ORTHOPEDIC

IMPAIRMENT IN
STUDENTS
By Rachel Lindsey

What is Orthopedic
impairment?
Individuals with Disabilities Education Improvement Act of 2004

(IDEA): It is a severe orthopedic impairment that adversely

affects a childs educational performance
Includes impairments caused by congenital anomalies, disease,

and other causes

Congenital Anomalies clubfoot/absence of a member
Diseases Poliomyelitis/bone tuberculosis
Other Causes Cerebral Palsy/amputations/fractures/burns

3 IDEA categories of orthopedic

impairment
1.

Neuromotor impairments

2.

Degenerative diseases

3.

Musculoskeletal Disorders

Neuromotor Impairments
Abnormality/damage to the brain, spinal cord, or nervous system
Aquired at or before birth
Result in complex motor problems
Examples of problems
Limited limb movement
Loss of urinary control
Loss of proper alignment to the spine

2 most common neuromotor impairments: cerebral palsy and spina bifida

Cerebral Palsy
Non-progressive disorder of voluntary movement or posture
Caused by malfunction/damage to the brain during pregnancy or infancy
Characterized by abnormal, involuntary, and/or uncoordinated movements
4 types of Cerebral Palsy
1.

Spastic (tight muscles, one or more muscle groups, stiff uncoordinated)

2.

Athetoid (movements are contorted, abnormal, and purposeless)

3.

Ataxic (poor balance as well as uncoordinated voluntary movement)

4.

Mixed

Spina Bifida
Developmental defect of the spinal column
Characterized by an abnormal opening in the spinal column
Involves paralysis to portions of the body
May or may not affect cognitive development
Spina Bifida Occulta mild
Spina Bifida Cystica severe

Degenerative Diseases
Diseases that affect motor development that get worse over time
Most common Muscular Dystrophy
Inherited diseases
Characterized by progressive muscle weakness from degeneration of muscle
fibers

Musculoskeletal Disorders
Various conditions that result in various levels of physical limitations
Most common juvenile rheumatoid arthritis and limb deficiency
Juvinile Rheumatoid Arthritis
joint condition in students 15 years of age or younger
causes the lining of the joints to swell and release fluid inside the joint
Joints become swollen, stiff, painful and warm to the touch
Sometimes called juvenile idiopathic arthritis

Musculoskeletal Disorders
cont.d
Limb Deficiency
present at birth
involves either the upper or lower limb
rare instances when multiple limb deficiencies occur
can be the complete absence of a limb, more commonly, part of the limb is missing and the
remaining portion has not formed normally.
Upper body deficiencies typically does not include a major loss of function, but lower body
deficiencies are typically more severe and require more attention

Prevalence in Schools
1.1% of all SPED students are given special education services for
orthopedic impairments
Out of 5,971,495 students in the SPED program, 68,188 students were
classified with Orthopedic Impairment

Impact on Learning
Typically no other impairments in cognitive, learning, perceptual,
language, or sensory issues
Except for some students with Neuromotor impairments whose
disease affects the brain
Usually focused on accommodations to be able to learn alongside
others in academic instruction
about 46% of SPED students for Orthopedic Impairment were
educated in general education classrooms.

Government Action
The Individuals with Disabilities Education Improvement Act
(IDEA)
passed in 1990, and reauthorized in 1997 and 2004 with provisions for students
with orthopedic impairments

Vocational Rehabilitation Act, Section 504

students with orthopedic impairments also may be eligible for accommodations
for general classroom inclusion

Americans with Disabilities Act (ADA)

provisions concerning discrimination against individuals with disabilities and
requirements that school facilities are accessible to all.

Things teachers need to be aware

of
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)

Specialists for these Students

Physical Therapists who work on gross motor skills
Occupational Therapists who work on fine motor skills
Speech-Language Pathologists who work with the student on problems with
speech and language
Adapted Physical Education Teachers
Other Therapists (Massage Therapists, Music Therapists, etc.)

Assistive Technology
Devices to Access Information:
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

Canes, walkers, crutches, wheelchairs
specialized exercise equipment
specialized chairs, desks, and tables for proper posture development

Sources
Project Ideal. "Orthopedic Impairments - Project IDEAL." Project IDEAL.
Texas Counsel for Developmental Disabilities, n.d. Web. 20 Nov.
2016.
Odle, Teresa. "Orthopedic Impairments." Education.com. N.p., 23 Dec. 2009.
Web. 20 Nov. 2016.
Smith, Douglas G., MD. "Congenital Limb Deficiencies and Acquired
Amputations in Childhood." InMotion 8.1 (2006): n. pag.
InMotion: Congenital Limb Deficiencies and Acquired
Amputations in Childhood, Part 1. InMotion, Jan.-Feb. 2006.
Web. 20 Nov. 2016.