Disabilities

This is a changing page as questions are asked or requests are made.

Students in Greenville County Schools may have many different disabilities. In the following list you will find the answers to some frequently asked questions about disabilities. Not all disabilities are represented in the following list. All of the following information is designed to help people in general learn about disabilities. This is not designed to help diagnosis or identify disabilities. While the intention of the following is to provide a basic understanding of disabilities, it is not all inclusive. For more information about any disability, people should turn to their medical doctors or other medical professionals. There are also some links to other websites for more information as well on the Disability Helpful Websites page.

Autism

This is a developmental disorder that affects the brain and can make communicating with other people difficult. Autism is one of the most common disabilities today. Autism is officially called Autism Spectrum Disorder because it has a wide range of how it affects students. (This includes Asperger's Syndrome, Classic Autism, and Pervasive Developmental Disorder.) Interactions are hard for students who have this disability. They may not understand or express facial expressions, body language, sarcasm, and sometimes humor. Some students have to directly learn how to "act" like others do. Some students are mildly effected and can attend regular classes with some support with social interactions and understanding how to get along with others or sometimes organization. While other students display stereotypical behaviors such as hand flapping, rocking, tapping, or spinning. Sometimes students will not make eye contact when speaking. Sometimes students with autism get easily frustrated, seem insensitive, or won't speak at all. 

In the classroom, typically students need extra time to complete tasks, patience to wait for a response, testing in a separate location to minimize distractions, toleration of noises or behaviors that are not typical, among others that may be needed based on the student's level of need. Many students who have autism struggle in at least one academic area in addition to behavior or communication difficulties. Consistency is extremely helpful for these students to learn patterns. They benefit from a highly structured classroom setting and procedures. Students many times need preparation before changes in the daily schedule. They also need to learn emergency procedures as soon as possible. Consistency and knowing what to do in each setting is both comforting and educational for these students.

Hearing Impaired (HI or HH)

This group of disability refers to those students who have significant hearing loss or are completely deaf. Students who have been identified as having this disability typically have the support of interpreters or cuing personnel. Sometimes students have made a lot of progress with cochlear implants, hearing aides, FM transmitters, etc. that they don't need other people to accompany them to classes.

It is important for these students to stay focused while in class. Distractions are hard for students with hearing impairments. Many times a copy of notes helps students and being able to have a minute to clarify with the teacher can be key to understanding something that they may have missed as well. When viewing videos or recordings, it is important to use the closed captioning. Sometimes students who have hearing impairments have also grown up in home with non-hearing parents. There is a different culture in the deaf community than in the hearing community and sometimes students need help navigating the differences. 

Learning Disabilities (LD)

This is the most "typical" disability for a student to have. That is to say it's the most common disability identified. Many times this disability is paired with others for students who have multiple disabilities (see bottom of list for more information). Students who have learning disabilities are effected in one or more of the following areas: reading fluency, reading comprehension, math fluency, math reasoning, written expression, or listening comprehension. 

Reading fluency is a measurement of how fast and how accurately one reads and at what level of difficulty. If a student reads below grade level, slower than typical, or makes many errors when reading, then usually they will qualify in this area. 

Reading comprehension is a measurement of what one understands when reading. Comprehension can be measured on a specific grade level or a variety of levels regarding a specific skill. There are many comprehension skills including, but not limited to: main idea, details, cause-effect, fact vs. opinion, summarizing, drawing conclusions, using context clues, sequencing, inferencing, compare and contrast, problem and solution, and categorizing. In lower grades we typically focus on identifying the main idea of a passage and then we progress to the other skills. 

Math fluency is a measure of how fast or accurately a student can solve math facts (add, subtract, multiply, divide). 

Math reasoning is applying math facts to word problems, equations, formulas, geometry, real world examples, or any other form of application.

Written expression is an assessment of writing including errors in capitalization, spelling, punctuation, grammar, organization, and format.

Listening comprehension is understanding what one hears.

Intellectual Disabilities/Cognitive Impairment/ Mental Disabilities (EMD/TMD now MID or ID)

Typically students who have a cognitive impairments, mental disability (formally known as mental retardation) have had a cognitive assessment that identifies their intelligence quotient (IQ). Intellectual disability means significantly sub-average general intellectual functioning, existing at the same time with deficits in adaptive behavior and manifested during the developmental period, that adversely affects a child’s educational performance. 

Students who have Intellectual Disabilities typically need both educational support and support in adaptive behaviors. They need to be overtly taught certain behaviors that other students inherently learn or learn quickly at the beginning of school. Sometimes this is a significant problem in organization, using the restroom, interacting with others, following directions, visual-spatial orientation, managing materials, etc. This is in addition to difficulties in learning (see listing under LD).

