Motor Impaired / Orthopedic Disability

Motor impaired/orthopedic disabilities include a heterogeneous grouping of conditions with a wide range of causes. Examples of some of the more common causes which are found in children are

• Nervous system disorders
• Muscular dystrophy
• Cerebral palsy
• Epilepsy
• Respiratory disorders (asthma)
• Spinal cord injuries
• Amputation of all types

One of the first considerations in the effective science education of individuals with motor/orthopedic impairments is a brief understanding of their impairment and the degree of educational accommodations they may need. With such information, a set of adaptive strategies can be derived that are fully appropriate to that particular student. However, since each student and condition varies, some of the strategies may not work for every student.

General Courtesy

While speaking to or interacting with an individual with a motor impairment / orthopedic disability, an instructor should consider the following:

• Ask the student to let you know when he/she needs assistance. Allow the student to be his/her own advocate.
• Do not lean on a student’s wheelchair, walker, or other assistive device. These are part of the student’s body space.
• Do not patronize a student in a wheelchair by patting him/her on the head.
• Encourage students who use crutches, canes, or walkers to keep them within close distance so they are accessible. Make accommodations for addition space when needed.
• Only push a person’s wheelchair when asked to do so. Also, be careful not to lean against a person's wheelchair.
• Be mindful of the environment. If a custodian is cleaning floors, ask for non-skid floor polish.
• If a spill occurs, clean the floor quickly of all liquids. Also, verbalize to the students when such hazards exist.
• If writing is difficult, make accommodations either by allowing additional time or by using a digital audio recorder.
• Encourage students to speak to the instructor about accommodations which have worked in the past and can be implemented in the classroom.
• If it appears that a student needs help, ask if you can help. If the student refuses, be courteous.
• If possible, sit down when speaking to a student in a wheelchair for an extended period of time.
• When planning field trips, take accommodation’s and needs into consideration. Call ahead to make sure your destination is accommodating.
• Words like “running” or “walking” are appropriate. Sensitivity to these words is unnecessary. People who use wheelchairs use these words as well.

General Strategies

The following are general strategies for accommodating people with mobility / orthopedic disabilities:

• If the functional limitation involves the lack of arm use then the use of Dragon-Dictate may be extremely useful. It may be used for such things as computer aided drafting and design (CADD) and other computer applications. There are also assistive technology options for mouse emulation.
• Arrange for library personnel to assist access to card catalogues, bookshelves, and microfiche and other equipment.
• Consider accessibility for transportation to classroom so that student is able to get to class on time.
• Consider accessibility throughout classroom. Consider desk alignment and avenues of movement to and from important classroom elements such as the entrance, lab area, and desk.
• Be familiar with the building's emergency evacuation plan to assure that it is manageable for the students.
• Student, instructor, and teacher aid/ paraprofessional should discuss transportation time between classes. If breaks between classes do not provide enough time for transportation, additional accommodations should be made.
• Instructors should be open to the idea of students recording lectures.
• If needed, consider using table-type desks with adequate leg space in classroom.

Laboratory

The following should be taken into consideration during laboratory activities:

• Allow more time for the student to complete the lab activities.
• Alter the height of tables to the student’s needs.
• Built-in lab tables (or small ramp/platforms) may need to be modified to accommodate wheelchairs.
• Working with the student, consider using alternate procedures while not disengaging the student from the activity.  
• Assign a thoughtful lab partner. One who can help to reach or manipulate objects as needed, but will not complete tasks for the student with a disability.
• Be aware of, and prevent the possible overheating of students who have poor heat regulation.
• All students should participate in activities as fully as possible.
• For students who cannot fully use a computer because of physical limitations, use alternative technology.
• If appropriate, provide assistance. However, provide positive reinforcement when the student shows the ability to do something unaided.
• In the laboratory, place water, gas, and electric facilities in accessible locations.
• Increase size of wheels, dials, handles, and buttons on lab equipment if needed.
• Place supplies and equipment in accessible locations.
• Perhaps a change in aisles (by relocating desks and/or chairs) is needed for wheelchair access.
• For hoods in laboratories, have operating knobs and switches within easy access.
• Provide an accessible means for the recording of data, charts, or graphs.
• Select non-manual types of laboratory teaching techniques (e.g., electronic probes vs. pipette bulbs).
• Use electric hot plates instead of Bunsen burners as heat sources.
• Use laboratory sinks that are accessible from three sides to enable use for individuals with limited movement.
• Use low-force electric micro switches for lights and equipment.
• Use modified lids on the tops of containers (wider and bigger).
• Use a portable eye wash.
• When information gathering involves a physical action that the student cannot perform, try using a different type of experience that will yield the same information.

