Teaming and Related Services for Children with Physical Disabilities, Health Impairments, and ADHD

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The transdisciplinary team approach has special relevance for students with physical disabilities and health impairments. No other group of exceptional children comes into contact, both in and out of school, with as many different teachers, physicians, therapists, and other specialists. Because the medical, educational, therapeutic, vocational, and social needs of these students are often complex and frequently affect each other, it is especially important that educational and health care personnel openly communicate and cooperate with one another. Two particularly important members of the team for many children with physical disabilities and health impairments are the physical therapist and the occupational therapist. Each is a licensed health professional that must complete a specialized training program and meet rigorous standards.

Physical therapists (PTs) are involved in the development and maintenance of motor skills, movement, and posture. They may prescribe specific exercises to help a child increase control of muscles and use specialized equipment, such as braces, effectively. Massage and prescriptive exercises are perhaps the most frequently applied procedures; but physical therapy can also include swimming, heat treatment, special positioning for feeding and toileting, and other techniques. PTs encourage children to be as motorically independent as possible; help develop muscular function; and reduce pain, discomfort, or long-term physical damage. They may also suggest dos and don’ts for sitting positions and activities in the classroom and may devise exercise or play programs that children with and without disabilities can enjoy together.

Occupational therapists (OTs) are concerned with a child’s participation in activities, especially those that will be useful in self-help, employment, recreation, communication, and aspects of daily living (e.g., dressing, eating, personal hygiene). They may help a child learn (or relearn) diverse motor behaviors such as drinking from a modified cup, buttoning clothes, tying shoes, pouring liquids, cooking, and typing on a computer keyboard. These activities can enhance a child’s physical development, independence, vocational potential, and self-concept. OTs conduct specialized assessments and make recommendations to parents and teachers regarding the effective use of appliances, materials, and activities at home and school. Many OTs also work with vocational rehabilitation specialists in helping students find opportunities for work and independent living after completion of an educational program.

Other specialists who frequently provide related services to children with physical disabilities and health impairments include the following (Downing, 2004; Etzel-Wise & Mears, 2004; Neal, Bigby, & Nicholson, 2004):

• Speech-language pathologists (SLPs), who provide speech therapy, language interventions, oral motor coordination (e.g., chewing and swallowing), and augmentative and alternative communication (AAC) services
• Adapted physical educators, who provide physical education activities designed to meet the individual needs of students with disabilities
• Recreation therapists, who provide instruction in leisure activities and therapeutic recreation
• School nurses, who provide certain health care services to students, monitor students’ health, and inform IEP teams about the effects of medical conditions on students’ educational programs
• Prosthetists, who make and fit artificial limbs
• Orthotists, who design and fit braces and other assistive devices
• Orientation and mobility specialists, who teach students to navigate their environment as effectively and independently as possible
• Biomedical engineers, who develop or adapt technology to meet a student’s specialized needs
• Health aides, who carry out medical procedures and health care services in the classroom
• Counselors and medical social workers, who help students and families adjust to disabilities