Accommodations:
Modifications:
Case Studies:
"As Susan welcomed the birth of her son Nick, she thought everything seemed normal. However, as she asked, “Is my baby fine?” the initial smiles surrounding her quickly changed to whispers and concerned looks. Soon, Nick was whisked away to specialists in a large children’s hospital while Susan was left behind. Shortly afterward, she was released, leaving with a balloon that read “It’s a boy!” but she held no baby boy in her arms. Susan did not realize then that the adventure had only begun as tests soon revealed that her baby had a congenital heart defect.
After Nick had three difficult open heart surgeries, his doctors decided that he could survive only with a heart transplant. Just before his second birthday, Nick received his new heart..."
(http://www.cdc.gov/ncbddd/heartdefects/living.html)
Because many students with heart conditions also have other conditions including cognitive impairments, Nick should be evaluated for any cognitive abnormalities. Nick may also need modified standards when it comes to physical education, especially during the healing process. Any activities that may be strenuous and include a lot of physical activity in the general education classroom will be used with caution and Nick's expectations will be discussed privately. There will be open communication between Nick, his parents, and his teachers to discuss any limitations.
"Our twins, a boy and girl, were born 6 weeks premature in 2002. Our son, Shandler, was born with two congenital heart defects: coarctation of the aorta and bicuspid aortic valve. Coarctation of the aorta is a narrowing of part of the aorta (the major artery that supplies oxygenated blood to the entire body). Bicuspid aortic valve is an aortic valve that has two leaflets, instead of three. Shandler was fairly small, weighing only 4 pounds. At four days old, he began to have difficulty breathing. The doctors detected a heart murmur, and diminished pulses in his legs and feet. Through echocardiography (ultrasound of the heart), the congenital heart defects were found. Three days later, the heart surgeon repaired the coarctation. There is no intervention for his bicuspid aortic valve.
Our family was absolutely terrified that he wouldn’t survive major heart surgery because of how tiny he was. He did well for about two weeks after surgery, and then he developed complications (a risk with any surgical procedure). Fluid collected around his lungs, making it difficult for him to breathe. He required a ventilator to assist with breathing and chest tubes placed to drain the fluid. After six weeks of no improvement in his condition, as well as developing bacterial meningitis (which almost took his life), he was taken back into surgery. Within 24 hours, he was able to breathe on his own again. After 11 weeks in the newborn intensive care unit, Shandler was finally able to come home, to be reunited with his twin sister and live with our family. However, he was discharged with a feeding tube. This was necessary because his heart condition caused fatigue during feedings, and he was not able to take the full amount necessary by mouth...
Seeing Shandler today, you wouldn’t know he had such a rough start in life. Although he is small for his age, he is able to run and play with his peers, and eats everything in sight!! However, he does require yearly follow-up by a cardiologist. Through echocardiography, they look for any signs of aortic narrowing again, as well as checking the function of his bicuspid aortic valve. Complications of bicuspid aortic valve include: congestive heart failure, leakage of blood through the valve back into the heart, and narrowing of the valve’s opening. The valve will require repair or replacement if this occurs. Shandler is never allowed to participate in contact sports (football, hockey and wrestling). Despite this restriction, he is a bright, happy 5th grader, who loves to play jokes on others (especially his sisters). He enjoys building things, reading Harry Potter books, and is a whiz in math and other school subjects. He will always have his “battle scar”, although he jokes that it “makes him look tough”!! We have been truly blessed to have Shandler in our family."
(http://www.cdc.gov/ncbddd/heartdefects/living.html)
If Shandler was in my class, I would sit down with parents and Shandler and discuss what types of activities are appropriate for her to participate in. Shandler may have modified standards in physical education class due to no contact sports. Teachers will be required to have CPR training and an IED will be placed in the school. In any activities with strenuous physical activities, Shandler's participation will be limited and monitored. Signs of heart failure will always be watched for.
- Assistive technology
- Two sets of books (one for school and one for home)
- Allowing extra time to complete assignments (Students with CHD may have more appointments and miss school)
- Allowing extra time to get from class to class
- Allowing students to go to the office for medications
- Extra bathroom passes (diuretic medication causes frequent urination) (Gavin, 2013)
- Students with CHD often need to consume extra calories to keep their weight. Once heart condition is corrected, this is not usually the case. These students may need to be allowed an extra snack break.
