| Other Health Impairments |
| IDEA DEFINITION OF 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 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 which adversely affects a child's educational performance. The list of chronic or acute health problems included within this definition is not exhaustive. Children with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) may be classified as eligible for services under "other health impairment" in instances where the ADD/ADHD is a chronic or acute health problem that results in limited alertness, which adversely affects the child's developmental/educational performance resulting in the need for special education and related services. Criteria A child displays a health impairment when: A health impairment has been diagnosed by a licensed physician, licensed psychologist, licensed professional counselor, or licensed clinical social worker; AND/OR The health impairment adversely affects the child's educational performance. Other Health Impairments Terminology HEALTH DISORDERS -- disabling conditions characterized by limited stamina, vitality, or alertness due to chronic or acute health problems. MEDICALLY FRAGILE -- at risk for medical emergencies and dependence on technological support, such as a ventilator or nutritional supplements, to sustain health or even life. TECHNOLOGICALLY DEPENDENT -- require some technological assistance to breathe, to pass urine, or to meet other essential health needs while participating in home, school, or community activities. A brief look at a few disorders included in Other Health Impairments (on an individual basis -- decided by each child's committee ...) MUSCULAR DYSTROPHY -- a group of inherited chronic disorders that are characterized by a gradual wasting and weakening of the voluntary skeletal muscles. Progressive weakness and degeneration of the skeletal, or voluntary, muscles which control movement. Muscles of the heart and some other involuntary muscles are also affected, as well as other organs. Loss of ability to walk, use arms and hands. There are nine different types of muscular dystrophy. The seriousness of them is influenced by heredity, age of onset, the physical location and nature of onset, and the rate at which the condition progresses. The most common form is Duchenne muscular dystrophy, generally manifests between ages 2 and 6; survival past 20s is rare). Other types are: Becker (onset b/w 2 and 16; survival to middle age); congenital (at birth; shortened life span); distal (onset 40 to 60 years); Emery-Dreifuss (onset childhood to early teens; sudden death may occur from heart damage); Facioscapulohumeral (onset teens to early adult); Limb-Girdle (onset late childhood to middle age); Myotonic (onset 20 to 40); and Oculopharyngeal (onset 40 to 70 years). HUMAN IMMUNODEFICIENCY VIRUS and ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) -- HIV: a virus that reduces system function and has been linked to AIDS; AIDS: the symptomatic clinical manifestation of impaired cellular immunity due to infection with the HIV type 1. The HIV type 1 infection attacks certain white blood cells within the body and the patient may suffer recurrent bacterial diseases. Individuals with AIDS move through a series of disease stages. The first is exposure. The second is characterized by the production of antibodies in infected individuals. These antibodies appear about 2 to 12 weeks after the initial transmission of the virus. About 30% of individuals experience flu-like symptoms for a few days to several weeks. During stage 3, the immune system declines, and the virus begins to destroy cells of the immune system. During this phase, which can last for 3 to 10 years, many individuals are asymptomatic. During stage 4, individuals begin to manifest symptoms including weight loss, fatigue, skin rashes, night sweats. At stage 5, recurrent and chronic diseases begin to take their toll. Gradually the immune system fails and death occurs. SEIZURE DISORDERS -- a cluster of behaviors (altered consciousness, characteristic motor patterns, etc.) that occur in response to abnormal neurochemical activity in the brain. Epilepsy is a condition that from time to time produces brief disturbances in the normal electrical functions of the brain, affecting a person's consciousness, bodily movements, or sensations. The intensity and length of these depend on the severity of the seizure. There are generalized seizures (absence, atonic, tonic-clonic, and myoclonic), partial seizures (simple and complex), non-epileptic seizures, and status epilepticus. Generalized seizures affect both cerebral hemispheres from the beginning of the seizure. They produce loss of consciousness, either briefly or for a longer period of time. Generalized tonic clonic seizures (grand mal seizures) are the most common. They begin with stiffening of the limbs (the tonic phase), followed by jerking of the limbs and face (the clonic phase). Absence seizures (also called petit mal seizures) are lapses of awareness, sometimes with staring, that begin and end abruptly, lasting only a few seconds. There is no warning and no after-effect. More common in children than in adults, absence seizures are frequently so brief that they escape detection, even if the child is experiencing 50 to 100 attacks daily. They may occur for several months before a child is sent for a medical evaluation. Myoclonic seizures are rapid, brief contractions of bodily muscles, which usually occur at the same time on both sides of the