ESB 3101 Introduction to special needs education

By Dr Wanyera JOOUST chapter

Definition of terms and clarification of concepts

There are various terms and concepts used to describe learners with special needs. It is
important that we clarify the main ones before we go further. They include:

 Impairment
 Disability
 Handicap
 Disorders
 Exceptionality
 Inclusion
 Special education
 Inclusive education
 Special needs
 Special educational needs
 Special Needs Education
 Special needs in education.

Impairment
Impairment refers to any loss or damage to a part of the body through either accident,
disease, genetic factors or other causes. This leads to the loss or weakening of that part
affected. For example: If one lost fingers in an accident that hand may not function
properly. In this case impairment is the loss of the fingers.

Disability

This refers to any loss or reduction of functional ability (resulting from an impairment) to
perform an activity in the manner or within the range generally considered normal for a
human being within the cultural context. It is also a limitation of opportunities that can
prevent people who have impairments from taking part in activities to an equal level with
others. There may be physical or social barriers to full participation. For example: A
person whose legs are paralyzed cannot walk independently. In this case, disability is the
difficulty in walking.

Handicap

A handicap is a disadvantage or a restriction of activity, which may result from a

disability or from societal attitudes towards a disability. Handicaps prevent the fulfillment
of roles that are appropriate according to the age, gender, social and cultural norms. An
individual who is not given am opportunity to become independent by society is

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Handicapped.
A handicap can therefore be lessened if the society provides support to enable a person
with a disability to be independent.

Disorder
It is a condition resulting from an illness that causes a part of the body unable to function
appropriately. This is a medical oriented term. For example: Disorder of the digestive
system or suffering from a mental disorder.

Exceptionality
This is term refers to any individual who’s physical, mental or behavioral performance
deviates from the norm positively or negatively. A person with exceptionality is not
necessarily disabled. The term embraces people with difficulties such as in hearing,
behavior, and speech.

Inclusion

Inclusion is a philosophy, which focuses on process of adjusting the home, the school and

society so that all individuals regardless of their differences can have the opportunity to

interact, play, learn, work, experience the feeling of belonging and develop in accordance

with their potentials.

Special education

This is a specially designed programme of instruction designed to meet the unique needs
of learners with special needs including those with disabilities.

Inclusive education

This is an approach in which learners with special needs receive services and support
appropriate to their individual needs within the regular education setting.

Special needs

These are conditions or factors that hinder an individual’s normal learning and
development. They may be temporary or life-long. The conditions that may hinder proper
progress of an individual may include disabilities, social, emotional, health or political
difficulties. These conditions are also referred to as barriers to learning and development.
The barriers can be within the learners or in the environment or a combination of both.

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The term special needs is a general term for persons who need some form of support in
order to carry on with daily life activities.

Special educational needs

Individuals have different abilities and potentials in performing tasks. In education, there
are individuals who do not perform like the others, but could improve with appropriate
support. These learners have learning or educational needs which vary from one learner
to another. These are then referred to as special educational needs.

List special education needs have you noted

among learners in your school/class?

Special educational needs may include difficulties in:

 Reading
 Writing
 Understanding concepts
 Communicating with teachers and peers.

Special Needs Education (SNE)

This is education, which provides appropriate in curricula, teaching methods, educational

resources, medium of communication or the learning environment. The modifications are
meant to meet the special educational needs of individuals as described above. SNE is
learner-centre, flexible and adjustable to individual needs and abilities.

Do you think it was necessary to change from special education to special needs
education?

Special education focuses mainly on disability rather than the learner’s learning needs.
You should therefore appreciate that when working with learners with special needs, their
education is not special but rather their needs.

Special needs in education

What are special needs in education?

This is when certain learning barriers occasioned by the learner’s handicap, disability or
exceptionality hinder learning. For example: A learner with hearing impairment may be
unable to follow lessons in a regular class because he/she cannot follow verbal
communication. Similarly a learner who is gifted and talented will be disadvantaged if
he/she learns faster than them.

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Learners with visual impairment will also experience difficulties following teachers’
notes and textbooks and examples given in ordinary print. Due to these differences, these
learners require Special Needs Education with appropriate modifications on the
curriculum, teaching methods, teaching/learning materials, medium of communication
and the environment in order to meet their individual needs.

Categories, characteristics, incidence and prevalence of learners with

special needs

Who are learners with special needs?

As you learned in section one, special needs refers to conditions or factors that hinder an
individual’s normal learning and development affecting performance and abilities
significantly from average learners’ developmental norms such as physical,
psychological, social and cognitive.

1. Hearing impairment
2. Visual impairment
3. Deaf blindness
4. Mental disabilities
5. Specific learning difficulties
6. Autism
7. Communication difficulties
8. Emotional and behavioral difficulties
9. Physical, health and multiple difficulties
10. Cerebral palsy

Others are those:

 Who are gifted and talented
 Living under especially difficult circumstances.

Categories of learners with special needs

 Sensory impairments
 Cognitive differences
 Communication difficulties
 Emotional and behavioral difficulties
 Physical and multiple difficulties and
 Those living under especially difficult and circumstances.

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Learners with sensory impairments

Sensory impairments are those with impaired sensory organs. These may include the
following:

 Hearing impairment
 Visual impairment
 Deaf blindness

Learners with hearing impairment

Hearing impairment is an inability to hear well or not hearing at all. Hearing loss can be
classified according to:

 Severity
 Age at onset
 The part of the ear affected.

Classification according to severity of hearing loss.

Some learners may only have slight hearing loss while others may have severe hearing
loss. There are five major categories of hearing loss. These are those with:

 Slight hearing loss

 Mild hearing loss
 Moderate hearing loss
 Severe hearing loss
 Profound hearing loss

Learners with slight hearing loss: These learners who can follow normal conversation
if there is no noise in the room but will need to sit at the front and face the speaker. They
may also have difficulty hearing faint or distant speech. They will not usually have
difficulties in regular school situations.

Learners with mild hearing loss: Learners in this category may understand a
conversation only at a distance of about one meter. Such learners’ will only be able to
follow the conversation if the room is very quiet. They may miss as much as 50% of
class discussions if voices are faint and may exhibit limited vocabulary and speech
anomalies. This means that learners should face the speaker or use an individual hearing
aid.

Learners with moderate hearing loss: These learners may have difficulties hearing in
all situations and:

 Can only follow loud conversations

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  Are deficient in language use and comprehension
 Are likely to have defective speech
 Have limited vocabulary
 Need the use of a hearing aid and in some cases, speech training.

Learners with severe hearing loss: These learners may hear loud voices about 30cm
from the ear. They may be able to identify environmental sounds and discriminate
vowels but not all consonants. They need individual hearing aids and instruction to be in
Total Communication.

Learners with profound hearing loss: These learners may hear some loud sounds but
are aware of vibrations more than tonal pattern. The learners rely on vision rather than
hearing as the primary avenue of communication. They need hearing aids and sign
language.

Classification according to age at onset

There are two types of hearing impairments as classified according to age at onset. These
are:

Pre-lingual deafness: This refers to deafness present at birth or occurring before the
learners develop speech or language.

Post-lingual deafness: This refers to deafness, which occurs after the learners, have
developed speech or language, mainly after the age of three years.

Who then are learners with hearing impairment?

These are learners who have difficulties with the sense of hearing. They hear at a level
below that of a person considered to have normal hearing. As noted above, functionally
there are two main types of learners with hearing impairment. These are learners who
are:

 Hard of hearing
 Deaf

Learners who are hard of hearing

These are learners who despite the hearing loss, have enough useful hearing left (residual
hearing). This hearing ability can enable them to her speech and acquire spoken
language with or without the use of a hearing aid. However, for them to hear speech
well, the sound volume must be raised. This can be done by:

 Speaking a bit louder than normal to them

 Placing them near the front of the class or near the speaker
 Ensuring their surrounding are quiet
 Making sure that they look at the speaker’s face
 Wearing suitable hearing aids.

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Learners who are deaf

You might be aware that, learners who are deaf are those whose hearing loss is so severe
that they cannot hear and understand speech even if the sound is made louder for them.
Hearing aids may only assist them to be aware of some environmental sounds such as,
sounds made by moving vehicles and booming sounds.

Functionally, those learners with slight to moderate hearing loss are referred to as
“hard of hearing” while those with severe to profound loss are referred to as “deaf”.

Classification according to the part of the ear affected

Before we discuss the classification of the hearing impairment, according to the part of
the affected. Let us look at the anatomy of the ear.
***
You will probably recall from your biology classes that the ear is functionally divided
into three parts. These are the outer ear, middle ear and inner ear as shown in the figure
below.
***
There are three main types of hearing loss according to the part of the part of the ear
affected.
These are:

 Conductive hearing loss

 Sensory-neural hearing loss
 Mixed hearing loss

Conductive hearing loss

This is where the damage or infections is either in the outer or middle parts of the ear.
This results in mild and moderate hearing loss. Those with this type of hearing loss have
residual hearing left and can hear and understand spoken language with the help of
suitable hearing aids.

Sensory-neural hearing loss

This is when the damage is in the inner ear. This results in severe and profound hearing
loss with little residual hearing left. Children with this type of hearing impairment usually
do not acquire and use spoken language. They can however use hearing aids to be aware
of environment sounds.

Mixed hearing loss

This refers to a combination of conductive and sensory-neural hearing losses. This

means both the middle ear and inner ear are affected at the same time.

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Generally conductive hearing impairment is less severe in its effects than the sensory-
neural. It is associated with a range of speech, language, and learning difficulties in
childhood.

Characteristics of learners with hearing impairment.

As explained earlier there are two main groups of learners with hearing impairments.
There are deaf and hard of hearing.

Learners who are deaf:

 Don’t acquire spoken language normally

 Have speech flow difficulties, (speech lacks the normal rhythm, stress and
intonation)
 Have too high or too low pitched voices since they cannot hear themselves
to adjust their voices
 Have limited social relationships because of communication difficulties,
which may in turn make them to develop feelings of isolation and
rejection
 Have frequent substitutions, distortions and omissions of sounds of
speech. For example, the learners may say/ood igh/instead of/good night
 Confuse certain consonants like /p/ and /b/, /t/ and /d/
 Slow and labored speech
 Mainly use gestures or signs to make themselves understood

On the other hand, learners who are hard of hearing:

 Ask for repetition of what has been said

 May have frequent ear infections
 Have difficulties in group discussion especially in noisy surroundings
 Have difficulties in hearing and high frequency speech sounds such as
/s/, /sh/, /t/, /k/, /ch/
 Misunderstand others since they cannot comprehend all that is said to
them
 Are unable to monitor their voices and hence speak loudly or softly
 Have difficulties in understanding directions
 Avoid participating in oral activities
 Cup the ears in the direction of sounds
 Have frequent loss, substitute and omissions of consonant sounds
 Stare at speaker’s ‘face’ aiming to lip read what is said
 Appear confused or not responding to instructions
 Have poor vocabulary in relation to age and social background
 May withdraw from the of the learners

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.
Education implications faced by learners with hearing impairment.

The educational implications that may be faced by learners with hearing impairments are:

 Inability to hear well in a classroom with a noisy surrounding

 Poor verbal communication skills between the child and the teacher and
peers
 Lack of acceptance and social isolation because of lack of communication
 Ineffective communication between the child and family especially the
parents and siblings. This may limit the child’s opportunities to acquire
knowledge and skills usually acquired by children through interaction with
parents, siblings and community.
 Inability to follow school routine since he/she may not hear the bell.

Intervention strategies

How can you help a learner with hearing impairment?

Learners who are hard of hearing

Children who are hard of hearing can be helped in the following ways:

 Advising on suitable school placement

 Advising parents to seek medical help
 Utilizing peers to assist the learner with class routine such as sharing notes
 Providing the child with all details of the lesson in written form. The
child’s academic performance can be improved with proper classroom
managements and use of technical and teaching aids. Use of visual aids is
a must for teaching learners with hearing impairment.
 Advising the parents to have the learner fitted with a suitable and effective
hearing aid (if advised by a specialist)
 Giving the chills preferential seating in the classroom. This allowing
him/her to sit near the teacher and where there is a good source of light
 Facing the child when talking to him/her. Talk slowly and clearly in a
good tone without mouthing words.
 Counseling the school community to accept the child.
 Referring the learner to the health centre for medical check ups and
treatment
 Encouraging the learner to observe general basic ear hygiene.

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Learners who are deaf

Majority of learners who are deaf may need special needs education where Total
Communication philosophy is the main communication strategy. In addition
communication you can also assist a child who is deaf as follows:

 Advising on school placement

 Encouraging the child to observe general ear hygiene
 Encouraging the family and the community to learn the communication
techniques used by the child for effective communication.

Though learners who are hard of hearing may be educated in an inclusive setting they
will find it much more difficult than learners who have normal hearing to learn
vocabulary, grammar, word order, idiomatic expression, and other aspects of verbal
communication.

Incidence and prevalence of learners with hearing impairments

What is incidence?

Incidence in this case refers to the number of new cases of learners with special needs
and disabilities identified in a given period of time (usually a year).

What is prevalence?

Prevalence in this case refers to the total number of existing cases (new and old) of
learners with special needs and disabilities in the population at a given time. Prevalence
is usually described as the “number per thousand”.

What is the incidence of hearing impairments?

According to the World Health Organization, approximately 10% of the population have
disabilities. Furthermore, it is estimated that at least 5% of these learners in regular
schools have some special educational needs. Of these about 1 in every 1,000 learners
has hearing impairments. It is estimated that Kenya has about 300,000 cases of persons
with hearing impairments.

Learners with visual impairment

Who are learners with visual impairment?

These are learners with difficulties in the structure and or functioning of the eyes. Visual
difficulties range from slight visual impairment to total blindness. Below see a diagram
showing the structure of the eye.

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Learners with visual impairments can be classified into two main groups. These learners:

 Who are blind

 With low vision

Learners who are blind

These are learners who have totally lost their sense of vision and are unable to tell the
difference between darkness and light.

