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(Cognitive Impairments, Speech-Language/Audiology, Physiological/Injury…

- - - - Incidence: The incidence for multiple disbailties is low. 2% of students recieving speacial services have multiple disabilities. (NCES, 2020)
  - - - High Incidence Rate
        
        1:23
        In the United States, 33% of 7.1 million students with special needs have specific learning disabilities
        (National Center for Education Statistics, 2020)
    - - A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations.
        (IDEA, 2018)
        
        Traits of Specific Learning Disabilities
        (American Psychiatric Association, 2018)
        
        Difficulty with mathematical reasoning
        e.g. applying math concepts or solving math problems)
        
        Difficulty understanding the meaning of what is read
        
        Difficulty understanding number concepts, number facts or calculation
        
        Difficulty with written expression
        (e.g. problems with grammar, punctuation or organization)
        
        Difficulty with spelling
        
        Difficulty reading
        (e.g. inaccurate, slow and only much effort)
        
        Student Struggles
        (Stanberry & Rashkind, 2009)
        
        The inability to process specific information often leads to lack of attention, confusion and inability to digest content and reading below grade levels
        
        Social skills deficit
        
        Struggles in specific subjects
        
        Types of Learning Disabilities
        (IDEA, n.d.)
        
        Dyslexia
        Difficulty reading, spelling and writing
        https://www.youtube.com/watch?v=kE3DqJP-nkI#action=share
        
        Dysgraphia
        Difficulty putting one's thoughts on to paper
        Problems with writing can include: spelling, grammar, punctuation and handwriting
        
        Dyscalculia
        Difficulties learning number related concepts or using symbols and functions to perform math calculations
        Problems include difficulties with number sense, memorising math facts, math calculations, math reasoning and math problem solving
        
        Non-Verbal Learning Disabilities
        Difficulties interpreting nonverbal cues like facial expressions or body language and may have poor coordination
        
        Oral/Written Language Disorder and Specific Reading Comprehension Deficit
        Difficulties that affect an individual's understanding of what they read or of spoken language.
        The ability to express one's self with oral language may also be impacted
        
        Severity
        (American Psychiatric Association, 2018)
        
        Mild
        Some difficulties with learning in one or two academic areas, but may be able to compensate
        
        Moderate
        Significant difficulties with learning, requiring some specialized teaching and some accomodations or supportive services
        
        Severe
        Severe difficulties with learning, affecting several academic areas and requiring ongoing intensive specialized teaching
    - - Text-to-speech software
        Such as WordTalk or TextHelp for proofreading
        
        Helps with
        
        Reading reports, texts, single words
        
        Needing to re-read sentences for meaning
        
        Has difficulty remembering new words
        
        Has difficulty following instructions
        
        Poor attention and concentration
        
        Low self esteem
        
        For students with Dyslexia, it will help them overcome their reading and writing difficulties
        
        For students with ADHD, although the cause of the problem being attention and concentration rather than phonological awareness, it will still be useful
        
        For students with Dyscalculia, it will be useful when the math problems are presented in words rather than symbols
      - Memory related software
        
        Helps with
        
        Difficulty remembering deadlines and new words
        
        Difficulty following instructions
        
        Difficulty following instructions
      - Speech-to-text
        Such as Ghotit or Grammarly to help with spelling and grammar
        
        Helps with
        
        Difficulty with written work
        
        Takes longer than average to do written work
        
        Poor spelling
        
        Difficulty reading on their own
        
        Poor handwriting
        
        Poor attention and concentration
      - Concept maps (mind maps)
        bridges the gap between ideas in their brain and the written form
        
        Helps with
        
        Difficulty in remembering long text
        
        Has problems explaining ideas and concepts
        
        Has difficulty following instruction
        
        Finds it hard to organise themselves
        
        How to Make a Mind Map
        https://www.youtube.com/watch?v=wLWV0XN7K1g
      - Talking Calculators
        Auditory feedback allows a student to check the accuracy of the keys before he presses it and verify the answer before he transfers it to paper
    - - Allow students to have access to notes before hand
      - Break down larger tasks
      - Graphic Organizers
        Graphic organizers help students break down math problems into smaller steps.
        Click here for some examples
      - Modified examination conditions (American Psychiatric Association, 2018)
        
