Module 9 – Understanding Sensory Impairments and Physical Disabilities
Estimated Time: 60 minutes
Student Aims:
· To learn about different physical disabilities
· To learn about different sensory impairments
· To identify learning difficulties/sensory impairments
· To understand how educators can support disabilities and impairments
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9.1 Introduction
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Physical disabilities and sensory impairments are complex areas that affect each individual in different ways.
The reality is that every pupil is different. No two disabilities are the same, even if they happen to fit under the same heading. Visually impaired children suffer varying degrees of sight loss; children who are hard of hearing will have varying degrees of hearing loss; and physical disabilities, whether from birth, accident or disease, all manifest in many different ways.
Even still, children cope with their disabilities in different ways, which further complicates the possibility of generalisations. For the most part, educators are not fully involved in diagnosing these disabilities. Often, children with serious impairments will enter the classroom with a diagnosis. However, this does not mean that educators should not have a full understanding of what it means to have a disability. Without this understanding, it is almost impossible to assess and support the pupil’s progress regardless of what level they are at.
In this module, you will learn more about two specific types of disabilities: sensory impairments and physical disabilities. You will understand who is included in these groups and what your role is in identifying, assessing and supporting these groups.
Throughout this module, take time to compare and contrast not just the identifying factors of each disability but what kind of support each pupil needs. Identifying similarities and differences will help you build a solid foundation in caring for and supporting pupils in the classroom.
9.2 What Are Physical Disabilities and Sensory Impairments?
The spectrum of physical, sensory and multi-sensory difficulties is wide.
In terms of sensory difficulties, this can range from permanent and profound hearing loss or severely sight impaired to less severe levels or temporary sensory losses.
For school purposes, children with a vision impairment or sight loss may need adaptation to their environment or learning materials.
Pupils with hearing loss may also need sign language provision.
Physical needs may be the result of metabolic, neurological, or physical causes. Physical causes may only require that the pupil has access to certain facilities and equipment. Other pupils will also have social or learning needs.
Some children will have multi-sensory difficulties that may be associated with physical difficulties. This can prevent some children from having full access to the regular school routine.
9.3 Managing Disabilities and Impairments in The Classroom
Managing disabilities and impairments in pupils does not lie squarely on the shoulders of parents or teachers.
Ensuring that children with disabilities get full access to the classroom is the responsibility of a number of professionals who must work closely together. These include specialist teachers, audiologists, optometrists, GPs, school medical officers, school nurses, social workers, psychologists, speech and language therapists, occupational therapists and advisory staff.
9.4 When Are Children Identified?
Many children with physical disabilities or sensory impairments are often identified early.
The identification often comes from the child’s doctor within the first few years of life. Educational adjustments are made in schools beginning from their first years. However, not all children can be identified this early.
Some disabilities are the result of an illness or accident and are identified later in life. The educator’s role in identifying disabilities or assessing how disabilities are changing will be outlined later.
9.5 Different Types of Sensory Impairments and Physical Disabilities
There are several types of sensory impairments and physical disabilities.
It is important to remember that similar disabilities may not be the same in one pupil as they are in another pupil because they might feature different causes or progressions.
Sensory Impairments
Sensory impairments generally fit within three primary categories: hearing loss, visual impairments, and multi-sensory impairments.
Hearing Loss
There are different levels of hearing loss from mild hearing loss (21-40 decibels) to profound hearing loss (95 decibels or more).
A child has a hearing impairment by SEN standards anytime they use hearing aids or require adaptation to their learning environment or curriculum.
Remember that some children are born deaf or hard of hearing while others may become deaf or hard of hearing because of illness or injury.
According to the National Deaf Children’s Society, there are two main types of hearing loss:
· Sensorineural deafness, or nerve deafness: this is hearing loss in the inner ear. This usually means that the cochlea isn’t working effectively. Sensorineural deafness is permanent.
· Conductive deafness: this means that sound can’t pass efficiently through the outer and middle ear into the inner ear. This is often caused by blockages such as wax in the outer ear. Conductive deafness is usually temporary, but it can be permanent in some cases.
Visual Impairments
Pupils with visual impairments include children who are sight impaired (“partially sighted”) and children who are severely sight impaired (“blind”).
It is important to note that pupils who wear glasses to fully correct their vision are not included in this category.
Some children are born severely sight impaired. Others have progressive vision loss, which means their vision will be regularly assessed.
It is also important to note that vision loss can occur because of illness or injury.
Multi-Sensory Impairments
Pupils who have a combination of hearing and vision difficulties are said to have a multi-sensory impairment. Pupils at the far end of the spectrum are deafblind; however, many have some residual hearing or sight.
Depending on the extent of the multi-sensory impairment, it may be difficult to support the pupil in the classroom. Being impaired in both sight and hearing can potentially eliminate several areas of adaptation compared to pupils who have one fully functional sense.
These pupils are also more likely to have additional disabilities. It is also often difficult to get a clear idea of the pupil’s intellectual abilities.
