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Kuder, S. Jay. Teaching Students with Language and Communication Disabilities (The Pearson Communication Sciences and Disorders Series) (p. 191). Pearson Education. Kindle

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Other neuromotor disorders, such as spina bifida can also affect language acquisition and development. Spina bifida refers to a group of conditions in which a portion of the spinal cord is not completely enclosed by the vertebrae in the spinal column. In some cases, part of the spinal cord protrudes. In the most serious form of the disorder, myelomeningocele, damage to the spinal cord can cause sensory and motor losses. In addition, in about 80 percent of the cases, fluid accumulates in the brain, causing the condition known as hydrocephalus. If not treated quickly, hydrocephalus can cause Intellectual disabilities. Surgery can often correct the spinal cord abnormality in spinal bifida, but some sensory and motor disabilities can remain.

Impairments in language are characteristic of many children with spina bifida, especially those who also have hydrocephalus. Although children with spina bifida often have strengths involving vocabulary and grammar, difficulties with the use of language in context have frequently been reported. Sometimes called the “cocktail chatter” phenomenon, their communicative interactions have been described as “chatty” conversations that remain at a superficial level. In addition, although their speech may be fluent and well-articulated, it may include verbal perseveration, excessive use of stereotyped social utterances, and overfamiliarity.

Many children with spina bifida have difficulties with academic skills including math and reading comprehension. Although children with hydrocephalus (which is associated with a

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number of neurological disorders, not just spina bifida) typically have good vocabulary and word attack skills, they have difficulty making inferences, understanding literal story content, and producing their own stories.

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For no other group of exceptional learners is the continuum of educational services and placement options more relevant than for those with neuromotor or neurological disorders. Some students require a complex and coordinated array of specialized instruction, therapy, and related services. In addition, the transdisciplinary approach is beneficial for students with physical disabilities.

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Environmental modifications are frequently necessary to allow a student to participate more fully and independently in school. Modifications include wheelchair-accessible classrooms or other assistive technology. IDEA defines assistive technology (AT) as devices and services needed to obtain and effectively use devices. A service is any resource that directly assists with the selection, acquisition, or use of an AT device. Adapted eating utensils, computerized speech devices, and telecommunication devices are all examples of AT.

One major consideration in the education of students with physical impairments is the physical environment of the classroom. For some students with mobility problems, this may be the prime area in which modifications must be made. Teachers must ensure that the physical layout is suitably arranged to accommodate students with physical impairments.

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The effects of TBI on learning and behavior are determined by the severity of the injury and the part of the brain that sustained damage. Although people with brain injuries make significant improvements during the first two years post-injury and continue to improve at a more gradual pace for many years, most will have permanent physical, behavioral, and/or cognitive impairments.

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