Targeted +: Physical and Sensory

The CYP who has an audiological diagnosis of permanent:

• Moderate/ Severe/ or Profound bilateral sensorineural hearing loss.

They are prescribed hearing aids or wear auditory implants (e.g., cochlear implants).

Targeted support is required from the HI Service.

Speech clarity may be affected. These difficulties may impact on literacy, phonic skills, and numeracy.

Text-based comprehension and inferential skills may be delayed. 

Some Deaf CYP may be bilingual because their first language at home with Deaf parents/ carers is BSL and they can communicate using spoken English. 

The CYP may:

• have language delay and some gaps in vocabulary and find it hard to keep pace with the quantity of new topic-based vocabulary.
• find it difficult to listen and attend if there is background noise, especially in group situations.
• seem more dependent on cues from others in the class before engaging in an activity.
• experience auditory fatigue and appear to lack concentration.
• have difficulties understanding and using language for problem solving and may find it hard to ask for help or to seek clarification.
• find it difficult to understand and contribute to group discussions.
• have difficulties taking part in social situations and following conversations, e.g., during breaks and lunch time.
• be affected by issues of ‘being different’ which can impact on their social and emotional wellbeing and self-esteem.
• need to follow an intensive listening and language programme in a quiet environment, to develop speech and language.
• experience difficulties benefiting from incidental learning.
• experience difficulties accessing the spoken and written language used within the classroom, especially as the curriculum becomes more demanding/ advanced.
• require the provision of additional specialist equipment, such as assistive listening devices (radio-aid systems) to support clearer access to the teacher/ speaker’s voice within learning situations.
• requires provision of some additional to and different from learning interventions (e.g., to support pre/ post teaching of vocabulary/ language linked to the curriculum, to support reading development (e.g., additional opportunities to hear and say the phonics sounds to support decoding the printed text and to read 1:1 to answer questions about the text). 
• need to be provided with opportunities to work in a quieter space to support communication and learning with others during the school day (e.g., a quieter space or room to support group work learning with peers or the delivery of 1:1/ small group interventions).

The CYP:

• requires exam access arrangements to be made by the school. This could include adjustments such as: the provision of additional time as part of their usual way of working; sitting the exam in a quieter room 1:1/ with a small group; access to a live speaker (e.g. for a Spanish GCSE exam); the ability to listen to their own copy of the audio-recording to stream the content more clearly directly to their hearing aids (e.g. connect the radio-aid transmitter directly to a laptop).  
• receives support from other professionals with a specialism in HI, such as the NHS’ Speech and Language Therapist and the Auditory Implant Centre’s QToD. 
• requires the provision of adaptations to access audio and video content (e.g., subtitles to be displayed, provision of a transcript, a summary of the key points). 

All the above difficulties will impact upon the CYP’s full access to and understanding of the curriculum, as well as information about the world around them.

The CYP has a diagnosed visual impairment. These will typically align to the moderate to profound visual loss criterion as provided by NatSIP. They are likely to be registered as Sight Impaired (partially sighted) or Severely Sight Impaired (blind). 

The CYP will have access to a QTVI from the Vision Impairment Service who will provide and support with the appropriate recommendations including access to a specialist Habilitation Officer when required and specialist teaching from the Vision Impairment Service based on the Specialist Curriculum Framework for CYP with Vision Impairment. They will typically visit three to eight times a year. 

The CYP may:

• have mobility and orientation skills that are not in line with their age and stage.
• need exam access support from Vision Impairment Service which should reflect the CYP’s usual way of working.
• have difficulties with perceiving depth, position, distance and speed in a variety of different environments.
• be affected by lighting levels (glare, low lighting levels), inside, outside and when moving between areas of different lighting.
• struggle to navigate in busy and/or unfamiliar environments.
• need additional support at points of transition.
• struggle to initiate social interactions, develop friendships and/or understand social situations.
• not have secure and accurate understanding of concepts outside of their visual experience due to reduced opportunities for incidental learning.
• have difficulty linking language to meaning e.g., concept development.
• take additional time to develop their gross and fine motor skills in line with their age and stage.
• have difficulties with focusing tracking, scanning, and vision-motor integration.
• have difficulty in expressing their own emotions and understanding the emotions of others.
• struggle to understand the impact of their vision impairment.
• have a deteriorating vision diagnosis.
• the CYP’s self-advocacy skills may not be in line with their age and stage.
• need additional time and support to access pre-learning and post-learning to identify and confirm misconceptions and to be introduced to new resources.
• suffer from visual fatigue and require visual rest breaks.
• need access to a specialist Habilitation Officer through the Vision Impairment Service to
• Learn specialist mobility techniques such as sighted guide, trailing, routes mapping, long- and/or symbol cane use in order move safely within their environment.
• Learn how to complete elements of self-care/daily living tasks with a level of independence in line with their age and stage.
• be learning to use alternative methods to access and record their learning e.g., Braille, touch typing, magnification, screen reader.
• struggle to self-advocate in line with their age and stage.Have difficulties with perceiving depth, position, distance and speed in a variety of different environments. 

Secondary

The CYP may:

• need additional support at points of transition: in-year, between settings and when transferring to Further/Higher Education.
• need a package of support for preparation for adulthood, including work experience and employment.

The CYP has very restricted movement and hoisting/position changes may be required regularly during the day.

They may have minimal fine motor skills and/or have restricted purposeful hand movement.

The CYP needs access to alternative means of recording work, ICT, developing keyboard skills/touch typing, voice activated speech VOCA (communication aid).

Their physical condition may be variable from day to day, depending on a number of factors, e.g., weather and temperature, muscular pain, sleep, fatigue and/or medication.

Their speech production may be affected by breath control or impaired for physical reasons and finds it difficult to make themselves understood or finds it too tiring to repeat themselves. 

The CYP may:

• have a range of learning difficulties which are directly related to neurological impairment e.g., processing, working memory, attentional difficulties.
• show regression of previously acquired skills, e.g., for CYP with a deteriorating condition or childhood dementia.

A personalised medical, self- care and/ emergency evacuation plan may be required.