LESSON Learners with Difficulty in Walking and Moving

5
OBJECTIVES:
 Define physical disability.
 Discuss characteristics of learners with difficulty in walking / moving along
with their challenges in learning.
 Differentiate types and causes of physical disabilities.
 Discuss accommodation, environmental modifications and assistive
technology.
 Analyze the importance of accommodations and assistive technology to
learners with difficulty in walking and moving.
 Apply appropriate intervention and adaptive supports for learners with
difficulty in moving and walking.
Introduction
You are now in lesson5 of learners with exceptionalities of Module 4. This lesson provides an
overview of what a physical disability is, and its types and causes that will deepen your understanding
on the concept of movement and walking abnormalities. You will also explore various practical
adaptations need to be implemented to assist students with physical disabilities to achieve success
alongside with their classroom peers and special equipment/s or materials that might need to be built or
developed in order for them to participate in school and classroom activities more easily and
independently. Since many students with physical disabilities have no cognitive impairments, the
general educator and special educator should collaborate to include the student in the general
curriculum as much as possible. Enjoy reading

Instruction: Think of your favorite sport on television or favorite sport

character. Perform (without equipment) your character’s
favorite action. Pretend to push button to replay it on “fast
forward”, “slow motion”, “backwards”.
 Analysis

After doing this activity, please consider the following questions below:
 How did you feel when you perform the activity?
 Can you share to the class your experience/challenges while performing
the activity?
 Based on the activity above, what is the implication of movement to you?

Abstraction

PHYSICAL DISABILITIES - What are they?

A physical disability is the long-term loss or impairment of part of a person’s body function,
resulting in a limitation of physical functioning, mobility, dexterity or stamina. Due to the
functional loss the person will experience the inability to perform normal movements of the
body, such as walking and mobility, sitting and standing, use of hands and arms, muscle control,
etc. The impairment may range from mild to severe, may have minimal impact on the student or
interfere substantially with functional ability. Some may appear entirely normal; others have a
highly visible disabilities.
A person can be physically disabled due to two reasons:
 Congenital/Hereditary- the person has physical disability since birth or the disability
developed at a later stage due to genetic problems, problems with muscle cells or injury
during birth.
 Acquired- the person acquired the physical disability through road or industrial
accidents, infections such as polio or diseases and disorder.
How comfortable or uncomfortable are you when you encounter someone with a physical
disability? Explain your answer.

What are the characteristics of physical disability?

Some children with skeletal deformity have surgery. Others have to use various types of
braces prosthetic and orthopedic devices before, after or in place of surgery. Others may use
adaptive wheelchairs. The referral characteristics for the student with a physical disability fall
more into the area of physical characteristics.

Physical and mobility impairments characteristics may include:

 Persons with physical and mobility impairments may experience deficits in motor and/or
fine motor functioning, locomotor and non-locomotor functioning.
 There is the potential for deficits in cognitive, social, and adaptive behavior skills, as well
as impairments in language, vision, hearing or other sensory areas.
 Persons with physical and mobility impairments may experience stiffness and/or
spasticity, as well as loss of muscle strength. They may need help with learning, or
activities of daily living.
 Persons with physical and mobility impairments may need assistance with mobility,
transfers, and ambulation.
 They may have a limited range of motion, and be reluctant to attempt movement, or
experience a perceptual or cognitive impairment.
 They may experience pain, discomfort; depression or anxiety.
 Persons with these impairments may require prolonged bed rest, and have medical
restrictions.
 They may have musculoskeletal or neuromuscular impairments as well.
 It impedes speech production and the expressive language

In order to understand TYPES AND CAUSES

physical disability better:

1. Neurological Impairments- are a group of disorders that

primarily relate to the central nervous system---comprised of the brain and spinal cord. A
neurological impairment or disability may affect an individual’s speech, motor skills,
vision, memory, muscle actions and learning abilities.
Causes of Neurological Impairments:
 Infectious diseases
 Hypoxia
 Poisoning
  Congenital malformation
 Physical trauma
 Jaundice
 Rh Incompatibility
 Smoking

