Let’s Talk About: Other Health Impairment (OHI) Eligibility

The Other Health Impairment (OHI) eligibility is a catch-all for students who do not fit in one of the eleven other categories (Autism spectrum disorder, Deafblind, Deaf/hard of hearing, Emotional and behavioral disorder, Intellectual disability, Orthopedic impairment, Significant developmental delay, Specific learning disability, Speech-language impairment, Traumatic brain injury, or Visual impairment), but have an impairment adversely affecting their educational performance. 

Defined by the IDEA in section 34 C.F.R § 300.8(c)(9), OHI is defined as having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness for the educational environment that (1.) is due to chronic or acute health problems, (2) adversely affects a child’s educational performance. Some of the diagnoses that can fall into this category are asthma, ADHD, diabetes, epilepsy, heart conditions, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette Syndrome. 

I like the terminology “heightened alertness to environmental stimuli that results in limited alertness to the educational environment.” Do you know why? It allows us to have conditions not in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) included for eligibility consideration. Conditions such as Sensory Processing Disorder (SPD) and Executive Function Disorder are not diagnoses in the DSM. The International Classification of Disease (ICD), produced by the World Health Organization (WHO), does include “Impaired Executive Function” but does not recognize SPD either.  If you are unfamiliar, the DSM is used in the US and Canada; the ICD is global.  They both provide standards for diagnostic classifications. Anyway, as an advocate, I can easily make a case for a child who has a Sensory Processing Disorder to be eligible under the OHI category because of the wording in the definition. 

Once again, please remember a student may have one of the diagnoses listed above; however, if that impairment does not negatively impact their education, they will not be eligible for Special Education services. 

The evaluation for eligibility under OHI includes 

1. A current (within one year) medical evaluation from a licensed medical doctor or licensed clinical psychologist. The report from the doctor must indicate the diagnosis and prognosis of the child’s impairment. Also, medications, surgeries, special health care procedures, and special diet or activity restrictions should be included. 

2. A comprehensive educational assessment indicating the adverse effects of the health impairment on the student’s educational performance. The assessment report should document any deficits in pre-academic or academic functioning, adaptive behavior, social/emotional development, motor development, or communication skills resulting from the child’s impairment. 

There are some exclusionary factors, too. If a lack of appropriate instruction in reading, math, and writing, limited English proficiency, visual, hearing, or motor disabilities, intellectual disabilities, emotional disturbances, cultural factors, environmental or economic disadvantage, or an atypical educational history are the “determinate” factors, the child cannot be eligible as OHI. 

Any appropriately certified teacher in any educational program can serve a child eligible for OHI. The team should determine the appropriate setting and service delivery model for the individual student.