        Additional time on tests and assignments that require writing
        
        Using computers for typing rather than writing by hand
  - - - Autism Spectrum Disorder is an umbrella term for a developmental disorder characterized by difficulties in social interaction and communication, repetitive behaviors and a restricted behavioral range. (DSM-V, 2013)
        
        Practical translation: ASD is characterized by behavioral excess (too much) and behavioral deficit (not enough) as well as irregular reactions to sensory input (sight/sound/smell)
        
        Behavior Excesses
        (Autism Speaks, 2020)
        
        Repetitive actions or obsessive-compulsive behaviors ie filling a cup with water, dumping it out, repeat; lining things up into rows, knocking over, repeat.
        
        topic perseveration - colloquially defined as "obsession." interest in/talking about very narrow topic sets ie Blimps, Godzilla or the Angler Fish.
        
        Echolalia - repeating words or language in place of socially appropriate responses
        
        Sensory Stereotypy - self-stimulation; "ticking" or hand flapping
        
        Insistence on routine/sameness
        
        Preference for Being Alone - Overall lack of interest in social interaction
        
        Behavioral Deficits (Autism Speaks, 2020)
        
        Language Development An estimated 33% are non-verbal. Speech delays or a lack of language in early years are a common sign of eary detection
        
        Eye contact and other social communication signals-- responding when name is called, lack of response to verbal requests, lack of imitation skills, flat facial expressions
        
        Socialising/Play lack of interest in other children/playing; indifference to distress/pain in others; lack of play skills;lack of pretend play
        
        Reciprocal Communication - expressing needs, carrying out reciprocal conversations
        
        Acceptance of Variety - rigid insistence on routine/sameness
      - Can it be cured?
        
        No. But with early intervention there is strong chance that independent living skills can be taught to enable ASD clients to live independently with dignity.
    - - Boys1 in 34
      - Girls 1 in 144
    - - Communication Assistants
        An estimated 33% of the autistic population are non-verbal. Language delays and deficits commonly co-occur with ASD
        
        Picture Exchange Communication System (PECS)
        Catalgue of visuals representing different activities, things, feelings and more. Commonly used intervention.
        
        Speech Generating Devices (SPGs) SPGs cover a variety of devices and software that create speech from either written inputs or icons
        
        Alternative and Augmentative Communication (AAC) systemshttps://youtu.be/r3m8_YmTDDM
      - Note Taking Apps/Software Transcription is a significant challenge. Apps like Evernote, OneNote, Sonocent can make note taking and retrieval easier.
      - Personal computing devices -laptops/ipads
    - - Paraprofessional/specialist presence - ABA therapists or shadow teachers; social-skills training/groups; Speech and Language Therapy; Functional Behavioral Analysis for problem behaviors; Behavior Plans
      - Priority Seating Typically at the front of class
      - Task Modification/Differentiated Instruction Decrease/increase task scope/depth/modality to accommodate to learning style/capability. Generally outlined in IEP.
      - Sensory Tools Noise cancelling headphones, fidgets, calming zones, Quiet corners, etc.
      - Extended Break Times/ Movement Breaks More frequent break periods and/or for longer duration.
  - - - According to the National Institute of Neurological Disorders (NINDS) and Stroke (2019), a traumatic brain injury (TBI) is defined as a brain injury that occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain.
      - A traumatic brain injury can be mild, moderate, or severe (NINDS, 2019). An individual with a mild TBI will remain conscious may experience a loss of consciousness for a few seconds or minutes. Moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation.
    - - According to the CDC (2010), An estimated 1.7 million TBIs occur
        in the United States annually.
        https://www.cdc.gov/traumaticbraininjury/pdf/blue_book.pdf
        
        Children between the ages of 0-4 are more susceptible to having a TBI
        https://www.youtube.com/watch?v=Rt2NAn8oMMo
    - - Collaboration:
        According to Julie Bowen (2018), regardless of the severity of the injury and length of rehabilitation services, advance communication and coordination between the hospital, therapists, family, and the school system is a critical first step in student’s returning to school. The goal of this communication should be to gather medical and functional information to assist the school in developing an appropriate and individualized plan for the student’s reentry into school
      - Assessments:
        
        Functional Behavioral Assessment (FBA) to examine, measure, and treat many deficits associated with TBI, particularly behavioral changes related to increased impulsiveness, inappropriate emotional outbursts, aggression, and inattention.
        
