EDU 221, chapter 7, fa2014, physical disabilities and health problems

1. Physical Disabilities and
Health Problems
Chapter 7 – The Exceptional Child: Inclusion in Early Childhood
Education; Allen, K. Eileen and Cowdery, Glynnis E.; 2015

2. 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

3. Physical Disabilities
• Physical disabilities – “conditions that interfere with the normal
functioning of bones, joints, and muscles” (Allen & Cowdery, 2015)
• 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

4. 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

5. 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

6. 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.

7. 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.

8. 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

9. 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 CAST, an educational
and research organization about Universal Design for Learning

10. Adaptive Materials and Equipment (cont.)
• Pp. 151 – 156 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 

11. 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.

12. 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

13. 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 and the NC
School Health Program Manual
• Administer medications as permitted by NC DCDEE
• Emergencies – have emergency plans that are practiced
• Maintain confidentiality