GROUP 7

Orthopedic Impairment

 Orthopedic Impairment

The most common of physical disabilities.

 Physical Disability

Any condition that interferes with a student’s ability to use his or her body.

Orthopedic Impairment

A bodily impairment that is severe enough to negatively affect a child’s

educational performance.

Causes

 genetic abnormality

 disease

 injury

 birth trauma

 amputation

 burns

 other causes

Other Causes

 Spina bifida

 Diabetes
  Nervous system disorders

 Traumatic spinal cord injury

 Stroke

 Muscular Dystrophy

 Cerebral Palsy

Main Categories

1. Neuromotor Impairments

 involve the central nervous system (brain, spinal cord, or nerves that send impulses to

muscles)

 affect a child's ability to move, use, feel, or control certain parts of the body

 e.g. spina bifida, cerebral palsy, and spinal cord injuries

2. Musculoskeletal Disorders

 Skeletal system impairments that involve the joints, bones, limbs, and associated muscles

 include defects or diseases of the bones and muscles, such as limb deficiency or club-

foot.

3. Degenerative diseases

 Those that affect motor movement such as muscular dystrophy.

Orthopedic Disorder

Spina Bifida
  is a cleft spine, or incomplete closure of the spinal column. It is the most common

permanently disabling birth defect. Spina bifida occulta is the mildest and most

common form.

Meningocele

 With this type, the spinal cord develops normally, but the meninges, or protective

covering, push through the opening in the vertebrae.

 Meningocele can be repaired surgically.

Myelomeningocele

 It is the most severe form of spina bifida.

 The bones of the spinal cord do not completely form and the spinal canal is incomplete,

resulting in the spinal cord and meninges protruding out of the child's back.

Scoliosis
It is a side-to-side curvature of the spine, measured by x-ray examination as greater than 10

degrees. It makes the shoulders, hips, or both

appear uneven and can cause pain in the back.

Cerebral Palsy

 It includes a number of chronic disorders that impair movement control.

 appear early in life and generally do not worsen as children age.

 caused by injury to parts of the brain that control the ability to use muscles. The injury

can occur before birth, during delivery, or soon after birth.

 early signs normally appear by the time a child is 18 months of age.

Three main types of CP

 Spastic - where muscle tone is too high or too tight

 Athetoid or dyskinetic CP, - can affect the whole body with slow, uncontrolled

movements and low muscle tone

 Mixed CP - a combination of the symptoms from both athetoid and spastic CP.
 -has some muscles that are too tight and others that are too loose so that some movements

are involuntary and mobility is limited in other areas by stiffness.

Muscular Dystrophy

 It is a group of muscle diseases that weaken the musculoskeletal system and hamper

locomotion. Muscular dystrophies are characterized by progressive skeletal muscle

weakness, defects in muscle proteins, and the death of muscle cells and tissue.

 It often occurs in families with no known history of the disease. Muscle weakness, rapid

progression, and difficulty with motor skills are some of the characteristics

Characteristics of Children with Orthopedic Impairment

 problems with motor skills

 Some students have associated speech impairments or multiple disabilities

 use various types of braces, prosthetic, and orthotic devices before, after, or in place of

surgery. Others use adapted wheelchairs.

 social interactions often are limited

 may have pain and discomfort, may sleep poorly and therefore be fatigued in class

 Poor self-concept and poor self- advocacy skills

 feel helpless or depressed as a result of their physical disability

Assessment

 a thorough medical evaluation of the child's orthopedic impairment by a licensed

physician.
  documentation of observations and assessments

 various checklists, inventories, rating scales, and interviews

Team Approach in Assessment

The team that assesses a child with an orthopedic impairment must involve:

 a parent and at least one of the child's general education classroom teacher/s

 a licensed special education teacher, school counselor and/or psychologist

 a licensed physician, and other profession personnel as appropriate.

Educational Provisions and Program

Provisions:

 The Individuals with Disabilities Education Improvement Act (IDEA) was reauthorized

in 1997 and 2004 and includes provisions for children with orthopedic impairments

 Students with orthopedic impairments also may be eligible for accommodations for

general classroom inclusion under Section 504 of the Vocational Rehabilitation Act,

passed in 1973.

 The Americans with Disabilities Act (ADA), which was passed in 1990, includes

provisions concerning discrimination against individuals with disabilities and

requirements that school facilities are accessible to all.

Programs:
  Inclusion in general education classes, but some students may need services from

resource rooms, special classes, schools, or residential facilities, as well as hospital or

homebound programs

 Setting up the appropriate placement, services, and environment begins with asking the

student what he or she needs and evolves through the assessment and individualized

education plan (IEP) process.

 To assist with academic tasks, a teacher might secure papers to a student's work area

 Provide writing instruments that require less pressure to produce a mark, such as felt-tip

pens or soft lead pencils.

 Specialists such as physical therapists and orthopedic therapists will be involved in the

educational assessment

 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)

Multiple types of assistive technology may be used:

Devices to access information: These assistive technology devices focus on aiding the student to

access the educational material. These devices include:

  screen reading software

 speech recognition 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:

 wheelchairs

 crutches

 walkers

 canes

 specialized exercise equipment specialized chairs, desks, and tables for proper posture

development

Current Trends

 Decreases in the rates of one of the common causes of orthopedic impairment, spina

bifida.

 The implementation of campaigns to promote folic acid supplementation for women of

childbearing age

 Parent involvement in children's learning is positively related to achievement