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Taylor University Formal Research Paper: Student’s with Physical Disabilities

Jon Pawley

Education Department, Taylor University

SED 220: Exceptional Children

Dr. Melissa Jessup

December 6, 2021
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Introduction

IDEA uses the term “orthopedic impairment” to denote what is commonly called a

physical disability. Approximately one percent of the students served under IDEA are identified

as having an orthopedic impairment (Turnbull et al. 2020 p. 360). The definition and causes of

physical disabilities will be explored, and individuals’ academic and personal life, strengths and

challenges, and impact on growth and development will also be examined. Supports, and

instructional strategies for students with physical disabilities will be considered. Finally, the

paper will be summed up with personal reflections on how I plan to interact with students with

disabilities as a secondary math teacher and as a Christian.

IDEA Definition

The IDEA definition of an orthopedic impairment is,

a severe orthopedic impairment that adversely affects a child’s educational performance.

The term includes impairments caused by a congenital anomaly, impairments caused by

disease (e.g., poliomyelitis, bone tuberculosis), and impairments from other causes (e.g.,

cerebral palsy, amputations, and fractures or burns that cause contractures) (Sec. 300.8

(C) (8), 2017).

Etiology

Orthopedic impairments due to congenital anomalies can be caused by genetic factors,

socioeconomic and demographic factors, environmental factors, infections, and maternal

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nutritional status (Obiakor & Bakken, 2019, pp. 176-177). Genetic factors causing congenital

anomalies can be caused hereditarily by an inherited gene or through mutations in which a gene

changes suddenly (Obiakor & Bakken, 2019 p. 176). Incidence of congenital anomalies increases

dramatically when parents are related by blood (Obiakor & Bakken, 2019 p. 176). Obiakor and

Bakken states that, “Low income may be an indirect determinant of congenital anomalies, with a

higher frequency among resource-constrained families and countries. It is estimated that 94% of

severe congenital anomalies occur in low- and middle-income countries.” (2019 p. 176).

Environmental factors include maternal exposure to pesticides and other chemicals, certain

medications, alcohol, tobacco, and radiation. (Obiakor & Bakken, 2019 p. 176). According to

Obiakor and Bakken, maternal infections such as syphilis, rubella, and Zika virus are significant

causes for congenital anomalies (2019 p. 176). Finally maternal nutrition may cause congenital

anomalies due to insufficient folate or excessive intake of vitamin A (Obiakor & Bakken, 2019

pp. 176-177).

In addition to congenital anomalies, physical disabilities may be caused disease.

Impairments can be caused by diseases such as poliomyelitis or certain types of tuberculosis

including bone tuberculosis (Obiakor & Bakken, 2019 p. 177). Physical impairments may also be

caused by other factors such as cerebral palsy, spina bifida, amputations, and burns that are not

considered to be diseases and are not necessarily congenital.

Characteristics of Individuals with Orthopedic Impairments that Impact Function within

School, Home, and Community life

A student’s education must be adversely affected in order for them to be classified by

IDEA as having an orthopedic or physical impairment (LaRose et al. 2016 p. 1). LaRose et al.

state the following:

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This disability may interfere with a student’s ability to walk, write, or perform other

physical tasks in the classroom and laboratory setting. It might also affect the student’s

ability to communicate with others, hindering their ability to respond to questions orally

(2016 p. 1).

Furthermore, “Orthopedic impairments may also affect the student’s endurance in performing

various tasks, and they might tire more easily.” (LaRose et al. 2016 p. 1).

Student with physical disabilities may have challenges at school related to an inability to

write when taking tests, quizzes, or other assignments (LaRose et al. 2016 p. 2). At home or in

the community students with physical disabilities may have difficulty participating in or

accomplishing many activities that involve movement or communication; examples include

chores, sports, games, personal hygiene, and eating and drinking (Targett et al. 2013, p. 232).

Strengths and Challenges of Students with Orthopedic Impairments

As just stated, individuals with orthopedic impairments may have challenges, depending

on the severity and specifics of the impairment, related to their ability to walk, write, or perform

many other physical tasks, as well as with their ability to communicate verbally (LaRose et al.

