Module 13 Children with Physical Disabilities
Children with physical disabilities have non-sensory physical impairments or
health impairments that interfere to a significant extent with their academic performance. This means that the definition
excludes things like hearing and seeing. Special education assistance for this area includes modification of the environment,
adaptive equipment, and assistance with transportation if needed. Services may include physical and occupational therapy.
Children with physical disabilities may have other disabilities needed a team approach to meet all their needs. The common
element among people with physical disabilities is that there is some sort of interference with normal motor function. Their
range of intellectual abilities would be the same as the general population without disabilities. Some may be average or below
while others will be in the gifted range.
Three categories of physical disabilities:
Neurological Conditions – These are disabilities commonly caused by damage
to or incomplete development of the brain or spinal cord. The most common neurological
conditions are cerebral palsy, epilepsy, spina bifida, and traumatic brain injury.
Orthopedic Conditions – This refers to damage, disease, or lack of development
of the bones, muscles, or joints of the body. Some common orthopedic conditions are juvenile rheumatoid arthritis, muscular
dystrophy, and absence or loss of all or part of a limb.
Health Conditions – This covers anything else caused by acute or chronic
disease. This is a very broad category but generally the difference is that the condition is usually not affecting movement
of motor coordination directly. Some health conditions include asthma, diabetes, cystic fibrosis, or sickle cell anemia. Many
students in this category may not need extensive support in their ability to learn, speak or walk. They may need minor accommodations
such as modification of curricula such as physical education or need of the teacher to be aware of medication requirements
Concerns related to Physical Disabilities:
Physical disabilities frequently cause difficulty in mobility because of poor
muscle coordination, abnormal muscle movements, paralysis, or weakness. This may require the use of wheelchairs, crutches,
or prosthetic devices.
Control of the muscles in the oral area (tongue), normal functioning of the
vocal tract and respiration tract are necessary for normal speech. An individual may not be able to imitate or reproduce speech
sounds. This makes it difficult to communicate regarding everyday normal matters. It also affects social relationships i.e.
unfortunately; it is not unusual for someone to assume that a person whose speech is unintelligible is mentally retarded even
though the person is of normal intellect. People with speech problems due to
physical disabilities often use graphic display boards such as picture boards. Some people use computer systems which produce
Other activities of daily life which may be difficult for a person with physical
disabilities include eating, dressing, bathing and toileting. They may need a
personal assistant to help with some tasks or have extended time or accommodations to finish things by themselves.
Emotional and social development concerns may develop along with physical disabilities.
Children dealing with acute and chronic medical conditions may have great physical discomfort and hospitalizations. They may
have terminal illnesses or losses of body functions from which they may never fully recover. They may not be easily accepted
by their peers due to their physical differences or undesirable side effects such as drooling or incontinence. This is likely
to affect general disposition and personality. Clinical depression or excessive acting out, low self-esteem or feelings of
rejection may develop.
Accommodations for Physical Disabilities
Students are likely to be of normal or gifted intellect and should be able
to perform academic learning similar to other students. Their difficulty is more likely to be in the process of communicating
their knowledge or in accomplishing daily tasks such as carrying objects, walking to class, or tending to personal hygiene.
Physical, occupational, or speech therapists work with the academic teachers to design and implement a program which allows
the student to progress. Even medically fragile students are often able to be maintained with tubes, respirators and wheelchairs
in regular classrooms with minimal medical oversight. Some buildings may need modifications but many facilities already comply
with the Americans with Disabilities Act to have ramps or elevators instead of stairs and levers versus doorknobs. The key
is matching activities with the individual with awareness of physical limitations such as motor skills or activities of daily
life. Physically disabled students should reasonably expect to function effectively in least restrictive environments with
Sample Accommodation Story
One of my more rewarding life experiences was when I had oversight of a number
of residential vocational training centers. One of these had been designated as a disabilities center. Most students had learning
disabilities or visual and hearing difficulties. I remember a panic call from the nursing supervisor informing me that she
planned to discharge the first wheelchair bound student who had come to the center. Apparently he was having difficulties
controlling his bowels and was leaving deposits on the floor in the halls. Convincing staff at the center that students with
all types of disabilities should be accepted had been a challenge. Now here was a 16 year old male student with a problem
no one wanted. The Center Director and I worked on an intervention plan. Had
this student had this problem before coming to the center? (No) Had his diet changed significantly since coming to the center?
(Yes) Did he have any stress concerns while at the center? (Yes) Where there routines at the center that were difficult for him? (Yes).
It turned out that the bell schedule between classes was not long enough for
him to toilet himself. He was totally paralyzed below the waist and could not
feel bowel movements. Rather than be late to class and be criticized by teachers, he did not attempt to go to the bathroom
often until it was too late. He was on a totally different diet in the cafeteria than he had been living at home. He was under
stress for a number of things including homesickness and lack of privacy in the dormitory. For example, the shower curtain
in the bathroom would normally be at knee level for a standing person. His bath chair in a quasi-prone position left him exposed
to other people. The solutions? A long shower curtain going full length to the
floor, mandatory bathroom breaks between classes long enough for him to complete his business, and a nutrition consultation
on foods which affect the bowel system. I am pleased to report that this young
man became an excellent student. He became the first student to complete driver education at the center using hand controls.
The last I heard of him, he had graduated and was living independently in his own apartment. A great success story!
Here are some on-line resources for parents and teachers:
How to teach children with physical disabilities:
Characteristics of Students with Physical Impairments:
Division for Physical and Health Disabilities
What Children with Physical Disabilities Need from their Parents:
Health Site on Physical Disabilities: