Mental Wellbeing

Education for Mental Health Toolkit - Inclusivity – Sensory Impairments

Sensory disabilities are classified as 'low-incidence' (occurring in low numbers) and 'high-needs” (requiring specialised support in accessing the general education curriculum) disabilities. Students with sensory disabilities can face unique challenges in relation to inclusion (1-3).

Sensory impairments

Summary

Sensory disabilities are classified as 'low-incidence' (occurring in low numbers) and 'high-needs” (requiring specialised support in accessing the general education curriculum) disabilities. Students with sensory disabilities can face unique challenges in relation to inclusion (1-3). In particular, the design and delivery of the curriculum can have an important role, potentially making it more difficult to engage in learning, increasing social isolation and creating self-doubt, anxiety and loss of motivation (4). Alternatively, appropriate adjustments and an inclusive curriculum can enhance students’ sense of connection and belonging and enable better learning (5). Literature suggests that an inclusive curriculum incorporates a combination of teaching methods/strategies with a social model approach, which can be supported by the adoption of a universal design throughout the curriculum (4, 6, 7).

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Universal Design for Learning (UDL) is a model of inclusive curriculum that can improve learning for all students (5). Simple considerations that enable students with sensory disabilities to engage with curriculum content and learning activities, can have significant positive impact (8), such as using accessible slides with subtitles, providing transcripts, ensuring students receive information in appropriate formats and using audio technology when it is available. Benefit can also be gained by including students in ongoing curriculum design and delivery, to properly understand their experience and adjust learning, teaching and assessment strategies accordingly (8).

Previous research found that teachers' attitudes towards meaningful inclusion are of significant importance when creating an inclusive learning environment to support a positive learning experience and they are a prerequisite for successful inclusion (2, 9, 10). The role of the individual teaching academic is therefore vital in creating learning environments in which students with sensory disabilities can flourish (9). Student wellbeing can benefit when academic staff are perceived to care about and believe in students as individuals (11). However, it is important to note the systemic aspect of this – academic staff cannot be expected to develop the knowledge, skills and strategies necessary alone. They must be supported with the necessary time, resource and development input from within their university (2).

Blindness and visual impairment

It is important to remember that each student is different, and their experience of their disability will also be different. What has worked for one visually impaired student in the past may not work for another visually impaired student in the future (12). Collaboration between Student Services and academic staff can help to ensure that students receive appropriate adjustments for them, and that the curriculum does not unintentionally exclude a student from learning or their cohort. However, it should be noted that the process of arranging and managing a support package can create extra workload for disabled students, leading to fatigue, a sense of being overwhelmed and disengagement. Supporting students with an inclusive curriculum and easing the process of implementing adjustments can help ameliorate this (13)

Assistive technologies can be extremely helpful for some students with a visual impairment, particularly if learning materials are designed with this in mind. Others may benefit from simple adjustments, such as reserving seats at the front of class and consulting with them in relation to the design of learning activities (12).

Hearing impairments

Students who are deaf or who experience hearing loss can experience difficulties accessing and engaging with learning and with feeling that they belong to the academic environment, due to issues with social interaction and dissatisfaction with social life (14). As with other types of sensory impairments, students with hearing impairments differ significantly, in part depending on the type and degree of their hearing loss or deafness. There are four clinically recognised degrees of hearing loss: 1) mild, 2) moderate, 3) severe, and 4) profound (15). Additionally, there are individuals who have lost hearing before acquiring language and others who have lost it after having acquired language, which can have a significant impact on levels of adjustment as well as on the degree of hearing impairment. Some people utilise lip reading, some sign language, others hearing aids or cochlear implants, and many rely on a combination of these (16).

Students with hearing loss might be best supported by reasonable adjustments, assistive devices and technology. These accommodations can be diverse and range from including a sign language interpreter to wireless assistive listening devices or even just being provided with preferential seating places in the classroom (17).

Deaf and hearing-impaired students often prefer visual learning strategies, but this can be challenging in environments that mostly rely on talking and on learning delivered through sounds and word of mouth. The provision of notes, slides and transcripts can support students to ensure they have not missed important learning (16, 17).

Students with hearing impairments can become isolated from the learning environment as issues related to social contact and interaction with other students can arise, which can have a negative impact on learning (18). Participation in tutorials can become an anxiety-provoking task as not being able to hear the nuances of verbal exchanges can put them in a disadvantaged position (16, 19). Establishing self-supporting learning communities that recognise and respond positively to diversity in the classroom, can help to ease these concerns and help students develop belonging in the community.

Key lessons

  1. Sensory impairments are 'low-incidence' (occurring in low numbers) and 'high-needs” (requiring specialised support in accessing the general education curriculum) disabilities and students dealing with these conditions undergo unique challenges in relation to inclusion.
  2. Factors such as teacher attitude, co-operation between Student Services and academic staff, the use of inclusive curriculum design and assistive technology can all play a significant role in developing inclusive practice and supporting learning and wellbeing of students with sensory impairments.
  3. The use of multimodal instructions is of fundamental importance to give students the possibility to see and hear at the same time (e.g., subtitled PowerPoint presentations).
  4. Benefit can be gained from including students in the planning and evaluation of curriculum to ensure that their needs are met; it is good practice to talk directly to the students to understand their specific needs and to develop effective ways to support them, their learning, and their wellbeing.
  5. The types of accommodations needed may vary depending on the student and their disability.

