Chronic Health Impairments & Illnesses Definition -
The NJ state definition for "Other health impaired" corresponds to "chronically ill" and means a disability characterized by having limited strength, vitality or alertness, including a heightened alertness with respect to the educational environment, due to chronic or acute health problems, such as attention deficit disorder or attention deficit hyperactivity disorder, a heart condition, tuberculosis, rheumatic fever, nephritis, asthma, sickle cell anemia, hemophilia, epilepsy, lead poisoning, leukemia, diabetes or any other medical condition, such as Tourette Syndrome, that adversely affects a student's educational performance. A medical assessment documenting the health problem is required.
The federal government, through IDEA ’04, uses the term “other health impairments” to describe, collectively, conditions and diseases that create special health care needs or health disabilities for students (Smith 318). The Federal definition for 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 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, and sickle cell anemia; and adversely affects a child’s educational performance.
Asthma Definition - Asthma, a condition caused by narrowing of airways accompanied by inflammatory changes in the lining of the airways, may result in severe difficulty in breathing with chronic coughing. Health care needs include appropriate medications, environmental modifications, and monitoring and frequently result in no limitation of activities (Smith 323).
Diabetes Definition - Juvenile Diabetes: a chronic disease in which the body does not make or properly use insulin. This hormone converts sugar, starches, and other foods into energy. There are two different types, type 1 which deals with the immune system and type 2 which deals with problems that the body encounters reacting to insulin. (“Helping Students with Diabetes Succeed”)
Question 2: What are the developmental characteristics of persons with this disability?
Asthma Characteristics
With regard to the impact that asthma has on a child’s developmental characteristics:
Emotional factors are not the cause of asthma; however, emotional stress can occasionally trigger asthma. Emotional stress such as anxiety, frustration, and anger can also trigger asthma, but the asthmatic condition was present before the emotional stress. Therefore, a child’s asthma is not “in his or her head,” as many people believe (Childhood Asthma Overview).
Asthma impacts the lifestyles of patients and parents alike. In addition to the lifestyle adjustments people make to avoid triggers, asthma limits the activities people can enjoy. Patients reported strained relationships with family members, friends, and sometimes employers as a result. Parents said their children with asthma often felt isolated. They complained about their children being left on the sidelines, and adult patients recalled the hardship of being the child who couldn’t play and got left behind (Search LungUSA).
Children with asthma are at greater risk for internalizing their problems. Asthmatic children display more symptoms of anxiety than other chronic illnesses. Anxiety is related to feelings of not being able to breathe, which is a scary feeling. Some other issues in kids with asthma and anxiety are poor self-esteem, activity restrictions, and lower social skills. Statistics show that 39% report fearing death from asthma, 63% report feeling anxious socially, and dating. With friends 39% will tell their friends that they have asthma; however, 29% are embarrassed to have an attack in front of peers (Kullgren).
“School nurses observe that asthma among students causes significant difficulties in their schools. A majority (51%) think asthma is more disruptive of school routine than any other chronic diseases. Over 80% of nurse’s surveyed think asthma has an effect on school absenteeism. Nearly half (46%) observe that not all students with asthma are able to participate in all school day activities, including gym and recess, and academic performance is at risk for those who suffer with asthma” (ORC Marco).
“In the American Lung Association-NASN Asthma Awareness Survey 84% favor providing opportunities for students with asthma to express their feelings through their school assignments such as art and writing. 76% favor integrating physical exercise activities specifically for students with asthma into the regular curriculum; and 66% favor instituting a “buddy” system or student club with rewards or other incentives to sensitize students to asthmas as well as other relevant medical, social, or cultural differences” (ORC Marco).
With regard to physical activities and their level of functioning a child should not think that they can’t be part of a team because he or she has asthma. They can do what anyone else can do. Swimming seems to be the least asthma-provoking form of exercise which is especially good because a child breathes in warm, humid air as they swim. Sports that have some “down time” like baseball might be easier to manage than those that keep them in constant motion like soccer. But if a child loves a sport or activity, chances are that by working with a healthcare team they will be able to figure out a way to play (Teens & Asthma).
