccessible, it will be necessary to find an accessible location or alternate class that is held in an accessible location.