Meeting Physical and Health Needs of Children with Disabilities Teaching Student Participation and Management

by Heller, Kathryn W.; Forney, Paula E.; Alberto, Paul A.; Schwartzman, Morton N.; Goeckel, Trudy

• ISBN13: 9780534348373
• ISBN10: 0534348378
• Edition: 1st
• Format: Paperback
• Copyright: 2000-03-20
• Publisher: Cengage Learning

Summary

This book teaches pre-service special education teachers how to teach children with physical disabilities and health impairments (i.e., orthopedic impairments, visual impairments, deaf-blindness, etc.). Heller and her co-authors practically illustrate how to effectively monitor students' health, assist students in providing their own care, and intervene if significant health-related problems occur in the classroom. This text includes a wide variety of techniques for meeting the student's physical and health needs, including how to position the student for optimal instruction, lifting and handling procedures, feeding techniques, and how to work with health-related apparatus and medications.

Table of Contents

Preface	xvii
About the Authors	xix
PART I INSTRUCTIONAL AND HEALTH ISSUES	1	(96)
Promoting Health in Students with Disabilities	3	(22)
Description of Health Problems and Their Impact	4	(7)
mental Health Issues	4	(1)
Social Health Issues	5	(1)
Physical Health Issues	5	(6)
Equipment, Assistive Strategies, and Instructional Strategies	11	(4)
Equipment and Adaptive Equipment to Address health Concerns	11	(1)
Assistive Strategies to Address Health Concerns	12	(2)
Instructional Strategies for Physical Management, Self-Help, and Health Procedures	14	(1)
Management Issues	15	(9)
IHP and IEP	15	(2)
Guidelines and Legal Implications	17	(2)
Training Issues	19	(3)
Infection Control	22	(2)
Summary	24	(1)
Promoting Independence through the Use of Instructional Strategies	25	(28)
Assessment and Content Selection	26	(4)
Ecological Inventory	27	(3)
Discrepancy Analysis	30	(6)
Performing a Task Analysis	30	(1)
Observing and Scoring Performance	30	(3)
Recording Student Errors and Doing a Performance Discrepancy	33	(1)
Providing Instruction, Adaptations, or Alternate Performance Strategies	34	(2)
Instructional Strategies	36	(10)
Antecedent Prompts	37	(3)
Learning Strategies	40	(1)
Response Prompts	41	(4)
Demonstration-Guided Practice-Independent Practice Model	45	(1)
Collecting Data	46	(3)
Error Correction and Analysis	49	(1)
Error Correction	49	(1)
Error Analysis	49	(1)
Expanding Instruction	50	(2)
Entry Level	51	(1)
Acquisition	51	(1)
Proficiency	51	(1)
Maintenance	51	(1)
Generalization	51	(1)
Application	51	(1)
Summary	52	(1)
Communication for Physical and Health Needs	53	(14)
Description of Augmentative Communication	54	(1)
Nonsymbolic Communication	54	(1)
Nonaided Symbolic Communication	54	(1)
Aided Symbolic Communication	55	(1)
Equipment and Adaptive Equipment for AAC	55	(3)
Assistive Strategies to Promote Communication	58	(6)
Accessing Communication Boards and Devices	58	(2)
Vocabular Selection	60	(4)
Instructional Strategies for AAC	64	(2)
Summary	66	(1)
Medications and Procedures for Administration	67	(30)
Description of Medications and Administration Considerations	70	(5)
Permission to Administer Medication at School	70	(2)
Receiving and Storing Medication	72	(1)
Safety Precautions for Administration	72	(3)
