Students who qualify for special education services under the category Physically Impaired frequently have a medical diagnosis of a physical impairment such as cerebral palsy, spina bifida, muscular dystrophy, spinal cord injuries, or arthrogryposis. Orthopedic impairment means a severe orthopedic impairment that adversely affects a child's education performance. The term includes impairments caused by congenital anomaly (e.g., clubfoot, absence of some member, etc.), impairments caused by disease (e.g. poliomyelitis, bone turberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures). 34 C.F.R. 300.7 (c)(8)

Transferring Students

Definition
"Physically impaired" means a medically diagnosed chronic, physical impairment, either congenital or acquired, that may adversely affect physical or academic functioning and result in the need for special education and related services. (MR. 3525.1337.)

Criteria
A pupil is eligible and in need of special education instruction and services if the pupil meets the criterion in item A and one of the criteria in item B.

A. There must be documentation of a medically diagnosed physical impairment.

B. The pupil's

1. need for special education instruction and service is supported by a lack of functional level in organizational or independent work skills as verified by a minimum of two or more documented, systematic observations in daily routine settings, one of which is completed by a physical and health disabilities teacher*;
2. need for special education instruction and service is supported by an inability to manage or complete motoric portions of classroom tasks within time constraints as verified by a minimum of two or more, systematic observations in daily routine settings, one of which is completed by a physical and health disabilities teacher*; or
3. physical impairment interferes with educational performance as shown by a achievement deficit of 1.0 standard deviation or more below the mean on an individually administered reliable, valid, and adequately normed achievement test.
*Contact ASEC to arrange for a P/HD teacher.

Assessment for Physical Impairment

The educational assessment for a student with a physical impairment must include a licensed Physical and Health Disabilities (P/HD) teacher. The comprehensive assessment should identify the educational needs of the student related to the physical impairment and his or her learning skills. The assessment may require adaptations to traditional assessment tools to compensate for motor and sensory skills. The multidisciplinary assessment team will include licensed teachers and other specialists with knowledge in the area(s) of suspected educational needs.
 

Team Members

A Physical and Health Disabilities Teacher is required to be a member of the IEP team. This person is responsible for planning and completing evaluation/reevaluation for students with physical impairments from pre-Kindergarten to age 22. The role of a P/HD teacher is to provide expertise in determining the educational implications and strategies unique to the physical disability; assist in developing appropriate goals and objectives, curricular modifications, adaptations, accommodations and use of assistive technology to meet curriculum requirements and to present disability specific inservice.

The P/HD teacher is itinerant and generally provides consultation services to the school. Direct service can be provided by the Physical and Health Disabilities teacher, but most academic services are provided through a multidisciplinary team teaching model utilizing a school's special education teachers.
 

In addition, services may be provided by one or more of the following team members:
• Physical Therapist
• Occupational Therapist
• Developmental Adapted Physical Education
• Nurse
• Speech Language
 

Frequent Educational Needs:

• Provision of compensatory skills through adaptations, modifications, technology, and equipment for motor and perceptual skills

• Provision of educational strategies for organizational, attending, and memory skills

• Development of self-advocacy skills regarding the student's needs as they relate to the physical impairment

• Development of evacuation plans, safety consideration, mobility, health plans

• Opportunity to access all curricular and educational experiences, including participation in courses requiring lab or hands-on work, field trips, music programs, and extracurricular activities.

Best Practice Policy Recommendations for Transferring Students

Districts within the Area Special Education Cooperative do not have specific written policies or guidelines regarding lifting or carrying students. The following is information (email dated April 15, 2009) provided by Lois Lillie, contracted by the Metro ECSU through the State Low Incidence grant in the area of Occupational and Physical Therapy regarding transfers. In all cases case managers and paraprofessionals must follow the guidance and recommendations made by the physical therapist or occupational therapist.

Lifts using One Person

"Best practice" would suggest that 40 pounds is the upper limit for a 1 person lift, especially if the child does not have the ability to actively assist. Other factors that might further reduce that limit include excessive tone, physical/behavioral resistance, environmental conditions like space constraints or wet surfaces. The risk of injury to both parities (adult & child) increases with greater weight and combinations of these factors.

If the child has the ability to bear weight on their legs and has some trunk extension control, and with the agreement of the physical therapist, it may be appropriate for 1 person to do a transfer (standing pivot or sliding sit) rather than "lift". This determination would be made through a physical therapy evaluation of the student. The Physical Therapist must provide and document that the staff have been trained in appropriate procedures, that necessary equipment is available and operational, and the follow up monitoring is documented on a periodic basis to assure that recommended strategies can be appropriately demonstrated by staff. The IEP should clearly document what needs to happen regarding transfers and/or lifts.

Because safety of the child and adult is critical, the physical therapist is required to report non-compliance with this guideline to the building principal.

Transitioning Preschool Children

While the size and weight of preschool children may be within the weight recommendations above, staff is strongly discouraged from carrying preschoolers when making transitions within the building or to buses. Because of safety and liability concerns, children who for whatever reason need to be physically assisted from one place to another, should be transitioned using strollers, provided extra time to transition, or use other recommendations provided to staff by the physical therapist.