Chapter Eighteen Chapter Eighteen Special-needs Students Special-needs Students

Handicaps Classified Handicaps Classified Physical Physical

Medical Medical Sensory Sensory Intellectual Intellectual Attention Attention Learning Learning Speech Speech Cultural Cultural Emotional Emotional

Constitutional Aspects Constitutional Aspects United States United States Canada Canada

Special–education Requirements Special–education Requirements Zero Reject Zero Reject Appropriate Evaluation Appropriate Evaluation Individualized Education Individualized Education

Programs Programs Mainstreaming Mainstreaming Longer Programs Longer Programs Procedural Fairness Procedural Fairness

Provincial Provisions Provincial Provisions Special-needs Pupils Special-needs Pupils Ministerial Responsibilities Ministerial Responsibilities Special Education Programs Special Education Programs Advisory Committee Advisory Committee Administrative Bodies and Administrative Bodies and

Appeals Appeals Mainstreaming Mainstreaming

Litigation Litigation Procedural Fairness Procedural Fairness Mainstreaming Mainstreaming

Medical Problems in Schools Medical Problems in Schools Types of Problems Types of Problems Special Situations Special Situations Administering Medication Administering Medication Medical Procedures Medical Procedures

School Organization School Organization Residential Schools Residential Schools Segregated Day Schools Segregated Day Schools Segregated Classes Segregated Classes Resource Rooms and Centres Resource Rooms and Centres Itinerant Teachers Itinerant Teachers Regular Classes Regular Classes

Conclusions Conclusions

Handicaps Classified Handicaps Classified Special-needs students are different Special-needs students are different

enough from the majority of students that enough from the majority of students that the school must make special the school must make special accommodation for them.  accommodation for them. 

. . . handicaps or disabilities . . . may be . . . handicaps or disabilities . . . may be physical, medical, sensory, intellectual, physical, medical, sensory, intellectual, attention, learning, speech, cultural, attention, learning, speech, cultural, emotional, or some combination of these.  emotional, or some combination of these. 

Special-needs students may be called Special-needs students may be called exceptional students, exceptional students,

The educational accommodations made for The educational accommodations made for them result in what is termed “special them result in what is termed “special education” (inclusion in NB).  education” (inclusion in NB). 

Progressively changing Progressively changing

vocabularyvocabulary I was a “crippled child”.  In adolescence I was I was a “crippled child”.  In adolescence I was “handicapped”.  In college I was “disabled”.  I “handicapped”.  In college I was “disabled”.  I guess I'm still disabled unless some new word guess I'm still disabled unless some new word has taken hold.  A friend tells me that there's a has taken hold.  A friend tells me that there's a new fad in social work and that we are now new fad in social work and that we are now called “the physically challenged”.  That called “the physically challenged”.  That makes me gag.  I hope no one calls me that to makes me gag.  I hope no one calls me that to my face. (Robert J. De Felice, in my face. (Robert J. De Felice, in Newsweek)Newsweek)   

An organization previously known as the An organization previously known as the Canadian Association for the Mentally Canadian Association for the Mentally Retarded has changed its name to the Retarded has changed its name to the Canadian Association for Community Canadian Association for Community Living.  . . . Living.  . . .

Parents of exceptional children have avenues Parents of exceptional children have avenues for involvement in the education of their for involvement in the education of their children that are not open to the parents of children that are not open to the parents of ordinary children.  ordinary children. 

Classification.Classification.

Physical Physical Physical handicaps, sometimes called orthopedic Physical handicaps, sometimes called orthopedic

impairments, include loss of, or loss of the use of, impairments, include loss of, or loss of the use of, part of the body and various motor handicaps.  part of the body and various motor handicaps.  Paraplegia, quadriplegia, cerebral palsy, spina Paraplegia, quadriplegia, cerebral palsy, spina bifida, and muscular dystrophy are included bifida, and muscular dystrophy are included here.  here. 

