Teaching Students with Physical Disabilities

Educating a disabled population that totals approximately 6.8 million in the United States involves not only providing specialized services but also examining common perceptions that both teachers and students hold regarding students with disabilities. The main piece of legislation concerning the education of students with disabilities is the Individuals with Disabilities Education Act (IDEA), which requires public schools to provide students with disabilities with free education in a "least restrictive environment." Educators' views on including students with physical disabilities in mainstream classrooms can vary, with some seeing it as a way to improve disabled students' academic outcomes and promote understanding, and others viewing the practice as detrimental to both disabled and non-disabled students.

Keywords Assistive Technology; Disability; Free Appropriate Public Education (FAPE); Inclusion; Individualized Education Program (IEP); Individuals with Disabilities Education Act (IDEA); Least Restrictive Environment (LRE); Mainstreaming; Physical Disability; Related Services; Special Education

Overview

In America, over 8.5% of children qualify as disabled according to the guidelines established by the Individuals with Disabilities Education Act, or IDEA (Office of Special Education and Rehabilitative Services, 2006). The federal government mandates that these children receive a free and appropriate public education (FAPE) within the least restrictive environment (LRE). Educating a disabled population that totals approximately 6.8 million involves not only providing specialized services but also examining common perceptions that both teachers and students hold regarding the physically disabled.

Legislative Background

According to a report published in the Congressional Digest ("Updating the Law on Services to Disabled Schoolchildren," 2005), prior to the 1975 passage of the Education of All Handicapped Children Act (EAHCA), an estimated one million school-aged children with disabilities were deprived access to public education. In addition, several hundred thousand children with disabilities who were able to attend public schools struggled to learn alongside their non-disabled classmates due to a lack of proper services designed to meet their special needs.

On November 29, 1975, President Gerald R. Ford signed into law a landmark piece of legislation that would change the course of special education in America. The Education for All Handicapped Children Act (EAHCA), later renamed the Individuals with Disabilities Education Act (IDEA), had as its overarching goal the education of all children with disabilities within the United States (Davis, 2007). Specific to achieving this goal, the Act required that all disabled children be provided with a "free appropriate public education" in the "least restrictive environment" (Davis, 2007 ; "Updating the Law on Services to Disabled Schoolchildren," 2005).

Furthermore, the Act included three additional purposes:

• "to assure that the rights of children with disabilities and their parents … are protected;

• "to assist States and localities to provide for the education of all children with disabilities; and

• "to assess and assure the effectiveness of efforts to educate all children with disabilities" ("Twenty-five years of progress in educating children with disabilities through IDEA," 2005).

To achieve its stated purposes, the Act initially provided that, by 1982, the federal government would fund 40% of the costs of additional expenditures made for special education programs. Over the years, subsequent modifications changed the provision to a maximum rather than a standard of 40%. As a result, the federal government contributes approximately 18% of the cost of special education in America's public schools (Davis, 2007). This law formed the foundation for special education improvements that changed the lives of children with disabilities ("US Department of Education IDEA'97 Overview," 2003). In 1997, the Act was amended and reauthorized for the first time since its original 1975 passage. In 2004, the legislation was again re-authorized, becoming the Individuals with Disabilities Education Improvement Act (IDEIA).

In the IDEIA legislation, the federal government defines special education as "specially designed instruction at no cost to parents to meet the unique needs of a child with disability" ("Individuals with Disabilities Education Improvement Act of 2004"). Specifically, such education includes "instruction conducted in the classroom, in home, in hospitals, and in other settings; and instruction in physical education" ("Individuals with Disabilities Education Improvement Act of 2004"). Furthermore, the IDEIA legislation defines a child with a disability as follows:

a child with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance … orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities and who, by reason thereof, needs special education and related services (Individuals with Disabilities Education Improvement Act of 2004).

According to the US Department of Education, while the pre-1997 EAHCA/IDEA legislation represented substantial strides in providing children with disabilities with an adequate public education, shortcomings existed, and in order to ensure fulfillment of the mission of IDEA, amendments were required (IDEA'97 Overview, 2003). Among the specific failures present with pre-1997 IDEA, the Department of Education listed the following:

• Twice as many students with disabilities dropped out of school as compared to students without disabilities

• Many students with disabilities faced limited opportunities to excel due to the fact that they remained without access to the same curriculum and assessments as students without disabilities (IDEA '97 Overview, 2003).