body. Occasionally, they involve one arm or a foot. People usually think of them as sudden jerks or clumsiness. First aid is usually not needed, however, a person having a myoclonic seizure for the first time should receive a thorough medical evaluation. Atonic seizures produce an abrupt loss of muscle tone. Other names for this type of seizure include drop attacks, astatic or akinetic seizures. They produce head drops, loss of posture, or sudden collapse. Because they are so abrupt, without any warning, and because the people who experience them fall with force, atonic seizures can result in injuries to the head and face. Protective headgear is sometimes used by children and adults; the seizures tend to be resistant to drug therapy. No first aid is needed (unless there is injury from the fall), but if this is a first atonic seizure, the child should be given a thorough medical evaluation. In partial seizures the electrical disturbance is limited to a specific area of one cerebral hemisphere (side of the brain). Partial seizures are subdivided into simple partial seizures (in which consciousness is retained); and complex partial seizures (in which consciousness is impaired or lost). Partial seizures may spread to cause a generalized seizure, in which case the classification category is partial seizures secondarily generalized. Partial seizures are the most common type of seizure experienced by people with epilepsy. Virtually any movement, sensory, or emotional symptom can occur as part of a partial seizure, including complex visual or auditory hallucinations. Seizure disorders may be caused by tumors of the brain, complications from head trauma, infections of the central nervous system, vascular diseases, alcoholism, infection, maternal injury or infection (prenatal), genetic factors, drugs, toxic chemicals, poisons, etc. DIABETES MELLITUS -- a disease characterized by inadequate use of insulin, resulting in disordered metabolism of carbohydrates, fats, and proteins. Insulin is a substance secreted by the pancreas that functions to process carbohydrates, enabling glucose to enter the body's cells. There are two kinds of diabetes -- insulin-dependent diabetes mellitus (IDDM), commonly known as Type I or juvenile onset diabetes; and non-insulin-dependent diabetes mellitus (NIDDM), referred to as Type II or adult onset diabetes. Glucose, a sugar, is used by the body for energy. Some glucose is used quickly, and some is stored in the liver and muscles for later use. However, muscle and liver cells cannot absorb and store the energy released by glucose without insulin. Without insulin, glucose accumulates in the blood, causing a condition called hyperglycemia. Left untreated, this condition can lead to loss of consciousness or diabetic coma. Symptoms of diabetes are extreme hunger, thirst, and frequent urination. Complications from untreated diabetes include blindness, cardiovascular disease, kidney disease. CYSTIC FIBROSIS -- a hereditary disease that usually appears during early childhood. This generalized disorder of the exocrine glands is characterized by respiratory problems and excessive loss of salt in perspiration. The secretion glands produce abnormal amounts of sweat, mucus, and saliva. Three major organs are affected: the lungs, the pancreas, and the sweat glands. The glue-like mucus in the lungs obstructs their functioning and increases the likelihood of infections, gradually destroying the lungs. As lung deterioration occurs, the heart is burdened, and heart failure may result. The pancreas is affected when excessive mucus prevents critical digestive enzymes from reaching the small intestine. Without these enzymes, proteins and fats consumed by the individual are lost in frequent, greasy, flatulent stools. A child with CF has major social and psychological problems to deal with, directly related to chronic coughing, small stature, offensive stools, gas, delayed onset of puberty and secondary sex characteristics, as well as time away from friends and school due to hospitalizations. SICKLE CELL ANEMIA -- an inherited disease that affects the structure and functioning of red blood cells. The hemoglobin molecule in the red blood cells of an individual with sickle cell anemia is abnormally vulnerable to structural collapse when blood-oxygen level is diminished. The molecules become distorted and form bizarre shapes. This process, called sickling, distorts the normal donut-like shape of cells into shapes like microscopic sickle blades. Obstructions in vessels can lead to stroke and damage to other organs. People with sickle cell anemia experience unrelenting anemia. They also have frequent infections and periodic vascular blockages, which cause severe and chronic pain in the extremities, abdomen, and back. ASTHMA is a chronic disease that affects airways into the lungs and affects breathing. Airways that carry oxygen to and from the lungs become inflamed and irritated in reaction to some kind of substance or situation. The lungs are made up of bronchial tubes which, as they travel away from the nose and throat, branch out like a tree. They become smaller and smaller until they form tiny sacs called alveoli. Bands of muscle cover the bronchial tubes all the way down through the alveoli. An individual with asthma has airways that tend to be red and swollen and are easily irritated in response to triggers, such as pollen and cigarette smoke. When irritated, the airways' inside walls become even more swollen and the muscles tighten, causing