Physical or Health Disabilities Defined
The federal government considers physical disabilities and health disabilities as separate special education categories. IDEA '04 uses the term orthopedic impairments to refer to conditions that in this text we call physical disabilities. Students with physical disabilities have problems with the structure or the functioning of their bodies. The federal government, through IDEA '04, uses the term other health impairments to describe, collectively, conditions and diseases that create special health care needs or health disabilities for students. These two special education categories are not as separate or discrete as their definitions make them seem. For example, some conditions typically grouped under physical disabilities or orthopedic impairments also result in long-term health problems. One student with cerebral palsy may face physical challenges and need considerable assistance from a physical therapist (PT) to learn how to control movement, and yet have no special health care needs. Another student also with cerebral palsy may have both physical limitations and serious health care needs. Many children with health-related disabilities also have limitations to their physical well-being and require ongoing medical attention. And some combine major health issues with speech or language impairments (Owens, Metz, & Haas, 2003). Many of them present special needs at school. However, possibly more than is true of any other group, many students with physical or health problems require accommodations to participate in general education environments but do not require special education services.
Although we discussed attention deficit hyperactivity disorder (ADHD) in a separate chapter, note that IDEA '04 includes this condition as part of the "other health disabilities" category. In this text, we present information about conditions more traditionally considered physical or health disabilities.
The two major groups of physical disabilities are
- Neuromotor impairments
- Muscular/skeletal conditions
Some diseases, such as polio, are now prevented in the United States. Others, such as multiple sclerosis, are found in adults but seldom seen in children; and some, such as muscular dystrophy and spina bifida, have extremely low prevalence rates. Other conditions, such as epilepsy and cerebral palsy, are more prevalent, and teachers should have knowledge about these conditions because they might teach students who have special needs as a consequence of them. Neuromotor impairments are conditions caused by damage to the central nervous system (the brain and the spinal cord). The resulting neurological impairment limits muscular control and movement. Muscular/skeletal conditions are impairments that affect the limbs or muscles. Individuals with these conditions usually have trouble controlling their movements, but the cause is not neurological. Some need to use special devices and technology even to do simple tasks—such as walking, eating, or writing—that most of us take for granted. And, because physical disabilities are often so obvious, it is easy to overlook the associated difficulties many of these individuals have with social skills (Coster & Haltiwanger, 2004).
When responsible educators encounter diseases and conditions they know little about, they seek out all the information they need to provide an appropriate education to students involved. Educators also understand that these disabilities range in severity from mild to severe. And, in many cases, they are only one of multiple conditions an individual must face (Kennedy & Horn, 2004; McDonnell, Hardman, & McDonnell, 2003). For example, epilepsy is frequently found in children with mental retardation. But remember never to make the terrible error of associating health or physical disabilities with a cognitive disability. They do not always go hand in hand. Now, let's focus on some specific physical disabilities.
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