Physical Disabilities and Health Problems

Chapter 7 – The Exceptional Child: Inclusion in Early Childhood Education; Allen, K. Eileen and Cowdery, Glynnis E.; 2012

Health and Physical Activity

• Important for overall optimal development• Children with physical and/or health impairments cannot explore the

environment in ways that maximize their development• Physical impairments impact skeleton, joints, and muscles• Health impairments may be chronic or acute• Overlapping condition are common

Physical Disabilities

• Physical disabilities – “conditions that interfere with the normal functioning of bones, joints, and muscles” (Allen & Cowdery, 2014)• Cerebral Palsy – the most common physical disability ; caused by

neurological problems that impact muscle control.• Problems are not progressive• CP may range from mild to severe physical impairments

Types of Muscle Problems for Classifying CP

• Spasticity – hypertonic muscle tone; joints do not have the range of motion they should have• Hypotonicity – “floppy” baby syndrome; child has too little muscle

tone; impacts head and posture control.• Athetosis – children with this tend to keep primitive reflexes and have

problems with voluntary muscle control• Ataxia – a lack of motor coordination that affects balance and makes

fine motor coordination difficult• Other classifications according to affected body parts - Diplegia,

hemiplegia, paraplegia, quadriplegia

Challenges for Children with CP

• Lack of motor control and failure to meet physical development milestones• Lack of motor control may impact eating and ability to speak, even if

there is no intellectual impairment• Physical and occupational therapists are important team members for

the interdisciplinary team for a child with CP

Spinal Cord Injuries

• Unlike with CP, the brain is not affected. The muscles below the spinal cord injury no longer receive signals from the brain. • Children with spinal cord injuries do no have any sensation below the

injury• Spina bifida occurs in the first 30 days of fetal development and is a

neural tube defect. • Children with spina bifida may be hydrocephalic and may have

incontinence.

Muscular Dystrophy

• Characterized by a progressive weakening of the muscles• Duchenne’s disease is the most common and affects only boys. • Children with MD are encouraged to use muscles as much as possible

• Other impairments• Hip dysplasia – occurs in girls more often than in boys; requires treatment for

child to learn to walk properly• Juvenile Rheumatoid Arthritis – characterized by inflammation of the joints

and surrounding tissue; symptoms may disappear as child gets older.

Program Implications

• Interdisciplinary team requires a variety of professionals• Both commercial and creative adaptive equipment may be needed• Environment will need to be adapted to support all children in the

program, including the child with physical disabilities• Prospective interdisciplinary team members:

• Physical and occupational therapists• Speech and language therapist• Psychologist or other behavior specialist

• Consistent implementation of therapy goals important• All therapeutic activity must be supervised by appropriate specialist

Adaptive Equipment• Mobility devices• Helmets, rails, etc. may be needed for safety• Braces, walkers, wheelchairs, scooters

• Avoid learned helplessness• Positioning devices • Universal Design for Learning (UDL) – grew out of architecture and

making space available for all people; for children, it is to provide learners with materials that can be accessed and used in a variety of ways; further information available online at the National Center on Universal Design for Learning

Adaptive Materials and Equipment (cont.)

• Pp. 157 – 159 in your text describe manipulatives, creative materials, self-help devices and environmental barriers that can be adapted for use with children both with and without disabilities (think UDL)• All of these suggestions may be useful for your final Environment Key

Assessment

Health Problems

• Asthma – common, but very serious health problem for children• Know what to do in the event of an asthma attach

• Cystic fibrosis – most common inherited chronic disease among Caucasian children; incurable; people may now live into their 30s and 40s with this disease; causes respiratory and digestive problems.• Hemophilia – rare inherited blood clotting disorder• Leukemia – most common cancer among children; much higher

survival rate than in the past• Sickle-Cell Anemia – incurable disease found among African American

children, but is decreasing in the U.S.

Health Problems (cont.)

• Heart problems – • Diabetes • Type 1 – is caused by an autoimmune disorder; the rarer type of diabetes• Type 2 – the body fails to use insulin efficiently; may cause hypoglycemia or

hyperglycemia

• Seizure disorders• Febrile seizures – these are not harmful and are brought on by a high fever• “Generalized tonic-clonic (grand mal) seizures”• Absence seizures (petit mal) – may be more difficult to recognize• Partial psychomotor seizures

Health Problems (cont.)

• AIDS • Obesity – causes various health problems; may cause social and

emotional problems; encourage healthy eating and appropriate exercise for all children in your care

• Health Problems and Classroom Practices• Maintaining health records; see required records from NC DCDEE• Administer medications as permitted by NC DCDEE• Emergencies – have emergency plans that are practiced• Maintain confidentiality