Learners with low vision

The World Health Organization (WHO) defines low vision as “having a significant
visual handicap but also having significant vision that can be used”. Educators give an
educational definition and say that “anybody with low vision is visually impaired but
may increase visual functioning through the use of optical aids, non-optical aids,
environmental modifications and or low vision techniques”.

Generally most learners with low vision can use their vision for many school-learning
activities. Under varying conditions, depending on the amount of light, contrast and
individual differences. Such learners can be trained to see and become visual learners.

According to research, it is estimated that about 80% of all conditions that cause visual
impairments in Kenya are preventable.

Characteristics of visual impairments

Below are some of the characteristics of learners with low vision. You may notice that
learners with low vision:

 Complain of not seeing well

 Have difficulties reading and copying from the chalkboard.
 Read and write with their heads tilted to one side.
 Read books held very close to or very far from the eyes.
 Complain about too much or too little light in the classroom.
 Regularly make quick eye movement from side to side.
 Trip over objects on the ground which you would expect them to see.
 Have difficulties in grasping objects that are directly in front of them.
 Complain of double vision.
 Have watery or reddish and painful eyes.
 Omit some letters while reading or writing.
 Use their index fingers to point what they are reading.
 Have eyes that do not fixate (involuntary eye movements).
 Withdraw from the rest of the learners.
 Are unable to watch something moving near the face.
 Have clumsy movements and poor balance when walking.
 Have white patches in the centre of their eyes (in the iris).
 Move their heads instead of the eyes while reading.

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  Write un even letters (for example, very small, or big letters and
sometimes not in straight lines).

What are some of the characteristics of learners who are blind?

From observation you may notice the following mannerisms among learners who are
blind:

 Poking of the eyes

 Poor posture
 Clumsy movements
 Rocking of the body and forth
 Frowning of physical grimaces
 Making repetitive meaningless sounds
 Turning of their heads rapidly from side to side
 Clapping their hands at inappropriate times.

Educational implication for learners with visual impairment

As you may be already aware, learners with visual impairment may have problems in
coping with the teaching and learning. There are many of these learners especially those
with low vision in our schools. The needs of these learners can be met in regular schools,
but before we say how we can cater for them, it is important to know the difficulties
which the two groups of learners may face.

What difficulties do you think learners with visual impairment face in a learning
environment?

Some of the difficulties that may be faced by these learners are difficulty in:

 Reading and copying from the chalkboard and therefore may lag behind
others in academic activities.
 Reading books written in ordinary print
 Finding their way within the class and school.
 Identifying objects, posters and other learning materials within the class.
 Learning concepts that have to be perceived through sight, such as colour
and sky.

How can we help learners with visual impairment?

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Solutions to the difficulties faced by learners with visual impairment will always depend
on; the age of the learner, severity of the visual problem and subject/activities at hand.
There are three levels of interventions. These are:

 Medical intervention
 Educational intervention
 Psychological intervention

Medical intervention

Most eye diseases and defects can be prevented or treated. Learners should therefore be
referred to hospitals that have eye units to undertake:
 Cataracts extractions
 Trachoma and other eye treatment
 Provision of eye glasses to improve vision

Educational intervention
What can you do in a learning environment to assist learners with low vision?

For learners who can read enlarged print and have little or no problem in mobility, you
could simply use the following forms of intervention:

 Moving the child nearer to the chalkboard in the classroom or in a position

which allow him/her to participate well in learning activities.
 Providing large print materials.
 Advising parents to provide optical low-vision devices or take the child to
eye specialist for advice.
 Assigning sighted learners in the class to act as guides. Make sure they
don’t become too dependent on them.
 Treating them just in the same way as their sighted peers.
 Encouraging them to participate in as many school activities as possible.
 Arranging the classroom in such a way that, there is enough lighting in
them.

Remember, some may not tolerate bright light.

How can you assist learners who are blind in a learning environment?

For learners who are blind you may assist them by:

 Orientation and mobility training

 Training in typing, Braille reading and writing
 Training on activities of daily living
 Training on listening skills
 Provision of tactile diagrams

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  Training on auditory/listening skills (sound seasoning)

Incidence and prevalence of learners with visual impairment

Prevalence

Currently, there is no up-to-date statistics on the total population of learners who have
visual impairments in Kenya. However, it was estimated that about 1% of the total
population of about 28.7 million (1999 national population census) had visual
impairment. This means that about 287,000 people were visually impaired in 1999.

Incidence

According to research, it is estimated that 46% of all visual impairment cases in Kenya
are due to cataract. Cataract is a condition in which the lens inside the eye loses
transparency and turns milky, cloudy or opaque.

Other major causes of eye difficulties are trachoma, glaucoma and accidents. (East
Africa Medical Journal, Vol. 4 (2006).

Learners who are deaf blind

This is a condition where a person has impairments of both vision and hearing. Some
may be totally blind while others may have useful vision. At the same time, they can be
deaf or hard of hearing.

Who are learners with deaf blindness?

These are learners who may have visual and hearing impairment. This makes it difficult
for them to utilize the two senses of seeing and hearing properly. Some learners who are
deaf blind are totally deaf and blind, while others have residual hearing and residual
vision.

Learners with residual vision are able to move about in their environments, recognize
familiar people, see sign language at close distances and perhaps, read large prints.
Those with residual hearing are able to recognize familiar sounds, understand some
speech, or develop some speech for communication purposes.

Characteristics of learners who are deaf and blind

If a learner has both visual and hearing impairments, it may be difficult for him/her to:

 Look at you
 Respond to your smile
 Follow a moving object with the eyes

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  Walk, eat and dress himself/herself
 Grasp objects in front of him/her or handed to him/her
 Look at pictures and read a text in books
 Turn their heads towards you when talking to them
 Turn their heads towards sounds
 Respond when you call them
 Understand what you may say to them
 Develop spoken language

What are other characteristics of learners who are deaf blind?

Other characteristics of learners who are deaf blind will include the following:

 Self-stimulatory behavior, such as, eye pocking, light gazing, rocking,

banging and twisting various parts of their bodies over and over in
rhythmic patterns.
 Moving meaninglessly in the environment,
 Lying on the ground, reluctant to move and explore often curled up in a
prone position, (some deaf blind learners do not reach out to touch or
explore objects at all.
 Playing with one object in a repetitive meaningless way, banging or
flicking it in front of their eyes over and over.
 Frustrations, behavioral difficulties and tactile defensive behaviors if
placed in inappropriate programs.

Education Intervention for Learners who are Deaf blind

You need to help them to learn the same things and activities that learners with sight and
hearing learn. You could do so in some of the following ways:

 Shoeing positive attitude – this will greatly encourage the learner to be

active and explore his/her surroundings.
 Adapting the curriculum
 Encouraging the learner to use residual hearing as you talk to him/her
while you play or work with him/her. If the child does not use the hands
properly, you can sit or stand behind him/her with your hands on their
hands, while you do the activity together.
 Having personal contact with the learner. This will develop security and
personal relationship which is necessary for further development.
 Providing them with hearing aids (if the learner has a hearing loss)
 If they do not see well, let them be provided with eye glasses to enable
them to see properly.
 Training and stimulating the learner on activities to develop:
o Communication skills

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 o Visual stimulation skills
o Motor and self-care skills
o Cognitive skills
o Social skills

Incidence and Prevalence of learners who are deaf blind.

The availability of incidence data for learners who are deaf blind is mainly limited to
official statistics available for those with hearing impairment or visual impairment in
many countries. However, about 15 out 100,000 (0.015%) of school going age children
have deaf blindness. (East African Medical Journal, Vol. 83, No. 4 (2006).

Learners with cognitive differences

Learners with cognitive differences are classified into the following categories.

 Mental disabilities
 Giftedness and talented ness
 Specific learning difficulties
 Autism

Learners with mental disabilities.

Who are learners with mental disabilities?

You might be already aware that these are learners with substantial limitations in present
functioning. They are characterized by significant sub-average intellectual functioning,
existing concurrently with related limitations in two or more of the following applicable
adaptive skill areas:

 Communication
 Self-care
 Home living
 Social skills
 Community use
 Self-direction
 Health and safety
 Functional academics
 Leisure time and work

Functionally, learners with mental disabilities will experience serious setbacks in

learning, adapting and adjusting in various environments including home and school.

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Categories of Learners with mental disabilities ( Intellectual Difference)
Learners with mental disabilities are classified into four major categories based on the
severity of their disabilities, adaptive behavior and educational performance. These are
learners with:

 Mild mental disabilities

 Moderate mental disabilities
 Severe mental disabilities
 Profound mental disabilities

Learners with mild mental disabilities

These are learners who deviate only to a relatively minor degree in their level of
functioning from “normal learners” of the same chronological age. While the slow rate at
which these learners develop motor, social and language skills may be noticeably
different from their “normal” peers; they may not often suspected until they enter school.

Learners with mild mental disabilities can in many cases be educated within a regular
school system. They can learn academic skills to approximately standard six or seven
but may not pass well in the standard eight examinations (KCPE).

However, learners with mild mental disabilities have potentialities for development of:

 Social adjustment to a point that they can get a long independently in the
community.
 Occupational and vocational skills to enable them be self-supporting,
partially or totally at adult life.

Learners with moderate mental disabilities.

This category of learners tends to be very slow in learning. They also demonstrate
developmental delays in skills such as sitting, crawling, walking and also in language
development. For example, they may not begin to walk or talk until they are two or more
years of age. Signs of delayed development occur very early in life, but sometimes they
are not being recognized by unsuspecting parents or significant others.

Learners with severe mental disabilities

Learners in this category show marked deficits in adaptive behavior. In most cases,
severe impairment will be evident at birth.

Most of them have genetic disorders, severe sensory and emotional difficulties. In
addition, majority have pronounced difficulties in the areas of motor, social, speech and
language skills.

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With proper training, those of school going age can develop minimal communication
skills and learn basic self-help skills.

Learners with profound mental disabilities.

These learners may be identified at birth or within a few weeks after birth. They may be:

 Bed ridden
 Unable to move about on their own
 Unable to survive without assistance
 In need of total care throughout their lives.

Characteristics of learners with mental disabilities

Some of the possible characteristics you may find in learners with mental disabilities may
include:

 Being slow in acquiring and developing skills such as speaking and

walking
 Being unnecessarily slow in carrying out tasks
 Not able to transfer the same activities into different situations
 Not able to understand what is said or follow instructions
 Failing to acquire, understand and use language to express need
 Failing to develop social and emotional relationships
 Having difficulty in remembering experiences or things learnt
 Lacking the ability to connect a picture or object with an activity or word
or name
 Having excessive purposeless movements in class, home or play field
 Having retarded motor development
 Having difficulty in paying attention or focusing on an activity to its
completion
 Lacking rhythm of movement
 Having attention problems
 Memory and thinking difficulties.

Educational implications for learners with mental disabilities

During school years, they show extreme difficulties in academic subjects and usually are
able to progress beyond class two. They may however:
 Learn self-help skills like feeding, dressing, selecting daily clothing,
preparing some foods, washing and ironing clothes for themselves.
 Attain social adjustment in the family and the neighborhood. For
example, they may learn to share items and ideas with others and
especially family members as well as cooperate in a family unit and in the
neighborhood. They may learn the need to respect other people and
property, and have the ability to protect themselves from common dangers
in the home and the neighborhood.

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  Attain economic usefulness in the home, in a workshop or in the
neighborhood. For example, they may assist in chores around the house
and may do routine jobs under supervision.

Intervention strategies for learners with mental disabilities

Intervention strategies are methods and techniques you may use to teach learners with
mental disabilities.

Children with mild mental disability

Ensure that you teach skills that will enable them to be:

 Socially competent
 Personally adequate
 Academically functional

When you are teaching, arrange tasks in small sequential steps, where each step is taught
and checked to ensure that the child finds it interesting and successful. The emphasis
should be on developing the child’s:

 Self-confidence
 Language skills
 Good habits of health, safety, work and play
 Vocational skills

Children with moderate mental disability

These children should be supported to develop habit of activities of daily living, such as,
self-care, cleanliness, health, eating behavior. They need also to be helped in developing:

 Communication skills
 Ability to follow direction
 Social skills

Children with severe and profound mental disability

Home or hospital visitation programmes may be required for these children who often
cannot go to school. You may therefore provide the following training:

 Communication skills
 Motor skills
 Social skills

Incidence of learners with mental disabilities

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It is often difficult to diagnose mental disabilities in the first years of life unless it is a
severe enough to impact significantly on the achievement of early motor, language, and
social milestones. Mild forms of mental disabilities may not be evident until the child
begins school, thus the prevalence rate of this type of disability are extremely wide
ranging, depending upon the age of the subjects and the methods used to teach. Mental
disabilities may also be present as part of another condition, such as children whose
primary diagnosis is that of autism, epilepsy, and other medical syndrome.

There are no proper statistics of persons with mental disabilities in Kenya. It is however,
estimated that about 3% of the population may be having mental disabilities. This means
that, going by the 1999 national census of 28.7 million, Kenya had about 863,000 persons
with mental disabilities of whom about 215,000 (about 25%) were school going age
learners between 4 and 15 years.

Learners who are gifted and talented

The term ‘gifted and talented” describes learners who possess demonstrated or potential
abilities that give evidence of high performance in areas such as intellectual, creativity,
specific academic or leadership ability or in the performing and visual arts, ahead of their
age groups.

A learner who is gifted and talented usually does much better than learners of the same
age group and hence requires services or activities not ordinarily provided for the
average learners. The gifted and talented learners may be good in one or more areas
that give promise of future high-level achievement.

Classification of learners who are gifted and talented

You may classify earners who are gifted and talented into four main categories. These
are:

 Gifted learners
 Talented learners
 Highly motivated learners
 Creative learners

Learners who are gifted

You might have noticed that within the school setting, there are learners who enjoy
school activities and go through the curriculum with less difficulties. Such learners do
very well as they show exemplary performance in their education in lower and higher
institutions of learning. Gifted learners are bright and show a high level of intelligence.
They are able to deal with facts and their relationships. They may be good in one area
like language or mathematics or sciences. On the other hand, they may also excel in all
academic areas. Many of them may also show leadership abilities.

