Id 001

Open, Distance & Electronic Learning
(ODEL)

Special Needs Education
Module ID 001
Introduction to Children with

Special Needs.
Kenya Institute of Special Education

Kise Vision
“To be a Regional Centre of Excellence
in Special Needs Education & Related
services.”
More About the Author
Mr. Stephen Mwaura is a lecturer in the Department of Hearing Impairment at the
Kenya Institute of Special Education (KISE). He is currently, the Deputy Academic
Registrar – Open Distance and Electronic Learning. He trained originally as a
primary school teacher and taught at Mbiri Primary school, Murang’a District,
before undertaking special education studies at Kamwenja Teachers College. He
majored in the Education of Learners with Hearing Impairment and has taught
in various special schools for children with hearing impairment and also served
as a District Special Programmes Coordinator. He holds a Master of Philosophy
degree in Special Needs Education from the University of Oslo, Norway; Diploma
in the Education of the Deaf from Instutuut Voor Doven, St. Michielsgestel,the
Netherlands and a certificate in Audiology maintenance technology from North
East Survey College of Technology (NESCOT). United Kingdom. He has widely
travelled and has participated in various fora on Special Education.
Mr. Samuel Wanyera has worked as an assistant Head of Department Distance

Learning, in charge of students support services at the Kenya Institute of Special
Education. He trained at Kagumo Teachers’ College in 1977 as a primary school
teacher. He was among the pioneer students who trained at the Kenya
Institute of Special Education for Diploma in the Education of Persons with visual
impairments. In addition he has worked in a Psycho Educational Assessment
Centre, served as a supervisor of a school in the PRISM project and more recently
as a consultant in Special Needs Education of the “Mradi wa Kuendeleza Elimu
Zanzibar” (MKEZA) project of the Ministry of Education Zimbambwe. He holds
a Bachelors Degree in Special Education from Kenyatta University and a Master
of Philosophy degree in Special Needs Education from the University of Oslo,
Norway.
Published by

Open,Distance and e-Learning,(ODEL) P.O.Box 48413-00100,Nairobi, Kenya.
Tel: +254-020-8007977 Fax: +254-020-8007966, e-mail: info@kise.co.ke
Open,Distance and Electronic Learning
(Special Needs Education)
Module 1D-001
Introduction to Children with Special Needs

© Kenya Institute of Special Education (KISE) 2007
First Edition 2002, Second Edition 2007,
Re-Printing 2009
ISBN 9966-789-01-4
All rights reserved . No part of this work may be reproduced or used in any form or by any means-
graphics, electronic, or mechanical, including photocopying, recording, taping, or information
storage and retrieval systems – without written permission of the publisher.
Open,Distance and Electronic-Learning(Module 1)

Authors: Stephen Mwaura
Samuel Wanyera
Editors:
First Edition Robert Karanja
Second Edition Robert J. Maneno

Editor: Dr John Mugo
Design, Illustrations Samson Oyombi

and Layout: Josephine M. Nkuubi
Publisher: Kenya Institute of Special

Education

Acknowledgements
Kenya Institute of Special Education (KISE) wishes to acknowledge with great
appreciation the tremendous contribution of individuals, institutions and organisations
that assisted in the publishing and production of this module. These include: the joint
authors, Stephen Mwaura and Samuel Wanyera, and the editors, Robert Karanja
and Robert J. Maneno for the first and second edition respectively. Special thanks
go to Mr. Ben Gitau for the invaluable technical advice in the preparation for the
development and production of this module and others in the series.
We would also wish to thank the Royal Danish Embassy, for the continuous support,
advice and encouragement through Dr. Kurt Kristensen, the DANIDA Consultant
during the initial stages of the production of the module.
Our gratitude also go to the following institutions whose members participated

actively in the two workshops held to prepare the development and production of
this module and others in the series: Ministry of Education, Science and Technology
(MOEST) Inspectorate, Kenya Institute of Education (KIE), University of Nairobi
(UoN), Kenyatta University (KU), Kenya Society for Deaf Children (KSDC) and
Kenya Polytechnic.
We also want to thank the members of the Publishing Committee comprising, Mrs.
Monica Kilonzo, Benedict Kilei, Stephen Mwaura, Peter Ndichu, Mwangi Kithure,
Lynette Ong’era, Jeslinah Mwabili, Grace Ogonda, Mary Runo, Cammy Otiato and
Teddy Oketch for their technical and professional input.
Finally, special thanks go to Samson Oyombi and Josephine Mirembe Nkuubi for the

Table of Contents
Contents
Page
Acknowledgement……………………………………………………..............
iv
Table of Contents ……………………………………………………...............
v
Your Comments...... …………………………………………………...............
vii Module Introduction ……………………………………………….................
. viii Module Orientation …………………………………………………...
............ ix Symbols used in the module ………………..……………………
................... x
Unit 1: Diversity of children with special needs and disabilities.........

2
Introduction………..……………………………………………. 3
Section 1: Definition of terms and clarification of concepts

used in special needs education ……..…………… 4
Section 2: Categories, characteristics, incidence and prevalence

of children with special needs and
disabilities…...... 10
Summary…………………………………………………………….................
129
Self-Test……………………………………………………………...................131
Learning outcomes…………………………………………………..................
132
Unit 2: Causes and prevention of impairments....................................133
Introduction …………………………………..…........................ 134


Unit 3: Effects of special needs and disabilities....................................149
Introduction……………………….........……………….…......... 150
Section 1: Effects of special needs and disabilities on

the child…………………………......................... 151
Section 2: Effects of special needs and disabilities on the

family……………………………........................... 168

Summary………………….……………………………….
..........178
Self-Test………………………………………………....….........
179
Learning outcomes………………………………………........... 180
Answers to self tests 1..………………………………..…................................

181
Answers to self test 2....................................................................................... 183
Answers to self test 3...................................................................................... 186
Glossary……………………………………………..……................................188

Your Comments
Dear Learner,
This is the first edition of this Module. We therefore call for your comments
and observations on this module.
This is to enable us make further improvement on this module inorder to

fulfil your needs.
Please use the evaluation form attached.
We look forward to your feedback.
Please send your comments to:
Deputy Academic Registrar

Open, Distance and Electronic-Learning (ODEL)
P.O. Box 48413-00100, NAIROBI, KENYA
Fax: +254-20-8562425,
e-mail: info@kise.co.ke

Module Introduction
Dear Learner,
Welcome to Module 1D 001: Introduction to Children with Special Needs.
Aim
The aim of this module is to introduce you to the different categories of children with
special needs in education, causes of special needs and their implications to learning
and development.

Objectives
By the end of this module you should be able to:
• define terms and clarify concepts used in Special Needs Education.
• describe the diversity and characteristics of children with special needs and
disabilities.
• explain the causes and prevention of impairments.
• discuss the incidence and prevalence of children with special needs by age and
gender in Kenya and selected countries.
• discuss the effects of special needs and disabilities on the child and family.
In this module you will be introduced to different categories of children with special
needs and disabilities and how you can identify them. This module also gives
definitions and clarification of terms and concepts used in Special Needs Education.
You will also learn about the causes and prevention of different impairments. You
will further be introduced to effects of special needs and disabilities on the child and
family. The incidence and prevalence of children with special needs and disabilities
in Kenya and other selected countries are also explained in this module.

This module is divided into three units, namely:
Unit 1: Diversity of children with special needs and disabilities
Unit 2: Causes and prevention of impairments
Unit 3: Effects of special needs and disabilities
Module orientation
In this module, every unit begins with an aim and objectives. Read them carefully
because they will guide you on what you should achieve at the end of every unit. The
units are divided into sections. As you read the units, you will find in-built activities,
which may require your written or practical responses, observations, discussions or
consultations. You are encouraged to try these activities.
Besides these practical activities, you will find self-tests at the end of every unit.
These exercises are meant to function as study tools to help you keep on the right
track as you read the units. Make a genuine attempt to respond to all exercises and
compare your answers with those given at the end of the module. If you score below
50%, you are advised to re-read the unit. You are advised to use the scoreboard to
rate yourself

Symbols
The Kenya Institute of Special Education has selected various symbols for use in the
Open, Distance and Electroninc Learning materials. (ODEL)You were introduced to
them in the Learner’s handbook. Below is a reminder of the symbols.
Objectives
It indicates the objectives of the units in the
module.
Question Mark
It indicates an in text question asked to the
learner as he or she proceeds with the reading of
the module
Activity
It tells the learner to complete the activity set
in the text before he/she proceeds with the read-
ing of the module. He/she has to write down the
answers, ideas or opinions.
Discussion
It tells the learner to consult, research and find
someone, preferably a fellow student, to discuss
with.
Refer
It points out the need to refer to other modules
or to recall certain important information
Note this point

It indicates a key point or a tip.

Summary

It shows the summary of the main points as per
the objectives of the unit.
Self test
This symbol shows the learner a self-test which
is usually at the end of every unit. The self-test is
a practical exercise, which enables the learner to
test how well he/she has understood the content
in the unit.
Learning Outcomes
It points out whether the learner has understood
the unit content in relation to the set objectives.
Congratulations
It signifies successful completion of the module
by the learner
Answers to self tests

This signifies answers to the self-tests that are
given at the end of each unit.
Glossary

It shows the meaning of difficult terms used in
the module.
Reference

This signifies reference materials that have been
used in developing the module.
Take note of these signs every time you come across them in this module!

