OI

Orthopedic Impairment: Definition

Orthopedic impairment means a severe skeletal, muscular, or neuromuscular impairment. The term includes impairments resulting from congenital anomalies (e.g., including but not limited to skeletal deformity or spina bifida), and impairments resulting from other causes (e.g., including but not limited to cerebral palsy or amputations). This definition is found in State Board of Education Rule 6A-6.030151, F.A.C.

For information on eligibility:

http://www.fldoe.org/academics/exceptional-student-edu/ese-eligibility/orthopedic-impairment-oi.stml

Instructional Considerations

  • Motor: Impaired physical functioning
    • Examples include the need for special equipment including crutches, braces, custom splints, or a wheelchair are needed to perform in classroom activities; limited self-care skills
  • Communication: Potential major communicative impairment
    • Examples include difficulty expressing or understanding language; difficulty grasping reading; augmentative communication and alternative communication devices and procedures necessary for communication.
  • Cognitive: Impaired cognitive functioning
    • Examples include short attention span, difficulty expressing or understanding language, difficulty grasping concepts such as reading and math.
  • Sensory: Potential problems hearing and/or seeing
  • Emotional and Social: Impaired emotional and social development and functioning

General Information

Neuromotor impairments are disabilities resulting from damage to the central nervous system that impairs the brain’s control of muscle movement and the muscle receptor’s sensory feedback about speed, direction of movement, and body position (Educating Exceptional Children, Chapter 12; National Dissemination Center for Children with Disabilities Fact Sheet Number 12 (NICHCY) at http://www.parentcenterhub.org/nichcy-resources/).

  • Cerebral palsy. A number of disabilities are caused by damage to the motor control centers of the brain. The damage affects muscle tone, which in turn interferes with voluntary movement and full control of the muscles, and delays gross and fine motor development. CP includes four major classifications: spastic, dyskinetic, ataxic, and mixed. In spastic cerebral palsy, muscle tone is abnormally high and increases during activity. Muscles and joints are tight or stiff, and movements are limited in the affected areas of the body. In dyskinetic cerebral palsy, tonal abnormalities involve the whole body. The individual’s muscle tone is changing constantly, often rigid while he or she is awake and decreased when asleep.
  • Ataxic cerebral palsy is a condition in which voluntary movement involving balance is abnormal. Individuals with ataxic CP have difficulty controlling their hands and arms, and their gait is unsteady. Mixed cerebral palsy includes a combination of spastic, dyskinetic, and ataxic CP. The affected area can be (1) hemiplegic-just one side of the body (either left arm and left leg, or right arm and right leg); (2) diplegic-the whole body is involved, but the legs are more severely involved than the arms; and (3) quadriplegic-involvement is equally distributed throughout the body.
  • Neural tube defects. This includes spina bifida (the separation of a portion of the backbone) and myelomenigocele (the protrusion from the spinal cord of a sac of fluids containing portions of the spinal cord).

Physical impairments include degenerative diseases, which affect the muscles and their supporting framework, the skeleton, and orthopedic and musculoskeletal disorders.

  • Muscular dystrophy and spinal muscular atrophy (degenerative diseases). These are inherited disorders in which the muscles weaken and deteriorate. The most common form, Duchenne muscular dystrophy, occurs primarily but not exclusively in boys.
  • Juvenile rheumatoid arthritis (Orthopedic and musculoskeletal disorders). Inflammation of the joints accompanied by fever and pain in the joints during acute periods. This begins at or before age 16 and causes swelling, stiffness, effusion, pain, and tenderness in the joints.
  • Spinal curvatures (orthopedic and musculoskeletal disorders). Scoliosis is a form of spinal curvature in which the spine forms a “c” or an “s” when it is viewed from behind.
  • Osteogenesis Imperfecta (orthopedic and musculoskeletal disorders). An inherited congenital fragility of the bones.
  • Other types of orthopedic and musculoskeletal disorders include limb deficiencies, hip conditions and other musculoskeletal conditions.