Visual Impairments

These disabilities impact the use of eyes. Some of these students have partial vision while others are completely blind. Sometimes these students are accompanied by a large amount of equipment to see what they need to during class. Sometimes these students will use braille both to read their books and to write. Some students will have things like a cane to sense where they are. These students will usually receive support from the Vision teachers and sometimes the Orientation and Mobility staff. Students who have partial vision typically will have some type of an enlarger for materials, a viewer for seeing things at a distance, magnifying lenses and/or a monocular.

Navigating the classrooms and the school environment as a whole are both important for students who have visual impairments. Patience and making sure they have what they need are important for student learning. Students who have partial vision typically need papers and books enlarged and use of all their equipment. Students who are completely blind, also need access to their materials and equipment. It is best for these to be put in the same location everyday so it is not a scavenger hunt every time that they come to class. Peer buddies can be helpful, but use caution when help involves moving expensive or breakable equipment.

Orthopedic Disabilities 

Sometimes orthopedic disabilities are also called physical disabilities, but this can be a misnomer since many of these disabilities affect a person both physically and mentally. The following list is not a complete list of orthopedic disabilities, but represents many of them.

Arthrogryposis

Students who have arthrogryposis have joints that don't move as much as normal or may even be stuck in a certain position. Many times the muscles around these joints are not strong or flexible. Arthrogryposis occurs when a baby does not move around enough inside the womb. In the early stages of development, the tendons, ligaments, and muscles develop. If the baby doesn't move much, then extra tissue forms on the joints which makes movement harder. These contractures can happen in arms, legs, hands, the spine, and even the jaw. Many children who have arthrogryposis have other health issues that they are dealing with in addition to the arthrogryposis. Usually arthrogryposis is a feature of another condition, most often amyoplasia. This disability can effect a few joints or all joints in the body or any range in between. Arthrogryposis does not get worse over time, in fact therapies and some medical procedures can help a person who has this physical disability. 

Effect on Education: Students who have arthrogryposis (effecting their legs, ankles, or feet) generally need extra time between classes or other transitions in school. Many students need assistance with writing or extended time for writing. Some it is an issue of speed, for others their fingers are severely effected and they cannot write at all. Most students who have this disability have average intelligence, however some students may also have a learning disability or other disability in addition to arthrogryposis. Some students will be dealing with broken bones or joints because of this disability, and will be recovering from surgery or having their fractures set.

Cerebral Palsy (CP)

Cerebral Palsy is commonly referred to as "CP". CP is caused by brain damage that occurs before or during a child's birth or during the first 3 to 5 years of a child's life. Cerebral palsy is not a progressive disability (it doesn't get worse by itself), although some related issues can cause other problems. The brain damage that leads to CP can also lead to other health issues including vision, hearing, and speech problems and learning disabilities. Many students who have CP do have seizures. Not every student who has cerebral palsy is affected the same way. Typically students who have cerebral palsy are affected by muscle tone, movement, and motor skills. There is not a cure for CP, however treatment, therapy, special equipment, and sometimes surgery can help a child who has cerebral palsy. Students who have CP can be affected only physically, mentally, or both. Many students who have CP have both physical difficulties and learning disabilities. As students grow up, they learn how to deal with educational weaknesses or physical limitations. Many students also grow in independence as they age as well. 

Effect on Education: Many students who have CP that I have worked with have difficulties doing multiple things at one time due to CP being a processing disorder. Sometimes it looks like a student is being lazy or inattentive in class, when they may be having difficulty with listening, taking notes, preparing to answer questions, and possibly writing answers to questions on assignments. Many times these students can be helped with granting extra time, eliminating or shortening note taking (providing copies of notes), and/or providing a scribe. Not every student will need all of these as accommodations, but these are things to consider. Other accommodations may also be more appropriate depending on the student. 

Ehlers-Danlos Syndrome

Ehlers-Danlos Syndrome is a hypermobility of the joints. It is an inherited connective tissue disorder in which joints can move beyond the normal range of motion. Hypermobility of joints usually decreases with age, however some people's stay hypermobile until adulthood. Along with the hypermobility, students who have this syndrome often have chronic pain, joint dislocations, and other medical issues. Treatment for this is focused on treating pain and other symptoms, usually in the form of medicine and/or surgery. There is no cure for this disability, however by itself it does not get worse. Some typical interventions are: muscle conditioning, protective braces, and avoiding activities that can increase the risk of joint injuries. 

