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Orthopedic Impairments often refer to physical disabilities or conditions that mostly affect the musculoskeletal system. This is considered a blanket term because many conditions can fall under an orthopedic impairment. Conditions such as scoliosis, muscular dystrophy, and cerebral palsy are all examples of orthopedic impairments. The challenges of orthopedic impairments can affect learning, day-to-day functions, and even one's social life.

Common abbreviations include:

Orthopedic Impairment (OI)

Cerebral Palsy (CP)

Osteoarthritis (OA)

Scoliosis (SCL)

Muscular Dystrophy (MD)

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Characteristics of those who have orthopedic impairments can vary based on the location and the severity of their condition. Some general characteristics that most people face include

Physical:

-Limited Mobility

-Assistive Devices

-Pain and Discomfort

Cognitive:

-Adaptability

-Anxiety

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-Extended time for assignments

-Specialized equipment

-Individualized Education Program (IEP)

-Frequent Breaks

-504 Plan

-Test-taking arrangments

-Modified Activites

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Identification Procedures & Service Delivery

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Identification Procedures & Service Delivery

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Students who have orthopedic impairments are able to be in classrooms, while some students may need additional assistance. For students who need additional assistance, IEPs or Individualized Education Programs are used to assess whether or not a student needs adapted seating, extended times for assignments, smaller classrooms, and many more adaptable procedures for students. A 504 Plan is also needed to help support students. The 504 plan ensures that students have the same educational opportunities as others. It is also very similar to an IEP because there may be seating arrangements and modifications used to better support the student.

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Some behavioral management and social strategies for those with orthopedic impairments include

- Individual strategies to manage frustration, such as expressing their emotions verbally or practicing relaxation techniques.

- Make sure the environment is fully accessible with features like ramps, accessible restrooms, and appropriate seating, and adjust tasks to suit individual needs.

- Incorporate tools like communication devices, adaptive writing instruments, or mobility aids to foster independence and minimize frustration.

-Emphasize positive reinforcement through praise and recognition of desired behaviors.

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National: Project Ideal showcases ways educators can improve strategies to better support students with orthopedic impairments.

https://www.dpi.nc.gov/districts-schools/classroom-resources/exceptional-children/resources-for-educators#:~:text=Accessible%20Education%20Materials%20General%20Information,-Co%2D%20Leads:&text=org.,with%20the%20Public%20School%20Unit.

State: The NC Department of Instruction explains orthopedic impairments as well as other conditions. It also goes into detail about supporting students.

https://www.dpi.nc.gov/districts-schools/classroom-resources/exceptional-children/programs-services

Local: Public schools that offer services for orthopedic students, such as mobility instruction and occupational therapy.

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Definition

Orthopedic impairment is defined as a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments 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 contractures).

Prevalence

The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 1.1%, or 68,188 students, received special education services based on a classification of orthopedic impairments.

Characteristics

The IDEA category of orthopedic impairments contains a wide variety of disorders. These can be divided into three main areas: neuromotor impairments, degenerative diseases, and musculoskeletal disorders. The specific characteristics of an individual who has an orthopedic impairment will depend on both the specific disease and its severity, as well as additional individual factors.

A neuromotor impairment is an abnormality of, or damage to, the brain, spinal cord, or nervous system that sends impulses to the muscles of the body. These impairments are acquired at or before birth, and often result in complex motor problems that can affect several body systems. These motor problems can include limited limb movement, loss of urinary control, and loss of proper alignment of the spine. The two most common types of neuromotor impairments are cerebral palsy and spina bifida.

Cerebral palsy refers to several nonprogressive disorders of voluntary movement or posture that are caused by malfunction of or damage to the developing brain that occurs before or during birth or within the first few years of life. Individuals with cerebral palsy have abnormal, involuntary, and/or uncoordinated motor movements. The four most common types of cerebral palsy include:

Spastic (very tight muscles occurring in one or more muscle groups that result in stiff, uncoordinated movements)

Athetoid (movements are contorted, abnormal, and purposeless)

Ataxic (poor balance and equilibrium in addition to uncoordinated voluntary movement)

Mixed (any combination of the types)

Cerebral palsy is also classified by which limbs (arms and legs) are affected. Major classifications include hemiplegia (left or right side), diplegia (legs affected more than arms); paraplegia (only legs), and quadriplegia (all four limbs).

