5.8 Physical disabilities and sensory impairments

A few 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, it is serious enough to interfere with activities in regular classroom programs and to qualify the student for special educational services or programs.

Physical challenges that are this serious are relatively infrequent compared to some of the other special needs discussed in this chapter, though they are of course important in the lives of the students and their families, as well as important for teachers to accommodate. Only about one per cent of US students have a hearing loss serious enough to be served by special programs for such students (United States Department of Education, 2005). Only about half that number have visual impairments that lead them to be served by special programs. For two reasons, though, these figures are a bit misleading. One reason is that many more students have vision or hearing problems that are too mild (such as wearing eyeglasses for “ordinary” nearsightedness). Another is that some students with serious sensory impairments may also have other disabilities and therefore not be counted in statistics about sensory impairments.

Hearing loss

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 you are to encounter the student 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 (“Just give a hearing test!”), 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 often receive special help (or at least receives additional diagnosis) sooner. Mild or moderate hearing loss is much more common, however, 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—though not always, and in any case so do some students without any loss. They may also 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, though for entirely different reasons. 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, for example, or is careful in choosing which questions to answer in a class discussion. And so on. 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.