Mobility and Orthopedic Disabilities
A variety of mobility-related
disabilities result from neuro-muscular and orthopedic impairments.
These disabilities may be congenital, or they may be the result of an
accident or illness. They may include conditions such as spinal cord
injury, paralysis, cerebral palsy, severe forms of arthritis, polio/post
polio, spina bifida, orthopedic injury, or amputation, later stages of
AIDS, stroke, and muscular dystrophy. Some students may have invisible
disabilities that include pulmonary/respiratory disorders, cardiac
conditions, epilepsy, cystic fibrosis, multiple sclerosis, Fibromyalgia
and other limiting conditions.
Functional abilities and limitations
will vary widely, even within one disability group. Some conditions are
such that the person experiences pain, spasticity, or lack of
coordination. In other conditions there periods of remission where the
student seems to have no impairment of functions (e.g., multiple
sclerosis). Some who use wheelchairs are able to stand but not walk.
Others can walk with the aid of canes, crutches, braces, or walkers.
(Some wheelchair users may have full use of their arms and hands,
whereas others do not.) Using a wheelchair may help these individuals
conserve energy or move about more quickly.
The best judge of what the student can
or cannot do is the individual student. However, the student must
present clear documentation from an outside source detailing necessary
classroom and examination accommodations. This documentation must be
present prior to the student enrolling in classes. The college must have
adequate time to prepare to assist the student.
CHARACTERISTICS
·
Classroom
access may be difficult
·
Eye-hand
coordination may be decreased
·
Notetaking and
writing may be decreased due to weakness or paralysis
·
Verbal
communication may be impaired
·
Physical
stamina and endurance may be decreased
INTERACTION
·
Speak directly
to the student as you would any other class member.
·
Converse with
the student in a wheelchair at his or her eye level.
·
Leaning on a
wheelchair is inappropriate. The chair is part of the person’s body
space.
·
Using words
like “walking” or “running” is appropriate; sensitivity to these words
is not necessary.
·
Ask if you can
help if it appears the student needs assistance. Accept a “no thank you”
graciously.
TECHNOLOGY
Adaptive computer devices are especially
helpful for the person with limited hand use. Students should discuss
software or equipment options that may assist them with their Vocational
Rehabilitation case manager. The equipment should be used in labs or
areas where the student can work in an integrated setting. The Learning
Assistance Center may also have technology that would benefit the
student. Examples of technology that may benefit the student include,
but are not limited to the following:
·
adapted mouse
·
“sticky keys”
software that eliminate use of mouse
·
word
prediction software
·
voice input
software
IN THE LAB
Laboratory work is an important part of
a postsecondary education. Students who have mobility disabilities
are not excluded from lab work because of their disability. Some
accommodations may be necessary to make the experience worthwhile and
safe. The student should discuss with the instructor early in the
semester what strategies will be used. The student should be doing all
of the thinking required for the assignment. For example, if the student
uses a lab partner. The lab partner may manipulate the tools and
equipment, while the student answers the related written assignment
questions.
(In
compliance with the Virginia State Higher Education Workgroup 2001 ADA
Guidelines & The American Association for the Advancement of Science.)
OTHER MEDICAL DISABILITIES
There are other impairments,
neurological and medical, which do not fit under the major categories
already discussed but which are covered under 504/ADA. These
disabilities can affect students by significantly impairing their energy
level, memory, mobility, speech, vision or muscular coordination (e.g.,
heart condition, sickle cell anemia, hemophilia, arthritis, asthma,
diabetes, respiratory disorders, seizure disorder, cancer, kidney
problems, Tourette’s Syndrome, severe chronic pain, AIDS). In some
cases, the degree of impairment may vary from one day to the next
because of the nature of the medical condition, medication received, or
therapy. Some conditions deteriorate year by year, resulting in
emotional consequences for the student. Other students may need
accommodations found elsewhere in this manual while some will need no
accommodations at all. The following will assist you in working with the
students in this category.
AIDS
Acquired Immune Deficiency Syndrome
(AIDS) is caused by a virus that destroys the body's immune system. This
condition leaves the person vulnerable to infections and cancers that
can be avoided when the immune system is working normally. The virus is
transmitted primarily through the exchange of bodily fluids. There is no
evidence to date that it is transmitted through casual contact.
Manifestations of AIDS are varied,
depending on the particular infections or diseases the individual
develops. Extreme fatigue is a common symptom. Classroom adaptations
will likewise vary.
Students with AIDS may be afraid to
reveal their condition because of the social stigma, fear and/or
misunderstanding surrounding this illness. Therefore, it is extremely
important that confidentiality be strictly observed. If the topic
should arise in class, faculty should deal openly and non-judgmentally
with the issue, fostering an atmosphere of understanding.
Classroom accommodations will depend
upon the student’s medical condition, which can range from no
accommodations to more extensive accommodations.
Arthritis (Rheumatoid)
Arthritis affects people of every age,
including children. Rheumatoid arthritis is the most common and is a
total body (systemic) disease characterized chiefly by inflammation of
the synovial joints (e.g., shoulder, elbow, wrist, knee, hip, ankle, and
small joints).
