Multiple disabilities is when a child has two or more disabling conditions. In most school districts speech-language impairment is considered a secondary disabling condition rather than as part of multiple disabilities.

Orthopedic Impairments are impairments where there is a physical limitation due to a medical condition. As with all disabilities, there must be an educational impact.

I haven't worked with many students with orthopedic impairments since my internship nearly 15 years ago. However, there was one student who I was glad to have had the opportunity to interact with that this post brings to mind. My understanding was that she went through school with an orthopedic impairment and due to her physical limitations, she had always received additional educational support in one of the most structured classrooms and with limited interaction with typically developing peers. However, I noticed that she had some capabilities that seemed to be more proficient than other students in the class she was in. Through luck, circumstance, and her hard work, we found that her intellectual and academic ability were significantly higher than previously determined. She graduated with a high school diploma.

That was one instance that reinforced the idea that just because people look different, it doesn't mean that their brains work differently than ours. Sometimes we get caught up by the appearance of a person in a wheelchair or a person who needs to use assistive devices and we don't realize that that limitation does not necessarily preclude them from being able to do things similarly to us.

Other health impairments are medical limitations which cause a student to demonstrate difficulty with their education. This can be many different medical impairments, although there are a few common ones. Attention- deficit/hyperactivity disorder (ADHD) is probably the most common by far.

As with all disabling conditions, just because somebody has been diagnosed with a disability does not mean that they will necessarily be eligible to receive services. Prong two of the eligibility requirements says that the disabling condition must have an adverse impact on a student's educational performance. If a student has ADHD but doesn't require additional instruction in order to demonstrate success in the general education classroom, then that student may not be eligible for additional educational supports.

Although ADHD is the most common other health impairment, any other medical condition which has an adverse impact on a student's education may be a disabling condition. I have worked with students who have had such significant difficulties with their diabetes management that they require additional educational supports. 

One thing I've found as I work with parents of individuals with special needs is that often I'm not telling people something they don't already know. Often they don't have a name for the difficulty they are seeking information about, but they know that the problem is there.

Intellectual disabilities is an area where that is apparent, as are specific learning disabilities. 

Individuals with intellectual disabilities demonstrate difficulties across a variety of domains, often including all academic areas as well as adaptive behavior delays. These individuals have low intelligence scores and demonstrate difficulties with self-care, communication, and socialization.

As I stated above, most parents of students with these needs are aware that their children are struggling with these concerns. Sometimes it is a bit of a relief for parents to learn that there is a name for this difficulty even though it can be difficult for parents to accept the lifelong consequences of a diagnosis like this. Unfortunately, many individuals with these concerns will struggle to continue throughout their life.

Helen Keller was an example of a person who had deaf-blindness. Deaf-blindness is when a person has both a visual impairment and is deaf or hard of hearing.

Since this is a short post, I figured I would include a second topic that probably deserves its own post, but can at least be introduced here. Individuals within the disability advocacy community highlight the importance of person first language. While this can feel a little clunky as we are speaking or writing, it is the most appropriate language to use when talking about individuals with special needs. Person first language is the way that I have been talking about individuals with special needs throughout these posts, including in the past two sentences. The difference is that we wouldn't call somebody a flu person. We would say that person has the flu. The same is true for individuals with special needs. The person has autism or other special needs. The disease does not define the person.

While this often requires some rethinking about the language we use, it becomes easier to use the more often one does use it.

Visual Impairment is another disabling condition which is more medically based. The criteria are:

• The visual acuity with correction is 20/70 or worse in the better eye; or
  
• The visual acuity is better than 20/70 with correction in the better eye, and there is documentation of either of the following conditions: a diagnosed progressive loss of vision or a visual field of 40 degrees or less;
  
• The visual acuity is unable to be determined by a licensed optometrist or ophthalmologist, and the existence of functional vision loss is supported by functional vision assessment findings; or
  
• There is evidence of cortical visual impairment, and
  
• The student’s visual impairment adversely affects his or her educational and functional performance. The adverse effects of the visual impairment on the child’s educational performance require specialized instruction and related services.

A few major types of visual impairments that I have worked with in the past include individuals with nystagmus and optic nerve detachment. These individuals often come to the school with a diagnosis from an eye doctor so the involvement of a school psychologist in an evaluation role is somewhat limited.

As I begin the listing of special education categories in South Carolina, you may have noticed that I skipped over Autism. Since Autism is a hot topic in much of the country, I figured I would address it near the end while I go through some of the less controversial and/or more medically based eligibility categories. 

In South Carolina, deaf and hard of hearing is a category of disability that is primarily driven from an audiological report, conducted by a licensed audiologist. South Carolina's criteria are as follows:

• The student has a hearing loss that is 20 dB or greater at any one frequency, either unilaterally or bilaterally, or
  
• The student has a fluctuating hearing loss, either unilaterally or bilaterally. AND
  
• The student’s hearing impairment adversely affects his or her educational performance. 

One thing to note as we go through these eligibility categories is that the last criteria will be present in each category. There could be a student who has significant hearing loss but is able to compensate for this loss and does not require additional educational supports in order to demonstrate success in the general education environment. 

Over the next few days, I will be reviewing the thirteen different categories of disability. I will leave specific learning disability until the end because there are 8 different areas of eligibility under that one category alone. Today, I'll list the categories and over the next few days, I'll discuss each with some level of detail. 

The 13 different categories of disability are:

• Autism
  
• Deaf and Hard of Hearing
  
• Deaf-blindness
  
• Developmental Delay
  
• Emotional Disabilities
  
• Intellectual Disabilities
  
• Multiple Disabilities
  
• Orthopedic Impairment
  
• Other Health Impairment
  
• Specific Learning Disability
  
• Speech-Language Impairment
  
• Traumatic Brain Injury
  
• Visual Impairment
  

The above categories are based on the South Carolina eligibility document as my practice is dedicated to South Carolina. There are some small differences from state to state, although South Carolina basically mirrored the federal guidelines, so there are significant similarities from state to state.