Transcript ORTHOPEDIC IMPAIRMENTS

ORTHOPEDIC
IMPAIRMENTS
TLSE 457-Section 1
Summer 2004
By Andy J. Arison & Kristen Barco-Kida
What is an orthopedic impairment?
Our textbook defines orthopedic
impairments as diseases or
disorders that are related to the
bones, joints, and/or muscles.
An orthopedic impairment is
covered under IDEA if it
adversely affects educational
performance.
A few of the orthopedic
impairments that we will discuss
today include:
Cerebral Palsy;
Muscular Dystrophy;
Spinal Cord Injuries;
and
Spina Bifida.
What is cerebral palsy?
Cerebral palsy is a physical impairment
that affects movement.
The four types of cerebral palsy are:
1) spastic;
2) athetoid or dyskinetic;
3) ataxic; and
4) any combination of the those above.
Presumed causes of cerebral palsy
Before birth:
Failure of a part of the brain to develop,
blocked blood vessel, complications during
labor, extreme prematurity, multiple births,
STDs, poor nutrition, effects of anesthetics or
analgesics
Early childhood:
Head injury, near drowning, poison ingestion,
illness/infection, genetics
Prevalence/Incidence Rates
It affects 1 in every 400 births.
It is estimated that 500,000 people in the
United States currently have cerebral
palsy.
It is the most common orthopedic
impairment among students in public
schools.
How can cerebral palsy be
diagnosed?
Test an infant’s motor skills.
Examine the mother’s and infant’s medical
histories.
Test the infant’s reflexes and early
development of hand preference.
Look for signs of slow development,
abnormal muscle tone, and unusual
posture.
What are some characteristics of
students with cerebral palsy?
Difficulty with fine motor tasks,
maintaining balance, and chewing and
swallowing
Involuntary movements
Abnormal reflexes
Weak or tight muscles
Poor coordination
Speech difficulties
What is muscular dystrophy & what
causes it?
Muscular dystrophy is a disease that weakens
the muscles.
There are 43 types of muscular dystrophy, most
of which are caused by alterations in specific
genes.
The most common type is Duchenne muscular
dystrophy, and it only affects boys.
It is a genetic disease passed from mother to
son or it can arise in a young boy due to a
spontaneous genetic mutation.
Prevalence/Incidence Rates
In the United States, it is
estimated that between 50250,000 people are
affected each year.
That number is on the rise
due to technological
advancements and earlier
testing.
How can muscular dystrophy be
diagnosed?
Muscular dystrophy can be
diagnosed through an
EMG (electromyogram),
blood test, and/or a muscle
biopsy.
If a blood test is performed
and it reveals high levels of
creatine kinase, this
indicates that the muscles
are damaged.
What are some characteristics of
students with muscular dystrophy?
Between two and six years of age:
Frequent falling;
Difficulty getting up from sitting or lying position;
Waddling gait; and
Fattening of the leg muscles.
Later on in life:
Wheelchair by age 12; and
By the late teens or early 20s, respiratory and
cardiovascular problems develop and ultimately result
in death.
What is spinal cord injury?
 Spinal cord injuries occur when a
traumatic event results in damage to cells
within the spinal cord or severs the nerves
that relay signals up and down the spinal
cord. It causes paralysis, loss of
sensation, and loss of reflex function.
 Spinal cord injuries occur suddenly and
without warning.
 The four types of spinal cord injuries are:
1) compression;
2) contusion;
3) lacerations; and
4) central cord syndrome.
 Terms for the types of paralysis:
1) paraplegia; and
2) quadraplegia.
What causes spinal cord injury?
Traumatic injury:
Car accidents;
Falls;
Diving accidents;
Shotgun wounds;
Horse, motorcycle, sporting
event-related; and
Various other types.
Alcohol plays a significant role
in many of these.
Prevalence/Incidence Rates
In the United States, there are approximately
10,000 new spinal cord injuries each year.
There are over 250,000 people currently
affected.
Spinal cord injuries can happen to anyone at
any time of life.
The typical case is a man age 19-26.
How is spinal cord injury
diagnosed?
Diagnosis occurs after a
traumatic injury by a medical
professional.
What are some characteristics of
students with spinal cord injury?
Varying degrees of paralysis
What is spina bifida?
 Spina bifida is a birth defect where an abnormal opening
in the spinal column results in some degree of paralysis.
 Spina bifida literally translates to “cleft” or split spine.
 There are 3 types of spina bifida:
 [1]-Spina bifida occulta; and
 Spina bifida cystica ([2]-meningocele; & [3]-myelomeningocele)
What causes spina bifida?
There are environmental as well as
genetic factors:
Lack of folate/folic acid in the mother during
pregnancy; and
Heredity.
Prevalence/Incidence Rates
Approximately 4 in every 1,000 births are
affected.
There are many thousands of people
currently affected.
How is spina bifida diagnosed?
Ultrasound
Amniocentesis, checking for
increased levels of alphafetoprotein.
After birth, it is physically
apparent if a baby has spina
bifida.
There may be a buildup of fluid
around the brain (hydrocephalus)
What are some characteristics of
students with spina bifida?
Muscle weakness
Paralysis
Incontinence
Poor short term memory
Easily distracted
Poor attention, organization, sequencing, time,
generalization, motivation, left-right
discrimination, and coordination.
What are some assistive technologies that can be
used for students with orthopedic impairments?
 Altered pencils and pens
 Standing table
 Altered keyboards (BAT)
 Easels
 Powerpads
 Adjustable seats and
 Eye-controlled input
desks
 Portable reading racks
 Speech-controlled input
systems (dragon-dictate
and write-away)
 Icon-driven
communication (dynavox)
systems (cyberlink)
 Touch screens
 Track ball
 Foot mice
*A website that includes several
examples is located here
Some instructional ideas &
resources for teachers:
Please see handout
References
Bigge, J.L., & O’Donnell, P.A. (1976). Teaching individuals with physical and multiple disabilities.
Columbus: Charles E. Merrill Publishing Company.
Calhoun, M.L., & Hawisher, M. (1979). Teaching and learning strategies for physically handicapped
students. Baltimore: University Park Press.
Friend, M. & Bursuck, W.D. (2002). Including students with special needs: A practical guide for
classroom teachers. Boston: Allyn and Bacon.
The Irish Association for Spina Bifida and Hydrocephalus (2004). What is spina bifida? Retrieved May
24, 2004 from http://www.iasbah.ie.
Muscular Dystrophy Family Foundation (2002). Muscular dystrophy family foundation. Retrieved May
24, 2004 from http://www.mdusa.org.
National Information Center for Children and Youth with Disabilities (2004). National dissemination
center for children with disabilities. Retrieved May 25, 2004 from http://www.nichcy.org.
National Institute of Neurological Disorders and Stroke (2001). Spinal cord injury information page.
Retrieved May 24, 2004 from http://www.ninds.nih.gov.
Ohlone College (2004). Students with physical disabilities. Retrieved May 25, 2004 from
http://www.ohlone.cc.ca.us/org.
Texas Pediatric Surgical Associates (n.d.). Spina bifida neurological issues. Retrieved May 24, 2004
from http://www.pedisurg.com.
United Cerebral Palsy (2001). Cerebral palsy facts and figures. Retrieved May 24, 2004 from
http://www.upc.org.
West Virginia University (1999). Strategies for teaching students with motor/orthopedic impairments.
Retrieved May 25, 2004 from http://www.as.wvu.edu.