MODULE 7 Learners with Additional Needs

Learners with Difficulty Hearing

INTRODUCTION
Individuals with hearing impairment are either deaf or hard of hearing.
Students who are deaf do not have sufficient residual hearing to understand
speech without special instruction and training. On the other hand, students
who are hard of hearing have enough residual hearing to understand speech
and learn in regular class without much difficulty.
Such hearing impairment is not simply an inability to hear or to communicate
through speech. The most destructive effect of deafness is the deprivation of
language. A hearing person acquires the complex linguistic system of his/her
culture as part of normal growth and development in a spontaneous effortless
and natural manner. Deafness on the other hand, deprives the person of the
normal use of the hearing mechanism. He or she does not acquire the listening
skills that provide the base for the development of speaking, reading, writing
and other communication competencies.

A. Abstraction
Hearing Impairment
Hearing impairment or disability refers to the reduced function or loss of the
normal function of the hearing mechanism. The impairment or disability limits the
person’s sensitivity to tasks like listening, understanding speech, and speaking in
the same way those persons with normal hearing do.

Deaf
A person who is deaf cannot use hearing to listen, understand speech and
communicate orally without special adaptations mainly in the visual mode.
While a hearing aid amplifies the sounds by increasing the volume to make the
sounds louder, a person who is deaf cannot understand speech through the
ears alone. He or she may be able to perceive some sounds but his or her sense
of hearing is not enough or nonfunctional for the ordinary purposes in life.
Speech is accompanied by visually perceived actions like gestures, signs and
facial expression.

Hard of hearing
A person who is hard of hearing has a significant loss of hearing sensitivity but he
or she can hear sounds, respond to speech and other auditory stimuli with or
without the use of hearing aid. He or she is more like a hearing person than one
who is deaf because both of them use audition or listening to auditory stimuli in
the environment, unlike a deaf person who relies more on visual stimuli.

The Anatomy of the Human Ear

The ear has 3 main parts: the external or outer ear, the middle ear, and the inner
ear that extends to the central auditory nervous system in the brain. The external
or outer ear called the auricle or pinna directs the sounds into the auditory
canal or external acoustic meatus. When sounds enter the external acoustic
meatus, they are slightly louder or amplified as they are directed toward the
middle ear. Sounds enter the middle ear through the Eustachian tube and pass
through the tympanic membrane or eardrum. The eardrum moves in and out in

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response to changes in sound pressure. The movements of the eardrum change
the acoustical energy into mechanical energy which is transferred to the three
smallest bones in the body, the ossicles or ossicular chain, composed of the
malleus or hammer, incus or anvil and stapes or stirrup. The footplate or base of
the stapes rests in an opening called the oval window, the path through which
mechanical energy enters the inner ear. The vibrations of the ossicles transmit
the mechanical energy from the middle ear to the inner ear with the little loss.
The most complex and sensitive part of the entire hearing apparatus, the inner
ear, is covered by the temporal bone, the hardest bone in the body. The
cochlea is the main receptor organ for hearing and contains two fluid-filled
cavities and the organ of Corti. The cochlea looks like a coiled shell of a snail.
The vibrations stimulate the approximately 20,000 tiny hair cells to transform the
mechanical energy into electrical nerve impulses or neural energy. These
impulses are transmitted along the auditory nerve through the central nervous
system pathways to the brain where the auditory experience is processed and
understood. The semicircular canals in the inner ear controls the sense of
balance.

Classification of Hearing Impairment

1. Conductive Hearing Loss – Problem with conducting sound vibes to the

inner ear due to abnormalities and complications of the outer or middle
ear
2. Sensor neural Hearing Loss – defects in the inner ear (cochlea) or
auditory nerve
3. Mixed Hearing Loss – problems in the outer, middle and inner ear
(combination of conductive and sensory neural hearing loss); sounds are
distorted
4. Central hearing loss – damage in hearing receptions and pathways of
the brain
5. Congenital – present at birth
6. Adventitious – acquired later in life
7. Prelinguistic – acquired after the child had developed speech or
language
8. Unilateral – hearing loss in one year; generally learned speech and
language without difficulties; difficulties in localizing sounds and listening
in noisy places
9. Bilateral – hearing loss in both ears