Muscle weakness, reduction in muscle
size, loss of joint movement, and pain with movement characterize the
effects of arthritis and how it limits a person’s activities. It is
important to remember is that each person is affected differently and
the condition varies from one day to the next.
Students with rheumatoid arthritis may
need Notetakers, and permission to tape record lectures. They may need
extended time on tests, or use alternative testing measures (multiple
choice or short answer exams instead of essays).
Autism
Autism and Pervasive Developmental
Disorder (PDD) are neurological disabilities that affect social
interaction, communication, and restrict activities and interests.
Persons with more advanced language skills tend to use a small range of
topics and have difficulty with abstract concepts. Those with autism
often have difficulty with changes in routine or familiar surroundings.
The classroom environment should be structured so that the program is
consistent and predictable. Students with autism learn better and are
less confused when information is presented visually as well as
verbally.
Cancer
Cancer can occur in almost any organ
system of the body, thus the particular disabling effects will vary
greatly from one person to the other. Some people experience visual
problems, lack of balance and coordination, joint pain, backache,
headache, abdominal pain, drowsiness, lethargy, difficulty in breathing
and swallowing, weakness, bleeding, and/or anemia.
The primary treatments for cancer are
radiation therapy, chemotherapy, and surgery that may engender
additional effects. Therapeutic treatment can cause violent nausea,
drowsiness, fatigue, loss of academic functioning, and absences from
class. Surgery can result in amputation, paralysis, sensory deficits,
and language and memory problems.
Specific accommodations will depend upon
the person’s condition and reaction to treatment.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) is a
condition caused by repetitive motion that can cause pain, tingling,
numbness, and weakness in the fingers and thumb. CTS can begin suddenly
or gradually. It often affects both hands and if not treated can lead to
permanent nerve and muscle damage in the hands. CTS can occur at any
age. In non-work related cases, CTS usually affects persons in their
50s. In work related cases, it can appear between the ages of 20 and 40.
This condition is more common in women than in men. Students with CTS
may need Notetakers, extended test times and deadlines for research
reports.
Cerebral Palsy
Cerebral Palsy (CP) is caused by an
injury to the motor center of the brain, which may have occurred before,
during, or shortly after birth. Manifestations may include involuntary
muscle contractions, rigidity, spasms, poor coordination, poor balance
or spatial relations. Visual, auditory, speech, hand-function and
mobility problems might occur.
Students with CP are all unique. For
appropriate classroom accommodations, refer to the sections on speech,
visual impairments, and/or mobility and orthopedic impairments.
Chronic Fatigue Syndrome
Chronic Fatigue Syndrome is known by
many names such as CFIDS, CFS, chronic Epstein-Barr virus, the "yuppie"
flu, and many other names. It is a complex illness characterized by
incapacitating fatigue, neurological problems, and many other symptoms.
The symptoms may include low-grade fever, sore throat, painful lymph
nodes, muscle weakness, aching, sleep disturbance, vision, attention and
cognitive problems.
Student accommodations will vary
depending upon specific symptoms, which can encompass most of the
accommodations listed previously.
Fibromyalgia
Fibromyalgia is an arthritis-related
condition that causes widespread pain in the muscles and tendons at
specific “tender points” throughout the body. Other symptoms include
chronic fatigue and non-restful sleep. Stress, anxiety, and fatigue make
this condition worse. In addition to medical treatment, other treatments
that have been used include meditation, visualization, relaxation
techniques, stress management, biofeedback, yoga and stretching
exercises, and counseling.
Students with Fibromyalgia will vary
greatly depending on their personal conditions. Their accommodations
will be dependent upon the manifestation of each individual condition.
Lupus
Lupus is a chronic, autoimmune disease,
which causes inflammation of various parts of the body, especially the
skin, joints, blood, and kidneys. The immune complexes that build up in
the tissues can cause inflammation, injury to tissues, and pain. The
symptoms vary with each person, but may include achy joints, fever,
prolonged or extreme fatigue, arthritis, skin rashes, kidney
involvement, pleurisy, photosensitivity, hair loss, seizures, or mouth
or nose ulcers. For most people, lupus is a mild disease affecting only
a few organs. For others it may cause serious and even life-threatening
problems. For the vast majority of people with lupus, effective
treatment can minimize symptoms, reduce inflammation, and maintain
normal bodily functions. Accommodations will be made on an individual
basis.
Multiple Sclerosis
Multiple Sclerosis (MS) is a progressive
disease of the central nervous system, characterized by a decline of
muscle control. Symptoms range from mild to severe and may include
blurred or double vision, legal blindness, tremors, weakness or numbness
in limbs, unsteady gait, paralysis, slurred speech, or cognitive
dysfunction. The age of onset usually occurs between 20 and 40,
therefore, students are likely to have difficulty adjusting to their
condition.
The course of MS is highly
unpredictable. Periodic remission may last from a few days to several
months. Striking inconsistencies in performance are not unusual. For the
appropriate classroom accommodations, refer to the section(s) on speech,
visual impairments, mobility and hand-function disabilities.
