Comprehensive Overview of Other Health Impairments


IDEA Definition of Other Health Impairments


According to IDEA, an Other Health Impairment is defined as:
Other health impairment means 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:


(i) 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, and sickle cell anemia; and
(ii) adversely affects a child's educational performance [34 C.F.R. 300.7(c)(9)].


Overview of Other Health Impairments


Many conditions and diseases can significantly affect a child’s health and ability to function successfully in school. Most health impairments are chronic conditions; that is, they are always present, or they recur. By contrast, and acute condition develops quickly with intense symptoms that last for a relatively short period of time. To be served under the OHI category, the student’s health condition must limit strength, vitality, or alertness to such a degree that the student’s educational progress is adversely affected. More than 200 specific health impairments exist, and most are rare (Turnball et al., 2004). Within this category is Attention Deficit/Hyperactive Disorder. Only time will tell whether AD/HD finds its way to another special education category or whether it becomes a category of its own in the future. Presently, the inclusion of AD/HD has caused a significant increase in the size of the category (U.S. Department of Education, 2001).


Causes-Etiology of Other Health Impairments


The etiology of specific health impairments varies. Most result from infections, genetic factors, environmental influences, prenatal influences, perinatal influences, and postnatal influences. However, they can be grouped into some general areas (Smith, 2004):

  • Allergies e.g. Hepatitis
  • Heredity e.g. Hemophilia
  • Accidents e.g. seizure disorders
  • Multiple factors e.g. Epilepsy
  • Unknown


Prevalence of Other Health Impairments


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 classification in special education, or less than 1% of all school-age students.


Age of onset of Other Health Impairments


Due to the various types of health impairments that adversely affect children’s performances in school, no specific age of onset can be generalized to the entire school-age population that receives special education services. Some health impairments are congenital (present at birth) and other conditions are acquired during the child’s development as a result of accident, illness or unknown cause.


Gender Features of Other Health Impairments


Due to the number and specific types of health impairments covered in this section, no statement concerning gender patterns can be generalized.


Familial Patterns of Other Health Impairments


Due to the number and specific types of health impairments covered in this section, no statement concerning familial patterns can be generalized.


Cultural Features of Other Health Impairments


Although European Americans are proportionately underrepresented among students with disabilities, their highest representation is in the “Other Health Impairments” category.


Characteristics of Other Health Impairments


According to the Starbright Foundation (2002; cited in Turnball et al., 2004), 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” (p. 313).
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


Educational Implications of Other Health Impairments


When responsible educators encounter diseases and conditions they know little about, they seek out all the information they need to provide an appropriate education to students involved (Smith, 2004). One of the main considerations in the education of these students is the use of the team approach in developing and carrying out a child's educational program. The team generally includes the parents, teachers, medical professionals, and health-related professionals such as a physical therapist. Parents are critical members of the team and should be involved in all educational decisions. Sirvis (1988) noted that the team should design a program that meets the needs of the student in five basic goal areas: "(a) physical independence, including mastery of daily living skills; (b) self-awareness and social maturation; (c) communication; (d) academic growth; and (e) life skills training" (p. 400). Interdisciplinary services such as occupational and physical therapy and speech and language therapy are of prime importance for youngsters who have physical disabilities.


It is often necessary to modify and adapt the school environment to make it accessible, safe, and less restrictive since discriminating architecture doesn’t have to discriminate (Leibrock & Terry, 1999, p.17). Accessibility guidelines are readily available, and when these guidelines are followed the environment becomes easier for the child to manage independently.


It is important that modifications be no more restrictive than absolutely necessary so that the student's school experiences can be as normal as possible. While it is necessary to stress the importance of avoiding overprotection of students with physical or health impairments, it is also important to permit students with disabilities to take risks just as their able-bodied cohorts do.
Recent advances in technology have helped to make life more nearly normal for students with physical disabilities. For example, students with cerebral palsy can use computer terminals to aid in communication. Through technology, even a person with the most severe handicaps can have greater control over communication and daily living skills.


Modifying the environment may mean providing special adaptive equipment such as specially designed desks, positioning devices, wedges, or standing tables. Adaptations also may include establishing procedures for dealing with medical emergencies when students have serious medical problems.


Finally, what role teachers should play in the medical management of children is an ongoing and contentious issue (Temple, 2000) since teachers are being called on to assume more responsibilities for the medical management of their students (Heller et al., 2000).

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