Original OI content is preserved and organized under universal anchors for retrieval. Minimal, brand‑agnostic updates add classroom implications and strategy menus for fine motor, range of motion, and gross motor access, with citations to IDEA, Florida rules, and WATI/ATIM resources.
Orthopedic Impairment
Florida Definition Orthopedic impairment means a severe skeletal, muscular, or neuromuscular impairment. The term includes impairments resulting from congenital anomalies (e.g. including but not limited to skeletal deformity or spina bifida), and impairments resulting from other causes (e.g., including but not limited to cerebral palsy or amputations). This definition is found in State Board of Education Rule 6A-6.030151, F.A.C. General Characteristics Early intervention and identification at birth or infancy or as soon as the disability occurs is critical. Early intervention can minimize the severity of the disability or prevent the development of additional disabling or medical conditions. In addition, the use of correct physical management procedures, adaptations, and devices can increase the acquisition of motor and self-care skills. The early development of adequate skills gives children a foundation for increasing their interaction with the environment, which in turn furthers the acquisition of cognitive, language, and social skills necessary for school success. The U.S. Department of Education estimated that about 0.54 percent of all school-age children have physical or health disabilities (ranging from mild to severe). With the use of medication and the provision of an accessible setting and/or medical support teams, most students with physical or health impairments are able to function well in regular classes. Determining prevalence of figures is complicated by local variations in the classification of disabilities and the lack of a federal education category for children with physical disabilities (National Dissemination Center for Children with Disabilities Fact Sheet Number 12 (NICHCY) at ). Types of Orthopedic Impairments Neuromotor impairments are disabilities resulting from damage to the central nervous system that impairs the brain’s control of muscle movement and the muscle receptor’s sensory feedback about speed, direction of movement, and body position (Educating Exceptional Children, Chapter 12; National Dissemination Center for Children with Disabilities Fact Sheet Number 12 (NICHCY) at ).
Cerebral palsy. A number of disabilities are caused by damage to the motor control centers of the brain. The damage affects muscle tone, which in turn interferes with voluntary movement and full control of the muscles, and delays gross and fine motor development. CP includes four major classifications: spastic, dyskinetic, ataxic, and mixed. In spastic cerebral palsy, muscle tone is abnormally high and increases during activity. Muscles and joints are tight or stiff, and movements are limited in the affected areas of the body. In dyskinetic cerebral palsy, tonal abnormalities involve the whole body. The individual’s muscle tone is changing constantly, often rigid while he or she is awake and decreased when asleep.
Ataxic cerebral palsy is a condition in which voluntary movement involving balance is abnormal. Individuals with ataxic CP have difficulty controlling their hands and arms, and their gait is unsteady. Mixed cerebral palsy includes a combination of spastic, dyskinetic, and ataxic CP. The affected area can be (1) hemiplegic-just one side of the body (either left arm and left leg, or right arm and right leg); (2) diplegic-the whole body is involved, but the legs are more severely involved than the arms; and (3) quadriplegic-involvement is equally distributed throughout the body.
Neural tube defects. This includes spina bifida (the separation of a portion of the backbone) and myelomenigocele (the protrusion from the spinal cord of a sac of fluids containing portions of the spinal cord).
Physical impairments include degenerative diseases, which affect the muscles and their supporting framework, the skeleton, and orthopedic and musculoskeletal disorders.
Muscular dystrophy and spinal muscular atrophy (degenerative diseases). These are inherited disorders in which the muscles weaken and deteriorate. The most common form, Duchenne muscular dystrophy, occurs primarily but not exclusively in boys.
Juvenile rheumatoid arthritis (Orthopedic and musculoskeletal disorders). Inflammation of the joints accompanied by fever and pain in the joints during acute periods. This begins at or before age 16 and causes swelling, stiffness, effusion, pain, and tenderness in the joints.
Spinal curvatures (orthopedic and musculoskeletal disorders). Scoliosis is a form of spinal curvature in which the spine forms a “c” or an “s” when it is viewed from behind.
Osteogenesis Imperfecta (orthopedic and musculoskeletal disorders). An inherited congenital fragility of the bones.
Other types of orthopedic and musculoskeletal disorders include limb deficiencies, hip conditions and other musculoskeletal conditions.
Diagnostic Indicators Most children with multiple and severe disabilities are identified at birth through early assessments (e.g., APGAR, Brazelton Neonatal Behavioral Assessment Scale). A physician or a team of specialists will make the diagnosis. Characteristics
Primary
Motor: Impaired physical functioning Examples include the need for special equipment including crutches, braces, custom splints, or a wheelchair are needed to perform in classroom activities; limited self-care skills
Communication: Potential major communicative impairment Examples include difficulty expressing or understanding language; difficulty grasping reading; augmentative communication and alternative communication devices and procedures necessary for communication.
Secondary
Cognitive: Impaired cognitive functioning Examples include short attention span, difficulty expressing or understanding language, difficulty grasping concepts such as reading and math.
Sensory: Potential problems hearing and/or seeing
Emotional and Social: Impaired emotional and social development and functioning
Technologies (computer access, communication, academic, social)
Update (2025-09-24): Strategy menu (match to student & task): altered paper position/slant; stabilized work surfaces; ergonomic or enlarged grips; low-force or alternative pens; keyguard or alternative keyboards; word prediction; speech-to-text; page-turners; binder clips/book holders; adapted scissors; switch-access for on-screen writing; and reduced written output with equivalent demonstrations of learning. source (ATIM/WATI Seating & Positioning), source (WATI Ch. 4–5)
Update (2025-09-24): Provide adjustable desks/stands; mount devices within neutral reach; use larger target sizes and spacing; enable dwell-click and sticky keys; create custom shortcut sets; offer scanning/switch or eye-gaze when direct access is inefficient; schedule task “sprints” with rest breaks; and pre-stage materials to minimize repeated transfers. source (ATIM/WATI Seating & Positioning II)
Update (2025-09-24): Ensure clear travel paths; height-appropriate workstations; use classroom layouts that support wheelchair turning radii; integrate positioning devices (standing frames, supportive seating) per therapy plans; provide lab/PE adaptations (stabilized equipment, grips, ball launches); plan alternate access for field trips and emergency egress. source (ATIM: AT for Motor Access)
Update (2025-09-24): Common classroom impacts include fatigue and pain with sustained tasks; prolonged time for transitions; positioning needs for posture, vision, and breathing; access to writing/typing and page turning; mobility and evacuation planning; access to manipulatives/labs/PE; and variability day-to-day with medical status. Address these through proactive scheduling, reduced physical load, materials access in multiple formats, and explicit plans for safety and independence. source (WATI)
Update (2025-09-24): IDEA defines Orthopedic Impairment at 34 CFR §300.8(c)(8): a severe orthopedic impairment that adversely affects educational performance (including congenital anomalies, disease, and other causes such as cerebral palsy, amputations, fractures/burns causing contractures). source (eCFR)
Update (2025-09-24): Teams must consider assistive technology (devices/services) in IEP development (34 CFR §300.324) and may include AT that is needed in the home or other settings to receive FAPE (34 CFR §300.105). source (LII §300.324) source (LII §300.105)
Update (2025-09-24): Florida rule 6A-6.030151, F.A.C., outlines state criteria for OI eligibility and evaluation components (medical and educational). source (Florida Admin. Code)