Muscular Dystrophy
Muscular Dystrophy refers to a group of
hereditary, progressive disorders that most often occur in young people,
producing degeneration of voluntary muscles of the trunk and lower
extremities. The atrophy of the muscles results in chronic weakness and
fatigue and may cause respiratory or cardiac problems. Walking, if
possible, is slow and appears uncoordinated. Manipulation of materials
in class may be difficult. Refer to the section on mobility and
hand-function impairments for appropriate accommodations.
Seizure Disorder
Students with epilepsy and other seizure
disorders are sometimes reluctant to divulge their conditions because
they fear being misunderstood or stigmatized. Myths about this disorder
include it being a form of mental illness or it is contagious and
untreatable. These misconceptions have arisen because the ultimate
causes remain uncertain. There is evidence that hereditary factors may
be involved and that brain injuries and tumors, occurring at any age,
may give rise to seizures. What is known is that seizures result from
imbalances in the electrical activity of the brain.
Three distinct types of seizures exist:
Petit Mal
means small seizure and is characterized by eye blinking or staring. It
begins abruptly with a sudden dimming of consciousness and may last only
a few seconds. Whatever the person is doing is suspended for a moment
but resumed again as soon as the seizure is over. Often, because of its
briefness, the seizure may go unnoticed by the individual as well as by
others.
Psychomotor seizures
range from mild to severe and may include staring, mental confusion,
uncoordinated and random movement, incoherent speech and behavior
outbursts, followed by immediate recovery. They may last from two
minutes to a half hour. The person may have no recollection of what
happened, but may experience fatigue.
Grand Mal seizures
may be moderate to severe and may be characterized by generalized
contractions of muscles, twitching and limb jerking. A few minutes of
such movements may be followed by unconsciousness, sleep, or extreme
fatigue.
Students with seizure disorders are
often under preventative medication, which may cause drowsiness and
temporary memory problems. Such medication makes it unlikely that a
seizure will occur in class.
In The Event of a Grand Mal Seizure,
Follow This Procedure:
·
Call for
emergency assistance, or have a student do so.
·
Keep calm.
Although its manifestations may be intense they are generally not
painful to the individual.
·
Remove nearby
objects that may injure the student during the seizure.
·
Help lower the
person to the floor and place cushioning under his/her head.
·
Turn the head
to the side so that breathing is not obstructed.
·
Loosen tight
clothing.
·
Do not force
anything between the teeth.
·
Do not try to
restrain bodily movement.
After a seizure, faculty should deal
forthrightly with the concerns of the class in an effort to forestall
whatever negative attitudes may develop toward the student.
Tourette’s Syndrome
Tourette’s Syndrome is a neurological
disorder characterized by involuntary movements and vocalizations that
occur repeatedly in the same manner. The following are more detailed
characteristics: involuntary blinking of eyes, head jerking, flailing
arms, throat clearing, peculiar noises, and ritualistic behaviors. The
movement (tic) is involuntary and as irresistible as a sneeze.
Typically tics increase as a result of
tension or stress and decrease with relaxation or concentration on an
absorbing task. The student’s movement and noises can be annoying or
even somewhat disturbing to the class. Remember, they are occurring
involuntarily so do not react with anger or annoyance.
The severity of symptoms ranges from
very mild (barely noticeable) to severe and disabling. Other symptoms
may include obsessive-compulsiveness, attention deficit disorder or a
learning disability. Classroom accommodations will vary with the
condition. Tests in a private room, which can be proctored by the
instructor, may be necessary. The student can then focus all energy on
the test instead of on suppressing the tics. Permission for the student
to leave the classroom when tics become overwhelming may help.
If the behavior is just poor behavior
and not the result of the Tourette’s Syndrome it should not be
tolerated. Speak to the
student in private about his or her behavior and your classroom
expectations.
Traumatic Brain Injury
Traumatic Brain Injury (TBI) also known
as traumatic head injury (THI) is an acquired injury to the brain caused
by external physical force, resulting in a total or partial functional
disability or psychosocial impairment, or both that adversely affects
educational, social, or daily performance.
TBI is the leading cause of death and
disability in children and adolescents in the United States. The most
frequent causes of TBI are related to motor vehicle crashes, falls,
sports, and abuse or assault.
Students with brain injuries are
becoming increasingly more prevalent on college campuses. As a result of
TBI the student can be affected physically, cognitively, and/or
psychosocially or behaviorally. Any or all of these impairments may be
present to different degrees.
Classroom accommodations will be similar
to those for learning disabilities, attention deficit disorder,
psychological disorders, or physical impairments discussed in previous
sections depending on the student’s affected areas.
In order to work constructively with
students with TBI, the following may be helpful for faculty, staff, or
tutors. This is what the student needs in order to re-learn and
understand concepts after an accident. Every point might not apply as
an academic accommodation, but it presents a picture of people with TBI.
CHARACTERISTICS
·
Memory loss
·
Distractibility
·
Short
attention span
·
Low threshold
for frustration
·
Inability to
deal with abstract and figurative concepts
·
Reduced
stamina
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