INED7212 Module Reader 2021

Inclusive Education
10/07/2021
INED7212
Word Art
Module Reader
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INED7212 Module Reader 2021
TABLE OF CONTENTS
Introduction .....................................................................................................................6
CHAPTER 1: Addressing Barriers to Learning using ADHD as an Example............................7
1.1 Environmental and Attitudinal Barriers: ....................................................................... 7
1.2 Individual Barriers:....................................................................................................... 8
CHAPTER 2: Support Strategies .......................................................................................11
2.1 How to Support Learners............................................................................................ 11
2.2 What is Curriculum Differentiation? ........................................................................... 12
2.3 Differentiating Assessment ........................................................................................ 13
2.4 Concessions ............................................................................................................... 15
CHAPTER 3: How to Create a Support Plan – The Role of SIAS in the classroom ................17
3.1 Creating a Support Plan.............................................................................................. 17
3.2 How to Create a Support Plan..................................................................................... 19

3.2.1 Step 1 – Screening using the Learner Profile .................................................................................19
3.2.2 Step 2 Support Needs Assessment Forms (School Level Intervention) .........................................22
CHAPTER 4: SUPPORTING Learners with Physical Barriers to Learning .............................31
4.1 Physical impairments ................................................................................................. 31
4.2 Challenges for learners with Physical Barriers ............................................................. 32

4.2.1 Accessibility ....................................................................................................................................32
4.2.2 Motor (movement) Impairment ....................................................................................................32
4.2.3 Negative self-image and low expectations ....................................................................................33
4.2.4 Language delays .............................................................................................................................33
4.2.5 Communication ..............................................................................................................................33
4.2.6 Psychological Challenges ................................................................................................................33
4.3 Examples and General Areas of Support ..................................................................... 34

4.3.1 Cerebral Palsy (CP) .........................................................................................................................36
4.3.2 Spina Bifida .....................................................................................................................................39
4.3.3 Burns ..............................................................................................................................................45
4.4 Assistive Devices ........................................................................................................ 48
4.5 Augmentative and Alternative Communication (AAC) ................................................. 54

4.5.1 What does AAC Include? ................................................................................................................54
© The Independent Institute of Education (Pty) Ltd 2021 Page 2 of 170

CHAPTER 5: Supporting Learners with Neurological Barriers to Learning..........................58
5.1 Neurological Impairments .......................................................................................... 58
5.2 ADHD ........................................................................................................................ 61

5.2.1 Why is ADHD considered a neurological condition? .....................................................................61
5.2.2 How to assist ADHD learners in the classroom ..............................................................................61
5.2.3 Classroom Layout to help ADHD learners feel less distracted.......................................................62
5.3 Tourette’s Syndrome.................................................................................................. 63
5.4 Autism Spectrum Disorder ......................................................................................... 65

5.4.1 What is Autism? .............................................................................................................................65
5.4.2 Symptoms of Autism ......................................................................................................................67
5.4.3 Relationship between ADHD and Autism ......................................................................................72
5.4.4 Support for learners with ASD .......................................................................................................73
5.5 Epilepsy ..................................................................................................................... 78

5.5.1 What is epilepsy? ...........................................................................................................................78
5.5.2 Different Types of Seizures ............................................................................................................81
5.5.3 Managing Epilepsy in the Classroom .............................................................................................87
CHAPTER 6: Supporting Learners with Intellectual Barriers to Learning ............................91
6.1 Definition of Intellectual Impairments ........................................................................ 91
6.2 Signs of Intellectual Impairments ............................................................................... 91
6.3 Problems that Children with Intellectual Impairments may Experience in the Classroom
92
6.4 Advice for Parents and/or Caregivers ......................................................................... 93
6.5 Learning Impairments vs. Intellectual Impairments ..................................................... 94
6.6 Examples of Intellectual Impairments ......................................................................... 95

6.6.1 Down Syndrome .............................................................................................................................95
6.6.2 Foetal Alcohol Syndrome (FAS) ......................................................................................................96
6.7 Support Plan for Learners with Intellectual Impairments ............................................. 98

6.7.1 General Support .............................................................................................................................98
6.7.2 Support for Learners with Down Syndrome ..................................................................................98
6.7.2 Support for Learners with Foetal Alcohol Syndrome.....................................................................99
6.8 Giftedness ............................................................................................................... 100

6.8.1 What is Giftedness? .....................................................................................................................100
6.8.2 Giftedness as an intellectual barrier ............................................................................................100

6.8.3 Characteristics of Giftedness .......................................................................................................101

6.8.4 Advice for Parents of Gifted Learners ..........................................................................................102
6.8.5 The Difference between High Achievers and Gifted Learners .....................................................103
6.8.6 Support Plan for Gifted Learners .................................................................................................103
CHAPTER 7: Supporting Learners with Visual Barriers to Learning .................................. 106
7.1 Visual Impairments .................................................................................................. 106
7.2 Different Types of Visual Impairments and How They Affect Vision and Learning ...... 112
7.2.1 Albinism ........................................................................................................................................113
7.2.2 Cataract ........................................................................................................................................114
7.2.3 Glaucoma .....................................................................................................................................115
7.2.4 Onchocerciasis or “River-Blindness” ............................................................................................116
7.2.5 Refractive Errors...........................................................................................................................117
7.2.6 Retinitis Pigmentosa (RP) .............................................................................................................117
7.2.7 Trachoma .....................................................................................................................................119
7.3 Needs of Learners with Visual Impairments .............................................................. 120
CHAPTER 8: Supporting Learners with Hearing Barriers to Learning ............................... 125
8.1 Hearing Impairments ............................................................................................... 125
8.2 The Impact of Unaddressed Hearing Loss .................................................................. 126
8.3 Characteristics of Learners with Hearing Impairments ............................................... 127
8.4 Needs of Children with Mild to Moderate Hearing Loss ............................................. 127
8.4.1 There are three main types of hearing loss .................................................................................127
8.4.2 Identifying Hearing Loss ...............................................................................................................128
8.4.3 Appropriate Interventions ...........................................................................................................129
8.4.4 Advice for Parents of Learners with Hearing Loss .......................................................................129
8.4.5 Amplification Devices ...................................................................................................................130
8.5 Needs of Learners with Deafness .............................................................................. 131

8.5.1 Basic Needs ..................................................................................................................................131
8.5.2 The Use of Sign Language ............................................................................................................131
8.5.3 The Use of an Oral Approach (lip reading) ...................................................................................132
8.6 Support Plan for Learners with Hearing Impairments ................................................ 133
8.6.1 Classroom Communication ..........................................................................................................134
8.6.2 Using an Interpreter in Class ........................................................................................................134
8.6.3 Accommodations .........................................................................................................................135
CHAPTER 9: Supporting Learners with Literacy Barriers ................................................. 137

9.1 Literacy Barriers ....................................................................................................... 137
9.2 Language of Learning and Teaching (LoLT) ................................................................ 138

9.2.1 What is LoLT? ...............................................................................................................................138
9.2.2 Assessing the Needs and Creating a Support Plan for LoLT Barriers ...........................................139
9.3 Dyslexia, Dysgraphia and Dyspraxia .......................................................................... 140

9.3.1 Dyslexia ........................................................................................................................................141
9.3.2 Dysgraphia....................................................................................................................................142
9.3.3 Dyspraxia ......................................................................................................................................143
9.4 Assessing the Needs and Creating a Support Plan for Learners with Dyslexia, Dysgraphia
and Dyspraxia ...................................................................................................................... 146
9.4.1 Support for Dyslexia .....................................................................................................................146
9.4.2 Support for Dysgraphia ................................................................................................................147
9.4.3 Support for Dyspraxia ..................................................................................................................148
CHAPTER 10: Supporting Learners with Mathematical Literacy Barriers ......................... 151
10.1 Mathematical Literacy Barriers ................................................................................. 151

10.1.1 How do we expect Mathematical skills to develop in children?.............................................152
10.1.2 How can we tell if a child may be experiencing a barrier to learning Mathematics?.............152
10.2 Maths Anxiety ......................................................................................................... 153
10.3 Dyscalculia ............................................................................................................... 155
10.4 Assessing the Needs and Creating a Support Plan for Learners with Mathematical
Literacy Barriers ................................................................................................................... 158

INTRODUCTION
The United Nations described education as being universal and extending to all
children, youth and adults with disabilities (UNESCO Bangkok, 2009) and the
Convention on the Rights of Persons with Disabilities (2008) reiterated the
importance of education in the upliftment of those who have been marginalised due
to their disabilities. In the first semester, you were introduced to the concept of
Inclusive Education, impairment vs disability, barriers to learning and person-first
language. Hopefully, you were supported in developing the understanding that
inclusive education is the most practical way forward to support children
experiencing barriers to learning due to the high costs of running special schools,
isolation of many children in special schools, benefits for both children living with and
without barriers to learning, and development of an inclusive culture and society
(DBE, 2001).
Through the reader, module guide and activities, this module aims to support you in
further developing an understanding of the barriers to learning experienced by many
children whom you may encounter in the classroom and see you exercising your
knowledge of the concepts from INED7211 in through practical application.

CHAPTER 1: ADDRESSING BARRIERS TO

LEARNING USING ADHD AS AN EXAMPLE
In this chapter, we will revise and expand on the concept of barriers to learning.
While the concept of impairments and disabilities is important, we need to remember
that both children with and without impairments may face Barriers to Learning,
Development and Participation (UNESCO Bangkok, 2008). Should these barriers
not be identified and interventions put in place, children experiencing barriers may
not reach their full academic, social, emotional or physical potential, and that these
barriers may be experienced temporarily and may become permanent if not
effectively addressed and removed.
In the previous module, barriers were considered in terms of being intrinsic or

extrinsic. However, UNESCO Bangkok (2008) considers barriers in a slightly
different way and cites the following Environmental and Individual Barriers as
forming obstacles to achieving learning potential:
1.1 Environmental and Attitudinal Barriers:
• Limited or no access to early intervention programmes

• Teachers, school administrators and school inspectors
• Legal and regulatory systems
• Curricula
• Teaching approaches and teaching/learning material
• Assessment and evaluation system
• School and classroom environments
• Social, economic and political conditions

1.2 Individual Barriers:
• Communication
• Poor motivation
• Insecurity, low self-esteem and lack of self-confidence
• Abuse
• Gender
• Lack of social competence
• Temperament
• First-generation learners
• Cultural, language and religious minorities
• Impairment
• Health conditions
In this way, it is possible to see that while a barrier might be caused extrinsically, it
will affect the child as an individual, e.g. abuse is inflicted by an abuser, however,
affects the child as an individual. An environmental barrier is more likely to affect all
the children or a group of children rather than only a specific individual child. More
information on these barriers are available on pages 8-12 of PM 3, Teaching
Children with Disabilities in Inclusive Settings (UNESCO Bangkok, 2008). This list is
by no means complete as there are many more barriers that may affect children’s
abilities to learn, develop and participate, and unless barriers are identified, they may
become permanent and are much less likely to be removed or limited.
While we may feel that we, as teachers, will not be able to reduce or remove all
these barriers, and that our influence over the curriculum or economic conditions are
limited, it is important to be aware of the ways in which these barriers affect the
children in our schools and communities academically, socially, emotionally and
physically. Through the creation of inclusive classrooms and learning-friendly
schools and communities, we may be able to reduce the consequences of
environmental barriers. Something to keep in mind is that the earlier a barrier to
learning and development is addressed, the greater the possibility of minimising the
lasting effects of the barrier.

Fortunately, UNESCO Bangkok (2008) have provided us with some practical tips for
removing Barriers to Learning, Development and Participation:
• Create an environment in which all children feel equally valued.
• Children should be allowed to communicate in their first language, even when
this is different from the language of instruction used in school, whether sign
language or another minority language. If you or none of the other teachers in
your school speak the child’s first language (mother tongue), try to find someone
who does, such as someone from her/his family or community.
• Children should be allowed time to express their thoughts and opinions. Many
children with disabilities will need more time than other children to express
themselves.
• Try to ask questions to children (especially those who are struggling with
academic learning) that you are confident they will be able to answer. This will
build confidence and motivate children to continue their learning.
• Be generous, genuine and honest with praise. This will help children to build
confidence and to develop a healthy self- esteem.
• Children should be encouraged to state their opinion, and we should try to use
their suggestions wherever this is possible.
• We should encourage both boys and girls to become involved in all curricular and
extracurricular activities.
• If a child suddenly changes behaviour or acts differently from the way s/he used
to, we should try to find out why. If we suspect that this may be caused by abuse
(verbal, emotional, physical or sexual), we should seek advice and help from
organisations that work with child rights and child protection. These organizations
are found in most communities throughout the world. The nearest Save the
Children and UNICEF offices may also be able to help.

• We should evaluate the academic, social, emotional and physical development

(progress) of children, instead of just measuring their performance in comparison
to others. The progress children make should be evaluated based on their
individual learning plans. These plans should be developed paying close
attention to possible barriers to learning, development and participation the child
may face.
• Organize the classroom and seat the children to optimise opportunities for
communication, interaction and learning for all the children in the classroom –
with special focus on those children who experience barriers to learning,
development and participation.
• Make sure that you let all the children in the class know that you care about them
and their needs.
• Identify at least one good quality that every student has demonstrated over the
past month
You can explore PM3 (UNESCO Bangkok, 2008) for more information on this
subject. Download the document from the following URL or use the QR Code below.
https://unesdoc.unesco.org/ark:/48223/pf0000182975?posInSet=1&queryId=ba5789
3a-5932-4e6c-8902-593214fe8e59
The next chapter will consider support strategies that we, as teachers will be able to
put into place.

CHAPTER 2: SUPPORT STRATEGIES
Inclusive Education is not about treating all children

the same, it is about treating each child according to
their specific needs.
This chapter focuses on equipping you with the tools that you need to provide support to
children within your class and school.
2.1 How to Support Learners
There are many different ways of supporting children who are experiencing barriers to
learning, and it is important to note that what works for one child may not be as effective with
another child. As such, we, as teachers, need to be aware of the many sources that we can
draw on to find new and effective ideas. We also need to carefully evaluate possible support
strategies so as to ensure that we do not create larger barriers. An example of this may be
forcing left handed children to write with their right hand in the belief that it was wrong to use
the left hand to write. As a result, many children experienced effects such as anxiety,
withdrawal, poor handwriting, and difficulty with concentration and memory.
Ideally, we should draw on research-based support strategies, but also be cognisant that
factors such as personality, learning preference, and other environmental factors will affect
the success of any strategy. Some of the most important factors include teacher’s, learner’s
and parent’s attitudes to the barrier and the strategy to be put in place.
Sometimes, teachers and parents express concern that a child is receiving special
treatment. This is not accurate. Within the concept of Inclusive Education, all children are
equally valued, however, no two people are identical and as such may not benefit from all
being taught in the same way. Often, what occurs is that when one child receives the
support, he/she needs, the rest of the class benefit as well.

This can occur in many ways, such as implementing a phonic programme to support one
child may benefit all the children in their reading development. Alternately, having a child
who has ADHD sit on a ball at the back of the classroom may mean that he/she is now able
to expend energy in a safe way and no longer disrupts the others by getting up and walking
around the classroom.
2.2 What is Curriculum Differentiation?
The Department of Education provides us with a number of strategies that can be used in
combination with CAPS curriculum, this is referred to as Curriculum Differentiation.
“Curriculum differentiation is a key strategy for responding to the needs of learners
with diverse learning styles and needs. It involves processes of modifying, changing,
adapting, extending, and varying teaching methodologies, teaching strategies,
assessment strategies and the content of the curriculum. It takes into account
learners’ ability levels, interests and backgrounds. Curriculum differentiation can be
done at the level of content, teaching methodologies, assessment and learning
environment” (Department of Basic Education, 2011).
If you have not yet accessed PM2, the Guidelines For Responding To Learner
Diversity In The Classroom Through Curriculum And Assessment Policy Statements
(Department of Basic Education, 2011), please do so by scanning the QR code or at
the following link
http://www.thutong.doe.gov.za/ResourceDownload.aspx?id=46301
Or via the Thutong, the Department of Education’s website at
www.thutong.doe.gov.za/InclusiveEducation
When differentiating the curriculum, we need to remember that assessments may

also require differentiation.
You need to study the detailed explanation of differentiation within PM2. You should
focus on gaining an understanding of the three levels of curriculum differentiation.

They are:
1. Differentiating curriculum content
2. Differentiating the learning environment
3. Differentiating teaching methods
Make sure that you understand these levels and are able to apply them to the phase
you are specialising in.
2.3 Differentiating Assessment
If you differentiate your curriculum, it is important to do proper assessment of what the

learners have been taught. To differentiate the assessment, you need to remember that
learner needs cannot be met in the same we for every learner.
The purpose of assessment is to…

• inform instructional planning
• inform instruction
• evaluate effectiveness of teaching for all learners
• assess learning
• identify learner needs and strengths
• evaluate achievement against predetermined criteria for grading and reporting

The Principles for Assessment in a Diverse Classroom

When you have high expectations about every learner, you need to help them to fulfil those
expectations and structuring the way in which you do assessment, will help tremendously.
Every learner should have access to a standard of assessment suited to their needs. No
learner should be disadvantaged by the assessment strategy that a teacher uses.
Teachers are accountable for learners’ achievements, therefore the responsibility of fair
assessment rests on the shoulders of the teacher.
Assessment plays an integral role in the teaching and learning process. Assessment should
be authentic and provide for multiple abilities, styles and needs. All learners can be
accommodated within the flexible educational framework of South Africa. The learner’s
ability will determine what should be expected of him/her.
In a learner centred approach, we need to rethink the conservative practice of assessing all
learners using same assessment tasks at the same time. We need to use an assessment
approach and plan that is flexible and that accommodates a range of learner needs.
How to assess in a differentiated way:

• Allow for different styles or intelligences
• Allow for oral and written assessment tasks
• Give multiple choice options
• Allow questions requiring short answers for certain learners
• Focus on positive aspects or talents of the learner
• Apply concessions such as extra time, reader, audio-visual equipment
Please consult PM2 for more details.

2.4 Concessions
Concessions are accommodations that we use for learners that have a barrier to learning.
The concession functions as sa support tool to help the learner perform closer to their
potential in tests and examinations. The most common examples of concessions are the use
of a computer, spelling and additional time. There is a wide range of concessions available
that can help with the various barriers that learners might face.
To apply for concession, a full assessment of the learner needs to be done. This includes a
full education assessment with an educational psychologist who needs to make the
necessary recommendations in a report. This report is added to an extensive application
through the learner’s school.
While concessions are usually only granted by the department at high school level, it is
important that we put them in action early on so that they can practice and adjust to the way
the concessions work. We cannot simply give a child a reader in a test if the child has never
worked with a reader before as this would mean that the child would not know that they can
ask the reader to reread sections, read slower or faster, repeat a word or questions.
Alternatively, if the school decides to use an MP3 player, the child needs to know how to
pause, go back and find the next question.
If a child uses a computer, the child needs to use a computer in class to learn how to type,
use the screen reader to read their work back to them, and format their work using
numbering, headings, font size, etc.
If the application for a concession is only applied for in grade 12, it may not be granted.
Another reason to start with concessions before high school is that the application needs to
include a history of it having been used and the need for it.
Please consult the following document for an extensive explanation on the types of
concessions available in South Africa.
To access PM4 Click on the link or scan the QR code. It will
automatically download the PDF.
https://www.education.gov.za/LinkClick.aspx?fileticket=ZlgknpSYL3g%3
D&tabid=390&portalid=0&mid=1127&forcedownload=true

REFERENCES
Department of Basic Education. (2011). Guidelines For Responding To Learner Diversity In
The Classroom Through Curriculum And Assessment Policy Statements. Directorate
Inclusive Education. http://www.thutong.doe.gov.za/ResourceDownload.aspx?id=46301

CHAPTER 3: HOW TO CREATE A SUPPORT PLAN –

THE ROLE OF SIAS IN THE CLASSROOM
3.1 Creating a Support Plan
This chapter focuses on how to go about ensuring that you are able to identify which children
have additional support needs and create a support plan. It should be read in combination
with PM5 Policy on Screening, Identification, Assessment and Support (Department of Basic
Education, 2014).
If you have not as yet downloaded this document, please do so now. You can either scan
the QR code or enter the URL below into your browser to download the policy as a .pdf
document. The MS Word version of the documents should be available for you in the unit
your online learning platform.
https://www.education.gov.za/LinkClick.aspx?fileticket=2bB7EaySbcw%3
D&tabid=617&portalid=0&mid=2371
The Screening, Identification, Assessment and Support (SIAS) Policy was designed to
provide the procedures “to identify, assess and provide programmes for all learners who
require additional support to enhance their participation and inclusion in school” (Department
of Basic Education, 2014)
The SIAS Policy aims to assist schools, teachers and support professionals in the
development of a holistic support system for children who are at risk of developing barriers
to education for a variety of reasons. Through a set of forms, this policy outlines the protocol
that has to be followed in identifying and addressing barriers to learning that affect individual
learners throughout their school career.
Chapter 6 of the SIAS Policy (page 27 – 29) explains the three Stages involved with the
SIAS process, however, the material below aims to provide you with additional information
on how to go about completing the process and create awareness of the expectations
placed on you as the teacher in your role as caregiver, mediator of learning and learning
support provider in the classroom, starting with an overview of the process.

Summary of the SIAS Process

3.2 How to Create a Support Plan.
3.2.1 Step 1 – Screening using the Learner Profile
While we may notice children in our classes who have additional support needs, either
through their behaviour, tests, classwork and interaction with their parents and caregivers,
not every child who has additional support needs may stand out in an obvious way. For this
reason, the Department of Education has developed a screening tool that is completed for
every child. This very first step in the SIAS Policy is the completion of the Learner Profile.
The Learner Profile is completed for every child and should be updated annually and
whenever any information on the child changes. This form is usually completed as part of
application process after the application form has been completed. Schools may have a
slightly different process, where the form may be completed by the parent and/or school
secretary, and sometimes by the teacher. Thereafter, it is added to on an annual basis,
usually by the teacher or a staff member, or more often when necessary. If a child transfers
from one school to another, this document moves with the child directly from the old school
to the new one.
Within this set of forms are items that as asterisked (*) which indicate that a child may be “at
risk” of experiencing a barrier to learning and development. This does not mean that the
child is experiencing a barrier at that specific time, however, it indicates that teachers and
staff should be aware that the child has a higher chance of experiencing a barrier to learning
and development. If the child is not experiencing a barrier at that point in time, teachers
should be on the look-out for barriers so that support can be put in place as soon as possible
to limit the negative effects that may occur as a result.
In order to be aware of possible barriers, class teachers are expected to check each child’s
Learner Profile and file before the year begins. Indicators that should draw the teacher’s
attention include such factors as:
• Receiving a grant where the parent or caregiver receives money for food and care of the
child, e.g. foster care, care dependency grant, child-support grant, foster care grant,
disability grant, etc.
• Allergies which could be fatal or cause illness, e.g. bee stings, egg or peanuts where the
teacher should know what to do in case this does occur.
• Disability, chronic illness or medical conditions, e.g. cerebral palsy, juvenile arthritis or
epilepsy.

• Indications of problems related to growth, birth, or development which may have been
noted at clinic or hospital visits.
• Early intervention Services what may affect the ability to learn, which include poverty,
health, disability or social assistance.
o The ability to learn is directly affected by nutrition, safety and other needs being
met.
o Children are not in control of the environments in which they live and
interventions by social services or other child welfare organisations may indicate
that there has been some form of upheaval in their lives.
o In addition, children who live in children’s homes may not have as much support
and supervision in completing of homework or may lack stationary needed to
keep up with the requirements of school.
o If a child has needed occupational or speech therapy this may indicate that they
may have difficulties with learning to read and write, so greater attention may be
necessary to ensure that the child is developing these skills at a suitable rate, or
that additional support may be needed.
• Areas needing ongoing support. It is important that support which has been put in place
is regularly monitored, and that it does not simply fall away as the child progresses into
the next grade. These should be supported by copies of school, therapy and medical
reports that should be included in the child’s file. Please tell parents to keep the original
reports safe as these form part of the evidence which motivate for concessions for
assessments. Therapy reports include occupational therapy, speech therapy,
psychology, physiotherapy and remedial academic interventions.
Early identification of barriers means that interventions can be put in place to minimised or
removed experiencing a barrier to learning. Early intervention has been shown to have
greater success in overcoming barriers. Therefore, being aware of risk factors that
predispose a child to having additional support needs is important in ensuring that children
do not slip between the cracks simply because they may have a more introverted or shy
personality and do not draw obvious attention to their needs.
When information is included in the area marked by an asterisk (*), the teacher should
complete the Support Needs Assessment Form of the Strategy on Screening, Identification,
Assessment and Support (SIAS).

