OHI

Other Health Impairment: Definition

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 is due to chronic or acute health problems. This includes, but is not limited to, asthma, attention deficit disorder or attention deficit hyperactivity disorder, Tourette syndrome, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and acquired brain injury. This definition is found in State Board of Education Rule, Florida Administrative Code (F.A.C.).

For information on eligibility:

http://www.fldoe.org/academics/exceptional-student-edu/ese-eligibility/other-health-impairment-ohi.stml

Instructional Considerations

  • Stamina: General strength, vitality, and alertness.
    • Examples include monitoring and adjusting the classroom to take into account breathing problems, sensory stimulation, physical reactions.
  • Academic Behavior: Potential problems with focus and impulse control.
    • Examples include task persistence problems, high levels of activity, disconnectedness, reactions to sensory stimulation.
  • Emotional and Social: Impaired emotional and social development and functioning.
    • Examples include inappropriate social behaviors, problems working with peers, problems taking turns, inappropriate language, low self image.
  • Health: A need for professional medical support.
    • Examples include nursing support, monitoring and adjusting the classroom to take into account allergies, breathing problems.
  • Cognitive: Depending on the impairment, there may be some cognitive processing problems.
  • Placement: Educational services may need to be provided outside the classroom, e.g. home bound services.

General Information

Approximately 595,000 or .77% youth in the United States are receiving special education and related services under the category of other health impairments. Of all students, 10-30% will experience a childhood chronic illness lasting three months or longer. Currently, there are more than 200 specific health impairments that exist. With the use of medication and the provision of an accessible setting and/or medical support teams, most students with other health impairments are able to function well in regular classes.

Epilepsy. Epilepsy is characterized by general (tonic-clonic and absence) and partial (simple partial and complex partial seizures). Children who have epilepsy typically have below average IQs and lower academic achievement than their non-disabled peers. They are at risk for being diagnosed with Attention Deficit/Hyperactive Disorder and are reported to have higher levels of depression. About 40% of individuals with epilepsy have a Genetic and environmental factor.

Cardiopulmonary conditions. Cardiopulmonary conditions are health problems that affect the heart, blood, and lungs. Two cardiopulmonary conditions mentioned under Other Health Impairments are asthma and cystic fibrosis. Asthma is the most chronic illness of children and is the leading cause of school absences. This condition affects breathing and involves swollen lungs, difficulty breathing, and acute constriction of the bronchial tubes. Symptoms of asthma can vary widely and range from mild intermittent to severe persistent. Students with asthma are more likely to experience fatigue associated with a lack of sleep. The combination of high absenteeism and fatigue/exhaustion negatively impact the academic achievements of students with asthma. Cystic fibrosis is a lethal genetic disease affecting the respiratory and digestive systems. Cystic fibrosis occurs primarily in Caucasians.

Diabetes. Diabetes is a disorder in which the blood sugar of the individual is abnormally high because the body does not produce enough insulin (Type 1 diabetes) or because the body is insensitive to the insulin that is produced (Type 2 diabetes). Type 1 diabetes can develop at any time (including in infancy) but usually begins between the ages of 6 and 13. Type 1 diabetes may develop rapidly over the course of a few weeks and include an excessive need to urinate (polyuria); increased thirst (polydpsin); dehydration leading to weakness, lethargy, increase in appetite (polyphajea); a rapid pulse and possibly blurred vision. Type 2 diabetes used to be considered a disease of adolescents or adults, but it is becoming more common in children who are overweight or obese, and 10 to 50% of the newly diagnosed childhood cases of diabetes are Type 2.

Ulerative colitis and Crohn’s Disease (IBD) involve inflammation of the intestine, ulcerative colitis affects the colon, while Chron’s may affect any part of the intestinal system causing thickness of bowel wall.

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome(AIDS). This is a breakdown of the body’s immune system caused by the human immunodeficiency virus (HIV).

Sickle cell anemia. Sickle cell anemia is an abnormality of the hemoglobin molecule found within the red blood cells. In sickle cell anemia, the oxygen-carrying cells are crescent-shaped and can be trapped in body organs, resulting in a shortage of oxygen and vulnerability to infection.

Attention-deficit hyperactivity disorders. Attention-deficit hyperactivity disorders (ADHD) is a specific form of information processing problem related to an individual’s inability to attend to or focus on a given task. The organization for Children and Adults and Attention-Deficit/Hyperactivity Disorder (CHADD) defines ADHD as follows: “Attention-deficit/hyperactivity disorder (ADHD) is condition affecting children and adults that is characterized by problems with attention, impulsivity, and over activity.

Other health-related conditions of acquired diseases. These include chronic and sometimes life-threatening diseases such as cancer (leukemia, malignant tumors), diabetes, and hemophilia. Acquired diseases include diseases like Lyme disease, encephalitis, and meningitis (Educating Exceptional Children, Chapter 12).

Common Causes

Health impairments are transmitted through viruses, genetics, or through unknown causes.

  • Epilepsy. Two known factors cause epilepsy, genetic factors and environmental factors. Approximately 40% of individuals with epilepsy have a genetic contribution. Environmental factors that are linked with epilepsy are prenatal brain infections, birth trauma and poisoning, stress, fatigue,and sleep deprivation. However, the cause of epilepsy is only known in about 25% of the cases.
  • Cardiopulmonary conditions. Asthma can be an inherited condition. An asthma attack can be triggered by such environmental factors as food, exercise, cold air, respiratory infections, and environmental allergens, including cigarette smoke, dust, mold, gases, and chemicals. Cystic fibrosisis a genetic disease.
  • Ulcerative colitis and Chron’s Disease (IBD). Causes of both ulcerative colitis and Chron’s include hereditary genetics, weakened immune and inflammatory response, and intestinal bacteria.
  • Diabetes. Diabetes is a developmental or hereditary disorder characterized by an inadequate secretion of insulin.
  • Cystic Fibrosis. Cystic fibrosis is an inherited, systematic, generalized disorder of the secretion glands that begins at conception.

Diagnostic Indicators

  • Neuroimaging and prenatal screening (maternal serum alpha-fetoprotein, fetal surgery) can help doctors determine the presence of a condition considered to be health impairment.
  • The treatment of many disorders begins with careful medical investigation followed by other diagnostic procedures.