To remedy these shortcomings, the 1997 reauthorization of IDEA outlined a five-fold plan committed to the following:

• "Raising expectations for children with disabilities;

• "Increasing parental involvement in the education of their children;

• "Ensuring that regular education teachers are involved in planning and assessing children's progress;

• "Including children with disabilities in assessment, performance goals, and reports to the public;

• Supporting quality professional development for all personnel who are involved in educating children with disabilities" (IDEA'97 Overview, 2003).

The 1997 reauthorization of IDEA followed by the 2004 updates and subsequent reauthorization of the law now form the basis for educating Americans with disabilities.

Applications

Teacher & Student Perceptions

Educating a child with a physical disability is a multifaceted undertaking involving not only the provision of special services and the design of Individualized Education Programs, but also attention to the psychological and social factors inherent in integrating a child with a disability into a predominantly non-disabled educational setting. Issues that must be considered include the presupposition of teachers in welcoming handicapped students into their classrooms, the reaction of fellow-students for whom physical disability is not a daily part of their lives, and the reality of needing to adapt existing services or provide additional services in order to give students with disabilities equal access to public education.

Wechsler, Suarez, and McFadden (1975) conducted a study on the attitudes of teachers towards educating students with physical disabilities. The study, released near the same time as the passage of the EAHCA, was in response to a Massachusetts law requiring the integration of students with disabilities into the classroom. Regarding specific types of physical disabilities, the study selected six: heart conditions, asthma, use of crutches or braces, convulsions or seizures, impaired vision, and impaired hearing. Over half of the teachers surveyed indicated complete willingness to have a student with crutches or braces in their classes, and nearly half indicated the same regarding students with heart conditions or asthma. When the disability was more immediately impairing, however, as in the case of vision or hearing problems or convulsions or seizures, teacher willingness dropped to 34 percent, 32 percent, and 27 percent, respectively. When asked if integration was the educational path best suited to children with physical disabilities, a decisive majority of the teachers responded that children with heart conditions, asthma, convulsions or seizures, and crutches or braces should attend regular classes full-time as do non-disabled children. In cases of visual or auditory impairment, however, the response again fell, with only 13% of teachers indicating that these students should participate full-time in a regular classroom learning environment.

A more recent study reported by Idol (2005) in which eight schools were surveyed to determine, among other things, staff perceptions of including students with disabilities in regular classrooms, most of the teachers showed support for inclusion. Furthermore, the teachers believed that inclusion was not only beneficial to the disabled students, but it was also beneficial to the non-disabled students in their classrooms. Idol's study included both physical and mental disabilities.

However, support for integration is not unanimous, and on the opposing side of the issue stand educators who hold that integration deprives non-disabled students of adequate service and attention. The British Columbia Teachers' Federation conveyed the sentiments of several educators that mainstreaming students with disabilities presents serious problems ("I'm a teacher, not a nurse!" 2002). Most common among the teachers' remarks were the time demands inherent in serving students with disabilities and the fact that these demands infringed upon service to the non-disabled students. Also, the behavioral manners of disabled students and the fact that these behavioral manners presented poor examples for and, at times, posed risks to the non-disabled students were cited.

While integration of students with disabilities requires reflection and adjustment by teachers, also significant in the process is the reaction of other students to their physically disabled peers. Tamm and Prellwitz's (1999) study of this social aspect of integration provides valuable insight into the issue. According to their report, 90% of children with disabilities in Sweden attend a local school, and for many, integration becomes a reality as early as daycare age. The test group students ranged in age from six to ten, and the student in question was a fictional student to whom the subjects were introduced through a drawing they were asked to provide of a child sitting in a wheelchair. In the control group, only one student had first-hand experience in having a friend who was a wheelchair user. Based on the drawing provided by the students, they were asked a series of questions in relation to the student, and these questions covered the areas of physical limitations, social assimilation, self-esteem among the disabled children, and potential areas of future employment for the disabled. Tamm and Prellwitz found that the majority of the students questioned looked favorably on the disabled student. The non-disabled students indicated that they would welcome the disabled student into their playtime and social activities, and the students believed that the disabled child possessed the same level of social interaction and high self-esteem as they did.