Try it for yourself:

The segment on the next page is from the Learner Profile for Joseph Soap, a hypothetical
learner in a school.
Carefully examine the learner profile and then consider what you think it tells you. After that,
read the interpretation provided below and see if you identified any of the same ideas.

Possible interpretation:
As Joseph has an allergy to bee stings, it is necessary to know what treatment is needed
should he be stung and for medication to be kept at school if necessary.
Jo receives a foster care grant, therefore, he may or may not have had a difficult history. As
the fourth of 6 children living in a foster home, he may need additional support with
homework, and money may be tight for extras.
Jo was quite premature at birth, which may be linked to learning difficulties. He had delayed
milestones and was underweight which may be linked to his being premature and/or
malnutrition as he is now in foster care. He may have experienced some hearing loss as he
did not start to speak until he was 2½, the same age that he had his tonsils out and
grommets put in. This indicates that he may have had ear and throat infections which may
have caused temporary hearing loss.
While the factors which identify Jo as being high risk don’t mean that he will definitely have a
barrier to learning, they do indicate that we need to be aware that he might experience one
now or in the future, and the definitely tell us that we need to take a closer look and ask
some questions to see if Jo needs any additional support.
3.2.2 Step 2 Support Needs Assessment Forms (School Level

Intervention)
SNA 1:
Within the classroom, the teacher not only has the responsibility to teach, but to ensure that
children learn. During this stage, the teacher is required to take ownership of the identifying
the needs that a child may have and implementing the initial support that the child receives.
The SNA 1 document forms guides the teacher through the next step in the support process.
Once a child is identified as having, or being at risk of having, additional support needs, it is
necessary to gain a clearer picture of the barrier in terms of the areas of need that the child
may be experiencing as well as the strengths that the child has, and the support is needed in
order to minimise or remove the barrier.
The teacher, child (aged 12 and up), and parent meet together to make decisions on support
that may be implemented. It is necessary for the parents and child (if old enough) to be in
agreement so that support provided in school may be followed through at home, and
involving the child means that he/she understands the need and takes ownership in the
support process which increases likelihood of success.

Within the SNA 1 form, the teacher records the following:

• A description of areas of concern
• Scholastic profile which shows the child’s progress thus far
• Disability that may have been identified and when it was identified
• Strengths, Needs and Support Needed in the following categories:
o Communication
o Learning
o Behaviour and social competence
o Health, wellness and personal care
o Classroom and School
o Family, home and communication situation
• Teacher interventions/support are recorded in terms of successes and challenges:
o Curriculum Intervention
▪ Differentiation of the curriculum content
▪ Adaptation or differentiation on teaching methods
o Adaptation of the learning environment
o Modification of the physical environment
o Additional comments on the barrier to leaning, support interventions and
continuing challenges
o Additional support that you as the teacher require from the SBST
o Consultation log of meetings between the teacher, parent/ guardian/ caregiver,
and learner, and the views that they may have expressed during consultation.
The progress and support that the child is receiving is reviewed at least once a term or more
often if needed. Specific dates are set to review the support so that the child does not simply
slip through the cracks.
Depending on the level and type of support needed, the teacher may request immediate
involvement of the SBST.
SNA 2:
Should the teacher find that there is insufficient progress in minimising the barrier(s) that the
child is experiencing, then the School Based Support Team is called on to review the child’s
needs, develop a support plan and further support for both the child, teacher and school.

This support may be provided in terms of

• Communication;
• Learning;
• Behaviour and social competence;
• Health, Wellness and personal care;
• Classroom and school;
• Family, home and community;
• Teacher development/ training,
• Occupational, speech, physio- and psycho- therapy, etc
Special needs teachers, speech therapists, occupation therapists, physiotherapists and

psychologists who are based at Resource Centres form part of the DBST, along with the
district officials. In some cases, one or more of these support personnel may come to the
school on a regular basis in order to train teachers, implement a support programme
Should the School and District Based Support Teams decide that the support required is
more than the mainstream or full service school is able to provide, it is then recommended
that the child be moved to a special needs school or resource centre.
While this process may seem long-winded, it is designed in such a way that children should
not be unnecessarily side-lined into special needs schools without having had the
opportunity to attend a local school and have friends in their local community. Just because
a child has a disability or barrier to learning, does not mean that the child must go to a
special needs school as resource centre, where high levels of support are provided.
Remember, in terms of scaffolding, the teacher needs to provide the minimum amount of
support for the child to achieve successful learning. Should too much support be provided for
too long, then the child may become dependent on that support and not develop the
independence that they have the capacity to achieve. The support/ scaffolding that is
provided needs to also be reduced steadily and as quickly as possible to encourage the child
to be independent.
How quickly to reduce/remove support is often quite a tricky. While I do not advocate
gambling, I often recommend to new teachers to try the R100 bet system. This requires
R100 and a jar. If you are prepared to bet R100 that when a child can do something
independently, let them try. If they succeed, you can return your hundred rand to your wallet.
If the child is not successful, place the R100 in your jar and reinstate the support, and try

again at a later date. You will quite quickly learn to judge whether a child is ready to remove
a support intervention. If not, you will probably be able to spoil yourself or your class at the
end of the year.
See the SNA 1 in action:
Below is a case study that has been developed specifically for you to see how to complete
the SNA 1 document.
Please note: While this case study is based on experience in working with children, the child
is fictional and any resemblance to any real person is completely incidental.
Njabulo Jili is a seven-year-old boy from a local township. He attends Happy Hills Primary
School where you teach grade 1. His mother runs the tuckshop at the school. Njabulo is the
younger of two children. His older brother is in high school, and his father works in the next
city so only comes home on weekends. His mother finds it exhausting to look after him all
week alone, so her sister has moved in with them help look after him. In addition to working
at the school, Mrs Jili spends her break times toileting and feeding Njabulo, however, this
must be done during class time as she is on duty during the breaks.
In class, Njabulo’s Spina Bifida makes it difficult for him to keep up with the work as he has
poor fine motor development and low muscle tone which makes writing difficult. Although he
can do activities orally, he speaks slowly and quietly. You do not have time to do all
Njabulo’s work orally with him as there are 40 learners in your class. In class, Njabulo moves
around only one section of the classroom in his wheelchair and the other children push him
around the school to the library and music rooms. Njabulo manages better than you thought
he would, and you think this may be because he attended a pre-school in a neighbouring
suburb run by the Spina Bifida Association, where he received occupational and
physiotherapies. Njabulo has a ready smile but is very shy and seldom speaks above a
whisper. He has a gentle nature and gets on well with the other children in the class. At
break, he loves to play soccer and is usually the goalie.
In class, he loves to play on the computer, and recently you have noticed that he is able to
write sentences and draw pictures using the mouse. When reading a story to the class, you
find that Njabulo often answers simple questions correctly but struggles with higher order
thinking questions when under pressure.




Hopefully, you have better idea of what a completed SNA 1 form would look like by this
point. Remember, the teacher is never required to come up with all the ideas for support on
his/her own.
There are many sources of information and support for teachers including fellow teachers,
Heads of Department or Phase, websites, therapists and non-profit organisations and
parents.

REFERENCE
Department of Basic Education. (2014). Policy on Screening, Identification, Assessment and
Support. Department of Basic Education.

CHAPTER 4: SUPPORTING LEARNERS WITH

PHYSICAL BARRIERS TO LEARNING
In South Africa and in other countries where the health service cannot meet the
needs of the population, it is all too easy for physically disabled children to be
classed as mentally disabled; and for mildly mentally disabled children to be classed
as impossible to educate (or not "worth" the effort) (Gaize et al., 1999).
4.1 Physical impairments
In this chapter, we focus our attention on Physical Impairments, the impact that they
may have on learning and teaching with a view to identifying the resulting support
needs and putting in place support strategies to promote learning and participation.
While physical impairments is a contains a huge variety of impairments, it can be

split into two main groups:
● Musculo Skeletal Impairments and
● Neuro Musculo Impairments.
Impairments in both groups affect the ability to move and control the body, however,
the source of the impairments differ.
Musculo Skeletal Impairments are caused by diseases, degeneration or deformities

in the muscles or bones, which reduces the ability to move body parts. In this
category, we will focus on Burn Injuries, though other impairments include losing a
limb, Brittle Bones (Osteogenesis Imperfecta), Juvenile Arthritis and Muscular
Dystrophy (What Is Physical Disability?, 2017).
Neuro Musculo Impairments result from diseases, degeneration or disorders in the

nervous system which includes the nerves and brain. This affects the person’s ability
to control their muscles. In this category, we will consider Cerebral Palsy and Spina
Bifida, though other impairments that fall into this category are Polio (Poliomyelitis),
Stroke, Head Injury and Spinal Cord Injury (What Is Physical Disability?, 2017).
Additional support to develop physical abilities and address difficulties can often be
provided through
● occupational therapy (mainly fine motor),
● physiotherapy (gross motor),
● speech therapy (speech and language),
● nurses (medical support)
● and psychologists or social workers (social and emotional).
Unfortunately, not all schools or parents have the financial means to engage these
support specialists though through the District Based Support Teams and Special
Schools as Resource Centres support may be accessed to assist children who
require low to moderate support needs.
Information on specific physical disabilities can be obtained from local, national and
international non-profit organisations which can be accessed through the internet or
directly from the Non-Profit Organisations.
4.2 Challenges for learners with Physical Barriers
4.2.1 Accessibility
The most common barrier that these learners face first, is that of limited physical
access to the learning environment which includes the classroom, playground and
the general school premises. Once they get the needed support to overcome this
initial barrier, they can create coping strategies that will help them and those around
them.
4.2.2 Motor (movement) Impairment
If a learner experienced a brain injury or has a disorder that deals with the nervous
system, it can affect their range of movement as well as coordination. Technology
has done much to help in this field. Think of motorised wheelchairs that give freedom
to the user as it allows the learner to get around without assistance.

4.2.3 Negative self-image and low expectations
Negative self-image and negative perceptions of the disability can lead to learners
with physical barriers having low expectations of themselves. This unfortunately also
happens with the grownup around them, parents and teachers. We feel sorry for
them and therefore lower our expectations of them which again leads to a lowering
of the possibilities they have to fulfil their potential.
4.2.4 Language delays
Some of these learners have missed out on important stages of learning during their
school years and this will then have an impact on their language development. This
can negatively affect all aspects of their academics as language skills form the basis
of all other skills that need to be learned.
4.2.5 Communication
Communication can be difficult for learners who stammer or stutter, as well as those
with any other speech and language difficulty. As talking with friends, family and
strangers form a major part of our social development, the barriers that learners face
when trying to express themselves, should not be underestimated. These difficulties
can make a person sound less intelligent than what they actually are since they
appear to be struggling with basic concepts. This means that the potential of these
learners also goes unrecognised. This is something that teachers should be aware
of, since they can help the learners to recognise their true ability so that they can set
achievable goals for themselves.
4.2.6 Psychological Challenges
People with physical barriers can struggle to remaining positive due to all the barriers
that can be present. They often feel like they’re slowing everyone else down as they
cannot complete tasks as quickly as others. They also feel that people see them as
lazy when they’re actually incapable of doing certain tasks. They often get teased for
being different. All these factors can make them feel unwanted. One of the key
aspects of social development is to experience a feeling of belonging. Teachers and
other caregivers should strive to include learners with physical barriers in activities

that the children around them are engaged in. Use this as an opportunity to teach
everyone involved how to accommodate each other.
4.3 Examples and General Areas of Support
For children with physical impairments, issues around access and safety need to be
addressed, which includes accessibility to classrooms and restrooms as well as how
steep ramps are. Ramps should have a maximum ratio of 1:12. That means that for
every 1 metre that a ramp goes up it needs to be at least 12 metres long, otherwise it
makes it very difficult for wheelchair users to push themselves up it or control their
speed coming down, and increases the chance of wheelchairs tipping over or
accidents occurring.
Generally speaking, children with physical impairments may have problems relating
to some, if not all, of the following to differing degrees:
● movement,
● posture (e.g., sitting, standing),
● grasping or manipulating objects,
● communication,
● eating independently,
● perception or how they sense something either internally or externally,
● reflex movements,
● and/or automatic functions which may affect toileting
and may require differing amounts and types of support. In many cases, it may
affect the speed at which children are able to process and carry out activities or
actions.
Children with physical impairments may need to use more energy, concentration and
focus to complete the same work as their peers so may need rest and movement
breaks, reduced workload, additional time, more space or modified devices.

For specific information on the accommodations and assessment available, please

refer to PM4, available as the following link or by scanning the QR code:
https://www.education.gov.za/LinkClick.aspx?fileticket=ZlgknpSYL
3g%3D&tabid=390&portalid=0&mid=1127&forcedownload=true
Finally, children with physical impairments may be absent from school as they may
need to visit clinics or hospitals for regular check-ups and fittings for prostheses,
orthotics and crutches and wheelchairs.
As a teacher, it is important to keep a careful watch on how children are sitting to

ensure that they have a stable base for working, make sure that desks are the
correct height for wheelchairs and ensure that children’s splints or orthotics are not
causing pain or rubbing skin raw. Children may need help to be seated correctly as
sitting in uncomfortable positions may result in pressure sores or pain and stiffness
(Brei & Kelly, n.d.; Department of Basic Education, 2014).

4.3.1 Cerebral Palsy (CP)
Cerebral palsy falls into the group of physical impairments called Neuro Musculo
Impairments. The impairment itself is situated within the brain but affects the child’s
ability to control their muscles.
There are a variety of different types of CP. Classification is usually done according
to the main type of movement that is affected. These are usually:
● Stiff muscles (spasticity)
● Uncontrollable movements (dyskinesia)
● Poor balance and coordination (ataxia)
4.3.1.1 Spastic Cerebral Palsy
Most people (80%) with CP have this type. As it causes more tension in the muscles,
it makes them stiff and hard to move. This is why the movements look strange.
Figure 1 Spastic Cerebral Palsy(Reiter & Walsh, n.d.)
4.3.1.2 Dyskinetic Cerebral Palsy
This type causes problems in controlling hands, arms, feet and legs movements. It
makes it very hard to sit and walk. Movements are also uncontrollable and can be
slow or fast. Dyskinetic CP can also affect the face and tongue which would make
talking and swallowing hard to do. Dyskinetic CP varies all the time. It can change
from day to day, or even more frequently. Dyskinetic CP is also known as Athetoid
CP.
Figure 2 Athetoid and Dyskinetic Cerebral Palsy (Reiter & Walsh, n.d.)
4.3.1.3 Ataxic Cerebral Palsy

This causes poor balancing and coordination. Both of these functions are necessary
for walking so people with Ataxic CP tend to walk very unsteadily. Controlling
movements, such as writing, may be really difficult.
Figure 3 Ataxic Cerebral Palsy (Reiter & Walsh, n.d.)

4.3.1.4 Mixed Cerebral Palsy
This means that the learner has more than one type of CP.
For a list of difficulties, as well as practical tips for teaching children with CP, please
read PM3 , page 57.
Cerebral Palsy as well as other physical disabilities can also be categorised

according to how they affects the body, e.g.
• Diplegia: Two limbs either upper of lower
• Paraplegia: the lower body
• Hemiplegia: one side of the body
• Quadriplegia: arms and legs
Figure 4 Cerebral Palsy (Gillette Children’s Specialty Healthcare, n.d.)

In the poignant short movie, Cousin (Eliot, 1999), Adam Eliot tells
the story of his older cousin who has cerebral palsy and his
memories of playing together as children, and provides viewers
with the simple understanding that children may have of one
another.
https://www.youtube.com/watch?v=l8ztayHkVXo&t=2s
4.3.2 Spina Bifida
Spina Bifida is an NTD or Neural Tube Defect that occurs when the neural tube fails
to close during foetal development. This means that the spine is not fully protected.
This usually happens before the 28th day of pregnancy, before a woman even knows
she is pregnant and occurs in approximately 1 out of every 1000 babies that are
born.
The effects of Spina bifida vary dramatically based on where the opening to the
spine occurs and the size of the opening (Brei & Kelly, n.d.). This higher up the spine
the opening is situated, the more of the body is affected, while the bigger the
opening, the more damage is likely to occur to the spine itself and the greater the
risk of damage. The Spina Bifida Association refers to it as the “snowflake condition”
of birth defects because no two cases are the same.
While there are others, the three most common types of Spina Bifida are Spina
Bifida Occulta, Meningocele and Myelomeningocele.
Figure 5 Types of Spina Bifida (ConnectAbility Australia, 2020)

4.3.2.1 Spina Bifida Occulta
Spina Bifida Occulta or SBO occurs in about 15% of healthy people and may be
called “hidden Spina Bifida” as they may not even know that they have it as it usually
does not harm to the spinal cord and nerves and has no visible signs. Usually,
people discover it when they have an X-ray done of their back for other purposes.
However, some people may experience pain and neurological symptoms.
4.3.2.2 Spina Bifida Meningocele
In Spina Bifida Meningocele, a small sac pushes through the spinal cord. The sac is
filled with nerve fluid so there is usually no nerve damage. Children with
Meningocele may have minor impairments. Usually, a child with Meningocele is
operated on to protect the spinal cord and much of the time, the child is not
paralysed (Spina Bifida Association, n.d.). However, there may be some sensory
loss in the lower limbs so it is important to watch that children do not injure their feet.
4.3.2.3 Spina Bifida Myelomeningocele
Spina Bifida Myelomeningocele (Meningomyelocele), also called Spina Bifida

Cystica, is the most severe form. In this form, the parts of the spinal cord and the
nerves come out through the spine which causes nerve damage and other
impairments. According to the Spina Bifida Association, 70 – 90% of children with
Myelomeningocele have too much fluid on the brain, which left untreated, may cause
brain damage. This occurs when the fluid that protects the brain and spinal cannot
drain and builds up causing pressure and swelling.
Children who have Myelomeningocele are usually operated on within days of their
birth to prevent infection and prevent further damage to the spinal cord. However,
many may have a loss of sensation or paraplegia and require the use of a
wheelchair or other mobility devices (NINDS, 2021). Therefore, as children with
Spina Bifida may have limited sensation in their legs and feet, teachers should
ensure that children’s feet are protected so that they are not injured, e.g., wearing
socks when swimming to prevent grazing the toes on the bottom of the pool.

Figure 6 Baby with Spina Bifida (Stanford Children’s Health, n.d.)
It is especially important for teachers to monitor the health of a child with Spina Bifida
in their care. As Spina Bifida causes the spine and nerves to come into contact with
the environment and causes lack of function of muscles and organs, teachers need
to be aware that children with Spina Bifida are at risk of developing health problems.
According to Model Farms High School (2021), NINDS (2021) and the Spina Bifida
Association (n.d.) this may include:
● loss of muscle strength due to nerve damage. While some children with Spina
Bifida walk independently, others may need to use leg braces, walkers, crutches
or wheelchairs.
● Scoliosis, which is a curvature of the spine. It is important to check that children
who are in wheelchairs are properly seated and supported to provide a stable
base to support working with their arms, hands and heads.
● Brain malformation (Chiari II) where the brainstem and cerebellum protrude into
the neck area. While this seldom causes problems, teachers need to be
observant if a child has difficulty swallowing, breathing and has arm weakness.
The parents or guardians would need to be contacted and the child taken to their
specialist, as surgery may be necessary.
● Hydrocephalus may occur if there is a blockage in the cerebrospinal fluid. The
child may need an operation for a shunt to be inserted. If a child has a shunt, the
teacher needs to be observant of the child having headaches or difficulty seeing
as this may indicate that there is a blockage in the shunt and the parents need to
take the child to their doctor.

● Children who have shunts are also at risk for meningitis which is an infection that
causes severe headaches and requires treatment.
● Bowel and bladder incontinence affect most individuals with
myelomeningocele. The nerves at the very bottom of the spine control bowel and
bladder function and don’t usually work properly in people with this type of Spina
Bifida. As a result, children may need a regimen (usually four hourly) or other
assistance to drain their bladders periodically.
o Pre-schoolers may need assistance with catheterisation and an assistant
can usually be trained to assist with this. However, this quickly becomes a
supervisory role it is very important that children learn early on to self-
catheterise as this reduces chance of bladder and kidney infections.
o Incomplete catheterisation means that the urine that stays in the bladder
may move back up into the kidneys and back into the body. Unfortunately,
this may lead to kidney failure and death.
● Finally, children who use wheelchairs need to be encouraged to move around
independently as this improves muscle tone and strength and reduces the risk of
obesity. To accommodate this, it may be a good idea for the children with Spina
Bifida to leave slightly early so that the corridors are less crowded. Peers can
also assist with movement around the school, such as opening doors and
ensuring paths are clear of bags and other items that learners leave lying around.
Children with Spina Bifida may experience challenges with motor skills, attention,
memory, and organisation. The Spina Bifida Association (n.d.) point out that children
with Spina Bifida may display the following strengths and weaknesses that may
affect their learning at school. Included are also suggestions for supporting children
in the classroom. Please remember that there are at least “A hundred ways to eat a
chocolate” so if one strategy is ineffective, there are many more ideas to try (Laas in
McKinney, 2014).
● Perceptual-motor problems may result in poor hand-eye coordination and limited

motor skills that may limit their abilities to move, use tools such as pens and
pencils, read and write.

● Comprehension: Children with Spina Bifida may have difficulty in understanding

concepts. All stimuli must go through the muscles and nerves into the brain.
When this signal is disrupted, the brain may take longer to comprehend or
misunderstand what is being taught. Therefore, it may be necessary to begin by
providing concrete or semi-abstract examples or learning aids before moving into
abstract concepts, or to support abstract concepts with visual and tactile teaching
aids.
● Children with Spina Bifida may have difficulty paying attention at school where
they may miss assignments, work slowly or overlook social cues.
● While their physical impairment may mask obvious restlessness, children with
Spina Bifida often appear fidgety and impulsive, and as a result, they may end up
doing things quickly and carelessly. As with inattention, if these behaviours
continue it may be necessary to refer the child to a psychologist, paediatrician or
neurologist for an evaluation. It should be noted that children with Spina Bifida
may still have ADHD.
● Organisation: Children often have trouble keeping things organized and are likely
to lose or misplace things. Help children to organise their stationery, desks and
bags themselves by allocating things specific places. Organizational difficulties
may also extent to completing activities as well. It may help to provide a
numbered list of instructions that the child can refer to, or to-do list that the child
can check off once completed.
● Sequencing: Related to organizational skills, children and adolescents with Spina
Bifida often have trouble keeping ideas or doing activities in their proper order.
Good stories that can be told in an orderly way may not easily be written down
because children cannot organize ideas. Sequencing problems become obvious
when doing math, telling time, and counting change.
o Children with Spina Bifida may need additional practice to master
sequencing activities.
o Frames may also be provided for children to work in that will help them to
sequence their work, e.g., introduction, problem, solution, plot twist, and
resolution for story writing.
o Break activities into smaller parts so that they do not seem quite so
overwhelming, and a sequence is automatically provided for the child to
follow.

● Decision Making/Problem solving: People with Spina may experience difficulty

making decisions that require using what was learned in the past to solve a new
problem now.
o Offer the child opportunities to make choices to practice this skill but limit
the options. e.g. Would you like to paint or colour?
o Model problem-solving in class and allow the child to follow the process
with you. As this process is repeated using other problems, encourage the
child to play a more active role in problem- solving.
● Limitations in development of independence. As it is often easier and faster for
parents or caregivers to do things for children with Spina Bifida, many children do
not learn to persevere and learn to do things for themselves such as dressing
and putting on shoes. While this may be easier at the time, the Spina Bifida
Association (n.d.) warns that it may affect children’s self-esteem and belief in
their own abilities to complete a task. In the long run, which may flow through to
the classroom, where children may give up rather than rising to the challenge
when faced with more difficult problems. Also, children may be passive in class,
which may limit their learning as they interact less during discussion. Instead,
they suggest that children be given additional time and be involved in making
choices and helping with daily tasks.
● In terms of Intelligence, children with Spina Bifida usually have average
intelligence. However, as every child is different, there may be a broad range
of scores from exceptional to those who experience learning difficulties.
Interestingly, the Spina Bifida association points out that children who have
better Verbal IQ scores, are more likely to do better in school.
● Children with Spina Bifida may experience health problems which may
negatively impact their learning and performance at school.
● Children with Spina Bifida may do better in reading and spelling than in
mathematics.
● The more spinal cord damage a child has, the greater the chance of learning
problems.
● Children with Spina Bifida may tire quickly and may need regular rest breaks.