 Cerebral Palsy- It is not a disease. It is a condition characterized by a paralysis,

weakness, in-coordination and or other motor dysfunction because of the damage
to the brain.
Causes: Damage to the parts of the brain which control movement during the early
stages of development. In most cases, this damage occurs during pregnancy.
However, damage can sometimes occur during birth and from brain injuries in early
infancy (such as lack of oxygen from near drowning, meningitis, head injury or
being shaken).
Classification of Cerebral Palsy according to the extremities involved;
 Quadriplegia – involvement of the four limbs.
 Diplegia – involvement of the four limbs with the legs more affected
than the arms.
 Paraplegia –involvement of the legs.
 Triplegia – involvement of three limbs.
 Hemiplegia – one side of the body is affected.
 Monoplegia – one limb is affected.

Types of Cerebral Palsy

 Muscle Stiffness or SPASTICITY –the child who is ‘spastic’ has muscle
stiffness.
 Uncontrolled movement or ATHETOSIS –these are slow, wriggly of
sudden quick movements of the child’s feet, arms, hand or face muscles.
 Poor balance or ATAXIA – the child who has ‘ataxia’ or poor
balance has difficulty in beginning to sit and stand, fall often and
have very clumsy use of hands.
 MIXED – some people have more than one type of cerebral palsy.

What do you think are the challenges of a student with cerebral palsy?

 Seizure Disorder- A sudden alteration of consciousness usually accompanied by

motor activity and or sensory phenomena
Types of Seizures
The International League Against Epilepsy suggest 2 major types of seizures:
 Generalized - involves the discharge of cells in a large part of the brain.
 Partial - begins in a localized area, and only a small part of the brain is
involved.
 Other terminologies;
Tonic/Clonic - the person loses consciousness, becomes rigid due to
strong muscle contractions
(tonic stage) then begins to jerk rapidly or
shake (clonic stage).
 Absence - brief, generalized seizures manifested by a brief “absence” or
lapse of consciousness lasting up to 30 seconds.

What will you do if one of your student has a clonic seizure attack?

 Spina Bifida - s a birth defect that occurs when the spine and spinal cord don't form
properly.
Causes: The type and amount of disability caused by spina bifida will depend upon
the level of the abnormality of the spinal cord. Children with spina bifida may have:
 partial or full paralysis of the legs
 difficulties with bowel and bladder control.

2. Musculoskeletal Conditions- Musculoskeletal complaints involve the muscles or components

of the skeletal system. This includes the muscles themselves, the tendons and ligaments
and other soft tissues such as the bursa (sacs of fluid that help in the lubrication of the
joints).
 Muscular Dystrophy – weakening and wasting away of muscular tissue
 Atrophy - degeneration of tissue, such as muscles or nerves.
 Myopathy - a weakening and wasting away of muscular tissue in which
there is no evidence of neurological disease or impairment.
 Dystrophy - hereditary, progressive weakening and wasting away of muscle
tissue in which there is no evidence of neurological disease.

 Arthritis - a disease involving inflammation of the joints.

 Rheumatoid Arthritis - a systemic disease with major symptoms involving
the muscles and joints.
 Osteoarthritis -a type of arthritis common among children with disabilities
in which movement is painful or impossible because of damage to the
cartilage around the joint.