Modifications:
- In physical education class, students with CHD may need accommodations with physical activity. Students may become exhausted easily. It's important to discuss health needs with a parents or doctor and determine what physical activity needs are necessary. Physical activity is necessary to keep the heart health, but the amount and type is variable.
- Some students with CHD may have developmental delays. Students that have additional delays may require other modifications but as far as a typical student with CHD, monitoring activity is most important.
Case Studies:
"As Susan welcomed the birth of her son Nick, she thought everything seemed normal. However, as she asked, “Is my baby fine?” the initial smiles surrounding her quickly changed to whispers and concerned looks. Soon, Nick was whisked away to specialists in a large children’s hospital while Susan was left behind. Shortly afterward, she was released, leaving with a balloon that read “It’s a boy!” but she held no baby boy in her arms. Susan did not realize then that the adventure had only begun as tests soon revealed that her baby had a congenital heart defect.
After Nick had three difficult open heart surgeries, his doctors decided that he could survive only with a heart transplant. Just before his second birthday, Nick received his new heart..."
(http://www.cdc.gov/ncbddd/heartdefects/living.html)
Because many students with heart conditions also have other conditions including cognitive impairments, Nick should be evaluated for any cognitive abnormalities. Nick may also need modified standards when it comes to physical education, especially during the healing process. Any activities that may be strenuous and include a lot of physical activity in the general education classroom will be used with caution and Nick's expectations will be discussed privately. There will be open communication between Nick, his parents, and his teachers to discuss any limitations.
"Our twins, a boy and girl, were born 6 weeks premature in 2002. Our son, Shandler, was born with two congenital heart defects: coarctation of the aorta and bicuspid aortic valve. Coarctation of the aorta is a narrowing of part of the aorta (the major artery that supplies oxygenated blood to the entire body). Bicuspid aortic valve is an aortic valve that has two leaflets, instead of three. Shandler was fairly small, weighing only 4 pounds. At four days old, he began to have difficulty breathing. The doctors detected a heart murmur, and diminished pulses in his legs and feet. Through echocardiography (ultrasound of the heart), the congenital heart defects were found. Three days later, the heart surgeon repaired the coarctation. There is no intervention for his bicuspid aortic valve.
Our family was absolutely terrified that he wouldn’t survive major heart surgery because of how tiny he was. He did well for about two weeks after surgery, and then he developed complications (a risk with any surgical procedure). Fluid collected around his lungs, making it difficult for him to breathe. He required a ventilator to assist with breathing and chest tubes placed to drain the fluid. After six weeks of no improvement in his condition, as well as developing bacterial meningitis (which almost took his life), he was taken back into surgery. Within 24 hours, he was able to breathe on his own again. After 11 weeks in the newborn intensive care unit, Shandler was finally able to come home, to be reunited with his twin sister and live with our family. However, he was discharged with a feeding tube. This was necessary because his heart condition caused fatigue during feedings, and he was not able to take the full amount necessary by mouth...
Seeing Shandler today, you wouldn’t know he had such a rough start in life. Although he is small for his age, he is able to run and play with his peers, and eats everything in sight!! However, he does require yearly follow-up by a cardiologist. Through echocardiography, they look for any signs of aortic narrowing again, as well as checking the function of his bicuspid aortic valve. Complications of bicuspid aortic valve include: congestive heart failure, leakage of blood through the valve back into the heart, and narrowing of the valve’s opening. The valve will require repair or replacement if this occurs. Shandler is never allowed to participate in contact sports (football, hockey and wrestling). Despite this restriction, he is a bright, happy 5th grader, who loves to play jokes on others (especially his sisters). He enjoys building things, reading Harry Potter books, and is a whiz in math and other school subjects. He will always have his “battle scar”, although he jokes that it “makes him look tough”!! We have been truly blessed to have Shandler in our family."
(http://www.cdc.gov/ncbddd/heartdefects/living.html)
If Shandler was in my class, I would sit down with parents and Shandler and discuss what types of activities are appropriate for her to participate in. Shandler may have modified standards in physical education class due to no contact sports. Teachers will be required to have CPR training and an IED will be placed in the school. In any activities with strenuous physical activities, Shandler's participation will be limited and monitored. Signs of heart failure will always be watched for.