        An ABC (Antecendent-Behavior-Consequence) assessment is one simple means of conducting an FBA. In conducting an ABC Assessment, assessors record the events that occur immediately before and after the unwanted behavior (antecedents and consequences). They collect information such as time of day, with whom the behavior occurs, specific places, other events, and rate and type of reinforcers are collected to help select an appropriate replacement behavior and an effective intervention plan.
        (Bowen, 2018)
      - Typical Classroom Accommodations:
        -Assistive devices can include technical equipment and materials such as tape recorders, calculators, electronic spellers, computers or word processors, augmentative communication devices, timers, alarms, and beepers
        -Mobility equipment (e.g., wheelchair, walker, electric scooter).
        -Other external cues used to remind students include labels, maps checklists, pictures or icons, photograph cues, post-it-notes, calendars, planners, and journals.
      - How to help students in the school.https://www.youtube.com/watch?v=z0s3y-LO-YY
  - - - Characterized By:
        
        • significant limitations in intellectual functioning (e.g., reasoning, learning and problem solving)
        • significant limitations in adaptive behaviour (e.g., conceptual, social and practical skills in everyday life)
        • onset in childhood (before the age of 18 years)
        (American Speech-Language-Hearing Association, 2020)
      - Conditions and Health Problems that Occur with Intellectual Disability (American Speech-Language-Hearing Association, 2020)
        
        Conditions that commonly co-occur or are fully comorbid with Intellectual Disability include:
        • Autism spectrum disorder
        • Speech and language disorders
        • Cerebral palsy
        • Down syndrome
        • Fetal alcohol syndrome
        • Fragile x syndrome
        • Anxiety or mood disorders
        • Schizophrenia
        • Attention-deficit/hyperactivity disorder
        • Impulse-control disorder
        
        Health problems associated with individuals with intellectual disability include:
        • hearing loss
        • heart conditions
        • obesity-related problems
        • seizure activity
        • visual impairment
    - - Approximately 6.5 million people in the United States and 69,000 Canadians have an intellectual disability. The total global population that have an intellectual disability is 1-3% or 200 million people. It is significantly more common in low-income countries where 16.41 in every 1,000 people have an intellectual disability (Special Olympic, n.d.; Special Olympics British Columbia, 2020).
    - - In the classroom
        
        Video of the Effective Ways to Teach Students with Intellectual Disability to Read
        https://www.youtube.com/watch?v=ePdeV6v5FHg
        
        List of the Best Strategies for Your Classroom:
        (Texas Council for Developmental Disabilities, 2013; Children’s Resource Group, 2019; Rea-Keywood & Brill, 2018)
        
        • If possible, teach students in small groups or 1:1
        
        • Stick to a routine
        
        • Reward students when they learn a new skill
        
        • Teach one concept or activity component at a time
        
        • Teach one step at a time to help support memorization and sequencing
        
        • Always provide multiple opportunities to practice skills in a number of different settings
        
        • Use physical and verbal prompting to guide correct responses and provide specific verbal praise to reinforce these responses
        
        • Use repetition and reinforcement to learn new skills
        
        • Use visual supports (e.g., picture cues)
        
        • Use a visual schedule
        
        • Label activity learning stations/areas, supply tables and cabinets
        
        • Display step-by-step directions on equipment
        
        • Always allow for more time when in transition from one activity to another or one place to another
        
        • If possible, decrease the amount of transitions
        
        • Model new skills for the students
      - Check out this list of strategies to be used with individuals with an intellectual disability in the home, at school and in the community:
        https://do2learn.com/disabilities/CharacteristicsAndStrategies/IntellectualDisability_Strategies.html
      - Interventions
        
        Communication Intervention
        
        Speech-language pathologists (SLPs) ensure that intervention provides plenty of opportunities for communication and incorporates a variety of language functions (e.g., greeting, requesting) and varied communication contexts (e.g., home, educational and community settings) (American Speech-Language-Hearing Association, 2020).
      - Assistive Technology
        (Special Education, 2019)
        
        Text-to speech software helps individuals who have difficulties reading standard print.
        