Strategies for Group Interactions & Discussions

While participating in group interactions and discussions, consider the following:

• Include all students in group projects, interactions, and discussions.
• If needed, allow students more time to complete activities.
• Lower chalkboard, whiteboard, or screen for information to be accessed by all.
• Treat students with disabilities as equal partners within groups with peers.

Reading

While participating in reading assignments, consider the following:

• Acknowledge student understanding using non-verbal forms of communication.
• Use a smart phone or other device to record digital audio.
• Break large amounts of text into smaller sections.
• If needed, consider using easels, portable reading racks, or adjustable seats and desks.
• Allow additional time to complete reading if necessary.
• If a student is able to use a computer that can be a better option for reading. Please be able to provide electronic formats.

Field Experiences

While participating in field experiences with students, consider the following:

• Discuss areas of difficulty with student. Together, create a plan for alternative procedures when necessary with the goal of not disengaging the student.
• If needed, consider alternative activities which have the same learning outcome / objectives.
• Before attending a field experience, call ahead to be certain that students in wheelchairs are able to participate fully.
• When planning for transportation, be mindful of the needs of students who use wheelchairs, walkers, or canes. Additional space on buses or alternative buses may be needed.
• While on the field experience provide assistance when needed, but provide positive reinforcement when activities are completed independently.
• The peer-buddy system is a strong tool for providing support for all students throughout a field experience.
  • Providing each student with a buddy allows everyone to have someone to work with. This includes students with disabilities as well as their peers.
• If possible, increase wheel, button, or handle size on equipment.
• Make special arrangements with the curators of the field experience if needed in order to provide meaningful experiences for all students.
• While considering if a field experience is appropriate, take the following into account;
  • Are there parking spaces reserved for people with disabilities?
  • Is there a ramp or step-free entrance?
  • If the site is not on the ground floor, does the building have an elevator?
  • Are water fountains and telephones low enough for a student in a wheelchair?
  • Discuss any special needs with students.

Research

Take the following into consideration while participating in research activities:

• Review and discuss with the student the steps involved in a research activity.
• Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.
• Depending on the site of the research check the previous two sections.

Testing

Take the following into consideration during testing:

• Allow more time for students with disabilities to complete testing.
• If necessary, use an alternative location for testing. This may allow students to take their time without the pressure of seeing peers complete exams.
• Give exams in a manner which is meaningful to the student. If the student requires oral or computer based exams, teachers should be accommodating. 
• If needed, allow students to submit answers using alternative means such as an audio recording.
• Consider using “writers” for students, having them orally disseminate their answers while a peer writes them down.
• Be aware of the time needed for writing. Some students may need additional time based on writing speed.
• Provide assessments in different forms other than testing.

Organizations

The Christopher and Dana Reeve Foundation
The Christopher and Dana Reeve Foundation is a merger of the American Paralysis Association and the Christopher Reeve Foundation. It is a national nonprofit organization that supports research to develop effective treatments and a cure for paralysis caused by spinal cord injury.

Council for Exceptional Children – Division for Physical, Health, & Multiple Disabilities
The Division for Physical, Health and Multiple Disabilities (DPHMD) is the official division of the Council for Exceptional Children (CEC) that advocates for quality education for all individuals with physical disabilities, multiple disabilities, and special health care needs served in schools, hospitals, or home settings.

The Epilepsy Foundation
The Epilepsy Foundation of America is the national organization that works for people affected by seizures through research, education, advocacy, and service.