Learners who are talented

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You may realize in addition to good school performance, gifted learners may have other
exceptional abilities. For example, some learners do exceptionally well in music, fine art,
mechanics, dancing, singing, athletics or sports. These exceptional abilities are called
talents. These skills may not necessarily be matched by academic achievement, but since
they are far above those of other learners in the same age group, they call for special
attention.

Learners who are highly motivated

Learners with above average intellectual abilities show a high level of motivation
concern. Learners who are highly motivated may achieve much with only just above
average intelligence. In identifying gifted and talented learners the level of motivation
must be considered by teachers and parents.

Learners who are creative

Creativity is the ability to think in new ways and to produce original ideas or products.
Creative learners have unusual high levels of originality and have abilities to restructure
the world in unusual forms. For example, somebody might have come up with a certain
design; another one modifies it so that, despite using the same materials and
measurements, the final design comes out very unique and more attractive.

We also have creative writers and musicians. Writers use the same words we all use but
in their own imaginative ways produce unique write ups. Similarly, musicians use
musical notes to compose new melodies out of familiar sounds.

Characteristics of giftedness and talented ness

The following are some of the possible characteristics of giftedness and talented ness:

 Leading in academic and other activities

 Learning rapidly, easily and with less repetition
 Showing a lot of creativity and always generating a variety of new ideas
 Enjoying reading books meant for older readers
 Having unusually advanced vocabulary and using terms in meaningful
ways
 Displaying a great deal of curiosity about many things and constantly
asking questions about anything and everything
 Appearing to have behavior difficulties due to their autonomy and
sensitiveness in an environments where non-conformity is not tolerated
 Evaluating facts and argument critically
 Studying difficulty subjects because they enjoy the challenge of learning
 Having diverse, spontaneous and frequently self-directed interests
 Showing special and superior ability in manipulating materials from the
environment in making unique models
 Displaying keen sense of humor even in situations where others may not
see

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  Having high reasoning abilities and passing judgment about people, events
and things
 Having self confidence with peers as well as adults
 Incorporating a large number of elements such as art work, good role
playing, dramatizing and music
 Showing exceptional leadership abilities
 Being very articulate or verbally fluent for their age.

Educational Implications of learners who are gifted and talented

What challenges do you think learners who are gifted and talented face?

As explained earlier in this section, some learners who have high intelligence are creative
and have special talents. As they are different from others in the class, they will have
their own unique challenges.

Due to their high intelligence, these learners do not fit well with there peers. They may
be unable to develop positive interpersonal relationships and become withdrawn or
loners. Some teachers find them too challenging and often misinterpret their behavior.

Learners who are gifted and talented may also:

 Engage in some disruptive behavior in class. This may be because the
learner finds class work and other activities meant for their age group too
easy. The learner will therefore finish the assigned task within a short
time and due to boredom may engage in disrupting classroom activities.
 Find themselves too dominate in group or class discussions to an extent
that others will give little or no contribution at all. This does not augur
well with the other learners.

Unless you find outlets, these learners who are gifted and talented may channel their
energies and intelligence into unfavorable social habits such as making unnecessary
noise in class or even taking drugs.

Intervention strategies for learners who are gifted and talented

What are the qualities of a good teacher of children who are gifted and talented?

For you to help the learner who is gifted and talented, you need to:

 Recognize and accept the learner’s special abilities

 Encourage the learner to explore his fields of interests
 Help the learner to develop or enrich his social confidence
 Avoid imposing expectations and demands that are beyond the learner’s
level of ability
 Avoid having negative attitudes towards the learner reinforce the learner
positively.

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Learners who are gifted and talented are just like any other. They have basic needs
like other learners. You also need not be gifted to deal with them. However, you need
to be, tolerant, loving, understanding, flexible and competent, have broad range of
interests and skills, creative and ready to learn.

How can you assist a learner who is gifted and talented in a classroom environment?

There are several possible ways in which a learner that is gifted and talented can be
educated. As a teacher, much will depend on your creativity and classroom organization.
Each learner should be considered and treated as an individual. There are three main
ways in which a teacher may assist a learner who is gifted and talented.

 Ability grouping
 Enriching experiences
 Acceleration programmes.

Ability grouping
Ability grouping includes the following approaches:

 Regular classroom with cluster

 Regular classroom with pullout
 Individualized classroom
 Special class with some integrated classes
 Special class
 Special school

Enriching experiences What do you understand by the term ‘enrichment”?

Enrichment is the addition of disciplines or areas of learning not normally found in the
regular curriculum.

Enrichment allows each learner to investigate topics of interest in depth. Some of these
may be completed during classroom time. For example, if you are teaching Geography in
standard five, you can ask the learner who is gifted ad talented to make a model using the
knowledge learned.

Acceleration programmes.
Acceleration is any process that leads to the learner’s more rapid movement through the
regular programme of a regular school. It may include:

 Early school entrance/admission

 Grade (class) skipping
 Planned completion, for example of three grades in two years
 Early advanced placement in college or any other arrangement that leads
to the learners’ completion of the regular programmers in less than the
normally required time.

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Other approaches that you may use to help a learner who is gifted and talented are:
 Analyzing your instructional programme to avoid them becoming bored
 Providing special materials and or activities beyond the regular curriculum
 Designing enrichment activities which should support the child in learning
to relate and evaluate facts and ideas to think originally, to work through
complex problems and issues and apply understanding to new situations
 Giving the chills more responsibilities that are challenging
 Being a good role model
 Increasing individual attention
 Promoting creativity by stimulating the child’s awareness of the
environment
 Exposing the child to a wide range of experiences on a personal level
 Acknowledging the child’s work or efforts.

A learner who is gifted and talented usually does much better than learners of same age
group and hence requires services or activities not ordinarily provided to the average
learners. The gifted and talented learners may be good in one or more areas that
promise of future high-level achievement.

Incidence and Prevalence of learners who are gifted and talented

Most countries notably the United States estimate that 3% of their population is gifted
and talented. No precise information has been given on the exact number of the gifted
and talented in Kenya. However, going by this estimate then in 1999, Kenya had about
860,000 gifted and talented individuals.

Learners with specific learning difficulties

Specific learning difficulties refer to conditions that affect academic performance in

learners. Learners with specific learning difficulties look absolutely normal but it is quite
difficult to pick them out amongst learners. They seem to have the ability to perform
learning activities, yet they so not perform as expected. They develop slowly
intellectually than other learners of the same age. This is due to their difficulty with the
basic processes that are applied in understanding or using spoken language.

Learners with specific learning difficulties may have difficulties in one or more of the
following areas:

 Oral expression
 Written expression
 Reading and comprehension
 Basic reading
 Mathematical reasoning (calculation)
 Listening
 Spelling

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Children with specific learning difficulties do not include those learners with learning
problems caused by other conditions like visual, hearing, intellectual and physical
difficulties.

Characteristics of learners experiencing specific learning difficulties

Learners with specific learning difficulties may have one or more of the following:
 Basic reading difficulties
 Basic writing difficulties
 Spelling difficulties
 Number concepts (arithmetic calculations) difficulties
 Comprehension difficulties
 Difficulties in self expression
 Listening difficulties

Other characteristics are:

 Being distracted most of the time and continuously moving around.
 Being hyperactive or hypoactive
 Frequent changing of moods one time the learner is happy, and the next
time he/she could be beating others.
 Not paying attention in class, especially for longer periods of time
 Clumsy in activities involving fine motor.
 Speech and hearing difficulties that have nothing to do with hearing
impairment
 Memory and thinking difficulties.

You can only suspect that learners have specific learning difficulties when the difficulties
have been observed over a long period of time. For example, a learner may write 6 for 9
or b for d.

Educational implications of learners with specific learning difficulties

Difficulties associated with specific learning difficulties are easy to detect in a classroom
situation. However, in order to detect these difficulties you need to know what to look
for. In the classroom, these learners may be:

 Having letter reversal problem. They may see “d” as “b” or “e” in the
reverse
 Unable to write on a straight line
 Unable to copy from a given object
 Unable to perform simple arithmetic
 Have verbal expression problem
 Having reading problems, such as repeating words, confusing similar
words and letters.

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  Having spelling problems, such as incorrect order of letters
 Having difficulties associating the correct sound with appropriate letters.

Intervention strategies for helping learners with specific difficulties

There are several strategies that you can use to assist and support learners with specific
learning difficulties. You can assist them by doing the following:

 Setting reasonable goals

 Providing clear instructions to the learners
 Making special physical arrangements for the highly destructive and
hyperactive learners
 Setting guidelines for appropriate classroom behavior and help the
learners to work towards them
 Giving learning activities that are equivalent and suitable to their abilities
and interest
 Modifying the activities into smaller simple units
 Planning the activities from the simplest to the most complex
 Using visual aids in the classroom
 Developing and implement individual programmers

Incidence of learners with specific learning difficulties

In many aspects of specific learning difficulties the terminology that is used can vary
from one country to another. For example, in UK mental retardation as having a mental
disability. Whereas in North America this term may mean different condition. It is
therefore difficult to have official statistics that tell us how many people there are with
specific learning difficulties.

Due to variations in the assessment used to identify learners with specific learning
difficulties, there are no exact known numbers of cases. However, we are aware of the
fact that a large group of the school-aged learners may have these difficulties who are
referred as “slow learners”. It is estimated that about 30% of school-aged learners have
specific learning difficulties.

In your class who may have noted learners with specific learning difficulties in one of
the areas discussed. Discuss the strategies you may apply to remediate the problem.

Learners with autism

“Autism” is a developmental disability significantly affecting verbal and non-verbal
communication, social interaction, awareness, and imaginative play (valuable interest and
behavior) generally evident before age three that adversely affects educational
performance.

How you can identify learners who are autistic?

 Insistence on sameness; (resistance to change)

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  Difficulty in expressing needs; use gestures or pointing instead of talking
 Repeat words or phrases in place of normal or responsive language
 Laugh, cry, or show distress for no apparent reason
 Prefer to be isolated
 Have temper tantrums
 Difficulty interacting with others
 Resist being held or cuddled
 Have little or no eye contact
 Unresponsive to normal teaching methods
 Sustained inappropriate play
 Spin or line up objects
 Inappropriate attachments to objects
 Apparent over-sensitivity or under-sensitivity to pain
 No real fears of danger
 Noticeable physical over-activity or extreme under-activity
 Uneven gross/fine motor skills
 Not responsive to verbal cues; act as if they have impairment although
hearing is normal
 Pronoun reversal problems
 Unusual sleep patterns
 Food selectivity tendencies.

Education implication of learners with autism

Learners with autism display problems in cognition and behavior which have got
underlining problems in perception and understanding. They have varied abilities,
intelligence and behavior. Some do not speak; others have limited language that often
includes repeated phrases or conversations while others have repetitive play skills which
may have serious implications on education.

From the age of three, children with autism are eligible for an educational program
appropriate to their individual needs. Educational programs for students with autism
focus on improving communication, social, academic, behavioral, and daily living skills.
Behavior and communication problems that interfere with learning sometimes require the
assistance of a knowledgeable professional in the autism field who develops and helps to
implement a plan which can be carries out at home and school.

Autism interferes with learning process in communication, social participation, cognition

and sensory processing.

Educational intervention strategies

Learners with autism are first and foremost learners. They have more similarities to other
learners than differences. Although some learners with autism encounter genuine

27
instructional challenges, they learn well with appropriate, systematic, and individualized
teaching practices.

To provide effective instructions for learners with autism, you should address the
following:

 Ensure that the learners are in good health, free from pain and irritation,
and in a safe, stimulating and pleasurable setting.
 Provide structure in the environment, with clear guidelines regarding
expectations for appropriate and inappropriate behavior.
 Provide tools, such as written or picture schedules, to ensure that the flow
of activities is understandable and predictable.
 Adapt the curriculum to suit individual’s characteristics but not on the
label of autism.
 Focus on developing skills that will be of use in the learner’s current and
future life in school, home and community.
 Carefully plan transitions to new placements and new school experiences
which usually require careful planning and assistance.
 Encourage parents and other family members to participate in the process
of assessment, curriculum planning, instruction and monitoring. They
often have the most useful information about the student’s case history
and learning characteristics, so effective instructions should take
advantage of this vital resource.

Prevalence of autism
Just like many other types of special needs and disabilities there are no official statistics
of learners with autism in Kenya and many other countries. However, according to
research studies, prevalence estimates in most countries is about 1 per 1000 learners with
a ratio of 3 to 4 male to each female learner.

Learners with communication difficulties

What is communication?
Communication is the process of exchanging ideas, information and experiences between
two or more people. It is a two-way process through which one sends a message and the
other is expected to understand it and give a feedback.

What is a communication difficulty?

Communication difficulty is a condition, which either interferes with the smooth flow of
one’s speech and language or hinders the acquisition and development of such a
language. This condition, in turn, interferes with the process of communication. This
may affect the learner’s learning and development.

Communication difficulties may be divided into two categories:

 Speech difficulties
 Language difficulties

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Speech Difficulties

A child is considered to have speech difficulty if his speech does not sound normal
compared to the speech of his/her peers.

How would you tell that speech is not normal?