        Intel reader is a mobile handheld device that has a camera that captures printed text and coverts it to text-to-speech software.
        
        Kurzweil 3000 is software that helps individuals that struggle with writing. It has a talking spell-checker, picture dictionary graphics, text magnification and more.
        
        Personal FM Systems are used for individuals with hearing impairment in noisy environments (e.g., school)
        
        Sound-field Systems are great for the classroom to help assist listening for all children. It uses a microphone that projects sound through mounted speakers around the classroom.
- - - - Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance. (IDEA, 2018)
        
        Types of Speech and Language Impairments
        (Project IDEAL, nd)
        
        Three basic types of speech impairments
        
        articulation disorders
        
        Articulation disorders are errors in the production of speech sounds that may be related to anatomical or physiological limitations in the skeletal, muscular, or neuromuscular support for speech production.
        
        Omissions
        
        Substitutions
        
        Distortions
        
        fluency disorders
        
        Fluency disorders are difficulties with the rhythm and timing of speech characterized by hesitations, repetitions, or prolongations of sounds, syllables, words, or phrases.
        
        Stuttering
        
        Cluttering
        
        voice disorders
        
        Voice disorders are problems with the quality or use of one's voice resulting from disorders in the larynx.
        
        Quality
        
        Pitch
        
        Resonance
        
        Loudness
        
        Duration
        
        Five basic areas of language impairments: phonological disorders, morphological disorders, semantic disorders, syntactical deficits, and pragmatic difficulties.
        
        phonological disorders
        
        Phonological disorders are defined as the abnormal organization of the phonological system, or a significant deficit in speech production or perception
        
        morphological disorders
        
        Morphological disorders are defined as difficulties with morphological inflections (inflections on nouns, verbs, and adjectives that signal different kinds of meanings).
        
        semantic disorders
        
        Semantic disorders are characterized by poor vocabulary development, inappropriate use of word meanings, and/or inability to comprehend word meanings.
        
        syntactical deficits
        
        Syntactic deficits are characterized by difficulty in acquiring the rules that govern word order and others aspects of grammar such as subject-verb agreement.
        
        pragmatic difficulties
        
        Pragmatic difficulties are characterized as problems in understanding and using language in different social contexts.
    - - USA: Speech and language impairments are considered a high-incidence disability. Approximately 20% of children receiving special education services are receiving services for speech and language disorders. This estimate does not include children who receive services for speech and language disorders that are secondary to other conditions such as deafness. More than one-half (55.2%) of all 3-, 4-, and 5-year olds with a disability receive speech and language services. (Project IDEAL, nd)
    - - In the Classroom
        (ASHA, 2005)
        
        Speech Pathologists
        (ASHA, 2005)
        
        language enhancements
        
        memory retraining
        
        cognitive reogranization
        
        improving abstract thinking
        
        General Education Teachers
        (Project IDEAL, 2019)
        
        corrective measures
        
        helping with speech and active listening activities
        
        providing immediate feedback when Speech Pathologist is not available
        
        give appropriate time to think and respond
        
        Be conscious of own communication styles
        
        Help students express their own needs & build self-esteem
      - At Home
        
        https://www.youtube.com/watch?v=PNcRMgqgE9M
  - - - An impairment in hearing, whether permanent or fluctuating that adversely affects a child's educational performance, that that is not included under the definition of deafness
        (US Department of Education, IDEA, 2006)
        
        Types of Hearing Impairment, or Loss
        
        There are 4 major types of Hearing Impairment, or Hearing Loss
        (Texas Coucil for Developmental Disabilities, 2013)
        
        Conductive Hearing Loss - caused by damage or obstruction in the external or middle ear
        
        Sensorineural Hearing Loss - Caused by damage to the inner ear, or auditory nerve that transmits impulses to the brain
        
        Mixed Hearing Loss - Combination of Conductive and Sensorineural Hearing Loss
        
        Central Hearing Disorders - Caused by "dysfunction in the central auditory system between the brain stem and the auditory cortex in the brain"
        