2016 p. 1). Students with orthopedic impairments may have strengths due to and in addition to

challenges related to the disability; for example, they can grow socially and emotionally by

participating in activities that promote positive interdependence when they are unable to

complete a task on their own (Turnbull et al. 2020 p. 377). Individuals with physical disabilities,

or disabilities in general, may develop greater resilience, creativity, humor, problem solving, and

many other social, emotional, and intellectual skills as a result of the daily challenges they face.
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Impact on Human Growth and Development During Lifespan

One study showed that individuals with cerebral palsy, a common physical disability,

exhibit greater pain and lower quality of life than healthy individuals. (Riquelme et al. 2011, p.

535). The study also found, however, that the pain felt by individuals with cerebral palsy is not

related to age, whereas with healthy individuals, age is a significant predictor of pain (Riquelme

et al 2011, p. 535). These findings do not necessarily carry over to any other physical

impairments, but are simply an example of the effect the disability may have over the lifespan.

Individuals with physical disabilities may tire more easily and may have trouble with

various physical tasks (LaRose et al. 2016 p. 1). Because of this, as children they may feel left

out of many childhood activities that require physical movement. As they age, individuals with

disabilities will be excluded from occupations that require physical ability, and will also continue

to require assistive technology. Many individuals experience pain from their disability which has

a significant effect on quality of life (Pawłowska-Cyprysiak, et al. 2013).

Academic, Family, and Transition Supports

LaRose et al. share three basic principles for accommodating students with orthopedic

impairments in the classroom: “(1) use others as resources, (2) be flexible in

your planning, and (3) be ingenious and creative.” (2016, p. 2). Students with orthopedic

impairments often have a large support team including special education teachers, an

occupational or physical therapist, and a speech and language pathologist (LaRose et al. 2016).

Students may require assistive technology, modified class assignments and assessments, and an

accessible classroom environment to ensure they receive an appropriate education (LaRose et al.

2016). Firstly, all members of a student’s support team should be familiar with the assistive
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technology so that it can be appropriately incorporated into instruction and interventions.

Secondly, classwork modifications may be required, including shorter quizzes for students who

tire easily or alternative methods of action or expression–for example, by answering questions

orally rather than in writing or vice versa. Lastly, when developing a physically accessible

classroom environment, consideration should be given to “seating (e.g., desk with attached chairs

vs. tables), floor traction, lighting, board visibility, width of aisles, work surface accessibility,

location of classroom supplies, and location of the student in the classroom.” (LaRose et al.

2016, pp. 2-3).

Family and transition supports are similar to academic supports but with some additions.

Assistive technology, and accessible environments are still relevant to the transition to adulthood

and the family setting. Transition services, “a results oriented process, that is focused on

improving the academic and functional achievement of the student with a disability to facilitate

the students [sic] movement from school to post school activities,” (Targett et al. 2014, p. 229).

play a critical role in equipping students with physical disabilities to succeed after school. IDEA

requires IEPs for students older than sixteen years old to address transition goals. The first step

of transition services is to identify how best to help the student by conducting a transition

assessment. After the assessment, beneficial supports such as assistive technology (AT) and

personal assistance services (PAS) may be identified as well as instructional content and

teaching strategies for the purpose of transition should also be identified (Targett et al. 2014, pp.

229-233).

Research-based Instructional Strategy: Self-monitoring

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Turnbull states the following: “Including students with physical disabilities in general

education settings often involves the use of assistive devices, such as communication devices or

mobility support devices. But, like all students, using innovative teaching strategies with students

with physical disabilities is equally important.” (Turnbull et al. 2020 p. 375). Turnbull continued

by describing a recent study by Sheehy, Wells, and Rowe on the effects of self-monitoring on the

math competency of a student with cerebral palsy.

