Other Health

Impairments
The Mico University College
 Definition
Health impairments include diseases and special health conditions that affects a child’s educational
performance. For example, childhood cancers, diabetes, asthma, sickle cell anemia and cystic
fibrosis. Health impairments affect a child’s
 Stamina
 Vitality
 Alertness

They are due to chronic , acute conditions, and infectious diseases that can negatively impact a
child’s educational performance.
1. Chronic conditions are long lasting and often permanent e.g., cerebral palsy
2. Acute conditions can cause severe and debilitating symptoms but are of limited duration e.g.,
a sickle cell crisis.
3. Infectious diseases are contagious disease that can adversely affect a child’s educational
performance e.g., HIV/AIDS.
 Health Impairments
According to IDEA, a child qualifies for special education services if a physical

disability or health related condition “adversely affects the child’s educational

performance” (Heward, 2013 p. 381)

Health impairments can affect school attendance and learning to such an extent that

special services, training, equipment, materials or facilities may be needed.

 Types of Health Impairments
Health impairments may include

Blood conditions e.g., hemophilia & sickle cell anemia

Congenital heart conditions and Rheumatic heart disease

Childhood cancers such as: leukemia & lymphomas

Tuberculosis

Hepatitis B

STORCH -syphilis, toxoplasmosis, other viruses, rubella, cytomegalovirus, and herpes.

Health impairments also include diabetes, asthma, sickle cell disease, cystic fibrosis and HIV/AIDS.
STORCH

1. S - syphilis [an infectious sexual disease that can be passed on to the developing baby;
may cause multiple organ problems, skeletal abnormalities and visual/hearing
problems]
2. T – toxoplasmosis [caused by a parasite that can be transmitted through careless
handling of cat litter, blood transfusion, organ transplants, eating contaminated soil,
eating raw or uncooked meat] Can cause damage to the developing fetus.
3. O - other viruses [e.g., chicken pox, shingles, and poliomyelitis]
4. R – rubella [before 1969 was the most common cause of birth defects]. Rubella, if
contracted during pregnancy can cause deafness and heart defects.
1. C – cytomegalovirus [a member of the herpes family and is extremely common]. Can

be found in body organs and body fluids. Produces mild symptoms in infected persons

but in persons with compromised immune systems it can cause severe neurological

damage. Also, dangerous to developing fetus as it can cross the placenta and cause

blindness.

2. H – herpes [herpes simplex virus type 1 (HSV-1) is the most common herpes simplex

virus. Often causes cold sores on the lips or infections of the eye. Is transmitted via

infected saliva. 90% of people will have developed antibodies to HSV-1 by adulthood
 Diabetes
A condition in which the body does not properly process food

for use as energy (CDC, n.d.)

There are two types of diabetes. Type 1 found in children, teens

and young adults. Occurs when the body does not make enough

insulin. This is referred to as insulin dependent. Type 2 found

in adults. Occurs when the body can’t use its own insulin as well

as it should; causing sugar to build up in the blood. This is

referred to as insulin resistant.

Insulin
Insulin is a hormone produced by the pancreas that allows glucose to
leave the bloodstream and enter the cells. When there is no insulin;
glucose stays in the blood and the cells are unable to get the energy
they need
Type 2 diabetes- Contributary Factors

1.Age (over 45 years)

2.Race (persons of African descent, Hispanics)
3.High blood pressure
4.A history of gestational diabetes
5.Poor diet
6.Sedentary lifestyle
7.Obesity
Prevalence
1. According to WHO (2003) Jamaica has 17.9% prevalence of diabetes in persons 15 years

and older. Diabetes is the second leading cause of death in Jamaica.

2. Diabetes that goes untreated can be fatal. Worldwide 3.2 million deaths are attributed to

diabetes.

3. There are many complications that can occur from diabetes as several organs and systems

are impacted by high sugar levels in the blood stream.