        (Discover, 2020)
    - - In the United States
        
        2 or 3 out of every 1,000 children in the US are born with a detectable level of hearing loss in one, or both ears
        1 in 8 people in the US, aged 12 years or older has hearing loss in both ears, based on standard hearing examinations
        (in total, about 13% or 30 million)
      - World Wide
        
        "Around 466 million people worldwide have disabling hearing loss" - 34 million individuals from this group are children
        By 2050 it is likely that 900 million people will have disabling hearing loss
        "Current estimates suggest an 83% gap in hearing aid need and use" in other words, "only 17% of those who could benefit from use of a hearing aid have access to, and use one
        (WHO, 2020)
    - - [10 Tips for Teachers of Students with Hearing Loss](https://youtu.be/z2EfxREKmsA
      - Video
        [Providing Services and Accommodations for Deaf and Hard of Hearing Students in a Mainstream Setting](https://youtu.be/NSHRQRsvFYs)
      - Types of Assistive Technology Includes:
        Hearing Aids and Auditory Training Devices - such as FM systems and Hearing Aids
        Alerting Devices (set with lights and vibrations instead of sound) - such as watches, doorbells, fire alarms, school bells, and alarm clocks
        Closed Captioning on television, film, videos, and prerecorded teacher presentations
        Telecommunication Devices - such TDDs (small keyboard display and modem, used on telephones) and text or instant messaging
        Some surgeries or operations - such as Cochlear Implants
        (Project IDEAl, Texas Council for Developmental Disabilities, 2013)
        
        Other ways to Assist
        (Laurent Clerc National Deaf Education Center, Gallaudet University, 2015)
        
        In the School:
        Incorporate Auditory and Visual support throughout the school
        Work effectively with sign language interpreters
        Offer sign language courses for all students
        Include deaf and hard of hearing adults in school wide programs
        Encourage deaf and hard of hearing students to participate in extracurriculars
        
        video
        Examples of Baby Sign Language
        (Pathways, 2016)(https://youtu.be/6UrcyZ-QeiU)
        
        In the Classroom:
        Learn about the student's family and background
        Learn what works in communicating effectively with each hearing impaired student
        Create visual supports: graphics, charts, hands-on demonstrations, power point presentations
        Allow for time to view pictures or read instructions
        Come up with a way to identify who is speaking throughout the class
        Repeat or paraphrase information and instructions for clarity
        Create accessible materials as appropriate for students' skill levels as indicated on their Individualized Education Program (IED)
        Maintain the same high expectations for deaf and hearing impaired students as you have for their hearing classmates
  - - - Official Definition: "Deaf-blindness means concomitant hearing and visual impairments, the combination of which causes such severe communication and other developmental and educational needs that they cannot be accommodated in special education program solely for children with deafness or children with blindness" (IDEA, 2018)
      - Deaf-blindness is a condition where there is both hearing and vision loss, which affects how the individual accesses auditory and visual information. The range of sensory impairment varies with each individual. However, many children who are diagnosed as deaf-blind have enough vision to move around their environments, and sufficient hearing to recognize some speech.
    - - World Statistics (World Federation of the Deafblind, 2018)
        
        0.2% of the world is has severe deaf-blindness to 2% of the world has a milder form of deaf-blindness
        
        40% of people with deaf-blindness have a low socio-economic status
        
        Children with deafblindness are 17 times less likely to be in school than non-disabled children. They are also twice less likely to be in school compared to children with other types of disabilities.
      - USA (National Center on Deaf-Blindness, 2018)
        
        In 2018, there was a national count of 9,904 children with deafblindness
        
        Top 3 by Race/Ethnicity 53.2% White 19.7% Hispanic 14.3% African-American
    - - Computer Adaptations
        
        Braille Translation Software & Printer: Converts Braille, into print, and embosses Braille on paper
        
        Screen Reader: Converts text to an audible speech
        
        Screen Enlargement: Increase the size of the text and images on a screen
      - Adaptive Devices
        
        Braille Notetaker: An electronic notetaking device that can be connected to a printer
        
        Optical Character Reader: Converts texts into audible speech or Braille
        
        Electronic Braillewriter: Produce and translates Braille
      - Telecommunication Devices
        
        Telecommunication Device for the Deaf (TDD): Phone that includes a Braille output. It has a small keyboard, and the user must relay information to an operator.
        
