Other Health Impairments
Chapter 11 Objectives
At the end of this presentation, you should be able to:
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Describe characteristics of other health impairments.
Understand causes of other health impairments.
Describe evaluation processes for students with other health impairments.
Reflect on the importance of inclusion for students with other health
impairments.
Understand the curricular and instructional needs.
Chapter Objectives
Other Health Impairments
Understanding Individual
Students
Who Is Kyle Edwards?
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Kyle is a 10-year-old boy with sickle cell disease.
His condition resulted in 10 hospitalizations in his
last school year.
Kyle understands what is necessary to do in order
to care for his condition.
He has developed friendships with other children
with health impairments from his times in the
hospital.
Because he also has an adult aunt with sickle cell
and has watched her studying to be a teacher, he
is determined to stay in school and succeed.
Through teachers involved in a program at the
hospital he uses for hospitalizations, he is working
to stay on track with his class.
Chapter Objectives
Defining Other Health
Impairments
How Do You Recognize Students
with Other Health Impairments?
How Do You Recognize Students with Other Health Impairments?
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IDEA defines as chronic health problems that have an adverse impact on educational
performance.
– Limited strength, vitality or alertness
– Heightened alertness to environmental stimuli
Distinguished from severe and multiple disabilities, physical disabilities, and traumatic
brain injuries
May be:
– Chronic: develops slowly and has long-lasting symptoms
– Acute: develops quickly with intense symptoms that last a relatively short period of
time
More than 200 specific health impairments exist.
This chapter focuses on more typical conditions.
Describe characteristics of other health impairments.
Challenges Facing Children with Health Impairments
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Loss of sense of control
Lack of understanding about the condition
Fear, worry, anxiety/stress, anger, guilt
Change in family dynamics
Experience of loss because of how life has changed
Isolation
Medical noncompliance
Depression, withdrawal
STARBRIGHT Foundation
Challenges Facing Children with Health Impairments
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Boredom
Loss of peer interactions
Pain
Decreased self-esteem
Lack of feelings of normalcy
Negative body image
Impact on identity and social interactions, including those at school
STARBRIGHT Foundation
Describing the Characteristics of
Sickle Cell Disease
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How Do You Recognize Students
with Other Health Impairments?
Sickle cell disease
– The most common inherited blood condition, affecting about 80,000
Americans
– About 1 in 500 African Americans and 1 in 1,000-4,000 Hispanic
Americans are born with the condition
– Symptoms include hand-foot syndrome, pain, nosebleeds, and anemia
– Affects the hemoglobin (red blood cells), causing them to be sickleshaped rather than rounded
– Teachers can help students by:
• Avoiding stressors (heat, cold, poor diet, inadequate liquids)
• Observing students for symptoms of pain and consider the emotional aspects
of dealing with pain
Describe characteristics of other health impairments.
Describing the
Characteristics of Epilepsy
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How Do You Recognize Students
with Other Health Impairments?
Epilepsy
– Characterized by seizures (abnormal electrical discharges in the brain)
– (see Figure 11-1 on page 316 in text)
• Generalized seizures
– Tonic-clonic
– Absence
• Partial seizures
– Temporal lobe, also known as psychomotor
– Focal motor or focal sensory
– Myoclonic
– Teachers can help by:
• Identifying and eliminating environmental factors that trigger seizures
• Provide classmates with factual information on seizures
http://www.epilepsy.com/epilepsy/seizure_tonicclonic.html
Describe characteristics of other health impairments.
Describing the
Characteristics of Asthma
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How Do You Recognize Students
with Other Health Impairments?
Asthma
– A disease process that is characterized by narrowing of the bronchi (lung
passageways) making breathing difficult
– Most prevalent chronic illness of children and leading causes of school absences
– Prevalence has become epidemic, increasing by 72% from 1982 to 1994
– Symptoms can vary widely
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Mild intermittent
Mild persistent
Moderate persistent
Severe persistent
– Students may use anti-inflammatories or bronchodilators
– Teachers can help by:
• Following students’ leads about exercise regimens
• Know essential first-aid skills for managing asthma episodes
• Follow a student’s action plan for episodes
Describe characteristics of other health impairments.