Medical Medical Medical handicaps include asthma, diabetes, Medical handicaps include asthma, diabetes,

epilepsy, and heart conditions, among others that epilepsy, and heart conditions, among others that impair physical and intellectual performance.  impair physical and intellectual performance.  Many such conditions can be treated, or at least Many such conditions can be treated, or at least be controlled, with drugs, some of which may be controlled, with drugs, some of which may have to be administered at school.  have to be administered at school. 

Sensory Sensory Common impairments of the senses affect Common impairments of the senses affect

vision and hearing.  vision and hearing.  They range in severity from minor refractive They range in severity from minor refractive

errors to blindness and from sub clinical errors to blindness and from sub clinical hearing losses at specific frequencies to hearing losses at specific frequencies to complete deafness.  complete deafness. 

Relatively minor errors of refraction are so Relatively minor errors of refraction are so common and so easily corrected with lenses common and so easily corrected with lenses that they are usually not thought of as that they are usually not thought of as handicaps.  handicaps. 

Deafness and impaired hearing may be Deafness and impaired hearing may be associated with delayed or incomplete associated with delayed or incomplete language development.  language development. 

The American Association on Mental The American Association on Mental Deficiency defines mental retardation as Deficiency defines mental retardation as “significantly sub-average general intellectual “significantly sub-average general intellectual functioning resulting in, or associated with, functioning resulting in, or associated with, impairments in adaptive behaviour, and impairments in adaptive behaviour, and manifested during the developmental period” manifested during the developmental period” (Winzer et al., 106).  . . (Winzer et al., 106).  . .

Mentally retarded children are sometimes Mentally retarded children are sometimes referred to as developmentally delayed referred to as developmentally delayed

. . . The degree of retardation is measured by . . . The degree of retardation is measured by the relationship between developmental age the relationship between developmental age and chronological age.  and chronological age. 

Although giftedness is not normally thought of Although giftedness is not normally thought of as a handicap, gifted children are sometimes as a handicap, gifted children are sometimes considered special-needs and are placed in the considered special-needs and are placed in the intellectual categoryintellectual category

Intellectual

Attention Attention

The term “attention deficit disorder” describes an The term “attention deficit disorder” describes an especially significant classroom problem (Nichamin especially significant classroom problem (Nichamin and Windell).  and Windell). 

frequently associated with hyperactivity in young frequently associated with hyperactivity in young childrenchildren

and the inability to pay attention for a sustained timeand the inability to pay attention for a sustained time cause is not well understood but appears to be cause is not well understood but appears to be

biochemical in nature and genetic in origin.  biochemical in nature and genetic in origin.  hyperactivity creates problems for teachers but hyperactivity creates problems for teachers but

inattention creates problems for pupilsinattention creates problems for pupils the non-hyperactive child with this disorder may go the non-hyperactive child with this disorder may go

unrecognized or be misclassified.  unrecognized or be misclassified.  drugs like Dexedrine or Ritalin control the problem drugs like Dexedrine or Ritalin control the problem

but do not cure it. but do not cure it.  drugs may be administered in the school under the drugs may be administered in the school under the

supervision of a school staff member.  supervision of a school staff member.  Considerable controversy now surrounds the use of Considerable controversy now surrounds the use of

Ritalin because of its alleged side effects, particularly Ritalin because of its alleged side effects, particularly over the long term.  over the long term. 

Learning Learning ““Learning disabled” is a residual label Learning disabled” is a residual label

frequently attached to specific problems frequently attached to specific problems that are often not well understood.  that are often not well understood. 

Learning disabilities are characterized Learning disabilities are characterized by achievement levels that fall well by achievement levels that fall well below measured ability.  below measured ability. 

Specific learning disabilities include the Specific learning disabilities include the inability to communicate (aphasia), the inability to communicate (aphasia), the inability to read without other known inability to read without other known cause (dyslexia), specific handwriting cause (dyslexia), specific handwriting impairments, and other similar impairments, and other similar problems. problems. 

A learning disability is suspected when A learning disability is suspected when other known potential causes such as other known potential causes such as sensory problems or mental retardation sensory problems or mental retardation are ruled out.  are ruled out. 

