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Students with Orthopedic Impairments, Traumatic Brain Injury, and Other…

- - - - Irving Independent School District v. Tatro (468 U.S., an 8-year-old girl with spina bifida (a condition discussed later in this chapter) needed clean intermittent catheterization (CIC) every 3 or 4 hours to help her relieve her bladder, and she could not attend school if this procedure was not performed. Her parents believed the school district was responsible for providing this service, but the district considered it a medical procedure not covered by IDEA. The U.S. Supreme Court supported the parents’ view, identifying this procedure as a related service—that is, one needed by the child in order to attend school (unlike procedures needed just once a day that could be performed during nonschool hours). The court ruled that because the procedure could be performed by a school nurse or anyone else who attended a brief training session, it was not a medical service—that is, one that had to be completed by a physician—and thus, school personnel were directed to provide this support.
      - Cedar Rapids Community School District v. Garrett F. further clarified schools’ responsibilities for providing health-related services. Garrett F. was paralyzed from the neck down at age 4 as a result of a motorcycle accident, and his parents had ensured that his many physical needs were met in the classroom by providing a nurse for him. However, when Garrett was in fifth grade, his parents requested that the school district take over paying for this intensive support. The school district maintained that this was a medical service not required through IDEA. The U.S. Supreme Court ruled against the school district, stating that the only services considered medical were those that could only be performed by a physician. It established that the nursing care needed by Garrett was a related service under IDEA and that schools were obligated to provide it if required for students to attend school.
  - - - in IDEA this disability category is termed orthopedic impairments, most educators refer to students as having physical disabilities.
      - a severe . . . impairment that adversely affects a child’s educational performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).
    - - The term cerebral palsy literally means “paralysis of the brain.” This disability is a group of conditions involving muscle control, posture, and movement that is not progressive, meaning that it does not get worse over time.
      - spina bifida (literally meaning “a split or divided spine”), and it also is a physical disability with a neurological basis
      - Spinal cord injuries, affecting some 282,000 people annually
    - - Duchenne muscular dystrophy
      - Juvenile idiopathic arthritis
  - - - closed head injury
      - open head injury
    - - Cognitive skills. Students may experience difficulty with reasoning, problem solving, memory, and organization.
      - Processing ability. A traumatic brain injury can affect the speed at which a student can interpret information received through all the senses.
      - Language. Depending on the part of the brain that is injured, some students may experience speech and language disorders. In particular, they may have difficulty comprehending language and speaking fluently.
      - Academic achievement. Many students with traumatic brain injuries regress in their levels of achievement and may struggle to regain lost skills and learn new ones.
      - Emotions. Students who have experienced traumatic brain injuries often are characterized as having a changed personality. They may have difficulty controlling their emotions, and they may become frustrated, angry, or upset with an intensity that surprises their teachers and other professionals and often leads students to experience difficulties with peers.
      - Behavior. Students with traumatic brain injuries may have behavior problems similar to those of other students (e.g., refusing to work, leaving the classroom without permission, hitting others), but their problems may be more intense and more difficult to address because of the other cognitive difficulties caused by the injury.
    - - This condition is the most common cause of disability and death among individuals in the United States under the age of 21, resulting in 62,000 hospitalizations and 564,000 emergency room visits each year.
  - - - Other health impairment means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit–hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia; and Adversely affects a child’s educational performance.
    - - Asthma, Epilepsy, HIV and AIDS, Cancer, Sickle cell disease, and Diabetes.
- - - - These students often cannot make judgments about appropriate behaviors, and they become anxious and frustrated when they are not told exactly what to do.
    - - One characteristic of students with physical and health disabilities is poor self-esteem (
    - - Students with physical and health disabilities also frequently need interventions related to interacting with their peers
- - - - usually is diagnosed by a pediatrician or pediatric specialist using many different types of procedures