An orthopedic impairment that adversely affects a child’s educational performance: includes impairments caused by congenital anomaly (e.g. clubfoot, absence of some boy parts (hands, etc), impairment caused by disease (e.g. bone tuberculosis, poliomyelitis, etc.) and impairments from other causes (e.g. cerebral palsy, amputations and fractures or burns that cause contractures. Services are provided as itinerant resource or as a class program depending on the individualized needs of the student. Services are usually provided in conjunction with occupational therapy and physical handicapped.