Facing Disability
Facing Disability is a web resource with more than 1,000 videos drawn from interviews of people with spinal cord injuries, their families, caregivers and experts.

Mobility International, USA
The American office of this London-based organization founded in 1973 to integrate persons with disabilities into international educational exchange programs and travel.

Model Spinal Cord Injury Systems Dissemination Center
The model spinal cord injury systems dissemination center provides educational materials and products that help people with this disability and also organize presentations.

The Muscular Dystrophy Association
A source for news and information about 40 neuromuscular diseases, MDA research and services is available to adults and children with neuromuscular diseases and their families.

National Multiple Sclerosis Society
The National MS Society, a non-profit organization offers programs and services including local referrals, information and education, professional and peer counseling, self-help groups, equipment assistance, and more.

The National Spinal Cord Injury Association
The NSCIA assists in the development of regional systems of comprehensive and integrated care, treatment, rehabilitation, and community living.

United Cerebral Palsy Association
This site provides information on the programs and services of one of the nation's health charity, it also offers a wealth of information on a variety of disability topics.

Disability-Specific Information

Nervous System Disorder

(Information available at www.hopkinsmedicine.org)

Disorders of the nervous system may involve vascular disorders (i.e. stoke), infections (i.e. meningitis, polio), structural disorders (i.e. brain or spinal cord injuries, Bell’s palsy), and degeneration (i.e., multiple sclerosis). Symptoms of nervous system disorders may include memory loss, lack of coordination, muscle rigidity, weakness or loss of muscle strength, and back pain which may radiate to extremities. Each individual may experience common symptoms differently.

Reference: Overview of nervous system disorders (n.d.) In John Hopkins Medicine. Retrieved from www.hopkinsmedicine.org/healthlibrary/conditions/adult/
nervous_system_disorders/overview_of_nervous_system_disorders_85,P00799/#

Muscular Dystrophy

(information retrieved from Davis & Dillon, 2010)

Muscular Dystrophy is an inherited, progressive disease of the muscular system causing weakness and atrophy. The type of MD is dependent on the specific gene mutation. Some characteristics of muscular dystrophy are that muscles fatigue easily, muscular weaknesses may lead to postural changes, and a decrease in motivation to learn or emotional changes as a result of progression of the disease.

Referenece: Davis, T. & Rocco-Dillon, S, (2010). Adapted Physical Education Desk Reference. PE Central Publishing, Blacksburg, VA.

Epilepsy

Epilepsy is not a disease, but a malfunction of the electrical pathways in the neurons (nerve cells) of the brain. Epileptic seizures are a result of these neuro-electrical irregularities in the brain neurons. Anti-convulsant medication can either completely or partially control seizures in approximately 80 percent of the epileptic individuals. A major problem with epileptic students whose seizures are not completely controlled by medication is the non-predictability of the occurrence of seizures.

Cerebral Palsy

Cerebral palsy is the term that covers a wide range of physical disabilities caused by damage to the brain during development. The impairment can range from severe to mild. Movement and posture are impaired and other conditions such as intellectual impairment, epilepsy, blindness, or deafness may also exist, depending on which area of the brain has been affected and the extent of the damage. Most people with cerebral palsy are not intellectually disabled, and most cerebral palsy individuals with physical impairments usually have a normal range of intelligence.

Respiratory Disorders (Asthma)

(Information available at National Heart Lung & Blood Institute)

Respiratory Disorders including asthma are characterized as chronic lung diseases that inflame and narrow the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing. Asthma affects people of all ages, but it most often starts during childhood.

Reference:  What is asthma? (n.d.) In National Heart Lung & Blood Institute. Retrieved from www.nhlbi.nih.gov/health/health-topics/topics/asthma/

Amputation

Amputation is the removal of an injured or diseased body part. An amputation may be the result of a traumatic injury, or it may be a planned operation to prevent the spread of the disease in an infected finger or hand.  Students who have had amputations of upper body or lower body limbs may use prosthetics as assistive technology for everyday life.