Orthopedic Handicaps

Orthopedic Handicaps Cerebral Palsy & Spinal Cord Injury Daniel Ewald Physical Disability vs. Orthopedic Impairment • Physical disabilities – severe or multiple disabilities, – traumatic brain injury, and – other health impairments. • Orthopedic impairment is simply more specific. • From IDEA: Orthopedic impairment means a severe orthopedic impairment that adversely affects a child’s educational performance. The term includes impairments caused by congenital anomaly, impairments caused by disease, and impairments from other causes. (C.F.R. Sec. 300.7(b)(7)) Traits of Cerebral Palsy (CP) • Cerebral = Brain injury • Palsy = lack of muscular control • An injury to the brain • Maybe detectable at birth • Must be diagnosed before age 6/3** • Is not progressive • Usually have normal life span – Symptoms may increase or decrease – The motor area, or muscular control, is damaged • Can happen in either left or right hemisphere or both • Different degrees depending on cause and time Symptoms of Cerebral Palsy • • • • • Difficulty with balance or walking Involuntary movements Sensory problems May have seizures Mental Retardation • Stuttering/Vocal Impairments – 3% of all kids have mental retardation – 50-70% pr kids with cerebral palsy have mental retardation – Due to this, students maybe thought to have mental retardation since they are unable to communicate effectively. Cerebral Palsy Basics • Anyone with CP has terms attached to their condition associated with when, type, and location(s) affected – When did it happen? – What Type is it? • Prenatal – before birth • Perinatal – during birth • Postnatal – after birth – Where is it mostly Located? •Monoplegia – one limb •Paraplegia – legs only •Hemiplegia – half the body • • • • Spastic\Hypertonic – tightness prevents movement Athetoid – involuntary movement Ataxic – lack of coordination, balance, trouble walking Mixed – Can form any combination •Quadplegia – all limbs •Diplegia – Legs affected more than arms •Triplegia – 3 limbs (usually legs and 1 arm) •Double hemplegia – Arms affected more than legs QUIZ!!! • Based on the terms on the past page, • Hints: Happened due to umbilical cord what is Daniel’s type of Cerebral Palsy? complications. Only one type. Two location terms. Perinatal– Ataxic – Hemiplegia – Diplegia – Cerebral Palsy CP Statistics • It’s estimated 2 to 3 people out of every 1000 have cerebral palsy. • Usually overshadowed by other – There are over 50,000 Canadians with CP. disabilities. • In 97-98, about 1.2% of students had CP Causes • During pregnancy – – – – – multiple births damaged placenta infections poor nutrition malformations of brain • During labor: • In early childhood: – – – – – – premature delivery – abnormal positioning of the baby – lack of O2 infection such as meningitis brain hemorrhages head injury lack of O2 seizures Preventable causes • Head injury – Accident, “shaken baby syndrome” • Jaundice • Meningitis • Severe lead poisoning • Rh incompatibility • Ruebella (German measels) Spinal Cord Injury Quiz What would stop working if you suffered a SCI at one of the following numbers? 1 2 1=Dead 2=Diaphragm 3=Hands 3 4 5 4=Chest 5=Abdominal 6=Legs 7=Genitals 6 7 Spinal Cord Injury Terms • Paraplegia – P – paralysis from the waist down • Quadriplegia – Q – paralysis from the shoulders down • Complete – C – total loss below SCI • Incomplete – I – partial control below SCI • People have one underlined and one italic Traits of SCI • Depends on type of SCI – Numbness, tingling, loss of sensation, pain, or involuntary movement • Total or partial paralysis occurs – Total – no sensory input or movement – Partial – some sensory input and movement • Severity of injury and location on the spinal cord determines what will be affected and how • Possible to regain movement – Recovery occurs soon after injury till 2 years – Afterwards, very low chances Secondary Medical Problems From SCI • Bladder and urinary tract infections • Lung infections • Skin break down • Pressure sores (bedcores, particularly on buttocks) • Blood clots • Osteoporosis • Cardiovascular disease • An injury to the spinal cord What Causes SCI? – Spinal cord is a “rope” of nerve fibers – This rope is damaged in some way • Mild – can be fixed or small muscular loss • Severe – rope is severed SCI is also rarely caused by… • Blood clots • Abscesses • Tumors • Polio • Spina bifida • Friedrich's Ataxia (rare genetic disorder) SCI Facts • Incidence – between 183,000 and 230,000 people have it now – 11,000 new cases each year • SCI primarily affects young adults – 55% of SCI occurs from 16 – 30 yr old • SCI effects all ethnicities pretty much equally, – Almost half of cases caused by MVA – Falls, violence and sports contribute equally following percentages of the population closely • Cause Emotional Impact of SCI • When SCI occurs to students the effects are very traumatic • Suicide rates are generally higher – As time goes on, chances lessen • Students may face alienation from friends – Students can no longer participate as much • Students may feel like they cannot do anything Cerebral Palsy & Spinal Cord Injury Common Traits • Cerebral Palsy – an injury to the brain • Spinal Cord Injury – an injury to the spine • Both impede movement – Both have various degrees of affliction • Widely shown on TV – Celebrities – Commercials – TV characters • Pelswick, the first main character who is handicapped Treatments for CP & SCI • Physical Therapy – Practice day-to-day tasks – Try to (re)gain as much control as possible • Surgery – Not widely used since medicine has not yet been able to fix nerve damage in the brain or spine – Can be used to lessen pain, or loosen muscles • Stem Cells offer a viable cure for CP & SCI since nerve cells can be regrown – Tests in lab rats show nerve cells can be regrown Two Types of Technology used in the Class for CP and SCI • Augmentative (Alternative) Communication – Physically involved but cognitively able – Multiply involved with unknown cognitive abilities – Dispraxic, language delayed – Pre-verbal or emergent-verbal • Assistive Technology – Physically involved but cognitively able – Physically involved with unknown cognitive abilities – Multiply involved with unknown cognitive abilities – Fine Motor difficulties – Developmentally delayed How to Use Technology and Augmentative Communication Systems • Technology and Augmentative Communication • • • • Systems can be very powerful, but they are useless in enabling children to realize their potential without appropriate training and a supportive environment. Augmentative language or assistive technology system means: multiple systems. Assessment and evaluation are on-going TEAM processes. Vocabulary and Symbol selection are ongoing processes. Augmentative communication is effectively taught in an environment comparable to foreign language immersion. Continued • Augmentative Communication and Assistive • • • • Technology is most effective if taught in an interactive and pragmatic format. Partner training can play an important role in the success of communication and adaptations. Classroom and home integration are crucial to success. The art and science of augmentative communication and Assistive Technology is still a developing field. Implementing augmentative communication and assistive technology consumes an enormous amount of time and energy from therapists, teachers, parents and the child. But it's worth it! • Improves self-concept and self esteem • Provides motivation • Reduce frustration and behavior problems • Increase participation in daily life • Facilitates learning by making learning interactive instead of passive • Changes expectations of others for child's potential Main Thing to Keep In Mind with Orthopedic Handicaps… • MAKE THE ROOM HANDICAP ACCESSIBLE – Move the desks around – Make things lower – Allow extra time for student to get from point A to point B – If they have a powered wheelchair, seat them near an electrical outlet • Make sure it is alright with the student to have others push him/her Let’s See How Handicap accessible Towson Is • “All academic buildings have doors which meet A.D.A. criteria (lbs./pull).” – NOT all doors to academic buildings meet A.D.A. criteria. • “attendant operated” elevators • “Buildings with three levels or less may only have one accessible restroom.” – Students may need extra time to get to and from restrooms. Map handouts • Map the route from your dorm or parking garage to your first class. Would you have to alter the route for a person with physical disabilities? • Try this: – Get from the Towers to the Union Parking Garage!!! – Get into Newell Hall!!! But Just Because They May Be In A Wheelchair, Does Not Mean They Cannot Succeed