*As mentioned earlier, deafness may be congenital or adventitious. The degree

of severity of hearing impairment may be slight, mild, moderate, severe and
profound.*
Causes
Conductive hearing Impairment Sensorineural Hearing Impairment

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 Otitis media (middle air fluid)  Congenital viral infections
 Otitis external  Maternal rubella
 Impacted cerumen (wax)  Prematurity and low birth weight
 Blockage of the external auditory  Rh-factor incompatibility
meatus by a foreign object  Maldevelopment of the inner ear
 Congenital malformation of the  Heredity (congenital or acquired)
outer and middle ear  Meningitis
 Genetic syndromes  Encephalitis
 Cleft palate  Measles
 Traumatic head injury  Mumps
 Influenza
 Unexplained high fever auditory
nerve tumors

Characteristics of Deafness and Hearing Loss in Students

Some of the common characteristics of deafness commonly found in classrooms
include the following:

• Difficulty following verbal directions

• Difficulty with oral expression
• Some difficulties with social/emotional or interpersonal skills
• Will often have a degree of language delay
• Often follows and rarely leads
• Will usually exhibit some form of articulation difficulty
• Easily frustrated if their needs are not met — which may lead to some
behavioral difficulties.
• Use of hearing aids leads to embarrassment and fear of rejection from
peers.
• The child may be dumb besides being deaf.
• The speech defects are common among children with hearing
impairment.
• Difficulty in learning language/vocabulary.
• Consequently these children are low in intelligence because they are
incapable of using available opportunities.
External appearance/signs Complaints of children who ave
hearing difficulties
 Deformities of the outer ear  Buzzing or ringing in the head
 Discharge from ear  Earaces
 Undue muscular tension  Nausea or dizziness
 Breathing through the mouth  Inability to understand
 Blank facial expression directions

Identification processes:

 Early detection
 Audiometric testing – pure-tone audiometry
 Educational assessment
 Communication and language assessments – expressive and receptive
vocabulary skills, syntactical or grammatical skills, nonlinguistic language
competence
 Intelligence and achievement testing

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IF THERE’S A CHILD IN YOUR CLASS WHO IS HARD OF HEARING…..
Due to the growing implementation of mainstreaming, more and more
classroom teachers have hearing-impaired children in the classroom. For such
youngsters, school can be pleasant experience-and a far more productive one-
if you observe the following rules:

1. Always- turn and face the class when you have something to say. Don’t
“teach to chalkboard”. It may seem easy and natural while you’re writing on
it, but avoid it at all times.
2. Use preferential seating. Seat youngster with hearing losses near the front
of the classroom, close to your desk. A child with a bad left ear should be
seated on your right as you face the class, a child with a bad right ear on
your left.
2. Pay attention to your diction. Actors know that voices are projected not by
speaking louder but by emphasizing the consonants. Sounds like “h” and “th”
require special emphasis to be understood by a hearing impaired person.
4. Be vigilant to make certain you’re getting through. A student’s degree of
participation in class in one index of good learning. The child who appears
disinterested simply may not be hearing everything that is said.
3. 5. Stay in close touch with the parents. They can tell you whether medical
treatment is improving the child’s condition and what the long-term outlook
is.
6. Help the child overcome any self-consciousness. If it is necessary to refer to
the child’s handicap, always do so in private, never in front of the class.
4. 7. Allow the child to participate in appropriate activities. There’s no reason for
a younger who wears a hearing aid not to take part in active sports-keeping
the aid on- if he or she wishes. Never compel a youngster who wants to join in
a game to remain on the sidelines if there is no medical reason for it.
5. 8. Schedule regular private conferences with the children. Some youngsters
talk freely about their problems, other does not. Handicapped children,
especially, should always have to opportunity to speak-up. In listening you
may discover new ways to be helpful.