UNIT I
Diversity of learners with special needs
Introduction

Welcome to Unit I: Diversity of learners with special needs. In this unit you will
be introduced to some terms and concepts used to describe learners with special
needs including those with disabilities. You will also be introduced to different
categories of learners with special needs, their characteristics and how to identify
them. Finally Educational Implications and Intervention Strategies will also be
explained. Incidence and prevalence of these learners in Kenya and other selected
countries will also be explained.
Aim
This unit intends to make you understand the diversity of learners with special
needs and how you can identify them. It will also enable you to know incidence
and prevalence of these learners in Kenya in comparison with other selected
countries.

Objectives
By the end of this unit you should be able to:
• define terms and clarify concepts used in Special Needs Education.

• describe the classification and characteristics of learners with special
needs
• explain educational implications and intervention strategies
• explain the incidence and prevalence of learners with special needs in
Kenya and other selected countries.

This unit is divided into two sections:
Section 1: Definition of terms and clarification of concepts used in Special Needs
Education.
Section 2: Classification, characteristics, educational implications and intervention

strategies, incidence and prevalence of learners with special needs.
Enjoy your reading!
Section 1: 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
Let us now examine each of these terms and concepts one by one
Impairment
What do you understand by the term

“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

What do you understand by the term 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 paralysed
cannot walk independently. In this case, disability is the difficulty in walking.
Handicap
What is the meaning of the term “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 fulfilment of roles that are appropriate according to the age, gender, social
and cultural norms. An individual who is not given an opportunity to become
independent by society is handicapped.
A handicap can therefore be lessened if the society provides support to enable a

person with a disability to be independent.

From the definitions above what are the main differences between
the term “disability” and “handicap”. Discuss with a colleague.

Disorder

What do you understand by the term “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
What is exceptionality?

This is term refers to any individual whose physical, mental or behavioural

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, behaviour, and speech.
Inclusion
What is 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

What is 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
What is 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
What are 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.

The term special needs is a general one for persons who need

some form of support in order to carry on with their 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.
What special educational needs have you noted among

learners

in your school/ class?
You may have noted that 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 modifications 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-centred, flexible and adjustable
to individual needs and abilities.
Why do you think it was necessary to change from special

education to special needs education?
You must have realised that special education had focused 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 is 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 will be taught at the same pace as other learners in the class
because he/she learns faster than them. 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.
You will learn more about these terms in Module ID 11:

Introduction to Inclusive Education.

Discuss with a colleague the major differences among the three
terms namely, Special education needs, Special Needs
Education
and Special needs in education.

Section 2: Categories, characteristics, incidence and
prevalence of learners with
special needs
In this section you will be introduced to different categories of learners with special
needs, their characteristics and how to identify them. Education Implications and
Intervention Strategies will also be explained. This will prepare you to help them
at home and in school. You also will also learn about the incidence and prevalence
of different categories of disabilities in learners with special needs in Kenya and
some other selected countries.

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.

From your experience, list down some learners you may
have come across who might have special needs and therefore
require special consideration. Can you list down?
Hope your list include those with:
• hearing impairment
• visual impairment
• deafblindness
• mental disabilities
• specific learning difficulties
• autism

• communication difficulties
• emotional and behavioural difficulties
• physical, health and multiple difficulties
• cerebral palsy
Others are those:

• who are gifted and talented
• living under especially difficult circumstances
Categories of learners with special needs

What are the main categories of learners with special needs?
Your list may have included the following:
• sensory impairments
• cognitive differences
• emotional and behavioural difficulties
• physical and multiple difficulties and
• those living under especially difficult and circumstances
Now let us now discuss each of these categories briefly.
Learners with sensory impairments

What are sensory impairments?

Sensory impairments are those with impaired sensory organs. These may include
the following:
• deafblindness
Now let us discuss each of them briefly.
Learners with hearing impairment

What do you understand by the term “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
Let us now examine each of these classifications.
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.

What are the major categories of learners with
hearing impairment according to severity of hearing loss?

There are five major categories of learners with hearing impairment according to
severity of hearing loss. These are those with:
• slight hearing loss

• mild hearing loss
• moderate hearing loss
• severe hearing loss
• profound hearing loss
Let us now look at each of them briefly.
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 metre. 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

• 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 hear 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 surroundings are quiet
• making sure that they look at the speaker’s face
• wearing suitable hearing aids
Learners who are deaf
Who are the learners referred to as “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 ear 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 and
shown in the figure below.
Figure 1: The Structure of the Ear
Classification of Hearing Impairment

Let us now discuss the classification of hearing impairment according to the part
of the ear affected. Any damage or infection to any part of the ear cause hearing
loss. There are three main types of hearing loss according to the part of the ear
affected. These are:
• conductive hearing loss

• sensori-neural hearing loss
• mixed hearing loss
Let us look at each of these classifications briefly
Conductive hearing loss
What is 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.
Sensori-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

What do you understand by the term “mixed” hearing loss?

This refers to a combination of conductive and sensori-neural hearing losses. This
means both the middle ear and inner ear are affected at the same time.
Generally conductive hearing impairment is less severe in its

effects than the sensori-neural. It is associated with a range
of speech, language, and learning difficulties in childhood.

Characteristics of learners with hearing impairment
Let us now look at some of the characteristics of these two groups of learners.
What are some of the characteristics which may give

you a hint that a learner is deaf?

As explained earlier there are two main groups of learners with hearing impairments.
These 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 laboured 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 rest of the learners
Figure 2 shows a learner wearing a “behind the ear” hearing aid commonly known
as “BTE” while figure 3 shows the BTE hearing aid.

Figure 2: A learner wearing a hearing aid Figure 3: Hearing Aid
Figure 4 below shows a learner with hearing impairment cupping the ear in an
effort to hear better
Figure 4: A learners cupping the ear in an effort to hear well.
You will learn more about other different types of hearing aids in Module ID 4:
Introduction to Educational Resources.
Educational implications faced by learners with hearing impairment
What do you think are educational implications for

learners with hearing impairments?
educational implications that may be faced by learners with hearing impairments

The

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
What can you do if you suspect that a learner in your class may
be
suffering from a hearing problem? Discuss your answer with
your
colleague.

Intervention strategies

How can you help a learner with hearing impairment?

Below are some suggestions on how you can help a learner with hearing impairment
to function independently.
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
• Utilising 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 child 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.
• Counselling the school community to accept the child.
• Referring the learner to the health centres for medical check ups and
treatment
• Encouraging the learner to observe general basic ear hygiene
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 to
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 Organisation, 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 have hearing impairments. It is estimated that Kenya has about 300,
000 cases of persons with hearing impairments.

Visit a special school for learners with hearing impairment and
discuss with the teachers how they are taught. Discuss your
finding with your colleagues.
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.
Learners with visual impairments can be classified into two main groups. These
are learners:
• who are blind
• with low vision
Let us now look at these two groups briefly.
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 Organisation (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
Let us now look at some of the characteristics of learners who are blind and also
those with low vision.

What are some of the characteristics of learners with low
vision?
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 movements 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
• write un even letters (for example, very small, or big letters and sometimes
not in straight lines
Figure 5: A low vision learner putting a book to close to the eyes to read.

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 back 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
Visit the nearest school for learners with visual impairmen and
familiarize yourself with the educational provisions given

to learners with low vision and also those who are blind.

Discuss your findings with a colleague.
Below find illustration of a learner who is blind using a Braille machine and fingers
to read.
Figure 6: A learner who is blind using a Braille machine for writing and using the fingers to
read.

Figure 7: Learner trying to use fingers to read
Visit an eye clinic/hospital nearest to your station and

familiarize

yourself with medical provisions and eye tests are done to
persons
with low vision.
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?
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
Let us look at each of these interventions briefly
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 problems 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
• 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 about 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. 83, No. 4 (2006).

Visit the nearest school for learners with visual impairments
and
observe how the learners are taught how to read and write and
life skills subjects. Discuss your observations with a colleague.

Learners who are deafblind

What is deafblindness?
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 deafblindness?
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 deafblind 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 recognise familiar sounds, understand some
speech, or develop some speech for communication purposes.
Characteristics of learners who are deaf and blind

How can you discover that a learner does not see and hear well?

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
• 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 deafblind?
Other characteristics of learners who are deafblind will include the following:
• self-stimulatory behaviour, 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 deafblind 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, behavioural difficulties and tactile defensive behaviours if placed

in inappropriate programs.
Education Intervention for Learners who are Deafblind

How can you assist learners who are deafblind in a learning

environment?
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:
showing 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 chid 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:
 communication skills
 visual stimulation skills
 motor and self-care skills
 cognitive skills

 social skills

Visit a school or unit for learners who are deafblind and find
out

they are taught to communicate. Discuss your observations and
findings with a colleague.
Incidence and Prevalence of learners who are deafblind
The availability of incidence data for learners who are deafblind 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

What are cognitive differences?
Learners with cognitive differences are classified into the following categories.
• giftedness and talentedness
• specific learning difficulties
• autism
Let us now look at each of these groups briefly.

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 characterised 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.
Categories of Learners with mental disabilities
Learners with mental disabilities are classified into four major categories based on
the severity of their disabilities, adaptive behaviour and educational performance.
These are learners with:
 mild mental disabilities

 moderate mental disabilities
 severe mental disabilities
 profound mental disabilities

Let us examine each of these categories briefly.