Spina bifida is a developmental defect of the spinal column. Spina bifida is characterized by an abnormal opening in the spinal column and frequently involves some paralysis of various portions of the body. It may or may not affect intellectual functioning. Spina bifida is usually classified as either spina bifida occulta or spina bifida cystica. Spina bifida occulta is a mild condition while spina bifida cystica is more serious.

Degenerative diseases are composed of various diseases that affect motor development. The most common degenerative disease found in the school population is muscular dystrophy. Muscular dystrophy is a group of inherited diseases characterized by progressive muscle weakness from degeneration of muscle fibers.

Musculoskeletal disorders are composed of various conditions that can result in various levels of physical limitations. Two examples of musculoskeletal disorders include juvenile rheumatoid arthritis and limb deficiency.

Impact on Learning

The specific impact on learning of an individual is contingent upon the disease, its severity, and individual factors. Two individuals with identical diagnoses may be quite different in terms of their capabilities.

Many students with orthopedic impairments have no cognitive, learning, perceptual, language, or sensory issues. However, individuals with neuromotor impairments have a higher incidence of additional impairments, especially when there has been brain involvement. For most students with orthopedic impairments, the impact on learning is focused on accommodations necessary for students to have access to academic instruction.

Teaching Strategies

As with most students with disabilities, the classroom accommodations for students with orthopedic impairments will vary dependent on the individual needs of the student. Since many students with orthopedic impairments have no cognitive impairments, the general educator and special educator should collaborate to include the student in the general curriculum as much as possible.

In order for the student to access the general curriculum, the student may require these accommodations:

Special seating arrangements to develop useful posture and movements

Instruction focused on development of gross and fine motor skills

Securing suitable augmentative communication and other assistive devices

Awareness of medical condition and its affect on the student (such as getting tired quickly)

Because of the multi-faceted nature of orthopedic impairments, other specialists may be involved in developing and implementing an appropriate educational program for the student. These specialists can include:

Physical Therapists who work on gross motor skills (focusing on the legs, back, neck and torso)

Occupational Therapists who work on fine motor skills (focusing on the arms and hands as well as daily living activities such as dressing and bathing)

Speech-Language Pathologists who work with the student on problems with speech and language

Adapted Physical Education Teachers, who are specially trained PE teachers who work along with the OT and PT to develop an exercise program to help students with disabilities

Other Therapists (Massage Therapists, Music Therapists, etc.)

Assistive Technology

Due to the various levels of severity of orthopedic impairment, multiple types of assistive technology may be used. As with any student with a disability, the assistive technology would need to address a need of the student to be able to access the educational curriculum. For students with orthopedic impairments, these fall into three categories:

Devices to Access Information: These assistive technology devices focus on aiding the student to access the educational material. These devices include:

speech recognition software

screen reading software

augmentative and alternative communication devices (such as communication boards)

academic software packages for students with disabilities

Devices for Positioning and Mobility: These assistive technology devices focus on helping the student participate in educational activities. These devices include:

canes

walkers

crutches

wheelchairs

specialized exercise equipment

specialized chairs, desks, and tables for proper posture development

Organizations

United Cerebral Palsy Associations, Inc.

1660 L Street NW, Suite 700
Washington DC 20036

Web: www.ucp.org

United Cerebral Palsy of Texas

The national organization and its nationwide network of affiliates strive to ensure the inclusion of persons with disabilities in every facet of society-from the Web to the workplace, from the classroom to the community. As one of the largest health charities in America, the mission of United Cerebral Palsy is to advance the independence, productivity and full citizenship of people with disabilities through an affiliate network.