Physical Disabilities
There is a wide range of physical disabilities that can place a pupil on the SEN register. However, some physical disabilities do not affect a pupil’s ability to learn in the mainstream classroom, while others may cause severe disruption to their learning abilities in school.
Physical disabilities include:
· Cerebral palsy
· Spina bifida and hydrocephalus
· Muscular dystrophy
· Significant accidental injury – pupils who have been in an accident and sustained long-term injuries fall into this category of physical disability. In some cases, pupils who have a brain injury due to an accident can be included in this category.
Other – a pupil who has any other type of physical disability not previously mentioned can be included in this category as long as the disability is a barrier to learning.
Fact
It is estimated that there are over 23,000 children and young people (0-19 years) in the UK who are deafblind
Source: sense.org.uk (2022)
9.6 Supporting Pupils with Impairments and Disabilities
Supporting Hearing Impairments
Educators play an important role in observing the development of children, and this is especially important in children whose hearing impairments are either undiagnosed or getting worse.
Educators can look out for some of the most common signs of hearing loss:
· Delayed speech development
· Focusing on a speaker’s face and lips
· Failing to respond when someone calls their name
· Watching other children to imitate them even after verbal instructions
· Speaking at an inappropriate volume, either too loudly or too softly
Hearing loss can also impact children’s development in other ways. They will often have difficulties with social interaction and communication. Diagnosed pupils might use speech, sign language or a combination of both. However, helping children feel confident in social situations is important to prevent them from becoming withdrawn or attached to adults rather than their peers.
To support these children, it is essential to work alongside the child’s parents. It is impossible to assume or diagnose hearing loss on your own, and their parents will have a better idea of regular activity. Also, parents offer a lot of essential information about the best ways to communicate effectively with the child.
Everyone can support pupils with hearing impairments by including visual cues when using verbal language. You should also make sure that the child can see your face before you speak to them and be sure to have their attention when you talk to them. You should also check in with the child to make sure that they understood what you said, repeating yourself when necessary.
It is also helpful to monitor the noise levels in the environment, particularly if the child has a hearing aid. Hearing aids don’t just amplify voices but every sound in the room.
Supporting Vision Impairments
Children with significant visual impairments that cannot be corrected with glasses will often arrive at school already diagnosed. However, educators still play a role in monitoring their development by regularly assessing the functionality of the child’s vision.
Good indicators of the functionality of a child’s vision include:
· Obvious sensitivity to light
· Covers one eye when attempting tasks
· Trips frequently or runs into things
· Holds books and papers close to their face to read them
· Tilts and turns their head when focusing
Children who have sight impairments can be at a disadvantage when communicating because many of the important parts of communication are nonverbal. Thus, children with vision impairments may struggle to make out facial expressions to infer meaning or read reactions.
Taking turns in conversation can also be difficult because non-verbal cues are often the indicators used to show that the speaker has finished speaking.
Sight impairments can also limit mobility which is problematic throughout the child’s development. For young children, their sight motivates them to move. Seeing objects will encourage the child to reach, grab, crawl and walk. Children who can’t see the toy or an object of desire aren’t motivated to be mobile.
Playing is also negatively impacted by limited sight because children are unable to visually observe their peers at play. When they can’t observe, their own play skills can often be limited.
Finally, independence is an issue in young children with sight impairments. The ability to help themselves is diminished and delayed until later years.
Educators can support the child by building a relationship with the child’s parents and the relevant specialists. However, there are plenty of things that can be done in the classroom to help support a vision-impaired child’s development.
When making wall displays, educators can create clear designs that are not cluttered. Making them colourful also helps partially sighted children distinguish between the different elements on the board.
Toys are helpful when there is a clear colour contrast between them. Books that have simple illustrations and large prints are also useful for children. Allow the child more time to explore new activities and toys so they can use their tactile senses to become familiar with them.
Keep play in a familiar and secure place, especially for young children. Then, they can familiarise themselves with the space to have more independence and play more freely.
For example, if a toy rolls away, they can explore on their own without hesitancy on the part of the child or the educator. However, you should encourage children to do this in new areas as well.
Classroom activities that encourage the use of multiple senses, not just sight, are also useful for a child’s development. Listening to people and noises, and touching toys and objects, should be encouraged in children with partial sight.
When speaking to the child, say their name before giving them instructions. This will get their attention and let them know that the instructions are directed at them. They might miss this if they can’t see you looking at them or gesturing towards them. You can also enable them by not just giving them instructions but describing the things you need them to do. It is also helpful to describe what you or their peers are doing. It is important, however, not to overload children’s working memory with too many instructions at one time.
Social skills can be difficult for children with visual impairments. You can encourage the child to connect with their peers, but you can also encourage the other children to connect with the child to make sure the pupil is integrated into the classroom’s social circles.
Supporting Physical Disabilities
There are many physical disabilities that you may need to support in the classroom. Some students might have a loss of mobility or partial loss of mobility or even an unsteady gait. They may require alternative means of mobility. They may also have poor oral motor control.
