Orthopedic Impairments

1. Orthopedic Impairments Melissa Yennie Jamie Donahue

2. What is an Orthopedic Impairment? • Under federal law (IDEA), an orthopedic impairment means a severe bodily impairment that adversely affects a child's educational performance. An orthopedic impairment involves the skeletal system-bones, joints, limbs, and associated muscles.

3. What causes an Orthopedic Impairment? • The term includes impairments due to the effects of congenital anomaly (e.g., clubfoot, absence of some member, rheumatoid Arthritis, etc.), impairments due to the effects of disease (e.g., muscular dystrophy, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

4. Lets see how much you know 2 1 4 5 3

5. Answers to Worksheet • Matching • Draw a line going to the correct answer. • Picture # 1 Rheumatoid Arthritis • Picture # 2 Severe Burn • Picture # 3 Amputee • Picture # 4 Leg Injury • Picture # 5 Club Foot • True/False • __F___ Orthopedic Impairments include- Scoliosis, Cerebral Palsy, ADHD, and Muscular Dystrophy. • __T___ Students with Orthopedic Impairment receive IEPs. • __T___ People can develop or be born with Orthopedic Impairments. • __F___ Students with Orthopedic Impairments always have poor social skills • __F___ a student in a wheel chair doesn’t need any modifications in PE. • __T___ a student with an amputated leg can participate in sitting volleyball. • How many did you get correct?

6. Sub-Categories of Orthopedic Impairments • Congenital Anomaly - Club Foot • Diseases - Muscular Dystrophy • Other Causes - Injuries

7. Club Foot • Definition- • Clubfoot describes a range of foot abnormalities usually present at birth in which a persons foot is twisted out of shape. The term "clubfoot" refers to the way the foot is positioned, like the head of a golf club. Clubfoot is a common birth defect. • Causes- • The cause of clubfoot isn't known, But scientists do know that clubfoot isn't caused by the position of the fetus in the uterus. • Treatment – • Treatment begins soon after birth since a babies bones are so flexible. Treatment methods include: - Stretching and casting. This entails manipulating the foot into a correct position and casting it to maintain that position. Repositioning and recasting occurs every week for several weeks. After the shape of the foot is realigned, it's maintained through stretching exercises, special shoes or splinting at night for up to two years. - Surgery. Some severe cases of clubfoot may require surgery. An orthopedic surgeon can lengthen tendons to help ease the foot into a more appropriate position. After surgery, the child needs to wear a brace for a year or so to prevent recurrence of the deformities. • Even with treatment, the defect may not be totally correctable, but treatment usually improves the appearance and function of the foot.

8. Club Foots’ effect on the 3 Domains • Psychomotor- Walking on the side of their feet. This may also cause their calf muscle not grow properly. • Cognitive- Many children that have clubfoot often go through many surgeries at a very young age. This could cause them to often miss school and be behind. • Affective- The child may worry about their body image as they get older.

9. Club Foot These are severe cases of club foot. Your future students may have mild to severe cases of club foot if they have not been corrected.

10. Muscular Dystrophy • Definition- • refers to a group of genetic, hereditary muscle diseases that weaken the muscles that move the human body. There are nine MD diseases, Duchenne is the most common. • Causes- • These conditions are inherited, and the different muscular dystrophies follow various inheritance patterns. The best-known type, DuchenneMuscularyDistrophy (DMD), is inherited in an X-linked recessive pattern, meaning that the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes and is thus considered sex-linked. • Treatment – • There is no known cure for muscular dystrophy, therefore there is no specific treatment. Inactivity can worsen the disease. Physical Therapy, occupational therapy, speech therapy and orthopedic instruments (e.g., wheel chairs, standing frames) may be helpful • Symptoms- • Progressive Muscular Wasting (weakness), Poor Balance, Frequent Falls, Walking Difficulty, Calf Pain, Limited Range of Movement, Muscle Contractures, Respiratory Difficulty, Drooping Eyelids, Scoliosis, Inability to walk