Diabetes Characteristics -
Juvenile Diabetes can have an affect on the developmental aspects of a child’s life. Their physical health is affected because diabetes can affect their blood vessels, eyes, kidneys, nerves, gums, and teeth. As they grow older, their diabetes will put them at higher risk of heart disease and stroke as well. Social and emotional health can also be affected. All children with diabetes react differently to their situation. Some become accepting while others become resentful, some are open to discussing it and yet others attempt to hide it. Children do not want to be left out or feel different because of their disease and the care that it takes to maintain diabetes can often make children with the disease angry or resentful. Their care also can compromise independence from their families. Much is required to maintain diabetes and sometimes parent’s overprotection can lead to struggles with dependence, oppositional behavior, and rebellion. Another growing affect that diabetes can have is depression. More and more children are found to suffer from depression due to their diabetes. (“Helping Students with Diabetes Succeed”)
Asthma Support“The education professionals who make a real difference in the academic lives of these students are first and foremost responsive to the individual learning needs they bring to school” (Smith 325). If I were a teacher in a general education classroom I would want to create an appropriate and supportive learning environment. I think that it is extremely important to be aware of what to do if an emergency happened with one of my students. The “if, thens” must be carefully outlined and planned in collaboration with doctors and the medical profession (Smith 324). Asthma attacks are often triggered by components such as chalk dust, paint fumes, animals, foods, dirt, pollen, etc. many of which can be eliminated. Therefore, as a teacher I would be able to reduce the occurrence of episodes and cut down on the absences from school by considering my classroom environment where asthmatic children are receiving an education. I would ensure that the classroom is clean and dust-free, that the windows are closed during pollen season, air conditioning vents are cleaned, and humidifiers are helpful. Although this may sound like “housekeeping” rather than academics, a child cannot remain in an unhealthy environment. Children with asthma may have their academics adversely affected; therefore, accommodations need to be made (Smith 332).
Teachers also play a very important role by helping individuals with asthma find activities that reduce asthma triggers and unsafe physical exertion. For all students with health disabilities there should be consultations with the student, the parents, the school nurse, and the student’s physician which can lead to the development of plans that reduce the possibility of asthma attacks or can be put into action when a crisis occurs. Socially, the students should feel able to participate to the extent possible in extracurricular events such as participating in P.E, sports, dances, etc. However, if the student needs to remain indoors, perhaps a buddy system could be recommended. If a field trip would not be advisable for a student with asthma, then the field trip should be reconsidered for the rest of the class (Smith 332).
As a teacher it would be important to educate the students in my class regarding asthma and sensitize them to the factors that trigger asthma, and is for non-asthmatic children to be helpful and understanding. Also, if anybody does have a cough, cold, or infection to be sure that students are washing their hands regularly and have disinfectant wipes around the classroom at all times.
Diabetes Support -
Teachers in general education classrooms that teach students with diabetes should be willing to work closely with the parents of the child or children. This creates a good support system for the child as well as the family and can also help create a safe feeling environment. Teachers should make sure that a child with diabetes can inform his or her classmates of the disability in an appropriate and informative way so everyone can be ready if there is an emergency situation. Teachers should also make sure to treat the child as normal as possible, to prevent feelings of resentment or anxiety, and be aware that the child may have social, emotional, or developmental problems. A simple understanding of not only the disease but also the struggles and feelings that a child with juvenile diabetes can go through can make all the difference. Children may also need special accommodations for insulin shots, such as a few minutes before lunch, and an emergency supply of glucose should always be kept close at hand in case an emergency occurs. Also, simple things as being proactive in diabetes health teams, providing information on the child’s condition to a substitute teacher, and respecting the student’s privacy are also simple strategies that could help a teacher create trust within his or her classroom. (“Helping Students with Diabetes Succeed”)
Question 4: What resources would help you as a teacher to serve this child?