Speech Speech Speech impairments are treated by speech therapists Speech impairments are treated by speech therapists

. . . often employed by school boards.  . . . often employed by school boards.  Cultural Cultural children whose cultural and language background children whose cultural and language background

are unfamiliar to the school and therefore handicap are unfamiliar to the school and therefore handicap the child in the school.  the child in the school. 

Children who are denied the cultural and linguistic Children who are denied the cultural and linguistic experiences normally available to preschool children experiences normally available to preschool children because of inadequate parenting or a generally bad because of inadequate parenting or a generally bad environment are referred to as culturally or socially environment are referred to as culturally or socially deprived.  deprived. 

Emotional Emotional Emotional handicaps include depression, Emotional handicaps include depression,

hyperactivity, the inability to form satisfactory hyperactivity, the inability to form satisfactory interpersonal relationships, a variety of behavioural interpersonal relationships, a variety of behavioural difficulties, and some impairments that border on the difficulties, and some impairments that border on the medical, such as anorexia nervosa and bulimia.  medical, such as anorexia nervosa and bulimia. 

Autistic children are included in this category Autistic children are included in this category because of their unusual behaviour.  because of their unusual behaviour. 

Constitutional Aspects Constitutional Aspects Provision in the Canadian constitution [under] the “Equality Provision in the Canadian constitution [under] the “Equality

Rights” clause (sec. 15) of the Rights” clause (sec. 15) of the Constitution Act, 1982Constitution Act, 1982, came , came into effect three years after the rest of the actinto effect three years after the rest of the act

The act - The act - provides generally for the equal benefit and protection of provides generally for the equal benefit and protection of

the law the law disallows discrimination based on named grounds, including disallows discrimination based on named grounds, including

physical and mental disability.  physical and mental disability. 

A second subsection A second subsection allows for . . . affirmative action (discriminatory practices allows for . . . affirmative action (discriminatory practices

that favour a disadvantaged group0  that favour a disadvantaged group0  What the American courts found to be implicit in their What the American courts found to be implicit in their

constitution has been made very explicit in the Canadian constitution has been made very explicit in the Canadian version.  version. 

Canadian provinces have moved to conform to these Canadian provinces have moved to conform to these constitutional requirements.  constitutional requirements. 

Special–education Special–education Requirements Requirements

The requirements for meeting the needs of The requirements for meeting the needs of special-needs students as interpreted by a special-needs students as interpreted by a number of jurisdictions, American and number of jurisdictions, American and Canadian, are listed and defined here.  Canadian, are listed and defined here. 

This list contains all the major program This list contains all the major program modifications that are commonly made for modifications that are commonly made for special-needs students as a group.  special-needs students as a group. 

Many jurisdictions have not legislated all of Many jurisdictions have not legislated all of them, but they do represent what is widely them, but they do represent what is widely considered to be good practice in this area.  considered to be good practice in this area. 

Zero RejectZero Reject The principle of zero reject requires that no The principle of zero reject requires that no

resident child of school age be turned away resident child of school age be turned away from school, regardless of any disability.  from school, regardless of any disability. 

All handicapped children are entitled to a free All handicapped children are entitled to a free and appropriate education.  and appropriate education. 

The education can be in a public or private The education can be in a public or private school but must be at public expense.  school but must be at public expense. 

Zero RejectZero Reject In many provinces, specialized private schools In many provinces, specialized private schools

were catering to handicapped children when were catering to handicapped children when the public schools were excluding them, and the public schools were excluding them, and some of these private schools still exist.  some of these private schools still exist. 

This form of specialization. . . brings about the This form of specialization. . . brings about the segregation of the handicapped, segregation of the handicapped,

[it] violates the mainstreaming principle [it] violates the mainstreaming principle discussed later in this list.  discussed later in this list. 

education must be appropriate to the needs of education must be appropriate to the needs of the individual child and will necessarily differ the individual child and will necessarily differ from child to child.  from child to child. 