GUIDELINES TO TEACH STUDENTS WITH HEARING LOSS IN INCLUSIVE SCHOOLS

A. Accept the child positivity. Remember that the hearing impaired child is a first
child and secondly Deaf.
B. Face the child directly, speak slowly and in normal tones and be expressive.
C. Use normal speeches do not shout.
D. Encourage speech and language development.
E. Explain the simple terms to other students what hearing loss means.
F. Avoid embarrassing the student with hearing loss when talking about his
problem. ( Teachers and students from IAVIs)
G. Determine the seating arrangements (move away from background noise and
place the child in the front seat close to the teacher)
H. Rephrase what you have said if you think the student has not fully understood.
I. Remember the distance increases listening difficulty so do not move around.
J. Consider appointing a student helper in the classroom or school.
K. Present all information visually at all times.
L. Beware of special language needs.
M. Help the hearing impaired child develop responsibility by giving tasks
N. Remember that concentrated looking and listening are tiring. Give breaks from
by assigning individual seat work.
O. Noise will interfere with listening and understanding. Keep the classroom as quite
or hearing friendly as possible.
P. Check each morning to ensure amplification devices such as hearing aids are in
good working order.
Q. Use all available resources for the hearing impaired student.
R. Use parents and family members as part of the team.

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 S. Give praise when it is deserve.

Learning the finger spell

Simple gestures to a person who is deaf..

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 MODULE - Learners with Additional Needs
Learners with Difficulty Seeing

INTRODUCTION
Vision is perhaps the most important distance sense for interpreting the
world around us. It helps us to perceive and understand as to what is taking
place around us. It provides a continual feedback and a frame reference for
action. Eyes are one of the primary organs that are fully developed at birth.
Visual abilities improve rapidly during the first years of life. For all of us, vision is the
primary way we master skills for physical, psychosocial and cognitive aspects of
self and environment.
Vision is a distance sense, which provides information from outside our bodies.
The term “visual impairment” is used as a generic term. Often other terms like
blind and low vision are also used, depending on the nature and degree of loss,
which in turn affects the individual in significant way like difficulty in mobility,
access to printed information and independent living.

A. Abstraction
Blindness and Low Vision
There are two general definitions of blindness. The first is the legal definition that is
based on measurement of visual acuity, field of vision and peripheral vision.

Visual Acuity - Visual acuity is the ability to clearly distinguish forms or

discriminate details at a specific distance. Normal visual acuity is measured by
reading letters, numbers and other symbols from a chart 20 feet away. The
Snellen chart is commonly used for this purpose. The sizes of the letters in the
chart correspond to the appropriate distances where they can be read with
normal vision. Thus, when a person can read the row of letters marked 20/20
correctly, he or she has normal vision. His or her visual acuity is 20/20, that is, he
or she can read the letters that normal vision permits to be read 20 feet away
when seated 20 feet away from the chart.

Field of Vision - The field of vision refers to the area that normal eyes cover
above, below and on both sides when looking at an object or when gazing
straight ahead. The field of normal vision covers approximately a range of 180
degrees. When looking directly at an objet, the central field of vision is used.

Peripheral Vision - The peripheral vision covers the outer ranges of the field of
vision. A person may have poor central vision but good peripheral vision.

Tunnel vision results from an extremely restricted field of vision. It is like looking at
the objects in the environment through a narrow tube or tunnel. The field of
vision can decrease slowly undetected among children and adults over a
period of years. A complete eye examination should include both visual acuity
and field of vision.

Legal Blindness
Legal blindness refers to the condition where visual acuity is 20/200 in the better
eye after the best possible correction with glasses or contact lenses. The field of
vision, whether central or peripheral is limited to an area of 20 degrees or less
from the normal 180-degree field. A legally blind person with his or her eye
glasses or contact lenses on can see or read only at 20 feet objects and letters

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that those with normal vision can see or read 200 feet away. The person
experiences difficulties in everyday activities especially in discerning fine details
of objects and things in the environment. In the United States, persons who are
legally blind are eligible to receive a wide range of benefits from the
government. These include special education or vocational rehabilitation
services, free mail service and income tax exemption.

Educational Definition
Not all legally blind persons are totally blind. In total blindness the person is
absolutely without sight but may have light and movement perception and
travel vision. The degrees of blindness include light perception (person can
differentiate between light and dark, day and night), movement perception
(person can detect if an object or person is in motion or in still position) and
travel vision (field of vision is enough to travel safely in familiar areas). Although
classified as blind, the person can still use his or her residual vision.

