Other Health Impairments
Report by John Sufficool
IDEA states that:
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, that—
(i) 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, sickle cell anemia, and Tourette syndrome; and
(ii) Adversely affects a child’s educational performance. [§300.8(c)(9)]
The Other Health Impairment (OHI) covers many different health issues. There are thirteen health
problems mentioned in the actual legislation, but schools use this term to get help for many students who have not been diagnosed with any of these actual problems. The term ”such as” implies that the list is not exhaustive. As long as the school determines that the child has “limited strength, vitality, or alertness,” and that these “adversely affects” their education, the school can make modifications for the child and apply for funding for that child. In other words, OHI has become the catch-all of the IDEA legislation.
There are two types of help available for students with OHI.
The first is Early Childhood Intervention. This is for children age 3 or under. It primarily consists of identifying children who need help and developing an individualized family service plan to help meet the need of the child and the family.
The other is Special Education and needed services. This includes free evaluation of the child ages 3-21,
and any special education services or modifications to the normal classroom in order to ensure the success of the students.
The health issue that gets the most attention and that is often over diagnosed is Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder. This seems to be the label given to most students who give teachers a hard time or who do not readily adhere to the classroom rules. In fact, ADD/ADHD is defined as: “a condition that can make it hard for a person to sit still, control behavior, and pay attention.”

Types and symptoms
There are two major types of attention deficit: inattentive and hyperactive.
· Children who are inattentive often have trouble focusing on and finishing tasks. This can manifests itself in many ways.
1. They have trouble finishing school work or chores.
2. The child may have trouble with organization
3. The child does not pay attention to details and often turns in sloppy or half finished work.
4. They get distracted easily during school work or games.
5. They often lose things
· Children who are hyperactive are always on the go. They have trouble with impulse control and often act before they think. Children who are hyperactive often have the following symptoms:
1. They fidget or squirm.
2. They get out of their seats without permission.
3. They often like to climb or jump on things. (desks, trees, beds, etc)
4. These students tend to talk too much.
5. They often have trouble waiting and interrupt people while they are talking or butt in line during a game or other activities.
These symptoms usually begin before the child is 7 years of age, but can often go undiagnosed until the child is older. Most often in school where the child is asked to sit still much of the day and concentrate on one activity for a prolonged period of time. 5 out of every 100 children in school have ADHD. Boys are three times more likely to have this than girls. Some experts dispute this. They say girls are just not diagnosed as much as boys because they have more subtle symptoms and do not cause as many problems as the boys.
Diagnosis and Treatment
Doctors diagnose ADHD with the help of parents and teachers. They often use surveys filled out by parents and teachers to help them make their determination. Doctors are still not sure what causes ADHD. Recent tests show that children with ADHD do not have enough neurotransmitters in their brain. The neurotransmitters are the chemicals that control behavior. There are many different medications a doctor can give to a child to replace the missing chemicals and activate that part of the brain and allow the child to have more impulse control. Many parents choose not to give their children these medications because they have some adverse side effects including, loss of appetite, apathy, and moodiness. There are also some all natural herbal treatments that parents often try.
Parents who refuse medication for their child often seek environmental modifications to help control behavior. Many parents change their children’s diets. Others change the physical environment of the child, trying to change bed times, amount of TV watched, room color, and other external stimuli. Often parents try to train the child to act appropriately by giving rewards to the child when they complete a small task. They try to teach the child to find ways to cope with the daily distractions of life.

School Modifications
As a general rule, schools recommend that children with ADHD take the medication prescribed by the doctor. However, parents have the right to refuse to have their child on medication. This presents a challenge to teachers and administrators. Adding to this frustration is the fact that all ADHD students are not eligible for special education under IDEA. This leaves teachers looking for different ways to reach these students. Not all students respond the same way so teachers need to have a wide array of strategies available.
Teaching strategies that work

Because there are so many different strategies and modifications that can be made for ADHD students, I have chosen to share a few that have worked for different teachers.
Behavior and Environmental
· Token/reward system: this system offers rewards to students for accomplishing small tasks or for staying focused for short periods of time, often 1 to 5 minutes at a time. The students can turn these tokens in for small prizes or free time. This teaches the child to focus and then you can slowly increase the time requirements.
· Self imposed time outs: Teachers give students tokens (usually 3 or 4). When the child begins to feel overwhelmed or lose control, they can turn in one of the tokens and take a 5 minute timeout in the activity center.
· Classroom helper or special jobs: many teachers have identified a certain strength or interest in the child and they tap into this gift by letting the child hand out paper, get supplies for group activity, or other activities that allow them to move about the room in an organized way.
· Teachers often put the child close to their desk or away from distractions such as learning centers or computers. In this way, the child has fewer distractions.
Assignment modifications:
· Teachers often break down assignments into individual components and give them to the child one at a time.