Appropriate EvaluationAppropriate Evaluation The evaluation of a child The evaluation of a child must be culturally and linguistically fair, must be culturally and linguistically fair, consistent with any perceptual or motor consistent with any perceptual or motor

handicaps that the child has, handicaps that the child has, conducted by a team of experts, and conducted by a team of experts, and repeated at intervals.  repeated at intervals.  tested in their mother tongue with a variety of tested in their mother tongue with a variety of

tests that are appropriate to their cultural tests that are appropriate to their cultural background.  background. 

Special testing arrangements must be made for Special testing arrangements must be made for children who may be of normal intelligence but children who may be of normal intelligence but who are blind or deafwho are blind or deaf

must be re-evaluated periodically to monitor must be re-evaluated periodically to monitor progress and avoid any possible misclassification progress and avoid any possible misclassification or misplacement.  or misplacement. 

Individualized Education Programs Individualized Education Programs An individualized education program - (IEP), An individualized education program - (IEP), prepared yearly for each special-needs child prepared yearly for each special-needs child includes:includes:

Documentation of the student's current level Documentation of the student's current level Annual goals/ attainments expected by the end of the Annual goals/ attainments expected by the end of the

school year, school year, Short-term objectives, - the intermediate steps Short-term objectives, - the intermediate steps

leading to the mastery of annual goals, leading to the mastery of annual goals, Documentation of the particular special education Documentation of the particular special education

and related services that will be provided to the and related services that will be provided to the child, child,

An indication of the extent of time a child will An indication of the extent of time a child will participate in the regular education program, participate in the regular education program,

Projected dates for initiating services and the Projected dates for initiating services and the anticipated duration of services, anticipated duration of services,

Appropriate objective criteria, evaluation Appropriate objective criteria, evaluation procedures, and schedules for determining mastery procedures, and schedules for determining mastery of short-term objectives, at least on an annual basis. of short-term objectives, at least on an annual basis. 

Individualized Education ProgramsIndividualized Education Programs The IEP will be written by a special-education The IEP will be written by a special-education teacher or a small team of specialists.  teacher or a small team of specialists. 

Parents at minimum, are provided with a copy of the Parents at minimum, are provided with a copy of the document on request, and in many jurisdictions they document on request, and in many jurisdictions they will be asked to approve it.  will be asked to approve it. 

Parents or even the student, if mature enough, may Parents or even the student, if mature enough, may become part of the IEP team and be involved in the become part of the IEP team and be involved in the meetings necessary to write and revise the meetings necessary to write and revise the document.  document. 

The IEP is a quasi-contract that commits the school The IEP is a quasi-contract that commits the school to implement a program for the child with the to implement a program for the child with the necessary human and material resources needed to necessary human and material resources needed to accomplish it.  accomplish it. 

It acts as a formalized vehicle of communication It acts as a formalized vehicle of communication between the school and the home and provides a between the school and the home and provides a basis for discussing the child's problems and basis for discussing the child's problems and progress.  progress. 

Progress actually made can be monitored by Progress actually made can be monitored by reference to the IEP.  reference to the IEP. 

MainstreamingMainstreaming

Placing special-needs children into the Placing special-needs children into the mainstream implies integrating them as mainstream implies integrating them as much as possible with children who have no much as possible with children who have no special needs.  special needs. 

The term “least restrictive environment” has The term “least restrictive environment” has been employed to describe this form of been employed to describe this form of integration.  integration. 

The child's placement should be as close to The child's placement should be as close to the regular class as is appropriate for that the regular class as is appropriate for that child's needs and abilities.  child's needs and abilities. 

Mainstreaming ensures that special-needs Mainstreaming ensures that special-needs children have role models that include children have role models that include children without serious handicaps. children without serious handicaps. 

Longer Programs Longer Programs lengthening the school program for lengthening the school program for

special-needs students has been an special-needs students has been an important issue in special education.  important issue in special education. 

. . .involves extending the age range during . . .involves extending the age range during which school services are available to the which school services are available to the child at both the upper and lower ends.  child at both the upper and lower ends. 