Muscular Dystrophy (MD)

Muscular Dystrophy has been made famous by the Muscular Dystrophy Association (MDA). They have telethons every year in hopes of raising money for research and supporting individuals who have muscular dystrophy. Muscular dystrophy is a degenerative disability. It effects the muscles in the person's body. The specific type of muscular dystrophy determines the rate at which the disease spreads and effects the person. Some students who have muscular dystrophy also have a learning disability, but many do not. Since this disability mainly effects the muscles of the body, supports are typically related to writing or movement throughout the school environment. As the disease progresses, students will need increasing supports for writing speed and the formation of writing in addition to physical supports such as walkers, someone to help carry items or obtain items during classes, and/or use of wheelchairs. Many students who have muscular dystrophy struggle to be as "normal" as everyone else. Typically, they don't want to be singled out or be seen as different by their peers. As much interaction as possible with peers who do not have disabilities is encouraged. Most students who have muscular dystrophy that is degenerating struggle because they can remember when they could do what they can't do now. Currently there is no cure for muscular dystrophy; although therapies, diets, medications, and sometimes surgeries can be helpful and slow the progression of this disability.  

Academic support: patience and understanding are key for these students. As students regress physically, they will need extended time and/or shortened assignments whenever possible. Many students will need scribing and printed/provided notes at some point and physical assistance for materials. Counseling may also be needed depending on the student.

Muscular Atrophy (MA)

Muscular Atrophy is generally a genetic condition. Although it is less "famous" than Muscular Dystrophy, it is different. There are five different types of MA, four types are linked to chromosome 5 while one is not. It effects the nerve cells in the lower part of the brain to break down. The brain stops sending messages to the muscles of the body. Due to messages not being sent to the muscles, the muscles will start decreasing and waste away unless interventions are put in place. SMA1 (sometimes called Werdnig-Hoffmann disease) starts from birth to six months old and is the most severe form of SMA. SMA2 (also called chronic infantile SMA) effects children between 6-18 months old and can be moderate to severe. SMA 3 (also called Kugelberg-Welander disease or juvenile spinal muscular atrophy) effects kids as early as 18 months of age or as late as adolescence. This is the mildest form of SMA. SMA4 is the adult form of MA. Most people affected by this start having symptoms after age 35 and the symptoms slowly develop and worsen. SMA not linked to chromosome 5 varies greatly in severity and the muscles most affected. It generally starts affecting muscles farther from the center of the body and then affect other muscles. Most of the time these students want to be as "normal" as possible. As with MD, the student's intelligence is not affected. Although there are physical limitations, there may not necessarily be academic weaknesses. Some students who have MA have scoliosis, respiratory issues, and possibly eating difficulties. Currently there is no cure for muscular atrophy. Many students are helped by physical and occupational therapies and some surgeries. Progress is being made regarding medications, therapies, and early detection indicators.

Academic support: Due to the wide variety in the severity of this disability, it is hard to pinpoint student needs. The support needed might just be extra time to complete work or the support needed might include peers support, assistance from a paraprofessional for writing support, management of all materials, restroom assistance, and more. The above suggestions for MD may also be appropriate based on the student. 

Spina Bifida

Spina Bifida is a disability that can effect the students motor skills and learning. Spina bifida is caused when while in the mother's womb the spinal cord of the baby does not close all the way. Officially, scientists believe that there are many genetic and environmental factors that cause spina bifida. Spina bifida has been linked to the mother's folic acid levels during and before pregnancy and women are encouraged to take a daily supplement during child bearing years. There are several types of spina bifida and therefore there is a range of how much students are affected by this disability. Most are affected both physically and mentally. Many students who have spina bifida are very social. They enjoy being with people and carrying on conversations. Some say inappropriate things in order to get closer to people that they are attracted to, while others will use compliments to do the same thing. Teaching students appropriate phrases to use when speaking to others is many times necessary so the student does not get in trouble. In textbooks talking about spina bifida, this is called "bar talk" because it sounds like they are trying to pick up another person. Many students who have spina bifida, who I have had the joy to teach, have had very active parents who control what the student hears and sees. These students generally will use compliments to gain attention rather than other statements that would be inappropriate in the school setting. Working with the student who has spina bifida to understand appropriateness of comments is important both in and out of school. 

Many students who have spina bifida need to be redirected due to loss of attention during instruction. Because of the gaps in the spine, many students who have spina bifida use crutches or a wheelchair because they have a loss of or weakness in mobility control. Sometimes surgeries and/or therapies can help the student who has spina bifida be able to be more mobile. Students who have spina bifida typically also have difficulties in regard to using the restroom. 

Many also have Latex allergies. So, what is the outlook? Students who have spina bifida can lead full lives. Many do well in school with needed supports. Most will live to adulthood and have normal intelligence. Several also play sports and participate in other fun extra curricular activities.

Common accommodations may include redirection, student repetition of directions, and extended time for completion. Some student also may need assistance with materials, scribing, and oral administration.

