Page 89 - School Bus Operators and Attendants Handbook

Spina Bifida and Spinal Cord Injury

This defect or injury to the spinal cord results in a partial or complete paralysis below the injury. In Spina
Bifida, the spinal cord is incompletely formed or malformed, and occurs before birth. A spinal cord injury is
caused by trauma to the spinal cord, as from an accident. In both these conditions, the messages that are
generally sent from the brain to the muscles cannot get through, so the muscles below the injured areas
do not get the message to “move”. If some of the messages get through, there is partial paralysis, and if
none get through, there is total paralysis. When the muscles of the trunk and legs are involved, the student
is considered paraplegic. If the arms are also involved, the student is considered quadriplegic.

Symptoms include:
 Paralysis
 Bladder and bowel paralysis
 Partial or complete loss of skin sensation to pain, temperature, and touch in the area of paralysis
 Hydrocephalus which is an excessive accumulation of spinal fluid in the head, or enlargement of
the head. This may be seen in a student with Spina Bifida.
 Shunt; reduces pressure. It may be put into the head, go down behind the ear, through the neck
and drain into the abdomen.

Other health-impaired

A student who is “Other Health-Impaired” is one who has limited strength, vitality, or alertness due to
chronic or acute health problems. The health conditions can adversely affect the student’s educational
performance. These issues may include:

 Heart condition  Rheumatic fever
 Asthma  Tuberculosis
 Diabetes  Sickle Cell Anemia
 Seizure disorder/epilepsy  Tourette’s Syndrome
 Respiratory illness  Leukemia
 Allergies  Attention Deficit/Hyperactivity Disorder

School and transportation personnel need to be made aware of student health concerns, care of the
student while in their supervision, and how to respond to a crisis or distress situation. The school nurse,
and other health care providers, will share information and provide training for personnel on an as-needed
basis. The following information provides more details on the most common Health-Impaired students:

Tourette’s syndrome

This disorder is marked by many characteristics, but the ones that appear to cause the most concern on
the bus are cursing and foul language, facial and body tics, and obsessive/compulsive behaviors. Students
generally are normal in looks and intelligence, and the behaviors they display are often beyond their
control.

Page 89 of 149
Exceptional Student Education (ESE)