The study is introduced with the following statement in the abstract: “Students with

cerebral palsy (CP) without severe intellectual impairments often experience difficulties in

mathematics performance.” (Sheehey et al. p. 211). Sheehey et al. conducted a study,

to examine the impact of a tactile cued self-monitoring with self-graphing intervention on

the number of basic math problems completed and the number of math problems

completed accurately by a student with CP in a first-grade inclusion classroom. Results

indicated that the student increased the number and accuracy of single-digit addition and

subtraction computations during independent work in an inclusion setting using this

intervention. (2017, p. 211).

Perceived competence contributes to a student’s desire to learn mathematics. Motivation towards

math appears to be learned at an early age–self-monitoring, a strategy that requires students to

observe, record, and self-evaluate their behavior, has been shown to be more effective in creating

behavior change in some cases than teacher-regulated interventions. Self-monitoring also

increases students’ motivation which in turn produces academic improvements. Self-monitoring

may be most effective for improving math and writing skills (Sheehey et al. 2017, pp. 211-212).

The specific self-monitoring strategy used in the study by Sheehey et al. required the

student to plot the amount of addition and subtraction problems answered correctly on a bar
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graph (Sheehey et al. 2017). In addition to graphing, the student was given a device that vibrated

at 30 second intervals, and was asked to make a mark on the paper next to the question he was

working on when the device vibrated. Repeated intervention using this strategy produced a

dramatic increase both in accuracy and amount of problems completed in five minutes, in

addition to this, the student showed enthusiasm for graphing his progress (Sheehey et al. 2017,

pp. 215-217). Another more extensive study conducted on over a thousand high school students

summed up the benefits of self-monitoring as follows:

Findings suggest that when students feel that their schoolwork is purposeful and

interesting, and that the classroom environment and teachers are responsive and

supportive, they will be autonomously motivated to engage in self-regulated learning.

Autonomous motivation propels students to engage in deep-processing of information

and to persist and exert effort in their studies even when the school subject or studying

becomes boring or taxing. Self-regulation of effort ultimately results in enhanced

mathematics achievement (León et al. 2015, p. 156).

Research-based Instructional Strategy: Cooperative Learning

Students with physical disabilities can feel isolated and left out from general education

classrooms due to their inability to physically participate in many activities (Turnbull et al. 2020

p. 377). Many students, even those without physical disabilities, consider math to be boring and

unnecessary for daily life (Flynn, 2013, p. 1; Zakaria, 2013). The problem is increased when

potentially isolated and unengaged students with orthopedic impairments are combined with the

often unengaging and boring subject of math. One proven answer to both these issues is the

cooperative learning instructional strategy which promotes deep learning, critical thinking skills,
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social skills, personal growth, better grades, and more positive attitudes (Zakaria, 2013, p. 273).

Cooperative learning requires students to study and work in small groups to achieve a common

goal (Flynn, 2013, p. 7; Zakaria, 2013, p. 273). Cooperatively learning should have the following

characteristics in order to be implemented effectively:

1. Positive interdependence: students support their group members by accomplishing

different tasks that are all essential for overall success.

2. Individual accountability: students should be held accountable for both individual and

group performance to prevent uneven effort

3. Face-to-face interaction

4. Social skills instruction

5. Debriefing (Flynn, 2013, p. 94, Turnbull et al. 2020 p. 377).

To sum up, cooperative learning is an effective, research based instruction strategy for improving

students’ attitudes towards mathematics as well as their grades. Strategies that encourage

positive attitudes and inclusion may be particularly relevant to students with physical disabilities

who may feel excluded and unengaged because of their disability (Turnbull et al. 2020 p. 377).

Working with Individuals with Orthopedic Impairments as a Secondary Math Teacher

Unlike most other disabilities, orthopedic impairments or physical disabilities don’t affect

intellectual functioning. Because of this, students with physical disabilities probably will not

require specialized instruction for math as would, for example, a student with a specific math

learning disability or an intellectual impairment. Though they will often require assistive

technology or other supports, these serve to bring them to the level in which they can adequately

and comfortably engage in the class. The exception to this is if the physical disability also causes
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a communication impairment, in which case special instruction, such as strategies that allow

different forms of communication, may be necessary to provide an appropriate education. So,

while specific math instruction aimed at students with physical disabilities may not be necessary,

it is important to not use instructional strategies that will overly exclude them or handicap their

performance. For example, a quiz that requires students to jump out of their seat when they know

the answer would not be appropriate. The instructional strategies of self-monitoring and

cooperative learning are only two strategies among many that may be used to teach math, but

were discussed rather than others because studies have been conducted that have scientifically

shown them to be effective when used with students with physical disabilities.