Learners with mild mental disabilities

Who are 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
rate at which these learners develop motor, social and language skills may
slow
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 examination
(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 recognised by unsuspecting parents or
significant others.
Visit a special school or unit in your locality for learners with

mental disabilities. Identify the differences in characteristics

between learners with mild and those with moderate mental
disabilities. Discuss your findings with a colleague.
Learners with severe mental disabilities
Learners in this category show marked deficits in adaptive behaviour. 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.
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
How can you identify 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 retarded motor development
 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 difficulty in paying attention or focussing 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, bathing, dressing, selecting daily clothing,
preparing some foods, washing and ironing clothes for themselves.
 attain social adjustment in the family and the neighbourhood. 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 neighbourhood.
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
neighbourhood.

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

Intervention strategies for learners with mental disabilities
What strategies may you apply to teach 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 habits of activities of daily living,
such as, self-care, cleanliness, health, eating behaviour. They need also to be
helped in developing:
 communication skills
 ability to follow directions
 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
Visit a school for learners with mental disabilities and find out
how
the learners are taught to read, write and activities of daily
living.
Incidence of learners with mental disabilities
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, cerebral palsy, 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
What do you understand by the term “gifted and talented”?

term “gifted and talented” describes learners who possess demonstrated
The
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
Let us now examine each of these categories.
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
You may realize that 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.
Figure 8: Learners showing various aspects of creativity

Figure 9: Learners demonstrating leadership skills
Characteristics of giftedness and talentedness

What are the general characteristics of learners who are

gifted and talented?
The following are some of the possible characteristics of giftedness and

talentedness:
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 behaviour difficulties due to their autonomy and
sensitiveness in an environments where non-conformity is not tolerated
 Evaluating facts and arguments 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 humour even in situations where others may not

see
 Having high reasoning abilities and passing judgement 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, dramatising 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 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 behaviour.

Learners who are gifted and talented may also:
 engage in some disruptive behaviour 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 the

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 unfavourable social habits such as making unnecessary
noise in class or even taking drugs.

Intervention strategies for learners who are gifted and talented
Before discussing the intervention strategies to support learners who are gifted and
talented, let us first look at the qualities of a good teacher of these children.
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.

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

organisation. 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. These are by providing the learner with:

 ability grouping
 enriching experiences
 acceleration programmes.
Let us now discuss each of them.
Ability grouping
What is ability grouping?
Ability grouping includes the following approaches:

 regular classroom with cluster

 regular classroom with pullout
 individualised 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 experiences allow 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 and
talented to make a model using the knowledge learned.
Acceleration programmes.
What is “acceleration”?

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 programmes in less than the normally
required time.
Other approaches that you may use to help a learner who is gifted and talented
are:
 analysing 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 child 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 give promise of future
high-level achievement.
Incidence and Prevalence of learners who are gifted and talented
countries notably the United States estimate that 3 % of their population is

Most
and talented. No precise information has been given on the exact number
gifted
of the gifted and talented in Kenya. However going by this estimate then in 1999,
Kenya had about 860,000 gifted and talented individuals.
Identify a learner or any other person in each of the four main

categories of giftedness and talentedness and list the
behavioural characteristics. Discus with your colleague.
Learners with specific learning difficulties
What are specific learning difficulties?
These 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 do 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.
O R A L
Learners with specific learning difficulties may have difficulties in one or more of
E X P R E S S I O N
the following areas.

W R I T T E N
E X P R E S S I O N
oral expression

B A S I C R E A D I N G
S K I L L S
 written expression
 reading and comprehension
 basic reading
 Cmathematical
O M P R E H E N S reasoning (calculation)
R E A D I N G
I O N M A T H E M A T I C A L
 listening
R E A S O N I N G
( C a l c u l a t i o n )
 spelling
The figure 10 below illustrates a Ldiversity of problems experienced by a learner

I S T E N I N G
with specific learning difficulties.
C O M P R E H E N S I O N
Figure 10: Learners experiencing specific learning difficulties.
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
How can you know that learners have 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
characteristics are:
Other

• 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
What kinds of difficulties do learners with specific learning

difficulties experience in an classroom setting?
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
• 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

How can learners with specific learning difficulties be helped?

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 behaviour 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 programmes
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.

to variations in the assessment used to identify learners with specific learning
Due
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-age
learners have specific learning difficulties.
Identify a learner in your class who may have specific learning

difficulties in one of the areas discussed. Discuss with a
colleague the strategies you may apply to remediate the

problem.

Learners with autism
What do you understand by the term “autism”?
“Autism” is a developmental disability significantly affecting verbal and non-verbal

communication, social interaction, awareness, and imaginative play (valuable
interest and behaviour) generally evident before age three that adversely affects
educational performance.
How can you identify learners who are autistic?
Learners with autism may exhibit the following characteristics
• insistence on sameness; (resistance to change)

• 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 hearing impairment although
hearing is normal
• pronoun reversal problems
• unusual sleep patterns
• food selectivity tendencies
Education implication of learners with autism

What are educational implications for learners with autism?

Learners with autism display problems in cognition and behaviour which have got
underlining problems in perception and understanding. They have varied abilities,
intelligence and behaviour. 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. Behaviour 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 carried 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 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 behaviour.
• 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 males 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

Let us discuss each of them briefly
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
Let us now look at each of these speech difficulties briefly.
Articulation Difficulties

What is 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
consonants e.g. ‘sit’ may be pronounced as ‘siti’
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.

What do you understand by the fluency difficulty?

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.

What are the pronunciation characteristics of children with
stammering problems?
You will notice the following pronunciation characteristic in children who

stammer:
• 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 a 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

are two types of communication difficulties. These are:
There
• Language difficulties

• Speech Difficulties
Let us examine each difficulty in some detail.
Language difficulties
The following are the two main types of language difficulties

• receptive language
• expression language
Receptive Language
What are the receptive language difficulties?
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.
• 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 recall messages.

• Inadequate vocabulary.
• Dyslexia (severe reading and spelling problems)
Expressive Language Difficulties
What are 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 behaviour
is known as echolalia.
• · Inability to program and activate the relevant parts of the body to

convey the intended meaning. For example, a paralysed person knows
what to say but may not be ablke 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
How can you identify 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 disorganised sentence structure.
• 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.

If you apply the knowledge you have now gained in
this subsection, you may help learners with communication
difficulties to overcome their problems in communication.
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 behavioural difficulties

Emotional and Behavioural difficulties (EBD) are emotions and behaviours 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
Let us now examine at each of them briefly.

may have seen learners in your class or community whose behaviour deviates
You
too much from that of other learners of the same age or class.

What then do you understand by the word “behaviour”?

Behaviour is 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……?
Make a list of what you think are normal and unacceptable

behaviours from learners either at home or in your class.
Discuss with your colleagues

What then does “emotional and behaviour difficulty” mean?
Emotional and behaviour difficulty are a deviation from appropriate behaviour

for a certain age, which significantly interferes with the learner’s learning and

development or the lives of others.

Practically, all learners display age-appropriate behaviour 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 behaviour difficulties
We can thus summarise emotional and behaviour difficulties as behaviours

which:
• go to the extreme and are intensely inappropriate

• are chronic and persistent
• are unacceptable because of social or cultural expectations

Who are learners with emotional and behavioural difficulties?
These include learners 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 behaviour or feelings under normal conditions
Characteristics of emotional and behaviour difficulties
How can you identify learners having emotional and behaviour

difficulties?
Some kinds of behaviour that can make you be sensitive to the possibility of
emotional and behaviour difficulties are, learners who:
• are most of the time lonely and have no friends

• have inappropriate types of behaviours or feelings under normal
circumstances, such as:

verbally and physically aggressive and threatens others,

disruptive, destructive, dominating and hyperactive

inattentive, blames others and seeks attention

disobedient and rude

depressed, cries easily and extremely shy

bored and untidy

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
• 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 behavioural 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 behaviour
problems at one time or another, the criteria for
determining whether learners have an emotional
and
behaviour difficulties should be based on:
· how often the behaviour is repeated
· how intense the behaviour is
· how inappropriate the behaviour is

Educational intervention strategies of learners with emotional and behaviour
difficulties
What are some of the education strategies which may be

applied
to assist learners with emotional and behaviour difficulties?
In order for you to help learners with emotional and behaviour difficulties, you
need to use various approaches. These approaches include:
• behaviour modification
• individual and group counselling
• creating good school climate
• explaining to the learners that you expect a reasonable standard of
behaviour to be maintained
• telling the learners what you expect of them in a firm and clear way
• rewarding the learners’ appropriate behaviour and ignoring inappropriate
behaviour as stipulated by the school rules
• structuring the learning environments so that the learners have no room
for displaying the inappropriate behaviour
• guiding and counselling play as a major role in improving the behaviours
Prevalence
of learners with emotional and behaviour difficulties

The prevalence of learners with behaviour 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 behaviour difficulties. For example, high economic societies are
more likely to notice some odd behaviour in learners and adults while pastoral and
rural societies may register little non-acceptable social behaviour.

However, it is estimated that the prevalence of emotional and behaviour difficulties
in Kenya among learners aged 4-15 years is about 1 %.
Learners with physical and multiple disabilities
What are physical disabilities?

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.
Let us look at each of these groups separately.
Learners with orthopaedic disabilities

Who are learners with orthopaedic disabilities?
These are learners with motor impairments resulting from difficulties related to
bones and muscle 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

orthopaedic difficulties who may be found in our schools are those with:
• amputation

• scoliosis
• muscle cramps
• brittle bone disease (osteogenesis imperfecta)
• leg perthes disease
• muscular dystrophy
Let us discuss each of these briefly
Learners with amputation

What is an 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. The diagram bellow illustrates an amputated
leg.