Complications
Retinopathy: a deterioration of the retina due to damage to the blood
vessels in the retina, can lead to blindness.
Cataracts: clouding of the eye’s lens [cataracts develop at an early
age in persons with diabetes]
Glaucoma: caused by increase in fluid pressure inside the eye leading
to optic nerve damage and loss of vision [a person with diabetes is
twice as likely to develop glaucoma]
Cardiovascular Disease [CVD]: there is a strong correlation between diabetes and
CVD. Heart disease and strokes are the #1 cause of death in persons with diabetes
especially Type 2 diabetes. Diabetes encourages the laying down of cholesterol
which blocks or partially block the vessels of the heart, compromising blood flow.
The American Heart association considers diabetes to be 1 of 7 major controllable
risk factors for controlling CVD.
Neuropathy [nerve damage]: characterized by pain, tingling, numbness in arms,
legs, feet, hands or in and organ in the body. 60%-70% of people with diabetes will
have some form of neuropathy.
Acute Renal Failure [ARF]: a serious condition carrying a mortality rate of 50%.
This when the kidneys fail to function properly and is unable to get rid of body
waste. Diabetes is the leading cause of kidney failure. Individuals may need
dialysis or transplantation.
Amputations: impeded blood flow to the feet can cause nerve damage
[neuropathy] and make cuts harder to heal. Small injuries can result in ulcers that
are difficult to treat. Amputation may be necessary if infection has severely
damaged the tissue (gangrene) and or bone.
Diabetes accounts for 50% of all non-traumatic amputations.
 Asthma
The most common pulmonary disease among children. It causes wheezing,
breathlessness, chest tightness and coughing.
Asthma is triggered by a reaction to:
allergens (pollens, moles, dander)
irritants (smoke, dust, pollution)
Asthma may also be triggered by:
stress, changes in the weather, strong odors, illnesses and exercise
Asthma has a strong heredity basis (if one parent has asthma there is a 50% chance
their child will develop asthma) suggesting an allergic intolerance to some stimulus
may be inherited.
 Types of Asthma
1. Adult-onset asthma – asthma that develops in adulthood. Often triggered by a change in
environment or an illness.
2. Allergic asthma – asthma is triggered by the body’s sensitivity to certain triggers such as
pollen, dust and pet dander.
3. Asthma / COPD overlap – COPD is a chronic obstructive pulmonary disease that causes
difficulty with breathing. Some persons have asthma as well as COPD.
4. Exercise induced asthma –The airways narrow as a result of the physical activity. The
quick breathing in of drier air than what is in the body causes the airways to narrow
resulting in difficulty breathing.
5. Non-allergic asthma –asthma is brought on by extreme weather changes (heat or cold).
Stress can also cause non-allergic asthma.
6. Occupational asthma –asthma caused by environmental conditions such as chemical
fumes, dust or other irritants in the atmosphere
(American College of Allergy, Asthma and Immunology, 2014
 Asthma- what happens
When exposed to a particular trigger, an allergens or irritants; the airways swell up and
produce mucus making it difficult to breath.
The bronchioles close- down, and a wheezing sound is heard as the child tries to draw air
into the lungs.
The muscles in the airwaves tighten causing the airways to narrow, making it difficult for
air to get into the lungs.
 Asthma –characteristic features

 Difficulty breathing

 Shortness of breath

 Coughing

 Wheezing
Asthma Triggers
 Asthma- what happens

 When exposed to a particular trigger, an allergens or irritants; the airways swell

up and produce mucus making it difficult to breath.

 The bronchioles close, and a wheezing sound is heard as the child tries to draw

air into the lungs.

 The muscles in the airwaves tighten causing the airways to narrow, making it

difficult for air to get into the lungs.

 The
Asthmatic Lung
 Educational Implications and Strategies for Children with Health
Impairments

 Need to be educated about the health impairment

 Be aware of medication and possible side effects

• Plan for fatigue as students may tire easily

• Prioritize learning as students may have poor attendance

• Use peers as a support system for the student

• Reduce demands of assignments

• Establish emergency procedures

• Accommodate the health needs of student. For example, allowing frequent

bathroom breaks for students with diabetes.