1016 La Posada, Suite 145
Austin, TX 78752

Email: info@ucptexas.org
Web: www.ucptexas.org

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Easter Seals--National Office

Easter Seals offers help, hope and answers to more than a million children and adults living with autism and other disabilities or special needs and their families each year. Services and support are provided through a network of more than 550 sites in the U.S. Each center provides exceptional services that are individualized, innovative, family-focused and tailored to meet specific needs of the particular community served.

230 West Monroe Street, Suite 1800
Chicago, IL 60606-4802

Web: www.easter-seals.org

March of Dimes Birth Defects Foundation

The March of Dimes mission is to improve the health of babies by preventing birth defects, premature birth, and infant mortality. They carry out this mission through research, community services, education and advocacy to save babies' lives. March of Dimes researchers, volunteers, educators, outreach workers and advocates work together to give all babies a fighting chance against the threats to their health: prematurity, birth defects, low birthweight.

1275 Mamaroneck Avenue
White Plains, NY 10605

Phone: 914-428-7100; 888-663-4637
Email: askus@marchofdimes.com
Web: www.marchofdimes.com

National Rehabilitation Information Center (NARIC)

The core mission of the Center is to collect and disseminate the results of research funded by the National Institute on Disability and Rehabilitation Research (NIDRR). NARIC staff members have been dedicated to providing direct, personal, and high-quality information services to anyone throughout the country.

4200 Forbes Boulevard, Suite 202
Lanham, MD 20706

Email: naricinfo@heitechservices.com
Web: www.naric.com

Spina Bifida Association of America

The Spina Bifida Association (SBA) serves adults and children who live with the challenges of Spina Bifida. Since 1973, SBA has been the only national voluntary health agency solely dedicated to enhancing the lives of those with Spina Bifida and those whose lives are touched by this challenging birth defect. Its tools are education, advocacy, research, and service.

4590 MacArthur Boulevard, N.W., Suite 250
Washington, DC 20007

National Institute of Neurological Disorders and Stroke (NINDS)

The mission of NINDS is to reduce the burden of neurological disease - a burden borne by every age group, by every segment of society, by people all over the world. NINDS conducts, fosters, coordinates, and guides research; operates research projects, program projects, and research center grants; and collects and disseminates research information related to neurological disorders.

National Institutes of Health
National Institue of Neurological Disorders and Stroke
P.O. Box 5801
Bethesda, MD 20824

Web: www.ninds.nih.gov

References

Gargiulo, R.M. (2006). Special education in contemporary society: An introduction to exceptionality. Belmont, CA: Thomson Wadsworth.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives: Special education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

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Orthopedic impairment is defined as a severe orthopedic impairment that adversely affects a child's educational performance.

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National: The federation for children with special needs provides parents with resources such as insurance, family support, and parent-to-parent support groups.

https://prepparents.org/resources/for-parents/special-education-parent-guides/north-carolina-special/

State: The NC PREP Program teaches parents about special education and how to access their child's needs when it comes to public education.

https://www.lcpsnc.org/services/exceptional-children

Local: Lenoir County Public Schools provides parents with different services for their children, including therapists and behavioral support.

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The Federation empowers families so that they have the information and resources they need for their children. We work with families with children from birth to adulthood, providing individual assistance, training, and leadership development and support. We focus on education, early intervention, health care, transitions, children in foster care and group homes, and building strong family engagement to support all children, especially those children with disabilities, those at risk, and those with economic, cultural or linguistic barriers.

Enter a keyword or phrase to search our website for resources, trainings or assistance.

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Federation for Children with Special Needs

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The Federation empowers families so that they have the information and resources they need for their children. We work with families with children from birth to adulthood, providing individual assistance, training, and leadership development and support.

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Orthopedic Physician Associates. (2022, December 24). Orthopedic Impairment: Definition, Characteristics, Causes & Types | OPA. OPA Ortho. https://www.opaortho.com/what-is-orthopedic-impairment/

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What Is an Orthopedic Impairment? (2020, June 26). Bowen Hefley Orthopedics. https://www.drbillhefley.com/what-is-an-orthopedic-impairment/

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Danville Community College. (n.d.). Mobility and orthopedic disabilities. Danville Community College. https://danville.edu/mobility-and-orthopedic-disabilities

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