According to the Individuals with Disabilities Education Improvement Act of 2004 (IDEA), orthopedic impairment is as follows: “a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments due to the effects of congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments due to the effects of disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures)” (Pierangelo & Giuliani, 2007, p. 268). Examples:
Disabling physical problems such as those resulting from poliomyelitis, bone tuberculosis, cerebral palsy, amputations, and fractures or contractures from burns would be considered as orthopedic impairments under the IDEA.
This disability category includes all orthopedic impairments, regardless of cause. Examples of potential causes of orthopedic impairment include genetic abnormality, disease, injury, birth trauma, amputation, burns, or other causes.
Other causes of orthopedic impairments may include:
· Spina bifida
· Nervous system disorders
· Traumatic spinal cord injury
· Muscular Dystrophy
· Cerebral Palsy
Orthopedic impairments involve a wide range of causes and a diverse group of students. Some children have impairments caused by congenital anomalies, whereas others have experienced injuries or conditions that have resulted in orthopedic impairments. Congenital causes include cerebral palsy, osteogenesis imperfecta, joint deformity, and muscular dystrophy. Motor vehicle accidents, sports injuries, premature birth, and other injuries and conditions may cause orthopedic impairments. Burns and broken bones can result in damage both to bones and muscles. Some children have their impairments from birth, while others acquire a physical disability, so age of onset varies widely. There does not appear to be any trend toward greater incidence of orthopedic impairment in boys or girls or based on cultural or racial factors.
Orthopedic impairments often are divided into three main categories to help characterize the potential problems and learning needs of the students involved. These categories are neuromotor impairments, musculoskeletal disorders, and degenerative diseases. Although neuromotor impairments involve the central nervous system (brain, spinal cord, or nerves that send impulses to muscles), they also affect a child's ability to move, use, feel, or control certain parts of the body. Clinically, they are separate and distinct types of disabilities with entirely different causes from musculoskeletal disorders, but they result in similar limitations in movement. Some examples of neuromotor impairments are spina bifida, cerebral palsy, and spinal cord injuries. Skeletal system impairments that involve the joints, bones, limbs, and associated muscles represent the mus-culoskeletal disorders. Musculoskeletal disorders include defects or diseases of the bones and muscles, such as limb deficiency or club-foot. Degenerative diseases are those that affect motor movement such as muscular dystrophy. More than 50 diseases and disorders are associated with orthopedic impairments. Along with subgroup types for these disorders, spina bifida, scoliosis, cerebral palsy, and muscular dystrophy are some of the more well-known conditions that cause orthopedic impairments in children. Spina bifida is a cleft spine, or incomplete closure of the spinal column. It is the most common permanently disabling birth defect. Spina bifida occulta is the mildest and most common form. Next in severity is meningocele. With this type, the spinal cord develops normally, but the meninges, or protective covering, push through the opening in the vertebrae. Meningocele can be repaired surgically. Myelomeningocele is the most...
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