You may be able to detect abnormality in speech when:

 Words may be pronounced poorly
 The flow of speech may no be fluent
 The voice may be too loud/soft, too low/high or it may not be pres

Types of Speech Difficulties

There are three main types of speech difficulties. These are:

 Articulation difficulties
 Fluency difficulties
 Voice difficulties

Articulation Difficulties
This is speech difficulty related to problems of pronunciation.
A learner with articulation difficulty may find it difficulty in articulating sounds in words
or in sentences. The child may pronounce the sound wrongly, omit it in a sentence,
substitute it for another or add an additional sound next to it sentences.
There are therefore, four types of articulation difficulties; namely:

a) Malarticulating/pronouncing sounds wrongly: Pronouncing a sound (e.g. /s/)

wrongly whenever it occurs in isolation, that is whenever it occurs at the
beginning, end or middle of words.
b) Omissions: Omitting a sound in words e.g. ‘siti’ may be pronounced as/ - it/.
c) Substitutions: Substituting a sound for another in words e.g. substituting /s/
for /k/. ‘sit’ may be pronounced as ‘kit’.
d) Addition: A child may be adding, a vowel to every word that ends with a
consonant e.g. ‘sit’ may be pronounced as ‘siti’.

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Fluency Difficulties
Speech is fluent when it is produced spontaneously, effortlessly, quickly and with a
smooth flow. When we speak, sounds are combined to form words; and words sentences.
The production of the words and sentences should be spontaneous and the flow should be
rhythmic.
Fluency difficulty therefore is a condition where one is unable to talk in an easy and
relaxed way resulting in a speech that is unnaturally hesitant. The most common fluency
difficulty is stammering, also referred to as stuttering. We say that a person stammers
when his speech at age 5 or above so hesitant that it is a problem to him/her or others.

Pronunciation characteristics of children with stammering problems

 Prolongation: Some stammers tend to prolong sounds in words e.g. the

word ‘banana’ may be pronounced as ‘ba-----------nana’.
 Repetition: A stammer may repeat a sounds or syllabus in words and
sentences e.g. ‘w-w-w-w-when I s-s-s-s-saw him, I c-c-c-c-collapsed’.
 Complete Blockage: Such a learner or even adults usually gets stuck on
the first sound of word, e.g. for ‘Kisumu’, he/she may only sound
‘k-----------------------.

Due to these difficulties, a stammerer may avoid words that contain sounds that are
difficult to him/her.

Communication Difficulties

There are two types of communication difficulties. These are:

 Language Difficulties
 Speech Difficulties

Language Difficulties

The following are the two main types of language difficulties

 Receptive language
 Expression language
Receptive Language
The main receptive language difficulties include the following:

 Inability to recognize or identify incoming stimuli e.g. The patient may be

fully aware that he is hearing, seeing or touching something but cannot
discern what it is, hence cannot name it.

30
  Inability to assign meaning to spoken, written or signed words. Children
may experience this difficulty when they have not formed the necessary
concepts of the world around them or when they cannot relate the words
and what they symbolize.
 Difficulty understanding sentences because they have not mastered the
grammar of the language.
 Comprehension difficulties due to inability to relate different parts of a
passage or discourse resulting in lack of cohesion and coherence.
 Attention deficits: Inability to attend to a message.
 Inability to interpret the meaning of words and sentences in context.
 Inability to interpret the spoken or signed message according to the body
language accompanying it.
 Memory deficits e.g. inability to retain and re call messages.
 Inadequate vocabulary.
 Dyslexia (severe reading and spelling problems).

Expressive Language Difficulties

Some of the expressive language difficulties include the following:

 Sentence construction difficulties: Inability to construct appropriate

sentences in the target language because the child has not mastered or is
unable to master the grammar of the language. This is a characteristic of
those with severe mental disabilities and hearing impairment.
 Inability to use appropriate body language to convey meaning: This
problem mainly is demonstrated by children with cerebral palsy and also
with mental disability.
 Inability to use appropriate word context: These are children who tend to
produce utterances not related to context as found in children with autistic
spectrums. They tend to repeat sentences at random. This language
behavior is known as echolalia.
 Inability to program and activate the relevant parts of the body to convey
the intended meaning: For example, a paralyzed person knows what to
say but may not be able to activate the organs of speech to move in order
to produce the intended message.
 Word finding difficulty: Difficulty in finding specific words when
engaged in a conversation or when confronted with a question.
 Difficulty deciding how to respond to an incoming message.

Learners with communication difficulties have speech and language problems due to
inability to receive and express language as expected.

Characteristics of learners with communication difficulties

The following are some of the possible indicators, which may help you, identify learners
with communication difficulties. These may include, learners who:
 Stammer or stutter
 Speak abnormally too fast
 Have disorganized sentence structure

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  Substitute, omit, distort or add speech sounds
 May have too high or too low tone
 May have hoarse or nasal voice under normal conditions
 Do not engage in activities that involve talking, such as asking questions in class
 Tend to speak in isolated words or short sentences
 Have tendencies to breathe through the mouth
 Have difficulties in controlling saliva
 Have phonological awareness problems
 Produce sounds through the nose instead of through the mouth
 Produce sounds through the mouth instead of through the nose.

Incidence of learners with communication difficulties

There are no clear available data on children with primary communication difficulties in
Kenya. However, according to research studies in developed countries, the prevalence of
those with communication difficulties is about 5% or 50/1000 children.

Learners with emotional and behavioral difficulties

Emotional and Behavioral Difficulties (EBD) are emotions and behaviors that are not
appropriate in relation to age and socio-cultural expectations. EBD significantly
interferes with one’s learning and development and the lives of others.

EBD’s are classified into:

 Attention deficit and hyperactive disorders

 Aggression
 Social problems
 Conduct disorders
 Personality disorders
 Juvenile delinquency

You may have seen learners in your class or community whose behavior deviates too
much from that of other learners of the same age or class.
Behavior is therefore anything that a person does or says. Some commonly used
synonyms include activity, action, performance, response and reaction. Since everyone
acts, performs and reacts at some particular time, it means everyone has behaviour

What do you think are normal and unacceptable behavior in a learners either at home or
in class.

What then does “emotional and behavior difficulty” mean?

Emotional and behavior difficulty are a deviation from appropriate behavior for a certain
age, which significantly interferes with the learner’s learning and development or the
lives of others.

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Practically, all learners display age-appropriate behavior at one time or another. As a
teacher you may have come across learners who seem to be unhappy or distressed. You
may have also met some who are aggressive. It is therefore not right for you to conclude
that such learners have emotional and behavior difficulties.

We can thus summarize emotional and behavior difficulties as behaviors which:

 Go to the extreme and are intensely inappropriate

 Are chronic and persistent
 Are unacceptable because of social or cultural expectations

Learners with emotional and behavioral difficulties include those who

 Have learning difficulties which cannot be explained through intellectual,

sensory and health difficulties
 Are unable to build or maintain satisfactory interpersonal relationships
with family members, peers and teachers
 Have tendencies to develop physical symptoms or fears associated with
personal or school difficulties
 Show general pervasive mood of unhappiness or depression
 Have inappropriate types of behavior or feelings under normal conditions.

Characteristics of emotional and behavior difficulties

Some kinds of behavior that can make you be sensitive to the possibility of emotional and
behavior difficulties are, learners who:

 Are most of the time lonely and have no friends

 Have inappropriate types of behaviors or feelings under normal
circumstances, such as:
o Verbally and physically aggressive and threatens others
o Disruptive, destructive, dominating and hyperactive
o Inattentive, blames others and seeks attention
o Disobedient and rude
o Depressed, cries easily and extremely shy
o Bored and untidy
o Do not take criticism positively

 Are unable to build or maintain satisfactory interpersonal relationships with peers

and teachers
 Are unable to learn that cannot be explained by intellectual, sensory, motor or
health factors
 Are absent from school for no apparent reason
 Steal from other learners
 Have temper tantrums at late childhood and adolescence
 Have tendencies to develop physical symptoms of pain or fears associated with
personal or school difficulties
 May have temper tantrums at late learners hood and adolescence

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  May consistently consider themselves as stupid and incapable with words such as
“I don’t know”, “I can’t do it” and “I don’t understand”.

It is not enough for you to know the behavioral difficulties of learners. It is also quite
important to establish the cause of the difficulty so that you may advise the parents,
guardians or anybody else taking care of these learners.

Since most learners will show emotional and behavior problems at one time or another,
the criteria for determining whether learners have an emotional and behavior difficulties
should be based on:
 How often the behavior is repeated
 How intense the behavior is
 How inappropriate the behavior is.

Educational intervention strategies of learners with emotional and behavior

difficulties
In order for you to help learners with emotional and behavior difficulties, you need to use
various approaches. These approaches include:

 Behavior modification
 Individual and group counseling
 Creating good school climate
 Explaining to the learners that you expect a reasonable standard of
behavior to be maintained
 Telling the learners what you expect of them in a firm and clear way
 Rewarding the learners’ appropriate behavior and ignoring inappropriate
behavior as stipulated by the school rules
 Structuring the learning environments so that the learners have no room
for displaying the inappropriate behavior
 Guiding and counseling play as a major role in improving the behaviors.

Prevalence of learners with emotional and behavior difficulties

The prevalence of learners with behavior and emotional difficulties varies from one
country to another and even from one region to another within a country. Various factors
contribute to the complexity of determining the prevalence. These include the perception
among different persons and cultures as to what constitutes emotional and behavior
difficulties. For example, high economic societies are more likely to notice some odd
behavior in learners and adults while pastoral and rural societies may register little non-
acceptable social behavior.

However, it is estimated that the prevalence of emotional and behavior difficulties in

Kenya among learners aged 4-15 years is about 1%.

Learners with physical and multiple disabilities

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Physical disabilities include conditions that may make it difficult for learners to move or
to manipulate the physical environment, interact freely and communicate easily. These
may be put into two major groups, namely:

 Orthopaedic disabilities
 Neurological disabilities.

Learners with orthopedic disabilities

Who are learners with orthopedic disabilities?

These are learners with motor impairments resulting from difficulties related to bones and
muscles systems. Muscles and bones act in a coordinated way to effect the movements of
body parts. Bones and muscles suffering deformities will display difficulties in
movement which is also uncoordinated. Examples of learners with orthopedic difficulties
who may be found in our schools are those with:

 Amputation
 Scoliosis
 Muscle cramps
 Brittle bone disease (ontogenesis imperfect a)
 Leg perthes disease
 Muscular dystrophy

Let us discuss each of these briefly

Learners with amputation

What is amputation?

Amputation refers to a condition where limbs are greatly reduced in size or missing at
birth or to limbs that have been lost or severed in the course of one’s life. Amputation
may be either acquired or congenital. A person with one or more of the limbs missing is
called an amputee.

What difficulties do amputees encounter?

Amputees may encounter various difficulties. These may include difficulties in:

 Walking
 Writing
 Turning pages of books if all limbs are amputated
 Feeding

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  Dressing
 Playing.

You will learn more about the effects of amputation in unit 3 of this module.

Educational implications faced by learners with amputated limb or limbs

What difficulties do you think learner with imputed limbs encounter in school?

Learners with amputated limbs may be faced with numerous difficulties in an inclusive
setting. Some of these difficulties will include the following:
 Inability to walk properly
 Inability to hold pens if upper limbs are missing
 Inability to turn pages in a book to read
 Inability to feed and dress himself /herself.

Intervention strategies to support learners with amputated limbs

Learners with amputated limbs have normal intelligence and can therefore integrate and
learn well in a regular school but with some modifications and adaptations of the
classroom and environment. Some of the intervention measures include:

 Rehabilitation and provision of facilities that will facilitate performance of

learning tasks, such as:
o Mobility and adaptive devices, for example prosthesis ( artificial limbs)
for those with lower limb amputation, crutches and walking sticks
o Typewriters
o Pencil holders
o Book holders
o Head pointers
o Page turners

 Training in the proper use of mobility and other adaptive devices

 Adapting suitable materials for the learners
 Adapting physical education activities to ensure maximum fitness and exercise
 Allowing them extra time to complete their tasks, if need be
 General nursing care
 Encouraging the learner to learn to live with and accept his/her condition
 Advising the parents/guardians to take learner to health centres for check ups
incase of sores due to prosthesis.

Learners with brittle bone disease

What is brittle bone disease?

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Brittle bone disease is an inherited bone disease characterized by a defective development
in the quantity and quality of bones (i.e. the bones fail to grow into normal length and
width). They are weak, soft and fragile.

Characteristics of learners with brittle bone disease

What are the possible indicators of brittle bone disease?

You will observe the following in learners with brittle bones:-

 Keep on getting fractures from time to time in school and a home
 Mobility problems or difficulties to walk around
 May have writing problem
 Stunted growth.

Educational implication encountered by learners with brittle bone disease

What are some of the educational implications faced by learners with brittle bone
disease?

Due to the delicate skeletal framework of bones, learners with this problem may
experience some of the following problems:

 Keeping on getting fractures from time to time

 Missing class regularly due to fractures and hospitalization
 Having mobility writing difficulties
 Not able to participate in strenuous learning exercises such as physical education,
games and athletics.

Teachers should be aware of the difficulties facing a learner with brittle bone
disease, whereby physical education and other related strenuous activities may not
be possible.

Intervention strategies to support the children

What are some of the intervention strategies that can be given to support these
learners?

Learners with brittle bone disease have normal intelligence. They can therefore learn in a
regular school but with some adaptations such as:

 Ensuring safety in the classroom and environment to minimize accidents

 Avoiding vigorous exercise that may affect the bones
 Availing mobility and adaptation devices for those who may require them
 Providing alternative passive activities, such as board games and cards
 Making them to understand their weak bone conditions in order to take care of
themselves

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  Training those who may be using adaptive and mobility aids on how to use them
properly.

Learners with muscular dystrophy

What is muscular dystrophy?

Muscular dystrophy refers to a genetic disease characterized by a gradual atrophy

(wearing and weakening) of muscle tissue. The muscles of the body become
progressively weaker and wasted without presence of a disease in the central nervous
system. The causes are not very clear but are assumed to be hereditary, where the mother
who is usually the carrier although unaffected, transmits the disorder more frequently to
the male children.

The wearing and weakening of muscles begin in the shoulders and then lips and
thereafter spreads to all other voluntary muscles.

We can summarize muscular dystrophy as a condition which:

 Affects mainly boys, with mothers as carriers

 Does not show apparent disability at birth, but sometimes walking may be
delayed for a few months
 Is usually first observed at about 2-3 years of life
 Renders learners incapable of walking by 10-11 years of age
 Is progressive and continues getting worse until premature death, which usually
occurs between 15-30 years of age
 Has no known cure.