Figure 11: A boy with an amputated leg

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
• 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:
 mobility and adaptive devices, for example prosthesis (artificial limbs)
for those with lower limb amputation, crutches, and walking sticks
 typewriters
 pencil holders
 book holders
 head pointers
 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?
Brittle bone disease is an inherited bone disease characterised 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 at home.
• mobility problems or difficulties to walk around
• may have writing problem
• stunted growth

Figure 12: Some of the physical signs of brittle bone disease
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 hospitalisation
• having mobility difficulties
• having 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 the environment to minimise

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
• 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 tissues. 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 summarise 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
Back sways
How can you identify cases of muscular dystrophy?
Protruding
abdomen
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
Enlarged
climbing
calves using his legs when getting up
• distortion of posture with a tendency for the chest to curve forward
• awkwardness and difficulty in walking ortiptoeieng
running, with frequent falls
• difficulty in rising from a fall
Figure 13 shows some characteristic features of muscular dystrophy

Figure 13: A boy showing some 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 ort
short leg braces or a wheel chair depending on the condition.
Weakness of the arms and shoulders may not allow the use
of crutches
• 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 minimise 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
• counselling 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 counselling 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 you 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
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 characterised by a fit or sudden loss of

consciousness, convulsions or 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)
• lose bladder and bowel control
• experience difficult breathing, headache and vomiting
• suddenly stop what he/she is doing and briefly have a strange, empty,
blank behaviour
• drop things
• 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?

I hope you have mentioned some of the following ways:
• 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 learner 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 hisand

Open,Distance collar; turn his/her head
Electronic-Learning(Module 1)
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
• 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”.
Figure 14: Teacher and learner assisting a learner during an epileptic seizure

Educational implications for learners with epilepsy
Learners with epilepsy may experience some difficulties, which may affect their
learning. These may include:
• 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 minimised 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
Learners with cerebral palsy
What is 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.
at figure 15 (i), (ii) and (iii) showing conditions related to cerebral palsy.
Look


(i) Spastic – stiff but weak limbs (ii) athetosis-characterized (iii) ataxia – uncoordinated wide-
leading to clasp-knife type of mainly by the continuous spread gait
movements writhing movements of
limbs
Figure 15 (i), (ii) and (iii)
Characteristics of learners with cerebral palsy

How will you identify a learner with cerebral palsy?
I hope you mentioned the following indicators:
• 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 learners suffering from cerebral palsy may experience some of the following
difficulties:
• 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 counselling and guidance
• referring the child 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
• organising 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
What is spina bifida?
I hope you 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
What are some characteristics of spina bifida?
I hope you mentioned the following characteristics:
• Dark bags or lumps which develop at any level of the spine but in most
common at the level of the waists
• Lower limbs paralysed 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
Figure 16: A learner with spina bifida

Educational implications faced by learners with spina bifida
What difficulties do learners with spina bifida experience?
You may have listed the following:
• may be absent from school to go to hospital frequently for neurological,

urinary and orthopaedic consultations and procedures.
• may have paralysis of the lower limbs and poor bladder and bowel control
resulting in unpleasant odours 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:
 lower intelligence
 poor vision perception
 insert a shunt which drains the fluid from the head (for those with
hydrocephalus)
 correct foot and spinal deformities
• training them on bladder and bowel management

• allowing them enough time to complete their academic activities
• being tolerant with them and encouraging them in all possible ways
• adapting facilities and curriculum to suit the learner’s needs
Learners with hydrocephalus

Have you seen a learner with an extra ordinary big head?

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 that I want you to learn about. These
are:
• congenital hydrocephalus
• acquired hydrocephalus
Let us look at each briefly:
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 haemorrhage
or diseases such as meningitis and cerebral malaria.
More than 80% of the babies born with spina bifida also have
hydrocephalus condition.

Figure 17: Learners with hydrocephalus and club foot
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
• 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:

 stimulation and development
 communication skills
 balance and coordination
• be tolerant and encourage them in all possible ways
• refer them for medical checkups
• prepare individualised 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)
What is poliomyelitis?
As you may remember, 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?

I hope you mentioned the following among others:
• paralysis

• degeneration (wasting away) of muscles and bones

• stunted growth of the affected limb or limbs
• non-progressive disorders of movements
Figure 18: a post- polio learner
Educational implications encountered by learners with poliomyelitis
What difficulties do you think learners with polio

experience in a learning environment?
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
of learners with who suffered from poliomyelitis:
• training them on how to use mobility devices and corrective appliances such
as wheel chairs, crutches, special orthopaedic boots, caliphers 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
Who are learners with multiple difficulties?
I hope you said that learners with multiple disabilities are those with more than
one disability. For example learners who are
• deafblind

• cerebral palsy
• mental disabilities with visual impairments
Characteristics of learners with multiple disabilities

How can you tell whether a learner has multiple disabilities?
You may have given the following characteristics of learners with multiple
disabilities have:
• little or no communication, that is, unable to:

 express themselves or understand others
 use hands or other signs (gestures) meaningfully to pass messages to
others
• delayed physical and motor development (delayed milestone), such as:

 inability to move about independently
 inability to sit up or support themselves
 deformities of limbs and body posture
 remaining in bed or home bound for most of their lives
• frequent inappropriate behaviours, such as:
 rocking back and forth
 self stimulation e.g. by manual stimulation of their sex organs
 self injuring e.g. banging the head
How can you tell whether a learner has multiple disabilities?
Educational difficulties faced by learners with multiple difficulties

What difficulties do you think are faced by learners with
multiple disabilities?
Some of the problems faced by these learners are:
• Communication difficulties. They cannot:

 express themselves or understand others
 gesture - meaningfully to pass messages to others
• Delayed motor and physical development. They generally experience the
following difficulties:
 limited ability to move about independently
 inability to sit up or support themselves
 deformities of limbs and body posture
 bed ridden or home bound most of their lives or
• Frequent inappropriate behaviour, such as:
 rocking back and forth
 self-stimulation, for example by manual stimulation of sexual
organs
 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:
 dressing themselves
 keeping themselves clean
 eating
 attending to their toilet needs
Intervention strategies to support learners with multiple difficulties

learners with multiple difficulties never fully outgrow their dependence on
Most
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 individualised educational programmes using task analysis
approach
• Providing special equipment and devices such as crutches and wheel
chairs,
• Guiding and counselling the parents to accept and support the child.
• Referring the child to health centres for medical check ups and other
services
• Designing and implementing individualised programmes
• 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 diseases such as:
• asthma
• burns
• heart diseases
• haemophilia

• tuberculosis
• diabetes
• sickle cell anaemia
Let us now discuss each of these health problems one by one.
Learners with asthma
What is asthma?

You may have said that 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.
Characteristics of asthmatic attacks

Sits Forward
Shoulders hunched
What are the symptoms of asthma?
Breathing through
the mouth
I hope you mentioned the following symptoms.
• a clear running nose, followed by dry, hacking and non-productive cough

at the beginning of an attack
Hands in knees
• difficult in breathing during attack
• wheezing and excessive sweating
• bluish coloration of nails, whitish colouration 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, labouring to breath during the attack.

Look at figure 19 showing learners in an asthmatic attack. A learner sits forward on

the chair, hands on knees, shoulders hunched and breathing through the mouth.
Figure 19: How a learner is positioned during an asthmatic 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 behaviour changes.
Discuss with a colleague how frequent asthmatic attacks could

cause disabilities.
Learners with burns
What are burns?
I hope you described burns as injuries to the skin and or underlying tissues as a
result of being burnt by fire or chemicals.
What are the possible effects of burns?
You may have mentioned the following effects among others:

• psychological reactions on the affected part of the body
• ulcers

• withdrawal as a result of a feeling profoundly helplessness
• hypertension
• seizures
• 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
Intervention strategies to support learners with burns
Burns can leave very 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

What is a heart disease?
I hope you described a heart disease as any abnormal condition of the heart. Heart
diseases include 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.
What are the common possible indicators of heart

difficulties?
• 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
• 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 hospitalised 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
Discuss with a colleague how you can incorporate a learner

with
a heart disease in all the learning activities in your class.

Learners with haemophilia
What is haemophilia?

may define haemophilia as a condition marked inability of the blood to clot.
You
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 haemophilia
What are possible characteristics of haemophilia?

I hope
you included the following:
• 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
Who are 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 by 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 traumatised

• Abused and neglected learners
• Homeless and unaccompanied learners
• Those affected and infected/infected by HIV and AIDS
Others are:
• street children

• child labourers
• 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
Let us discuss each of these learners.
Children who are traumatised

Who are these children?
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 traumatising 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.

How can teachers help these children? Discuss your answer

with your coleagues

Children who are abused and neglected

What do you understand by “child abuse and neglect”?
Child abuse is any act or intention to treat learners badly by directly or indirectly
hurting them. This involves both physical and or psychological violence, for
example persistent beating of the child and or calling the child unfriendly names
respectively.
On the other hand, child neglect is rendering no care by parents or caregivers to

children. 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.
Visit the children’s office in your area and find out how
your culture impacts on child abuse and neglect.
Characteristics of children who are abused and neglected
Physical and behaviour indicators of children who are abused and neglected

What are some of the possible physical and behaviour
indicators of children who are abused and neglected?
Indicators of abuse and neglect in children can be both physical and behavioural.
These include:
• physical abuse
• physical neglect
• sexual abuse
• psychological mistreatment
Let us now highlight each of these:
Physical abuse
Physical indicators
• unexplained bruises in various stages
• human bite marks and bald spots
• unexplained burns
• unexplained fractures
Behaviour indicators
• withdrawal and aggressiveness,
• uncomfortability 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
• atigue, 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 in external genitalia
• venereal diseases
• frequent urinary or yeast infections
• 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
• speech disorders
• delayed physical development
• ulcers, asthma and severe allergies
• habit disorders such as sucking and rocking

• antisocial and destructive manifestations
• passive and aggressive- behaviour
• delinquent behaviour
• developmental milestone
Street Children

Who are “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
Let us look at the different groups briefly
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.
Figure 20: The phenomenon of street learners that is a common sight in Kenya’s urban
centres
Prevalence of street children
It is estimated that there are more than 300,0000 learners living and working on the
streets of urban centres in Kenya. Out of these about 50% of them are concentrated
in and around Nairobi, the capital city.
Child labourers (Working children)
What is child labour?