● Remember that it may take more effort for a child with Spina Bifida to
complete a task independently. As the teacher, you can
● Reduce the size of the task, e.g., do every 2nd sum.
● Allow for more time to complete the task.
● Offer genuine praise for the effort that the child is putting in.
Remember, learning is a process, not just a product.
4.3.3 Burns
Burns in children are very common as many families in SA have limited or no

electricity and, therefore, rely on candles or gas lamps for light; wood, gas or
kerosene stoves or even open fires for cooking; and gas or fire for heat during
winter. While many safety strategies have been put in place in homes in developed
countries, the World Health Organization (2008) expresses great concern that these
have not been widely applied in low- and middle- income countries and that the
resulting incidence of death and injury amongst poorer members of society remain
high. This puts families at risk for accidental burn injuries.
Figure 7 Girl with Burns (Saaraa Medical Solutions, 2017)Gaize et al. (1999) explain that
burns are most commonly caused by hot liquids or fire, but that they can also result
from cold (frostbite), high and low voltage electricity, acid and alkali chemicals,
abrasion and friction, and irradiation.

In South Africa, the loss of fingers through fire is common. Hands are usually the first
form of protection and take the brunt of the heat. Many children may develop long
term complications and problems such as formation of scar tissue, and contractures
may occur because of the tightening of the skin around a joint causing impaired
mobility. As a result, of these contractures, many children have shortened fingers
and the remnant fingers may be fused together (Gaize et al., 1999).
Figure 8 Contracture of fingers due to severe burns
Rehabilitation of burn injuries may take months or years and multiple operations
including skin grafts, while the results may show improvement in movement or
function, however, much of the scarring remains (Foley, n.d.). Sadly, the scarring
carries with it the stigma of looking different as well as the psychological trauma of
the incident and hospitalisation at a young age, which may mean a child being
separated from their family for extended periods of time.
Greenhalgh (2020) explains that “our identity in society is dictated by our face” where
attractiveness and regular features are admired. Others immediately notice when
there are any differences and even polite people may stare and ask what happened.
Other children may feel that there is something wrong with that person and may cry
or taunt that person. Sadly, the media has often supported the association of people
with facial scarring as being evil. As a result, many people with facial scarring may
choose to hide their faces for their own emotional and psychological protection.

What can teachers do to support children with burns?

In the classroom, it is necessary to be aware of the child’s needs as well as the
reaction of classmates who may not have encountered children with burn injuries
before.
● The teacher needs to be very matter-of-fact and open when discussing the issue
with the class, allowing children to realise that beauty is deeper that just one’s
skin and keep in mind the positive aspects of the child.
● The teacher and school should set up proactive strategies to prevent bullying or
exclusion, such as setting up a buddy system
● The school may engage in wellbeing and resilience building programmes to help
support all children, such as the Bounce Back! programme (Noble & McGrath,
n.d.)
● Physical adaptations may need to be made as children may have difficulty in
holding items such as paper, pencils, paint brushes, etc.
o Occupational Therapists may build splints for children to support the hands
and joins. As a teacher, you may need to watch that the splint is effective
and that it isn’t rubbing or chaffing. Ideally, the child should be able to use
the splint as independently as possible but may need help when putting on
and removing the splint.
o Children’s hands may become tired and sore, allowing for children to take
regular breaks to stretch and relax their hands and bodies. If not
encouraged to move, joints may become stiff and contractures may
increase.
o Children may be required to wear pressure garments to protect skin that
has been burned or grafted. As a teacher, you may need to monitor
whether the child has any discomfort/

4.4 Assistive Devices
An assistive device is any item, piece of equipment, or system – whether bought,

modified, or customised – that is used to increase, maintain or improve the functional
capacities of an individual (Bornman & Rose, 2010)
An assistive device can:

• Increase physical ability
• Maintain physical ability
• Compensate for loss of function
• Control movements
• Be a substitute for specific body part/ system
• Reduce the need for help from another person
• Give self esteem
Broadly speaking, you get two types of devices:

• Low-tech
o These are mechanical devices that usually do not require electricity or
batteries to operate.
o They are generally simpler and may be less expensive than the high
tech alternative.
• High-tech
o These devices usually (though not always) require electricity or
batteries in order to work.
o These may be more computerised or rely on hydraulics or motors.
o High-tech devices may be more complex in design, and are usually
more expensive than their low tech alternatives.
It is important to note that there are often second hand assistive devices available,
and some of the non-profit organisations may loan or sponsor devices for children
whose families or schools may be unable to afford them.

Tabulated below are a few examples of high and low tech devices.
Low-tech High-tech
BIGtrack 2.0 Trackball (computer mouse)

(PC Link Computers, n.d.)
An elastic band (Your Kids OT, 2017)
Eye-gaze tracker
Specialist Pencil Grips (Your Kids Control a computer with your eyes (Edit
OT, 2014) Microsystems, 2021)
Manual Wheelchair (CE Mobility, Rigid frame Motorised Wheelchair(CE

2020a) Mobility, 2020b)
Price: from R5080.00 Price from R71465.00

Focus mode
Set kitchen timer for a specific time

Forest
length to complete an activity and put it on the
child’s table to help children focus their
Pomodoro technique apps to assist with
attention.
focus (Geekbot, 2020)
While a wheelchair will help one child who has a mobility impairment, a kitchen timer
or pomodoro app may help all the children keep track of time, not only the children
who may have ADHD.
Some Examples of Assistive Devices:
• Mobility aids, such as wheelchairs, scooters, walkers, canes, crutches,

prosthetic devices, and orthotic devices.
• Hearing aids to help people hear or hear more clearly.
• Cognitive aids, including computer or electrical assistive devices, to help
people with memory, attention, or other challenges in their thinking skills.
• Computer software and hardware, such as voice recognition programs,
screen readers, and screen enlargement applications, to help people with
mobility and sensory impairments use computers and mobile devices.
• Tools such as automatic page turners, book holders, and adapted pencil
grips to help learners with disabilities participate in educational activities
• Closed captioning to allow people with hearing problems to watch
movies, television programs, and other digital media.
• Physical modifications in the built environment, including ramps, grab
bars, and wider doorways to enable access to buildings, businesses, and
workplaces.
• Lightweight, high-performance mobility devices that enable persons with
disabilities to play sports and be physically active.
• Adaptive switches and utensils to allow those with limited motor skills to
Choosing assistive devices

As a teacher, you may be asked by parents to assist with the choice of device or,
alternatively, you may feel that a child may benefit from the use of a device to be
used in class or at school. As such, it is important to make informed decisions with
regards to how suitable the device is for the child to use in the classroom, school or
home and which device would be best for this.
It is important to be aware that there are people will be able to assist you in this, and
that some assistive devices need to be chosen according to a specific child’s needs
and that it may be necessary to be modified accordingly and may not be used by
other children.
While some assistive devices are easy to choose, there are times when you may
need to consult with someone who specialises in the field. Some of the professionals
who may be able to assist with devices include physiotherapists, speech therapists
and occupational therapists.
• Occupational therapists can often assist where children may have difficulty in
holding a pencil or writing implement with suitable grips, or even splints for
children who do not have fingers or thumbs.
• Occupational and speech therapists may be able to assist with choices of AAC
devices and programmes used for communication.
• Physiotherapists may be able to assist with devices such as wheelchairs,
crutches, seating and toileting devices.
When choosing an assistive device, Morin (n.d.) advises using the following
questions:
• Does this tool address the child’s specific needs and challenges?
• Does it use the child’s strengths?
• Is there a simpler tool that would work as effectively?
• Will it be easy to incorporate into everyday life?
• Is it portable?
• Is the child willing to use it?
• Is the child able to use it? (Many devices will allow for the child to try a demo.)
• How easy is it to learn to use the tool?

• Will you have support or training in how it works, even if it’s only used at school?
• Will parents or caregivers have support or training in how it works?
• Is the tool compatible with the existing technology your child uses?
• Will the software work on the child’s mobile device or a school computer?
• How reliable is the device?
• What technical support is available?
• If the tool is purchased for school use only, do parents have access to a
comparable tool that the child can use at home?
• When considering high tech devices that require software, consider the following:
o Will it be necessary to pay an annual license?
o Are upgrades included in the cost of the software or will these have to be
purchased. Some software that may seem cheaper to start with may turn
out to be more expensive if one needs to keep buying upgrades.
o Will the software be suitable for later grades as well or is it only suitable for
earlier grades?
In the classroom, it is necessary to consider whether a device needs to be

specialised so that only one child may use it or whether it may serve multiple
children.
Clicker 8 is educational software that can be used with an onscreen keyboard, switch
or eye-gaze tracker for writing support.
Learn more about how Clicker can support writing skills by scanning the QR code or
clicking on the link
https://www.cricksoft.com/uk/clicker

Items such as wheelchairs usually need to be specific to the child in terms of size,
type and support, especially as the child needs to be as independent as possible and
seating is exceptionally important to create a stable base for writing or desk work.
Poor seating can result in a child experiencing pain and they may even develop
pressure sores which, if left untreated, may result in severe illness and even death.
Durability is also an issue.
While a standard manual wheelchair may be suitable for a well-developed urban

environment, it may have a very short lifespan in a rural environment or informal
settlement and an off-road or solid frame chair may be necessary. In some areas,
children may be brought to school in wheelbarrows because wheelchairs cannot
navigate the terrain (Fufa et al., 2014).
Wheelchair for rugged terrain.

Note the supported cushioning and seating support
(MacDonald, n.d.)
It is also important to realise that to a child who requires one, their wheelchair is not
just a chair but becomes an extension of the self. In the same way that you would
not like someone to touch you without your permission, you should not touch a
person’s wheelchair without first asking. It is considered very rude to move someone
in a wheelchair without asking them if they would like assistance first.
With regards to Assistive Technology, the University of Toronto

runs AT Select, an Academic Intervention Lab. It is an excellent
place to explore some of the academic support assistance that
is available for specific difficulties that children may experience.
Follow the link or scan the QR code to explore the site.
https://www.atselect.org/tasks-to-techs

4.5 Augmentative and Alternative Communication (AAC)
Augmentative and alternative communication may be used for children who have
communication difficulties. AAC is often used for children who have
• limited speech e.g. speech aphasia,
• Cognitive impairments,
• Cerebral palsy and/or
• Autism Spectrum Disorder.
Most importantly, when using AAC in the classroom, it must be functional.
4.5.1 What does AAC Include?
4.5.1.1 Graphic symbols
e.g. pictures, line drawings or written words.

There is an entire pictographic language called the Universal Picture Communication
System. Below is a visual schedule of how to wash your hand during Covid-19.
C O VID-19 VISUAL SC HEDULE HO W TO WASH YO UR HANDS
1. Tu rn ta p o n 2. We t h a n d s 3. Tu rn ta p o ff 4. Pu t so a p o n 5. Ru b so a p in
ha nd s p a lm o f h a n d s
* ^ * ^ ^
6. Ru b so a p o n to p 7. Ru b so a p 8. Ru b so a p o ve r 9. Tu rn ta p o n 10. Wa sh so a p o ff
o f ha nd s b e twe e n fin g e rs tip o f fin g e rs
^ ^ ^ * ^
11. Tu rn ta p o ff 12. Dry h a n d s o n a 13. Th ro w th e 14. Le a ve b a thro o m 15. With c le a n

p a p e r to we l p a p e r to we l in th e ha nd s
b in
* ^ * ^
This is a visual schedule. A visual schedule can help people to understand how a sequential process or procedure works. It is especially helpful for people with
intellectual disabilities or autism, to help them understand what to do next or what will happen next. When a person is able to anticipate what will happen
next, it can decrease their anxiety and increase their independence. To use the visual schedule, sit with the person before starting the activity and explain the
procedure to them step by step, pointing to the pictures as you explain. During the procedure, before each step, show the person the picture. When that step is
completed, show them that you are moving on to the next step by pointing to the next picture.
*symbols from www.bildstod.se and ^https:/ / www.vecteezy.com.

4.5.1.2 Gestures or Manual signs
Example: South African Sign Language (SASL), Makaton.
Makaton is a language programme using a systematic multi-modal approach of

speech, signs and symbols to teach communication, language and literacy skills to
people with communication and learning difficulties. As it is simpler to use, it lacks
the grammatical and linguistic complexity of sign language, however it is an effective
form of communication for people who would otherwise be unable to communicate. It
also differs from sign language as it is used together with normal grammatical
speech.
Visit the Makaton South Africa website to learn more about

Makaton and explore their Sign of the Week page to learn a few
signs. https://www.makaton.co.za/page/sign-of-the-week-1
South African Sign Language is a recognised South African language and children
who are deaf are able to learn using SASL as their home language. While it is not
specifically AAC, it may be used with children who have difficulty with speech for
communication purposes. The benefit of SASL is that is can be used at high levels
including tertiary institutions.
4.5.1.3 Computers and speech generating devices (voice output devices)
The advances in smart phones and tablets have seen many AAC apps emerging,
and these are wonderful for those children who have fine motor functionality to use
them. However, for those children who have more severe forms of Cerebral Palsy
that make controlled fine motor movement difficult, the use of bigger and sturdier
devices are still more effective. Many of these devices can be controlled with an eye-
gaze tracker for those who have good eye control and very little functional
movement, or a simple clicker switch for those who are able to make controlled
movement with a hand or head.

Tap to talk is a very simple beginner app that can be loaded onto a
phone, iPad or tablet, and is available for free (ABC Pediatric Therapy,
2014). It is a great app to give you a basic idea of how AAC can be used
in a very functional way.
Quicktalker FT 23 (AbleNet, 2021) is a less expensive

speech generating device, however has greater
limitations than a high end device such as a Tobii
Dynavox device. The Quicktalker FT 23 has free software
that can be used to make your own symbol overlays to
expand the vocabulary. Explore the Quicktalker ranger at
https://www.ablenetinc.com/speech-generating-devices/
The I-110 offers a suite of communication and

learning support software pre-installed that caters
to beginners and experts and can adjust the
software based on changing of needs (Tobii
Dynavox US, n.d.). Featuring a purpose-built,
ultra-rugged design, Gorilla Glass, naturally
intuitive user interface, and an IP54 classification, the I-110 is an AAC device that
delivers exceptional durability, performance, and reliability. It even comes with an
integrated kick-stand. Learn more about the Tobii Dynavox range at
https://www.tobiidynavox.com/devices/multi-access-devices/i-110/#Overview
4.5.1.4 AAC support in South Africa
Explore more about AAC at Interface KZN, a non-profit

organisation who provide individual and group therapy to those
who need access to AAC. http://www.interface-kzn.co.za/

REFERENCES
Brei, T., & Kelly, L. (n.d.). Level of SB Function. Spina Bifida Association. Retrieved
24 April 2021, from https://www.spinabifidaassociation.org/resource/sb-the-spine/
Gaize, H., Jones, B., & Manfred, H. (1999). Children of Fire and Dorah Mokoena
Charitable Trust School’s Guide. Children of Fire.
McKinney, E. (2014). 100 Ways to Eat a Chocolate. Rolling Inspiration,

November/December.
Model Farms High School. (2021). Spina Bifida—Teaching for Inclusion.

http://web1.modelfarms-h.schools.nsw.edu.au/disabilities.php?page=spina-bifida
NINDS. (2021). Spina Bifida Fact Sheet. National Institute of Neurological Disorders
and Stroke. https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-
sheets/spina-bifida-fact-sheet
Spina Bifida Association. (n.d.). What is Spina Bifida? Resources and Prevention.
Spina Bifida Association. Retrieved 24 April 2021, from
https://www.spinabifidaassociation.org/what-is-spina-bifida-2/
What is Physical Disability? (2017, September 1). GPII DeveloperSpace.

https://ds.gpii.net/content/what-physical-disability


NEUROLOGICAL BARRIERS TO LEARNING
5.1 Neurological Impairments
Neurological Impairments are impairments that are caused by changes in the brain.
In the first unit, we focussed on the most common of these impairments, ADHD, so
in this unit, we will examine a few more common neurological impairments: Epilepsy,
Tourette’s Syndrome, Autism. Theme 1 explores what neurological impairments are
and includes a brief section on Tourette’s Syndrome. Theme 2 focuses on Autism,
which is becoming more and more common in our classrooms, and Theme 3 looks
at Epilepsy and managing seizures in the classroom.
While neurological barriers are caused by changes or disorders within the brain, they
may seem unnerving to teachers as they are seen in the way that they affect the
behaviour of children and, therefore, may be harder to pinpoint and easier to label as
something else. While many neurological barriers may need to be treated by doctors
through medicine, there is much that we, as teachers, can do to help to minimise the
impact of these barriers and reduce the severity of the barrier within the classroom
through the way in which we manage our classrooms and behaviours, our attitudes
towards children and the example that we set to the rest of the class.
According to the Queensland Department of Communities, Child Safety and

Disability Services (2014), a “Neurological impairment occurs when there is damage
to the nervous system, which includes the brain and spinal cord. Damage to either or
both of these areas can affect the way the brain processes information and
communicates with the rest of the body”.
The brain is complex, consisting of around 50 billion neurons (cells), each of which
can connect with up to 10 000 other neurons, and it is responsible for controlling
every aspect of our body (Eysenck & Keane, 2015).

Without becoming too complicated, we will take a brief look at the brain and consider
how affecting the brain cells in these areas may affect the behaviour that children
may exhibit in the classroom.
Figure 1 Parts of the Brain (Course Hero, n.d.)
The cerebrum is divided into four lobes:

● The frontal lobes are responsible for personality characteristics, problem-
solving, judgment, smell recognition, and movement.
● The parietal lobes interpret sensation (touch and pain), helps identify objects
and controls handwriting, and body position.
● The temporal lobes are involved with short-term memory, speech and hearing,
musical rhythm, and smell recognition.
● The occipital lobes contain the brain's visual processing system.
● In the middle of the cerebrum is corpus callosum which connects the left and
right sides (hemispheres). For example, when reading you need to coordinate
what you are seeing (occipital lobe) with the language that you know (temporal
lobe) and understand the concepts that are being written about (frontal lobe).
Below the occipital lobe is the cerebellum, at the base and back of the brain, which
is responsible for balance and coordination.

The brainstem (middle of brain) controls movement of the eyes and mouth, relaying
sensory messages (such as hot, pain, and loud), breathing, consciousness, the
heart, involuntary muscle movements, sneezing, coughing, vomiting, and
swallowing.
The brain is surrounded by membranes called the meninges filled with fluid. If there
is swelling in the meninges, this can put pressure on the brain which causes a
headache, sensitivity to light, seizures, difficulty concentrating, confusion, amongst
others, and can make learning in the classroom very difficult.
If you consider the different areas and their specific roles, it is possible to see that
changes in their function could affect a child’s behaviour in a variety of ways.
As with all cases where children’s behaviour may differ from what is expected, they
become at risk for bullying and exclusion, and it becomes necessary to proactively
prevent bullying or intervene if it is already occurring.
The Tourette Association of America recommend the following:

● Encouraging your school to enact innovative bullying prevention practices. An
example of this involves promoting peer leadership to create a culture among the
students of tolerance and acceptance of others.
● Identifying a trusted adult in the school whom children can report to or go to for
assistance.
● Determining how school staff will document and report bullying incidents and
ensure that staff on duty are observant.
● Agreeing, in advance, on how any students doing the bullying will be treated. It is
important to recognize that students who bully have a unique set of issues that
must also be addressed.
● Allowing the child with a neurological barrier to leave class early, or to sit closest
to the classroom door so that he or she may unobtrusively leave first, to avoid
hallway incidents.
● Holding separate meetings for school staff and classroom peers to help them
understand neurological barriers.

● Including the child’s bus/transport driver in any discussions of the neurological

barrier. Bullying often occurs on the school bus, and the driver can be an
invaluable ally for children.
● Educating peers about school district policies on bullying behaviour, including
how students who bully will be treated.
5.2 ADHD
We covered ADHD in LU 1. This is a short recap of what it entails and some of the
facts that are worth repeating so that you can get a holistic understanding of why it
falls within the neurological barriers to learning.
5.2.1 Why is ADHD considered a neurological condition?
Brain images of children with ADHD may show differences compared to children
without ADHD. For example, in some children with ADHD certain parts of the brain
are smaller or less active than the brains of children without ADHD. These changes
may be linked to specific brain chemicals that are needed for tasks such as
sustaining attention and regulating activity levels.
ADHD is a neurological condition related, in part, to the brain's chemistry and

anatomy. ADHD manifests itself as a persistent pattern of inattention and/or
hyperactivity/impulsivity that occurs more frequently and more severely than is
typically observed in people at comparable levels of development.
5.2.2 How to assist ADHD learners in the classroom
To be able to know how to assist the learners, you first have to understand how
ADHD affects learning. According to Inclusive Education, South Africa, learners with
ADHD will struggle with paying attention as they are easily distracted and their
inattention to tasks would mean that they need assistance with planning.

Being impuslive means that the learner will be easily frustrated and impatience will
lead to interuptions in the class such as blurting out answers instead of waiting to be
asked to answer.
Behaviour problems that are common would be the resistance of authority and this
leads to the learner being resistant to instructions given. This can cause frustration
for teachers and caregivers. It also makes the learner an easy target for being bullied
by other learners. Labels such as “naughty” and being “stupid” can aggravate the
behaviour even further.
For a list on teaching and support strategies, visit
https://fundaoer.org/wp-content/uploads/2019/06/Including-a-Learner-with-ADHD.pdf
5.2.3 Classroom Layout to help ADHD learners feel less distracted
Layout – keep it simple

Avoid classroom layouts that places the learner in a position of seeing the whole
class all the time. This will cause major distraction and the learner will struggle to
focus on what is being taught in class. Also try not to have decorations in the front of
the class as this will make it difficult for the learner to focus on the teacher. This does
not mean that you cannot be creative, it simply means that you need to place your
teaching aids such as posters and notice boards on the sides or the back of the
class.
Seating arrangements
1. Place the learner near the teacher – this position is not likely to create much
distraction during your teaching time. It also gives you, the teacher, the
opportunity to monitor what the learner is doing so that you can help him or
her to stay on task. Try not to isolate the learner as this would not help them
with social interaction. The idea is to help them focus, not to eliminate contact
with other learners.

2. Place the learner next to or near a good role model, a child that has sound
work ethics and that can assist the ADHD learner to be more organised and to
stay focused during lessons. This gives both learners the opportunity to work
cooperatively and it creates opportunities for social interaction.
3. Provide a low-distraction workspace that will give the learner a distraction-free
zone for study time and for taking tests. This could be towards the back of the
class. Just ensure that the desk is faced towards the wall so that visual
distractions are mostly eliminated. Remember that this zone is for assistance,
and should not feel like a form of punishment for the learner (U.S. Department
of Education, 2021).
Keep materials to a minimum

Items that are not often used, should be packed away. Only keep the essential items
out on the learner’s desk. This will help the learners to be organised as well as to be
less distracted by items that are not needed.
Plan your instruction so that the learners do not need to take things out and pack
others away during the course of the lesson. Watson (2012) uses the example of
eliminating the use of a textbook for a lesson if only a few problems will be taken out
of it. Rather write the sums on the board so that the learners only need the class
workbook and a pen or pencil when doing the work. The suggestion to limit pre-make
materials, such as the cutting out of shapes, can also help the ADHD learner to feel
less distracted.
5.3 Tourette’s Syndrome
Tourette syndrome is a neurological condition that usually consists of motor and/or

vocal tics. According to the Queensland Department of Communities, Child Safety
and Disability Services (2014) some of the tics that might be seen are
● Jumping
● touching other people
● twisting and twirling the body and limbs
● jerking the head
● shrugging shoulder
● blinking eyes

● grimacing;
● twitching the nose or mouth
● repeating sounds and words
● uttering inappropriate words and phrases.
However, it is very rare for people with Tourette syndrome to experience all of these
symptoms. It is important to note that tics can increase if the child is nervous or
stressed (Tourette Association of America, n.d.).
Along with Tourette syndrome, some children may also have difficulties with paying
attention and learning, hyperactivity, impulsivity (ADHD) and obsessive-compulsive
or repetitive behaviours, and around 80% of children with Tourette syndrome may
also have epilepsy.
While there is no cure for Tourette syndrome, children with the condition have a
normal life expectancy and for many, psychological and behavioural therapy and or
medications will reduce symptoms from the late teen years onward. Some will even
become symptom-free, no longer requiring medication (Queensland Department of
Communities, Child Safety and Disability Services, 2014).
Some of the ways to support children with Tourette Syndrome include:
● Reducing stress in the classroom by creating a warm, accepting environment.