Describing the
Characteristics of Cancer
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How Do You Recognize Students
with Other Health Impairments?
Cancer
– Unrestrained growth of cells in body organs or tissues
– Cancer is the primary cause of death in children under age 15.
– More than half have leukemia or brain tumors.
– Possible treatments include:
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Chemotherapy
Radiation
Surgery
A combination of the above
– Side effects from treatments may result in learning disabilities.
– Teachers can help by:
• Including students in activities with their peers as much as possible
• Creating a secure environment where the child can succeed, but does not feel as if
he/she is being treated differently
Describe characteristics of other health impairments.
Describing the
Characteristics of Diabetes
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How Do You Recognize Students
with Other Health Impairments?
Diabetes
– About two out of every 1,000 people under the age of 20 have diabetes
– Occurs when the pancreas stops producing or produces too little insulin
– Symptoms include:
• Increased thirst and urination
• Weight loss
– Two serious conditions can result:
• Hyperglycemia (too much sugar) resulting in ketoacidosis
• Hypoglycemia (too little sugar) resulting in insulin shock
– Teachers can help by:
• Monitoring for symptoms of hyper- or hypoglycemia
• Knowing the necessary first aid processes
• Allowing students to find methods of monitoring blood sugar that is as unobtrusive as
possible
Describe characteristics of other health impairments.
Describing the
Characteristics of HIV
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How Do You Recognize Students
with Other Health Impairments?
Human immunodeficiency virus (HIV)
– A retrovirus that causes AIDS
– HIV gradually infects and destroys T4 and other immune cells
– Causes a person with HIV to be more susceptible to opportunistic infections
– HIV is spread through certain body fluids
– In the final stages, HIV progresses to acquired immunodeficiency disease (AIDS)
– African Americans have the highest risk of HIV transmission; 64% of adolescent
AIDS cases in 2000 were African American
– Teachers face three issues:
• Confidentiality
• Preventing transmission (universal precautions)
• Understanding how the condition affects learning and behavior
Describe characteristics of other health impairments.
Identifying the Causes and
Prevalence
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How Do You Recognize Students
with Other Health Impairments?
Causes
– Infections
– Genetic factors
– Environmental factors
– Prenatal and perinatal influences
– Postnatal influences
Prevalence
– In 1999-2000, school served 197,761 students as other health impaired
(about 0.54% of the school-age population)
– There has been a 351% increase since 1990-91, primarily due to the
inclusion of students with AD/HD in this category
Understand the causes of other health impairments.
Determining the Presence
How Do You Evaluate Students with
Other Health Impairments?
Figure 11-4
Describe evaluation processes for students with other health impairments.
Determining the Nature and
Extent of Services
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How Do You Evaluate Students with
Other Health Impairments?
Students whose health condition adversely impacts their educational
performance are entitled to an IEP.
If there is no adverse impact, they may still be entitled to a 504 plan for health
services and any needed accommodations.
The school nurse is an important member in the planning of either document.
Students should also have health care plans, specifying procedures for
medications or treatments, making up work missed during absences, and
plans for medical emergencies.
Related services may also include school health care services.
– These must be able to be administered by the nurse or other trained
school personnel.
IEP’s may also contain respite care for family members.
Describe evaluation processes for students with other health impairments.
How Do You Assure Progress in
the General Curriculum?
Including Students
Figure 11-5
Reflect on the importance of inclusion for students with other health impairments.
Planning Universally
Designed Learning
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How Do You Assure Progress in
the General Curriculum?
Adapting instruction
– Teachers should ask three questions:
• What are the most important academic standards the student needs to meet?
• How can I ensure the student attains those standards efficiently?
• How can I motivate the student to attain those standards?
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Adapting evaluation
– Frequent student absences require teachers to determine an efficient way
of determining if the student has mastered the essential standards.
