Some students have serious physical, medical, or sensory challenges that interfere with their learning. Usually, the physical and medical challenges are medical conditions or diseases that require ongoing medical care. The sensory challenges are usually a loss either in hearing or in vision, or more rarely in both.
Whatever the specific problem is, it is serious enough to interfere with activities in regular classroom programs and to qualify the student for special educational services or programs.
A child can acquire a hearing loss for a variety of reasons, ranging from disease early in childhood, to difficulties during childbirth, to reactions to toxic drugs. In the classroom, however, the cause of the loss is virtually irrelevant because it makes little difference in how to accommodate a student’s educational needs.
More important than the cause of the loss is its extent. Students with only mild or moderate loss of hearing are sometimes called hearing impaired or hard of hearing; only those with nearly complete loss are called deaf. As with other sorts of disabilities, the milder the hearing loss, the more likely it is that the student is in a regular classroom, at least for part of the day.
Signs of hearing loss
Although determining whether a student has a hearing loss may seem straightforward, the assessment is often not clear cut if it takes the student’s daily experiences into account.
A serious or profound hearing loss tends to be noticed relatively quickly and therefore can often receive special help sooner.
Mild or moderate hearing loss is much more common and is more likely to be overlooked or mistaken for some other sort of learning problem (Sherer, 2004).
• Students with a mild hearing loss sometimes have somewhat depressed (or lowered) language and literacy skills but so do some students without any loss.
• Students with a mild hearing loss may seem not to listen or attend to a speaker because of trouble in locating the source of sounds, but then again, sometimes students without loss also fail to listen.
• Students with hearing loss may frequently give incorrect answers to questions, but so do certain other students with normal hearing.
In addition, partial hearing loss can be hidden if the student teaches himself or herself to lip read or is careful in choosing which questions to answer in a class discussion.
Systematic hearing tests given by medical or hearing specialists can resolve some of these ambiguities. But even they can give a misleading impression, since students’ true ability to manage in class depends on how well they combine cues and information from the entire context of classroom life.
In identifying a student who may have a hearing loss, therefore, teachers need to observe the student over an extended period of time and in as many situations as possible.
In particular, a teacher must look for a persistent combination of some of the following behaviours over repeated or numerous occasions (Luckner & Carter, 2001):
• Delayed language or literacy skills, both written and oral
• Some ability (usually partial) to read lips
• Less worldly knowledge than usual because of lack of involvement with oral dialogue and/or delayed literacy
• Tendency to social isolation because of awkwardness in communication
Students with visual impairments have difficulty seeing even with corrective lenses. Most commonly the
difficulty has to do with refraction (the ability to focus), but some students may also experience a limited field of view (called tunnel vision) or be overly sensitive to light in general. As with hearing loss, labels for visual impairment depend somewhat on the extent and nature of the problem.
Legal blindness means that the person has significant tunnel vision or else visual acuity (sharpness of vision) of 20/200 or less, which means that he or she must be 20 feet away from an object that a person with normal eyesight can see at 200 feet. Low vision means that a person has some vision usable for reading, but often needs a special optical device such as a magnifying lens for doing so. As with hearing loss, the milder the impairment, the more likely that a student with a vision problem will spend some or even all the time in a regular class.
Signs of visual impairment
Students with visual impairments often show some of the same signs as students with simple, common nearsightedness.
These students may:
• Rub their eyes a lot
• Blink more than usual
• Hold books very close to read them
• Complain of itchiness in their eyes
• Complain of headaches, dizziness, or even nausea after doing a lot of close eye work
The difference between the students with visual impairment and those with ‘ordinary’ nearsightedness is primarily a matter of degree: the ones with impairment show the signs more often and more obviously. If the impairment is serious enough or has roots in certain physical conditions or disease, they may also have additional symptoms, such as crossed eyes or swollen eyelids.
As with hearing loss, the milder forms ironically can be the most subtle to observe and therefore the most prone to being overlooked at first. For classroom teachers, the best strategy may be to keep track of a student whose physical signs happen in combination with learning difficulties and for whom the combination persists for many weeks.