● Modelling correct responses to tics, such as ignoring them whenever possible.
● Preparing other children in advance so that they know what to expect and what
acceptable responses are. Open discussions are better as this will reduce
teasing and increase understanding.
● Realise that children with Tourette Syndrome may become frustrated and angry if
they cannot complete a task because of the interruptions that ticks may cause.
Allowing the child breaks to leave the room if they need to calm themselves.
● Explain to the child that it is okay to allow the tics to happen so that they are not
forced to suppress them.
● Allowing additional time to complete tasks, which reduces pressure and allows for
the interruptions that tics cause in the flow of work.
● Alternatively, reducing the workload to compensate for tics and time limits.
● Provide small items that children can fiddle with to avoid fidgeting.

5.4 Autism Spectrum Disorder
5.4.1 What is Autism?
The word ‘Autism’ is a combination from the Greek

words ‘aut’, meaning self, and ‘ism’ meaning state. The
neologism (newly created word) therefore refer to an
individual that is unusually absorbed in him/herself . The word ‘spectrum’ simply
means a wide variation from mild to severe. It believe the oldest record of a child
suspected of having Autism was the Wild Boy of Aveyron, a feral child who was
captured around 1800 in the South of France and later named Victor (APA Dictionary
of Psychology, 2020).
Autism is a neurological disorder that affects how people interact with others. It is not
something that can be outgrown. If you have Autism, you have it for life though you
may develop skills that may make it less obvious.
According to Autism Speaks (2021), 1 in 58 children are affected by ASD. Of those,

about 1/3 of people on the autism spectrum are non-speaking. Autism effects more
than one percent of the population. An estimated 70 million people on the planet are
on the autism spectrum (The Art of Autism, n.d.).
A person with Autism, may also other conditions (comorbidities), such ADHD as they
share some common challenges with social skills. These include difficulty in
understand nonverbal cues such as body language. Talking to people tends to be
difficult as the non-verbal aspects of communication is not something that someone
with ASD struggles with. What adds even more difficulty to the situation is the fact
that these learners cannot always control their voice volume or tone which could
make them unpopular with their peers. When people use puns or figures of speech,
such as ‘pull up your socks’, the learner with ASD takes the words to be literal and
pulls up their socks.
Approximately 40% of children with ASD may have a seizure disorder such as
Epilepsy which will need to be controlled, usually thought medication.

One of the trademarks of Autism Spectrum Disorder is the unusual behaviour that
may be displayed. One of the fascinating signs that is typical of learners with ASD is
their obsession with certain topics or objects, such as dinosaurs, snakes, dragons,
the British monarchy, or train stations. They may also display repetitive behaviours
by flapping their arms or rocking their bodies or noises. This is known as self-
stimulatory behaviour, more commonly called “stimming” and is believed to be a way
in which children with ASD calm themselves and respond to overstimulation from the
environment. The repetition of certain sounds or phrases can be very annoying for
people in close proximity to the learner. It is important to note that these behaviours
are not out of choice and are usually not intended to irritate those around them
(Morin, n.d.).
Autism as a Spectrum
Autism is now called Autism Spectrum Disorder, or ASD, because people with ASD
can have a range or spectrum of symptoms. Some who are characterised as having
Low Functioning ASD may struggle to talk while those at the High Functioning may
have exceptional vocabulary but still struggle to communicate effectively in a given
social situation. Although ASD is a lifelong condition, coping and managing skills can
be taught.
There are other conditions such as autistic disorder, pervasive developmental

disorder not otherwise specified (PDD-NOS) and Asperger syndrome that may have
traditionally been used to be diagnosed separately, but now all fall under the autism
spectrum umbrella (Autism Western Cape, n.d.).
People with severe or low functioning autism are usually totally dependent on other
people in most areas of their life. They struggle to communicate with those around
them. Those with high functioning autism are independent and can mix with others
(Integrated Treatment Services, n.d.).
It is important to realise that someone is not more or less Autistic than someone
else. You either have ASD or you don’t. Just because a person does not display the
characteristic much as someone else does, does not mean that they are less
affected by it. Many children with High Functioning Autism still experience feelings of

isolation, loneliness and anxiety, and are at risk of developing depression if they do
not receive sufficient understanding and support.
5.4.2 Symptoms of Autism
People with Autism see, hear and feel the world differently to those around them and
whilst there are common areas of difficulty, the challenges are different for every
individual.
Triad of Impairment
Although the symptoms of ASD can be very different along the spectrum, they do
share some similar characteristics. Traditionally, we use the ‘Triad of Impairment’ to
describe the three main behaviours which are often observed in children with ASD.
The summary below is based on the work on the Independent Treatment Services:
1. Social interaction
• May have difficulty with social situations and interactions. Sometimes they may
people as object or acts as though other people do not exist.
• May not respond to people’s efforts to communicate with them
• May struggle to make friends
• Finds it difficult to cope with change or unstructured, unplanned periods within a
day
2. Communication and Language
• May struggles to process and understand verbal information
• May not always understand jokes or social and body language
3. Imagination/Rigidity of thinking
• Prefers a structured routine
• May be obsessive with rituals
• May struggle with ‘make believe’ play
• May appear to have a lack of empathy for others. Often children with ASD have
an enormous amount of empathy, but may not know how to express this
effectively and therefore keep their facial expression and tone neutral.

• Awareness of danger is often lacking
All learners with ASD will struggle with these 3 areas, but it will be to a different
degree for each individual.
More recently, a Triad of Cognitive Processing has emerged which helps us to

understand why children with ASD may behave in certain ways (Cashin et al., 2009).
Based on this, we can gain insight into why the child with ASD may behave is
particular ways and how we can support the child in better communication.
The Triad of Cognitive Processing is now explained using a hypothetical case study
of Billy, a child with ASD, to illustrate the different aspects.
1. Visual Processing
Children with ASD tend to be more visual processors of information while
neurotypical children are linguistic processors. This means that when you mention a
word in a general context, neurotypical children will usually think of a concept in
general terms which a child with ASD will draw on what they have seen or
experienced.
The teacher says “It is big, black. It barks and growls viciously. What is it?”
The children reply “A dog”.
Billy replies, “I saw a shark at the aquarium, it was really vicious with sharp
teeth and swam around and around. Do you know that sharks have to keep
swimming or they die?”

The neurotypical child understands the answer to be a dog because a dog can be
black, white or brown animal that barks, whines and whimpers, has four legs, wags
its tail, etc. While Billy, the child with ASD, may picture a specific dog that he may
have encountered and then may not be able to relate the teacher’s sentence to their
schemata and not be able to infer the answer to the question.
As teachers, we need to utilise very specific language that does not confuse the
child. Also, once a child has learned a concept, we need to expose the child to as
many versions of that concept as well in order to help the child build a generalised
concept thereof.
2. Impaired Abstraction
Abstraction is the skill that allows neurotypical children to linguistically categorise
their interpretations of their experiences and the world around them in an organised
way. They construct webs of knowledge to access which are linked to each other
that enables them to make jumps from one to the next.
On the other hand, many children with ASD have difficulty in forming a unified base
of knowledge about the world. Information is stored on a visual basis (rather than a
linguistic one) and stored in chunks in the order it is received without being
connected to past experiences and other concepts.
As teachers, we can support our children with ASD in generalising concepts and
developing connections, and to focus on the elements which they need to access in
order to understand what we are asking of them.

The teacher tries again, “Your neighbours have a big, black pet. It is in your
neighbour’s garden. Imagine if you put your hand over the fence it might try to
bite you. What is it?”
Billy considers the question, evaluates it according what he knows to be are
facts, and responds with what he thinks is a logical answer, “My neighbours
don’t have any pets.
3. Impaired Theory of Mind (ToM)

Theory of mind is described as the basis for empathy. It is the natural understanding
that others’ minds work in the same way that ours do and, therefore, based on their
expressions and tone, we are able to fairly accurately guess how they are feeling
and what they may be thinking. It is something that neurotypical children naturally
take notice of, and as a result, regulate communication and social contact.
Being able to take note of these ever changing signals means that neurotypical
children will be able to adapt, drawing on their unified and change their responses to
situations. On the other hand, children with ASD may not be able to read the subtle
cues of a situation and therefore have difficulty in engaging effectively in the differed
situation as they do not have the flexibility of thought that the neurotypical child has
in their unified knowledge base.
This is one of the reasons that children with ASD may not understand a joke, irony or
sarcasm. They tend to understand language in a very literal sense and may not
interpret the nuances and metaphors in what they hear.

The teacher becomes frustrated and responds, “What? No, where have you
been through this whole lesson?”
Billy responds. “Sitting right here.”
The other children in the classroom giggle, and the teacher becomes angry as
she sees Billy’s behaviour to be cheeky and she feels like she is losing control
over the class.
The teacher reprimands Billy, “Your mother is going to hear about this. What
do you have to say about that?”
Billy does not respond as his logical answer was incorrect and he does not
understand why. The teacher’s behaviour is now overt and he realises she is
angry but doesn’t understand why.
The teacher then says, “What, has the cat got your tongue?
Finally, Billy is satisfied that this is a question that he knows the answer to and
responds, “No, there are no cats at school. My uncle has a cat called Frisky.”
The teacher then loses her temper and sends him to the office.
For children with ASD, who store information visually, applying their knowledge in a
new situation is very difficult and causes severe anxiety. While ASD affects the way
in which they process information, it does not seem to affect personality or
temperament. As such, children with ASD still respond in the regular way
neurotypical people do, and engage the flight/fright/freeze mechanism. In order to try
to regain control over a situation, may children with ASD resort to ritualistic
behaviours such as stimming, which was discussed earlier, or meltdowns which
require external support in gaining control over. It is important to understand that a
meltdown in not a tantrum.

Some of those children who are on the very high end of the Autism Spectrum
engage in something called “masking” which requires rigid control and holding
emotional outbursts at bay. Unfortunately, this means that the child remains in a
state of high anxiety and once the child gets to a safe space, such as their parent’s
car at the end of the day, the child then releases that emotion to the parent. This can
be problematic as the teacher may not realise that there has been a problem until
they receive a complaint from the parent. It is also unhealthy in that the child’s
amygdala (part of the brain associated with anxiety) becomes overactive from being
in a continuously heightened state.
As teachers, we need to work closely with parents and children to understand how
and why the child is behaving in a specific way.
Many children with ASD benefit from movement breaks, and sensory rooms where
they can escape to for short periods to recover from sensory overstimulation and
calm down.
Teachers also need to be cognisant of the triggers which may affect a child’s anxiety
levels and increase the chance of having a meltdown. There are many useful coping
skills that children can be taught, but the most effective ways of interacting with
children with ASD is to build up a relationship of trust and to say what you mean and
mean what you say.
Children with Autism benefit from consistent routines as this provides a secure
setting where they understand what is expected of them and how they should
behave within a familiar situation.
5.4.3 Relationship between ADHD and Autism
Although ADHD is not on the autism spectrum, there are some symptoms that they
have in common. The struggle to pay attention and the difficulty with social
interaction appear in both ADHD and ASD learners.

Another common characteristic is that both relate to genetics. It is highly likely that a
learner with autism likely has a family member with ADHD or another developmental
disorder.The similarity in between ADHD and ASD means that some of the
interventions or support that teachers can give, will benefit both disorders. Reducing
distractions or stimulations and following a routine will help these learners to cope
with the demands of the everyday classroom.
5.4.4 Support for learners with ASD
Before you can support a learner with ASD, you first need to establish what the
learner’s individual needs are, because each individual on the spectrum will have
unique needs based on his/her characteristics.
Early intervention is better for long-term development as it will help the child to
develop the skills needed to live happily, healthily and successfully. This will not just
benefit the child’s educational achievement, but will also improve the quality of the
child’s relationships with others.
It is advisable to incorporate the child’s parents and peers in the support that you
plan to provide so that everyone involved can work together to assist him/her in
developing in accordance to the support plan you create.
Depending in the level of impairment, teachers have to teach age appropriate social,
communication & vocational skills that are not automatically acquired during
development. All children in the class can benefit from focus on these skills so try to
make it part of your daily classroom routine.
In addition to the characteristics discussed above, it is believed that many children

with ASD have heightened senses which is why they may react in an extreme
manner when they experience sensory overstimulation.

Here are some classroom strategies that can help you to support ASD learners in
your class:
1. Classroom arrangement for optimal learning

• Classroom furniture should provide clear, visual boundaries. For example, use
coloured insulation tape to mark designated areas as children with ASD process
information in a visual manner.
• Natural lighting is optimal as learners with ASD are negatively affected by
constant flickering and buzzing of lights, and may struggle with very bright lights.
• Minimise auditory distractions – keep noise levels low. Alternatively, allow
children to wear earmuffs or noise reducing headphones. Ear plugs to reduce
noise can also be useful.
• To give them a sense of physical boundaries and security, it could help to keep
them in their chairs at circle time. Avoid rearranging the classroom unexpectedly
as this may upset their understanding of the classroom. If changes need to be
made, discuss these in advance with older children and involve them in the
decision making and implementation if possible.
• Allow for children with ASD to have a place where they can take a sensory break.
Ideally, this should be an area that does not have bright lighting, and can include
items such as a beanbag to sit in that provides physical pressure.
2. Have predictable routines & visual schedules

• Predictable routines are helpful: if something unexpected happens, learners with
ASD often display stereotypical behaviour such as rocking & repeating the same
word or phrase. Have a clear structure and a set daily routine will help them cope
with everyday life in the classroom.
• Examples of visual schedules could be ‘first-then strategy’ as well as organise
and predict (reduces anxiety). This can assist in the development of receptive
language.
• For older children, using a colour coded timetable which corresponds to colour-
coded book can make it much easier for children to identify which books they will
need for lessons, especially once they begin moving from classes for different
subjects.

3. Avoid change – be consistent

• Provide routine and visual schedules and avoid surprises.
• If there are going to be fun surprises, rather give the child with ASD notice so that
they can begin to adapt to the change over the next few days.
• Provide explanations of what can be expected and what the child will be
expected to do.
• Do not seat the child right in the middle of whatever is happening. Let the child sit
to the side, near you so that you can assist them if it becomes too much for them.
• Should the child become overstimulated, e.g. during a concert, ensure there is a
place that the child may retreat to if necessary.
4. Communication skills in the classroom

• Use their own vocalisations (what they’re saying) and gestures to expand on
naturally occurring situations.
• A multi-modal approach is useful, such as using speech, natural gestures,
manual signs & graphic symbols.
• The use of AAC strategies such as manual signs combined with speech can be
useful.
5. Picture exchange Communication System (PECS)

• PECS is a communication system used with children with ASD who have little or
no speech. It was mentioned briefly in chapter 4 under AAC.
• The child can make choices and communicate needs with the use of an icon or
picture.
• When child gives picture, teacher will say the word and encourage the child to do
likewise.
• This is a particularly useful tool to use in situations around the school where
children may need to communicate quickly, e.g. when needing to go to the
bathroom, ordering food at the tuckshop.

6. TEACCH
• TEACCH = Treatment and Education of Autistic and related Communication-
handicapped Children
• TEACCH is worldwide educational approach that includes: physical structure,
daily schedules, work systems (encourage children to work independently of
teacher e.g. work stations), visual structure & information.
• As with most approaches, it works best when visual cues are also used at home.
7. Addressing poor concentration

• Their focus on detail & stimuli that are not relevant often leads them to be
distracted, disorganised and unfocused, and may appear to be daydreaming.
• Break assignments into smaller, manageable units, with frequent feedback and
encouragement to stay focused.
• Provide a time limit and set a timer so that the child can see the time counting
down.
• Decrease homework to include only what is essential.
• Place child in front of class, direct questions to him/her by starting with his/her
name, or maybe gentle tap on shoulder.
8. Addressing poor academic difficulties

• The spectrum includes whole range of levels, though high level thinking and
comprehension skills are usually lacking as they require inferring and evaluating
linguistic material, so be sure to explain abstract concepts with care.
• Children with ASD are usually literal thinkers so avoid slang and idiomatic
speech.
• As they may not be good at recognizing facial cues, be clear with what you mean.
• Children with ASD often parrot what they have heard or read but lack
comprehension so be aware of this and engage in discussion and analysis of
what is read.
• Children with ASD may not generalise from specific contexts to overall principles
so be sure to engage in repetition where children can apply a concept to a more
generalised or different situation.

9. Addressing emotional vulnerability & developing social competence

• As Bornman & Rose (2010) explain, children with ASD may not understand
complex rules of social interaction. As a result, this may cause stress and
increase anxiety in social settings which may lead to depression.
o Teach children directly e.g., to start conversations with a greeting, and to
take turns.
o Be calm, predictable, compassionate & patient.
• Many children respond to behaviour modification principles: reward appropriate
behaviours rather than ignoring them, break behaviour into steps & use rewards
along the way.
• Teachers can tell stories in which the hero is a child with a particular impairment
or have discussion with older children.
• The teacher can tell social stories:
o using simple sentences & pictures to demonstrate the
▪ social behaviour,
▪ feelings,
▪ and reactions.
• Ultimately, the aim is to assist learners with ASD to understand others in social
communication and develop successful interaction.
Note the following:

• Provide external structure, organisation & stability
• Use creative teaching techniques
• Many of the suggestions provided in this topic would apply to children with
challenging behaviour in general!
A highly informative booklet based on ASD in South Africa named Classroom and
Playground: Support for children with an autism spectrum disorder, can be
downloaded for free.
This booklet is aimed at teachers and school staff with little or no experience of
working with children who have autism spectrum disorder (ASD). The booklet is

divided into two sections, one concentrating on classroom strategies and the second
focusing on playground issues.
The strategies are also covered in point form for ease of reference.
https://aut2know.co.za/wp-
content/uploads/2018/03/1433675205wpdm_Autism_Classroom
_Playground_Brochure.pdf
5.5 Epilepsy
5.5.1 What is epilepsy?
Epilepsy is the fourth most common neurological disorder. It affects more than 50
million people worldwide, and approximately 1 in every 100 people in South Africa
(Epilepsy SA, n.d.-b). It is defined by abnormal brain activity, causing seizures,
unusual behaviours, and even loss of consciousness .
What this means is that if someone has one seizure, they may not necessarily have
epilepsy. It also means that if someone has epilepsy, they may not actually have
seizures. Please remember that the correct word is a seizure, not a fit.
While this sounds confusing, it is important to explain a little further. Epilepsy is

caused by excessive chemical and electrical activity in the brain that does not
resolve itself in the way that it usually should.
If someone hits their head and has one seizure, that does not mean that they are
epileptic. It is necessary to have at least two seizures at least 24 hours apart.

What is a seizure?
Seizures are
• temporary,
• electrical chemical disturbance in the brain
that may cause
• a lowering/loss of consciousness
• disturbance in movement, sensation, behaviour and perception
that occur repeatedly.
The diagram below explains how a seizure occurs in the brain:

5.5.1.2 Seizure Thresholds and Seizure Triggers
Every person has a seizure threshold and if the brain activity goes over that
threshold, the person will have a seizure. People with epilepsy tend to have lower
seizure thresholds that those people who do not have epilepsy. There are many
factors that may lower one’s seizure threshold, making it more likely that a seizure
may occur (Epilepsy SA, n.d.-a).
These include:
• Being tired
• Being emotional
• Not having had enough sleep
While sometimes a seizure just happens and we don’t know why, at other times,
seizures can be brought on by a specific stimulus or trigger. Common triggers can
include:
• Hitting one’s head
• Flashing lights including
▪ flashing images on televisions or in movies,
▪ flashing lights in clubs,
▪ or even being woken up in the dark by someone turning on the light
This is known as photosensitive epilepsy.
5.5.1.3 Causes of Epilepsy
According to Djordjevic (2021) and Epilepsy SA (n.d.), the epilepsy may be caused
by:
• In approximately 66% of cases the underlying causes of the epilepsy is unknown.
The term that doctors use to describe this is idiopathic epilepsy.
• A head injury occurring at any age could be an underlying cause of symptomatic
epilepsy.
• A birth injury could be an underlying cause of symptomatic epilepsy.
• Alcohol and drug abuse could be an underlying cause of symptomatic epilepsy.

5.5.1.4 Medical Treatment for Epilepsy
While Epilepsy is categorised as a disease, there are no known cures for it.
However, it can usually be controlled with medication.
Bornman & Rose (2010) explain that anti-epileptic medication must be:
• Effective: The medication must prevent seizures from occurring. Not all
medication works effectively on all people so it is necessary to regularly monitor
how effective the medication is in preventing seizures
• Safe, having few side effects: Side effects affect people differently. If a child
becomes extremely drowsy and sleeps for two hours every time they take the
medication, the medication will then be preventing the child from developing and
learning. Unfortunately, in some cases, it may be necessary to take medication
that has strong side effects if this is the only medication that can control the
seizures.
• Affordable: the medication will be taken for many years, if not lifelong.
• Easy to take: Medication must be taken at the same times each day in order to
be effective.
• Easy to get: running out of medication may mean that the child then has
seizures so it needs to be easy to get in order to ensure it can be taken
continuously.
5.5.2 Different Types of Seizures
By now, you may have realised that there is more than one type of epilepsy, and that
seizures affect people differently. Kiriakopoulos & Osbourne Schafer (2017) explain
that there are now three main groups of seizures that are categorised according to
how the seizure starts or its “onset”.

Classification
of Seizures
Generalised Unknown
Focal Onset
Onset Onset
A generalised onset seizure involves the whole brain, while a focal onset seizure
is focussed in one or more part of the brain.
During most generalised onset seizures, the person will completely lose
consciousness for a short period of time. On the other hand, during a focal onset
seizure, a person may be aware during the seizure or seem awake but either
respond at a lower level or be non-responsive (Kiriakopoulos & Osbourne Schafer,
2017c).
In some cases, a person may experience a strange sensation as a seizure begins,

known as an aura. These sensations may differ from one person to the next,
however, if a person learns to identify their aura, they can then make sure that they
are in a safe place or tell someone that they are starting to have a seizure.
While there are many forms of seizures, we will focus only on the most common
types of seizures. Within generalised seizures, we will consider tonic-clonic and
absence seizures, and thereafter, discuss focal seizures.
5.5.2.1 Tonic-clonic seizures
Tonic-clonic seizures (preciously called grand-mal) have two stages: the tonic stage
and the clonic stage
According to the (Centers for Disease Control and Prevention, 2020; Kiriakopoulos &
Osbourne Schafer, 2017c), during the tonic phase, the person will
• Cry out (sometimes)
• Lose consciousness.
• Fall to the ground.
• The arms flex up and then extend and remain rigid for a few seconds.

During the clonic phase, the muscles contract and relax causing a jerking movement
which will eventually slow down and stop.
After the seizure:
• As the seizure ends, the person may be sleepy or confused for several minutes,
an hour, or more.
• They may lose bladder or bowel control during or after the seizure and need to go
to the bathroom.
When people have tonic-clonic seizures, they are not aware of what’s happening.
Sometimes, people bite their tongue or inside of the cheek during a seizure and their
muscles may feel sore.
What to do during a seizure in your classroom or school:

First Aid should be focused on making sure the person’s breathing is okay and they
don’t injure themselves (Kiriakopoulos & Osbourne Schafer, 2017b).