• Reducing the work needed on assignments or tests
• Alternative assessments, such as portfolios or journaling, which may also
leave a legacy for the student
Understand the curricular and instructional needs.
Collaborating to Meet
Students’ Needs
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How Do You Assure Progress in
The General Curriculum?
Students may need ongoing support from educators and others in order to
cope.
Teachers need preparation in the event of a student’s death.
– Teachers face their own grief, and must also help families and other
students
– Teachers need to be able to seek additional support from others
– Students may also lose friends they have made in the course of their
illnesses
Understand the curricular and instructional needs.
What Can You Learn from Others
Who Teach Students with Other
Health Impairments?
Early Childhood
What Can You Learn from Others Who Teach Students with Other
Health Impairments?
The Early Childhood Years
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Kids on the Block
Shares stories of children with health impairments through puppet shows
Children can ask puppets questions after the presentation, and the puppets
answer them.
There is an additional curriculum about sensitivity to differences with the
scripts.
The shows discuss the different terms that are more appropriate to use in
discussing health impairments.
Understand students with other health impairments.
What Can You Learn from Others
Who Teach Students with Other
Health Impairments?
Elementary
The Elementary Years
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Class Act
A school program available at the University of South Alabama’s Children’s
Hospital
Assignments are sent in from the students’ home schools and attendance at
Class Act counts as school attendance
Class Act employs both a teacher and a child life specialist
Goals are to prevent student retention and reduce stress, anxiety, and fear of
medical procedures
Understand students with other health impairments.
What Can You Learn from Others
Who Teach Students with Other
Health Impairments?
Middle/Secondary
The Middle/Secondary Years
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Meeting the Challenge
A program that encourages teens to express their feelings about having health
impairments
It teaches five levels of interpersonal skills
– Self-awareness
– Social imitation and conversational skills
– Assertion or direct communication
– Empathy or active listening
– Conflict resolution and problem solving
Helps students identify maladaptive reactions to situations specific to their
health impairment
Understand students with other health impairments.
Transitional and Post Secondary
What Can You Learn from Others
Who Teach Students with Other
Health Impairments?
The Transitional and Post-Secondary Years
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HIV University
Started as a support group among women with HIV who wanted to learn how
to live with their condition
Their school developed four programs that:
– Provided emotional support
– Eliminated barriers to participation (such as child care or language
barriers)
– Emphasized group problem solving
– Provided classes on topics relevant to living with HIV
Understand students with other health impairments.
Case Study Analysis
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Considering Kyle Edwards situation, design a plan to correspond with the
medical teaching staff.
If you were teaching Kyle in a medical facility, how could you meet Kyle’s
educational needs if information was not provided by the school?
Plan a meeting agenda to discuss Kyle’s progress and how he is doing in
comparison to his fourth-grade peers.
How can you as the classroom teacher ensure Kyle’s progress despite his
medical needs and his frequent absences
How is Kyle’s situation similar to students with other types of health
impairments?
How is he the same as his peers?
A Vision for Kyle’s Future
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Kyle’s grandmother hopes for a cure for
sickle cell.
She wants him to go to college and be a
doctor.
Kyle wants to be an athlete, or perhaps
an author of children’ books.
He also may consider becoming a doctor
so he can find a cure for sickle cell
himself.
Into Practice - Strategies for Kyle’s Transition to School
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Create a class unit about children with special needs.
Write movie reviews or TV reviews to send.
Send information about a new video or computer game, with secret codes.
Share comic books and follow up with a call.
Use e-mail to create buddy lists.
Create a website/chat room/info-board.
Make an audiotape or video.
Schedule phone calls, visits, special events.
Arrange for mail, [e-mail, and/or fax] deliveries every day, [including class
assignments].
Into Practice
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If Kyle Bessell were in your classroom next year, which of these strategies do
you think would be most helpful for meeting his needs?
Which strategies do you believe will be most challenging to implement for him
or other students? Why? How could you meet these challenges?
How could you incorporate some of these strategies to help students keep up
academically?