Page 87 - School Bus Operators and Attendants Handbook

 Position the student away from the lift and doorways if the student has a tracheotomy or other
respiratory condition.
 The student may be startled easily from loud noise or sudden movement. Try to prevent such
occurrences.
 Always contact the student’s physical therapist if there are questions or concerns about the
student.

Duchenne Muscular Dystrophy

This is an inherited degenerative disease that breaks down voluntary muscle tissue. This disease mostly
affects males. Students usually appear normal in motor development in their early years. By mid to late
elementary years, the disease may progress, whereby the student can no longer stand or walk
independently. Upper body strength also starts to decrease as the disease progresses. Difficulty with
propelling a wheelchair may occur, and the student is then given a motorized wheelchair.

Symptoms may include:

 Rapid muscle weakness and loss  Joint contractures, tightness
 Curved spine  Overweight
 Unusually large calf muscles  Respiratory issues

Interventions:

 Assist the student up and down the bus steps
 Often times, a goal for the student is to be as mobile and as independent for as long as possible.
Sometimes, a student may use a wheelchair only to get onto and off the bus, or travel longer
distances. He must transferred into the bus seat. The student’s physical therapist will assist in
showing how to do that. Help the student with his seat belt.
 If the student does walk, he may be unsteady. Be careful of the student falling. He/she may need
assistance if they fall.
 Be very sensitive about what is said to the student. Do not expect him/her to do something that
he/she is physically unable to do. The student may have done it yesterday, but today he/she may
not be able to perform the same physical task.
 As the student’s musculature weakens, sitting can become more difficult. The student’s physical
therapist will adjust the position of the student’s wheelchair to make him/her more comfortable.
The physical therapist will pass the information to the driver and attendant. Never adjust a
wheelchair, braces, or any equipment without specific orders from the physical therapist.
 Seek assistance if there is a need to lift the student. The student may slip due to flaccid muscle
tone and weakness.

Osteogenesis Imperfecta (OI)

The condition affects both males and females is inherited. The bones are imperfectly formed, and this
condition is commonly called “brittle bone disease”. The bones are easily fractured, the student’s skin is
loose and transparent, and the muscles lack tone. The student may be ambulatory and use braces or
crutches, or however, a wheelchair will most typically be used, especially for longer distances.

Page 87 of 149
Exceptional Student Education (ESE)