Documentation of Administration	75	(1)
Equipment and Assistive Strategies for Medication Administration	75	(14)
Oral Administration	77	(1)
Feeding Tube Administration	78	(1)
Topical Administration	79	(1)
Respiratory Administration	79	(4)
Nasal Administration	83	(1)
Ocular Administration (Eye Drops and Eye Ointments)	84	(1)
Otic Administration (Ear Drops)	85	(2)
Rectal Administration	87	(1)
Administration by Injection	88	(1)
Indwelling Continuous Pumps	88	(1)
Instructional Strategies	89	(1)
Problems and Emergencies	90	(4)
Side Effects	90	(1)
Allergic Reaction	90	(1)
Tolerance	90	(1)
Physical Dependence	90	(3)
Missed Dosage and Overmedication	93	(1)
Incomplete Administration	94	(1)
Wrong Medication or Dose	94	(1)
Choking	94	(1)
Management Issues	94	(2)
Individualized Health Plan and Individualized Educational Program	94	(1)
Medications Taken as Needed (p.r.n.)	95	(1)
Summary	96	(1)
PART II PHYSICAL AND MANAGEMENT SKILLS	97	(84)
Lifting, Carrying, and Transferring	99	(18)
Description of Lifting, Carrying, and Transferring	100	(1)
Equipment and Adaptive Equipment for Lifting and Transferring	100	(3)
Mechanical Lifts	100	(1)
Assistive Transfer Devices	101	(2)
Assistive Strategies for Lifting, Carrying, and Transferring	103	(9)
Handling Considerations Prior to Lifting	103	(1)
Lifting Considerations	103	(1)
Body Mechanics for Proper Lifting	104	(1)
Types of Lifting	105	(4)
Transfer Considerations	109	(1)
Assisted Standing Transfer	110	(2)
Instructional Strategies for Lifting	112	(2)
Teaching Students to Perform Independent Transfers/Task Analysis	112	(1)
Teaching Students to Life and Handle Items	113	(1)
Lifting Problems and Emergencies	114	(1)
Dropping a Student	114	(1)
Back Pain	114	(1)
Management Issues for Lifting and Transferring	115	(1)
Individualized Health Plan and Individualized Educational Program	115	(1)
Planning for Multi-Person Transfers	115	(1)
Summary	116	(1)
Proper Handling and Positioning	117	(32)
Muscle Tone and Primitive Reflexes	117	(2)
Hypertonia	118	(1)
Hypotonia	118	(1)
Fluctuating and Mixed Tone	118	(1)
Primitive Reflexes	119	(1)
Purpose and Goals of Proper Handling and Positioning	119	(2)
Description of Principles of Handling	121	(1)
Assistive Strategies for Therapeutic Handling	122	(3)
Inhibition Techniques	122	(1)
Stimulation Techniques	123	(2)
Principles of Positioning	125	(1)
Supine Positioning	126	(2)
Equipment and Adaptive Equipment	126	(1)
Assistive Strategies	127	(1)
Side-Lying Positioning	128	(1)
Equipment and Adaptive Equipment	128	(1)
Assistive Strategies	129	(1)
Prone Positioning	129	(2)
Equipment and Adaptive Equipment	129	(2)
Assistive Strategies	131	(1)
Sitting Positioning	131	(5)
Equipment and Adaptive Equipment	131	(4)
Assitive Strategies	135	(1)
Standing	136	(3)
Equipment and Adaptive Equipment	136	(3)
Assistive Strategies	139	(1)
Assistive Strategies for Transitioning between Positions	139	(1)
Positioning Materials	140	(4)
Object Manipulation Requirements	140	(1)
Object Modifications	140	(1)
Positioning the Student	140	(1)
Range of Motion	141	(1)
Work Surface Modifications	142	(1)
Positioning Devices	142	(1)
Fatigue and Endurance Levels	143	(1)
Instructional Strategies for Handling and Positioning	144	(1)
Handling and Positioning Problems and Emergencies	145	(1)
Pain and Discomfort	145	(1)