Child labour has been defined by International Labour Organisation (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 defines it as “the engagement of children under the age
of 16 years in the labour force”
The Children’s 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
Look at figure 21 depicting child labour

Figure 21: Child labour
Refugees and displaced children

Who are refuges 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.
Why do you think these people run away from their

countries to Kenya?
The majority of the refugees in Kenya arrived in the country due to war, famine
and the collapse of governments in neighbouring 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.
Look at figure 22 and 23 showing children in a family displaced by internal conflicts

and a Somali woman in a refugee camp respectively.

Figure 22: Children in a family that was displaced by tribal clashes
Figure 23: A Somali refugee woman holding her malnourished baby as she ponders for the
future.
Children who are homeless and unaccompanied

Who are homeless and unaccompanied children?

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.
Figure 24 shows a homeless child in the slums
Figure 24: A homeless child in the slums

Orphaned children
Who are orphans?

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
of mind nor motivation for learning.
peace

Children affected and or infected by HIV and AIDS
Who are affected or infected children 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.
who are infected are those who have acquired the syndrome which weakens
Those
immunity system against diseases. Besides the rising number of orphans due
their
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
stigmatised by the society thus affecting their self-esteem.
HIV and AIDS pandemic is now the single most serious setback in the efforts to
fulfil the rights of Kenyan learners, particularly those guaranteeing life, survival,
education and participation in development activities.
Child mothers
Who are 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.
Children from deprived and or rich families
Who are children from deprived or rich families?
In rich families, some learners may develop behavioural 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 labourers or prostitutes. This
therefore affects their learning.
Children heading families
What results to children heading families?

As 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.
Figure 25 below show an example of a child heading a family
Figure 25: A learner taking care of a young sibling
Child soldiers
Who are 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
Who are 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 characterised 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.
Look at figure 26 and 27 showing a young a boy with a gun herding livestock and
a malnourished child from ASAL region respectively.

Figure 26: A little boy armed with a gun herding livestock in Turkana district in Kenya.
Figure 27: A little malnourished and starving girl from ASAL

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. Share your answer with your
colleagues.

Educational implication and management of children living under especially
difficult circumstances in schools
What should you consider for inclusion of children living

under
difficult circumstance in schools?
Like in families, inclusion of children living under difficult circumstances in schools

calls for some considerations. These may include:
• attitudes
• resources
• communication
• parental involvement
• school community
Let us discuss each of these briefly
Attitudes
Many children living under difficult circumstances are deprived of participation

and involvement in schools due to negative attitudes. The school community
may se them as a shame or burden. They end up being stigmatised, excluded and
prejudiced.
The following should be done to reduce the negative attitudes:

• sensitise 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
What factors within a family can cause special needs in a child?

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, behaviour or
learning problems. Below are some examples:
• parents who pressurise 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. Disorganised homes constitute one of the main causes
of behaviour at problems in learning institutions.
School factors

What factors within the school may affect learning of
children’s with special needs?
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 learner are not accommodated
• demotivated 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 behavioural
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
Let us now discuss educational intervention for these children. But before discussing
the approaches, let us look at some guidelines necessary before preparing to teach
these children.
Before preparing to teach children in difficult circumstances,

what do you think should be considered first?
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 utilised to include children in

difficult circumstances in school. These approaches include:
• adaptation of the curriculum

• classroom management
• educational materials
Lets us discuss each of these briefly.
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.
What then does classroom management include?
Classroom management will include:
• organising time in the classroom where whereby there is a consistent

routine of activities at specific times.
• organising 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 behaviour within and outside
the classroom. You should involve the children in making
rules
• organising activities to suit the needs of all children
• using different teaching methods, which should be child-centred. For
example:
 child-to-child
 peer teaching/tutoring
 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.

Unit 1 Summary
This unit has introduced you to basic knowledge on diversity of learners with
special needs in education. You learnt that learners with special needs could be put
into two main groups. These are:
• special needs including those with disabilities
• learners living under especially difficult circumstances (in need of care

and protection).
Learners with disabilities
On learners with disabilities we discussed that disabilities, which affect learners’

learning and development, may be as a result of:
• sensory impairments
• psychosocial differences
• physical, health and multiple difficulties
Learners living under especially difficult circumstances
Here you learnt that:
• Learners living under especially difficult circumstances are those who by

reason of their circumstances exist in conditions that pose a serious risk to
their lives and survival. The learners are:
• Street children

• Child labourers
• Child mother
• Child soldier
• Children who are orphans
You have learnt about the characteristics and educational implications affecting
learners with:
• Hearing impairments
• Visual impairments
• Mental disabilities
• Gifted and talented
• Specific learning difficulties
• Communication difficulties
• Emotional and behavioural difficulties
• Physical and multiple disabilities
• Neurological disabilities
• Multiple disabilities
We hope that the knowledge gained in this unit will assist you to understand these
learners better and be able to support them in and outside school.
17 - 20 - Very Good
14 - 16 - Good
10 - 13 - Satisfactory
Below 10 - Read the Unit again

Self Test -Unit 1
1. Explain the concepts below using your own words?
• disability
• impairment
• handicap 1 mark x 4 = (4 marks)
• special needs
2. Identify two effects of each of the following conditions on the learner’s

learning and development:
• sensory difficulties
• physical difficulties
• cognitive difficulties 1 mark x 4 = (4 marks)
• multiple disabilities
3. Amongst your own children or in a class where you are currently teaching,
what behaviours within the learners may suggest lack of positive support?
1 mark x 6 = (6 marks)
4. From your experience write five factors that may affect your teaching.
1 mark x 6 = (6 marks)
Score board

Learning Outcomes
You have now completed Unit 1. The learning outcomes are listed below. Put a tick
in the column, which best reflects your learning and understanding of the content
covered in this unit.
If you have put a tick in the not sure column, please go back and study the section
in the unit before proceeding. If you are sure, go to the next unit.
Congratulations!

UNIT 2

Causes and prevention of impairments
Unit 2: Causes and prevention of impairments

Introduction
Welcome to Unit 2, Causes and prevention of impairments: In this unit you will
be introduced to some of the factors that may cause disabilities. This will help you
to understand the basic causes that you can be able to advise the parents and other
people living or working with learners with special needs. Prevention of some of
the impairments will also be discussed in the unit.
Aim
The unit intends to provide you with information about the main causes of special
needs and disabilities and how they can be prevented.
Objectives
By the end of this unit, you should be able to

• to describe the main causes of disabilities
• explain how disabilities can be prevented
The unit is divided into two sections
Section 1: Causes of impairments
Section 2: Prevention of impairments
Section 1: Causes of impairments

Although we have sufficient knowledge about causes related to different impairments
there are still many cases where the causes are unknown. Misconceptions about the
causes of impairments have caused hardships for learners involved as well as to
their families and at times their communities. In this section you will be introduced
to some common causes of disabilities;
Disabilities can occur during:
• Pre-natal stage (before birth)

• Peri-natal stage (during birth)
• Post-natal stage (after birth)
Let us now look at the main causes of disabilities at each stage briefly:
Pre-natal stage (before birth)

What are the main causes of impairments before birth?
I hope you mentioned the pre-natal causes as follows:
• hereditary causes believed to be running in families (genetic)

• poor nutrition, for example, due to unbalanced diet and lack of vitamins
during pregnancy
• diseases such as venereal diseases, cerebral malaria, meningitis, asthma,
diabetes, tuberculosis, and German measles
• food poisoning of expectant mother
• infections of the mother during pregnancy, such as poisons and intotoxins
and those involving very high fever
• use of certain drugs such as, quinine, chloroquine and antibiotics during
pregnancy
• foetal cerebral haemorrhage due to direct trauma, blood conditions of the
mother or other causes
• exposure to X-ray and radiation, especially during the first three months
of pregnancy
• misuse of narcotic drugs, cigarettes and alcohol by the mother during
pregnancy
Other causes at this stage are:
• blood incompatibility (the rhesus factor)

• anaemia during pregnancy
• congenital malformation of the ear and the ear canal, for example atresia
• accidents affecting the expectant mother
To ensure a healthy pregnancy, expectant mothers should be

advised to regularly attend ante-natal clinics.
Figure 28: Expectant mothers waiting to be attended in a health centre

Figure 29: An expectant mother should avoid smoking or drinking alcohol
Causes at peri-natal stage (during birth)

What do you think could cause disability during delivery?
• Pre-mature birth
• Low birth weight
• Breech birth. (This is where baby’s legs come out first during delivery)
• Neo-natal jaundice
• Head injuries caused by misuse of delivery instruments, such as forceps
during delivery.
• Birth injuries (trauma)

• Venereal diseases in mother, such as syphilis and gonorrhoea.
• Poor hygiene that may cause disease to the newly born baby.
• Brain damage due to lack of oxygen (anoxia). This may be as a result of:
 umbilical cord strangulation
 prolonged labour
 large head circumference of the baby during birth that leads to prolonged
labour hence use of forceps
Look at figure 30 showing one of the causes during birth
Figure 30: (i) Strangulation of the foetus (ii) Breech birth

by the umbilical cord
Accidents such as strangulation and breech birth may cause

brain damage that may result into mental disability
Causes at post-natal stage (after birth)

What are the main causes of disabilities during the post natal
stage?