While the students were eager to welcome a classmate who uses a wheelchair into their circle, they nevertheless recognized certain impediments to full integration. These included the use of regular bus transportation by a student who uses a wheelchair and participation in certain games requiring physical mobility. Still, overall, the students proved to be receptive to the prospect of welcoming a child with a physical disability into their classroom.

Provision of Special Services

When a student with a physical disability is assimilated into a regular classroom, legislative requirements mandate that the student be evaluated and provided with an Individualized Education Program, or IEP. An IEP is a written plan that must include an evaluation of the child's current educational status, an outline of measurable annual goals for the child, a description of how progress towards those goals will be assessed, a statement regarding what special services the child will need, and a statement of additional accommodations that may be required in order to measure the student's progress (Individualized Education Program, 2006). Once created, the IEP forms the measuring rod for a disabled student's academic and functional progress.

Requisite to implementation of the IEP, and at the core of educating children with disabilities, is the provision of special related services to the child. These services are those that the student needs in order to benefit from the learning process alongside non-disabled students. For physically disabled students, these services can include transportation, assistive technology, physical and occupational therapy, recreation, orientation and mobility services, and certain other services that might be needed to help a physically disabled child participate and excel educationally (Downing, 2004).

Transportation

According to IDEA, in order for students to receive a free and appropriate public education, they must be provided with the ability to travel both to and from school and within the school building. As a result, students affected by a disability that in some way interferes with their ability to travel and/or move about within the school building must be provided with transportation services at no additional cost to the student. These services may include specific bus arrangements or special mobility equipment designed to transport the student within the school building. While many school districts already provide public transportation to students, even those districts that do not may still be required to provide this service specifically to students with disabilities. Decisions regarding the provision of transportation services are made on a case-by-case basis by a student's IEP team.

Assistive Technology

Assistive technology may include anything from physical equipment designed to enhance the functional capabilities of a student to visual or hearing aids intended to improve a student's ability to interact and fully participate within the classroom. IDEIA regulations specify assistive technology to include:

• "evaluation of the needs of the child with a disability, including a functional evaluation of the child in the child's customary environment;

• "purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities;

• "selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;

• "coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;

• "training or technical assistance for a child with a disability or, if appropriate, that child's family; and

• "training or technical assistance for professionals (including individuals providing education or rehabilitation services), employers, or other individuals who provide services, employ, or are otherwise substantially involved in the major life functions of that child" (Individuals with Disabilities Education Improvement Act of 2004).

Often, a student's IEP team will consult with experts in the private sector to determine which device or devices the student may need in order fully to participate in his or her educational environment.

Physical & Occupational Therapy

Depending upon a disabled child's needs as assessed by his or her IEP team, physical and/or occupational therapeutic services may be required. According to IDEA, these must be provided by a qualified therapist, and Downing (2005) explains that they may include but are not limited to exercise focusing on motor skills, mobility, positioning, posture development, and joint and muscle strengthening. In addition, these services may focus on prevention and early intervention as well as functional improvement.

Recreation

IDEA considers recreation an important component of the full educational experience and, as such, mandates that students with disabilities be provided with special services designed to enhance their interest and ability to participate in productive recreational activities (Downing, 2005). Among the intentions of providing special services in this area are that students and parents will become aware of various recreational outlets available to them, that students will learn to adapt in order to be able to participate in different recreational activities, and that such participation will serve to enhance both the functional skills and the educational achievements of the students (Downing, 2005).

Recreational activities for students with disabilities do not necessarily need to take place within the school building or under the direction of school personnel. Oftentimes, community groups such as the Special Olympics or YMCA organize appropriate activities for students with disabilities (Downing, 2005).

Orientation & Mobility Services

Applying primarily to those students who are visually impaired, orientation and mobility services are designed to assist students in traveling and orienting themselves to their environment. Orientation and mobility assistance may take place in the home, school, or the community in general and serves, among other things, to enhance students' safety in their surroundings. Downing (2005) points out that orientation and Mobility Services differ from other transportation services in that the other services apply to disabled students whose disability is not visual.