If any injury has happened or the seizure lasts 5 minutes or more, or the child has
more than one seizure, call for medical help.
Do Not:
• Put anything in the child’s mouth.
• Give them water or food during or directly after a seizure as they could choke.
• Hold or restrain the child during or after a seizure. While still unconscious or
semi-conscious, they may not understand what you are doing and hit out and
injure you.
5.5.2.2 Absence Seizures
The Centers for Disease Control and Prevention (2020) describes absence seizures,
sometimes called petit mal seizures, as brief generalised seizures which may appear
as rapid blinking or a few seconds of staring into space.
While generally not dangerous, absence seizures can easily go unnoticed and may
appear to be daydreaming or ADHD. As such, it is important to track these
incidences if you start to notice them happening. This is also the reason that
paediatricians, paediatric-neurologists and psychiatrists may refer a child for an EEG
before diagnosing ADHD as the medication used to treat ADHD may lower the
seizure threshold and increase the chance of seizures.
What to do during a seizure in your classroom or school:

While the child may be quick to recover, they may still have missed out on a small
section of a discussion or lesson, and may be confused. It may be necessary to re-
orientate the child back to the lesson or help them to get started again with their
work.
5.5.2.3 Focal Onset Seizures
Focal seizures occur in one area or in cells on in once side of the brain and used to
be referred to as partial if the child remained aware. This has changed, so focal
seizures are now described in the following ways:

Focal Onset Aware seizures: where the child remains awake and aware during the
seizure.
Focal Onset Impaired Awareness: where the child is confused or their awareness
is affected in some way. The child will still seem to be awake but will either respond
very slowly or at a low level, or may not respond at all.
Focal onset seizures can also be categorised according to the behaviours which are
seen. These can include:
Motor symptoms such as twitching or jerking muscles, or automatisms which are
repeated movements that are not under the child’s control. Automatisms can include
clapping, walking, banging, rubbing of hands, lip smacking, chewing or even
wandering off and being unaware of their surroundings. Some seizures may include
repetition of words, laughing, screaming or crying.
These seizures may include an aura and typically last 1 to 2 minutes (Kiriakopoulos
& Osbourne Schafer, 2017a).
Figure 9: Focal Seizures and affected Brain Areas (Kiriakopoulos & Osbourne Schafer, 2017a)

What to do during a focal onset seizure with motor symptoms

Do not grab the child unless they are in danger, e.g. walking towards stairs or the
road. Guide them gently in a different direction. If you do grab the child, they may
unintentionally hit out and hurt you.
Once the seizure is finished, and full consciousness returns, the child may be
confused and may need a rest.
Non-motor symptoms don’t affect movement but could include changes in

sensation, emotions, thinking or cognition, autonomic functions (such as
gastrointestinal sensations, waves of heat or cold, goosebumps, heart racing, etc.),
or lack of movement (called behaviour arrest). These seizures are usually very short
and last a few seconds to around 2 minutes (Kiriakopoulos & Osbourne Schafer,
2017b).
For example, a temporal lobe focal onset seizure may affect the language
processing and emotion areas of the brain. The child may respond to questions
slowly with a grunt or simple “ja”. Before and afterwards, the child may become
upset or emotional and cry for no reason, or even experience sudden and unfounded
fears, such as the fear of toilets.
What to do during a focal onset seizure with non-motor symptoms

There is nothing that you can do to stop the seizure. Be patient and calm, and wait
for the seizure to finish. Once the child is fully recovered, help the child to re-
orientate back to the task at hand.
5.5.2.4 Auras
Auras may indicate the start of a seizure. An aura is in fact a focal aware seizure that
develops into another type of seizure such as a generalised tonic-clonic seizure.
The Epilepsy Society (2017) describe auras as sometimes feeling like

• a ‘rising’ feeling in the stomach or déjà vu (feeling like you’ve ‘been here before’);
• getting an unusual smell or taste;

• a sudden intense feeling of fear or joy;

• a strange feeling like a ‘wave’ going through the head;
• stiffness or twitching in part of the body, (such as an arm or hand);
• a feeling of numbness or tingling;
• a sensation that an arm or leg feels bigger or smaller than it actually is; or
• visual disturbances such as coloured or flashing lights or hallucinations (seeing
something that isn’t actually there).
If a child expresses that they are having an aura, it is generally best to allow the child
to sit or lie on the floor to avoid them falling or hurting themselves.
Sometimes, an aura may pass without a seizure and the child can then return to the
activity that they were busy with.
5.5.3 Managing Epilepsy in the Classroom
According to (Bornman & Rose, 2010) order to successfully manage epilepsy in the
classroom:
• Teachers must feel confident and know what to do in case of a seizure.
• Other children must be informed about epilepsy in advance and understand that it
is not scary or life-threatening.
• Teachers and children must know what to do in the case of a seizure.
• Classroom discipline must not be reduced for fear of triggering a seizure. Be
aware that some children may claim they are experiencing an aura to get out of
work that may be difficult or that they do not want to do. Should this start to occur,
it is best to thank the child for letting you know and you will keep an eye on them
while they work.
• Teachers must recognise and report side effects of medication to parents.
• When necessary, teachers may need to help to monitor the taking of medication
but as soon as the child is old enough, he/she must take this responsibility. Any
medication needs to be kept in a locked cabinet or draw and order children
should still be supervised.

• If seizures are not properly controlled, consider protective measures such as

o Monitoring on the playground/sport
o Wearing of a protective helmet
• Be careful of over-protecting learners as this can harm their independence and
self-confidence.
• The principle of participation should be applied wherever possible.
• Dangers should be carefully supervised e.g. open fires, candles, gas cookers.
Epilepsy SA has a variety of resources which you may find

useful in the classroom. They also have the link for this video
on epilepsy for children:
https://www.youtube.com/watch?v=n7z86JDNnPU

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INTELLECTUAL BARRIERS TO LEARNING
6.1 Definition of Intellectual Impairments
Words are a sticky issue! We should avoid using terms like “mental retardation.” While they
originally started out as specifically medical terminology, society has given words like these
negative connotations and as a result, they can be deeply hurtful. Literature may use terms
like “cognitive impairment” or “intellectual disability”. While these can be used
interchangeably, we will use the term Intellectual Impairment.
Learners with an intellectual impairment have reduced ability to understand new or difficult
information and struggle to apply new skills that they do learn in new situations. This means
that they may struggle to cope on their own. Childhood development will be slower or
different from that of a typical learner their age. The levels of intellectual impairment will
differ amongst different learners. Some might struggle with how to tell others what they need
and how to care for themselves, while others may manage to live independently as adults.
There are many causes that lead to intellectual impairments; however, intellectual
impairments usually start before the age of 18. Intellectual impairments may start before
birth or may develop as a result of an injury, a disease or a problem within the brain.
Some of the most commonly known causes of intellectual disability happen before birth as
do the two examples that we will focus on: Down Syndrome and Foetal Alcohol Syndrome.
Still other causes of intellectual disability do not occur until a child is older; these might
include serious head injury, stroke, or certain infections (CDC, 2019).
6.2 Signs of Intellectual Impairments
There are many characteristics, but we will only focus on the most prominent ones for the
purpose of this module as summarised by various websites, such as Therapy Travelers
(2018).

Children with intellectual impairments may

● sit up, crawl, or walk later than other children;
● learn to talk later, or have trouble speaking,
● find it hard to remember things,
● not understand how to pay for things,
● have trouble understanding social rules,
● have trouble seeing the consequences of their actions,
● have trouble solving problems, and/or
● have trouble thinking logically.
Learners with Intellectual Impairments may often have behaviour problems, such as having
explosive outburst, throwing temper tantrums and being physically aggressive. This is often
due to the frustrations they experience and their inability to communicate their feelings to
others.
6.3 Problems that Children with Intellectual Impairments

may Experience in the Classroom
Learners with intellectual impairments may take longer to learn concepts therefore educators
need to promote useful learning. While the list of potential problems is extensive
(Psych4Schools, 2018), we will focus on the most common ones that you are likely to face in
the classroom.
Thinking and reasoning – when new content is taught, learning will be slower than that of
the class. Teaching of skills need to be deliberate and direct as these learners may not learn
from observing others. Application of skills is also not easy and situations and contexts of
events are mostly not understood.
Communication and language – learners with Intellectual Impairments may feel very
frustrated due to their struggle to communicate their feelings or needs to others. This will
also affect learning in the classroom, as they may not always be able to respond to
questions or participate in discussions. Their vocabulary and ability to structure sentences is
likely to be lower than that of their class. Abstract concepts such as idioms and negative
numbers can be difficult for them to understand.

Learning difficulties – learning takes longer for these learners compared to their peers.
Remembering and recalling content is difficult. They will need lots of repetition and practice
before new information becomes part of their everyday memory. More time may be required
to complete tasks or a reduced workload may help.
Attention – due to short-term memory difficulties and having a short attention span, the
learner with an intellectual impairment may struggle to stay motivated and to focus in class.
If the task is demanding, they will quickly become tired and struggle to complete the task.
Often what is learnt today, may be forgotten tomorrow.
Lack of organisation – learners with an intellectual impairment struggle with organising

their desks as pens, books etc. may be all over the place. They may also struggle to
organise information, so sorting a list of items according to the instructions given, will be a
difficult task for them to complete. Putting a list of items in sequence may also be hard to do.
Children may therefore benefit from having tasks broken down and only being given one
instruction to complete at a time.
Emotions – due to the struggle to regulate emotions, children with intellectual impairments
may have low self-confidence. This may make them anxious or depressed. Some can be
aggressive while others can be very passive.
Social skills – as communication is difficult for children with intellectual impairment, they
may struggle to express themselves which makes it hard for them to make and keep friends.
They may struggle to see things from another person’s perspective and this can make them
unpopular with their peers. The fact that they struggle to understand social cues and rules
does not help them to be liked by others and they may struggle to understand certain games
or to just fit in. Often, due to the delay in development, some of these learners’ function at a
level of a younger learner and therefore prefer to play with the children in younger grades.
6.4 Advice for Parents and/or Caregivers
According to the National Association of Special Education Teachers (NASET, 2021),

parents can do the following to help their child:
● Learn what Intellectual Impairment is. The more you know, the more you can help your
child.
● Motivate your child to be independent. Help him/her to learn basic skills such as how to
get dressed, how to feed him or herself and using the bathroom.

● Give your child chores that are age appropriate. If need be, break these chores into
small steps.
● Communicate with your child’s teacher to find out what is being taught in class and then
find ways in which your child can apply those new skills at home.
● Look for events in your community that will help your child build social skills such as
joining a sports team or doing scouts.
● Interact with other parents whose children also have intellectual impairments. Share
practical advice and give emotional support.
● Discuss a support plan with your child’s school. Keep in touch with the teacher and offer
support. Find out how to help your child to practice the skills learnt in school.
6.5 Learning Impairments vs. Intellectual Impairments
Learning impairments affect a learner’s ability to learn skills (Integrity Inc., 2019). It does not
affect their intellectual ability. Children with learning impairments may struggle with reading
or writing. With the right support, these learners can overcome the barriers that they
experience with learning. Learning Impairments usually affect the following skills: math,
writing, reading and motor (movement) skills. Examples would be Dyslexia and Dyscalculia.
We will deal with these in chapter 8 and 9.
Intellectual impairments affect a learner’s intellectual ability (Integrity Inc., 2019). This means
that the child’s academic ability will be limited due to the impairment. Examples would be
Down Syndrome and Foetal Alcohol Syndrome which we will cover in the next section.
The main difference between learning impairments and intellectual impairments is that
learning impairments do not affect the learner’s intellectual ability. They merely affect the
way that the learner will learn. These impairments may be overcome if their learning is
adapted and coping mechanisms can be used to help them learn. Intellectual impairments,
however, do affect the learner’s intellectual or cognitive ability. This means that these
learners will need help with more than just learning barriers and that social and self-care
skills could be lifelong challenges.

6.6 Examples of Intellectual Impairments
6.6.1 Down Syndrome
6.6.1.1 What is Down Syndrome?
Down Syndrome is a chromosomal, genetic condition that happens at conception. It is a

result of an extra number 21 chromosome called Trisomy 21. This extra chromosome forms
due to a random error when cell division takes place. It causes delays in intellectual as well
as physical development (Western Cape Government, 2019).
The global estimate is that 1 in 1000 babies that are born in developed countries will have
Down Syndrome, while 1 in 650 babies in developing countries are affected (Western Cape
Government, 2019).
Down Syndrome cannot be cured. It is part of a person’s DNA. With the proper support,
people with Down Syndrome can succeed in life. They need loving home environments, the
correct medical care and early childhood intervention. Most learners with Down Syndrome
can be included in schools and can follow the CAPS curriculum which can be differentiated
according to their needs.
6.6.1.2 Characteristics of Learners with Down Syndrome
Learners with Down Syndrome are, like all other people, unique in their personality and
characteristics. Emotionally they often show great empathy with others, they may have good
social skills and may have good short-term memory as well as visual learning skills.
According to the New Zealand Ministry of Education (2018), learners with Down Syndrome
may display some of the following characteristics to different degrees:
● They have specific physical features such as distinctive eye and nose shapes, they can
have low muscle tone, be smaller in height and have slower developing motor skills.
● They have health and development challenges such as cardiac (heart) conditions, a
depressed immune system which means they are likely to get infections more often than
other learners, and may be hard of hearing or have low vision.
● They have learning challenges such as mild to moderate delays in developmental,
behavioural, and interpersonal skills. This will have an impact on their learning.

6.6.1.3 Effects of Down Syndrome on Learning
Learners with Down Syndrome may, according to Inclusive Education South Africa (2017)
struggle with reading, some aspects of maths, certain physical activities and the processing
of language. With the correct support, they will be able to make progress despite these
struggles. A major benefit to their condition is their strong social and communication skills.
They are generally easy to have a good relationship with and therefore make friends easily.
There are some learners with Down Syndrome whose support needs are too high or
complex for the ‘normal’ classroom.
With differentiation and the right accommodations, typical strategies in an inclusive

environment, most children, including those with Down Syndrome, can work together as
these strategies benefit all the learners in the class (Inclusive Education South Africa, 2017).
6.6.2 9Foetal Alcohol Syndrome (FAS)
Foetal Alcohol Syndrome (FAS) also known as Foetal Alcohol Syndrome Disorder (FASD).
Either abbreviation can be used for the purposes of this module.
6.6.2.1 What is FAS?
FAS is a form of intellectual disability that occurs when a pregnant mother drinks alcohol
while expecting. FAS is, therefore, 100% preventable. As it is not possible to tell at which
point a child contracts FAS, and FAS has been reported in women who only consumed
moderate amounts of alcohol, women should not consume alcohol when pregnant to protect
the development of the baby.
According to Western Cape Government (2021), South Africa has the highest reported FAS
in the world. In some communities it can be as high as 28%. The World Health Organisation
(WHO) estimates that the overall rate for FAS in South Africa is at least 6%.
When an expectant mother consumes alcohol while pregnant, the alcohol passes through
the placenta. The placenta supplies the baby with oxygen and nourishment. The baby’s
developing cells can be damaged by the alcohol which leads to serious defects that cannot
be cured. The brain is extremely vulnerable and the effects of the alcohol can lead to
permanent brain damage (Aware.Org, 2021).

6.6.2.2 Characteristics of Learners with FAS
Learners with FAS can show various physical signs such as a smaller head as well as
damaged organs. Some learners display specific facial features, but many learners with FAS
have either no or very few physical signs.
Behavioural characteristics can include:
● being impulsive
● having memory problems, not remembering sequences of events correctly
● taking longer to process information
● struggling with abstract thinking
● finding it hard to predict the outcomes of events
● suffering from anxiety or just being anxious by nature
● being easily frustrated
● suffering from various degrees of depression
● displaying inappropriate behaviour in certain circumstances (New Zealand, 2018).
6.6.2.3 Effects of FAS on Learning
According to Aware.Org, an organisation in South Africa that focuses on alcohol misuse and
abuse, recommends that we should note the following with regards to developmental and
behavioural problems, when trying to support learners with FAS:
● Children with FAS may have delayed development. This will mean that they will not
function on the same level as their peers and will need assistance to get to the expected
level.
● Learners with FAS are often hyperactive. This means that they need to have
opportunities to get rid of some energy. In addition, due to common heart problems, they
may not be able to take medication for ADHD.
● They often have attention problems, so the teacher will have to structure the lesson plan
in such a way that it will be stimulating without being too demanding or distracting.
● There may be difficulty in understanding cause and effect of behaviour. These concepts
will have to be broken down to a step-by-step process to help the learners understand
the idea of an action having a certain reaction and how we can predict the reaction
before we give the action.
● Some learners with FAS might struggle to control certain impulses which could lead to
impulsive behaviour such as shouting out the answer to a question or jumping up during
class time.
● As with ADHD learners, FAS learners can struggle with social skills which can negatively
affect their relationship with others (Aware.Org, 2021).

6.7 Support Plan for Learners with Intellectual

Impairments
6.7.1 General Support
As a teacher, you need to keep up to date with the latest developments in education, and
that includes new discoveries on how to support learners with various barriers. This means it
is important that you find out as much as you can about the barriers that the children in your
class might face.
It is always a good policy to find out what your learners’ strengths and interests are so that
you can focus on those and create the scenarios that will lead to success for them.
Try to always be concrete in your lessons. Explain what you mean. Do not simply rely on
verbal input. For example, show learners pictures or video clips of new concepts that you are
teaching them so that they understand what you are trying to explain to them.
Break tasks into small steps that children can easily follow. Demonstrate these steps to
them, then have them do the steps.
Learners with Intellectual Impairments need basic life skills to be taught to them. Things
such as how to work on their own, how to manage time, how to interact with others and what
are acceptable social behaviour will help them in their everyday lives, not just in the
classroom.
Work with the parents and the school’s relevant staff to create and implement a support plan
that is suitable for the learner’s needs. (NASET, 2021).
6.7.2 Support for Learners with Down Syndrome
Inclusive Education South Africa (2017), provides some excellent suggestions on how to
support a learner with Down Syndrome in the class.
Click on the link or scan the QR code.
https://fundaoer.org/wp-content/uploads/2019/06/Inclusion-of-Learners-
with-Down-Syndrome-in-ordinary-schools.pdf

6.7.2 Support for Learners with Foetal Alcohol Syndrome
The following strategies are aimed at supporting the FAS learner in the classroom, but they
are usually beneficial for the whole class.
The Classroom Environment

● Create quiet zones where learners can study/read in peace. Allow the learner to go to a
comfort zone when asked. Consider the use of headphones to listen to calming music or
just to block out the noise of the class.
● Use appropriate classroom seating.
● Limit distractions in the classroom. Don’t have too many decorations on the walls.
Minimise interruptions by using a sign on your door to state you are currently teaching
and that all interruptions should be limited to the last 5 minutes of the lesson.
● Help learners to organise the materials on their desks. Create a checklist of what is
needed and put the other items out of sight.
● Have clear classroom rules and display these for everyone to see. Be consistent. Do not
allow some behaviour on one day and then punish it the next day.
Active Learning Strategies

● Use a variety of learning strategies that will stimulate most of the senses. Don’t just have
visual or auditory lessons. Use cooperative learning to encourage social interaction.
Highlight important points for learners to see what should be focused on.
● Make use of more than one way of assessment, e.g. while some children may be able to
write a story about a concept that they have learned, children with FAS may be better
able to design a poster on the topic that still demonstrates their knowledge.
● Integrate physical activities within the lesson time. This will help with getting rid of pent
up energy and will allow for better focus afterwards.
● Keep steps for activities simple.
● Design opportunities for the learners to practice how to make decisions and to solve
problems. Allow the learners to help each other as this provides valuable life skills. Give
choices and encourage learners to make decisions.
● Show learners what appropriate behaviour looks like. Make use of roleplay. Make use of
a buddy system when leaving the classroom so that the FAS learner feels safe with the
person they have been paired with.

Establish Routines
● Have a daily schedule and stick to it. Display the schedule or timetable where the learner
can see it.
● Plan for change – if something is going to disrupt the usual schedule, make a plan on
how to deal with the changes. Discuss these changes with the learners.
● Make use of visual, auditory and sensory cues. Use body language, pictures, auditory
input such as music or video clips and any activity that would involve the other senses.
6.8 Giftedness
6.8.1 What is Giftedness?
Giftedness refers to an intellectual difference which means that those children who are
regarded as gifted develop differently (or faster) with regards to intellectual, academic and
creative aspects. Gifted learners often experience the world and think differently from their
peers.
Giftedness is not always apparent when looking at a learner’s academic results. Many
learners that are gifted can appear average or even below average in school as the school
system does not usually cater to the needs of children who are gifted.
Some learners may excel in many different areas while others only do so in a single subject.
To identify giftedness, a mix of intellectual testing and observations of characteristics and
behaviours are needed (Davidson Institute, 2020).
6.8.2 Giftedness as an intellectual barrier
Why can we regard giftedness as an intellectual barrier? While strictly speaking, giftedness
may not be seen to be an intellectual barrier, it can form a barrier to learning due to a
difference in intellectual functioning. In children who are gifted, the brain’s ability to process
information works in a different way that may make learning difficult in the classroom. Gifted
children often process information in different ways, including much faster, and will often
make jumps in logic that teachers and peers cannot follow. The curriculum doesn't cater to
their needs and therefore teachers need to adapt the curriculum to support the learning of
children who are intellectually gifted. While making adaptations, teachers need to remember
that on a social and emotional level, these gifted learners are still young and developing.
Surprisingly, children who are gifted may also often fail in school or do really badly.
The identification of giftedness may sometimes come as a surprise as the teacher may think
the child is “stupid” or needs to go into a remedial class, until they have a proper
psychological assessment and find out the opposite is true. Gifted learners often end up with
a very low emotional state as they believe they are not as clever as others because they are
not doing well at school. They often don't cope with a lot of pressure from teachers as they
already put so much pressure on themselves.
6.8.3 Characteristics of Giftedness
According to the Davidson Institute (2020) some of the common characteristic of gifted
learners are:
● The ability to understand content that are several grades above the age of their fellow
classmates.
● Showing astounding emotional complexity at a young age.
● Having a strong sense of curiosity.
● Being enthusiastic about specific interests and topics.
● Often display an unusual sense of humour.
● Problem solving that can be creative and unique.
● Creative ways of expressing their imagination.
● New information is quickly learned without needing many repetitions.
● Being very self-aware which means they are aware of different aspects of themselves
such as characteristics, behaviours and feelings (and how they differ from others).
● Social awareness, in that they can see the perspective of others and empathise with
them, even those who differ greatly from them. They may also aware of global issues
such as global warming.
6.8.4 Advice for Parents of Gifted Learners
An article called Guidance For Parents Of Intellectually Gifted Children (Zietsman, 2020)
listed some valuable tips for parents of gifted learners. Here are some of the key points that
were made.
It is not always necessary to have your child identified as being gifted. If the child is happy
and enjoys school, there is no need for assessment. But, if your child is experiencing
problems at school and struggles to cope with all the demands made on him/her, it would be
beneficial to have the assessment done. This will help to determine the reason for behaviour
issues or unhappiness at school or within themselves.
Some gifted learners might find it difficult to interact with their peers, while other gifted
learners thrive on social positions such as leadership roles. Parents need to talk to their child
to determine how he/she feels about social interaction with others and then support their
child as best as they can.
Parents should keep in mind that although gifted children usually do well at school, it is
possible for them to appear to have ADHD due to their excitement to learn or they can fail to
participate in activities with their peers as they are too focused on other interests. Being
bored in class can lead to the learner not paying attention. All these aspects can lead to the
child not doing as well as what parents would expect a gifted child to do.
Parents and teachers often expect gifted learners to do better than their peers in everything
they do, be it academics, social or cultural activities. Being gifted does not mean you are
brilliant at everything; it could mean that the child has one field/subject of interest only that
they excel in.
Adults in charge of gifted children should make sure that they do not expect the emotional
maturity of these children to match the intellectual ability. The child’s interests and ability
might be that of someone 2 years older, but the emotional maturity will not be the same.
Don’t expect the child to act like someone that is older than what the child actually is.
As with most children, gifted children have a deep need to feel accepted within a group.
They want to fit in with their peers. They are aware of the fact that they are different and they
are very aware when people talk about them. This can have a great emotional impact on
them. Parents and educators should guard against discussing the child within hearing
distance of the child.
Parents should try to supply their child with the necessary educational challenges that they
need. Join some of the organisations that offer programmes aimed at gifted children. This
will provide the chance to interact with other gifted children, plus it gives the children the
chance to feel mentally stimulated and builds curiosity for further exploration.
Working with the class teacher and supplying additional materials that can be used during
class time, will help the child and the teacher. Together, the parent, teacher and child can
come up with ways to stimulate interest beyond the normal scope of the curriculum.
6.8.5 The Difference between High Achievers and Gifted Learners
According to Machucho (2018), there are key differences between high achieving learners
and gifted learners. Here are some of the most prominent differences:
● High achieving learners work hard to get the results that they do, gifted learners do
naturally well without putting in much effort.
● High achievers will try their best to answer questions correctly in class as they thrive on
the praise that they will receive, but gifted learners are not concerned about being
correct, they want to explore and will ask more questions.
● High achieving learners mostly learn content in a set order, often in the order the content
was taught, while gifted learners could have gaps in their content knowledge and may
create interesting connections between seemingly unconnected content.
● The high achiever tends to mix with their fellow classmates, but gifted learners often feel
more comfortable in the company of adults or older children.
● High achievers understand age appropriate concepts that appear in books or movies;
gifted learners could become greatly concerned and question every aspect of the book
or movie.
● High achieving learners usually enjoy school while gifted learners often prefer to learn
independently and may not respond well in group work situations.
6.8.6 Support Plan for Gifted Learners
For a comprehensive list of differentiation strategies, click on the link or scan the QR code:
https://www.st-clair.net/Data/Sites/1/media/public/SpecialEd/gifted-
program/differentiation-and-enrichment-strategies-for-gifted-
students.pdf
REFERENCES
Aware.Org. (2021). Fetal Alcohol Spectrum Disorder. Aware.Org.Za.
https://aware.org.za/fetal-alcohol-syndrome/
CDC. (2019). Facts About Intellectual Disability. Centers for Disease Control and Prevention.
https://www.cdc.gov/ncbddd/childdevelopment/facts-about-intellectual-disability.html
Cole, B. (2020). September 9—International Fetal Alcohol Spectrum Disorder (FASD) Day.
1.
Davidson Institute. (2020). Characteristics and Traits of Gifted Children. Davidson Institute.
https://www.davidsongifted.org/prospective-families/gifted-traits-and-characteristics/
Inclusive Education South Africa. (2017). 2546_IESA_EU Factsheet 01_Down

Syndrome.indd. 2.
Integrity Inc. (2019). Learning vs. Intellectual Disability Treatment Options.

https://www.integrityinc.org/learning-vs-intellectual-disability-treatment-options/
Machucho, M. (2018). Are There Differences Between “Gifted” and “Bright” Children?
WeHaveKids. https://wehavekids.com/education/Are-There-Differences-Between-Gifted-
and-Bright-Children
Marina Zietsman. (2020). Guidance for Parents of Intellectually Gifted Children. Child
Magazine. https://www.childmag.co.za/guidance-for-parents-of-intellectually-gifted-children/
NASET. (2021). National Association of Special Education Teachers: Comprehensive

Overview of Intellectual Disability. https://www.naset.org/index.php?id=2296
New Zealand, M. of E., New. (2018). Understanding FASD. Inclusive Education.
https://www.inclusive.tki.org.nz/guides/fetal-alcohol-spectrum-disorder-and-
learning/understanding-fasd/
New Zealand Ministry of Education. (2018). Understanding Down syndrome. Inclusive

Education. https://www.inclusive.tki.org.nz/guides/down-syndrome-and-
learning/understanding-down-syndrome/
Psych4Schools. (2018). Intellectual Disability (Revised). Psych4Schools.

https://www.psych4schools.com.au/free-resources/intellectual-disability/
Therapy Travelers. (2018). Strategies for Teaching Students with Intellectual Disabilities.
TherapyTravelers. https://therapytravelers.com/strategies-teaching-students-intellectual-
disabilities/
Western Cape Government. (2019). Learn more about Down syndrome. Western Cape
Government. https://www.westerncape.gov.za/general-publication/learn-more-about-down-
syndrome
Western Cape Government. (2021). Foetal alcohol syndrome awareness programme.

