Disability Resource Guide for Teachers, Parents, and Students: Other Health Impairments
Rachael Pope/ Kwesi Payne
Towson University
Special Education 637
July 5th, 2011


I. Background Information on Other Health Impairments

Description of Disability:

Other Health Impairment” is one of the 14 categories of disabilities listed in our nation’s special education law, the Individuals with Disabilities Education Act (IDEA). Under IDEA, a child who has an “other health impairment” is very likely to be eligible for special services to help the child address his or her educational, developmental, and functional needs resulting from the disability.

IDEA states that:

Other health impairment: having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—

(1) Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and

(2) Adversely affects a child’s educational performance.

Characteristics:

According to the Starbright Foundation, there are numerous complex challenges facing children with health impairments. Common issues are: “loss of sense of control, lack of understanding about the condition, fear, worry, anxiety, stress, anger, and guilt, changes in family dynamics, isolation, isolation, medical noncompliance, boredom, depression, pain, decreased self-esteem, negative body image, and impact on identity and social interactions, including those at school”.Some general characteristics faced by individuals with other health impairments may include but not limited to:

  • Fatigue

  • Mobility issues

  • Issues involving attention

  • Coordination difficulties

  • Muscle weakness

  • Frequent absences or lateness’s to school

  • Stamina

  • Inability to concentrate for long periods of time


Prevalence:

According to the 26th Annual Report (U.S. Department of Education, 2004), 449,093 students between the ages of 6 to 21 years of age were identified as having other health impairments. This represents approximately 7.5 percent of all students having a disability.



Determining eligibility for Special education:
To determine eligibility for special education for a child, comprehensive evaluation process is performed by a multidisciplinary evaluation team, which must include an orthopedic surgeon, internist, neurologist, pediatrician, or a family physician or any other approved physician. More specifically, to qualify as OHI eligible, a child must meet four conditions. First, he or she must suffer from a chronic or acute health condition (samples listed above). Second, the health condition must cause limited alertness to the educational environment due to limited strength, vitality, or alertness or heightened alertness to the surrounding environment. Third, the child’s educational performance must be adversely affected by the classification in special education, or less than 1% of all school-age students disability. A child with limited alertness whose educational performance is not affected does not qualify for placement as OHI. Finally, OHI, like all other qualifying conditions, must create a need for special education services. Generally speaking, analysis of OHI eligibility first considers the child’s health condition and its general effects on the child, and then looks separately at the disability’s effect on the child’s educational performance.
School officials deciding whether a child qualifies for special education services as OHI can begin by asking the following questions:
1. Does the student have a chronic or acute health problem?
2. Does the student have limited strength, vitality, or alertness? If not, does he or she have heightened alertness to general environmental stimuli?
3. If so, does the student’s limited strength, vitality, or limited alertness reduce his or her alertness in the educational environment? Or does the child’s heightened alertness to the surrounding environment limit his or her alertness to the educational environment? If so, is the limited, or heightened, alertness due to a chronic or acute health problem?
4. If so, is the student’s educational performance adversely affected by the limited alertness?
5. Finally, if so, does the disability create a need for special education?
Below is a link of an example of a Special Education Eligibility Criteria and Evaluation for Other Health Impairment (OHI) that is withheld in Wisconsin.
http://www.dpi.state.wi.us/sped/ohi.html
(Click on “OHI Eligibility Guide”)



II. Strategy and Intervention Practices

NOTE: While doing research on other health impairments, it became rather evident that most of the information out there is based on ADHA. The strategies listed below are based on children with ADHD however can be associated with any other OHI.
Evidence Based Strategies and Interventions:

Teachers who are successful in educating children with ADHD use a three-pronged strategy. They begin by identifying the unique needs of the child. For example, the teacher determines how, when, and why the child is inattentive, impulsive, and hyperactive. The teacher then selects different educational practices associated with academic instruction, behavioral interventions, and classroom accommodations that are appropriate to meet that child’s needs. Finally, the teacher combines these practices into an individualized educational program (IEP) or other individualized plan and integrates this program with educational activities provided to other children in the class. The three-pronged strategy, in summary, is as follows:

1. Evaluate the child’s individual needs and strengths. Assess the unique educational needs and strengths of a child with ADHD in the class. Working with a multidisciplinary team and the child’s parents, consider both academic and behavioral needs, using formal diagnostic assessments and informal classroom observations. Assessments, such as learning style inventories, can be used to determine children’s strengths and enable instruction to build on their existing abilities. The settings and contexts in which challenging behaviors occur should be considered in the evaluation.

