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Orthopedic Impairment and Traumatic Brain Injury: Program Placement and Focus

This is an excerpt from Adapted Physical Activity Across the Life Span by Carol Ann Leitschuh & Marquell Johnson.

Some orthopedic disabilities are obvious at birth, and infants with those disabilities can begin early intervention. Their early movement skills are delayed because the disability gets in the way of execution of skills. For example, maybe there is too much or too little tone in the muscles. The infant may try to go across the floor space but can’t move in the desired direction. With early intervention, pediatric PTs and OTs work with infants and children and the family to arrange environments for play that offer opportunities for learning and practice. When children with orthopedic disabilities enter kindergarten, the educational system takes over services with combined school-based OT and PT, and physical educators engage the student in physical activity and a multitude of environments.

A student returning to school after hospitalization with an orthopedic impairment may display no apparent aftereffect; others may exhibit a mild or severe movement disorder. Although there may be no visible debility, the physical educator should receive medical recommendations as to the amount of activity in which the student should engage, the kinds of activities that will prove most beneficial, and those that should be monitored carefully. With this knowledge, the adapted physical educator and general physical educator will be able to plan the kind of program that will help students increase their general level of fitness and motor efficiency to meet the physical demands of daily life. They can also seek input from PT and OT.

The returning student who has a moderate or severe disability may need considerable help in achieving maximum physical efficiency. Students who have considerable residual paralysis or a limb amputation are also likely to need help in making a satisfactory adjustment to their disability. Because of their possible concern about their appearance and their inabilities to perform motor skills, they may experience more anxieties about physical education class than about other phases of their school life. The physical educator can help alleviate their fears by assisting them to find a solution that is satisfying to them concerning dressing and showering in the presence of others, and by preparing them to meet the challenges of their restrictions.

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