Characteristics of learners with muscular dystrophy

You may identify a learner with muscular dystrophy by observing the following:
 Difficulty in running, climbing and sometimes in lifting
 Progressively becoming weak and wasted
 Supporting himself/herself against the floor on his knees, walking or climbing
using his legs when getting up
 Distortion of posture with a tendency for the chest to curve forward
 Awkwardness and difficulty in walking or running, with frequent falls
 Difficulty in rising from a fall.
***
figure2 shows some of the characteristic features of muscular dystrophy
Educational implications faced by learners with muscular dystrophy

A learner with muscular dystrophy may experience the following further complications:

 Hip and knee flexing contractions which may hinder the ability to stand
straight and walk. The child may need devices such as long or short leg
braces or a wheel chair depending on the condition. Weakness of the arms
and shoulders may not allow the use of crutches.

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  Foot deformities may interfere with the ability to stand and may require
therapeutic exercises to help strengthen joints and muscles.

Intervention strategies to support learners with muscular dystrophy

There are various intervention procedures, which can minimize the effects of muscular
dystrophy and help the child lead as normal life as possible. These include:

 Providing therapeutic exercises which can help delay the onset of

contractures
 Counseling to prepare the child for the eventual outcome and also to
develop positive image of himself/herself
 Providing braces to prevent deformities and keep the chest upright to
facilitate breathing
 Giving drugs to ease some of the effects of the condition
 Surgery to correct early deformities of lower limbs
 Providing mobility and adaptive aids to facilitate their movement and
learning
 Avoiding vigorous exercises which may strain the muscles
 Encouraging and stimulating them academically and socially
 Guiding and counseling the parents to prepare them to cope with the
deteriorating condition and eventualities of early death.

Learners with muscular dystrophy have normal intelligence and can learn well in a
regular school. However, provision has to be made for some adaptive aids and
equipment because the learner may experience various complications as the disease
progresses.

Learners with neurological disabilities

It is good for first to understand about neurological disabilities in neurological disabilities

refers to paralysis or lack of function resulting from the dysfunction of the brain and the
central nervous system.

The conditions associated with neurological disabilities include the following among
others:

 Epilepsy
 Cerebral palsy
 Spina bifida
 Hydrocephalus
 Poliomyelitis

Let us now look at each of these conditions:

Learners with neurological disabilities

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Neurological disabilities refer to paralysis or lack of functions resulting from the
dysfunction of the brain and the central nervous system.

Who are learners with neurological difficulties?

Learners with epilepsy

What is epilepsy?

Epilepsy is a brain disorder, which is characterized by a fit or sudden loss of

consciousness, convulsions o seizures.

Characteristics of learners with epilepsy

Have you come across a learner in your school who is epileptic? If so, what were the
features displayed by the learner?

I hope you came across a learner who was epileptic and you observed the following:

 Shouted once and collapsed

 Lost consciousness
 The body became rigid with jerked movements
 Noticed saliva drooling from mouth
 Observed loss of bladder and bowel control
 Experienced difficulties in breathing.

After the convulsions you may also have noticed the following:

 The learner appeared confused

 Performed purposeless activities such as rubbing arms or legs
 Experienced fear, anger and dizziness
 Went to deep sleep after the seizure.

Some characteristics of epilepsy include having extreme convulsions and seizures during
which the learners may:

 Collapse and have sudden loss of consciousness and rigidity of the body
followed
 Followed by jerking movements
 May shout and emit, gurgling sounds
 Be unable to control saliva (may foam at the mouth)
 Loss bladder and bowel control
 Experience difficult breathing, headache and vomiting
 Suddenly stop what he/she is doing and briefly have a strange, empty,
blank behavior
 Drop things

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  Chew or smack lips
 Appear to be confused and carry out purposeless activities such as rubbing
arms or legs
 Experience fear, anger, abdominal pains, dizziness or ringing in the ears
 Go to deep sleep after seizure.

Epilepsy is not a mental illness and cannot be passed from one person to another through
contact.

What would you do if a learner has a seizure attack in your class?

 Remain calm to avoid your learners from the same emotional reactions
since seizure itself is painless to the learners.
 Never try to restrain the learners because nothing can be done to stop a
seizure once it has begun.
 Clear the area around the leaner so that no injury from hard objects
occurs. Do not interfere with the movements in any way.
 After the attack you may talk to the learner to help him to overcome the
psychological trauma.
 Talk to other teachers and learners and assure them that the condition is
not contagious.
 Refer the learner to hospital if he was not on medication.
 Do not to force anything between the teeth. If the mouth is already open,
a soft object like a handkerchief may be placed between the side teeth.
 Move the learner into a horizontal position. Loosen his collar; turn
his/her head to the side for release of saliva. Place something soft under
the head.
 Do not call doctor unless the attack is immediately followed by another
seizure or if the seizure lasts more than ten minutes.
 When the seizure is over and the learner has gained consciousness, let
him/her rest.
 Inform the learner’s parents about the seizure.
 Turn the experience into a learning experience for the entire class.
Explain what a seizure is, that is not contagious and that it is nothing to be
afraid of. Teach the class to understand the learners, not pity him, so that
classmates will continue to accept the learner as “one of them”.

Educational implications for learners with epilepsy

Learners with epilepsy may experience some difficulties, which may affect their learning.
These may include:

41
  Negative perception by the society and peers who think that epilepsy is
contagious.
 The learner becoming disoriented due to frequent attacks thus failing to
cope with academic work.

Intervention strategies to support learners with epilepsy

Epilepsy cannot be cured but its effects can be minimized through:

 Referring the learner to hospital for medical treatment with drugs to

control the condition
 Talking to other teachers, peers and the community that epilepsy is not
contagious. This would ensure support for such learners in school.
 First aid skills and proper nursing care, especially during attack
 Making efforts to reduce emotional and psychological stress by
encouraging the child to lead as normal life as possible.

Cerebral palsy
Cerebral palsy is a disorder of the brain, which occurs as a result of brain damage, or lack
of development in the part of the brain controlling movement and posture. Look at figure
3 (i), (ii) and (iii) showing conditions related to cerebral palsy.
***
Characteristics of learners with cerebral palsy

 Slowness in acquiring skills and knowledge in some learners

 Facial abnormalities and or drooling in some cases
 Stiffness or rigidity of body parts especially the wrists, hips, knees and
ankles
 Increased muscle tension when the learner is excited or upset
 Abnormal position of the body
 Lack of muscle co-ordination
 Slow, wriggly or sudden, quick movements of the feet, arms, hands or face
in excitement or in an effort to grasp something
 Difficulty drawing straight lines due to involuntary movements
 Speech difficulties due to difficulty in controlling the muscles required to
produce speech
 Poor balance and posture
 Awkward gross and or fine motor movements
 May suffer from convulsions or fits
 Poor eye-hand coordination especially in writing activities and low
intelligence.

Educational implications for learners with cerebral palsy

A learner suffering from cerebral palsy may experience some of the following
difficulties:

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  Difficulties in performing functions requiring the use of their hands and
legs
 Communication difficulties due to weakness of the speech organ muscles
 Low intelligence as result of delayed milestone, which may affect their
academic work
 Hearing and sight problems which may affect their learning activities
 May suffer from convulsions or fits
 Learning difficulties especially in areas such as reading and writing

Intervention strategies to support learners with cerebral palsy

The damage to the brain that leads to cerebral palsy cannot be repaired. However,
affected individuals can be supported to become independent in life through:

 Providing suitable therapeutic exercises and mobility and functional or

supportive aids and nursing care.
 Giving psychological counseling and guidance.
 Referring the chills to other professionals such as occupational therapists
and physiotherapists.
 Providing activities to develop eye-hand coordination
 Encouraging them to use speech and for those who cannot produce
intelligible speech, devise for them other modes of communication such
as communication boards, bliss symbols, sign language or gestures.
 Providing appropriate learning and technical aids and adapted physical
education and sports equipment.
 Providing them with mobility devices such as crutches, walking sticks,
standing/walking frames and wheel chairs and training them on how to
use them.
 Providing them with alternative communication aids and mobility aids or
other services.
 Organizing and preparing activities which will stimulate growth and
development especially to children with delayed milestone.
 Enriching the classroom with a variety of educational resources to raise
interest in the learners.
 Modifying the curriculum for them to learn at their own pace.

Learners with Spina Bifida

You may have seen in some learners a growth protruding at the lower back that looks
like a swelling. This is spinal tissues which were exposed during foetal development.
This condition is called spina bifida.

Characteristics of learners with spina bifida

 Dark bags or lumps which develop at any level of the spine but in most
common at the level of the waists.

43
  Lover limbs paralyzed and have little or no sensation, so burns or pressure
sores may develop without the learners being aware of them.
 One or both hips may be dislocated
 May develop club foot.
 Poor urine and bowel control.
 Water developing in the brain and in the head which may enlarge leading
to hydrocephalus (unusually big head). This may lead to brain damage.
 Poor visual perception and lower intelligence as compared to an average
learner in the class.

Educational implications faced by learners with spina bifida

What difficulties do learners with spina bifida experience?

 May be absent from school to go to hospital frequently for neurological, urinary
and orthopedic consultations and procedures.
 May have paralysis of the lower limbs and poor bladder and bowel control
resulting in unpleasant odors which you and the rest of the class or school must
learn to put up with.
 Some learners especially those who develop hydrocephalus may have the
following problems:
o Lower intelligence
o Poor vision perception.

Many learners with spina bifida may have normal or near normal intelligence, so that in
spite of absences from school, they can learn if proper adaptations and facilities are
provided according to their needs.

Intervention strategies to support learners with spina bifida

Intervention measures can be taken to minimize the effects of spina bifida through:

 Nursing care to prevent pressure sores

 Referring them to health centre for medical attention and surgery to:
o Insert a shunt which drains the fluid from the head (for those with
hydrocephalus).
o Correct foot and spinal deformities.
o Training them on bladder and bowel management.
o Allowing them enough time to complete their academic activities
o Being tolerant with them and encouraging them in all possible
ways.
o Adapting facilities and curriculum to suit the learner’s needs.

Learners with hydrocephalus

you may have seen a learner with an extra ordinary big head

44
This condition is referred to as hydrocephalus! Hydrocephalus (commonly known as
“water in the brain”) is a condition caused by abnormal accumulation of fluids
(cerebrofluid), which expands the bones of the skull, and if untreated can cause damage
to brain cells. This may result into intellectual disabilities (mental retardation), fits and
occasionally paralysis of lower limbs. The condition can also cause slow general
development of the learners.

There are two types of hydrocephalus

 Congenital hydrocephalus
 Acquired hydrocephalus.

Congenital hydrocephalus
This refers to a condition born with the child. It is due to the malformations of the brain
causing blockage in the flow of fluid and separation of the bones of the skull. This
results to an enlarged skull.

Acquired hydrocephalus
This is a condition acquired after birth due to head injuries, cerebral hemorrhage or
disease such as meningitis and cerebral malaria.

More than 80% of the babies born with spina bifida also have hydrocephalus condition.

Educational implications encountered by learners with hydrocephalus

The following are some difficulties encountered by learners with hydrocephalus

condition, which may affect learning:
 Low intelligence as compared to average learners
 Poor motor activities
 Communication difficulties
 Poor visual perception
 May be absent from school for many days since they have to go to
hospital for medical check ups
 May have poor body balance as a result of the big head which may result
from falling from time to time.

Intervention strategies to support learners with hydrocephalus conditions

For effective management of learners with hydrocephalus condition, you:

 Should plan for activities which will improve:
o Stimulation and development
o Communication skills
o Balance and coordination

 Be tolerant and encourage them in all possible ways

 Refer them for medical checkups

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  Prepare individualized educational plan for the children
 Train them on balance and coordination to prevent them from falling
which may cause further injuries to the brain or fractures to the limbs.

Learners with Poliomyelitis (Polio)

Polio is caused by a virus that destroys the nerve in the spinal cord. There is no cure for
this condition but victims are advised to take long hours of bed rest to control the
activation of the virus until they recover. Post polio victims will have weak limbs and
will require support for mobility.

Characteristics of poliomyelitis (polio)

What are the effects of poliomyelitis?

 Paralysis
 Degeneration (wasting away) of muscles and bones
 Stunted growth of the affected limb or limbs
 Non-progressive disorders of movements

Educational implications encountered by learners with poliomyelitis

Learners with polio experience a variety of difficulties despite having normal

intelligence. Some of these difficulties are:
 Mobility problems which prevent them from moving about
 Weaknesses in fine and gross motor muscles
 Slowness in accomplishing academic tasks, such a writing notes and
exercises
 Frequent absenteeism from school due medical appointments for check
ups, and surgical operations to correct deformities and physiotherapy.

Intervention strategies to support learners who suffered from poliomyelitis

The following are measures that you can take to ensure full participation f learners with
who suffered from poliomyelitis:
 Training them on how to use mobility devices and corrective appliances
such as wheel chairs, crutches, special orthopedic boots, calipers and
braces. Modifying and adapting the classroom and school environment to
facilitate free movements and use of other facilities in the school.
 Providing adaptive materials for those who require them such as head-
pointers, page-turners, book-holders and pencil-grips
 Ensuring that the child has good posture when writing at a desk or table.

Poliomyelitis can be controlled and even eradicated through immunization. It is

therefore good for you to advise all parents in your school, and the community to take
immunization seriously.

Learners with multiple difficulties

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Multiple disabilities are those with more than one disability. For example learners who
are:
 Deaf blind
 Cerebral palsy
 Mental disabilities with visual impairments.

Characteristics of learners with multiple disabilities

 Little or no communication, that is, unable to:

o Express themselves or understand others
o Use hands or other signs (gestures) meaningfully to pass messages
to others.