Dropping a Child	145	(1)
Management Issues for Handling and Positioning	145	(3)
Individualized Health Plan and Individualized Educational Program	145	(2)
Tracking Implementation	147	(1)
Summary	148	(1)
Mobility	149	(32)
Description of Mobility Considerations	150	(1)
Equipment and Adaptive Equipment for Mobility	151	(12)
Walkers	153	(1)
Crutches and Canes	154	(2)
Wheelchairs	156	(2)
Other Mobility Devices	158	(3)
Other Assistive Technologies for Mobility	161	(2)
Assistive Strategies to Promote Mobility	163	(13)
Rolling	163	(2)
Crawling	165	(1)
Creeping	166	(2)
Scooting	168	(2)
Crusing	170	(3)
Walking	173	(2)
Wheeling	175	(1)
Instructional Strategies for Mobility	176	(1)
Mobility Problems and Emergencies	177	(1)
Falls	177	(1)
Skin Breakdown from Mobility Equipment	178	(1)
Management Issues for Mobility	178	(2)
Individualized Health Plan and Individualized Educational Program	178	(1)
Time Constraints Regarding Mobility	178	(2)
Summary	180	(1)
PART III BASIC SELF-HELP SKILLS AND RELATED HEALTH PROCEDURES	181	(126)
Eating and Feeding Techniques	183	(37)
Factors Affecting Eating and Feeding	186	(4)
Developmental Readiness	186	(1)
Oral Motor Competency	186	(1)
Sensory Awareness and Discrimination	187	(1)
Medical Stability	187	(1)
Positive Practice	187	(1)
Environmental Factors	187	(1)
Positioning and Motor Control	188	(2)
Equipment and Adaptive Equipment for Feeding and Eating	190	(2)
Spoons	190	(1)
Gripping Utensils	190	(1)
Sandwich Holders	190	(1)
Snack Cap	191	(1)
Stability of Bowls and Plates	191	(1)
Mechanical Feeders	192	(1)
Assistive Strategies for Feeding	192	(6)
Strategies for Lip Movement	192	(1)
Strategies for Lip Closure	193	(1)
Strategies for Jaw Closure	193	(2)
Strategies for Jaw Control While Chewing	195	(1)
Strategies for Activating Cheek Muscles for Chewing	195	(1)
Strategies for Developing Tongue Lateralization for Chewing	196	(1)
Strategies to Develop Swallowing	197	(1)
Procedure for Feeding	197	(1)
Instructional Strategies and Modifications for Eating	198	(5)
Teaching Utensil Use	199	(2)
Teaching Eating Finger Foods	201	(1)
Strategies for Changing Textures	202	(1)
Equipment and Adaptive Equipment for Drinking	203	(1)
Cups	203	(1)
Straws	204	(1)
Assistive Strategies for Drinking	204	(2)
Positioning	205	(1)
Cup Placement	205	(1)
Lip Control	205	(1)
Jaw Support	205	(1)
Thickness of Fluid	205	(1)
Instructional Strategies and Modifications for Drinking	206	(4)
Cup Drinking	206	(1)
Considerations When Using Physical Guidance for Cup Drinking	206	(1)
Straw Drinking	207	(3)
Eating and Feeding Problems and Emergencies	210	(5)
Oral Tactile Defensiveness and Lack of Tactile Response	210	(1)
Tongue Thrust	210	(1)
Tonic Bite and Unsustained Bite Reflexes	211	(2)
Hypersensitive Gagging/Choking	213	(1)
Gastroesophageal Reflux	214	(1)
Aspiration	214	(1)
Allergies	215	(1)
Management Issues for Feeding and Eating	215	(4)
Individualized Health Plan and Individualized Educational Program	215	(1)
Nutrition and Hydration	216	(3)
Special Diets and Restrictions	219	(1)
Summary	219	(1)
Tube Feeding	220	(23)
Description of Tube Feeding	221	(4)
Description of Feeding Routes	221	(3)
Types of Tube-Feeding Formulas	224	(1)
Equipment and Adaptive Equipment for Performing Tube Feeding	225	(2)
Assistive Strategies for Performing Tube Feeding	227	(7)