        Text Messages
    - - Communication Systems
        
        Verbal Methods: Use of words, spoken or not spoken, using a standard vocabulary or structure
        
        Lip Reading
        
        Tadoma: Tactual form of lip-reading
        
        https://youtu.be/U_QMS-hzRMs
        
        Sign Language
        
        Print
        
        Maginification
        
        On the palm - Communicator writes letters in the palm of the receiver
        
        Braille: A reading/writing system for the blind, composed of raised dots
        
        Non-Verbal Methods: Communication without words
        
        Body Language & Signals: Using body movement to communicate feelings, ideas and responses.
        
        Smiling
        
        Tensing muscles or grimacing to indicate discomfort
        
        Gestures like shaking your head for "no"
        
        Vocalizations: Use of the voice without words or formal language
        
        Cries, laughs, or screams
        
        Imitating sounds
        
        Pictures
        
        Printed
        
        Drawn
        
        Photographed
        
        Objects
        
        Using a toy or tool
        
        Touch Cues: Helping a child anticipate what is going to happen
        
        Gently lifting or tapping a child's arm
        
        Pro-Tactile ASL: Combination of Sign Language and Tactile (Quartz, 2016)
        
        https://www.youtube.com/watch?v=9GrK3P15TYU
      - Orientation & Mobility
        
        Physical and occupational therapists
        
        Vision teachers
        
        Health Professionals
        
        Orientation & Mobility specialists
  - - - Deafness means a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance. This does not include students who are hard of hearing, as they would be categorized in "hearing impairment."
        
        According to Friend and Bursack (2012), Deafness is considered a low incidence disability since less than 20% of all students are deaf.
    - - Providing Services and Accommodations for Deaf Students
        https://youtu.be/NSHRQRsvFYs
    - - Devices to enhance listening
        
        FM Loop Systems
        Sound is transmitted directly from a microphone that a speaker is wearing via an FM frequency. This way, the incoming volume is constant regardless of the distance from the speaker.
        Infrared and Audio Induction Loop Systems
        An infrared system uses invisible light beams to carry sound from the speaker to a personal receiver. These are not as common as they are better for large spaces
        Coupling Accessories
        These are accessories that can connect to media devices such as tablets, phones, or computers. There are cables that connect directly from a hearing aid or implant that connect directly to the media device, or some that are wireless.
        
        Devices to Convey Visual Information
        
        Visual Alerting Devices
        Specially designed alarm clocks, smoke detectors, doorbells, timers, and more are available to provide typically audible information in visual or vibratory ways.
        Captioning
        Captions are important for those that are deaf to have access to the media. The logo "CC" is usually provided to show that whatever is being watched has closed captions so that anyone hard of hearing can read what is being said.
        Real-Time Transcription
        There are real-time transcription systems that provide instant translation of the spoken word into English text using a stenotype machine, notebook computer, and real-time software.
        Telecommunication
        Texting, video chat, and captioned telephones
- - - - Visual Impairments is a decreased ability to see to a degree that causes problems not fixable by usual means, such as glasse
    - - The National Dissemination Center for Children with Disabilities reports that the rate of occurrence for visual impairments in individuals under the age of 18 is at the rate of 12.2 per 1,000.
    - - a specially trained teacher must determine that the visual impairment impacts the child’s ability to learn, and this professional determination, with the agreement of the IEP team ensures access to special education services.
        
        Low Vision
        
        Students can use their own vision to see
        
        Totally Blind
        
        students use tactile and auditory channels for learning and functional tasks
        
        Functionally Blind
        
        students can use limited vision for functional tasks but need their tactile and auditory channels for learning
    - - Computer adaptations
        
        Keyboards with large print, keyboards with large keys, screen magnifiers, braille computing equipment, screen reader software, text to speech software, notetakers can be used to help students with visual impairments.
      - Adaptive devices
        
        As computers have evolved almost all adaptive devices are now linked to Computer Adaptions. One that is still old-school is large text textbook.
      - Optical devices
        