-Delayed physical and motor development (delayed milestone),such as:

o Inability to move about independently
o Inability to sit up or support themselves
o Deformities of limbs and body posture
o Remaining in bed or home bound for most of their lives.

-Frequent inappropriate behaviors, such as:

o Rocking back and forth
o Self stimulation e.g. by manual stimulation of their sex organs
o Self injuring e.g. banging the head.

Educational difficulties faced by learners with multiple difficulties

Some of the problems faced by these learners are:

 Communication difficulties. They cannot:

o Express themselves or understand others
o Gesture- meaningfully to pass messages to others

 Delayed motor and physical development. They generally experience the

following difficulties:
o Limited ability to move about independently
o Inability to sit up or support themselves
o Deformities of limbs and body posture
o Bed ridden or home bound most of their lives.

 Frequent inappropriate behavior, such as:

o Rocking back and forth
o Self-stimulation, for example by manual stimulation of sexual
organs
o Self injuring, for example, banging the head.

 Lack of self help skills. They depend almost entirely on other people in
self-help activities, such as:
o Dressing themselves

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 o Keeping themselves clean
o Eating
o Attending to their toilet needs.

Intervention strategies to support learners with multiple difficulties

Most learners with multiple difficulties never fully outgrow their dependence on other
people. The following are some measures that can be put in place to support these
learners:

 Showing the learner love, patience and affection

 Assessing the learner to determine the skills the learner can perform and
those required to be learnt. This is particularly the Activities of Daily
Living, such as, eating, toileting and dressing.
 Preparing individualized educational programmers using task analysis
approach
 Providing special equipment and devices such as crutches and wheel
chairs
 Referring the child to health centre for medical check ups and other
services
 Designing and implementing individualized programmers
 Adapting the classroom/school environment to meet the needs of the
learners
 Talking to other learners to develop positive attitudes towards these
learners
 Designing toilets/latrines to accommodate the learner especially those
using wheel chairs
 Make modification of the school environment for accessibility.

Make a list of features in your school or community that in your opinion could hinder a
child with multiple difficulties in mobility and discuss how they could be alleviated with
the school administrator and community leaders.

Learners with chronic health diseases

This refers to learners with chronic disease such as:

 Asthma
 Burns
 Heart diseases
 Hemophilia
 Tuberculosis
 Diabetes
 Sickle cell anemia.

Learners with asthma

Asthma is a chronic respiratory condition, which occasionally results to difficulties in
breathing. It may be precipitated by allergy in the respiratory system. When in attach the
victims produce a wheezing sound as they attempt to breathe in and out.

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Characteristics of asthmatic attacks
 A clear running nose, followed by dry, hacking and non-productive cough
at the beginning of an attack.
 Difficult in breathing during attack.
 Wheezing and excessive sweating
 Bluish coloration of nails, whitish coloration of the eyes, lips and ear
lobes, if the attack is very severe.
 Considerable reduced activity in case of a severe attack.

A learner usually sits with his/her shoulders hunched forward, laboring to breath during
the attack.

Intervention strategies to support learners with asthma

Learners with asthma can always learn in regular schools, as long as teachers understand
their difficulties. Below are some strategies that may be used to support learners with
asthma.

 Eliminating any offending (allergic) substances as possible from the

learner’s environment.
 Giving the learner water to drink to help ease the wheezing.
 Encouraging the learner either to sit or stand but not lie down, as he/she
would be more relaxed while in a sitting position. While in a sitting
position, the learner can be encouraged to sit forward in a chair with
hands on knees, while breathing through the mouth.
 Trying to ensure that the learner has taken any prescribed medication and
be observant of any possible side effects or behavior changes.

Learners with burns

Burns as injuries to the skin and or underlying tissues as a result of being burnt by fire or
chemicals.

Effects of burns

 Psychological reactions on the affected part of the body

 Ulcers
 Withdrawal as a result of a feeling profoundly helplessness
 Hypertension
 Unreasonable fear of fire
 Scarred tissue leading to deformities
 Shortened muscles and tendons at the joints
 Reduced function of the affected limbs
 Low self-esteem.

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Intervention strategies to support learners with burns

Burns can leave ugly scars and may reduce ones functional ability. These learners can be
supported as follows:

 Encouraging the learner to accept the deformity

 Giving the learner a lot of psychological support
 Talking to the learner’s peers not to make fun of his/her deformity
 Providing supportive devices if necessary
 Referring the learner to the health centre for medical treatment and
nursing care
 Advising the parent/guardian to provide the learner with high-protein and
vitamin diet during the healing period.

Burns can leave very ugly scars and reduce ones functional ability. This may also affect
the learners’ self-esteem.

Learners with heart diseases

A heart disease is any abnormal condition of the heart. Heart disease includes irregular
functioning of the heart, as well as diseases of the coronary arteries, heart valves and
heart muscles.
There are two main types of heart diseases:

 Congenital heart disease

 Acquired cardiovascular disorders

Congenital heart diseases are much more common than acquired heart disorders.

Characteristics of learners with heart disease

 Shortness of breath, for example panting during feeding or other activities
 Fatigue (weariness) or the learners being dull most of the time
 Chest deformity
 Poor growth and development as a result of tissues receiving insufficient
blood and nutrients for growth
 A blue appearance caused by the circulation of deoxygenated blood
 Fainting
 Chronic cough
 Chest pain
 Recurrent respiratory infections.

Intervention strategies to support learners with heart diseases

Medical intervention
If a heart problem is confirmed, the following medical treatment can be carried out:

 Drug therapy to cure and lessen the problem

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  Surgery to correct heart valves and congenital defects such as hole in the
heart
 Use of diet with reduced fat content
 Use of exercises as advised by the doctor.

Educational intervention
Learners with congenital diseases attend regular schools. You should be aware that such
a child may get exhausted easily, and lack stamina to carry out certain activities and may
also be hospitalized frequently. There is need, therefore:

 Avoiding giving the learner strenuous exercises which could exhaust

him/her
 Understanding the medical history of the learner and reminding him/her
on medical appointments and when to take prescribed drugs
 Monitoring the learner’s academic performance and remediation on the
work covered during his/her absence.

Learners with hemophilia

Haemophilia as a condition marked inability of the blood to clot. In such cases blood
clots very slowly or not at all. The causes are unknown but the condition is hereditary
and is more common in boys than girls. It is transmitted genetically by mothers who are
predominantly carriers.

Characteristics of hemophilia
 Inability of the blood to clot
 Swollen joints and ankles for no apparent reason
 Under the skin and bruising easily

All the above mentioned could weaken the body system resulting to disabilities

Children living under especially difficult circumstances

These are children who by reason of their circumstances exist in conditions that pose a
serious risk to their lives for survival. They are not able to progress well in their learning
like other learners. This is because they are affected b various factors including, political,
socio-cultural, economic and health difficulties. These factors hinder their physiological
and psycho-emotional development. This in turn affects their learning and development.

The children are also referred to as “those in need of care and protection”.

The following is a list of children living under especially difficult circumstances hence in
need of care.
 Those who are traumatized
 Abused and neglected learners
 Homeless and unaccompanied learners
 Those affected and infected/infected by HIV and AIDS.

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Others are:
 Street children
 Child laborers
 Children who are refugees and displaced
 Children who are orphaned
 Child mothers
 Children from deprived and rich families
 Children heading families
 Child soldiers
 Children from pastoralist communities

Children who are traumatized

These are children who may have experienced torture or aggressiveness as a result of:
 War
 Conflicts
 Clashes

Such children may have also witnessed people being beaten, molested, raped, chased
from their homes, killed or even forced to kill others.

These traumatizing experiences leave the children socially and psychologically affected.
This eventually affects their learning and participation in daily life. They are deprived of
their freedom making it extremely difficult for them to gain from the regular school
system.

Children who are abused and neglected

Child abuse is any act or intention to treat learners badly by directly or indirectly hurting
them. It is also a failure to provide for the daily needs, hence affecting the children’s
social, emotional and psychological status. Other forms of abuse and neglect include
lack of affection, systematic scolding and withdrawal from schools. Forced marriages
may also interfere with their education.

Characteristics of children who are abused and neglected.

Physical and behavior indicators of children who are abused and neglected
Indicators of abuse and neglect in children can be both physical and behavioral. These
include:
 Physical abuse
 Physical neglect
 Sexual abuse
 Psychological mistreatment.

Physical abuse
Physical indicators
 Unexplained bruises in various stages
 Human bite marks and bald spots
 Unexplained fractures

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  Unexplained burns.

Behavior indicators
 Withdrawal and aggressiveness
 Uncomfortably with physical contact
 Early arrival at and late leaving school as if avoiding home
 Chronic runaway
 Complaining of soreness or moving uncomfortably
 Clothing which is inappropriate for the weather.

Physical neglect
Physical indicators
 Abandonment
 Unattended medical needs
 Consistent lack of supervision
 Consistent hunger, inappropriate dress, poor hygiene.

Behavior indicators
 Fatigue, restlessness, falling asleep in class
 Stealing food, begging from classmates
 Reports of no caretaker at home
 Chronic absenteeism from school.

Sexual abuse
Physical indicators
 Torn, stained or bloody underclothing
 Pain or itching in genital areas
 Difficulty walking or sitting
 Bruises or bleeding external genitalia
 Venereal diseases
 Frequent urinary or yeast infections.

Behavior indicators
 Withdrawal and depression
 Excessive seductiveness
 Low self-esteem, self-devaluation and lack of confidence
 Peer relation difficulties and lack of involvement
 Massive weight loss
 Suicide attempts
 Hysteria and lack of emotional control
 Inappropriate sex play or premature understanding of sex
 Feeling threatened by physical contact or closeness.

Psychological mistreatment
Physical indicators

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  Speech disorders
 Delayed physical development
 Ulcers, asthma and severe allergies.

Behavior indicators
 Habit disorders such as sucking and rocking
 Antisocial and destructive manifestations
 Passive and aggressive-behavior
 Delinquent behavior
 Developmental milestone.

Street Children
“Street children” is a social term that refers to those children for whom the street has
replaced the family and the home as the focal point of their existence and communal
interaction. The children live in circumstances devoid of any protection, supervision or
direction from responsible adults. The causes that bring children to the streets may be
poverty and civil strife. Some parents are poor and are not capable of providing basic
needs to their children.

Civil strife in most communities results in loss of moral attributes that include family
breakage. These conditions may make children to go and live in the streets.

There are four primary groups of children whose existence revolves around streets.
These are:
 Children on the street
 Children of the street
 Children who are completely detached from their families
 Children of street families.

Children on the street: These maintain good family ties while out there. They
therefore, return home in the evening after spending the day begging, working or
engaging in petty offences on the streets.

Children of the street: These have loose family contacts and spend some nights or days
or part of the day on the streets and occasionally go back home.

Children who are completely detached from their families: These children lead a
gang life and live in makeshift shelters in the streets. In most cases they have completely
no contacts with their families.

Children of street families: This is the most recent group of street children to emerge.
It consists of children who are born and bred on the streets. They know no other home.

Prevalence of street children

It is estimated that there are more than 300,000 learners living and working on the streets
of urban centre in Kenya. Out of these about 50% of them are concentrated in and
around Nairobi, the capital city.

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Child laborers (Working children)

Child labour has been defined by International Labour Organization (ILO) to mean, “any
economic activity performed by a person under the age of 15 years and that is detrimental
and exploitative”.

Kenya’s Employment Act of 2001 (Kenya) defines child labour as “any situation where
children provide labour in exchange of payment”.

Child labour is therefore any work that interferes with children’s upbringing and
education. The working children are spread across various economic sectors with the
main concentration being in domestic service. They also work in agriculture, quarrying
and mining, fishing, children prostitution, hawking, shoe shining, car washing, begging,
scrap metal and garbage collection. Those who go to school may find their
responsibilities as a burden and end up dropping out. The others may have no time to be
children.

Refugees and displaced children

Many people get displaced as a result of political upheavals such as wars, tribal clashes
and natural calamities. The displaced people live in refugee camps. In Kenya an
estimated 365,000 people were displaced during the inter-ethnic conflicts, which erupted
in some parts of the country in 1991/92, 1993/94 and 1997. These conflicts resulted in
great loss of property and disruption of settled community life.

Children who were about 50% of the estimated displaced people suffered most.
Education was disrupted as many schools were destroyed and others closed down. This
loss as well as being torn away from their homes and sometimes separated from their
parents and peers resulted to low self-esteem leading to difficulties in learning and
participation in development activities.

By the beginning of the year 2001, Kenya was host to more than 46,900 children
refugees. This constitutes about 23% of the total number of about 206,100 that sought
safe haven in Kenya.

These people run away from their countries to Kenya because:

The majority of the refugees in Kenya arrived in the country due to war, famine and the
collapse of governments in neighboring Somalia, Ethiopia, Sudan, Eritrea, Uganda,
Democratic Republic of Congo, Rwanda and Burundi.

The refugees especially children live in extremely difficult circumstances, which affects
their learning and development.

Children who are homeless and unaccompanied

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Children who are homeless and unaccompanied are those without homes and have
nobody to take of them. Children may end up in this situation as result of turmoil caused
by wars and/or natural calamities, like earthquakes killing their parents or relatives and
destroying their homes.

This can also be brought about by breakages in families. These children will be affected
socially and psychologically resulting to difficulties in learning.

Orphaned children

These are children who have lost both parents. Sorrow, guilt and or anger resulting from
having lost both parents may overwhelm such learners. Parents might have died from
illnesses and accidents. In 2001, the number of HIV and AIDS orphans under the age of
15 years was estimated to be more than 1 million in Kenya. Most of these children lack
proper care and supervision they need at this critical stage of their development.

Orphaned children have to content with discriminatory practices that ostracize them as
outcasts. They are denied the essential family care by reason of death or terminal illness
of their parents. Many children end up in the streets from where they are likely to come
into conflict with the law. These learners will have neither peace of mind nor motivation
for learning.