the passages to get narrower, and lessens air flow to the lung tissue. Mucus is also produced in larger than normal amounts, which clogs airways even more, making it harder to breathe. Common asthma symptoms are wheezing, coughing, shortness of breath and a feeling of tightness in the chest. Symptoms can come and go with asthma, and their intensity can vary. HEMOPHILIA AND OTHER BLEEDING DISORDERS -- a wide range of medical problems that lead to poor blood clotting and continuous bleeding. Doctors also call them terms such as coagulopathy, abnormal bleeding and clotting disorders. When someone has a bleeding disorder they have a tendency to bleed longer. The disorders can result from defects in the blood vessels or from abnormalities in the blood itself. The abnormalities may be in blood clotting factors or in platelets. Blood clotting, or coagulation, is the process that controls bleeding. It changes blood from a liquid to a solid. It's a complex process involving as many as 20 different plasma proteins, or blood clotting factors. Normally, a complex chemical process occurs using these clotting factors to form a substance called fibrin that stops bleeding. When certain coagulation factors are deficient or missing, the process doesn't occur normally. Within seconds of an injury, tiny cells in the blood, called platelets, bunch together around the wound. Blood proteins, platelets, calcium and other tissue factors react together and form what's called a clot, which acts like a net over the wound. Over the next several days to weeks, the clot strengthens, then dissolves when the wound is healed. In people with bleeding disorders, clotting factors are missing or don't work as they should. This causes them to bleed for a longer time than those whose blood factor levels are normal. It's a myth that persons with bleeding disorders bleed to death from minor injuries or their blood flows faster. Bleeding problems can range from mild to severe. Symptoms include excessive bleeding, excessive bruising, easy bleeding, nose bleeds, abnormal menstrual bleeding. Bleeding disorder risks include scarring of the joints or joint disease, vision loss from bleeding into the eye, chronic anemia from blood loss, anemia, neurologic or psychiatric problems, and death, which may occur with large amounts of blood loss or bleeding in critical areas, such as the brain. Causes. Some bleeding disorders are present at birth and are caused by rare inherited disorders. Others are developed during certain illnesses (such as vitamin K deficiency, severe liver disease), or treatments (such as use of anticoagulant drugs or prolonged use of antibiotics). They can include hemophilia and other very rare blood disorders. There are many causes of bleeding disorders, including von Willebrand's disease, immune system-related diseases, such as allergic reactions to medications, or reactions to an infection, cancer, such as leukemia, liver disease, bone marrow problems, disseminated intravascular coagulation, pregnancy-associated eclampsia, also known as severe toxicity of pregnancy, organ transplant rejection or Hemophilia A and B, exposure to snake venom, antibodies, and medicines, such as aspirin, heparin, Warfarin, and drugs used to break up blood clots. ADHD and ADD -- Attention Deficit Hyperactive Disorder and Attention Deficit Disorder. Attention Deficit Hyperactivity Disorder (ADHD) is a biological, brain based condition that is characterized by poor attention and distractibility and/or hyperactive and impulsive behaviors. It is one of the most common mental disorders that develop in children. If left untreated, ADHD can lead to poor school/work performance, poor social relationships and a general feeling of low self esteem. ADD or attention deficit disorder is a general term frequently used to describe individuals that have attention deficit hyperactivity disorder without the hyperactive and impulsive behaviors. The terms are often used interchangeably for both those who do and those who do not have symptoms of hyperactivity and impulsiveness. TOURETTE SYNDROME -- a condition characterized by motor or verbal tics that cause the person to make repetitive movements, emit strange involuntary sounds, or say words or phrases that are inappropriate for the context. Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman. The early symptoms of TS are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood. LEAD POISONING -- a condition that occurs when lead has built up in the body. Even in small amounts, lead can cause serious problems in mental and physical development; it can also be fatal. Symptoms include irritability, loss of appetite, weight loss, sluggishness, fatigue, abdominal pain, vomiting, constipation, learning problems, slowed growth, high blood pressure, pain and numbness of extremities, muscular weakness, headache, memory loss, mood disorders, etc. It is caused by exposure to lead. Lead was formerly used in paint and gasoline, and is still used in batteries, solder, pipes, pottery, roofing materials, and some cosmetics. Lead-based paint has been banned in the US since 1978. Those at higher risk for lead poisoning are infants, those that live in older homes, hobbies and crafts that use solder or lead paint, and living in a developing country. Lead can cause brain damage, damage in the kidneys and nervous system, seizures, coma, and death NEPHRITIS -- LEUKEMIA and other cancers -- RHEUMATIC FEVER -- HEART CONDITIONS -- |
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