E.g.. early intervention allows more E.g.. early intervention allows more effective remediation,effective remediation,

some special–needs children receive some special–needs children receive services from the age of three or even services from the age of three or even earlier.  earlier. 

slow learners benefit from instruction at slow learners benefit from instruction at the elementary and secondary levels well the elementary and secondary levels well into adulthood )to age 21 in NB)into adulthood )to age 21 in NB)

Special Education ProgramsSpecial Education Programs ““special education program” means, . . . an special education program” means, . . . an

educational program that is based on and educational program that is based on and modified by modified by the results of continuous assessment and evaluation the results of continuous assessment and evaluation includes a plan containing specific objectives and includes a plan containing specific objectives and an outline of educational services that meets the an outline of educational services that meets the

needs of the exceptional pupil;needs of the exceptional pupil;• ““special education services” means special education services” means facilities and resources, including support personnel facilities and resources, including support personnel

and equipment, necessary for developing and and equipment, necessary for developing and implementing a special education program; implementing a special education program;

Continuous assessment and evaluation is mandated Continuous assessment and evaluation is mandated without specific requirements for cultural without specific requirements for cultural appropriateness. appropriateness. 

Advisory CommitteeAdvisory Committee

With a few minor exceptions, every school With a few minor exceptions, every school board must establish a special education board must establish a special education advisory committee.  advisory committee. 

Its membership consists of three school board Its membership consists of three school board members and as many as 12 representatives of members and as many as 12 representatives of organized special interest groups other than organized special interest groups other than teacher groups that are concerned with teacher groups that are concerned with exceptional children or adults.  exceptional children or adults. 

Organizations such as the Learning Disabilities Organizations such as the Learning Disabilities Association and the Ontario Association for Association and the Ontario Association for Community Living would qualify.  Community Living would qualify. 

Administrative Bodies and Administrative Bodies and AppealsAppeals

Ontario's special–education Ontario's special–education amendments provide for a large and amendments provide for a large and complex set of administrative boards, complex set of administrative boards, committees, and tribunals.  committees, and tribunals. 

These are involved in the identification These are involved in the identification of children as exceptional, the of children as exceptional, the placement of such children, and placement of such children, and appeals from identification or appeals from identification or placement decisions.  placement decisions. 

LitigationLitigation

Special–education litigation in Canada has not yet Special–education litigation in Canada has not yet settled into an established pattern, but there are settled into an established pattern, but there are clearly some types of cases that are possible.  clearly some types of cases that are possible. 

Appeals of placement decisions for either substantive Appeals of placement decisions for either substantive or procedural reasons or procedural reasons

The most litigious question? The extent to which an The most litigious question? The extent to which an exceptional child is to be integrated with non-exceptional child is to be integrated with non-handicapped peers.  handicapped peers. 

Administrative bodies such as school boards that Administrative bodies such as school boards that make decisions concerning the legal rights of make decisions concerning the legal rights of individuals are required, by statute in some provinces individuals are required, by statute in some provinces and more generally under common law, to act fairly.  and more generally under common law, to act fairly. 

Difficult questions about the minority denominational Difficult questions about the minority denominational and language rights of exceptional children.  and language rights of exceptional children. 

Medical Problems in Schools Medical Problems in Schools

The introduction of children with medical and The introduction of children with medical and physical handicaps into schools has forced teachers physical handicaps into schools has forced teachers to become familiar with the more common medical to become familiar with the more common medical problems and has involved schools in medical problems and has involved schools in medical procedures previously restricted to hospitals, procedures previously restricted to hospitals, clinics, and homes.  clinics, and homes. 

Children now routinely undergo medical procedures Children now routinely undergo medical procedures in schools that at one time would have been the in schools that at one time would have been the very reason for their exclusion from school.  very reason for their exclusion from school. 

Some medical conditions require specific responses Some medical conditions require specific responses from school personnel on a continuing basis. from school personnel on a continuing basis. 

Types of ProblemsTypes of Problems Diabetes ;an inability to metabolize sugar, is Diabetes ;an inability to metabolize sugar, is

common in childhood and is routinely treated with common in childhood and is routinely treated with injected insulin.injected insulin.

    Children can develop acute symptoms in school Children can develop acute symptoms in school

because of too much or too little insulin given their because of too much or too little insulin given their food intake, amount of exercise, and emotional food intake, amount of exercise, and emotional state.  state. 