• Help classmates to understand the needs of the child. This will help reduce

teasing and encourage empathy and acceptance.

• Plan for time – the student may need extra time to complete activities

establish home/school link

• Children with health disorders generally can function in the general classroom

so long as their health needs are understood and met.

 Sickle Cell

 Sickle cell disease is an inherited disease that causes the red blood cells to have an abnormal

sickle/crescent shape.

• This makes these cells poor transporters of oxygen as their sickle shape causes the cells to block the

small blood vessels.

• In order to have Sickle cell disease, the child must inherit a sickle cell gene from both parents. Normal

red blood cells live about 120 days in circulation, but sickle cells live only about 10-12 days.
 Sickle Cell

Blood is the only fluid tissue in the body and is made up of plasma, red blood cells,

white blood cells and platelets.

Blood carries nutrients from digested foods and oxygen from the lungs to every

cell in the body and removes carbon dioxide and waste products.

The red blood cells (erythrocytes) carry oxygen to the cells through hemoglobin

(an iron containing protein that gives blood its red colour).

Persons who have sickle cell anemia have abnormal hemoglobin which

compromises the transportation of oxygen to the cells in the body.

 The sickle cell trait v/s sickle cell disease

Sickle cell trait - When a sickle gene is inherited from one parent and a

normal gene from the other parent. The individual does not have any

symptoms but can carry the defective gene. If a person with a trait has a

child with someone who also has the trait or the disease, there is a high

likelihood their child will have sickle cell disease.

 Types of Sickle Cell disease

There are several types of sickle cell disease. Different types are determined by the genes inherited.

Sickle cell anemia (SS) - When a sickle cell gene is inherited from each parent. SS is frequently found in

individuals of African and Indian descent.

Sickle Hemoglobin C disease (SC)- When one sickle cell gene is inherited from one parent and a different

defective gene is inherited from the other parent.

This disease presents similar symptoms as SS but less anemia because their blood count is higher. SC is

commonly found among individuals from West African, Mediterranean and Middle Eastern descent.
1. This disease presents similar symptoms as SS but less anemia because their blood count is higher. SC

is commonly found among individuals from West African, Mediterranean and Middle Eastern

descent.

2. Sickle Beta-Plus Thalassemia (SB) The severity of the disease depends on the amount of normal

betta globin produced. Chronic cases may need blood transfusions. SB is commonly found in

individuals from Mediterranean and Caribbean descent.

(Sickle Cell Association of the National Capital Area, Inc., 2017)

 Symptoms of Sickle Cell Disease
• Acute chest infections
• Aplastic crisis
• Hand-foot syndrome
• Infections
• Painful crises
• Splenic sequestration crisis
• Stroke
• Leg ulcers
• Joint or bone damage
• Kidney damage
• Eye damage
• Delayed growth
• Jaundice
 Symptoms of Sickle Cell disease

 Aplastic crisis: slowed production of red blood cells causing anemia.

Hand-foot syndrome: painful swelling of hands and feet; an early sign in infants
• Uneven bone growth: due to problems with bone marrow children may have uneven length
fingers and toes
• Infections: prone to infections
• Painful crisis: any part of the body, caused by cold or dehydration, can last hours, days or
longer. May need hospitalization
• Splenic sequestration: spleen becomes enlarged due to trapped RDC. can cause sever anemia.
• Delayed growth: late onset of puberty (18 or19)
• Jaundice: eyes may look yellowish due to presence of destroyed red blood cells floating in the
body fluid.
• Stroke: impaired blood flow to brain
 Cystic Fibrosis (CF)
• Cystic Fibrosis is an inherited disease caused by a faulty gene. It affects the
respiratory, digestive and reproductive systems.
• Usually found in persons of European descent. In Europe CF occurs in 1 in every
2-3,000 births.
• To have CF the child must inherit the gene from both parents. If only one gene is
inherited the child will be a carrier and will not experience the symptoms of the
disease.
Cystic Fibrosis – Characteristics
Salty sweat – sweat test is used to diagnose the disease in infants.

