Some children and young people require special educational provision because they have a disability which prevents or hinders them from making use of the educational facilities generally provided. These difficulties can be age related and may fluctuate over time. Many children and young people with vision impairment (VI), hearing loss (HL) or a multi-sensory impairment (MSI) will require specialist support and/or equipment to access their learning, or habilitation support. Children and young people with an MSI have a combination of permanent vision impairment and hearing loss.
Some children and young people with a physical disability (PD) require additional ongoing support and equipment to access all the opportunities available to their peers.
(6.35 SEND Code of Practice 2015 p98)
Physical Disability (PD)
This section describes children who have greater needs than most of their peers for support with their physical needs which can impact on their learning.
Some children with physical difficulties will have had their needs identified at an early age and may already have received support e.g. Cerebral Palsy, Hypermobility, will need ongoing support and interventions. For others, needs may not become apparent until the child is older, and they impact on his/her learning. Some children with physical difficulties may also have hidden learning difficulties such as planning and organisation that impacts their learning e.g. children with Developmental Coordination Disorder/Dyspraxia.
Many children with physical needs require on going minor adaptations to the learning environment and for the learning tasks including access to play that would be considered as reasonable adjustments under the Equality Act 2010. For some this is the only support that is needed, they do not need additional SEN support. With the right support and knowledge children with physical difficulty can achieve as much as other children (PDNet Standards 2018).
Where some children have a diagnosed progressive physical condition, e.g. Duchenne muscular dystrophy, it is important to plan and prepare early for later needs.
Other children have a temporary condition such as injured limb or post-operative care and need appropriate support to access learning.
Unmet physical needs may impact on the child/ young person’s ability to learn in the same way and at the same rate as their peers. The child/young person may also have linked social and emotional needs. Look across descriptors for all relevant areas of need to make sure that support is tailored appropriately.
Hearing Loss/Deafness (HL)
Many children with hearing loss will have their needs identified early and will be supported by the SENSS Deaf and Hearing Support (DHS) team. Children may have a temporary hearing loss that fluctuates or a hearing loss that is permanent. Some children benefit from a hearing aid(s) or other amplification devices.
Some younger children may have needs that go unrecognised until they reach a group setting or are expected to undertake tasks that require them to use hearing skills in a different context. It is also possible for some children to acquire a hearing loss. This could be caused through illness or accident or might be because they have a progressive condition or a condition that has a late onset. The most common cause of temporary and fluctuating hearing loss in childhood is commonly known as ‘Glue Ear’. Information about ‘Glue Ear’ is available on the Oxfordshire Local Offer.
Some children with a hearing loss will require on-going specialist teaching support from teacher of deaf children and young people to access the curriculum alongside their peers. Others may require a routine advisory visit to check the function and management of any equipment, to observe the child and feedback on their learning and to ensure that the setting is empowered to take responsibility for all aspects of the child’s inclusion.
Sometimes a child can meet many of the descriptors for a hearing need but when clinically assessed their hearing is within normal limits. It could be that they have a fluctuating hearing loss. If this is the case repeated assessment will usually determine the type and level of hearing loss.
If there is no underlying physical hearing loss it may be that the child/young person has auditory processing difficulties. In this case, the descriptors and guidance for supporting children with communication and interaction (C&I) needs should be used. A medical confirmation of a hearing loss does not necessarily mean a child has Special Educational Needs. However early intervention with specialist advice from the SENSS (DHS) Team ensures that the impact of the hearing loss on the child/young person’s progress is minimised.
The SENSS (DHS) Team will not usually become involved with a child unless a paediatric audiologist has first made an assessment. This is because there can be many reasons why a child may not appear to hear well, and a formal hearing assessment is needed to ensure that the guidance offered to a setting is appropriate.
If a child has not been seen by the community paediatric audiology team or a hospital audiology department, the first step is a GP referral to community paediatric audiology for further assessment. Parents should be asked to discuss this with their child’s GP.
Vision Impairment (VI)
Visual difficulties range from mild through to profound. Many children have their vision fully corrected by spectacles. A child should be considered to have a vision impairment if the visual difficulties are not due to basic refractive errors and cannot be fully corrected by glasses.
Many children with vision impairment will have their needs identified early and will be supported by the SENSS Vision Impairment (VI) team. Some children may have needs that go unrecognised until they are expected to undertake tasks that require them to use visual skills in a different context. Some acquire a visual loss through illness or accident.
A vision impairment can impact on many areas of child development, for example a child’s social and emotional development. Check across descriptors for all relevant areas of need to make sure that support is tailored appropriately.
Multi-Sensory needs (MSI or Dual Sensory Loss)
This section describes children who have multi-sensory impairment. The term ‘multi-sensory impairment’ usually refers to children who have a combination of hearing loss and vision impairment (i.e. dual-sensory loss) which used to be known as deaf blindness.
Other children with multi-sensory impairment may not have a combined clinical diagnosis of hearing loss and vision impairment but present as having substantial developmental delay in responding to sensory stimuli.
This section contains guidance on what you may observe if a child has both hearing loss and vision impairment.
Children with multi-sensory impairment usually have their needs identified at a very early stage. Occasionally multi-sensory impairment may occur as a result of an accident, trauma or a progressive syndrome in an older child, for example Usher syndrome, Alstrom syndrome. Some children also have additional difficulties.
Support and advice from a range of professionals is essential to meet the complex nature and pattern of needs displayed by these children.