Other Health Impairments

1. Other Health Impairments TLSE 240

2. Definition of other health impairments • Having limited strength, vitality, or alertness including a heightened alertness to environmental stimuli that result in limited alertness with respect to the educational environment • May be chronic (develops slowly and has long lasting symptoms) or acute (develops quickly and has symptoms that are intense but do not last long)

3. Examples • Asthma • AD/HD • Diabetes • Leukemia • Sickle Cell Anemia • Others • For IDEA the condition must adversely affect a child’s educational performance or it falls under the 504 plan.

4. Asthma • Primary cause of school absences (5 million absences a year) • On the rise (72% increase in 20 years) • Mild to life threatening conditions and death • Difficulty exhaling (not inhaling) • Air is trapped, tightness and swelling of bronchial tubes and mucus formation • About two children in a typical classroom • Triggers

5. Asthma • Medications • Anti-inflammatories reduce airway swelling • Bronchodilators open constricted airways • Take them as soon as symptoms develop • Classroom accommodations • Air purifier • Have an action plan

6. AD/HD • Neurological basis; cause appears to be genetic • Under IDEA – symptoms before age 7 and for at least 6 months, 2 settings, and adversely affect educational performance • 3 defining characteristics: inattention, hyperactivity, and impulsivity

7. continued • Physician diagnosis • Failure in brain circuitry underlying inhibition and self-control • Difficulty inhibiting impulses • Right hemisphere differences in glucose levels • Frontal areas, limbic system, posterior areas

8. AD/HD • On the rise • Boys to girls – 9% - 3% • Pre-natal • Drugs, alcohol, poor nutrition, smoking • Mother’s exposure to chemicals • Peri & Post-natal • Brain injuries, infections, chemical poisons

9. 3 Types of AD/HD • Predominantly inattention type • Predominantly hyperactive-impulsive type • Combined type

10. Predominantly Inattention Type • Difficulty paying attention, forgetful, easily distracted • Internally focused • Often overlooked by teachers • Appear sluggish, daydreamers, underachievers • Difficulty with selective attention • Mostly girls

11. Predominantly Impulsive Type • Difficulty sitting still and playing quietly • Can become workaholics • Blurt, frank, impulsive, interrupt conversations

12. Combined Type • Some features of previous 2 • 85% • Difficulty with interference control

13. Sickle Cell Disease • Most common inherited blood condition in US (80,000 Americans) • Inherited; more in African American population • Symptoms 1st year (swelling of hands and feet, body pain, nose bleeds, fatigue, infections of body organs)

14. continued • Not all red blood cells (which carry oxygen) are normal • Long sickle-shaped stiff cells clog blood vessels • This prevents organs/tissues from receiving adequate oxygen • Fluids needed • Watch stress level • Moderate (not strenuous) exercise

15. Human Immunodeficiency Virus • HIV gradually infects and destroys immune cells, primarily T4 cells • Body is unable to fight infections • Results in opportunistic diseases

16. continued • Stages • Latency (asymptomatic) • Middle (symptomatic) • Final (AIDS – acquired immunodeficiency syndrome) • T4 cell count less than 200 • More than one opportunistic infection

17. continued • More than 1 million people in the US had HIV in 1993 • Spread through blood, semen, breast milk, vaginal fluid • Fewer children born with HIV • Families do NOT need to disclose if child has HIV • Use universal precautions always with all students

18. Cancer • Unrestrained growth of cells • 2002 – 9,100 children under 15 (one third has Leukemia) • Primary cause of death at this age • Mortality rates declining

19. continued • Chemotherapy, surgery, radiation, or combination • Side effects – nausea, baldness, lowered white cell count • Some develop “short term” learning disabilities • Leukemia and brain tumors most common

20. Juvenile Diabetes • Pancreas stops producing or produces too little insulin so glucose (sugar) builds up in the blood • Begins before age 35 • In the classroom • Student must monitor blood sugar and follow a well-balanced, carefully controlled diet • Keep emergency kit for student

21. continued • Hyperglycemia and ketoacidosis • Blood sugar level too high • May experience hunger, fatigue, excessive urination, thirst, blurred vision • Need to administer insulin or diabetic coma can occur

22. continued • Hypoglycemia • Not enough sugar in blood • May be dizzy, sweaty, shaky, or nervous, and have a headache or blurred vision

23. Classroom Strategies • For the student who is frequently absent • For the student who re-enters school • Educating yourself, students, and staff • Health plan/Emergency plan • Communication with parents, child, and nurse • Watch energy levels • Others