Asthma Resources
Winning with Asthma is a web-based asthma education program for coaches and PE teachers who want to become more informed on how to recognize asthma, how it affects an athlete’s ability to compete, and learn how to handle an asthma emergency. The program can be completed in about 35-45 minutes at a time which is convenient for you! (http://www.winningwithasthma.org/)
The mission of the Mobile C.A.R.E. Foundation is to provide free and comprehensive asthma care and health education to children via mobile medical clinics, the Asthma Vans. This foundation brings asthma experts directly to the communities where asthma services are needed most. Children are then given a medical exam, and those who are found to have asthma are given medication and learn about the asthma “do’s and don’ts.” Then to help students stay healthy, Mobile C.A.R.E. provides follow-up visits, education and medication for free. (http://www.mobilecarefoundation.org/)
The goals of the Preschool Asthma Outreach Program are to increase awareness of asthma as a chronic illness, identify the symptoms and the environmental factors (indoor and outdoor) that affect asthma, introduce behaviors that help children participate in their own asthma care, educate parents, teachers, and day care workers of simple steps they can take to help preschoolers with asthma, reduce school absenteeism, and reduce emergency room visits. (http://www.oclung.org/webpages/asthma.html)
National Asthma Education and Prevention Program provides written materials and programs for people with asthma for their families, teachers, and other school personnel. (http://www.nhlbi.nih.gov/health/public/lung/index.htm#asthma)
The Asthma-Friendly Schools Initiative is a public health project that has the potential to impact the millions of American students with asthma. Its success relies on mutual efforts among schools, community agencies and leaders, and a planning process. The Asthma-Friendly Schools Initiative toolkit presents support and provides the tools for community organizations and schools to assess the school’s needs, including review of current capabilities and opportunities to strengthen infrastructure, education, and support to ensure that children with asthma are healthy, in school, and ready to learn.(http://www.lungusa.org/site/apps/s/content.asp?c=dvLUK9O0E&b=34706&ct=67480) Asthma-friendly schools are those that make the effort to create safe and supportive learning environments for students with asthma. They have policies and procedures that allow students to successfully manage their asthma. Student’s success will be higher if the school community takes part such as school administrators, teachers, and staff, as well as students and parents. (http://www.cdc.gov/HealthyYouth/asthma/strategies.htm)
Schools need to provide a full-time registered nurse all day. A nurse can certainly help in a school environment by monitoring and administering any necessary medication such as inhalers and tablets. It is also important for a school nurse to inform any teachers who have students in their classroom with asthma. By doing so, it will make it easier for a teacher to help a child if there was an attack, which can save a child from a trip to the emergency room (Teens & Asthma). And if necessary a student should be allowed to carry a rescue inhaler with them at all times in school incase of an emergency (ORC Marco).Janitors can help reduce triggers for asthmatic children by keeping the school clean and dust-free, and making sure that good air quality is maintained by the use of clean and effective air filters on the ventilation systems.
Diabetes Resources
Resources that could help a teacher to serve a child with diabetes are the American Diabetes Association, the American Academy of Pediatrics, and the Juvenile Diabetes Research Foundation International. Consulting school nurses or counselors can also be helpful. The American Diabetes Association is “the nation’s leading nonprofit organization providing diabetes research, information, and advocacy. (American Diabetes Association)” This group focuses on the treatment and the possible cure of diabetes and on improving the lives of those living with the disease. This group and their website can help teachers learn more about diabetes and the struggles that go along with maintaining it. The American Academy of Pediatrics will allow for a teacher or principal to get a better look into specifically juvenile diabetes not just diabetes itself. The website will give different articles on the topic and make it easier for the teacher to relate to what a student is going through. The Juvenile Diabetes Research Foundation International is a group that raises money and organizes a walk to help find a cure for diabetes. This provides one way a teacher can become proactive and supportive of their child with diabetes. Teachers can also use school nurses and counselors to help understand the emotional and social problems that children with diabetes endure everyday. The more a teacher can relate to her student the better off the student is. All these websites as well as resources like nurses and counselors provide a teacher with a good understanding of what diabetes is and how is affects a student’s way of life.
"American Academy of Pediatrics." 21 Nov. 2007
"American Diabetes Assocation." 21 Nov. 2007
"Helping Students with Diabetes Succeed." 20 Nov. 2007
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