· Teachers often give ADHD students shorter assignments. The object is to teach the child and reinforce that knowledge. Long assignments tend to frustrate ADHD students and adversely affect their grades.

· Good teachers know that these students tend to get bored and act out so they change their approach often. They use a large variety of tools such as cooperative learning, CRISS, learning centers, and many others.

Whatever strategy is used, it is important that teachers and parents work together. Teachers should support the strategies the parents are using at home, and parents should support the strategies teachers are using at school. ADHD students need to have organization and structure. If too many different things are going on, they will get frustrated and will not have as much success at home or school.

ADD/ADHD does not go away. It is not something that you grow out of. Many adults with this disorder no longer take medication. They have learned strategies to help them cope with the things life has given them. Still other adults have started taking medication as an adult or have continued to take the medication.
Success stories
Ty Pennington, the host of Extreme Home Makeover, has had ADHD all of his life. When he was in first grade, he would pick up his desk, put it on his shoulder and run around the classroom. He drove his teachers and his mother crazy. His mother had him tested and discovered that he had ADHD .At that time, in the early 70’s, ADHD was considered more of a mental condition. His mother did not want him to have that stigma so she chose not to tell him about his condition. She began to research the disorder and experiment with different methods. She discovered that the token system seemed to work the best. She talked to his teachers and convinced them to use the same method at school. Ty began to learn how to concentrate and do his work. By the time he was in high school he was making A’s and B’s.
Ty graduated and went to college. He found the unstructured college life distracting and soon dropped out of school. By this time, ADHD had become more acceptable and the medication had come a long way. His mother chose to tell him that he had ADHD. He went to the doctor and started taking medication. He went back to college and finished.

He used his talent as a carpenter and designer, along with his impulsive personality to get a job on TV. Now he uses his skills to host the number one home improvement show on TV, and has helped thousands of people across the United States.

Ty is a prime example of how a dedicated parent, working together with the school system can successfully educate an ADHD young person and help them grow into a successful, functional adult.
Another success story is that of Michael Phelps. He was diagnosed with ADHD as a young child. His mother, a middle school principal, knew that he was going to have a hard time in school, but she refused to let him fail. She also researched the ADHD and worked with his teachers to find strategies that worked with him. One of the things that seemed to work was hand signals. He had signals between his teachers, his mother and himself. Once, when his mother was upset, he gave her the “C” sign, which meant calm down.

Another thing that helped Michael was his love of swimming. This gave him the structure he needed to be successful. His mother supported her son’s love for swimming and used it to help with his schooling. She convinced his teachers to use word problems in math that dealt with swimming. This worked and Michael’s grades began to improve.

Michael Phelps went on to become the most decorated Athlete in Olympic History and is planning to compete in his third Olympics next year in London.
OHI and especially ADHD are disorders that affect many children around the country. Not all students with OHI qualify to receive special education. Only those with limited strength, vitality, and alertness that affect the educational success of the child fall under the IDEA legislation. This does not relieve schools and teachers of our duty to educate these students. It just means that we need to work extra hard to find ways to reach these students. This means researching methods that have worked at other schools, talking to parents, and working with medical professionals in order to give these students the best opportunity to succeed in school and in life.
Bibliography and references
http://www.youtube.com/watch?v=jHq7rHs--CM, http://www.youtube.com/watch?v=iJIU1ybbYWI,
http://nichcy.org/disability/specific/ohi, http://nichcy.org/disability/specific/adhd
http://www.additudemag.com/adhd/article/1998-2.html, http://www.naset.org/2278.0.html , http://learningdisabilities.about.com/od/mo/g/other_health_im.htm
Funny video to watch: http://www.youtube.com/watch?v=kIPGZs0UCQc