Western Cape Government. https://www.westerncape.gov.za/general-publication/foetal-
alcohol-syndrome-awareness-programme

VISUAL BARRIERS TO LEARNING
When we do the best that we can, we never know what miracle is

wrought in our life, or in the life of another. – Helen Keller
7.1 Visual Impairments
A visual impairment is the inability to process visual information because of an

absence or deficiency of a specific structure.
Before we can understand visual impairment, it is necessary to first understand the
visual system. The visual system consists of 3 components:
• Sight – the image that enters through the eye.
• Transmission of an image along the optic nerve.
• Interpretation of the image in the visual cortex for the brain.
Any interruption or change within one of these mechanisms will affect a person’s
vision.
Visual Impairment occurs when a person’s vision differs in such a way that it cannot
be corrected through ordinary visual devices, i.e., glasses or contact lenses. Visual
Impairments are divided into two categories:
Blindness refers to a total or a high degree of vision loss. Of all the people who are
blind, only about 18% are totally blind. This means that approximately 82% can
distinguish between light and dark, however, as those around them do not realise
that there is some vision available, many children are not taught to use their residual
vision.
Low Vision is a Partial vision loss that cannot be corrected by ordinary visual
devices (glasses or contact lenses. Just because you require glasses to read or
watch television does not mean that you have a visual impairment.
Low vision refers to a severely reduced visual acuity, a significantly obstructed visual
field, poor contrast sensitivity, or all three.
According to UNESCO Bangkok (2009), The World Health Organization’s definition

of low vision is visual acuity less than 6/18 and equal to or better than 3/60 in the
better eye with best correction. What does this mean? Visual acuity refers to the
size and distance that a person can see and is explained later under characteristics
of visual impairment.
Characteristics of Visual Impairments
Degrees of low vision: How do we know if a child is partially sighted or legally
blind?
Willings (2019) directs us to The World Health Organization’s classifications of visual
impairment. When the vision in the better eye with BEST POSSIBLE glasses
correction is:
● 20/30 to 20/60, the child has a mild vision loss, or near-normal vision
● 20/70 to 20/160, the child has a moderate visual impairment, or moderate low
vision
● 20/200 to 20/400, the child has a severe visual impairment, or severe low
vision. In the United States, a person with 20/200 in the BETTER eye is
considered legally blind.
● 20/500 to 20/1,000, the child has profound visual impairment, or profound low
vision
● less than 20/1,000, the child has near-total visual impairment, or near total
blindness
● no light perception, the child has a total visual impairment, or total blindness.
To better understand how children with visual impairments see and make the
necessary adjustments for support, it is important to know the language that it used
to describe the different aspects of vision. The following explanations from UNESCO
Bangkok (2009) have been expanded on for your better understanding of how they
affect children
• Visual acuity
The size and distance that the child can see. This affects how big we need to make
writing for the child to see and read it, as well as how far the child will need to sit
from the board.
Can the child see size 12, size 18 or size 36?

If a child has a visual acuity of 6/18, this means that at a distance of 6 metres the
child can see what others can see at 18 metres.
Think of a road sign: what you can see from 18 metres away, the child can only see
when 6 metres from the sign.
If a child has visual acuity of 3/60, then the child will have to stand 3 metres away
from what someone with perfect vision can see from 60 metres away. Should the
child’s visual acuity be less than this, i.e., if the child had to stand closer to the sign
than 3 metres, then the child would be classified as legally blind even though they
have some vision.
If someone has 20/20 vision, it means that at 20m they can see what most other
people at 20m from the sign can see.
• Visual field
This refers to the way in which we describe the areas that a person when the eye is
looking at a single point (without moving their eyes or head). Visual field is measured
in terms of degrees (°).
Sometimes levels of vision loss may be based on visual field loss (e.g., loss of
peripheral vision). In the United States, a person who has a remaining visual field of
20 degrees or less is considered legally blind.
If a child could see the following scene, the areas would be broken up as follows:
If someone has difficulty in the they may not see the

Superior visual field … low hanging branch
Inferior visual field … ridge in the road
Left peripheral visual field … the cars
Right peripheral visual field … the pavement
Central visual field … the boy on the bicycle
A child who has limited central vision may hold their head at a strange angle to read
using their peripheral (side) or superior (upper) vision.
• Visual motility
This is the ability to localise, fixate, follow, and track. These skills are used in
learning to read so that the eyes move naturally from left to right and are able to stay
on the same line. Children with visual motility difficulties may reread words or lose
their place easily, which will make it difficult to read for meaning. For example,
nystagmus will make a child’s eyes shake which makes it difficult to stay on one line
when reading, especially if the text and line spacing is small.
• Light sensitivity
Light sensitivity refers to how sensitive the eye is to light, and is measured in terms
of amount, type, and position of illumination.
While many of us have been moaned at by our parents for reading in dim light,
excessive light can also make it difficult to read or see clearly. In some cases, too
much light can enter the eyes when reading off white paper, especially under
fluorescent lighting, which puts strain on the child and makes reading more difficult.
Covering a page with a coloured overlay or printing worksheets on coloured paper
may make reading easier.
• Visual stability
Our visual ability may change, and sometimes decreases over time. It is necessary
to monitor changes in a child’s vision so that we can adjust support as come
conditions are degenerative.
• Visual perception
Visual perception is the ability of the brain to organise and interpret what the eyes
see, e.g., visual discrimination, visual analysis and synthesis, visual sequencing and
visual memory.
(Laas, 2017)
Visual Responses and Capabilities in Normal Visual Development

To be able to identify that a child may have a visual impairment, it is important that
we know what the expected development of vision is. At the age of 4 to 7 years, a
child with normal visual development:
• Discriminates, identifies, and reproduces abstract figures and symbols
• Traces, copies, and draws figures
• Sorts like figures by a single detail
• Identifies and perceives relationships in pictures, abstract figures, and symbols
• Identifies missing detail in pictures
• Identifies perceives and reproduces symbols in single form and in combination
(letters and words)
• Identifies letters in different print styles
• Reproduces abstract symbols from memory
• Identifies words on sight (Bornman & Rose, 2010)
Warning signs that a child may have a visual impairment include:

• Squinting, closing, or covering one eye
• Clumsy movements, shuffling walk, bumping into objects
• Holding the head in unusual positions and “peering”
• Holding materials close to the face or putting the head close to the desk
• Relying on sound clues such as environmental noises to help locate objects
• Choosing to sit in the front of the class where he sees best
• Not making good eye contact with other
• Avoiding visually demanding tasks
• Finder flicking or waving in front of eyes
• Pressing, poking, or rubbing eyes
• Redness or tearing of eyes
• Overreaching or under reaching for objects (Bornman & Rose, 2010)
7.2 Different Types of Visual Impairments and How They

Affect Vision and Learning
When we consider the different Visual Impairments below, we need to keep in mind
that:
• 80-90% of early learning is through visual input
• Miss out on many learning experiences
• Incidental learning is restricted
• Do not explore their environment
Causes of Visual Impairment
The Texas School for the Blind and Visually Impaired (2016) and UNESCO Bangkok
(2009) provide an extensive list of specific Visual Impairments, their corresponding
impact on vision and educational support strategies. Some of these have been
included here for you, along with further explanation to help you understand the
needs of children who have visual impairments.
7.2.1 Albinism
People with albinism are born with little or no colour (or pigment) in their eyes, skin,
and hair, and this happens in all race groups. They may have pale skin and very light
blonde hair.
Albinism affects the vision of those affected in a variety of ways, including nystagmus
which causes the eyes to shake.
Children may be provided with tinted glasses or lenses.
An additional barrier is the social barrier that affects children with albinism. There are
many myths regarding albinism, ongoing stigma attached to having albinism, and
children with albinism are also at risk of being abducted for witchcraft which is still a
concern in many countries in Africa, as well as South Africa (Khoza, 2015).
Impact on Vision Support

• Decreased acuity • Magnification (e.g., handheld
• Photophobia magnifier, electronic magnifier,
• Increased sensitivity to glare screen enlargement software,
• High refractive error telescope, etc.)
• Astigmatism • Close viewing
• Central scotomas High contrast materials
• Nystagmus • May need to use sunglasses, visors,
• Muscle imbalance or hats outdoors and indoors as well
• Eye fatigue with close or detailed • Lighting from behind
work • Reduced glare
• Reduced depth perception Line markers and templates
• Placeholders
Frequent breaks
South African model, Sanele Xaba, is working to change the face of albinism.
(Photographs supplied by and used with the permission of the model) .
7.2.2 Cataract
● Cataracts are the clouding of the lens of the eye which

interferes with the passage of light.
● While most cataracts are related to ageing, many children
are also born with cataracts, or the condition may develop
after eye injuries, inflammation, and other eye diseases, or
may be hereditary. Infections during pregnancy can also
cause cataracts.
● Cataracts becomes noticeable as the lens becomes white.
● Childhood cataract is widespread in many parts of the
world.
• Reduced visual acuity • Support of the wearing of any

• Blurred vision prescribed lenses
• Reduced colour discrimination • Magnification (e.g., hand-held
• Photophobia magnifier, electronic magnifier,
• Associated with nystagmus screen enlargement software,
• Visual ability fluctuates according to telescope, etc.)
light • Enlarged printed materials
• If cataracts are centrally located, near • Close viewing – allow to come to the
vision will be reduced board or image to see
• Increased sensitivity to glare • Support of eccentric viewing
• May need to use sunglasses, visors,
or hats outdoors and indoors as well
• May need reduced or diffused lighting
• Lighting from behind
• May need lamps with rheostats and
adjustable arms
• Reduced glare
7.2.3 Glaucoma
• Glaucoma occurs when the optic nerve that carries

information from the light sensitive area of the eye,
called the retina, directly to the brain is damaged,
usually by high pressure in the eye.
• Eyes need a certain amount of pressure to keep their
shape so that they work properly and stay healthy.
• When the pressure is too high, the child may find
bright light or sunlight uncomfortable (photophobia)
and have eyes that are slightly larger than usual.
• The child will also have a greater chance of
developing a “squint” (when the eyes look in different
directions) or a “lazy eye” (when one eye is weaker than the other), or the eyes
may water more often than for other children.
• Prescription eyedrops must be used regularly to reduce pressure and surgery
may be needed.
• Fluctuating visual functioning • Support use of sunglasses, visors, or
• Field loss hats in bright sunlight and bright lighting
• Poor night vision indoors
• Photophobia • Allow time for adjustment to lighting
• Difficulty reading changes
• Difficulty seeing large objects presented • Reduced glare
at close range • Adequate lighting (e.g., lamps with
• Decreased sensitivity to contrast rheostats and adjustable arms)
• Eye redness • High contrast materials
• Hazy cornea • May benefit from magnification (e.g.,
• Wide open pupil hand-held magnifier, electronic
• Stress and fatigue have a negative magnifier, screen enlargement software,
effect on visual performance telescope, etc.)
• May need visual efficiency training to
develop scanning skills
• Frequent breaks from visual tasks
• May need instruction in tactile learning
and braille
• Teachers must be alert to signs of pain
and increased ocular pressure.
7.2.4 Onchocerciasis or “River-Blindness”
• Onchocerciasis is transmitted by blackflies that live and thrive in many riverside

areas.
• Eye lesions can be found in all internal tissues of the eye where they cause
inflammation, bleeding, and other complications that ultimately lead to blindness.
• Ninety-nine percent of those affected live in Africa, while the remaining 1% lives
in Yemen, Mexico, Guatemala, Ecuador, Colombia, Venezuela, and Brazil.
• Onchocerciasis requires medical treatment.
7.2.5 Refractive Errors
• Myopia is commonly referred to as “short-sightedness”, where children are able

to see close to themselves and cannot see objects further from them.
• Hyperopia is known as “far-sightedness”, where children struggle to focus clearly
on objects near to them.
• These can occur with or without astigmatism, an irregularly shaped cornea or
lens that prevents light from focusing properly on the retina, the light-sensitive
surface at the back of the eye
• While refractive errors can cause blurred vision, eye strain, and headaches,
particularly after prolonged reading, they does not cause blindness.
• Mild to moderate refractive errors can be corrected using glasses or contact
lenses, and sometimes glasses and contact lenses. However, severe refractive
errors may not be fully corrected, requiring additional magnification using a
magnifier or monocular.
7.2.6 Retinitis Pigmentosa (RP)
• RP is a group of hereditary retinal diseases.

• The first signs of retinitis pigmentosa usually occur in early childhood, when both
eyes are usually affected.
• Night vision can be poor, and the visual field may begin to narrow.
• During later stages, children may have only a small
area of central vision remaining along with slight
peripheral vision. By late teens, progressive RP
may mean that a child is unable to read a letter due
to reduced visual acuity but increasing the size may
mean that the child’s visual field may be too small to
see the whole letter or word. Eventually blindness
sets in and the world becomes dark.
• RP is one of the most common eye diseases in
countries and cultures where marriage within the
family is practiced.

• Loss of peripheral vision • Avoid contact sports and other high
Night blindness risk physical activity to prevent
• Tunnel vision retinal detachment
• Decreased acuity • High illumination
• Decreased depth perception • Reduced glare
• Blind spots (scotomas due to retinal NOIR lenses or overlay filters may
scarring) be helpful
• Photophobia • Video magnifiers for maximum
May develop cataracts contrast
• May become totally blind • Night vision devices (e.g.,
• May be associated with myopia, Streamlight flashlights, Third
vitreous opacities, cataracts, and Generation® Night Vision Devices,
keratoconus etc.)
• Visual efficiency training in
organized search (grid) patterns
• Orientation and mobility evaluation
at night and in dimly lit places
For central vision loss: magnification
(e.g., handheld magnifier, electronic
magnifier, screen enlargement
software, telescope, etc.)
For peripheral field loss: increase
viewing distance to see more area.
• Using a computer and assistive
software (e.g., Jaws, Dolphin, etc.)
7.2.7 Trachoma
• Trachoma is caused by a micro-organism that spreads through contact with eye

discharge from the infected person (on towels, handkerchiefs, fingers, etc.) and
through transmission by eye seeking flies.
• After years of repeated infection, the inside of the eyelid may be scarred so
severely that the eyelid turns inward and the lashes rub on the eyeball, which can
further scar the cornea and lead to blindness.
• Photophobia • Sunglasses, visors or hats outdoors,
• Fracturing or scattering of light (as in and indoors as well
looking through a broken windshield • Reduced or diffused lighting from
• Increased glare Blurred vision Reduced behind (e.g., lamps with rheostats and
acuity adjustable arms)
• Front row seating with back toward
windows
• Reduced glare
• High contrast materials
• Magnification (e.g., handheld magnifier,
electronic magnifier, screen
enlargement software, telescope, etc.)
• Enlarged printed materials
Frequent breaks from visual tasks
• Support of eccentric viewing
• Auditory materials for long reading
assignments
• May need instruction in tactile learning
and braille
7.3 Needs of Learners with Visual Impairments
Bornman & Rose (2010) make the following recommendations when making
adaptations for children with visual impairments and blindness.
Physical Adaptations
• Ensure walkways are clear and open so that learners do not trip.
• Teach learners about landmarks so that they can become as independent as
possible.
• Replace visual cues with physical and auditory cues.
• Notifying learners when changes are made.
• Encourage independence.
• Get to know learners well and capitalize on their strengths.
• Teach using multiple modalities including sound, smell and
touch.
• Use concrete objects as many children may not have
learned about things incidentally as they may not have
been aware that they were in their environments.
• Use specific descriptive language, such as “Above your
head”, not vague instructions to find something “over
there”.
Reading
For children with less severe visual problems, use regular print with good contrast,
good quality.
Fonts such as Tahoma or Arial are better.
Many children who do not have much in the way of a central visual field may hold
their books at strange angles in order to use eccentric viewing to focus on the text.
Children with more severe visual impairments, may need:

● Large print (Photocopy to A3) with dark lines
● Older children prefer not to have A3 paper as it is hard to keep in their files or
books, in which case worksheets that are made by the teacher can simply use a
larger font to improve visibility.
● Braille – we use six-dot braille. The dots are about the
size of poppy seeds placed in a six-dot cell.
● White writing on a black page may be more visible.
● Tactile books such as I feel a foot! which has both high
contrast writing and braille, and the pictures are made of
material in different textures.
● For children who struggle with the glare of white paper,
try using light yellow, green or blue paper instead or
coloured overlay.
● High-and low-tech devices
– Magnifiers
– Monocular
– Talking watches, calculators
– Magnifying lamps
– Speech reading systems e.g. Jaws, Dolphin
Writing
● Machine/ hand-embossed braille
● Computerised braille
● Functional handwriting should be considered for blind
learners as it encourages independence (sign name
on a document)
● Special writing paper
– Raised, bold lines
– Enlarged line spacing
– Go over the lines of the page using a black marker pen.
● Pens
– Using black broad and fine tip markers or Koki pens can be easier to see.
– Pens/pencils with tactile and visual feedback – these raise up like puffy
paint when they dry.
With regards to braille, it should be noted that it is necessary to develop pre-braille

skills before learning braille in order to sensitise the fingertips until it is possible for
children to sort poppy seeds from sesame seeds, and count grains of rice.
For children who are losing their sight, it is necessary to

learn braille blindfolded. If the child can see the dots, they
will learn to recognise the letters visually rather than in
tactile form.
Figure 1 Raised writing patterns (left) to assist with pre-writing skills. (Laas, 2003)
Figure 2 Braille blocks (right) for teaching pre-braille skills (Laas, 2003)
It is important in our country to realise that we will not always receive the funding that
we would hope for to buy expensive equipment. Much of what we need can be made
inexpensively and there are many strategies that we can use that do not require a lot
of funding.
Find more about what you can do in this great article by Willings
(2018).
https://www.teachingvisuallyimpaired.com/when-student-doesnt-
qualify.html
It is important to realise that children with visual impairments may have a preference
for visual learning as well as art, and as teachers, it is our responsibility to foster their
learning so that they succeed in life.
Nathi Ngubane is a professional graphic artist who is completely blind in one eye and
has a visual impairment in the other. As a student, he was known to draw his
teachers in cartoons (with their permission) and do portraits of them to make extra
money (below). Nathi is now known for his comics, which are featured in
publications such as the Citizen and the Daily Maverick. He is also the globally
acclaimed author of Duma Says (below left). (Images used with permission of the
artist).
To discover more about Nathi’s schooling experience, follow the link or scan the QR
Code. https://www.youtube.com/watch?v=x1BGN5Dm_gE
Click on the link or scan the code to visit the Edit Micro’s
extensive catalogue of assistive devices and software for
children and adults with visual impairments and blindness. c
https://editmicro.co.za/product-category/products/special-needs-
inclusion/blind-and-
low-vision/
REFERENCES
Bornman, J., & Rose, J. (2010). Believe that all can achieve: Increasing classroom
participation in learners with special needs support. van Schaik.
Khoza, A. (2015, August 26). Albino victim’s family lives in fear. News24.
https://www.news24.com/News24/Albino-victims-family-lives-in-fear-20150826
Laas, H. (2003). LTSM for Children with Visual Impairments.
Texas School for the Blind and Visually Impaired. (2016). Specific Eye Conditions,
Corresponding Impact on Vision, And Related Educational Considerations.
https://www.tsbvi.edu/eye-conditions
UNESCO Bangkok. (2009). Teaching Children with Disabilities in Inclusive Settings.

UNESCO Asia and Pacific Regional Bureau for Education.