Spinal Cord Injury

Students with spinal cord injuries may or may not have been born with their injury. Most are not born with a spinal cord injury and is obtained later in life.  Spinal cord injuries usually cause paralysis in one or more areas of the body depending on the location of the injury. Some students who have spinal cord injuries need assistance because they cannot move their limbs, whether it be for writing assistance or in the restroom. Many students undergo surgeries and participate in therapies outside of school in order for the person to be as independent as possible. Spinal cord injuries are not necessarily linked to learning/educational difficulties in general. If the spinal cord injury is recent or if the student is in adolescence, many times the student will need someone to talk to about what they are experiencing in comparison to their peers. Sometimes thinking about what they are missing out on gets in the way of learning academics.

Common accommodations may include extended time for written work and scribing assistance, although depending on the location of the injury there may be many more.

Other Health Impairments

Attention Deficit (ADD/ADHD)

ADD/ADHD is probably one of the most known about disabilities in that most people have met or know someone who has attention deficit. AD can be effected by hormones and other environmental issues as well. Redirection is important for most students who have ADD/ADHD. There is a difference between attention deficit disorder and attention hyperactivity disorder. The students who have ADHD typically get more attention, because of the need for frequent prompting to comply with instructions so as not to interrupt classes, however students who have ADD are just as distracted without the hyperactivity added to it. Distractions can come from any source. Some students are a distraction to themselves. Abrupt sounds, noisy classmates, clicking of pens or caps, tapping pencils, a change of color, and other things can cause a distraction. Keeping these things in mind when creating lessons can help these students concentrate. Some need key information highlighted as the teacher is instructing, some might need a quiet location for taking tests, all of these students benefit from structure and knowing what to expect in a typical day.

Common accommodations repetition of directions, redirection, placement in the center of instruction or at the front of the class to minimize distractions

Epidermolysis Bullosa

EB is a skin disorder. The student is born with this. Typically the student will have blisters as a result of any change in the environment. Every time the weather changes, the student may develop blisters. Students who have this disability can get blisters that are so severe that hospitalization is required. Some students cannot wear lanyards or certain types of clothing because they rub blisters as well. Some have to use specific kinds of shoes to have cushioning. Some students use wheelchairs or specialized seats to relieve pressure on blisters. Typically a student who has EB will mainly be effected in education when they have blisters on their hands. 

Common accommodations may include extended time for work and possibly scribing assistance or use of assistive technology. Some also need to not be required to dress out or change clothes for activities such as physical education class.

POTS Disease

POTS is short for postural orthostatic tachycardia syndrome. POTS is a group of disorders that primarily has a reduced volume of blood returns to the heart after an individual stands up from laying down or any change of position. The primary symptom is lightheadedness or fainting which is accompanied by a rapid increase of heart rate. This can affect anyone at any age, but typically this affects women between 15-50 years of age (75%). The cause of POTS has yet to be determined by doctors. Some students who have POTS have peripheral denervation, overactivity of the sympathetic nervous system, or deconditioning. Therapies are targeted at relieving low blood volume or regulating circulation problems. No single treatment has been found to be effective for everyone. Sometimes medication and braces help. Symptoms may come and go for years for students with POTS. Research is currently underway to prevent, treat, and ultimately cure disorders like POTS.

Common accommodations may include extended time, flexibility of amount of work required, different ways of responding (including dictation of responses or using technology for responses), not requiring specific seat time as long as work gets turned in, etc.

Multiple Disabilities: This is a category that many students fall into because they qualify for services under one or more of the disabilities listed above or others. At the IEP team, the team will decide if the student who qualifies for services under two or more categories is mainly affected by one disability and the others are secondary in nature; or the team will decide that this cannot be determined, in which case "Multiple Disabilities" is what will be on the top of the IEP. During the multidisciplinary meeting (IEP meeting following the evaluation of a student), the team will document the specific disabilities in addition to listing multiple disabilities.

Traumatic Brain Injuries (TBI)

Traumatic Brain Injuries can occur at any age. Trauma during birth, childhood accidents, car accidents, military incidents,  and significant medical conditions can all cause traumatic brain injuries. Students who have traumatic brain injuries may need academic supports, emotional supports, physical supports, and any combination of these. Interventions and accommodations are widely varied depending on the needs of the individual.

Sources: kidshealth.org, social security administration (secure.ssa.gov), dictionary.com, nord.org, mda.org, cerebralpalsy.org, ucp.org, www.psychcentral.com, www.helpguide.org, www.medicinenet.com, www.spinabifidaassociation.org, www.add.org, www.chadd.org, www.ndss.org, college courses, and several years of experience