Module 4: Physical and Sensory Impairments

Students with physical impairments may:

• have difficulties with mobility, manual dexterity and speech.
• have their co-ordination and balance affected.
• experience major fluctuations in energy and pain levels from day to day
• need support with personal care.
• have fluctuating symptoms so impacts on students will vary from day to day and over time.
• experience pain, numbness and spasms that can impact their ability to use some equipment.

Physical impairment therefore covers a broad range of causes and symptoms. Impairments can be temporary or permanent, fluctuating, stable or degenerative, and may affect parts of the body or the whole of it. Some students with physical disabilities, neurological conditions or acquired brain injury may have perceptual difficulties. Students may have experienced barriers to learning that relate to negative perceptions of their disability and low expectations. They may also have missed out on vital stages of learning during their schooling, affecting language acquisition and the development of literacy.

Some students with physical impairments will use a wheelchair all or some of the time and others may walk with the aid of crutches or a walking stick. Others may not use any walking aid.

Students with sensory impairments may often use auxiliary aids and adaptive equipment at university. These may include guide-dogs, canes, interpreters, text to talk software and hearing aids. These aids assist in gaining access to the learning environment but it is important to recognise that they in themselves do not ensure access. Therefore, as teachers, we need to consider how we can make the learning environment and our teaching accessible to all students with sensory impairments including consideration of the learning environment, activities, videos, presentations, handouts, and textbooks/resources.   

Visual impairment is the term used to describe a loss of sight that cannot be corrected using glasses or contact lenses. Students who are blind or visually impaired vary considerably. There are two main categories of visual impairment:

• Registered partially sighted, which means the level of sight impairment is moderate
• Registered blind, which means a severe sight impairment where activities that rely on eyesight become impossible

Visual impairment operates across a spectrum. So, some students will have no vision, whereas others are able to see large print text. Some will have peripheral or tunnel vision and others will be able to see print if it is magnified. We should not assume that blind and visually impaired students use Braille – some will, and some will not. In addition, blind or visually impaired students will use a wide range of equipment and strategies depending on their particular need and circumstances. Only a small minority or partially sighted people have no useful sight.

Blind and visually impaired students are likely to be more dependent on their hearing for information gathering. People who have been blind since birth may have missed out on informal opportunities for learning to read, for example through the experience of signs and labels in everyday life. They will also have a conceptual framework for such concepts such as distance, dimensions and scale that is not drawn from visual images. They might have missed out on gathering everyday practical information about the world around them, which sighted people take for granted, and may therefore need to be introduced to new situations in a practical experimental manner before moving on to form concepts.

The principle that every student is an individual with individual needs is particularly true for students with visual impairments, as strategies which suit one student may be irrelevant, even hampering, to another. Only the visually impaired person can really say what they can, or cannot, see.

Students may have developed their own coping strategies and techniques and so it is essential for the student to be closely involved in discussion of teaching strategies appropriate to their situation.

Like blind and visually impaired students, students who are deaf or hearing impaired vary considerably. Whereas some students can follow conversations using a mixture of lip-reading and watching facial expressions, others struggle to do so. Some pre-lingual deaf students may use sign language to communicate, whereas students with at least some residual hearing may use hearing aids or a cochlear implant. Some students have good speech and communication whereas others do not.

There are four types of hearing loss:

Conductive hearing loss (affecting the conduction pathways for sound to reach the inner ear). Conductive hearing losses usually affect all frequencies of hearing evenly and do not result in severe losses.

Sensorineural hearing loss (from damage to the delicate sensory hair cells of the inner ear or the nerves which supply it). These hearing losses can range from mild to profound and they often affect the person’s ability to hear certain frequencies more than others.

A mixed hearing loss refers to a combination of conductive and sensorineural loss and means that a problem occurs in both the outer or middle and the inner ear.

A central hearing loss results from damage or impairment to the nerves or nuclei of the central nervous system, either in the pathways to the brain or in the brain itself.