Visual Impairment (VI) and Hearing Impairment (HI) in childhood include sight and hearing difficulties and sometimes a combination of both (known as multi-sensory impairments).
Visual impairment
Most children with VI attend their local school with specialist support from a local authority service; some go to a mainstream school that is specifically designated for blind and partially sighted pupils; others go to a special school for blind pupils.
Those with VI and additional or complex needs will probably attend a special school.
Wherever pupils with VI are educated, it is essential to provide a range of educational and social opportunities to enable them to participate on an equal basis with their fully sighted peers. Some will need minimal adaptations; others may have substantial needs.
Choosing a school for a child with Visual Impairment
When considering what’s best for your own child, look for a school that’s inclusive, positive and welcoming to all children, especially those with diverse or special needs.
Ideally seek a school where:
- Parental support and input are welcomed and the school and all staff are keen to work as a team. A good school will listen to your child and take account of their wishes.
- Teachers and those who will be working with your child have the training and support necessary to help them in their work with VI. The best schools will ensure training is ongoing.
- The teacher is organised and plans work so that your child can follow the curriculum fully and isn't disadvantaged. This may include using a range of strategies and approaches and adapting materials in advance for use in class.
- Responsibility for your child’s learning rests with the teacher and not with support assistants. Additional support and the ways in which it is to be supplied should be clearly defined and shared with all concerned.
- Independence is encouraged and mechanisms are in place to ensure your child doesn't become overly dependent on one particular adult helper.
How schools can help
- Collaborative working with a Qualified Teacher of Visual Impairment (QTVI).
- Use of Braille.
- Assistive technology eg touch-typing, Text-to-speech screen reading technology, Magnification aids.
- Encouraging the child to wear glasses, and use their cane if they have them.
- Seating and grouping – this may apply particularly when a pupil is using additional technology, to ensure they are not separated from their peers.
- Using all pupils’ names and giving more verbal feedback to compensate for difficulty in seeing body language.
- Backing up visual information with verbal instructions or descriptions (eg reading out loud what is being written on the board).
- Providing the pupil with his or her own copy of information.
- Ensuring that resources are well organised with a consistent layout and clear routes, so that the pupil has independent access.
- Making sure that there is good lighting in work areas, with no glare. However, where pupils are photophobic (sensitive to light), they may be more comfortable in a shaded area of the room.
- Ensuring resources are carefully chosen with contrast, size and information through touch in mind.
- Using matt paper; shiny may cause glare.
- Giving short tasks rather than long ones as VI pupils tire more easily.
- Giving extra time to complete work.
Hearing Impairment
Hearing loss in childhood may be genetic in origin or acquired. It is either sensorineural (of the inner ear and nerves) or conductive (outer ear). Sensorineural deafness is permanent, whereas conductive loss can fluctuate with conditions like glue ear. It is possible for a child to have a mix of both. If one ear is affected, it is called unilateral or one-sided hearing loss; if both ears, it is known as bi-lateral. For educational purposes, pupils are regarded as having a hearing impairment if they require hearing aids/adaptations to their environment and/or particular teaching strategies in order to follow the curriculum.
Children with a hearing impairment range from those with a mild hearing loss to those who are profoundly deaf. Very few children have no useful hearing. Some pass the hearing screen tests in school but are subsequently labelled lazy or disruptive because mild hearing loss has gone undetected. Deafness alone is not defined as a special educational need; approximately 40 per cent of deaf children in UK are not formally recognised as SEN, however, deafness is common in other conditions and syndromes eg Down’s Syndrome. Those with a significant loss may communicate through sign language such as British Sign Language (BSL) instead of, or as well as, speech.
It isn't always easy to spot a child with a hearing impairment but indicators include:
- withdrawn behaviour or a change in behaviour
- limited attention span
- mishearing and mispronouncing words
- not responding when called
- slowness of responses, especially with background noise;
- breathing through the mouth
- irritability and frustration
- delayed speech and language development
Choosing a school for a child with a hearing impairment
Some pupils may prefer to be placed in a school with a specialist HI unit attached and specialist teachers, or in a specialist school for the deaf. These offer a range of services such as speech and language therapy, or specialist equipment such as group hearing aids. Some local authorities will have a team of Teachers of the Deaf who visit mainstream settings.
There is a hotly disputed divide between those who believe that deaf children can be taught to speak using auditory-oral approaches (assisted by hearing aids, Cochlear implants, radio aids etc) and be integrated into mainstream society, and those who believe they should be taught through sign language. What suits your child best may depend on the method of communication in the home, the degree of hearing loss and how their peers relate to them.
How schools can help
- Sitting near to the teacher.
- Keeping background noise to a minimum.
- Use of small group teaching or individual tuition.
- Quiet areas for teaching.
- Limiting the time spent having to listen to the teacher.
- Enusring the teacher's face is always clearly visible.
- Maximising communication via visual aids.
- Writing key words on the board and providing notes for reference.
- Creating an acoustically treated environment.
- Letting other pupils repeat instructions.
Multi-Sensory impairments (MSI)
Children with multi-sensory impairment have both visual and hearing difficulties and are sometimes referred to as deaf-blind. Many have additional disabilities or medical conditions, and most will attend special schools.
Because they cannot learn by seeing or hearing and cannot use one sense to compensate for lack of the other, their experience is limited to the here and now. They need substantial extra help to learn and form relationships. They need approaches that make use of what sight and hearing they do have, as well as their other senses, such as touch.
But with the right support they can learn to make use of the senses they do possess and develop the confidence to form relationships, be curious and interested in the world around them.