 Clubfoot One or both feet turned at the wrong angle at the ankle.
 Scoliosis - abnormal curvature of the spine.
 Osteomyelitis - bacterial infection of the bones.
 Legg-Calve-Perthes Disease- flattening of the femur or hipbone.
 Arthrogryposis Muscles of the limbs missing or smaller and weaker than the
normal.
 Osteogenesis Imperfecta - also known as brittle bone disease, is a group of genetic
disorders that mainly affect the bones

3. Congenital Malformations
Common Malformations:
 Congenital malformations of the heart and/or blood vessel.
 Congenital dislocation of the hip.
 Congenital malformations of the extremities.
 Congenital malformations of the head and face.
Causes:
  Teratogens
 Deformity-producing factors that interfere with normal fetal development.
 German measles (rubella)
 A serious viral disease, which, if it occurs during the first trimester of
pregnancy, is likely to cause a deformity in the fetus.
 Phocomelia- A deformity in which the limbs of the baby are very short or
missing completely, the hands and feet attached directly to the torso, like
flippers; many cases resulted from maternal use of the drug Thalidomide
during pregnancy.
 Fetal Alcohol Syndrome – abnormalities associated with the mother’s
drinking alcohol during pregnancy. Defects range from mild to severe,
including growth retardation, brain damage, mental retardation,
hyperactivity, anomalies of the face, and heart failure.

Did you know that there are many ways you can create a more
accessible and supportive school and classroom environment?

Below are some guiding questions that you need to consider:

 Can the student move through the school doorways and corridors easily and safely?
 Are the school toilet areas easy to access with accessible toilets and hand washing
facilities?
 Do wheelchair ramps need to be installed?
 Is the outside equipment safe to use and does the student feel safe using it?
 Is the classroom uncluttered?
 Can students move around easily, view the board and sit and work alongside their peers?
 Can the student use all the tools and equipment in class and participate in all curriculum
areas?
If not, then you need to do something to make appropriate changes in the classroom based on
what is the need of learners with difficulty in moving and walking..

What is Accommodation?

Accommodation is a change that helps a student overcome or work around the disability. The
student is still expected to know the same material and answer the same questions as fully as the
other students, but he doesn’t have to write his answers to show that he knows the information.

In providing accommodations for students with physical disabilities we need to

remember that some conditions are characterized by periods of remission, so the disability will
not always be visible and will not always impact on the student’s ability to function in the
educational environment in the same way. Each learner with a physical disability should be
assessed individually and accommodations should be implemented based on the unique needs of
each student.
 In order for the student to access the general curriculum, the student may require these
accommodations:
 Special seating arrangements to develop useful posture and movements
 Instruction focused on development of gross and fine motor skills
 Securing suitable augmentative communication and other assistive devices
 Awareness of medical condition and its affect on the student (such as getting tired quickly)

Because of the multi-faceted nature of orthopedic impairments, other specialists may be

involved in developing and implementing an appropriate educational program for the student.
These specialists can include:

 Physical Therapists who work on gross motor skills (focusing on the legs, back, neck and torso)
 Occupational Therapists who work on fine motor skills (focusing on the arms and hands as
well as daily living activities such as dressing and bathing)
 Speech-Language Pathologists who work with the student on problems with speech and
language
 Adapted Physical Education Teachers, who are specially trained PE teachers who work
along with the OT and PT to develop an exercise program to help students with disabilities
 Other Therapists (Massage Therapists, Music Therapists, etc.)

The table below shows the common characteristics of a student with physical disabilities with
corresponding suggested accommodations or classrooms adaptations

Common Characteristics of a Commonly Suggested Accommodations/Classroom

Student with Physical Disabilities Adaptations

Create a physically accessible environment that is

not mobility-limited.

Be flexible with the schedule. Students may arrive late or

Student needs specialized transportation. have to leave before the class is over due to adapted
transportation services.

Replace written exams or assignments with an oral exam or

presentation.
Is often physically unable to hold a pen and Use of note takers.
write for extended periods of time or may Use of assistive technology (e.g., computer, assistive
experience challenges with input, output, software, mini recorder, etc.). 5
and information processing when working Use of a scribe or speech-to-text software to record answers
on assignments, tests, and/or exams. on tests/exams.
Provide a room other than the classroom for exams if
required.