        Optical Devices
        https://www.youtube.com/watch?v=ua-dwcooA-k
      - Colleges Requirements are Different
        
        In contrast, universities are only required to offer REASONABLE accommodation and that is different for each university.
  - - - "Orthopedic impairment is defined as a severe orthopedic 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)" (Ohio Department of Education, 2017)
        
        Neuromotor Impairments
        
        These are abnormalities or damage to the brain, spinal cord, or nervous system. They have a higher incidence of cognitive impairments (Project IDEAL, N.d). The most common neuromotor impairments are cerebral palsy and spina bifida
        
        Musculoskeletal disorders
        
        These are diseases that affect motor development. They include muscular dystrophy.
        
        These two categories are usually not followed by cognitive deficiencies.
        
        Degenerative Diseases
        
        Broad category of conditions that can result in physical deficiencies, including arthritis.
    - - In the United States
        
        1.1% of students requiring special education services in 2003-2004 received support based on orthapedic impairments.
        That is 68,188 students in total. (Project IDEAL, N.d).
      - Low incidence (Northern Arizona University, 2000)
    - - Often times, students with orthopedic impairments do not have no cognitive impairments, with the exception of neuromotor impairments which have higher incidents of cognitive impairments (Project IDEAL, N.d). Assistive Technology varies widely for individual students needs but general falls under two categories: Devices to Access Information and Devices for Positioning and Mobility (Project IDEAL, N.d).
        
        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 Position and Mobility. These are used to help the students move and participate in educational classroom activities
        
        canes
        
        walkers
        
        crutches
        
        wheelchairs
        
        specialized exercise equipment
        
        specialized chairs, desks, and tables for proper posture development
      - Other Strategies
        
        Occupational Therapy
        
        https://www.youtube.com/watch?v=WJs7dge75uM
        
        Occupational therapy can help students with orthopedic impairments build the physical skills required to participate in the classroom
        
        In the Classroom
        There are strategies teachers can use to accommodate those with orthopedic impairments in the class room.
        :check: special seating arrangements to increase comfort and ease
        :check: being aware of the student's medical condition and physical impacts
        :check: modifying tests or quizzes to fit the needs to students. For example, some students may respond better to oral questions
        :check: creating an accommodating physical environment
        (Project IDEAL, 2017) (Colclasure, LaRose, Thoron, 2016)
  - - - According to IDEA (2018), "Other Health Impairments" means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the education environment. These include, but are not limited to, chronic health problems like asthma, ADD, ADHD, diabetes, epilepsy, heart conditions, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrom.
        
        There are many different subtypes to these diseases, such as ADHD (Predominantly inattentive, predominantly hyperactive-impulsive, and combined). Depending on the type of disease and what the sub-type is, there could be different types of academic disruption that require different academic accommodations.
    - - According to the National Center for Education Statistics, "Other Health Impairments" is the third most prevelent disability behind "Specific Learning Disability" and "Speech or Language Impairment." This data is from 2017-2018 It is classified as high incidence (NCES, 2019)
    - - Adapt the school environment. Create accessible architecture per the ADA guidelines
        
        Computers and tablets that aid in typing rather than speaking.
        
        Talk to text software
        
        Specially designed desks
        
        Positioning devices
        
        Standing Tables
        
        Notebooks with dividers
        
        Special software
        
        (NASET, 2008)
        
        Due to the vast differences in these disabilities, it's the individual student that determines the needs for different kinds of assistive technology. Some just need low tech (notebooks, dividers, planners) that help with organization and time management. Other students will need special computer software or desks. (Project Ideal, 2013)
      - Tips for the Classroom
        
        It is important that modifications be no more restrictive than absolutely necessary. Students with disabilities need to be challenged at the same level as their able-bodied peers.
        
        Make sure the parents are always in communication with any adaptations in the classroom.
        
        Teachers are not expected to be experts in all health conditions. Consult professions, guidance counselors, and others when necessary to create a plan for any student who needs it.
        
        Modify tests or quizzes to give students extra time, or allow them a different medium that suits them physically. (An oral exam rather than written, for example.)
        
        Interdisciplinary services such as occupational and physical therapy and speech and language therapy are of prime importance for younger students who have physical disabilities.