This refers to the stage after the child is born. Some of conditions that may cause
disabilities include the following:
• Poor nutrition, such as unbalanced diet and deficiency of iodine and

vitamins.
• Exposure to poisonous agents and chemicals, such as pesticides, food and
medicine poisoning
• Diseases, such as meningitis, malaria, measles, mumps, otitis media and other
severe recurring ear infections, eye diseases, such as, cataract, trachoma and
glaucoma
• Misuse of drugs (medicines)
• Head injuries and brain damage due to accidents ( traffic, industrial and
domestic accidents)
• Brain tumour
• Birth injuries (trauma)
• Long and frequent exposure to loud noise
• Blockage of external auditory canal
• old age
• Under stimulation, such as when the learner is too little touched, cuddled,
hugged, talked to, or when the learner is hidden in a dark room over long
time.
• Poor hygiene brought about by flies, polluted or infected drinking water and
hygiene of the face, eyes and ears
• High fever with fits
• Severe diarrhoea and dehydration
Visit some elderly people in your community and discuss with

them issues related to disabilities Ask them what their beliefs

are regarding disabilities; causes, prevention and
treatment?
Discuss your findings with your colleagues.

Family and upbringing factors
This refers to factors in the family that may result to disabilities.
What are some factors that would cause special needs or

disabilities in a family?
The learner’s upbringing is critical for his/her future life. There must be good
understanding, discipline and acceptance of appropriate norms and values in any
society
We hope you know that, in a situation where fundamental gaps in upbringing

emerge, serious consequences occur. These may have far-reaching consequences
like emotional, behaviour or learning difficulties. Some of the factors which may
bring serious consequences are as follows:
• parents who pressurise 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 learners may unconsciously become hostile
towards parents and develop negative attitudes towards them and
school
• overprotection by parents leaves learners no room for freedom and

opportunities to become independent. Decisions are made for the
learners and they do not learn to take responsibility for their lives
and their schoolwork.


• some parents show very little interest in their learners’ activities.
They are not concerned with the learners’ 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 few or no routines,

for example, praying before meals. When parents are
inconsistent in their style of upbringing children, they begin to
feel uncertain and confused. Disorganised homes constitute
one of the main causes of behavioural learning difficulties.
Psycho-social factors
There are many factors that may bring about psychosocial impact as the learners
grow and consequently affect their psychological and sociological development
resulting into emotional and behavioural problems. These factors may include the
following:

• learners infected or affected by HIV & AIDS
• poverty and lack of employment
• poor nutrition due to poverty
• famine and other natural catastrophes
• political situations that bring in wars and violence, causing people to
seek for asylums as refugees.
• learners of minority families may suffer because they may feel strangers

in their own communities. In these communities these learners
may be teased and have no friends.
• poor homes with unhygienic surroundings and, far from social services
e.g. health centres
• deaths of one or both parents or siblings.
• rich families, that is learners developing behavioural difficulties due to
lack of proper attention, involvement and care often occurring

amongst rich families.
•· Child abuse and neglect
Section 2: Prevention of impairments
Introduction
In the previous section we dealt with the main causes of disabilities. I hope you
remember that impairments can occur before the child’s birth, during birth or after
birth. Lack of knowledge has for different reasons, often been a hindrance in taking

necessary steps for possible prevention. Being a teacher, you will always be in

contact with learners with special needs and their parents. You are therefore in a good
position to influence and help them to understand their learners, and environment
and also to explain to them how they can minimise chances of infections or traumas
that they result to disabilities.
In this section you will learn how disabilities may be prevented in each of the three
stages mentioned earlier in this section.

For you to get more information on clarification of prevention
measures visit the nearest hospital, rural health centre or
clinic.
Discuss the information with your colleagues.

Prevention of hereditary causes

What is heredity?
Heredity refers to characteristics that are genetically passed over to the children
from parents.
How can you advise parents to minimise disabilities that may be

caused by inheritance?
I hope you mentioned the following:
• Genetic counselling
• Avoid inbreeding, i.e. marrying close relatives.
In families where certain disorders have been circulating

from generation to generation, e.g., mental disabilities,
the chances of having learners with disabilities is very high

and hence the young generation should be given genetic

counselling.
Prevention of impairments before birth
How can impairments that occur before birth of

children be prevented?
This could be prevented as follows:
• Before deciding on having children, the woman should be thoroughly

examined by a doctor (gynaecologist) to see whether she is able to
physically carry a healthy baby.
• The blood composition of both the mother and father should be examined
for compatibility before a decision to have a baby is reached.
• The woman should not be too young or too old (the mother-to-be should
be of the right age)

• The mother’s health should be good and her body well nourished - she
should have a balanced diet.
• While carrying the baby, the expectant mother should not take strong

drinks, smoke, or use un-prescribed (over-the-counter) or other
dangerous drugs.
• A mother-to-be should not be overworked or carry heavy loads.
• The mother should not engage in sexual activity where there is a risk of
contracting a sexually transmitted disease.
• The mother-to-be should be emotionally stable.
• The mother should be immunised against maternal diseases and infections
such as rubella.
Prevention of impairments during birth
How can impairments be prevented during birth?

• As discussed earlier, there are various factors that may cause
impairments during birth. This could be prevented through:
• involving a qualified person to attend to the mother during the delivery of

a baby.
• use of proper and clean instruments during delivery of the baby, especially
for cutting the umbilical cord.
• observing hygiene during delivery, including protection of new born

infants from the effects of maternal venereal diseases
Prevention of impairments after birth
List down some of the measures that should be taken to

prevent impairments that may be caused to children after birth

(growing learners).

Your
list may contain the following amongst others:
• medicines should all be kept out of children’s reach.

• mothers should take their babies to post-natal clinic for vaccination and
immunization against infectious diseases such as measles, poliomyelitis and
tuberculosis.
• children should be protected from all types of danger both inside and outside
the home. sharp tools, for example, may injure them and cause permanent
disabilities.
• parents or caregivers should seek medical treatment/help whenever children
are ill.
• parents should be made aware the importance touching, cuddling and hugging
their young children for stimulation purposes.
Find out from your community what people think about

children with disabilities. Ask them what their beliefs are
regarding disabilities. Do they have any cures? Can the
society prevent these impairments? How? Discuss with your
colleagues.


Summary
Causes and prevention of impairment
In this unit you have learned some factors that may cause impairments and
disabilities and also preventive measures.
You learnt that impairments may occur in three main stages in life. These are:
• pre-natal stage (before birth)

• peri-natal stage (during birth) and
• post-natal stage (after birth)
In the pre-natal stage the major causes are heredity, poor nutrition by mother,
diseases such as rubella and misuse of narcotic drugs, by the mother during
pregnancy.
In the peri-natal stage the major causes are prolonged labour, umbilical cord
strangulation of the foetus, birth injuries/trauma, breech birth, low birth weight,
lack of oxygen, and misuse of delivery instruments.
You also learned about post-natal causes of impairments such as, meningitis,
cerebral malaria, measles, mumps otitis media, accidents, brain tumour and poor
nutrition, such as unbalanced diet and deficiency of iodine and vitamins.
17 - 20 - Very Good

14 are
There - 16 other -factors
Good within the family. Socio-emotional and
school factors that may cause special needs. These are over

10protection - 13 - by parents, poor discipline, abuse and neglect
Satisfactory
political situations that may bring war and violence. Within
the school, Below 10 teachers
- Read who
the use
Unitteaching
again methods which do not meet
needs of all the learners and inconsistent school discipline may
affect learners psychological and social growth.

I hope
the knowledge gained in this unit will assist you to understand the causes
and prevention of impairments that result to special needs and disabilities.
Self Test -Unit 2
Unit 2: Causes of Prevention of Impairments and Disabilities

1. What are the three stages in which impairment may occur in a child’s
life?
a) _________________
b) __________________
c) __________________
(1mark x 3 =3 marks)

2. Define the term congenital impairment.
(1 mark)

3. Identify any five pre-natal factors that may cause impairment.
(1/2 mark x 5) = (5 marks)

4. What are the six peri-natal factors that may cause impairment?
(1mark x 6) = (3 marks)
5. List any two post-natal factors that may cause impairment.
(1mark x 2) = (2 marks)

6. Explain three school factors within the school that may contribute to
special needs and difficulties in learning. (6 marks)

Score board

Learning Outcomes
You have now completed Unit 2. The learning outcomes are listed below. Put a tick
in the column, which best reflects your learning and understanding of the content
covered in this unit.
If you have put a tick in the not sure column, please go back and study the section
in the unit before proceeding. If you are sure, go to the next unit
Congratulations!

Unit 3
Effects of special needs and disabilities

Introduction
In unit 2 of this module, you were introduced to factors that may cause special

needs. You also learnt about the causes and prevention of the same. In this unit we

are going to look at the effects of special needs on the learner and his/her family.
Aim
The unit is intended to help you understand the effects of the various special needs
on the learner, family, peers and neighbours.
Objectives
By the end of this unit, you should be able to:
• explain the effects of special needs on the learners’ sensory, communication,

cognitive, psychosocial, psychosexual and motor abilities.

• describe the effects of special needs on the learners’ health and learning.