Working with Individuals with Disabilities as a Christian

One danger when teaching students with disabilities is the trap of having low

expectations. To paraphrase Dr. Mellissa Jessup, students will always rise to your expectations,

so you should always keep your expectations as high as you reasonably can (personal

communication, 2021). As a Christian teacher, I should have high expectations and desire the

absolute best for my students just as the Apostle Paul had high expectations for his disciples,

“For I am confident of this very thing, that He who began a good work in you will perfect it until

the day of Christ Jesus. For it is only right for me to feel this way about you all, because I have

you in my heart.” (NASB, 1995, Phil 1:6-7a).

Another mental trap that teachers can fall into is related to that of having low

expectations: having negative biases towards students with disabilities. As a Christian, I believe

that all people, including those with disabilities, are “fearfully and wonderfully made;” (NASB,

1995, Psalm 139:14a). They are not worth any less because of their disability, simply because
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they are made in God’s image. Therefore, I should not let any disability distract me from a

student’s God given dignity. Students with disabilities may have different characteristics,

challenges and strengths, and may require specialized support, but they are still people made in

God’s image worthy of dignity and love.

References

Flynn, C. (2013). Cooperative learning in secondary math classes (Doctoral dissertation,

Evergreen State College).

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LaRose, S. E., Thoron, A. C., & Colclasure, B. C. (2016). Teaching Students with Disabilities:

Orthopedic Impairment. EDIS, 2016(6), 3-3.

León, J., Núñez, J. L., & Liew, J. (2015). Self-determination and STEM education: Effects of

autonomy, motivation, and self-regulated learning on high school math achievement.

Learning and Individual Differences, 43, 156-163.

Obiakor, F. E., & Bakken, J. P. (Eds.). (2019). Special Education for Young Learners with

Disabilities. Emerald Publishing Limited.

Pawłowska-Cyprysiak, K., Konarska, M., & Żołnierczyk-Zreda, D. (2013). Self-perceived

quality of life of people with physical disabilities and labour force participation.

International journal of occupational safety and ergonomics, 19(2), 185-194.

Riquelme, I., Cifre, I., & Montoya, P. (2011). Age-related changes of pain experience in cerebral

palsy and healthy individuals. Pain Medicine, 12(4), 535-545.

Sec. 300.8 (C) (8). Individuals with Disabilities Education Act. (2017, May 2). Retrieved

December 3, 2021, from https://sites.ed.gov/idea/regs/b/a/300.8/c/8.

Sheehey, P. H., Wells, J. C., & Rowe, M. (2017). Effects of self-monitoring on math competency

of an elementary student with cerebral palsy in an inclusive classroom. Preventing School

Failure: Alternative Education for Children and Youth, 61(3), 211-219.

Targett, P., Wehman, P., West, M., Dillard, C., & Cifu, G. (2013). Promoting transition to

adulthood for youth with physical disabilities and health impairments. Journal of

Vocational Rehabilitation, 39(3), 229-239.

Tolentino, R. M. (2016). Improving math skills of special education students. International

Journal of Advanced Research in Education & Technology (IJARET), 3(2), 73-77.

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Turnbull, A. P., Turnbull, H. R., Wehmeyer, M. L., & Shogren, K. A. (2020). Exceptional lives:

Practice, Progress, & Dignity in Today's Schools (9th). Pearson Education, Inc.

Zakaria, E., Solfitri, T., Daud, Y., & Abidin, Z. Z. (2013). Effect of cooperative learning on

secondary school students’ mathematics achievement. Creative education, 4(2), 98-100.