Children affected and or infected by HIV and AIDS

Children affected by HIV and AIDS are those who have lost their parents or dear ones
through the syndrome. Medical statistics (2001) indicate that about 700 people died
every day in Kenya due to HIV and AIDS and related diseases.

Those who are infected are those who have acquired the syndrome which weakens their
immunity system against diseases. Besides the rising number of orphans due to AIDS as
mentioned above, the disease is causing early painful deaths among learners infected art
birth or through breast feeding. It is estimated that, about 30-40% of babies born to
infected mothers will also be infected with HIV and AIDS. Most of these babies
succumb to AIDS and die within two years. Those children who survive often
experience social and psychological difficulties such as being stigmatized by the society
thus affecting their self-esteem.

HIV and AIDS pandemic is now the single most serious setback in the efforts to fulfill
the rights of Kenyan learners, particularly those guaranteeing life, survival, education and
participation in development activities.

Child mothers

These are young girls who become pregnant and give birth before maturity, that is, below
the age of 18. Those who are at school are forced to drop out. Those who are not at
school become mothers before the rightful age. The new responsibility of being a mother
affects the children’s ability to learn and participate in development activities.

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Children from deprived and or rich families

In rich families, some learners may develop behavioral difficulties as a result of lack of
proper attention, involvement and care. They may also lack the guidance in the use of
resources. There may be rigidity in decisions made by parents. These results to low self-
esteem as well as lack of independence, which may affect learning.

On the other hand, learners from poor families may drop out of school as a result of
poverty. Such learners may end up in the streets, as laborers or prostitutes. This
therefore affects their learning.

Children heading families

The reason as why children head families
is a result of wars, internal conflicts and tribal clashes, natural disasters, displacement and
loss of parents, learners may be left on their own to fend for themselves. They take on
adult responsibilities of looking after their young sisters and brothers. The new and
demanding responsibilities may affect their abilities to learn and also develop.

Child soldiers
These are learners under the age of 18 years who are recruited in the armed forces. They
carry and use guns and are confronted by vast experience that they do not need at that age
of development. They have missed a stage in their lives of being learners. This greatly
affects their learning and development.

Children from pastoralist communities

Some districts in Kenya and other countries within the region are under a predominantly
pastoralist economy and nomadic lifestyle. These districts are classified as Arid and
Semi Arid Lands (ASAL). These areas are characterized by severe hardships, including:
 Hostile climate
 Drought and famine
 Livestock rustling and conflicts over pasture and water resources
 Banditry and general insecurity.

The combination of natural factors and inadequacies in planning has severely limited
pastoralist learner’s enjoyment of their basic right to survival, human development and
participation. The greatest challenge faced by these children is limited access to basic
social services, particularly education and health.

There are about 20 districts in Kenya under pastoralist economy and nomadic lifestyle.
List the factors that you think may affect children’s learning and development in these
districts.

Educational implication and management of children living under especially

difficult circumstances in schools
Like in families, inclusion of children living under difficult circumstances in schools calls
for some considerations. These may include:
 Attitudes
 Resources

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  Communication
 Parental involvement
 School community.

Attitudes
Many children living under difficult circumstances are deprived of participation and
involvement in schools due to negative attitudes. The school community may see them
as a shame or burden. They end up being stigmatized, excluded and prejudiced.

The following should be done to reduce the negative attitudes:

 Sensitize other children in the school and teachers about such children
 Counsel and guide these children to accept their situation
 Involve them in various school activities
 Use teaching approaches that create active learning, like peer teaching, so
that they can share their experience with others.

Communication

Children living under difficult circumstances need a healthy communication situation in

which they learn and develop. This means that:
 The way we communicate should not be commands, or giving directives.
It should be conversational and with respect of others views.
 The conversation should be useful and within the child’s experience.
 The language used in the conversation should be understandable and at
the level of those communicated to.

Parental involvement
Parents are a key resource in addressing issues about children living under difficult
circumstances. At school they play the roles like:
 Construction of school buildings
 Networking with other stakeholders in planning and intervention for all
children
 Being security to the children.

School community
Members of the school community should among other things:
 Encouraging other children to accept these children living under difficulty
circumstances as part of them
 Encouraging the children living under difficult circumstances to accept
their situation
 Provide funds for developing the schools.

Family and upbringing factors

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The child’s upbringing is critical for his/her future life. There must be, good
understanding, discipline and acceptance of appropriate norms and values of society.

In a situation where fundamental gaps in upbringing emerge, serious consequences occur.

These may have far-reaching consequences like emotional, behavior or learning
problems. Below are some examples:
 Parents who pressurize their children to achieve or who have
unrealistically high expectations of their children can make them
unyielding to parental pressure and or develop low self-esteem. The child
may unconsciously become hostile towards parents and develop negative
attitudes towards them and school.
 Overprotection by parents leaves children no room for freedom and
opportunities to become independent. Decisions are made for the
children and they do not learn to take responsibility for their lives and
their schoolwork.
 Some parents show very little interest in their children’s activities. They
are not concerned with the children‘s education and do not encourage
them to do well in school. This lack of interest affects their attitudes
towards themselves and school.
 In some homes where there is poor discipline often have little routines.
When parents are inconsistent in their style of upbringing children, they
begin to feel uncertain and confused. Disorganized homes constitute one
of the main causes of behavior at problems institutions.

School factors
There are numerous factors associated with school, which may cause special educational
needs in learners. Some of these are:
 Teachers who do not have proper skills may not be aware of the children’s
individual needs and may therefore not be able to assist those with special
needs
 Teachers who are not sensitive to the various needs of learners in their
classes. This means that, learners whose style or pace of learning is
different from the average are not accommodated
 Denominated teachers who are not sufficiently concerned about doing
their best for their learners. They usually spend little time on preparation
and present lessons in an unattractive, less motivating and illogical manner
 Teachers who use teaching methods, which do not meet needs of all
children. Because of poor teaching, the learners may result in poor
motivation and hence result to disciplinary or behavioral problems
 Inappropriate resources (human and economic) in schools may also result
in children developing learning difficulties. Educational resources may
not be linked with what is being taught and may not relate to the
experiences of learners
 Too rigid or too lax and inconsistent school discipline may affect learner’s
social and psychological growth.

Educational intervention for children living under especially difficult circumstances

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Before you prepare to teach children in difficult circumstances, you should have some
guiding principles. These will include:
 Knowing the children’s strengths and challenges
 Setting teaching objectives according to the potentials of each individual
child
 Allocating time appropriately so that they complete learning tasks and
activities within time
 Using appropriate and suitable teaching methods and materials, to cater
for individual needs of the children.

Now let us discuss some approaches that can be utilized to include children in difficult
circumstances in school. These approaches include:
 Adaptation of the curriculum
 Classroom management
 Educational materials.

Adaptation of the curriculum

Curriculum adaptation in an inclusive setting for children living under difficult

circumstances means modifying the regular curriculum to meet the needs of these
children. This means you take the existing curriculum and match it to the needs, abilities
and interests of the children.

When modifying or adapting the curriculum, you should consider the following:
 Content- this should help the children to develop skills, which are useful
for them in their future lives. This should include activities that help them
release the emotions they have. For example, music, dance and drama.
From this, then you proceed to academic subjects
 Content presentation- this requires looking at the rate at which you present
it. The methods of delivery should consider the needs of the children.

Classroom management approaches

One of the challenges you may meet in an inclusive classroom is how to manage it. You
should strive to create a calm orderly atmosphere where both the child and you can be
satisfied.

Classroom management will include:

 Organizing time in the classroom whereby there is a consistent routine of
activities at specific times.
 Organizing space in the classroom so that certain areas are assigned
various activities, for example, reading, nature corner and mathematic
corner
 Making class rules that promote expected behavior within and outside the
classroom. You should involve the children in making rules
 Organizing activities to suit the needs of all children
 Using different teaching methods, which should be child-centered. For
example:

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 o Child-to-child
o Peer teaching/tutoring
o Mediated learning.

Educational materials help children living under difficult circumstances learn what will
help them lead better lives in future. Some of them may have problems with their motor
abilities or senses. Educational materials will enable them to use their remaining
abilities. Some of these instructional materials are those used in teaching such as
textbooks, charts, maps, flashcards, radios and many others.

EFFECTS OF SPECIAL NEEDS AND DISABILITIES

Effects of sensory differences

In Unit 1, we learnt about the following sensory impairments.

 Visual impairment
 Hearing impairment
 Deaf blindness.

In this section we are going to discuss how these differences affect the learners’
education and development.

Visual impairment

Effects of total loss of vision

Blindness imposes three main kinds of effects and limitations on learners. It restricts the
learners’:
 Range of variety of experiences
 Ability to move about (mobility)
 Control of the environment.

The range and variety of experiences that blindness brings to an individual vary with the
age of onset. If the onset of blindness comes early in life the learners will not have visual
concepts and will therefore have a limited range and variety of experiences.

You should also know that, loss of vision also restricts ones ability to move about
because the individual does not have visual stimulation and feedback that stirs further

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investigations. This is what makes some learners to remain seated in one place for long
hours.

Total loss of vision in learners will also make it difficult for the individual to familiarize
with what is going on in the environment. This means that learners who are blind cannot
choose freely to do what they want and when the want. They may also find it difficult to
choose friends that interest them.

Visual impairment may also affect learners in the following areas:

 Psychological development
 Educational development.

Effects on psychological development

Self concept
You may have observed that learners with visual impairments tend to have more
difficulties establishing their personal identity (self concept). This is because of their
poorly defined role within a sighted world. This affects psychological development of
the learners, since one becomes more disadvantaged as compared to the sighted learners.

Isolation and withdrawal

Persons with visual impairments may have a tendency to be isolated socially. They may
also have feelings of isolation and detached from the environment. This makes it
difficult for them to choose companions with whom to hold conversations. This means
the person who is visually impaired will always need to be spoken to first. If you fail to
engage them in conversation, then they remain isolated.

Inadequate social role models

You remember that social behavior and attitudes are learned by observation and
imitation. Learners who are visually impaired find it difficult to emulate the role models
in daily life. This is because learners who are visually impaired have a limited variety of
observations, and their opportunities for participation in social activities are also
restricted. They therefore turn to self-stimulation as a means of passing time.

For example they may develop such habits as:

 Poking of the eyes
 Rocking their body back and forth
 Clapping their hands in appropriate times
 Turning their heads rapidly from side to side
 Making repetitive meaningless sounds.

Effects on education development

The educational development of learners with visual impairments is affected in a number
of areas. Some of these are:
 Cognitive development
 Sensory stimulation
 Concept formation

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  Physical development.

Sensory Stimulation
Development will also improve concept formation. For example, story telling, listening
to environmental sounds and identifying source of the sounds, listening to taped sounds
of learners in class or within the family and identifying the speakers.

Concept formation
Because the learners who are visually impaired lack one major source of sensory input,
their way of getting and processing information are deficient. The learners may not grasp
some concepts and may need more time and experience to grasp others. If the learners
have been blind from an early age, they may not be able to form concepts of objects and
things such as:
 Colour
 Big mountains and buildings
 Sky and clouds
 Echo and mirror images.

Learners with visual impairments have specific difficulties in concept formation.

Therefore educators need to put more emphasis on concrete experiences in order to help
the learners form concept that are meaningful to them. For example, when teaching the
concept of “a dog”, all sighted children will have seen a dog. However, those with total
visual loss will have only heard of a dog bark. A dog to them will be the barking of a
dog.

What can you as a teacher do to make the learner understand what a dog is?

The best way of introducing the concept of a “dog” would be to bring the real dog to the
class for the child to “feel”. In some cases, real objects may not be available. In such a
situation, you should use a model of the real object. The learners should be guided to
explore the object or its model using his/her hands and fingers.

You should always remember that growth and development of the visually impaired is
much like that of the sighted, though the rate might be slower, the visually impaired
might be slower due to environmental deprivation.

Rich experiences and opportunities for participating in a variety of physical activities will
aid the development of physical and motor skills which may be deficient when compare
to the sighted.

Effects of hearing impairment on learners

Hearing impairment may have effects on the learners’:
 Speech development
 Language development
 Social development.

Speech development

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When learners have hearing impairment, the most noticeable symptom is defective
speech. The learners’ leave out some important speech sounds, usually those that are
high pitched consonant sounds such as /s/. /sh/, /t/, /k/.

Language development
Hearing children develop language naturally through listening to people speak and
responding to them. As learners acquire a language they make use of all the senses in
order to perceive the world around them. For example, the use of sense of touch through
manipulating different objects and the sense of vision through observing what is in the
environment. The sense of smell and taste also contribute to the learning of language.

The sense of hearing actively enables the learners to perceive immediate sounds and
those that are far away. These senses also enable the learners to perceive spoken
language, which is learned not only through speaking and listening to the parents and
peers but also through conversation.

What then is the effect of hearing impairment on language development?

Social development
Another difficulty that learners with hearing impairment can have is lack of acceptance
by the community. As you already know, it is important for learners to fit in society and
be accepted socially. It is therefore necessary that learners be encouraged to:
 Take part in all activities
 Share with others
 Seek help and help others
 Accept the hearing community
 Feel that they can count on help anytime from the hearing community.

Effects of Cognitive Differences

Cognitive differences include:
 Mental disabilities
 Specific learning difficulties
 Giftedness and talented ness
 Autism

Effects of mental disabilities

Mental disabilities will affect the learners in the following areas:
 Language development
 Academic achievement
 Social and personal development.

Language development
A learner with mental disability lags behind other regular learners in language
development. For example learners with mental disability with a chronological age of ten
years, may be slower in acquiring language skills than a “normal” learner of seven years.

We can therefore generally say that, learners with mental disabilities may show delayed
development in:

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  Comprehension
 Receptive language
 Expressive language
 Vocabulary acquisition
 Reading skills
 Sound blending.

Academic achievement
Many learners with mental disabilities do not do well in school. Their academic
performance can lag behind by 2 to 5 or more classes. They delay in cognitive
development is considered the primary cause of their academic underachievement.