Preparing for Tube Feeding	227	(1)
Inserting the Tube	228	(1)
Verifying Placement and Residual Volume	228	(1)
Procedure for Intermittent Feeding	229	(2)
Procedure for Continuous Feeding	231	(2)
Care of Equipment	233	(1)
Daily Care	233	(1)
Instructional Strategies and Modifications for Tube Feeding	234	(1)
Time-Limited Steps and Caution Steps	235	(1)
Tube Feeding Problems and Emergencies	235	(4)
Aspiration	236	(1)
Tube Displacement	236	(1)
Nausea, Vomiting, and Cramping	237	(1)
Diarrhea	237	(1)
Site Infection	238	(1)
Leaking of Stomach Contents	238	(1)
Clogged Tube	238	(1)
Management Issues for Tube Feeding	239	(3)
Individualized Health Plan and Individualized Educational Program	239	(2)
Moving to Feeding	241	(1)
Summary	242	(1)
Toilet Training	243	(22)
Description of Toilet Training	246	(1)
Assistive Devices for Toilet Training	247	(2)
Adaptive Toilets	248	(1)
Other Adaptive Devices	249	(1)
Assistive Strategies for Toilet Training	249	(2)
Environmental Arrangement	249	(1)
Transfers	250	(1)
Positioning	250	(1)
Abdominal Massage	251	(1)
Medications	251	(1)
Instructional Strategies for Toilet Training	251	(7)
General Techniques for Toilet Training	251	(2)
Trip-Training Method	253	(1)
Pretraining Date	254	(3)
Bowel Training	257	(1)
Toileting Problems and Emergencies	258	(2)
Urinary Tract Infection	258	(1)
Constipation	258	(1)
Impaction	258	(1)
Diarrhea	258	(1)
Overhydration	259	(1)
Intestinal Parasites	259	(1)
Skin Breakdown	259	(1)
Pica and Fecal Smearing	259	(1)
Management Issues for Toilet Training	260	(4)
Individualized Health Plan and Individualized Educational Program	260	(1)
Augmentative Communication	261	(1)
Diet	262	(1)
Activity Level	262	(1)
Sex of Personnel Assisting the Student	263	(1)
Toilet Training in Inclusive School Settings and the Community	263	(1)
Summary	264	(1)
Urinary Catheterization and Urinary Collection Devices	265	(24)
Description of Clean Intermittent Catheterization (CIC)	267	(1)
Equipment and Adaptive Equipment for CIC	268	(1)
Assistive Strategies for Clean Intermittent Catheterization	269	(4)
Preparing for CIC	269	(1)
Procedure for CIC	270	(3)
Care of CIC Equipment and Daily Care	273	(1)
Instructional Strategies and Modifications for CIC	273	(3)
Time-Limited Steps and Caution Steps	275	(1)
Student Guidelines	276	(1)
CIC Problems and Emergencies	276	(2)
Infection	276	(1)
Inability to Pass the Catheter	276	(1)
Omission of Catheterization	277	(1)
No Urine on Catheterization	277	(1)
Urine between Catheterizations	277	(1)
Soreness, Swelling, and Discharge	277	(1)
Bleeding	277	(1)
Description of Crede	278	(1)
Equipment and Adaptive Equipment for Crede	278	(1)
Assistive Strategies for Crede	278	(1)
Preparing for Crede	278	(1)
Procedure for Crede	278	(1)
Instructional Strategies and Modifications for Crede	279	(1)
Crede Problems and Emergencies	280	(1)
Infection	280	(1)
Injury	280	(1)
Description of the External Urinary Catheter	280	(1)
Equipment and Adaptive Equipment for External Urinary Catheters	281	(1)
Assistive Strategies for Using an External Urinary Catheter	281	(3)
Preparing for Using an External Urinary Catheter	281	(1)
Procedure for Putting on an External Urinary Catheter (Condom Type)	281	(2)
Care of the External Urinary Catheter Equipment and Daily Care	283	(1)