• describe the effects of special needs on the family, peers and neighbours
This unit is divided into two sections:
Section 1: Effects of special needs on the learner

Section 2: Effects of special needs on the family
Enjoy you reading!

Section 1: Effects of special needs on the learner
Effects of sensory differences
What are the sensory differences that you learnt about in Unit 1
of this module?
In Unit 1, you learnt about the following sensory impairments.
• deafblindness
In this section we are going to discuss how these differences affect the learners’
education and development.
Visual impairment

How does the total loss of vision affect an individual?

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 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 they want. They
may also find it difficult to choose friends that interest them.
Discuss with a colleague why you think learners with visual

impairments find it difficult to choose friends.
Visual impairment may also affect the learners in the following areas:
• psychological development
• educational development
Let us discuss each of these effects briefly
Effects on psychological development
What are the effects of visual impairment on learning?

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 behaviour 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 educational 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
• physical development
Let’s look at these areas briefly.
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 compared

to the sighted.

Effects of hearing impairment on learners
We learned in the earlier sections about learners with hearing impairment and how
you can identify them. The severity of hearing loss differs from learner to learner.
Hearing loss, therefore affects learners’ general development in varying degrees.
How does hearing impairment affect learning and

development?
Hearing impairment may have effects on the learners’:

•
speech development
• language development

• social development
Speech development
What happens in child’s speech development when

the sense of hearing is impaired?
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

How do children develop language?
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
In Unit 1, you learnt about cognitive differences.
What are components of cognitive differences?
You remember that cognitive differences include:
• specific learning difficulties.
• giftedness and talentednes
• autism

What are the effects of cognitive differences in relation to
learning ad development?

Effects
of mental disabilities
Mental disabilities will affect the learners in the following areas:
• language development
• academic achievement
• social and personal development
Let us now look at these areas briefly:
Language development
How does mental disability affect a learner’s 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:

• comprehension
• receptive language
• expressive language
• vocabulary acquisition
• reading skills

• sound blending
Academic achievement

Does mental disability affect learners’ 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. The 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 behavioural
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 behaviours. 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
What effects do specific learning difficulties have on

learning and development?

Specific learning difficulties have marked effect on one or more of the
following:
• spoken language
• reading
• arithmetic
• spelling
• 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
• 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
What are the effects of specific learning difficulties on

emotional development? What are the effects of specific
learning
difficulties on 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 behaviour

manifestations make it difficult for these learners to interact adequately with
These
their peers and adults.
Effects of giftedness and talentedness
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 behaviour in class. This may be because the learners’ find class
work and other activities meant for their age group too easy and too boring.

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 well 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 behaviour.
Effects of emotional and behavioural difficulties
What are the effects of emotional and behavioural

difficulties on learning and development?

Children with emotional and behavioural problems may have serious difficulties
in:
• academic performance
• social interaction
Academic performance
You may recall that learners with emotional and behaviour 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 behaviour may be inappropriate compared to their
age mates.
Since these learners may not have the language to express themselves, they
misbehave, exhibit negative and hostile feelings or withdraw entirely from human
interactions, both physically and verbally. The learners with socialized aggressive
behaviour often get involved in petty crimes such as stealing.
Effects of communication difficulties

What are the effects of communication difficulties on

learning and development?
Communication difficulties may affect the learner’s:

Let us now have a brief explanation for each.
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
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
How do physical and health difficulties affect learning and

development?

Motor difficulties and health problems affect learner’s:
• motor functioning

• communication
• psychosocial development
Let us now explain each of these separately.
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 complete 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.

How do physical and health difficulties affect learner’s
academic
achievement?
You must have realized that 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

• 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?

You may have mentioned the following:
• food
• water
• shelter
• fresh air
Apart from needs mentioned above, you realise 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.
Who is a learner’s first “teacher”?
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?

I hope
you have mentioned the following:
• Shock
• Anger

• Bargaining
• Depression
• Acceptance and reorganisation
Let us now look at each of the above reactions.

Shock
What happens during this stage?
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.
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 the family genes, towards fate or simply towards
anyone and anything.

Bargaining
This stage may be characterised 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

What is 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
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.
What are some of the factors that may influence attitudes of the
family of learners with special needs and disabilities?
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
Let us look at each of these factors briefly

Severity of the disability
How does severity of disability affect parents?
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 parent –learners’ interactions
in different ways and require different parenting techniques. The more severe the
handicap, the 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.) are;
• 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
Why do you think the age at onset of disability may affect the
parent’s attitudes?
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
However, 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

Discuss with your colleagues what you think would be the best
way for medical staff or other professionals to break news to a
parent whose child has disabilities?
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

How can finances affect a family with a child with disabilities?
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
You will realise 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.
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 realise 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 judgement, opinion and recommendations of the experts.
Parents as an in-group
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 simply do not know what
it is like to have learners with a disability.
The myth of cure

What is 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

How can professionals assist parents of children with
disabilities?
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/

• Use every day language and minimise 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.
• Clarify 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 access to their
peers. Parents amongst themselves offer respect with empathy and without
the burden of clinical assessment.
In what aspects would you use any three of the services that
parents of learners with special educational needs
receive from professionally trained in providing special
educational needs. Discuss your answers with your colleague

Summary
In this section you have learned about the effects of special needs to learning and
development. You can now state and explain the effects in relation to:
• sensory difficulties
• psychosocial differences
• motor difficulties and health problems.
Most of these special needs in education affect learner’s:
• academic performance
• motor functioning
• speech and language development
• communication
• emotional development
• physical development
• social and personality development

Self Test - Unit 3

1. Outline three effects of special needs and disabilities on a learner with total
loss of vision ( 3
marks)
2. What are the effects of communicating difficulties on learning

development?
(4
marks)
3. Briefly describe any three activities professionals can assist parents of

children with special needs and disabilities. (6
marks)
4. Explain the effects of hearing impairments on learning and development

(3 marks)
5. List any four stages of emotional reaction of a parent with a child with special
needs (4 marks)
17 - 20 - Very Good
14 - 16 - Good
10 - 13 - Satisfactory
Below 10 - Read the Unit again

Learning outcomes
You have now completed Unit 2. The learning outcomes are listed below. Put a
tick in the column, which best reflects your understanding of the content covered
in this Unit.
If you have put a tick in the not sure column, go back and study the unit.

Congratulations!

Answers to Self Test - 1
1. Explanation of concepts
· 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 paralysed
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 fulfilment of roles that are appropriate according to the age, gender, social
and cultural norms. An individual who is not given an opportunity to become
independent by society is handicapped.
A handicap can therefore be lessened if the society provides support to enable a

person with a disability to be independent.

• 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.
2. Effects on learning and development in relation to:

• Sensory difficulties
 communication difficulties
 slow learning
 difficulties with perception
• Physical difficulties
 movement difficulties
 co-ordination difficulties
 manipulation difficulties
• Cognitive difficulties
 difficulties with understanding
 difficulty with comprehension
 difficulty with perception
• Multiple disabilities
 perception difficulties
 difficulty with fine and gross motor movements.
 social difficulties
3. Unavailability of resources
 lack of time
 too much teaching load
 school management which does not consider the needs of teachers.
 lack of skills to deal with particular learners or situations
 lack of motivation Open,Distance and Electronic-Learning(Module 1)

Answers to SelfTest- 2
1. (a) Pre-natal stage or before birth (b) Peri-natal or during birth

(c) Post-natal stage or after birth
2. Congenital is a condition of impairment present in an individual at birth

which may be due to hereditary or disease before birth.
3. Pre-natal stage (before birth) (Any five correct answers)
• Hereditary causes believed to be running in families,

during pregnancy
• venereal diseases, such as syphilis and gonorrhoea
• HIV and AIDS
• infections of the mother during pregnancy, such as rubella (German
measles) and those involving very high fever
• use of certain drugs such as, quinine, chloroquine and antibiotics during
pregnancy
• foetal cerebral haemorrhage due to direct trauma, blood conditions of
the mother or other causes
• exposure to x-ray, especially during the first three months of pregnancy
• exposure to radiation
• misuse of narcotic drugs, cigarettes and alcohol by the mother during
pregnancy
• incompatibility of mother-foetus blood type (the Rhesus factor)
• anaemia during pregnancy
• blood poisoning of expectant mother
• congenital malformation of the ear and the ear canal, for example atresia
• accidents affecting the expectant mother
during pregnancy

4. Peri-natal stage (during birth) (Any three correct answers)
Causes at this stage include:
• pre-mature birth
• low birth weight
• breech birth. (This is where baby’s legs come out first during delivery)
• neo-natal jaundice
• head injuries caused by misuse of delivery instruments, such as forceps
delivery.
• venereal diseases in mother, such as syphilis and gonorrhoea.
• birth injuries (trauma)
• poor hygiene.
• Brain damage occurring during birth can be caused by:
• lack of oxygen (anoxia) due to:
 wrong use of forceps during delivery
 umbilical cord strangulation
 prolonged labour
 large head circumference of the baby during birth
Any of the six answers
5. Post-natal stage (after birth) (Any two correct answers)
Some of the factors that may cause impairments after the learners have been born
include:
• poor nutrition, such as unbalanced diet and deficiency of iodine and vitamins
in learners.
• diseases, such as meningitis, malaria, measles, mumps, otitis media severe
diarrhoea and eye diseases, such as, cataract, trachoma and glaucoma among
others.
• misuse of drugs (medicines)
• brain tumou
r• birth injuries (trauma)

