(a) Definition.

1. (1) “Orthopedic impairment” means a severe orthopedic impairment that adversely affects a child’s developmental/educational performance.

2. (2) The term includes impairments:

   1. (A) Caused by congenital anomaly (e.g., clubfoot, absence of some member, spina bifida, etc.);
   2. (B) Caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.); and
   3. (C) From other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).

3. (3)

   1. (A) Physical characteristics may include paralysis, unsteady gait, poor muscle control, loss of limb, etc.
   2. (B) Many times the impairment is so great as to impede the expressive language of the child.
   3. (C) It is important to note that appropriate seating/positioning of a child is of primary consideration for effective:

(i) Screening;

1. (ii) Evaluation; and

   1. (iii) Instruction.

(b) Screening information.

1. (1)

   1. (A) Screening can be waived if current data (within the past six (6) months) are available.
   2. (B) Otherwise, it is required.

2. (2) Required:

   1. (A) Hearing;
   2. (B) Vision; and

   3. (C) Formal measures of:

      1. (i)

(b) (b) May include the areas of:

1. (1) (1) Cognition;
2. (2) (2) Motor;
3. (3) (3) Social/emotional; and

4. (4) (4) Self-help; and

   1. (ii) Speech/language.

5. (3) Recommended. Informal measures, such as:

   1. (A) Checklists;
   2. (B) Inventories;
   3. (C) Rating scales;
   4. (D) Interviews;
   5. (E) Behavioral observations in home and/or other natural environments; and/or

   6. (F) Access to and review of existing records and available information.

      1. (c) Required evaluation data.
6. (1) Social history. Emphasis on developmental, family, and health/medical history.

7. (2) Assessment.

   1. (A)

      1. (i) Medical.
      2. (ii) Written statement from a physician establishing the type of orthopedic impairment.
   2. (B) Cognitive/intellectual abilities (one (1) required).
   3. (C) Social/emotional (one (1) adaptive behavior assessment required).

   4. (D)

      1. (i) Self-help.
      2. (ii) May be included in the adaptive behavior, cognitive/intellectual, and/or the programming assessments.

   5. (E) Communicative abilities:

      1. (i)

(b) (b) Both receptive and expressive areas must be assessed.

1. (c) (c) Assessment must be comprehensive and must not be limited to one-word vocabulary tests;

   1. (ii) Articulation (when indicated); and

      1. (iii) Augmentative/alternative communication (when indicated).

   2. (F)

      1. (i) Motor (one (1) required).
      2. (ii) The assessment of specific motor dysfunction is the responsibility of a licensed physical and/or occupational therapist.
      3. (iii) Assessment includes:

(b) (b) Neuromuscular development;

1. (c) (c) Sensory integration;

   1. (d) (d) Daily living activities; and/or

(e) (e) Need for adaptive equipment.

1. (G) Programming (one (1) criterion or curriculum-based measure required).

   1. (d) Evaluation data analysis.
2. (1) Children ages three (3) to five (5) are considered to have an orthopedic impairment when they demonstrate a documented physical, motoric, or orthopedic impairment, disability, or chronic medical condition that interferes with the acquisition of new knowledge or skills in areas of development.
3. (2) The qualified provider’s motor evaluation report must document how this impairment adversely affects the child’s areas of development.
4. (3) A child’s cognitive functioning level must be considered when determining the significance of motor delay.

5. (4) Orthopedically impaired children may manifest functional impairments in:

   1. (A) Body balance;
   2. (B) Ambulation; and
   3. (C) Limb/hand utilization.
6. (5) The severity of these functional limitations must be such that the child needs special education.