Other Health Impairments What are they?

1. Other Health ImpairmentsWhat are they? Spirit Lake Consulting. Inc. Fort Totten, ND

2. What does OHI mean to staff in the schools? • The student with ‘other health impairments’ does not have the strength or alertness to keep up with their class. • Common ‘other health impairments’ on the reservations are asthma, ADD, ADHD and diabetes. • Less common health impairments are epilepsy, heart conditions, or hemophilia. • These health conditions impair a student’s ability to perform successfully in their education UNLESS MODIFICATIONS ARE MADE.

3. ASTHMA • The most common ‘other health impairment’ in children. During an asthma attack, the air breathed in gets stuck in the lungs and the airway starts to close. A mucus formation starts to build and the person breathes out less air than they breathed in. When this happens, the person then starts to breathe quickly and deeper, but this only causes rapid breaths that are not helpful. Asthma medication can reduce the frequency of these attacks for some children. Most children with asthma will use an inhaler which helps them breathe when an asthma attack occurs.

4. ASTHMA (continued) A major impact of asthma is on attendance. The average child with asthma misses 3-4 days of school per year due to asthma . About 10% of children with asthma miss TWO WEEKS or more of school due to asthma.

5. Attention Deficit Hyperactivity Disorder There are three types of ADHD: •Predominantly Inattentive Type: serious inattention problems, but few hyperactivity/impulsive symptoms •Combined Type: serious inattention problems and serious problems with hyperactivity and impulsivity •Predominantly Hyperactive/Impulsive Type: serious problems with hyperactivity/impulsivity, but not much problem with inattention For more information, we highly recommend CHADD http://www.chadd.org/ • Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD)

6. DIABETES Diabetes occurs when a person’s pancreas stops making, or makes less, of a hormone called insulin. When a person does not have insulin, their cells do not absorb glucose and all the unused sugar in a person’s body starts to build up in the blood. The kidneys then try to filter out all the excess sugar. • Type I is insulin-dependent diabetes. It is most common in children ages ten through sixteen and usually develops before a age 35. • Type II is no- insulin-dependent and happens when a person’s body cannot make or use insulin. This type is most common in people over 40, those who have a family history of diabetes and are overweight.

7. DIABETES Diabetes affects children’s school performance by its impact on attendance (school days are missed due to illness). Also, children’s ability to participate in physical education may be limited. This, however, depends on the child. Do not assume just because a child has diabetes he or she cannot play at recess or be a member of school teams. Discuss the child’s abilities with parents and other members of the IEP team. Children may have low blood sugar episodes during school and take several hours to recover, thus having difficulty completing the day’s school work.

8. Epilepsy Epilepsy is a seizure disorder. There are many types of seizures and a student may have one type or any combination of them. The two most common types are: Generalized seizures (also called grand mal) - convulsions occur as all many of the person’s muscles are involved. Sometimes people lose control of their bladder or bowels during a seizure. Absence seizures (also called petit mal) - last for just seconds. The person loses awareness of his or her surroundings.

9. CANCER This disease causes a person’s cells to grow uncontrollably. A common treatment is chemotherapy, which has many side effects, including increased chances of infection. More than half of students who have cancer have leukemia and brain tumors. These conditions may cause different types of learning problems, if the nervous system has been affected.

10. HIV HIV is a disease caused by a virus. It weakens the immune system so that the person finds it harder to fight off illness. The virus can be transferred through any activity involving body fluids such as blood, semen, vaginal fluid and breast milk. Relative to the other health impairments mentioned, HIV in children is extremely uncommon on most reservations.

11. TEACHING STUDENTS WITH OTHER HEALTH IMPAIRMENTS

12. Students may miss many days of school due to illness. Accommodations should be made to keep students from falling too far behind, including sending work home and providing a tutor in the child’s home or after school. Most students actually want to go to school, as they see it as a distraction from their illness and they need to socialize with their friends. Attending school and being with their friends helps them to feel “normal”. It is important to students who spend much of their time in emergency rooms, doctors’offices and hospitals to just be able to be a kid with the other kids.

13. MORE TEACHING STRATEGIES Change the lesson plans. If a student misses class a lot because she is sick, the teacher needs to change around the curriculum for her so she is not so far behind. She can receive lecture notes, videotaped lectures, or can use the Internet in researching topics from home. The teacher must also be aware of the student’s physical condition and mental abilities. Often students with health impairments do not have the same stamina as other students. They can be paired up with another student, given assignments that are shorter, or given more time to complete their work.They can use art instead of writing in an assignment if their writing abilities or other intellectual abilities have become limited

14. MORE TEACHING STRATEGIES Emotional issues. Students with OHI are different from other students and they have to deal with that fact. Some lose their hair from chemotherapy, others can’t eat anything with sugar in it because of their diabetes, some have seizures in front of their fellow classmates and become embarrassed or labeled as strange. They cannot blend in to be like everyone else because they just aren’t, even when they want to be just like everyone else. Other students may tease them, because that’s just what kids do. Teachers have to be prepared for this and be able to intervene when there is a problem. We don’t accept racist comments in our classrooms. It is not a case of ‘children can be cruel’ and the child has to learn to deal with it. As adults, we need to enforce acceptable behavior.

15. MORE TEACHING STRATEGIES Death issues. Students may be facing death and may not live past their youth. Teachers have to be ready if that situation comes up. They may have to talk to the student’s classmates, or perhaps the student and his/her family themselves. They have to also be aware of their own loss, losing a student. Some children are comforted by the idea of leaving a legacy. You may wish to work with the child to create artwork, poems, stories or other articles for family and friends. Again, this is one of those areas where communication with parents is essential.