Other Health Impairment: conditions that often qualify
By the IEP Atlas editorial teamLast updated
Short answer
Other Health Impairment (OHI) covers health problems that limit a child's strength, energy or alertness at school. The federal rule names examples such as ADHD, asthma, diabetes, epilepsy, heart conditions, sickle cell anemia and Tourette syndrome. Other conditions can count too. The condition must hurt school performance, and your child must need special teaching because of it.
Other Health Impairment is one of the 13 disability categories in IDEA. It is the category for health conditions that wear down a child's strength, energy or attention, so that school gets harder.[1] Many families first hear the term when a child with ADHD is evaluated, but the category is much wider than ADHD.
Having one of these conditions does not by itself mean your child qualifies. The team still uses the two-part test explained in how IEP eligibility is decided.
What the law says, in plain words
The federal definition has three pieces:[1]
- Your child has limited strength, vitality or alertness. Vitality means energy. Alertness includes being too alert to sounds and sights around them, which is common with ADHD.
- It comes from a chronic or acute health problem. Chronic means long-lasting. Acute means sudden or short but serious.
- It adversely affects educational performance. It makes school harder in a way the team can see.
Conditions named in the federal rule
The rule lists these as examples. The list uses the words "such as," so it is not complete.
| Condition | How it can affect school |
|---|---|
| ADHD or ADD | Trouble starting work, staying on task and finishing tasks |
| Asthma | Missed days, fatigue, limits during PE or recess |
| Diabetes | Blood sugar swings that affect focus; time out for checks |
| Epilepsy | Seizures, recovery time, side effects of medicine, memory gaps |
| Heart condition | Low energy, limits on activity |
| Hemophilia | Missed days for treatment, care during physical activity |
| Lead poisoning | Problems with attention and learning |
| Leukemia | Long absences for treatment, fatigue, lowered immunity |
| Nephritis (kidney disease) | Fatigue, missed days for treatment |
| Rheumatic fever | Fatigue and joint pain |
| Sickle cell anemia | Pain episodes, fatigue, hospital stays |
| Tourette syndrome | Tics that interrupt work; attention and anxiety problems |
Other conditions teams often consider
Because the list is only examples, teams also look at other health problems when they limit strength, energy or alertness. Families and teams often raise conditions like these:
- Crohn's disease or other bowel disease
- Cystic fibrosis
- Cancer and its treatment, outside leukemia
- Chronic migraines
- Long-term fatigue after an illness
- Fetal alcohol spectrum disorder
- Serious food allergies with frequent reactions
Your state may list more examples or use a slightly different definition. Ask the team for your state's wording.
Annotated example: an OHI summary
Here is part of a made-up eligibility summary. Hold it next to your own paperwork.
- Condition and doctor's report. The school often asks for medical information. It helps, but the school decides eligibility, not the doctor.
- Limited strength, vitality or alertness. This should describe what happens at school, with how often and how long.
- Adverse effect. Look for numbers you can check: scores, absences, missed work.
- Need for specially designed instruction. This is the line that turns OHI into an IEP. If your child only needs nurse visits and snacks, a 504 plan or health plan may fit better.
When OHI leads to a 504 plan instead
Many children with health conditions do well with accommodations alone, such as breaks, water, rest, a nurse plan or extra time. In that case, the team may say an IEP is not needed and suggest a Section 504 plan.[2] The guide to medical accommodations at school lists common ones. For ADHD in particular, ADHD and IEPs under Other Health Impairment walks through the choice.
If your child does qualify, goals should match the needs the team found. The library of IEP goals for other health impairment shows examples, and each one is written as a measurable annual goal.
Questions to ask the team
You can say these word for word:
- "Which parts of my child's condition did you see affect school?"
- "How many days or minutes of learning has my child lost this year?"
- "Is OHI the best fit, or did you look at other categories too?"
- "Does my child need special teaching, or would accommodations be enough?"
- "Who will write the health plan, and how does it connect to the IEP?"
- "What happens to my child's work during long absences?"
- "Can the school nurse come to the meeting?"
What to do next
- Gather medical records that describe how the condition affects energy, focus and attendance. Ask the doctor to describe effects, not only the diagnosis.
- Track school days lost. Note absences, nurse visits and early pickups for a few weeks.
- Ask for an evaluation in writing if one has not started. The sample request letter can be changed to describe a health condition.
- Plan for reevaluation. Health conditions change. A reevaluation can update the plan when treatment changes.
- Call your Parent Training and Information Center for free help in your state.[3]
The full process is in the IEP evaluation process.
Frequently asked questions
Is anxiety an Other Health Impairment?
It depends on the state and the child. Anxiety is not on the federal list of examples. Some teams consider it under OHI, and others look at emotional disturbance. The team should explain which category fits the evaluation results and why.
Does my child need a doctor's diagnosis to qualify under OHI?
Many states and districts ask for medical information to confirm the health condition. The school team still decides eligibility using its own evaluation and the two-part test.
Can a child qualify under OHI and another category?
Yes. A team can name a main category and list a second one. Either way, the IEP must cover all of your child's needs, not only those tied to the main category.
Use it in IEP Atlas
- IEP goals for other health impairment
- Other health impairment in the IEP glossary
- Measurable annual goal in the IEP glossary
- Section 504 in the IEP glossary
Related guides
- The IEP evaluation process: from referral to eligibility
- How IEP eligibility is decided: disability plus need
- ADHD and IEPs: qualifying under Other Health Impairment
- Primary vs secondary disability category
- How to request a special education evaluation in writing (sample letter)
- Triennial reevaluation: new testing vs record review
- Speech or language impairment eligibility, area by area
Sources
- 34 CFR §300.8: Child with a disability, Legal Information Institute, Cornell Law School
- Parent and Educator Resource Guide to Section 504 in Public Elementary and Secondary Schools (2016), U.S. Department of Education, Office for Civil Rights
- Center for Parent Information and Resources, CPIR
Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.