Student has difficulty finishing Extra time for tests/exams and perhaps some components of
assignments and/or tests in allotted time. coursework.
Common Characteristics of a Student Commonly Suggested Accommodations/Classroom
with Physical Disabilities Adaptations
When speaking to a person who uses a wheelchair for a long
Experiences fatigue and limited mobility period of time, avoid the need for them to strain in order to
when speaking to a person for a long look up at you by sitting beside or leaning toward them
period of time. during the conversation, in order for them to avoid
experiencing fatigue and/or pain.

Requires extra time to obtain formats

compatible with assistive technology.

What is Environmental Modification?

Environmental modifications are frequently necessary to enable a student with physical disability
to participate more fully in the classroom activities and independently in school. This may
involve, work space modifications, changes in the location of materials and equipment, object
modifications or adapting equipment or materials for given tasks, changing the manner in which
the task is done and use of manipulation aids.
Within the classroom, the problem of students with physical disabilities may be solved by simple
procedures that require little or no cost at all like the following:
1. Modifying school furniture by:
 changing desk and table tops to appropriate heights for students who are very short or
who use wheelchairs;
 adjusting seats to turn to either side so that the child with braces can sit more easily;
 providing foot rest;
 adding hinged extension to the desk with a cut-off for the child who has poor sitting
balance,
 eliminating protruding parts over which the child might trip.
2. Providing need-based assistance like:
 taping paper to the desk;
 devising some means of keeping pencils, crayons and other materials from rolling on the
floor;
 providing backracks or mechanical page turners;
 providing wooden pointer to indicate responses on the board;
 installing paper cup dispenser near water fountains for wheelchair users, and
 placing rubber mats over the slippery section of the floor.
Before going further, what do you think of the various accommodations and modifications
presented?
 What is Assistive Technology?

Assistive technology is defined in IDEA as any term, piece of equipment or product system
whether acquired commercially of the shelf, modified or customized that is used to increase,
maintain or improve, functional capabilities of a child with a disability.
Individuals with physical disabilities use both low tech assistive devices (e.g. adapted eating
utensils, picture communication books) and high tech assistive devices (e.g. computerized
synthetic speech devices, electronic switches that can be activated by eye movements) for a wide
variety of purposes including mobility, performing daily life skills, improved environmental a
manipulation and control, better communication, access to computers, recreation and leisure and
enhanced learning.
For those with more severe impairments, let students have access to computers for learning and
expressing themselves. Keyboard and mouse alternatives replace standard input devices. Voice
recognition software allows users to speak what they want to input instead of typing it.

Here are some of the categories:

1. Mobility aids- are assistive technology devices
that help people perform movements in a variety of
environments. These include manual and electric wheelchair, canes, scooters, walkers, vans
modified for travel electronic direction-finding mobility aids and other adaptation and devices.
2. Seating and positioning- are used to position the disabled person as the best posture to
participate in a particular activity. The activity might involve moving from place to place, sitting
during conversation, eating, sleeping and others.
3. Aids for daily living are devices used to increase independence. They assist an individual in
performing functional living skills or self-help activities such as cooking, eating, bathing,
toileting, dressing and home maintenance
Making the adjustment to life with limited mobility or motor control can be a difficult process.
As they experience success in the classroom, motivation and learning increase, and overall
student outcomes improve. There are many disability support services available to help them to
maintain their independence and live well in the community.
 Application:
1. Make a chart or a graphic organizer that lists and describes the different types and
causes of physical disability.

2. Read the scenario and fill up the form below of a student with musculoskeletal
condition. Determine what intervention and type of support needed: accommodation,
modification or strategy intervention then explain.

Liamm, a grade 4 student with muscular dystrophy, often experience muscle

stiffness, pain and physical fatigue. He is a highly motivated student and excels
academically. His language arts, science, and mathematics teachers typically
assign homework that requires access to the textbook used in each of these
classes. Because his teachers realize that carrying heavy textbooks home each
night is difficult for Liamm, they implement several types of support to help him
complete his assignment.