Insulin reaction, which is caused by an insulin Insulin reaction, which is caused by an insulin overdose, insufficient food, or excessive exercise, overdose, insufficient food, or excessive exercise, can occur quickly and is serious.  can occur quickly and is serious. 

Some board policies have recommended an almost Some board policies have recommended an almost routine administration of sugar to diabetics routine administration of sugar to diabetics (Alberta . . ., 20–21), but a teacher with a diabetic (Alberta . . ., 20–21), but a teacher with a diabetic child in the class should request specific instructions child in the class should request specific instructions for that particular child. for that particular child. 

Bronchial asthmaBronchial asthma Bronchial asthma is characterized by difficulty in Bronchial asthma is characterized by difficulty in

breathing.  An acute attack is serious, but most breathing.  An acute attack is serious, but most asthmatic persons carry medication with them.  asthmatic persons carry medication with them. 

Asthma is frequently caused by allergies, Asthma is frequently caused by allergies, Teachers may wish to avoid exposing asthmatic Teachers may wish to avoid exposing asthmatic

children to allergens that may be present during field children to allergens that may be present during field trips, laboratory experiments, and shop activities.  trips, laboratory experiments, and shop activities. 

Exercise can also be a factor in bringing on an Exercise can also be a factor in bringing on an asthmatic attack.  asthmatic attack. 

Teachers should request specific instructions for Teachers should request specific instructions for asthmatic children with respect to participation in asthmatic children with respect to participation in physical education, exposure to specific allergens, physical education, exposure to specific allergens, and self-medication in emergencies.  and self-medication in emergencies. 

Anaphylactic reactionsAnaphylactic reactionsIn schools, anaphylactic reactions most commonly occur in In schools, anaphylactic reactions most commonly occur in

cases of extreme allergy to bee or wasp stings or to certain cases of extreme allergy to bee or wasp stings or to certain foods.  foods. 

Anaphylactic reaction is an acute condition that requires Anaphylactic reaction is an acute condition that requires quick medical treatment. Teachers will often be asked to quick medical treatment. Teachers will often be asked to store the kit (an epi-pen which contains a predetermined store the kit (an epi-pen which contains a predetermined amount of a drug that acts as an antidote) and may be amount of a drug that acts as an antidote) and may be expected to inject the drug.  expected to inject the drug. 

Teachers should be aware of any children in their classes Teachers should be aware of any children in their classes who are subject to anaphylactic reactions and should be who are subject to anaphylactic reactions and should be especially aware of the offending substancesespecially aware of the offending substances

By far the most common problem food of this type found in By far the most common problem food of this type found in schools is peanut butter.schools is peanut butter.

. . . Although an epi-pen can provide quick relief from severe . . . Although an epi-pen can provide quick relief from severe symptoms, BUT a medical emergency still exists and the symptoms, BUT a medical emergency still exists and the child must be taken to a hospital as soon as possible.  child must be taken to a hospital as soon as possible. 

Hemophiliac childrenHemophiliac childrenand children with AIDSand children with AIDS

Prone to episodes of prolonged bleeding, Prone to episodes of prolonged bleeding, either internally or externally, schools either internally or externally, schools must act to prevent even minor injuries must act to prevent even minor injuries to such children.  to such children. 

Hemophiliac children do not participate Hemophiliac children do not participate in sports or physical education.  In in sports or physical education.  In elementary schools they are either kept elementary schools they are either kept in at recess or are segregated from in at recess or are segregated from children who are playing games.  children who are playing games. 

In departmentalized schools they often In departmentalized schools they often move from class to class before or after move from class to class before or after the other students to avoid being the other students to avoid being bumped.  bumped. 

Related to hemophilia . . .is acquired Related to hemophilia . . .is acquired immune deficiency syndrome (AIDS)immune deficiency syndrome (AIDS)

Notwithstanding public fears, AIDS is not an Notwithstanding public fears, AIDS is not an easy disease to catch, compared to influenza easy disease to catch, compared to influenza or the common cold for example. or the common cold for example. 