11. MDs’ effect on the 3 domains • Psychomotor- The onset of MD will begin with a child who may start to stumble, have difficulty going up stairs and begin to walk on his toes. As time goes on they might lose the ability to walk. A child may need to use a wheel chair or leg braces. • Cognitive- Children with DMD don’t really show signs of poor cognitive skills. • Affective- The child may also worry about their body image as they get older. And begin to become very angry towards other and self because his/her condition may be getting worse

12. Here’s a good way to inform your students about MD • BrainPop.com • http://www.youtube.com/watch?v=6wLnR7GJakY

13. Muscular Dystrophy

14. Injuries • Definition- • Injuries can include broken or fractured bones, sever burns, sprained joints, and pulled muscles. Anything that is short term and keep a student for performing normal activities • Causes- • Causes can vary from falls, sports accidents, play ground accidents, or any other accidental injury that causes a person to be impaired for some time. • Treatment- • Depending on the injury treatment varies. For a broken leg, a cast would be put on for a period of time, then taken off and the person might have some type of therapy.

15. Effects on the 3 domains • Psychomotor- • Depending on the injury will lose the ability of using that limb. • Cognitive- • Usually there is no cognitive effect but if a child has some brain damage they could experience memory loss. • Affective- • Some student might now like feeling of being left out.

16. Injuries Here are the various injuries you may come across in your school.

17. Activity Time • Grab a pen and paper • Using only your non-dominant hand, write down a few differences between the three sub categories we discussed. • Just in case you forgot they are…… • Congenital anomaly • Diseases • Short term injuries

18. Here are some scenarios, What would you do? • Scenario #1- A student has severe club foot, she wants to participate in a game of kick ball. What would you do? • Scenario #2- A student has very little leg strength due to his MD, he is not in a wheel chair, but uses a walker. How will you keep him active? • Scenario #3- A student has a broken arm and your teaching a basketball unit. How will you include him?

19. Here’s what we thought…… • Scenario#1- We would give the student some type of striking tool like a hockey stick. This way the student can hold it in their hands and still strike the ball coming at them. • Scenario #2- to keep this student active we would have him do stretching and strength training. • Scenario #3- We would teach the child the proper way to shoot but only using one hand. The child will be able to play almost normal with one hand. The only real modification we would make would be to make the defense more relaxed when playing that particular student.

20. Other helpful hints…… • Special seating arrangements may need to be mad to develop useful posture and movements • Can include special chairs, desks, • Activities are focused on development of the students gross and fine motor skills • Having suitable augmentative communication and other assistive devices • Augmentative communication is communicating without speech (nonverbal) • Awareness of the affects the medical condition might have on the student. • Example is if the student gets tired easily • If your student is in a wheelchair sit at eye level if the conversation is going to be a long one. • Always ask before you give assistance.

21. Now go out and Adapt to your special needs students!!! APE

22. Work Cited • (2007). Retrieved 03 2009, from Human Illnesses : http://www.humanillnesses.com/original/Men-Os/Muscular-Dystrophy.html • FWD Media Inc. (2009). Retrieved 03 2009, from Brain Pop: Duchenne Muscular Dystrophy: http://www.brainpop.com/health/diseasesinjuriesandconditions/duchennemusculardystrophy/ • Heller, D. K. (2001). Bureau for Students with physical and health impairments. Retrieved 03 2009, from In servicing School Personnel on Orthopedic Impairments : http://education.gsu.edu/PhysicalDis/new/article/inserv.htm • Mayo Clinic. (2008, Nov 6). Retrieved 03 2009, from Children's Health: http://www.mayoclinic.com/health/clubfoot/DS00814/DSECTION=treatments%2Dand%2Ddrugs • Muscular Dystrophy Association. (2007, 07). Retrieved 03 2009, from Diseases: www.mda.org/disease/dmd.html • National Association of Parents with Children in Special Education. (2007). Retrieved 03 2009, from Exceptional Children and Disability information: Orthopedic Impairment: http://www.napcse.org/exceptionalchildren/orthopedicimpairments.php • Project Ideal. (2008). Retrieved 03 2009, from Orthopedic Impairments: http://www.projectidealonline.org/orthopedicImpairments.php • Winnick, J. P. (2005). Adapted Physical Education and Sport. In J. P. Winnick, Adapted Physical Education and Sport. Human Kinetics.