Instructional Strategies and Modifications for Using an External Urinary Catheter	284	(1)
External Urinary Catheter Problems and Emergencies	284	(1)
Infection	284	(1)
Erection While Putting on the Catheter	284	(1)
Skin Breakdown	284	(1)
Description for Use of an Indwelling Catheter	284	(1)
Assistive Strategies for Indwelling Catheterization	285	(1)
Instructional Strategies and Modifications for Indwelling Catheterization	285	(1)
Indwelling Catheterization Problems and Emergencies	285	(1)
Infection	285	(1)
Accidental Removal of the Catheter	286	(1)
Management Issues for Urinary Catheterization and Use of Collection Devices	286	(2)
Individualized Health Plan and Individualized Educational Program	286	(1)
Diet and Fluid Intake	286	(1)
Sex of Personnel Assisting Student	286	(2)
Summary	288	(1)
Colostomies and Other Ostomies	289	(18)
Description of Ostomies	290	(3)
Nephrostomies and Ureterostomies	290	(1)
Ileostomies and Jejunostomies	291	(1)
Colostomies and Cecostomies	292	(1)
Equipment and Adaptive Equipment for Ostomies	293	(2)
Assistive Strategies for Ostomies	295	(4)
Preparation for Emptying a Colostomy Bag	296	(1)
Procedure for Emptying a Colostomy Bag	296	(1)
Preparation for Changing a Colostomy Bag	297	(1)
Procedure for Changing a Colostomy Bag	297	(2)
Care of Equipment and Daily Care	299	(1)
Instructional Strategies and Modifications for Emptying and Changing a Colostomy Bag	299	(2)
Time-Limited Steps and Caution Steps	301	(1)
Colostomy Problems and Emergencies	301	(2)
Gas and Odor	301	(1)
Leakage	302	(1)
Skin Problems around the Stoma	302	(1)
Bleeding from the Stoma	302	(1)
Diarrhea or Vomiting	303	(1)
Obstruction	303	(1)
Changes in the Appearance of the Stoma	303	(1)
Management Issues for Ostomies	303	(3)
Individualized Health Plan and Individualized Educational Program	303	(2)
Diet and Exercise	305	(1)
Emotional Acceptance and Stoma Concealment	306	(1)
Summary	306	(1)
PART IV INSTRUCTION IN RESPIRATORY PROCEDURES	307	(92)
Tracheostomies	309	(25)
Description of Tracheostomies	310	(2)
Equipment and Adaptive Equipment for Tracheostomies	312	(2)
Assistive Strategies for Tracheostomy Stoma Care	314	(2)
Preparing for Tracheostomy Stoma Care	314	(1)
Procedure for Cleaning the Tracheostomy Stoma	314	(2)
Assistive Strategy for Changing the Tracheostomy Ties	316	(2)
Preparing for Changing Tracheostomy Ties	316	(1)
Procedure for Changing Tracheostomy Ties	317	(1)
Assistive Strategy for Cleaning/Changing an Inner Cannula	318	(2)
Preparing for Cleaning/Changing an Inner Cannula	318	(1)
Procedure for Cleaning/Changing an Inner Cannula	319	(1)
Assistive Strategy for Changing/Cleaning the Tracheostomy Tube	320	(1)
Assistive Strategy for Suctioning a Tracheostomy	321
Instructional Strategies and Modifications for Tracheostomies	320	(4)
Tracheostomy Problems and Emergencies	324	(6)
Dislodgment of the Tracheostomy Tube	324	(1)
Obstruction	324	(1)
CPR	325	(1)
Emergency Tracheostomy Change	326	(3)
Aspiration	329	(1)
Falling Underwater	329	(1)
Irritation or Bleeding at the Stoma	329	(1)
Respiratory Infections	330	(1)
Management Issues for Tracheostomies	330	(3)
Individualized Health Plan and Individualized Educational Program	330	(1)
School Environment	330	(2)
Activity Restrictions	332	(1)
Communication	332	(1)
Emergency Tracheostomy Kit for School and Travel	333	(1)
Summary	333	(1)