Court cases to date have recognized this and Court cases to date have recognized this and have generally required the full integration have generally required the full integration of students with AIDS into regular classes, of students with AIDS into regular classes, in the absence of other handicaps (Strope).  in the absence of other handicaps (Strope). 

Because of the serious consequences of Because of the serious consequences of AIDS, teachers frequently take precautions, AIDS, teachers frequently take precautions, such as wearing latex gloves when dealing such as wearing latex gloves when dealing with sick children in school.  with sick children in school. 

SeizuresSeizures

Seizures usually reflect some Seizures usually reflect some neurological problem and may be neurological problem and may be minor or severe.  minor or severe. 

Children in school who are prone to Children in school who are prone to seizures are often under medication to seizures are often under medication to prevent them.  prevent them. 

The medication itself as well as the The medication itself as well as the underlying neurological problem can underlying neurological problem can cause learning difficulties for the child.  cause learning difficulties for the child. 

Special SituationsSpecial Situations Special precautions must be taken when handling Special precautions must be taken when handling

sick or injured children.  sick or injured children.  . . . in case of uncertainty, the child should not be . . . in case of uncertainty, the child should not be

left alone since minor problems can become left alone since minor problems can become serious.  serious. 

School authorities should attempt to contact the School authorities should attempt to contact the parents and may request that a parent come and parents and may request that a parent come and get the child, or a school staff member may agree get the child, or a school staff member may agree to take the child home.  to take the child home. 

. . . a school staff member may take the child . . . a school staff member may take the child directly to a hospital, but, especially with injured directly to a hospital, but, especially with injured children, this may not be a good idea.  children, this may not be a good idea. 

. . . in case of serious injury is to call for an . . . in case of serious injury is to call for an ambulance to ensure that the injured person is ambulance to ensure that the injured person is moved properly.  Improper handling of an injured moved properly.  Improper handling of an injured person can greatly exacerbate the injuries. person can greatly exacerbate the injuries. 

- Immunization- Immunization - Head lice - Head lice

teachers play an important role in ensuring teachers play an important role in ensuring that young children enter school for the first that young children enter school for the first time with the immunizations now required by time with the immunizations now required by law in many jurisdictions.  law in many jurisdictions. 

When an epidemic of head lice occurs, When an epidemic of head lice occurs, teachers warn pupils not to share hats, teachers warn pupils not to share hats, combs, or hairbrushes and to encourage them combs, or hairbrushes and to encourage them to shampoo frequently at home.  to shampoo frequently at home. 

Teachers may be asked to determine the Teachers may be asked to determine the incidence of head lice in their classes by incidence of head lice in their classes by examining children's hair for nits, the egg examining children's hair for nits, the egg cases of head lice.  cases of head lice. 

Administering MedicationAdministering Medication Children in schools often require medication during Children in schools often require medication during

school resulting in pressure on schools and teachers school resulting in pressure on schools and teachers to administer drugs.  to administer drugs. 

School boards have developed policies to handle School boards have developed policies to handle these situations these situations

Common elements are emerging from these. . .   Common elements are emerging from these. . .   Most policies disallow the routine dispensing of non-Most policies disallow the routine dispensing of non-

prescription drugs by teachers and school offices.  prescription drugs by teachers and school offices.  However:However: Policies that forbid the routine supply of non-Policies that forbid the routine supply of non-

prescription drugs by teachers often require that prescription drugs by teachers often require that they dispense far more dangerous prescription they dispense far more dangerous prescription drugs to pupils who must receive oral medication drugs to pupils who must receive oral medication during school hours. during school hours.

Written requests policiesWritten requests policies

. . . most policies require a written request by a . . . most policies require a written request by a parent and approved by a medical doctor who parent and approved by a medical doctor who must also provide instructions on the must also provide instructions on the administration of the drug.  School boards administration of the drug.  School boards frequently have forms for this.  frequently have forms for this. 

The purpose of the request form is to ensure The purpose of the request form is to ensure that the school is administering the drug with that the school is administering the drug with parental consent. parental consent. 