Funding Special Education Services

The above brief descriptions form a basis for understanding the legislative requirements as they address the provision of a free and public education for students with physical disabilites. In accordance with the "free" aspect, Downing (2005) explains that, although parents may not legally be required to fund these services, the cost of providing them must be covered, and such costs have moved increasingly to the shoulders of the schools. Since the federal government funds approximately 20 percent of the expenses incurred by schools for special education, and the costs of providing related services often creates a burden on school budgets (Downing, 2005). To address these concerns, some schools have begun pursuing partnerships with public insurance services such as Medicaid. Schools are permitted to explore these partnership options provided that such partnership does not incur out-of-pocket payment from the parents (Downing, 2005). In seeking effective strategies for funding special education related services, the guiding principle remains that such services must be free to disabled students and their families.

Viewpoints

Mainstreaming versus Inclusion

Not all assimilation of disabled students into regular educational environments is full assimilation, and Idol (2005) identifies the distinctions among various levels of inclusion. Full inclusion indicates that disabled students attend general classes with non-disabled students 100% of the time. Although this term is often used interchangeably with mainstreaming (Connor and Ferri, 2005), Idol distinguishes between the two practices. In inclusion, students receive 100% of their academic training within the same regular educational setting and program as their non-disabled peers. In mainstreaming, however, students spend part of their educational day in a regular classroom and part in a separate special educational setting.

While the practice of inclusion has steadily gained supporters, not all educators believe it to be in the best interest of the disabled child, and some consider it a disservice to the child as it deprives him or her of the "special" aspect of special education (Zigmond, 2001). In an attempt to address this concern, some educators have gravitated towards co-teaching, a practice in which two or more teachers share classroom space in teaching a group of students consisting of both disabled and non-disabled students. One teacher is a general educator and the other trained in special education (Zigmond, 2001).

While co-teaching has grown in popularity, Zigmond points out that research substantiating its effectiveness is lacking. The philosophy of advocating for full inclusion of children with disabilities in general education settings and requiring the same levels of outcome among all students negates the spirit of special education. Nonetheless, educating students with disabilities remains a significant part of our system of public education, and advances made as a result of legislative initiatives have greatly improved the educational prospects of children living with a physical disability ("Twenty-Five Years of Progress," 2005).

Terms & Concepts

Assistive Technology: Any equipment or technology used to improve or enhance the functional abilities of individuals with disabilities.

Free Appropriate Public Education (FAPE): Term used to define special education and services provided at public expense to individuals with disabilities.

Disability: A physical, mental, or sensory impairment that makes major life activities more difficult (ERIC Thesaurus).

Inclusion: The practice of educating disabled students in a regular classroom alongside non-disabled students.

Individualized Education Program (IEP): A program created specifically for a disabled student and outlining academic goals as well as special services and accommodations the student may need to accomplish those goals.

Individuals with Disabilities Education Act (IDEA): Federal legislation outlining the rights of children and youth with disabilities to receive a free and appropriate public education within the least restrictive environment.

Least Restrictive Environment: Identified in IDEA as the most appropriate setting for any student with a disability within the general student population and equal education access to the greatest extent possible.

Mainstreaming: The practice of including children with disabilities in a regular classroom when possible. The term is sometimes used interchangeably with inclusion; however, mainstreaming is distinct in that it provides for disabled students to attend some classes separately from non-disabled students.

Physical Disability: Any physical condition that hinders an individual from performing normal tasks in conventional ways.

Related Services: Special services or accommodations that a student with disabilities may need in order to benefit from public education.

Special Education: Educational methods, activities, or practices designed for students having some form of physical or mental disability.