Social and personality development

Learners with mental disabilities experience difficulties in personal and social adjustment
within their environment. They are unable to cope with the many experiences during
their early years of development and hence develop behavioral difficulties.
You may have also noted that they may experience social isolation and rejection. They
tend to be isolated by peers. The main reason for the rejection is that many of them
manifest immature behaviors. Some engage in activities that are not appropriate for their
chronological age. They therefore have few friends and are kept out of normal social life
much of the time.

Effects of specific learning difficulties

Specific learning difficulties have marked effect on one or more of the following:
 Spoken language
 Reading
 Arithmetic
 Spelling
 Psychological development
 Comprehension
 Listening
 Writing.

These areas are critical in the learning process. Any difficulties in any of them will
definitely affect learning.

Spoken language difficulties

The learners may have difficulties in understanding abstract words, concrete words and
words with multiple meanings. The learners may also have difficulties in understanding
how words are grouped together to form phrases, sentences or paragraphs.

Reading and writing difficulties

Learners with specific learning difficulties tend to have major difficulties in:
 Visual discrimination
 Auditory discrimination
 Sound blending
 Word analysis

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  Reading sight words.

The above problems will make it difficult for these learners to develop both reading and
writing abilities.

Arithmetic difficulties
Learners with specific learning difficulties may have difficulties in the following areas:
 Discriminating different shapes
 Grouping in sets and numbers
 Counting
 Recognition of place value
 Computational skills
 Measurement
 Telling time
 Quantitative language
 Monetary values
 Difficulties in solving problems.

Emotional development
These learners have psychological problems which affect their emotional and
sociological development. Their problems are manifested as:
 Inadequate self-concept
 Personality difficulties
 Anxiety
 Poor interpersonal relationships
 Dependency
 Distractibility/hyperactive
 Withdrawal
 Repeated behavior.

These manifestations make it difficult for these learners to interact adequately with their
peers and adults.

Effects of giftedness and talented ness

What difficulties do you think learners who are gifted and talented face?

As explained earlier in this section, some learners

 Have high intelligence
 Are creative and have special talents.

As they are different from others in the class, they will have their own unique difficulties.

You should also remember that learners who are gifted and talented may also engage in
some disruptive behavior in class. This may be because the learners’ find class work and
other activities meant for their age group too easy and too boring.

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Such learners may also find themselves dominating in group or class discussions to an
extent that others will give little or no contribution at all. This does not augur well with
the other learners.

Due to their high intelligence and motivation these learners do not fit will with their
peers. They may be unable to develop positive interpersonal relationships and become
withdrawn or loners. Some teachers find them too challenging and often misinterpret
their behavior.

Effects of emotional and behavioral difficulties

Children with emotional and behavioral problems may have serious difficulties in:
 Academic performance
 Social interaction

Academic performance
You may recall that learners with emotional and behavior problems may have:
 Short attention span
 Sensory deficits
 Health difficulties.

The above cited problems may prevent them from doing well in academic work. Others
develop conduct problems making it difficult for them to remain in class for long hours to
learn.

Social interaction
These learners are usually lonely and may be:
 Disrespectful to school authority
 Immature
 Shy and withdrawn – their behavior may be inappropriate compared to their age
mates.

Since these learners may not have the language to express them, they misbehave, exhibit
negative and hostile feelings or withdraw entirely from human interactions, both
physically and verbally. The learners with socialized aggressive behavior often get
involved in petty crimes such as stealing.

Effects of communication difficulties

Communication difficulties may affect the learner’s:
 Academic achievement
 Psychological development.

Academic achievement
The role communication plays in learning process cannot be underestimated. Language
acquisition is an indispensable tool in acquiring knowledge. The more severe one’s
language disorder is the more affected the learner’s performance is in school.

Psychological development

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Learners with communication difficulties experience psychological and social adjustment
difficulty. This is because they are painfully aware that their communication is defective.

You will notice that such learners may feel:

 Immature
 Inadequate
 Intellectually inferior or incompetent.

They also tend to perceive their defect as diminishing their self-worth and acceptability in
social relationships.

Effects of physical and health problems

Motor difficulties and health problems affect learners:
 Motor functioning
 Communication
 Academic achievement
 Psychosocial development.

Motor functioning
You may be aware that motor functioning is perhaps the most obvious result of physical
and health problems. This is due to the fact that physical status of the learners is affected
and may include both legs and arms. Gross motor and fine motor abilities can be greatly
impaired, thereby limiting not only movement of the arms and legs but also their
functional use such as:
 Walking
 Jumping
 Writing
 Holding eating utensils (e.g. a spoon, fork).

Other physical involvements include partial or paralysis of the affected body parts. This
may reduce sensation and causes contractures and stiffness to develop.

Communication
Some learners with motor difficulties have speech and language difficulties and find it
hard to communicate. Some may not have a voice due to respiratory disturbances.
Others may not interpret messages received because the part of the brain responsible for
this action may be damaged. Others can hear and interpret messages but may have
difficulties in expressing themselves using speech because the organs of speech are
affected.

Academic achievement
How do physical and health difficulties affect learner’s academic achievement?
Our society places a lot of emphasis on academic achievement. Academic achievement
to a large degree depends on learners’ cognitive abilities. Motor and health difficulties
may not necessarily lead to low cognitive abilities in learners. However, such learners
may have excellent cognitive abilities but be limited in their academic achievement
because:
 The curriculum has not been designed for their needs

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  They have difficulties manipulating both reading and writing materials
 Their poor health leads to regular hospitalization hence frequent
absenteeism from school. These leads to poor academic achievement.

Social and personal adjustment

What are some of the basic needs of learners?
 Food
 Water
 Shelter
 Fresh air.

Apart from needs mentioned above, you realize that learners also need to interact with
others. This also helps them to get a feedback on how people feel about them. This also
helps them in forming a positive or a negative self-concept. Many learners with physical
and health problems form negative self concepts because of the way people perceive
them.

Section 2: Effects of special needs on the family

In section 1, we explained the effects of special needs and disabilities on the child. This
section examines the involvement of parents, caregivers, families, peers and significant
others in helping to overcome the effects of special needs and disabilities. Factors that
may influence attitudes of parents, levels of their involvement in education and also
guidelines for professionals in dealing with parents are also explained.

A parent is a learner’s first teacher. This is the person who is always available to give
prompts, encouragement, praise and corrective feedback. A parent has quite a lot of
expectations for his/her child. Many parents are also aware of the effects of disability on
learning and development.

Stages of grief
What are some of the reactions you expect to be exhibited by parents with children with
disabilities when they first get the information?
 Shock
 Anger
 Bargaining
 Depression
 Acceptance and reorganization.

Shock
The first reaction of a parent is the denial that the child has a special need or disability. It
also provides the parent with feelings of guilt and shock while trying to come to terms
with the reality. During this time of shock, the child hardly gets any special attention.

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This stage generally coincides with the newborn period and efforts should be directed
towards encouraging acceptance of the reality and also building confidence in parenting
skills. Many parents stay on this stage for a long time.

Anger
During this stage, anger can be directed towards the professionals who did either too
much or not enough towards fate or simply towards anyone and anything.

Bargaining
This stage may be characterized by a search for a cure, another doctor or a different
educational programme for the learners. It reflects the anguish parents can experience in
finding answers to questions about their child’s health, handicapping conditions or
educational potential.

Depression
Depression may be expressed as feelings of inferiority. For example, a parent may think,
“I’m not a good parent. I can’t help. Hopes are lost ……” When depression is not
controlled it may permeate all aspects of family relationships. The result in some cases
has been either separation or divorce for the couple.

Acceptance
At this stage, parents are at peace with themselves as people and as parents and see their
child as an individual with his own strengths and weaknesses. Parents who have reached
this stage are most likely to have other children which may imply that they don’t see the
special need or disability as an overwhelming handicap.

Accepting does not mean liking the disability and thus does not mean that the anguish
and lost dreams will be forgotten. A parent of children with special needs or disability
requires empathy and not sympathy.

Factors that may influence parents’ attitudes

Attitude is the way you think or behave and feel about something or somebody.
There are several factors that may affect the parents and the entire family of learners with
special needs and disabilities. Some of them are:
 Severity of the disability
 Age at onset
 Socio-economic status
 How the information was received
 Financial hardships
 Time.

Severity of the disability

The severity of the learner’s disability often influences the attitudes and feelings of
parents and members of the family. The more obvious the disability, the less socially
acceptable it is. Different handicaps affect parents-learners’ interactions in different
ways and require different parenting techniques. The more severe the handicap, the

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greater influence certain factors will have on parents’ self-concept and sense of control
over the situation.

Some of the factors that may influence parents’ responses to learners with disability
include:
 The reward that parents derive from parenting
 How difficult and time-consuming routine care giving tasks (e.g. dressing,
feeding, etc.
 How frequently the learners needs to be hospitalized
 Additional financial resources that are required to support the learner’s
future
 Isolation of parents’ and friends because of the time and financial
commitments, as well as the social stigma associated with the handicap
 Less time for sleeping, recreational activities, and performing routine
household chores.

The impact of these factors greatly increases with the severity of the handicap.

Age at onset
The older the child is when the disability is diagnosed, the more difficult it is for the
parents. Even if the learners have been diagnosed as disabled previously, a subsequent
but new diagnosis of disability on top of the other disabling conditions may be
particularly difficult for parents because of the myth and stigma usually attached to
disabling conditions.

Socio-economic status
you may have noted that disabling conditions do not target particular socio -economic
groups, the higher the socio-economic status of the family, the more adverse the reaction
to the birth of learners with special needs or disability. However, parents of all socio-
economic levels share similar feelings about the birth of learners with special needs or
disability.

How the information was received

The manner in which parents are first told about their child’s disability may greatly
influence parent attitudes. What parents take away from that meeting can hinge on how
they were told as much as on what they were told.

Financial hardships
Financial matters are of concern to all families and range from providing the basic needs
e.g. food, shelter, clothing, security and education to the learners. The stress is
particularly hard on single-parent families who are mainly women and those in low
paying or less skilled jobs.

The fact that the presence of a child with special needs will extend the parents financial
burden greatly affects their attitude. Disabling conditions come with extra demands and
all these have an impact on the way the child is treated.

Time

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You will realize from your experience that parents of children with disability may need to
stay with them for longer periods.

Lack of time may contribute to stress, which can also be manifested in anger, impatience
or tension among the family members. Families with a child with a disability admit that
time is a rare commodity in their daily lives. This affects the way they view the child.
Many of them blame the child for denying them the time to relax, work and possibly to
socialize.

Effort should be made to refer parents to comprehensive centre-based services as much as

possible, and to locate alternative transportation sources such as other parents or
community vans to relieve some of the time pressure parents often experience.

Many parents of both non-handicapped and handicapped do devote time in working with
their learners at home. The difference is that the special instructional period is
assignment, while working at home is just a suggestion; the first is mandatory, while the
second is voluntary.

Critical Events
There are six main critical events of a family of a child with disabilities. These are:
 The disability is suspected in the newly born child
 The diagnosis is being made and the impairment is being treated
 The child is ready to enter a school programme
 The child reaches puberty
 The child reaches the age of vocational planning
 The parents grow old and worry that the learners will outlive them.

Three most important critical periods in the lives of all families, whether the child has
disabilities or not are:
 The child is ready to enter a school programme
 The child reaches puberty
 The child reaches the age of vocational planning.

The same events will occur whether the learners have disability or not. Parents have
similar experiences and same concern and fears. Professionals therefore need to be
aware of these critical periods in the life of the family so that they can respond
appropriately in giving information and assistance in locating resources to help reduce
their fear of the unknown.

Lack of control
You realize that feeling in control of one’s life is a natural desire for every person.
Parents of the children with disabilities, however, frequently feel powerless to what is
happening around them. Continuously contribute to feelings that one is not in control of
one’s life. Parents of the children with disability suddenly find themselves forced to rely
on the judgment, opinion and recommendations of the experts.

Parents as an in-group

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To a certain extent, parents’ attitudes towards professionals are formed from bonding
with other parents by sharing experiences and feeling about their learners and about the
professionals they have encountered.

Parents cannot share these feelings with most professionals, simply because most
professionals do not know what it is like to have learners with a disability.

The myth of cure

This is another factor that may influence the parent-professional relationship in the belief
that the learners “can be made better” through medical or educational intervention.
Individuals visit a doctor to cure an illness and attend school to obtain an education and a
chance for a better life.

Guidelines for professionals in dealing with parents

It is a fact that professionals hold the power in the parent-professional relationship. They
affect parents’ self-concept, confidence, and level of involvement in the educational
program by what information they choose to share and how they share it. Below are
some of the suggested guidelines for professionals working with parents of learners with
special needs and disabilities? They should:

 Involve parents in every step

 Talk face-to-face, eliminating any physical barriers (such as a desk or
telephone) and maintaining eye contact
 Ask parents what their needs are
 Be attentive and keen listeners, showing respect and concern for both the
parents and the learners
 Share all information and helping them to think positively about the
learners
 Be specific and objective about presenting information. Learn how to give
advice, including helping to device a realistic management plan with
suggestions for living on a daily basis
 Help parents understand the child’s abilities and assets. What the child can
do is much more important to both the child and the parent than what
he/she cannot do
 Use every day language and minimize use of jargon or acronyms. Give
parents a glossary of educational and medical terms to help them interpret
the language of other professionals
 Answer all questions honestly, but sensitively. Admit that you do not have
answers to all questions
 Plan future goals-and meetings cooperatively.
 Clarity and summarize the results of any meeting or conference before
concluding, and follow up with a written summary
 Give copies of all reports to parents (they must stay informed to stay
involved). Remember that all written materials should be in their parents’
native language and in an accessible mode of communication
 Create opportunities for parents to talk with other parents. The most
realistic way to decrease families’ isolation is by providing them with

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 access to their peers. Parents amongst themselves offer respect with
empathy and without the burden of clinical assessment.

DR Wanyera, S.O. (2023).

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