• long and frequent exposure to loud noise
• exposure to poisonous agents and chemicals, such as pesticides, food and
medicine poisoning
• blockage of external auditory canal
• old age
• head injuries and brain damage due to accidents ( traffic, industrial and
domestic accidents)
• under stimulation, such as when the learners is too little touched, cuddled,
hugged, talked to, or when learners is hidden in a dark room over long
time.
• poor hygiene brought about by flies, polluted or infected drinking water and
hygiene of the face, eyes and ears
Any of the three answers
6. School factors that may cause special needs in learner’s development in

school
• teachers who do not have proper skills may not be aware of the learners
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 learners are not accommodated
• demotivated 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 whose teaching methods are not learners-centred hence not
meeting learners needs. Because of poor teaching, the learners
may result in poor motivation and hence result to disciplinary
or behavioural difficulties
• inappropriate resources (human and economic) in schools may also result
in learners developing learning difficulties. Educational resources
may not be linked with what is being taught and may not relate

Answers to SelfTest - 3
Three effects of special needs and disabilities on a learner with total loss of
vision
• Inability to move about
• Inability to control environment
• Self concept
• ·Concept formulation
• Isolation and withdrawal
(Any three correct ones-3 marks)
2. Effects of communication difficulties on learning

• Academic achievement
• Psychological development
(well explained -2 marks for each=4 marks)
3. Three activities professionals can assist parents of children with special

needs and disabilities.
• Listening to them and answering their questions honestly
• Creating opportunities for them to talk to other parents
• Being specific and objective when presenting information about the
child
• Helping them to know the child’s abilities and assets
• Using simple clear language (avoid professional jargons or
acronyms)

4. Effects of communication difficulties on learning
• Speech development
• Language development
• Social development
(well explained -2 marks for each=6 marks)
5. Stages of emotional reaction of a parent with a child with disability.

• Shock
• Anger
• Bargaining
• Depression
• Acceptance and reorganisation
(Any four correct ones=4 marks)

Glossary
Glossary
Ability grouping Placing learners from general classroom settings
to
classrooms composed of learners with
similar ability levels
Adaptive behaviour Such as eating or toileting, which we need to know

to function as independent individuals
in society
Age at onset The age at which an impairment/disability or

condition take place
Allergy It is sensitivity to particular substances.

These substances
can occur in foods, drugs (medicines),
chemicals, animals,
insect bites, pollen (the dust of
flowers). An allergic reaction can show as skin rash,
swelling, tears in the eyes, coughing, swollen throat,
etc
Anoxia Deficit in oxygen carried by the blood stream,

resulting in a lack of oxygen to any part of the body
affected
Articulation The act of speaking distinctly
Attitude A feeling, emotion or mental position with regard to a

fact or state. A manner assumed for a specific purpose.
A state of readiness of a living organism to respond
in characteristics way to a stimulus.
Congenital Present in an individual at birth
Deaf The term is used to describe non-

functional hearing for the ordinary purpose of life.
Extrinsic During or motivating force from outside
Incidence Refer to the estimated number of people in a given

population
who possess or exhibit a given characteristic at some point
during
their lives.
Hyperactivity Learners who is hyperactive has a higher degree of

inappropriate motor activity than is considered
typical for a particular group.
Meninges Membranes surrounding the brain and the spinal cord
Meningitis Inflammation of the membranes surrounding the

brain and spinal
cord. It is contagious through close contact.
Meningitis can be
caused either by bacteria or by virus.
Motor Movement
Paralysis Loss of power and control in the muscles.
Perception Awareness of one’s environment through sensory

stimulation
Prevalence Refers to the total number of existing cases (new and old) in
the
population at a given time.’
Prosthesis Artificial limb (arm or leg) to replace the missing

(amputated) part of the body
Talented Outstanding performance or showing the potential for

performing at remarkably high level of accomplishment
when compared with others than their age, experience or
environment


References
Bauer, A.M., Shea, T.M. (1989). Teaching exceptional students in your

classroom. Boston: Allyn & Bacon
CanLearners (2001). The Prevalence of learnershood disability: Facts and issues.

Ontario: Hamilton
Chege, J. M., Mugwe, P., Kamau, R. W., Groewen, T., Mwangi, F., &
Mucheru, E. (1998). A Survey on prevention of deafness in
learners in Kenya. Nairobi: Unpublished report
Ferrell, K.A. (1989). Working with parents. In American foundation for the
blind.
Foundations of education for blind and visually disabled
learners
and youth. Theory and practice. New York:American Foundation
for the Blind
Gearheart, B.R. Weishan, M.W. & Gearheart, C. J. (1984). The Exceptional

student in the regular classroom. Washington, D.C: Mervill
Publishing Company
Gething, L. (1992). Person to person, 2nd edition. London: Paul H.

Brookes Publishing Company
Handman, M.L, Drew, J. C, Egan, M.W ( ) Human exceptionality. School,

community
and family. New York:Allyn and Bacon
Hallahan, D.P. & Kauffman, J.M. (1997). Exceptional learners. Introduction to

special education, seventh education. Boston: Allyn and
Bacon
Ingule, F. O., Rono, R. C. & Ndambuki, P. W. (1996). Introduction to

educational psychology. Nairobi: East African Educational
Publishers

KISE (1993/4). Special education in-service course for teacher, series 1-9
Nairobi: Distance Education Department, KISEKISE & UNISE
(2000).
Distance learning programme, module 1: Introduction to special
needs education. Kampala: Distance education department, UNISE
KISE & UNISE (2000). Distance learning programme, module 7: Barriers

to learning and development. Kampala: Distance education
department, UNISE
Ministry of Education (2006). Module 4: Differentiated learning. Lusaka:

Ministry of Education
Ministry of Education (2007): A Handbook of terms and concepts in special

needs education. Nairobi: KISE Publishers
Ministry of Education, Zambia (2006). Differentiated learning. (Module 4).

Lusaka: NISTCOL
NCNN (2001). Bridging the gap. Analysis of law and policy on learners in
need of special protection (CNSP) Nairobi: National Learners
in
Need Network
Ndurumo, M., M. (1993). Exceptional Learners. Developmental

consequences and intervention. Nairobi: Longman Kenya
Ltd
Reynolds C. R. & Janzen-Fletcher, E. (eds) (2002). Concise encyclopaedia of

special education : Washington: John Wiley & Sons
Scholl, G.T. (Eds) (1986). Foundations of education for blind and visually
handicapped and youth. Theory and practice. New York:
American Foundation for the Blind,Inc
Winston, P. J. (1993). Providing family support in integrated settings:

Research and recommendations. IN C. A. Peck, S. L.

Appendix
Who is Disabled ?
If you fail to see the person but only the disability,
then who is blind?
If you cannot hear your brother’s cry for justice,

then who is deaf?
If you do not communicate with your sister but

separate her from you,
then who is disabled?
If your heart and mind do not reach out to your

neighbour,
then who has the handicap?
If you do not stand up for the rights of all persons

including those with disabilities,
then who is the cripple?
Our “attitudes” towards persons with disabilities

maybe our biggest handicap!
Remember, behind every person with a “disability”

there is a “human being” and every
human being is equal in the eyes of the Almighty God

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Open, Distance & Electronic Learning

Introduction to Children with

Kenya Institute of Special Education

Mr. Samuel Wanyera has worked as an assistant Head of Department Distance

Kenya Institute of Special Education

Introduction to Children with Special Needs

Kenya Institute of Special Education

Open,Distance and Electronic-Learning(Module 1)

Editor: Dr John Mugo

Design, Illustrations Samson Oyombi

Publisher: Kenya Institute of Special

Kenya Institute of Special Education

Our gratitude also go to the following institutions whose members participated

Open,Distance and Electronic-Learning(Module 1)

Unit 1: Diversity of children with special needs and disabilities.........

Section 1: Definition of terms and clarification of concepts

Section 2: Categories, characteristics, incidence and prevalence

Unit 2: Causes and prevention of impairments....................................133

Introduction …………………………………..…........................ 134

Kenya Institute of Special Education

Section 1: Effects of special needs and disabilities on

Section 2: Effects of special needs and disabilities on the

Learning outcomes………………………………………........... 180

Answers to self tests 1..………………………………..…................................

Answers to self test 2....................................................................................... 183

Answers to self test 3...................................................................................... 186

Open,Distance and Electronic-Learning(Module 1)

This is to enable us make further improvement on this module inorder to

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Kenya Institute of Special Education

Welcome to Module 1D 001: Introduction to Children with Special Needs.

By the end of this module you should be able to:

• define terms and clarify concepts used in Special Needs Education.

• explain the causes and prevention of impairments.

Open,Distance and Electronic-Learning(Module 1)

Unit 1: Diversity of children with special needs and disabilities

Unit 2: Causes and prevention of impairments

Unit 3: Effects of special needs and disabilities

Kenya Institute of Special Education

Note this point

Open,Distance and Electronic-Learning(Module 1)

Answers to self tests

Kenya Institute of Special Education

Diversity of learners with special needs

Kenya Institute of Special Education

By the end of this unit you should be able to:

• define terms and clarify concepts used in Special Needs Education.

Open,Distance and Electronic-Learning(Module 1)

Section 2: Classification, characteristics, educational implications and intervention

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Section 1: Definition of terms and clarification

Kenya Institute of Special Education

What do you understand by the term

Open,Distance and Electronic-Learning(Module 1)

This refers to any loss or reduction of functional ability (resulting from an

What is the meaning of the term “handicap”?

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

A handicap can therefore be lessened if the society provides support to enable a

Kenya Institute of Special Education

This is term refers to any individual whose physical, mental or behavioural