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Muscular Dystrophy

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With Duchenne muscular dystrophy, individuals experience a decline in dexterity and gross motor skills as the condition progresses. As muscles atrophy, compensation for lack of strength and dexterity may include modified handles or grips and adapted utensils and the use of a motorized wheelchair. (Heller, Forney, Alberto, Best, & Schwartzman, 2009.) The individual and instructor will work with the special education team and therapists for compensatory positioning that allows access to various classroom materials and accessibility within the classroom. Compensatory positioning may include assisting the student with positioning within the wheelchair, classroom arrangement that allows wheelchair access, the use of wheelchair accessible desks, and the position of the wheelchair accessible desk within the classroom as the student may need to have a unobstructed view of the board at all times due to an inability to reposition his or her own body. (Heller, et. al., 2009.)
Adapted physical education and range of motion exercises can assist the student with preventing contractures, when the muscles deteriorates joints may become fixed, which limits mobility. (Muscular Dystrophy Association, n.d.) The student should only exercise as recommended by a physician and not exercise to the point of exhaustion because this may harm muscle tissues. (Muscular Dystrophy Association, n.d.) The student may also attend physical and occupational therapy regularly to assist with keeping the body ambulatory which may slow the progression of the disease by keeping the body flexible, mobile, and assisting with standing. ("A Teacher's Guide to Neuromuscular Disease", n.d.) Physical and occupational therapy may also help instructors learn how to transfer students with limited mobility. ("A Teacher's Guide to Neuromuscular Disease", n.d.)
An AT Analysis of Task and Student Performance will assist the team with determining the appropriate assistive technology for the student based on the task requirements and the performance of the student when completing the tasks. (Heller, et. al., 2009) The student fatigues quickly so the use of a power wheelchair is necessary to assist with mobility and other assistive equipment such as the use of modified handles or grips on writing and eating utensils may be implemented to allow for more independence. Adaptive calculators and keyboards with larger buttons may also be necessary to compensate for the decrease in dexterity. (Muscular Dystrophy Association, n.d.) Other assistive technology may include the use of communication devices as the student is easily fatigued and a paraprofessional to assist with note taking and using the restroom as the student may not have the muscle strength or endurance to use the facilities independently. ("A Teacher's Guide to Neuromuscular Disease", n.d.)

References
Heller, K. W., Forney, P. E., Alberto, P. A., Best, S. J., & Schwartzman, M. N. (2009). Understanding physical, health, and multiple disabilities.
Muscular Dystrophy Association (n.d.). Medical Management | Duchenne Muscular Dystrophy | MDA. Retrieved May 31, 2014, from http://mda.org/disease/duchenne-muscular-dystrophy/medical-management A Teacher's Guide to Neuromuscular Disease. (n.d.) Retrieved May 31, 2014, from http://mda.org/sites/default/files/publications/Teachers_Guide_NMD_P-225.pdf

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