Bibliography

Connor, D., & Ferri, B. (2005). Integration and inclusion--a troubling nexus: Race, disability, and special education. Journal of African American History, 90 (1/2), 107-127. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=17229267&site=ehost-live

Davis, M. (2007). Special education law was signed by Ford, despite reservations. Education Week, 26 , 21-21. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=23653880&site=ehost-live

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Downing, J. (2004). Related services for students with disabilities: Introduction to the special issue. Intervention in School & Clinic, 39 , 195-208. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=12216991&site=ehost-live

Estimated resident population ages 3 through 21, by state: 1996, 2004 and 2005. (2006). Retrieved February 16, 2007, from https://www.ideadata.org/tables29th%5Car_C-1.html

IDEA '97: Overview. (2003). Retrieved February 15, 2007, from http://www.ed.gov/offices/OSERS/Policy/IDEA/overview.html

Idol, L. (2006). Toward inclusion of special education students in general education. Remedial & Special Education, 27 , 77-94. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=20081079&site=ehost-live

I'm a teacher, not a nurse! (2002). Report / Newsmagazine (National Edition), 29 , 52. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=7505279&site=ehost-live

Individualized education program. (2006). Retrieved February 16, 2007, from http://idea.ed.gov/explore/view/p/%2Croot%2Cdynamic%2CTopicalBrief%2C10%2C

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Malik, P., & Anton, P. (2013). Supporting students with severe physical disabilities: The Illinois Model. Journal Of College & University Student Housing, 39/40(2/1), 172–185. Retrieved January 6, 2014 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=89746945

Office of special education and rehabilitative services. (2006). Retrieved February 16, 2007, from http://www.ed.gov/about/offices/list/osers/osep/index.html

Tamm, M., & Prellwitz, M. (2001). 'If I had a friend in a wheelchair': Children's thoughts on disabilities. Child: Care, Health & Development, 27 , 223. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=4649847&site=ehost-live

Twenty-five years of progress in educating children with disabilities through IDEA. (2005). Retrieved February 16, 2007, from http://www.ed.gov/policy/speced/leg/idea/history.html

Updating the law on services to disabled schoolchildren. (2005). Congressional Digest, 84 , 5. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=16067269&site=ehost-live

Wechsler, H., Suarez, A., & McFadden, M. (1975). Teachers' attitudes toward the education of physically handicapped children: Implications for the implementation of Massachusetts Chapter 766. Journal of Education, 157 , 17. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=5655718&site=ehost-live

Wilson, G., Kim, S., & Michaels, C. A. (2013). Factors associated with where secondary students with disabilities are educated and how they are doing. Journal Of Special Education, 47, 148–161. Retrieved January 6, 2014 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=90521859

Zigmond, N. (2001). Special education at a crossroads. Preventing School Failure, 45 , 70. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=4588118&site=ehos

Ziviani, J., Feeney, R., & Khan, A. (2011). Early intervention services for children with physical disability: Parents' perceptions of family-centeredness and service satisfaction. Infants & Young Children: An Interdisciplinary Journal Of Special Care Practices, 24, 364–382. Retrieved January 6, 2014 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=65832262

Suggested Reading

Block, M. E., Taliaferro, A., & Moran, T. (2013). Physical activity and youth with disabilities: Barriers and supports. Prevention Researcher, 20, 18–20. Retrieved January 6, 2014 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=87462005

Cook, B., Cameron, D., & Tankersley, M. (2007). Inclusive teachers' attitudinal ratings of their students with disabilities. Journal of Special Education, 40 , 230-238. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=23756352&site=ehost-live

Hedrick, B. N., Stumbo, N. J., Martin, J. K., Martin, L. G., Nordstrom, D. L., & Morrill, J. H. (2012). Personal assistant support for students with severe physical disabilities in postsecondary education. Journal Of Postsecondary Education & Disability, 25, 161–177. Retrieved January 6, 2014 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=82747990

McLeskey, J., & Waldron, N. (2007). Making differences ordinary in inclusive classrooms. Intervention in School & Clinic, 42 , 162-168. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier database. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=23438016&site=ehost-live

Smith, D., & Wild, T. (2006, October). Least-restrictive environment for students with visual impairments. Journal of Visual Impairment & Blindness, 100 , 592-593. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=23057193&site=ehost-live

The 5 W's of assistive technology. (2007). Exceptional Parent, 37 , 1-2. Retrieved February 16, 2007 from EBSCO Online Database Education Research Complete. http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=23715218&site=ehost-live

Walter, J. (2006). The Basic IDEA: The individuals with disabilities act in your classroom. Teaching Music, 14 , 22-26. Retrieved February 16, 2007 from EBSCO Online Database Academic Search Premier. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=23257500&site=ehost-live