It does not absolve teachers or the school of It does not absolve teachers or the school of liability for negligence.  The form to be filled out liability for negligence.  The form to be filled out by the doctor should indicate the name of the by the doctor should indicate the name of the drug, administration time and frequency, drug, administration time and frequency, dosage, contraindications, side effects, possible dosage, contraindications, side effects, possible dangers, and corrective action.  dangers, and corrective action. 

Teachers are not normally requested to Teachers are not normally requested to administer medication other than orally.  administer medication other than orally. 

Medical ProceduresMedical Procedures The presence of special-needs students in The presence of special-needs students in

schools has created a need for certain common schools has created a need for certain common medical procedures to be performed in schools.  medical procedures to be performed in schools.  Most will be performed by school nurses or Most will be performed by school nurses or attendants rather than teachers.  attendants rather than teachers. 

Some include feeding, toileting, and Some include feeding, toileting, and administering injected medication. administering injected medication. 

Physically handicapped students will require Physically handicapped students will require

lifting and positioning assistance from teachers, lifting and positioning assistance from teachers, teacher aides, or attendants, as well as help with teacher aides, or attendants, as well as help with crutches, walkers, and wheelchairs. crutches, walkers, and wheelchairs. 

three more esoteric procedures are especially three more esoteric procedures are especially

common: tube feeding, postural drainage, and common: tube feeding, postural drainage, and catheterization.  catheterization. 

Conclusions Conclusions Special-needs students are those for whom the Special-needs students are those for whom the

regular school program is not entirely regular school program is not entirely satisfactory because of individual personal satisfactory because of individual personal exceptionalities.  exceptionalities. 

Exceptionalities or special needs can be Exceptionalities or special needs can be classified as physical, medical, perceptual, classified as physical, medical, perceptual, intellectual, speech, cultural, emotional, or intellectual, speech, cultural, emotional, or some combination of these.  some combination of these. 

Schools must accommodate these students in Schools must accommodate these students in an appropriate way, frequently through an appropriate way, frequently through special–education programs.  special–education programs. 

The handicapped have asserted their right to The handicapped have asserted their right to publicly funded appropriate education and have publicly funded appropriate education and have received support by equal protection and received support by equal protection and benefit clauses in constitutions and by court benefit clauses in constitutions and by court interpretations of these that are favourable to interpretations of these that are favourable to their rights.  their rights. 

In an idealized regime, all school-age children In an idealized regime, all school-age children would be accepted into the public schools, and would be accepted into the public schools, and those with special needs would have their those with special needs would have their programs planned individually in a written programs planned individually in a written education program after having received a education program after having received a fair and appropriate evaluation of their fair and appropriate evaluation of their strengths and weaknesses.  strengths and weaknesses. 

They would be entitled to education in the They would be entitled to education in the least restrictive or most integrated least restrictive or most integrated environment and would have the right to environment and would have the right to appeal their assessments and placements to appeal their assessments and placements to an impartial tribunal.  an impartial tribunal. 

The mainstreaming of special-needs students The mainstreaming of special-needs students into regular schools has brought teachers into regular schools has brought teachers face-to-face with students with serious face-to-face with students with serious medical problems.  medical problems. 

Teachers need to know how to handle these Teachers need to know how to handle these problems and, in some cases, may be asked to problems and, in some cases, may be asked to give prescribed oral medication to students.  give prescribed oral medication to students.  Although teachers cannot become medical Although teachers cannot become medical specialists, it is important that they specialists, it is important that they understand clearly the problems of their own understand clearly the problems of their own special-needs students.  special-needs students. 

Special organizational structures have arisen Special organizational structures have arisen in educational systems to cater to the needs in educational systems to cater to the needs of a bewildering variety of exceptional pupils.  of a bewildering variety of exceptional pupils.  These organizational possibilities range from These organizational possibilities range from segregated residential schools through segregated residential schools through segregated classes in regular schools to segregated classes in regular schools to integration in regular classes with or without integration in regular classes with or without a program of periodic withdrawal.  a program of periodic withdrawal.