Orthopedic impairment is defined by the Individuals with Disabilities Education Act as any severe orthopedic impairment that adversely affects a child's educational performance. |
There are many types of orthopedic impairments, also known as physical disabilities, that can affect a child's performance in the classroom. These disabilities can be caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause constrictions). This site is a resource for several of many common impairments such as cerebral palsy, muscular dystrophy, spina bifida, as well as other orthopedic and musculoskeletal disorders and conditions.
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Within the school-age population, about 0.1% of students are affected with physical disabilities, while about 0.99% have other health impairments and about 0.2% possess multiple disabilities. Of all the students educated under the umbrella of special education, 1.1% are classified as having a primary disability of orthopedic impairment. The prevalence of physical disabilities varies in each age group; at preschool age (3-5 years old), 0.07% of all students overall are affected with physical disabilities. However, during the school-age years the prevalence of physical disabilities shoots up to 0.1% of the public school population.
Students with physical disabilities may exhibit symptoms that range from relatively mild to more severe. Different parts of the body may be affected by any physical disability, making classroom modifications essential even for teachers working within the general population setting. In fact while many students with multiple or severe disabilities are educated in special classes, the majority of students with orthopedic impairments are placed in general education settings.
(McLesky, Rosenberg & Westling, 2013)
According to IDEA, there are three main categories in which a specific orthopedic impairment can be classified: neuromotor impairment, degenerative disease, and musculoskeletal disorders. A neuromotor impairment is an irregularity of, or damage to, the brain, spinal cord, or nervous system. The two most common types of neuromotor impairments are cerebral palsy and spina bifida. Degenerative diseases can include many diseases, such as muscular dystrophy, that affect motor development. Musculoskeletal disorders, including juvenile rheumatoid arthritis and limb deficiency, can result in various levels of physical limitations.
Students with physical disabilities may exhibit symptoms that range from relatively mild to more severe. Different parts of the body may be affected by any physical disability, making classroom modifications essential even for teachers working within the general population setting. In fact while many students with multiple or severe disabilities are educated in special classes, the majority of students with orthopedic impairments are placed in general education settings.
(McLesky, Rosenberg & Westling, 2013)
According to IDEA, there are three main categories in which a specific orthopedic impairment can be classified: neuromotor impairment, degenerative disease, and musculoskeletal disorders. A neuromotor impairment is an irregularity of, or damage to, the brain, spinal cord, or nervous system. The two most common types of neuromotor impairments are cerebral palsy and spina bifida. Degenerative diseases can include many diseases, such as muscular dystrophy, that affect motor development. Musculoskeletal disorders, including juvenile rheumatoid arthritis and limb deficiency, can result in various levels of physical limitations.
Cerebral Palsy
Cerebral palsy is a non-progressive disorder that is characterized by impaired movement or exaggerated reflexes. This can include floppiness, extreme rigidity, abnormal posture, and unsteadiness in walking. It is called a non-progressive disorder because the symptoms do not continue to worsen or deteriorate over time. Cerebral palsy can be caused by any number of physical traumas suffered before, during and even after birth. There are four different kinds of cerebral palsy, and each variation's symptoms can range from mild to severe. Spastic cerebral palsy is the most common, occurring in up to 70% of individuals with CP. Many individuals affected with spastic CP may need a walker or wheelchair to move. Dyskinetic CP is characterized by involuntary movements and difficulty with fine motor skills. About 10% of individuals diagnosed with cerebral palsy have dyskinetic CP. Ataxic CP is characterized by uncoordinated movements and trouble balancing or walking, as well as other symptoms such as motor skills needed to write and type. Ataxic is the least common form of cerebral palsy, evident in 5-10% of individuals diagnosed with CP. The fourth type of CP is mixed CP, in which the individual will display different forms of cerebral palsy in conjunction.
Muscular Dystrophy
Duchenne muscular dystrophy is the most common form of muscular dystrophy, and is caused by a mutation of the gene on the X chromosome. It affects around 1 in 3,600 males and is characterized by rapid muscle degeneration. Other types of muscular dystrophy can include Becker’s muscular dystrophy, a less severe form in which physical symptoms can occur in adulthood. Congenital muscular dystrophy is another less severe form that is present from birth and includes muscle weakness and possible joint deformities. Duchene's muscular dystrophy is usually apparent after the child begins walking, and symptoms include difficulty with motor skills, muscle contractures, frequent falls, and awkwardness in walking. These symptoms will progress throughout life. The muscle deterioration is so rapid that most individuals affected are wheelchair-bound by age 12. Intellectual disabilities are not always present in those affected with MD. Occupational therapy is available for individuals with MD who need assistance to engage in daily living activities; however, there is no specific treatment or cure for muscular dystrophy. The average life expectancy is for individuals with Duchene's muscular dystrophy is around 25 years old.
Spina Bifida
There are several different types of this spinal disorder. Spina bifida is Latin for “cleft spine,” and is typified by incomplete development of the brain, spinal cord, and/or meninges (the protective covering around the brain and spinal cord). Meningocele spina bifida is when spinal fluid and meninges protrude through an abnormal vertebral opening. Some people with meningocele may experience little to no symptoms, while others may experience symptoms as severe as complete paralysis.
Myelomeningocele spina bifida is the most severe form, and occurs when the spinal cord or neural elements are exposed through an opening in the spine, resulting in partial or complete paralysis of the parts of the body below the spinal opening. This condition also affects the brain, and so many the individuals it affects will have physical as well as mental disabilities.
While the exact causes of spina bifida are unknown, many scientists believe it is a combination of factors such as genetics, nutrition and environment. It is most commonly diagnosed when the baby is still in utero, and in some cases it will go unnoticed until after the baby is born.
Myelomeningocele spina bifida is the most severe form, and occurs when the spinal cord or neural elements are exposed through an opening in the spine, resulting in partial or complete paralysis of the parts of the body below the spinal opening. This condition also affects the brain, and so many the individuals it affects will have physical as well as mental disabilities.
While the exact causes of spina bifida are unknown, many scientists believe it is a combination of factors such as genetics, nutrition and environment. It is most commonly diagnosed when the baby is still in utero, and in some cases it will go unnoticed until after the baby is born.
Orthopedic and musculoskeletal conditions
This group reflects a wide variety of conditions which inhibit normal development of the body and muscles. These disorders can include:
Juvenile arthritis, a form of arthritis that affects approximately 294,000 children and can induce pain, stiffness of joints and swelling. Occupational therapy, physical therapy and regular exercise can help to reduce joint pain and swelling.
Osteogenesis imperfecta, also known as "brittle bone disease," is characterized by sensitive bones that are prone to fracture. This is a mainly genetically inherited condition of which there are eight different types, all with varying degrees of severity.
Juvenile arthritis, a form of arthritis that affects approximately 294,000 children and can induce pain, stiffness of joints and swelling. Occupational therapy, physical therapy and regular exercise can help to reduce joint pain and swelling.
Osteogenesis imperfecta, also known as "brittle bone disease," is characterized by sensitive bones that are prone to fracture. This is a mainly genetically inherited condition of which there are eight different types, all with varying degrees of severity.