In special education, children who are blind are differentiated from those who
have low vision. Blind children use their sense of touch to red Braille and train in
orientation and mobility to move around and travel independently. A child with
low vision learns to read materials in large print. Corn’s definition of low vision
emphasizes the functional use of vision. Low vision is a level of vision that with
standard correction hinders an individual in the visual planning and execution of
tasks, but which permits enhancements of the functional vision through the use
of optical or non optical aids and environmental modifications or techniques.

TYPES AND CAUSES OF PROBLEMS OF VISION

The inability of the eyes to function efficiently may be traced to:
1. errors of refraction
- Hyperopia or Farsightedness
- Myopia or Nearsightedness
2. imbalance of the eye muscles
Strabismus- different images are cast on each retina resulting to cross-
eyedness or squinting.
Diplopia or Double Vision- results when the brain cannot fuse the
differences in the images cast on the retina into a single image.
Ambylopia- occurs when vision is suppressed in one eye and it
becomes weak or useless.
Nystagmus- is a condition in which there are rapid involuntary
movements of the eyeball that can result to nausea, vomiting and
dizziness.
3. Diseases
Diabetic Retinopathy- occurs when diabetes mellitus interferes with
the flow of blood to the retina causing it to regenerate.
Cataract- caused by the clouding of the lens
which results to progressive blurring of vision
and eventually blindness occurs.
Macular degeneration is the leading cause of
severe, irreversible vision loss in people over
age 60. It occurs when the small central
portion of the retina, known as the macula,
deteriorates. The retina is the light-sensing
nerve tissue at the back of the eye.
Coloboma-is a degenerative disease in which the central and or
peripheral areas of the retina are not completely formed.

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4. trauma or accidents

Impact of Vision Impairment and Blindness

The learning processes of students with vision impairment may be affected in the
following ways:

 Students with vision impairment may access information in a variety of ways,

for example Braille, audio-tape, or enlarged print. Braille readers cannot
skim read and may take up to three times as long as other students to read
a text. Students with some vision may be large-print readers. Many will be
unable to read examination questions and handouts in standard print or
read their own handwriting when answering examination questions. They
may also be unable to take their own notes. Extra time is needed to carry
out some tasks, such as locating words in a text when shifting from one
reading medium to another.
 Students who need information put into alternative formats must wait, often
up to six to eight weeks, for the material to be produced for them. This
means that they will often fall behind other students in the class.
 Students with vision impairment may feel isolated in the learning
environment, which can have an impact on learning.
 Headaches often result from eyestrain. This may reduce considerably the
study time available to these students.
 Participation and interaction in tutorials may be limited. It is difficult for
students who cannot see the body language and interactions of others to
feel comfortable about participating. Judging when it is appropriate to
interrupt or to take a turn in discussion is particularly difficult.

Teaching Strategies

There is a range of inclusive teaching and assessment strategies that can

assist all students to learn but there are some specific strategies that are useful in
teaching a group which includes students with vision impairment.

We often take for granted the amount of visual information received every day.
Many students with a vision impairment do not have a lifetime of visual
experiences to draw upon. It may be necessary to consider the amount of
assumed visual content in your subject when designing learning tasks.

 Prepare as much information as possible in electronic format - this makes it

much easier to provide materials in accessible formats and allows users with
disabilities to adapt the information to a format which is suitable for them.