2. Select appropriate instructional practices. Determine which instructional practices will meet the academic and behavioral needs identified for the child. Select practices that fit the content, are age appropriate, and gain the attention of the child.

3. For children receiving special education services, integrate appropriate practices within an IEP. In consultation with other educators and parents, an IEP should be created to reflect annual goals and the special education-related services, along with supplementary aids and services necessary for attaining those goals. Plan how to integrate the educational activities provided to other children in your class with those selected for the child with ADHD.


Promising Strategies and Interventions:
Behavioral Interventions

The purpose of behavioral interventions is to assist students in displaying the behaviors that are most conducive to their own learning and that of classmates. Well-managed classrooms prevent many disciplinary problems and provide an environment that is most favorable for learning. When a teacher’s time must be spent interacting with students, whose behaviors are not focused on the lesson being presented, less time is available for assisting other students. Behavioral interventions should be viewed as an opportunity for teaching in the most effective and efficient manner, rather than as an opportunity for punishment.

Effective teachers use a number of behavioral intervention techniques to help students learn how to control their behavior.

Define the appropriate behavior while giving praise. Praise should be specific for the positive behavior displayed by the student: The comments should focus on what the student did right and should include exactly what part(s) of the student’s behavior was desirable. Rather than praising student for not disturbing the class, for example, a teacher should praise him or her for quietly completing a math lesson on time.

Give praise immediately. The sooner that approval is given regarding appropriate behavior, the more likely the student will repeat it.

Vary the statements given as praise. The comments used by teachers to praise appropriate behavior should vary; when students hear the same praise statement repeated over and over, it may lose its value.

Be consistent and sincere with praise. Appropriate behavior should receive consistent praise. Consistency among teachers with respect to desired behavior is important in order to avoid confusion on the part of students with ADHD. Similarly, students will notice when teachers give insincere praise, and this insincerity will make praise less effective.

Selectively ignore inappropriate behavior. It is sometimes helpful for teachers to selectively ignore inappropriate behavior. This technique is particularly useful when the behavior is unintentional or unlikely to recur or is intended solely to gain the attention of teachers or classmates without disrupting the classroom or interfering with the learning of others.

Use With Caution Strategies and Interventions:

The following tools and techniques may be helpful but could have a negative affect:

Pointers. Teach the child to use a pointer to help visually track written words on a page. For example, provide the child with a bookmark to help him or her follow along when students are taking turns reading aloud.

Egg timers. Note for the children the time at which the lesson is starting and the time at which it will conclude. Set a timer to indicate to children how much time remains in the lesson and place the timer at the front of the classroom; the children can check the timer to see how much time remains. Interim prompts can be used as well. For instance, children can monitor their own progress during a 30-minute lesson if the timer is set for 10 minutes three times.

Classroom lights. Turning the classroom lights on and off prompts children that the noise level in the room is too high and they should be quiet. This practice can also be used to signal that it is time to begin preparing for the next lesson.

Music. Play music on a tape recorder or chords on a piano to prompt children that they are too noisy. In addition, playing different types of music on a tape recorder communicates to children what level of activity is appropriate for a particular lesson. For example, play quiet classical music for quiet activities done independently and jazz for active group activities.

III. In the News

Popular Press- Articles, Videos:

Peer Reviewed Journal Articles (2005 or later):

IV. Resources

Teacher Resource:
Some teacher resources for students with O.H.I. include:
  • The I.E.P. – the I.E.P. provides the teacher with a snapshot of the student’s disability and guides the teacher as how he/she should differentiate the lessons for the student
  • Guidance/School Counselors – serve as a resource of information for preparing lessons and handling any issues that may arise in the classroom with the student; Counselors also serve as a liaison between the parents and the teacher
  • School Administration – help teachers to deal with issues that may arise in the classroom (particularly behavioral issues); Administration often times serves as another liaison between teachers and parents.
  • Manipulatives (such as algebra tiles, response boards, etc.)
Assistive Technologies (AT)
Parent Resources:
There are some resources available to parents of students diagnosed with O.H.I. Some of these resources include:
Student Resources:
Resources for students include:
  • Guidance Counselors
  • Special Education Department
  • School Administration
  • Teachers
  • School Nurse
Relevant Electronic Resources for Any and All:
  • National Dissemination Center for Children with Disabilities:
http://nichcy.org/
  • Centers for Disease Control and Prevention
http://www.cdc.gov/
  • National Institute for Mental Health
http://www.nimh.nih.gov/index.shtml
  • National Association of Special Education Teachers
http://www.nimh.nih.gov/index.shtml