Managing Respiratory Secretions	334	(30)
Chest Physiotherapy: Moving and Loosening Secretions	335	(2)
Postural Drainage	335	(2)
Vibration	337	(1)
Coughing	337	(1)
Description of Suctioning	337	(2)
Equipment and Adaptive Equipment for Suctioning	339	(2)
Assistive Strategies for Tracheostomy or Nasotracheal Suctioning	341	(7)
Preparing for Tracheostomy or Nasotracheal Suctioning	341	(1)
Identifying the Need for Suctioning	342	(1)
Procedure for Tracheostomy or Nasotracheal Suctioning	343	(4)
Care of Equipment	347	(1)
Assistive Strategies for Nasal and Oral Suctioning with a Straight Catheter	348	(5)
Preparing for Nasal and Oral Suctioning	348	(1)
Procedure for Nasal and Oral Suctioning with a Straight Catheter and Suction Machine	348	(5)
Care of Equipment	353	(1)
Suctioning with Other Devices	353	(4)
Tonsil Tip Devices	353	(1)
Bulb Syringe	354	(1)
DeLee Suction Catheter	355	(1)
Procedure for Suctioning with a DeLee Catheter	356	(1)
Instructional Strategies and Modifications for Suctioning	357	(2)
Time-Limited Steps and Caution Steps	358	(1)
Suctioning Problems and Emergencies	359	(1)
Ineffective Suctioning	359	(1)
Obstruction	359	(1)
CPR	359	(1)
Reaction to Suctioning	359	(1)
Bleeding	360	(1)
Emotional Response to Suctioning	360	(1)
Management Issues for Managing Respiratory Secretions	360	(3)
Individualized Health Plan and Individualized Educational Program	360	(1)
School and Community Environment	360	(3)
Summary	363	(1)
Oxygen Management	364	(18)
Description of Oxygen Therapy	366	(1)
Equipment and Adaptive Equipment for Oxygen Delivery	366	(4)
Delivery Systems	366	(2)
Oxygen Sources	368	(2)
Humidification	370	(1)
Assistive Strategies for Oxygen Delivery	370	(3)
Preparing for Emergency Oxygen Delivery	370	(1)
Procedure for Emergency Oxygen Delivery Using Concentrated Oxygen	371	(2)
Daily Care and Equipment	373	(1)
Instructional Strategies and Modifications for Oxygen Delivery	373	(3)
Oxygen Problems and Emergencies	376	(2)
Poor or No Oxygen Flow	376	(1)
Alarms	377	(1)
Oxygen Leak	377	(1)
Hypoxia	377	(1)
Overoxygenation	377	(1)
CPR	378	(1)
Other Complications	378	(1)
Management Issues for Oxygen Delivery	378	(2)
Individualized Health Plan and Individualized Educational Program	378	(1)
Environmental Arrangement for Oxygen	378	(2)
Activity Restrictions	380	(1)
Summary	380	(2)
Ventilator Management	382	(17)
Description of Ventilators	383	(1)
Equipment and Adaptive Equipment for Ventilator Management	384	(1)
Assistive Strategies for Ventilator Management	385	(4)
General Student Care for Students Using Ventilators	385	(1)
Checking the Ventilator	385	(3)
Alarms	388	(1)
Assistive Strategies for Changing the Ventilator Circuit	389	(2)
Preparing for Changing the Ventilator Circuit	389	(1)
Procedure for Changing the Ventilator Circuit	389	(2)
Care of Equipment	391	(1)
Instructional Strategies and Modifications	391	(2)
Ventilator Problems and Emergencies	393	(2)
Ventilator Malfunction	393	(1)
Respiratory Distress	393	(1)
CPR	394	(1)
Obstruction and High-Pressure Alarm	394	(1)
Air Leak/Low-Pressure Alarm	395	(1)
Management Issues for Ventilators	395	(3)
Individualized Health Plan and Individualized Educational Program	395	(1)
Communication	395	(2)
Environment	397	(1)
Emotional Issues	398	(1)
Summary	398	(1)
References	399	(11)
Glossary	410	(5)
Index	415