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  Make required book lists and course materials available early so there is
sufficient time for them to be reproduced in audio or Braille, if required.
 Indicate compulsory texts in your reading list, noting important chapters if
possible. Specifying the order of reading within a text is helpful, as it can
take many weeks to have a book reproduced into audio or Braille.
 For students with vision impairment your teaching style will need to be
‘verbal’. Think about how to communicate information to students who
cannot see what you are doing.
 Verbalise what is written on the blackboard and on PowerPoints. Talk
through any calculations as they are made or procedures as they are
carried out. Read any printed information and describe any charts or
graphs being used.
 Academic activities which take place off-campus (such as industry visits,
interviews or field work) may pose problems and on-campus alternatives
may need to be considered.
 Provide an individual orientation to laboratory equipment or computers in
order to minimize the anxiety likely in an unfamiliar environment.
 Consider supplementing laboratory practical’s, experiments or field trips, for
example by audio taping commentaries.
 Inform the student if you plan to use videos, slides or PowerPoint, and discuss
alternative ways of presenting the necessary information.
 Because students with vision impairment are generally slower than other
students in completing reading tasks (reading is slower; considerable time is
involved in getting material taped or Brailled), provide reading lists well
before the start of a course so that reading can begin early. Consider
tailoring reading lists and provide guidance to key texts.
 Providing the student with a vision impairment with prior notice that you plan
to use a film or video in class allows him/her the option to request to see it
beforehand. This will enable him/her to sit very close to the screen or have
someone explain the film or video. It would be helpful to 'pause' on
important points when the student is viewing the resource in class with
others.
 A student may have difficulty finding his/her essay or assignment in a
pigeonhole or amongst a pile of other students' work.
 Students may not be able to read your hand-written comments. It would be
helpful if you could negotiate alternative feedback mechanisms with the
student.
 Students are usually able to access online learning materials with the use of
assistive technologies if websites follow accessible web design guidelines.
 The vision of some students may be affected by the glare from fluorescent
lights or sunlight so you may need to attend to some aspects of your
teaching environment. This should be done unobtrusively.
 Use tactile graphics where necessary
Assessment Strategies
In considering alternative forms of assessment, equal opportunity not a
guaranteed outcome, is the objective. You are not expected to lower
standards to accommodate students with a disability, but rather are required to
give them a reasonable opportunity to demonstrate what they have learned.
Once you have a clear picture of how the disability impacts on learning, you
can consider alternative assessment strategies:
 Students with a vision impairment may need particular adjustments to
assessment tasks.

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  Provide extensions to assignment deadlines if extensive reading has been
set. Consider setting alternative assignments in which students have the
opportunity to work intensively on a few selected texts rather than having to
read widely.
 Examination papers may need to be enlarged or Brailled, with tactile
diagrams, maps etc. It may be necessary to provide heavy line paper, a
scribe or special writing implements.
 Some students may undertake examinations using a personal computer with
assistive software. Some may need other assessment adjustments such as a
reader/scribe, an oral examination, audio taped questions or large print
papers. It may be necessary to provide extra space for equipment and
specific personnel or a separate examination venue if the noise from
equipment being used is likely to be distracting for other students.
 Provide extra time in examinations. Some students with vision impairment will
require double time for examinations so time for rest breaks will be essential.
Take-home examinations or split papers are a preferred option under such
circumstances.
Tactile graphics
People with a vision impairment are finding tactile graphics extremely valuable
and, in some cases, vital for successful study, work and leisure. While people with
a vision impairment are routinely provided with text transcribed into Braille,
audio or large print, the pictures, diagrams and maps which accompany text
are often omitted or only very briefly described.

Visual graphics can effectively be converted into tactile graphics, even for the
highly graphical information contained in maps and scientific material. This is not
simply a matter of taking a visual image and making some kind of tactile
photocopy – the tactile is a considerably less sensitive sense than the visual.

Visual graphics need to be re-designed by experts, in a variety of formats such

as vacuum-formed (thermoform), swell paper (microcapsule paper) and
embossed (such as that produced on a Braille printer). They can also be
accompanied by labels and descriptions in Braille or audio format.

Tactile graphics are useful when:

 the user is print-impaired but has some tactual ability
 a concept not easily described in words
 a real object is unavailable for touching
 the shape, form or pattern is significant
 it is necessary to illustrate scale and explain maps, technology or biological
relationships
 a one-time reference or reminder is needed
 the educational experience can be enhanced.

Tactile graphics are not, however, exact replicas of the original, nor are they
good for fine detail and representing very large graphics. They should not be
used without training and support materials.

Colour Blindness
Colour blindness (or colour deficiency) is typically a genetic condition, although
it can also be the result of injury, disease or ageing. (Although not actually
called colour blindness, age-related colour deficiency is a result of the yellowing
of the corneas, which severely hampers the perception of violet and blue.)
It is much more common in men than in women - around one in 12 men have
some kind of colour perception problem. There are many different types and
degrees of colour blindness. It is extremely rare to have monochromasy, the
complete absence of any colour sensation

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