Top tips

  1. Make materials multi-sensory, use interactive and tactile e-learning aids to allow for different kinds of learning. Give access to class notes and/or taping of lectures.
  2. Minimise noise and distractions and pay attention to the physical organisation of the classroom, to the presence/position of objects, and adjust the lightning in the teaching environment. Avoid talking in different directions and use assistive listening devices. Remember to be aware that facemasks, moustaches, beards, hands, books, or microphones in front of the face can impair lip-reading. When teaching online be mindful of the position of the lights and avoid being overshadowed because students might not be able to lip-read.
  3. Provide students with learning materials in advance, as students might need to have materials transcribed and accommodated to their needs, which could take a significant amount of time. Provide lists of subject-specific jargon and technical terms early in the course.
  4. Remember that it is not helpful for individuals with hearing impairment if you talk louder and/or more slowly, it is better to talk normally. Remember to gain the attention of your students before speaking, repeat clearly any questions asked by students before providing a response, use descriptive, explanatory language and verbal information to describe visual information.
  5. Meet with the student to talk about essential accommodations and to understand how to facilitate them.



    National organisations advocating for people with sensory impairments are Royal National Institute for the Blind and Action on Hearing Loss, which can be contacted if in need of advice.

Resources
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References
  1. Lieberman LJ, Lepore M, Lepore-Stevens M, Ball L. Physical education for children with visual impairment or blindness. Journal of Physical Education, Recreation & Dance. 2019 Jan 2;90(1):30-8.
  2. Miyauchi H. A systematic review on Inclusive Education of students with visual impairment. Education sciences. 2020 Nov;10(11):346.
  3. Ronal National Institute for the Blind. Children and Young People-England. RNIB Evidence-Based Review: London, UK. 2017.
  4. Bunbury S. Disability in higher education–do reasonable adjustments contribute to an inclusive curriculum?. International Journal of Inclusive Education. 2020 Jul 28;24(9):964-79.
  5. Rappolt‐Schlichtmann G, Daley SG. Providing access to engagement in learning: The potential of Universal Design for Learning in museum design. Curator: The Museum Journal. 2013 Jul;56(3):307-21.
  6. Morgan H, Houghton AM. Inclusive curriculum design in higher education: Considerations for effective practice across and within subject areas. The Higher Education Academy. 2011 May.
  7. Wray J, Aspland J, Taghzouit J, Pace K. Making the nursing curriculum more inclusive for students with specific learning difficulties (SpLD): embedding specialist study skills into a core module. Nurse Education Today. 2013 Jun 1;33(6):602-7.
  8. Smith AM. Supporting every teacher: transferring inclusive practices for learners with sensory impairments to online teaching [Internet]. Cambridge: Cambridge University Press; 2020 [updated 01 May 2020; cited 2021 November 19]. Available from: https://www.cambridge.org/elt/blog/2020/05/01/transferring-inclusive-practices-learners-sensory-impairments-online-teaching/
  9. Khan, N. (2012). Accommodating students with sensory impairment (S.I.) in inclusive classroom. Nava Gavesana: An International Research Journal,3(1), 73-77.[AN1] 
  10. Monsen JJ, Ewing DL, Kwoka M. Teachers’ attitudes towards inclusion, perceived adequacy of support and classroom learning environment. Learning environments research. 2014 Apr 1;17(1):113-26.
  11. Eloff I, O’Neil S, Kanengoni H. Students’ well-being in tertiary environments: insights into the (unrecognised) role of lecturers. Teaching in Higher Education. 2021 May 27:1-21. Available from: doi: 10.1080/13562517.2021.1931836
  12. ADCET. Vision impairment and blindness [Internet]. Hobart: Australian Government Department of Education, Skills and Employment; 2021 [cited 2021 November 19]. Available from: https://www.adcet.edu.au/inclusive-teaching/specific-disabilities/blind-vision-impaired
  13. Reed M, Curtis K. Experiences of students with visual impairments in Canadian higher education. Journal of Visual Impairment & Blindness. 2012 Jul;106(7):414-25.
  14. Lang HG. Higher education for deaf students: Research priorities in the new millennium. Journal of deaf studies and deaf education. 2002 Oct 1;7(4):267-80.
  15. Neumann K, Stephens D. Definitions of types of hearing impairment: a discussion paper. Folia Phoniatrica et Logopaedica. 2011;63(1):43-8.
  16. ADCET. Deaf and hard of hearing [Internet]. Hobart: Australian Government Department of Education, Skills and Employment; 2021 [cited 2021 November 19]. Available from: https://www.adcet.edu.au/inclusive-teaching/specific-disabilities/deaf-hearing-impaired
  17. Kirkpatrick D, Payne T, Mclean P, Goodacre C. Creating Accessible Teaching & Support (CATS) for students with vision impairment [Internet]. Australian Universities Teaching Committee. [Cited 2021 November 19]. Available from: https://www.adcet.edu.au/resource/7071/cats-booklet-vision-impairment
  18. Hendry G, Hendry A, Ige H, McGrath N. “I was isolated and this was difficult”: Investigating the communication barriers to inclusive further/higher education for deaf Scottish students. Deafness & Education International. 2020 Sep 9:1-8.
  19. Balch GI, Mertens DM. Focus group design and group dynamics: Lessons from deaf and hard of hearing participants. American Journal of Evaluation. 1999 Jun;20(2):265-77.