Many pupils with physical disabilities will sometimes have additional disabilities. They might have sensory impairments, cognitive delay or learning disabilities. Thus, a pupil may enter the classroom having been fully diagnosed with a condition or disability; however, educators can support pupils by looking out for these learning disabilities and supporting them in addition to the physical ones.
Compensating for a physical disability is often subject to several factors including age, abilities, cognitive status and the present and future needs of the pupil. Supporting the physical disability itself will also require the support of a transdisciplinary team including a physical or occupational therapist. Parents should also be involved every step of the way because they are most familiar with the ins and outs of their child’s care.
Educators can support the pupils by seating and positioning the pupil in the best place for them to function. In fact, not doing this can further impair their performance in the classroom. Depending on the disability, the best position is generally a seated position where their trunk is supported and their head is kept in the midline without compromising their freedom of movement. Their hips should be bent at 90 degrees so that their legs are supported for maximum comfort.
Pupils who cannot achieve this position on their own can be supported with various aids like custom seating systems, foot boxes, or other accessories that can accompany wheelchairs. Slab boards and custom slanted desks can also be used to help turn wheelchairs into a school desk environment that is suitable for learning and concentrating in a manner that supports the pupil physically.
You will also need to support the pupil’s living and leisure activities. These can be managed with low-end technology. Most schools will already include typical bathroom equipment as well as devices in changing rooms. The school should also have equipment to help those with oral motor difficulties eat in a manner that is safe, independent and socially acceptable. These include special plates, utensils and cups that help encourage independence and social eating.
Pupils should also be encouraged to have computer access.
Computers offer many valuable opportunities for all pupils. Employing the use of specialist software and assistive technology can help make computers more accessible to pupils with physical disabilities. Special devices like touch screens can also improve motor control for pupils who are unable to control a mouse. Scanning buttons and eye gaze technology can also be used for children unable to use their hands.
Finally, traditional software, like Microsoft software packages, will often have an accessibility feature that can be turned on for pupils. Voice recognition can also be a useful tool for computer time.
Educators also need to support the pupil’s ability to participate in class and their ability to communicate. Teachers may find that positioning themselves at the pupil’s eye level will help them communicate with pupils in a meaningful way that makes them feel supported by the teacher.
In turn, the teacher should encourage the pupil to communicate by regularly asking them questions or calling on them to share just as they do other pupils. However, it may be more appropriate to assess some children’s knowledge in different ways, ensuring that all children have access to the curriculum. Differentiation is key here. It may not be appropriate to assess the understanding of a student who is hard of hearing in exactly the same way as a hearing student if the student does not have the same access to speech.
Accommodations will include helping the pupil feel accepted in the classroom and by their peers. Encouraging inclusion as much as possible helps this happen, regardless of the pupil’s level of disability. Educators can provide support for peer group interaction and understanding on both sides. If necessary, teaching social skills for both sides may sometimes be required.
Adjustments need to be made for higher levels of fatigue. Pupils with disabilities may find that they become physically or mentally tired faster than other pupils. Making sure that the pace is adapted, or timelines are adjusted, can help them accomplish tasks without doing too much or too little.
For example, if a pupil understands a concept, assigning them extra work anyway, may actually be detrimental to their learning experience.
It is essential to give students time to process information before going on to another topic, and this is true of most learning difficulties and disabilities as well as for mainstream students. Rather, emphasis should be placed on creating time for re-teaching when required so that instruction can move at the correct pace for the pupil.
There may also be different methods of evaluating the pupil compared to their peers. These methods should work to compensate for any physical limitations they face.
There is also a further focus on the classroom environment. Keeping the whole classroom environment as accessible and safe as possible is the duty of the school. This includes using appropriate adaptive technology and equipment. However, there are small things that can change hour-by-hour that must be recognised and addressed as necessary. Even small changes can negatively impact a disabled pupil’s access and they are not always easy to see until they’ve already put the pupil at a disadvantage.
For example, clear yellow marking on steps should be provided throughout the school, as well as solid railings for children to walk up/down steps. On a rainy day, mobility issues may be more problematic, and this must be taken into account.
Pupils with physical disabilities also need support when attending school-related activities. Before taking field trips, educators need to ensure that the environment will be suitable for all pupils. All institutions should have their own policy for off-site trips; the protocol for risk assessing should be included within this policy.
Assignment
Understanding Sensory Impairments and Physical Disabilities
Time: 30+ minutes
This module has covered aspects that will be essential in any role as a special educational needs professional. Work through the following worksheet to find out exactly how much you have taken in.
Download the worksheet below and complete
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Conclusion
It is the duty of the school to support pupils with physical disabilities and sensory impairments. Doing so takes extra time and care; however, with the right policies and equipment in place, it can be achieved, and even pupils with severe disabilities can be supported in mainstream classrooms.
In Module 10, we discuss difficulties in cognition and learning
WELL DONE!
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