Persistent coughing – sometimes with phlegm

Wheezing or shortness of breath

Excessive appetite but poor weight gain

Greasy, bulky stool

The average survival age is 33.4 years [death is usually related to lung disease] – today some live

longer.

95% of men with CF are sterile.

• CF causes the body to produce excessive amounts of thick sticky mucus.
This mucus interferes with the functioning of many body systems especially
the respiratory system and the digestive system.
• In the lungs this mucus provides an ideal environment for bacteria to thrive
placing the child with CF at risk for repeated lung infections and eventual
damage to the lungs. Lung disease accounts for most deaths from CF.
• In the intestines, this mucus blocks the ducts that carry the digestives
enzymes into the intestines depriving the body of adequate nutrients
 HIV and AIDS
• The Human Immunodeficiency Virus (HIV) is the virus that causes AIDS – Acquired Immunodeficiency

Syndrome. When a person contracts HIV they may develop flue-like symptoms or no symptoms at all. HIV

continues to be a global public health issue (WHO, 2021)

• There were approx. 37.7 million people living with HIV at the end of 2020 (WHO, 2021).

• AIDS attacks the immune system which the body uses to fight infection. As the virus destroys the immune

cells the individual becomes immunodeficient.

• AIDS finds and destroys a particular blood cell called the CD4+ T cells which are critical to helping the

body fight disease. The CD4 cell count; measures the immune function.
AIDS is the late stage of HIV. At this stage, the person’s immune system is so severely compromised

that they cannot effectively fight disease and certain kinds of cancers and pneumonia. These

individuals are prone to infections of the gastrointestinal tract, central nervous system, respiratory

system and the skin.

Today because of advances in medications many people with HIV can live for years before

developing full blown AIDS

 The Jamaican Situation
Approximately 29,000 persons living with HIV and 16% are unaware of their status
(Ministry of Health, 2015).
Most of the cases in 2015 are in the age group 20-29 years and this group represented
29% of all reported cases.
The Ministry report also presented data showing HIV infections in children 5-19 years,
but it was believed that these cases were the result of mother to child transmissions
(Ministry of Health 2015,cited UNAID, 2014).
More males than females are affected, but in the age group 20-24 more females than
males are reported infected.
Transmission
 AIDS and children
• 2.5 million children (about twice the population of Hawaii) live with HIV around the world
[2009] and many more are indirectly affected by family members who have contracted the
disease. 16 million children (about the population of New York) have lost one or both parents
to AIDS

• In 2003, in Jamaica, 5,125 children lost one or both parents to AIDS

• Children can be infected with HIV/AIDS through mother to child transmission, blood
transfusion, sharing needles, sexual abuse, rape, multiple sex partners and early sexual
activity.

AIDS affect children in 3 ways

• Loss of social/family support [psych/emotional impact]
• Stigma and discrimination [social impact]
• Decreased access to education, health care and social services [material impact]
References
1. American College of Allergy, Asthma and Immunology (2014) Types of Asthma.
https://acaai.org/asthma/types-asthma
2. Centers for Disease Control and Prevention (n.d.) Diabetes
https://www.cdc.gov/media/presskits/aahd/diabetes.pdf
3. Heward, W. (2013). Exceptional children: An introduction to special education (10th ed). Pearson Sickle Cell
Disease
4. McCavit, T., L. (2012). Sickle cell disease. Pediatric in Review, 33(5), pp195-206. DOI:
https://doi.org/10.1542/pir.33-5-195
5. Ministry of Health, Jamaica (2015). Annual HIV epidemiological profile 2015. Facts and figures.
https://hstu.moh.gov.jm/wp-content/uploads/2020/07/2015-Epi-Update-Revised-Final.pdf
6. O’Hare, S. (Feb 22, 2016). Diabetes: A simple guide to understanding diabetes.
https://www.pedors.com/blog/diabetes-a-simple-guide/
7. Sickle Cell Association of the National Capital Area, Inc. (2017). Types of Sickle Cell disease.
http://scancainc.org/learn/types-of-sickle-cell-disease/