HEARING BARRIERS TO LEARNING
8.1 Hearing Impairments
According to the World Health Organisation (WHO, 2021), any person that cannot hear as
well as someone with normal hearing, can be described as having a hearing loss. Hearing
loss can be classified as mild, moderate, severe or profound. The hearing loss could be in
one or both ears and the loss of hearing will create difficulty in hearing conversational
speech and loud sounds.
What is the difference between being hard of hearing and being deaf? The distinction is
important as this will greatly affect the type of support that a learner that has hearing barriers
will be supported.
Hard of hearing means the hearing loss ranges from mild to severe. Learners that are hard
of hearing may still communicate by means of speech and can make use of hearing aids,
cochlear implants and other assistive devices.
A learner who is deaf has profound hearing loss as he/she will have very little or no hearing
at all. The usual method of communication will be to use sign language (WHO, 2021) or lip
reading.
Maryville University, 2021)
8.2 The Impact of Unaddressed Hearing Loss
If no intervention takes place, loss of hearing can affect many aspects of a learner’s life:
● Communication and speech will be affected.
● Understanding and processing of information in the classroom or in everyday
communication will be negatively affected as not all the information will be accessible
and therefore the learner may have gaps in their content knowledge.
● Social isolation may take place as the learner withdraws from groups due to the inability
to communicate with peers. This leads to loneliness which may lead to depression.
● In the long term, the effects of not being able to process what others say and not
knowing which alternative solutions are available will have an impact on the learner’s
ability to contribute to the economy and to society as a whole.
When hearing loss is identified in the early stages of its onset, appropriate interventions can
be introduced. This will minimise possible developmental delays. Assistance can be given on
how to communicate. Help with social and educational development can begin which will
mean that the child will be spared many of the frustrations that might otherwise have
become part of his/her life (Inclusive Education South Africa, 2019).
8.3 Characteristics of Learners with Hearing Impairments
Although hearing impairments are usually identified before school going age, it is possible
that a learner in your class may have hearing problems that have gone unidentified. In an
article called How to support a child with a hearing impairment in school, Finch (2020)
provides useful guidelines in terms of signs that teachers should be on the lookout for. Signs
that may indicate that a learner is struggling to hear in class may include:
● Not responding when their name is called
● Having problems with concentration, feeling tired all the time and experiencing frustration
with work
● Watching the teacher’s lips intently as the teacher speaks
● Often asking others to repeat what they said
● Speaking too loudly or too quietly
● Watching others do something before trying to do the same activity
● Withdrawing from interaction in the classroom
● Showing delayed speed and communication development, not being on the same level
as the rest of the learners in the class
● Mishearing or mispronouncing of words
● Cannot hear what is being said if there is background noise
● Not contributing to class discussions
● Finding it difficult to make the link between reading and speaking
8.4 Needs of Children with Mild to Moderate Hearing

Loss
8.4.1 There are three main types of hearing loss
1. Sensorineural hearing loss – this is the most common type. This permanent hearing
loss may be as a result of many conditions that cause damage to the tiny cells in the ear or
auditory nerve which carry information regarding the volume, pitch and meaning of sound to
the brain. Sensorineural hearing loss can make it hard to understand speech despite it being
loud enough to hear.
Typical symptoms of sensorineural hearing loss (Maryville University, 2021):
● Difficulty understanding children’s and female voices
● Dizziness or balance problems
● Trouble hearing high-pitched sounds
● Hearing voices but not understanding them
2. Conductive hearing loss – this is caused by a mechanical default in the outer or middle
ear. It can also be caused by a blockage in the ear canal that blocks sound from getting to
the eardrum. Usually this is temporary and it can be medically treated, but it can become
permanent, if it is not seen to.
Typical symptoms of conductive hearing loss (Maryville University, 2021):

● Sensing that our voice sounds different from how it used to sound
● Difficulty hearing speech
● Conversations sound muffled
● Strange smell coming from the ear
● Pain or pressure in one or both ears
● Ear discharge
3. Mixed hearing loss – this is when both sensorineural and conductive hearing loss are
present.
8.4.2 Identifying Hearing Loss
In South Africa we have school-based hearing screening which is used to identify learners
with hearing impairments. The goal of these screenings are to identify children with a
significant hearing loss so that further diagnosis can be recommended and the necessary
interventions can be implemented.
School-based screening is often the first detection of hearing loss. The Integrated School
Health Policy for South Africa acknowledges the importance of hearing screening by
including it as part of all the health phases with priority on the foundational phase.
The purpose of hearing screening is to identify children with hearing losses which may affect
their intellectual, emotional, social or speech / language development.
If you suspect that a child has a hearing problem and the child has not had a school-based
hearing screening, you can recommend that the child goes to the local clinic or to a doctor
who will then be able to refer the child to a specialist, should that be necessary.
8.4.3 Appropriate Interventions
Once a hearing impairment has been identified, appropriate interventions should be

introduced. These will lessen the developmental delays that could develop due to the
hearing problem. Interventions also promote communication, education and social
development. The type of intervention that will be used will depend on the degree and the
cause of the hearing loss.
Although hearing loss is not reversible (it cannot be restored), the impact of hearing loss can
be reduced with a variety of approaches such as:
● Hearing devices such as hearing aids
● Cochlear or middle ear implants
● Hearing assistive technology such as radio systems
● Therapy to develop speech
● Learning of non-verbal communication, such as sign language
8.4.4 Advice for Parents of Learners with Hearing Loss
Hickman (2004) offers some helpful tips for parents whose children have a hearing loss or
are deaf. Here is a brief summary of her advice for parents.
The first step would be to get a diagnosis. Once a specialist has given a proper diagnosis,
you will be able to make plans regarding which interventions would be best. The specialist
will likely refer you to an audiologist who will be able to assist you with devices and ways to
adapt your family lifestyle to best support your child.
Next, you can decide on which amplification system would be best for your child. Explore all
the options available.
Make some decisions regarding how you plan to teach your child to communicate. Are you
going to use sign language? Are you going to arrange speech therapy for your child? There
are many options and it will take some time doing the necessary research to find what will
work best for your child.
The quicker you can start with interventions, the less of an impact the loss of hearing will
have on your child’s developmental milestones.
8.4.5 Amplification Devices
Children most commonly use behind-the ear hearing aids. There are many colours and
different sizes to choose from. The device is anchored in the ear via an ear mould. This will
be specifically made for your child so comfort will be optimal. It will also ensure that the
device stays in place. As your child grows, new moulds will have to be made. These moulds
can also be made in a variety of colours.
In-the-ear and in-the-canal amplification devices usually help those with a moderate hearing
loss. They fit inside the ear and therefore no ear mould is needed. These devices are small
and more suitable for older children and adults.
(Hickman, 2004)
8.5 Needs of Learners with Deafness
8.5.1 Basic Needs
Deaf learners struggle with most aspects of education. Some of the typical problems that
these learners face are:
● They struggle to understand the teacher – not all deaf learners can lip read. Those that
do lip read may only make out half of the words as lip reading is not that accurate.
● Due to the lack of hearing, pronunciation is problematic as they cannot copy the ‘right’
way of sounding words. This means that language would be difficult as these learners
will not be able to make use of phonics.
● Lack of resources, such as assistive technology, can make it harder for deaf learners to
function optimally in the classroom.
● Deaf learners can become tired and irritable due the level of concentration they need to
apply to stay on track with the rest of the class.
● Like any other learner, deaf learners are very aware of social situations and fear
embarrassment. Communicating with their peers and forming friendships are important,
but difficult.
8.5.2 The Use of Sign Language
South African Sign Language (SASL) is the first language for the South African Deaf
community. There are also people that can hear that use SASL to communicate with family
and friends.
SASL has been on its way to becoming the 12th official language in South Africa. In March
2021, the first working session for all national departments to make contributions to
the draft 19th Constitutional Amendment Bill was held. While making amendments to
the constitution is a lengthy process, this is a very positive step forward. SASL as a
language has been available as a home language for deaf children since 2014 and
the SASL CAPS documents are available (Department of Basic Education, 2014),
SASL as a first additional language has not as yet been released, however, we are
hopeful to see it in the near future.
SASL is a complete language. It has its own grammar, vocabulary and syntax (rules for the
structure of the language). Click on the following link, or scan the QR code for a PDF booklet
on South African Sign Language.
https://www.westerncape.gov.za/assets/departments/cultural
affairssport/national_institute_for_the_deaf_sa_sign_langua
ge_booklet.pdf
Most people in South Africa cannot use SASL, and that’s why the potential of SASL being
introduced as a language for all to master, keeps on appearing in the media. For you, as a
future teacher, the learning of SASL will be beneficial. The question that comes to mind
though is: When are you likely to use it? Unless you have a deaf learner in your class, or you
meet someone that is deaf, or you have a family member that is deaf, the opportunity for the
use of SASL will be limited. Then again, many people have this attitude when learning their
additional language at school, yet they do find opportunities to use their additional language.
The bottom line is that learning basic sign language will be useful. Sign languages across
the world do differ based on the typical vocabulary of that country, but the basic signs may
be understood by others who can sign.
If you would like to access the SASL CAPS Documents for all phases (Department of Basic
Education, 2014), you can download them from:
https://www.education.gov.za/Curriculum/CurriculumAssessmentPolicyStatements(CAPS).a
spx
8.5.3 The Use of an Oral Approach (lip reading)
Lip reading is a technique used to understand speech by interpreting the meaning of the
movements of the speaker’s lips, face and tongue. This is done within the context and the
language that is being used. Again, we have the problem that if the learner is not using the
language that the teacher is using as his or her home language, the learner will struggle to
understand what is being said.
To complicate matters further, many of the sounds in English cannot be distinguished by

sight alone. Hickman (2004) offers the following example: “where there’s life, there’s hope”
could “look” like “where’s the lavender soap”.
Hickman (2004) also explains that it is not helpful to exaggerate mouth movements when
you speak to someone who can lip read as those exaggerated movements will make it more
difficult for the person to read your lips.
People that make use of lip reading also make use of visual cues from the environment.
They use their base knowledge of the topic that is being discussed. Therefore, a learner that
uses lip reading will try to link what is being said to what he/she has already learned. This
means that when new information is covered for the first time, learners could struggle to
grasp the new concepts.
People that do not experience hearing barriers need to be aware of the fact that not all deaf
or hard of hearing people can lip read. Some find it really difficult, and being able to lip read
is often regarded as a talent. (Hickman, 2004)
8.6 Support Plan for Learners with Hearing Impairments
A radio aid is a microphone that the teacher wears. It is connected to the hearing aid of the
learners with a hearing impairment. This device can also be passed to other learners during
group activities, so that the learner with the hearing aid can follow what is being said.
Teachers should meet regularly with the parents to ensure that the learner has consistent
support at school and home. During meetings you can discuss concerns as well as the
learner’s progress. Children often tell their parents about issues they have at school and
these meetings will give the parents the opportunity to raise the issues with the teacher
(Finch, 2020).
8.6.1 Classroom Communication
To promote positive communication, consider some of the following tips (Hickman, 2004):
● When talking to the class, face the learner that lip reads. Do not turn your back while
talking as this will make lip reading impossible.
● Before you address the learner, tap him/her on the shoulder or wave your hand so that
he/she knows that you are addressing him/her directly.
● When someone in the class asks a question or comments on something, you need to
repeat this and point out who was talking.
● Make sure that you have enough light in the classroom so that lip reading is possible.
● When changes are made to the timetable or in assignments given to the learners, make
sure that the learner that has a hearing impairment is aware of this.
● When doing group work, involve the learner in small group discussions. This will make
participation easier for the learner.
8.6.2 Using an Interpreter in Class
An interpreter’s role will depend on the age of the learner. Educators should explain to the
class why the interpreter is there and what his/her job is.
When addressing the learner, make sure to speak to the child and not the interpreter.
Ensure that the learner understands that he/she should respond to you and not to the
interpreter, even though the child may need to look may the interpreter and not you to follow
what is being said.
It is important to speak clearly and slowly to allow the interpreter enough time to interpret the
information you are sharing for the learner.
Keep in mind that the learner will be focusing on the interpreter and this means that they will
lose some of the information that you are giving. Make allowance for short breaks throughout
the lesson and day to allow the learner to catch up.
One of the benefits of having an interpreter in class is that other children may incidentally
begin to learn to sign as they watch the interpreter.
8.6.3 Accommodations
There are a variety useful Accommodations that you can make that will help the learner
with a hearing impairment. Some of these include:
● Give the learner an outline of the lesson topic before the start of the lesson so that the
learner can read through it, or go over it with their interpreter.
● Make use of visual aids such as pictures and video clips.
● Give the learner a list of key vocabulary before the lesson so that he/she can become
familiar with them beforehand.
● Seat the learner close to the front of the class so it’s easier for him/her to focus on the
person speaking. Inform guest speakers what the learner’s requirements are.
● Assign a hearing buddy to the learner. This buddy can help the deaf/hard of hearing
learner to follow what is being said.
● Adjust assessments to be suitable for the learner that experiences hearing barriers.
Listening comprehension and response to other learners would be unfair.
REFERENCES
Department of Basic Education. (2014). SASL Curriculum and Assessment Policy Statement
(CAPS). Department of Basic Education.
Finch, M. (2020). How to support a child with a hearing impairment in school | Engage.
Engage Education. https://engage-education.com/blog/how-to-support-a-child-with-a-
hearing-impairment-in-school/
Hickman, K. (2004). Ohio Coalition for the Education of Children with Disabilities:
(640932009-004) [Data set]. American Psychological Association.
https://doi.org/10.1037/e640932009-004
Inclusive Education South Africa. (2019). 2917 IESA EU Factsheet 13_Hearing

Impaired.indd. 2.
Maryville University. (2021). 3 Hearing Loss Types: Effects and Common Treatments.
Maryville Online. https://online.maryville.edu/blog/hearing-loss-types/
WHO. (2021). Deafness and hearing loss. https://www.who.int/news-room/fact-

sheets/detail/deafness-and-hearing-loss

LITERACY BARRIERS
9.1 Literacy Barriers
Literacy barriers fall under learning barriers which can be described as barriers in one or
more of the basic psychological processes involved when we use language (spoken or
written) and these barriers can affect our ability to listen, think, speak, read, write, spell or do
mathematical calculations. Typical examples of these that we will be covering in this chapter
are dyslexia, dysgraphia and dyspraxia. In chapter 10, you will learn more about difficulties
with mathematical calculations such as dyscalculia.
We use the term “Literacy Barrier” as it indicates that the learner has trouble with using
certain language (literacy) skills to learn. These skills include reading, writing, listening,
speaking, and reasoning. Difficulties in learning to read is the most common learning barrier.
Learners do not learn how to read and write at the same pace. Some learners experience
major difficulties in learning basic reading and writing skills. Reading is the starting point for
all learning. Without mastering reading skills, learners will experience difficulty in all
academic work, especially once they move from Foundation Phase where they are learning
to read to Intermediate Phase where they are expected to read to learn. This will also have
an impact on their career options once they leave school.
Print literacy comprises our ability to read (that is, decode words and understand written
text), spell (that is, encode words from speech to print), and write (that is, form simple words
and phrases, and ultimately generate extended written text). In all cases, reading is the
starting point for learning to be literate. Through reading, knowledge is developed, as well
as skills to make sense of the meaning of language.
Mastering literacy skills may also affect a learner’s social skills. If learners are effective in
learning, they are more likely to have the confidence to use their newly found knowledge in
their everyday life. They will be able to be self-sufficient and know how to collaborate with
others. Finally, they may be open to the ideas and opinions of others, even if these differ
greatly from their own.
9.2 Language of Learning and Teaching (LoLT)
9.2.1 What is LoLT?
We have 11 official languages in South Africa at present, and may soon have 12 once SASL
has been adopted into the Constitution. This has an impact on how education takes place in
our classrooms. Many children attend school in their mother-tongue during their foundation
phase and then switch to English from grade 4 onwards. To these learners, English is their
second language (ESL). Some parents choose to send their children to English schools from
their first day of schooling. This means that these learners need to learn how to switch to
English as their language of instruction before further education can take place (Spaull,
2013)
Studies have proven that when learners are taught in their mother-tongue during the first 3
years of schooling, these learners’ grasp of English tends to be better and this leads to
better learning overall in the intermediate and later phases. The consensus is that when
learners master the basic rules and structures of their mother-tongue, they better understand
the rules and structures of another language, such as English.
The department of basic education put together a Manual for Teaching English Across the
Curriculum (2013) that explains why the focus should be on getting teachers to understand
the importance of using English within all subjects. This manual explains the strategy for
Teaching English Across the Curriculum (EAC) and aims to assist educators in doing this.
The goal is to improve the teaching of English as a subject as well as English as a Language
of Learning and Teaching (LoLT). For learners to master content, they need to understand
the knowledge involved as well as the language in which the subject is being taught, in other
words, the LoLT. If the understanding of the LoLT is strengthened, then learners will decode
the content knowledge faster and this will improve their academic performance(Department
of Basic Education, 2013).
Why is this matter included in a module for Inclusive Education? If most of the learners in
South Africa are being taught in a language that is not their mother-tongue, it means that the
educators need to keep this in mind when teaching content. If the learners do not
understand the meaning of words or concepts, they cannot understand the content we are
trying to teach. If they don’t understand what is being said, how can they learn?
9.2.2 Assessing the Needs and Creating a Support Plan for LoLT
Barriers
To assess the needs of learners who struggle with English as their LoLT, you need to
determine what they can and cannot do. Make use of tests from lower grades and see how
well the learner understands the work. If need be, go down 2 or even 3 grades. Once you
have established the level that the learner can comprehend, you can now create a support
plan on how to bridge the gap between where the learner currently is and where the learner
should be.
Here are some ways in which you can support learners in your class whose home language
or mother-tongue is not English:
1. Make things visual. Write instructions on the board. Do not rely on learners
understanding instructions simply by listening to you.
2. Model the steps that learners are supposed to follow. By showing the learners what to
do, you will eliminate a lot of repetition and learners will feel more assured of their ability to
do what is required.
3. Make use of group work. When learners are in smaller groups, they will be more
comfortable in their attempts to communicate in English. They also get the opportunity to
develop social skills and practise their language skills.
4. Make use of a buddy system. Pair a learner that is struggling with English up with a
learner that has a good grasp of English, but who can also converse with the struggling
learner in his/her mother-tongue.
5. Teach vocabulary in context. Do not just give learners a list of random words to learn.
Make use of themes such as “My house” and build vocabulary around the themes.
6. Use basic language and an easy tempo. When learners feel overwhelmed by certain
words, there are often synonyms that could have been used that would have been easier to
understand, so try to rather use words that most of the learners will understand. The speed
at which you talk can also contribute to the feeling of being overwhelmed. Do not talk so
slow that the other learners get bored or frustrated, but try to keep a steady tempo for most
of the time.
7. Use non-verbal communication. Most teachers ‘talk’ with their hands and this is actually
helpful for learners that might not understand every word you are saying. Use your facial
expressions to convey emotions and make use of typical bodily gestures to indicate to the
learners what you are trying to explain.
8. Check for understanding. Ask learners to explain to you what you just taught them. This
will help you to determine whether the new content has been understood or not.
9. Create engaging lessons. Have a learner-centred approach and get everyone involved
during the lesson. When learners participate, they tend to learn better.
10. Incorporate technology. If you’re teaching in a school that has access to technology,
make full use of this. Learners enjoy the variety of ways in which technology can help them
to understand new concepts.
11. Make use of code switching. This means that you alternate (switch) between two or
more languages within the same sentence or explanation. As a teacher, if you code-switch,
try to repeat full sentences in both languages if possible. If you know some basic words in
the learner’s home language, make use of these words, as well as the English words
relevant to the topic, when you’re explaining new concepts. Allow for learners to code-switch
though they may use both languages in the same sentence. Repeat the sentence back to
the learner in English, but to not force the child to repeat the sentence as receptive language
is developed before expressive language.
9.3 Dyslexia, Dysgraphia and Dyspraxia
All three of these words start with the prefix ‘dys’, which means that something is impaired or
regarded as difficult. When used in education, these words indicate neurological disorders of
the brain meaning that the brain is required to operate differently in order to achieve the
same outcome. Some are caused by injury, but most are as a result of development
difficulties (Sharman, 2018)
9.3.1 Dyslexia
Learners with dyslexia struggle reading, writing and comprehension. Often they also struggle
with phonemic awareness such as hearing the separate sounds within words (Gavin, 2018;
Think, 2021).
Some characteristics that learners with dyslexia might show include:

● Understanding the relationship between letters and sounds.
● Often misread or misspell common words.
● Regularly forget the instructions given.
● Struggling to apply spelling rules.
● Despite extra lessons or support, reading does not improve.
● Avoiding activities involving formal language usage.
● The results that they achieve do not match the effort put in – working very hard does not
seem to help.
When you look at the typical characteristics, it becomes clear that learners with dyslexia will
struggle with learning if teachers do not make use of a variety of teaching methods.
The following school tasks are difficult for these learners (Sharman, 2018):
● Reading – following in the book as others read, having to re-read the same text a few
times (think of comprehension tests), reading traditional black text on white paper.
● Spelling – cannot remember how the word looks, struggle to ‘hear’ sounds and similar
sounds can cause confusion.
● Writing – struggle to put their ideas into writing, having difficulty with organisation.
● Memory difficulties – they struggle to remember the order of the alphabet; they battle to
put things into sequence.
● Motor control – they struggle with coordination; they have poor handwriting and they
struggle to copy things down.
● Listening – taking notes during lessons is not easy, they are easily distracted by
background noise.
● Spatial – struggle to tell the time and knowing left from right. They get lost easily.
9.3.2 Dysgraphia
Learners with dysgraphia struggle to write correctly. Even though they may have had correct
teaching in letter formation, writing may never become a reflex action and they will still have
to think about each letter as they write it. This can affect the content of their writing as well,
as they will be less inclined to use longer sentences and words, so their answers to
questions may be very limited whereas if they were to tell you the answer, they would
provide a full answer. They also find it hard to understand grammar rules, language patterns
and the formation of sentences or phrases (Gavin, 2018; Sharman, 2018)
Some characteristics that learners with dysgraphia might show (Think, 2021) include:
● Writing letters in reverse, struggling to remember how to form letters
● Struggle to form written sentences according to grammar and punctuation rules as they
often leave out words, use the wrong word order or use the wrong words
● They usually speak better than what they can write, which indicates a large gap between
the ideas they write down and their talking about the same topic.
● They struggle to copy information from the board or textbook
9.3.3 Dyspraxia
Learners with dyspraxia struggle with coordinated movements. Both fine motor and gross
motor skills are usually affected. They also struggle with organisational skills, communication
and concentration (Sharman, 2018).
The following school tasks are difficult for these learners (Sharman, 2018):
● Gross motor skills – struggle with climbing stairs, getting dressed and other coordination
activities such as running, hopping and sports.
● Fine motor skills – handwriting problems with pencil grip, spacing between letters and
words and the formation of letters.
● Organisation – struggle to remember rules and sequences, they find planning difficult.
● Communication – their speech can be immature, meaning they use simple words like
younger learners would; they also get their words mixed up and struggle with
pronunciation.
● Concentration – they can be easily distracted and they have limited focus
Case Study: Dan
Dan (not his real name) is a bright boy who enjoys learning but struggles with extreme
anxiety and dysgraphia, mild dyslexia. He most likely has dyspraxia as well, though this has
not been assessed formally.
In terms of dyslexia, Dan’s love of reading has been nurtured from very young, and reads
voraciously though he also loves to listen to audiobooks. He tends to spell phonetically,
which is a strength as it means that he will still attempt to use more advanced words from his
extensive vocabulary, even if he is not exactly sure of the spelling.
He received intensive occupational therapy from the age of 4 until grade 4. He often has
difficulty in starting tasks and putting his thoughts onto paper, although he has not difficulty
orally.
In grade 5, he moved onto working on a computer at school to relieve some of the anxiety he
feels when trying to write and to encourage him to express himself more in writing. At the
end of grade 6, he had a scribe for a number of his exams and did fantastically as he did not
need to be concerned with writing or spelling.
Fortunately, even though he struggles with writing, he will use it at home and in his art where
it is functional and he does not feel that he will be judged on the product, though he will still
not choose to write large amounts.
Dan is a very creative child and has been encourages to develop

his artistic skills as a form of expression.
A few examples of Dan’s writing have been included here so that
you can see how to his writing is affected by dysgraphia.
Dragon Legend – 2015, age 7
Note the reversed “g”, unusual formation or the “r”, and

uppercase “A” inside a word, as well as the uppercase “L” that is
the same size as a lowercase “e”.
I do not feel normal – 2016, age 8
Note the irregular sizing and use of capitals within the sentence, as well as the unusual letter
formation of the D (Doo) and r (normil), and lack of punctuation. That said, the sentence is
enormously communicatively effective.
While not visible due to the page being cropped, the message was written towards the right
side of the page, starting closer to the middle of the page than the left. Dan has always had
some spatial difficulties. He still struggles to catch a ball, though he did learn to ride a bicycle
at age 8.
Cartoon – 2020 Age 11
By now, Dan has started to express himself through cartoons. He still loves dragons but has
now added Pokémon to the list of interests and has started to write his own cartons.
Note the writing still has a very scratchy look to it. Letters lack neat closure and do not follow
a straight line. While Dan uses a computer for school, he is still encouraged to write
9.4 Assessing the Needs and Creating a Support Plan for

Learners with Dyslexia, Dysgraphia and Dyspraxia
9.4.1 Support for Dyslexia
Helpful strategies are:

● give extra time to practice their reading
● give reading assignments in audio formats such as voice messages
● give the option of using electronic devices with text-to-speech tools, such as Dragon
Naturally Speaking or Read and Write Gold.
● be specific in your instructions – consider
working one-on-one or in a small group
● using a reading program that makes use
of all the senses (multisensory approach)
● focus on phonic skills through the use of
non-word reading, to help children learn
how to combine the sounds
● Use word lists to teach sight words, also
known as high frequency words –
o try speed reading challenges where a child practices a list of words for the week
and times themselves reading it every day to see if they can beat their time. It is
very important that children compete against themselves and not others.
This is a useful way to encourage the learning words that make up
most of the texts that they will be reading, and later include
vocabulary to support content learning e.g. Dolch Word List which
can be accessed at http://www.dolchword.net/dolch-word-list-
frequency-grade.html
● Repeated reading is also a very useful strategy to use to encourage word memory and
reading for meaning
● Nickerson's (2012) Fluency folder is a great free tool that can be downloaded from the
following link. Inside, it has lovely tips for parents (and teachers) on what they should be
listening out for during reading homework, available from
https://www.teacherspayteachers.com/Product/Fluency-Folder-118802
Accommodations that will be beneficial to learners with dyslexia are (Kate Kelly,
2021):
● extra time for reading and writing
● extra time during assessments
● providing learner with notes before the lesson to reduce note-taking during class
● use of audiobooks
● shorten assignments
● simplify answering of tests and worksheets by giving them the option to circle the correct
option
● pictures of directions and schedules
● provide sentence starters so that the learner knows how to start their response
● allowing assessments in different ways such as oral reports and video presentations
● spelling concessions for assessments
9.4.2 Support for Dysgraphia
Helpful strategies are (Mary L. Gavin, 2018):

● give extra time to practice their writing skills
● give permission to record lessons to listen to when doing revision
● access to the teacher’s notes or that of another learner that is diligent and willing to
share
● show learners how to organise their thoughts on paper
● encourage them to edit and proofread their work
● provide examples of completed assignments
● use graph paper or paper with raised lines
● allow learners to choose what they write with – pen or pencil
● encourage correct pencil grasp by using a pencil grip
● recommend occupational therapy to help the learner improve writing skills
● allow electronic devices (assistive technology) equipped with note-taking software such
as speech to text
● give learners a break before they proofread their work so that they can approach it with
‘fresh’ eyes
● provide a checklist for editing – it can include spelling ,grammar, neatness etc.
● Do not make comments based on poor writing or remove marks if you cannot read the
writing, rather ask a child to read their work back to you.
Accommodations that will be beneficial to learners with dysgraphia are:

● extra time for tests that require writing
● sentence starters to show how to start the written answer
● opportunity to respond orally instead of in writing
● break written assignments into steps
● making use of a computer/device in class
● spelling concessions so that spelling doesn’t count during assessments (Kelly, 2021)
9.4.3 Support for Dyspraxia
The Understood Team (2021) suggests the following helpful strategies:

● Encourage the use of an occupational therapist to strengthen gross and fine motor skills.
● Therapy can also help learners to break down basic tasks such as buttoning up a shirt or
tying shoelaces.
● Introduce activities that do not require handwriting.
● Adjust your class’s seating plan – put the learner with dyspraxia near the front so that
he/she has an easier view of the board.
● Allow breaks during lesson time – getting up and stretching will help with concentration.
● When you give directions on how to do a task, demonstrate this in a step by step
manner.
● Help learners with tasks that require fine motor skills such as cutting out a picture.
● Teach the learner physical skills in small steps before they it gets taught to the rest of the
class.
● Repeat activities to help the learners to develop motor pathways (muscle memory of how
to do a task) as this will help them to get better at doing the activity.
● When explaining the steps for a physical action, make use of multisensory instruction to
help the learner to remember the steps.
● Allow learners to record lessons instead of having to take notes.
● Give access to the teacher’s notes or that of another learner that is diligent and willing to
share.
Accommodations that will be beneficial to learners with dyspraxia are (Understood

Team, 2021):
● Allow the use of technology in the class for note taking and for assessments
● Extra time for assessments that involve writing
● Provide alternative ways for answering assessments that do not involve writing, such as
doing the test verbally.
● Provide sentence starters to show the learner how to start writing the answer.
● Provide worksheets, notes and textbooks with larger print.
Finally, it is important to keep in mind that children who experience learning disorders are
usually bright children who may end up experiencing very poor motivation, and may become
disruptive in class as a result. They are aware that their peers, who may not be as bright as
they are, are learning to read and write effectively while they flounder.
In older children it may be necessary to support content-learning while still helping them to
move past the stage of beginner reader. This is one of the reasons that children in the
intermediate phase still require reading practice and development.
REFERENCES
Department of Basic Education. (2013). Manual for Teaching English Across the Curriculum,
2013.
Gavin, M. L. (2018). Dyslexia Factsheet (for Schools) (for Parents). Nemours KidsHealth.
https://kidshealth.org/en/parents/dyslexia-factsheet.html?WT.ac=ctg
Kelly, K. (2021). The difference between dysgraphia and dyslexia.

https://www.understood.org/en/learning-thinking-differences/child-learning-
disabilities/dysgraphia/the-difference-between-dysgraphia-and-dyslexia
Nickerson, A. (2012). Fluency Folder. One Extra Degree.

http://oneextradegreeteaching.com/
Sharman, J. (2018). Understanding Dyslexia, Dyspraxia, Dyscalculia and Dysgraphia.

https://www.innovatemyschool.com/ideas/understanding-dyslexia-dyspraxia-dyscalculia-and-
dysgraphia
Spaull, N. (2013). Language(s) of learning in South Africa. Nic Spaull.

https://nicspaull.com/2013/10/27/languages-of-learning-in-south-africa/
Think. (2021). Learning Disorders (Dyslexia, Dysgraphia & Dyscalculia). Singapore’s Best
Psychologist & Counselling Service. http://think-psych.com/child-psychologist-services/child-
psychologist-counsellor/learning-disorders-dyslexia-dysgraphia-dyscalculia/
Understood Team. (2021). The Difference Between Dyspraxia and Dysgraphia.

https://www.understood.org/en/learning-thinking-differences/child-learning-
disabilities/dysgraphia/difference-between-dysgraphia-dyspraxia

MATHEMATICAL LITERACY BARRIERS
10.1 Mathematical Literacy Barriers
Mathematics is a language on its own, one that many learners cannot “speak”. If a learner
has good memory skills and can cope with abstract reasoning and recognising patterns,
Mathematics is usually an easy language to understand. For those learners who do not have
these skills, Mathematics can be really difficult. These struggling learners need their work to
be scaffolded to help them grasp basic mathematical concepts so that they can learn how to
successfully solve mathematical problems. For learners with a physical disability, writing
maths sums or drawing geometric figures can be very challenging (Thor, 2016) .
Taking into account that Maths is a language, we and our children need to develop
mathematic fluency so that we can speak it effectively. If you, as an educator, would like to
have your learners who become fluent in mathematics, you need to build their math skills. As
with any other language, learners need to practice math in order to become fluent.
However, as Thor (2016) explains, there are a number barriers that may hinder the
development of Mathematical Fluency, and other barriers to learning.
These barriers are:

• Visual perception where children struggle to process the information that they have
seen.
• Language perception, where students have difficulty in processing and thus
understanding what they hear.
• Integration where children may struggle to organise, order and sequence
information, and may have difficulty with abstraction.
• Conceptual understanding where children may have difficulty understanding the
mathematical concepts. Even though they may be able to use a procedure/formula to
solve a problem, they cannot explain why they have done the steps.
• Writing numbers and symbols may be problematic,

which may also extend to arranging them in order the
correct order according to place value.
• Overdependence as children may become over reliant
on teachers for solving problems or deciding on which
strategy to choose.
10.1.1 How do we expect Mathematical skills to develop in

children?
Morin's (n.d.) list of characteristics of children’s mathematical development by age offers

great insight into the construction of both logical problem solving and the ways in which
children learn mathematics from their environment from a young age right up till high school.
While keeping in mind that children’s development varies, it is necessary for you, as a
teacher, to know the expected development in Mathematics in order be able to identify
where is a barrier such as Dyscalculia may be affecting their learning.
Please access the expected stages in mathematical development in

order to familiarise yourself with these by scanning the QR code or
clicking on the link below.
https://www.understood.org/articles/en/math-skills-what-to-expect-at-
different-ages
10.1.2 How can we tell if a child may be experiencing a barrier

to learning Mathematics?
Lee (n.d.) explains the different ways in which children struggle with
Maths focussing on the development of Number Sense. Access the
article and video by scanning the QR Code or clicking on the link.
https://www.understood.org/articles/en/understanding-your-childs-trouble-
with-math
The mathematical barriers that we will focus on in this chapter are Maths Anxiety and
Dyscalculia.
10.2 Maths Anxiety
Not all forms of mathematical barriers come in the form of actual ability to do maths, or as a
learning disorder. The connection of negative emotional experiences or thoughts to Maths
may lead to the development of Maths Anxiety that has been shown to have a negative
effect of mathematical learning (Brown, 2016).
One of the greatest dangers of Maths Anxiety is that it creates a negative spiral:
● The more anxious one feels regarding maths, the worse one performs.
● The worse one performs, the worse more anxious one feels.
Brown (2016) explains that “Psychologists have found there can be a very real physical
response to maths in both adults and children. This includes the release of hormones like
cortisol, which are characteristic of the fight or flight response”.
The Understood Team (n.d.) describe the signs of math anxiety in children as:
● worrying they’ll do poorly on a math test, even though they understand the material and
have studied.
● doing poorly on math tests, even after preparing for them, because anxiety gets in the
way.
● getting through homework fairly easily and answer most problems correctly. But they feel
anxious about doing it.
● making mistakes because they’re so anxious: They may focus too much on some
details, or have trouble focusing on others.
● trying to avoid going to math class when there’s a quiz or test.
● getting good grades on math homework and classwork, but not on tests.
Supporting Children with Maths Anxiety
Blazer (2011) and (Brown, 2016) recommend the following strategies in supporting children
who have maths anxiety:
Children should:
• Practice math every day as repetition increases confidence.
• Use good study techniques as this improves memory and improves concentration.
• Study according to one’s own learning style as this aid in better understanding of
concepts.
• Don’t rely solely on memory, ensure there is good understanding of how to solve
problems than remembering steps.
• Focus on past successes. Success breeds success and focussing on our successful
experiences helps us to develop self confidence in our abilities to achieve.
• Ask for help. Rather than struggling on and experiencing frustration and
demotivation, children should ask for help if they feel unsure. This scaffolding can be
reduced as confidence builds through repetition.
• Practice relaxation techniques. Emotional support is as important as academic
support. For younger learners, a great example is using “Bug Badges” as a physical
action against anxiety. The children make their own bug badge, which is then
laminated and a safety pin was attached to the back. When children are feeling like
something is “bugging” them, they put on their bug badge to help them feel brave.
• The example below was created by a grade 3 boy who used to become
physically ill and begin to vomit in class, even though he was capable of doing
the work. He his badge was a snake as he loves reptiles and his snake would
scare away the bugs. While still experiencing anxiety, he was able to control
his anxiety and opted to take Core Mathematics to grade 12.
Teachers can focus on

• helping children to learn the language of maths.
• Placing more emphasis on formative testing.
• Understanding the level that their children are at.
• Adapting teaching and resources.
• Help teach relaxation techniques.
• Creating a calming, positive and encouraging atmosphere in the classroom.
Further information and strategies on supporting learners who experience Maths Anxiety can
be accessed at the following links:
http://www.mathsinsider.com/conquer-math-anxiety/
https://files.eric.ed.gov/fulltext/ED536509.pdf
https://www.understood.org/articles/en/understanding-your-childs-
trouble-with-math
10.3 Dyscalculia
Dyscalculia is often referred to as Maths Dyslexia, and as that explains, the barriers that
occur are not simply as a result of poor teaching. While poor teaching may result in
Acquired Dyscalculia, true or developmental Dyscalculia occurs when a child has been
exposed to good quality teaching and struggles to develop Mathematical fluency due to a
learning difficulty. Dyscalculia is affects between three and six percent of children, and those
who experience Dyscalculia have a much higher likelihood of having Dyslexia as well (Moll
et al., 2014).
Dyscalculia can be described as the difficulty in the development of numerosity or the how
muchness of a number, and while it shares some characteristics, it may appear differently at
different stages of children’s development.
General characteristics of having Dyscalculia (Gavin, 2018) may include:

● Difficulty learning to count or have a poor memory for numbers
● Trouble writing numbers, finding correct place values, and lining up equations
● Difficulty remembering math facts
● Being unable to follow a sequence of steps
● Struggling to understanding numbers, math symbols, and word problems
● Finding it hard to visualize patterns
● Difficulty in measuring things
● Having an exceptionally slow and difficult time solving math problems
● Avoiding games that require strategies involving math
● Becoming extremely frustrated or anxious with schoolwork related to math
The following signs of Dyscalculia at different levels within schools have been adapted from
Understood.org to apply more accurately to South African schools (Understood Team, n.d.-
b):
Signs of dyscalculia in preschool and grade R
Doesn’t seem to understand

Trouble with learning to
the meaning of counting, Struggles to recognize
count after other children
e.g. doesn’t touch objects to patterns - smallest to largest
have mastered this skill, e.g.
count them or count out 5 or tallest to shortest
skips numbers
objects when asked to.
Struggles to connect a
Doesn’t link the number number to an object – 3 can
symbol to the word - 7 and be groups of things like
the word seven three cookies, three cars, or
three flowers
Signs of dyscalculia in Foundation and Intermediate Phases
Has trouble learning Still uses fingers to Struggles to identify

and recalling basic count instead of math signs like +
math facts, e.g. other ways e.g. like and ‒ and to use
2+4=6 mental maths them the right way
Has a tough time Has trouble with

understanding math place value, often
phrases, like greater putting numbers in
than and less than the wrong column
Signs of dyscalculia in Senior Phase
Struggles with math

Has a tough time
concepts like commutativity
understanding math Has trouble keeping score in
(3 + 5 is the same as 5 + 3)
language and coming up sports games and gym
and inversion (being able to
with a plan to solve a math activities
solve 3 + 26 ‒ 26 without
problem
calculating)
Has a hard time figuring out Avoids situations that

the total cost of things and require understanding
keeping track of money (like numbers, e.g. games that
at the tuckshop) involve maths
Signs of dyscalculia in high school
Has trouble applying math Has trouble measuring things like

Struggles to read charts and graphs concepts to money, e.g. making ingredients in a recipe or liquids in
exact change and figuring out a tip a bottle
Has trouble finding different

approaches to the same math
Lacks confidence in activities that
problem, like adding the length
require understanding speed,
and width of a rectangle and
distance, and directions, and may
doubling the answer to solve for
get lost easily
the perimeter (rather than adding
all the sides)
Children with dyscalculia may experiences, behaviours and attitudes towards Maths:
● Children expect to do poorly on a math test because they don’t understand the material,
even after studying.
● They do poorly on math tests, even after preparing for them, because they don’t
understand the material.
● They spend a long time doing homework and get many of the answers wrong.
● Children try to avoid going to math class, especially when there’s a quiz or test, because
they’re sure they’ll fail.
● Children get poor grades on math homework, classwork, and tests.
Often, when discovering the existence of Dyscalculia, students believe that this is the reason
that they “cannot” do Maths, however, true Dyscalculia is much rarer than one would think.
While a proper dyscalculia diagnosis requires formal testing by a qualified professional, you
can try this online this online test to see the types of criteria involved.
https://www.additudemag.com/self-test-for-dyscalculia-in-adults/
The children’s version is also available if you think that a child may have dyscalculia. If the
test comes back as indicating this as a possibility, it would be a good idea to refer them for a
formal assessment.
https://www.additudemag.com/screener-dyscalculia-symptoms-test-
children/
10.4 Assessing the Needs and Creating a Support Plan for

Learners with Mathematical Literacy Barriers
If you suspect a student has dyscalculia, Gavin (2018) recommends seeking an educational
evaluation to a parent or guardian.
To support learning, teachers can help children with dyscalculia to become aware of their
strengths and weaknesses. Helping students understand their learning styles and using
alternative approaches can enable them to achieve confidence and success in math.
Extra math support in school and tutors outside the classroom can help children with
dyscalculia focus on specific learning difficulties. Reinforcing math facts and practicing new
skills can help make understanding math concepts easier. It must also be remembered the
additional tuition is not always financially possible for many parents and this should not be
the only recommendation that you provide.
Other strategies for inside and outside the classroom include:

● giving extra time to work on math-related assignments.
● Make sure that the instructions that you provide for Maths homework can be
understood by parents as well. If a child doesn’t understand what to do, the parent
may reinforce their belief that it is too hard if they also cannot understand what to do.
● using graph paper for students who have difficulty organizing problems on paper.
● planning and organizing students' approach to math problems. Have a set plan of
attack when facing a problem.
● using estimating as a way to approach solving math problems.
● using objects and visuals to help solve problems – when abstract problems become
too much, draw a picture or use concrete objects.
● starting with concrete examples before moving to harder, more abstract concepts.
And if the abstract is too much of a jump, move back a step to the concrete again.
Simple number snakes made from a shoe-lace strung with chunky beads may be
enough to provide concrete support without the embarrassment of counting on one’s
fingers.
● explaining math concepts and terms clearly and encouraging students to ask
questions. Provide charts or word walls with mathematical vocabulary and definitions.
● providing a quiet place to work with few distractions.
● using a calculator to work out answers rather than struggling and becoming
demotivated. Using a calculator is still a worthy skill to know!
As with all learning disorders, Dyscalculia has many forms and ranges in severity. Should a
learner be diagnosed with Dyscalculia, they should still be encouraged and supported to
develop some degree of mathematical fluency. However, it should be noted that learners
with Dyscalculia may be allowed to take and alternative subject in the FET phase rather than
Core Mathematics or Maths Literacy, e.g. Hotel Keeping or History which do not require the
use of calculations.
For this exception to be made, it must be shown that they have received a formal
Dyscalculia assessment, usually carried out by a psychologist, and a history to show that
they have also had interventions put in place to assist in the development of Mathematical
skills. This assessment should be done at the latest in grade 9 before subject choices need
to be made.
If you suspect that a child may have any type of barrier to learning, please tell the parents or
guardians to make copies of all assessments and reports that may show that a child has
experienced this difficulty as these form the basis of the history and motivation for this
concession. Please advise them to never hand over the original reports but to rather provide
schools with copies.
Arm yourself with some facts and dispel a number of myths:
https://www.understood.org/articles/en/7-common-myths-about-
dyscalculia
Other websites that you may find useful on this topic include:
https://www.understood.org/articles/en/4-ways-dyscalculia-can-affect-social-skills
http://think-psych.com/child-psychologist-services/child-psychologist-
counsellor/learning-disorders-dyslexia-dysgraphia-dyscalculia/
https://www.innovatemyschool.com/ideas/understanding-dyslexia-dyspraxia-
dyscalculia-and-dysgraphia
REFERENCES
Blazer, C. (2011). Strategies for Reducing Maths Anxiety. Miami Dade County Public
Schools Informaiton Capsule, 1102(September).
https://files.eric.ed.gov/fulltext/ED536509.pdf
Brown, C. (2016). Teaching maths – what does the evidence say actually works? The
Conversation. http://theconversation.com/teaching-maths-what-does-the-evidence-say-
actually-works-64976
Gavin, M. L. (2018). Dyscalculia Factsheet. Nemours KidsHealth.

https://kidshealth.org/en/parents/dyscalculia-factsheet.html?WT.ac=ctg
Lee, A. M. I. (n.d.). Understanding why kids struggle with math. Retrieved 1 July 2021, from
https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/math-
issues/understanding-your-childs-trouble-with-math
Moll, K., Kunze, S., Neuhoff, N., Bruder, J., & Schulte-Körne, G. (2014). Numerical learning
disability: Dyscalculia linked to difficulties in reading and spelling. ScienceDaily.
https://www.sciencedaily.com/releases/2014/07/140730093842.htm
Morin, A. (n.d.). Math skills at different ages [Understood.org]. Retrieved 1 July 2021, from
https://www.understood.org/en/learning-thinking-differences/signs-symptoms/age-by-age-
learning-skills/math-skills-what-to-expect-at-different-ages
Thor, V. (2016). Math Learning & Barriers. https://www.slideshare.net/vthorvthor/math-

learning-barriers
Understood Team. (n.d.-a). Math Anxiety vs. Dyscalculia in Kids: Comparing the Signs.
Retrieved 1 July 2021, from https://www.understood.org/en/learning-thinking-
differences/child-learning-disabilities/dyscalculia/math-anxiety-vs-dyscalculia-comparing-the-
signs
Understood Team. (n.d.-b). Signs of dyscalculia at different ages. Retrieved 1 July 2021,
from https://www.understood.org/en/learning-thinking-differences/signs-symptoms/could-
your-child-have/signs-of-dyscalculia-in-children

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Inclusive Education

CHAPTER 1: Addressing Barriers to Learning using ADHD as an Example............................7

1.1 Environmental and Attitudinal Barriers: ....................................................................... 7

1.2 Individual Barriers:....................................................................................................... 8

CHAPTER 2: Support Strategies .......................................................................................11

2.1 How to Support Learners............................................................................................ 11

2.2 What is Curriculum Differentiation? ........................................................................... 12

2.3 Differentiating Assessment ........................................................................................ 13

2.4 Concessions ............................................................................................................... 15

3.1 Creating a Support Plan.............................................................................................. 17

3.2 How to Create a Support Plan..................................................................................... 19

CHAPTER 4: SUPPORTING Learners with Physical Barriers to Learning .............................31

4.1 Physical impairments ................................................................................................. 31

4.2 Challenges for learners with Physical Barriers ............................................................. 32

4.3 Examples and General Areas of Support ..................................................................... 34

4.4 Assistive Devices ........................................................................................................ 48

4.5 Augmentative and Alternative Communication (AAC) ................................................. 54

© The Independent Institute of Education (Pty) Ltd 2021 Page 2 of 170

CHAPTER 5: Supporting Learners with Neurological Barriers to Learning..........................58

5.1 Neurological Impairments .......................................................................................... 58

5.2 ADHD ........................................................................................................................ 61

5.3 Tourette’s Syndrome.................................................................................................. 63

5.4 Autism Spectrum Disorder ......................................................................................... 65

5.5 Epilepsy ..................................................................................................................... 78

CHAPTER 6: Supporting Learners with Intellectual Barriers to Learning ............................91

6.1 Definition of Intellectual Impairments ........................................................................ 91

6.2 Signs of Intellectual Impairments ............................................................................... 91

6.4 Advice for Parents and/or Caregivers ......................................................................... 93

6.5 Learning Impairments vs. Intellectual Impairments ..................................................... 94

6.6 Examples of Intellectual Impairments ......................................................................... 95

6.7 Support Plan for Learners with Intellectual Impairments ............................................. 98

6.8 Giftedness ............................................................................................................... 100

© The Independent Institute of Education (Pty) Ltd 2021 Page 3 of 170

6.8.3 Characteristics of Giftedness .......................................................................................................101

CHAPTER 7: Supporting Learners with Visual Barriers to Learning .................................. 106

7.1 Visual Impairments .................................................................................................. 106

7.3 Needs of Learners with Visual Impairments .............................................................. 120

CHAPTER 8: Supporting Learners with Hearing Barriers to Learning ............................... 125

8.1 Hearing Impairments ............................................................................................... 125

8.2 The Impact of Unaddressed Hearing Loss .................................................................. 126

8.3 Characteristics of Learners with Hearing Impairments ............................................... 127

8.5 Needs of Learners with Deafness .............................................................................. 131

CHAPTER 9: Supporting Learners with Literacy Barriers ................................................. 137

© The Independent Institute of Education (Pty) Ltd 2021 Page 4 of 170

9.1 Literacy Barriers ....................................................................................................... 137

9.2 Language of Learning and Teaching (LoLT) ................................................................ 138

9.3 Dyslexia, Dysgraphia and Dyspraxia .......................................................................... 140

10.1 Mathematical Literacy Barriers ................................................................................. 151

10.2 Maths Anxiety ......................................................................................................... 153

10.3 Dyscalculia ............................................................................................................... 155

© The Independent Institute of Education (Pty) Ltd 2021 Page 5 of 170

© The Independent Institute of Education (Pty) Ltd 2021 Page 6 of 170

CHAPTER 1: ADDRESSING BARRIERS TO

In the previous module, barriers were considered in terms of being intrinsic or

1.1 Environmental and Attitudinal Barriers:

• Limited or no access to early intervention programmes

© The Independent Institute of Education (Pty) Ltd 2021 Page 7 of 170

1.2 Individual Barriers:

© The Independent Institute of Education (Pty) Ltd 2021 Page 8 of 170