Multi-sensory Impairments Affecting Children's Development - Essay Example

?Assignment Self Assessment (Brief review of my work) The aim of my professional practice is to become well versed in terms of how to support pupils with multi-sensory impairments. My initial concern regarding two particular pupils was that due to cognitive, visual, and physical impairment, they had restricted opportunities to learn and develop. I felt it was crucial that I develop strategies that help them to connect with the world. My main aim was to enable them to experience the world around, and motivate them to move on. Overall, I was determined to incorporate strategies to overcome difficulties in accessing world around them. Introduction ‘A deaf-blind child is not a deaf child who cannot see or a blind child who cannot hear; the problem is not an additive one of deafness plus blindness. Nor is it solely one of communication or perception. It encompasses all these things and more. The deaf-blind are multisensory deprived; they are unable to utilize their distance senses of vision and hearing to receive non-distorted information.’ (McInnes & Treffery, 2001:2) The deafblind, like a multi-sensory impaired child, lacks the capability to use his/her senses to receive and process information. This is due to the limited access to information received through damaged senses. The deafblind children face a complexity of issues such as failure to communicate effectively in their social environment and interpreting events. This often results to restriction of the affected individuals in accessing and acquiring important information, as well as hampering their development (Chen, 1993, 1996 & 1999; Chen & Dote-Kwan, 1998; Fraiberg, 1977; McInners, 1999; McInners & Treffery, 2001; Mednick, 2004; Murdoch, 1994; Orelove et al., 2004; Wasserman et al., 1985). In this assignment, I will explain the complexity of needs that multi-sensory impaired children experience, and how this affects their development, knowledge, and understanding of the world around them. I will also seek to explore possible strategies that could be implemented to gradually extend their worlds, based on my observations of two particular pupils in my school. This assignment is divided into the following three sections. Firstly, I will attempt to define multi-sensory impairment and thoroughly explore its direct impact on learning on a day-to-day basis. Secondly, I will outline the abilities of two particular pupils in order to gain an insight into their learning. Finally, I will discuss various strategies, which would enable the pupils to access and improve their understanding and knowledge of the world, including a comprehensive reasoning behind the choice made and its effectiveness in practice. My role in relation to this project chiefly concerned observing and working with pupils. It was important to collaborate with teachers and support staff, as they could provide additional knowledge and experience of the children. In addition, I received a lot of support from my colleagues in this project. My objective was to find was of improving learning opportunities for pupils. Therefore, it was crucial to facilitate various strategies to increase pupils’ awareness, understanding, and knowledge of the world around them. Meaning and definition of multi-sensory impairment Children with multi–sensory impairment have historically been referred to as “deafblind”. Indeed, some people still refer to them as deafblind (Best, 1983; Brown, 1997; Brown & Bates, 2011; Collins, et al., 1991; Miles & Riggio, 2011; SENSE, 2011). In my opinion, being deafblind is different from being multi-sensory impaired. Children with multi-sensory impairment have more complex needs than deafblind. When it comes to cognition, it is even more difficult to determine their intellectual abilities and capabilities (DfE, 2011; DfH, 2011; Murdoch 1992; Pallant, 2011). According to available literature, the task of recognizing and identifying the needs of multi-sensory impaired children with regard to learning and educational needs is one of the key barriers faced by educators and researchers alike. Murdoch (1992:189) sated that, ‘there is little information availed on the global developmental patterns of children with multi-sensory impairment.’ Fox (1983:90) stressed that, ‘developmental milestones for children with multi-sensory impairment are irrelevant because their developmental route may be different (…) to their normal peers.’ This is because the presence of multi-sensory impairments significantly affects deafblind children’s ability to understand the environment in the same manner as the normal children. Since vision, auditor, and physical skills are primary requirements in early developmental learning activities such as exploring, organizing, and interpreting information, lack of such skills renders an individual highly incompetent to perform such routine tasks (Alsop et al., 2002; Freeman, 1985; Huebner et al., 1995; Murdoch, 1997 & 2000; Myklebust, 1960; Preisler, 1997; White, 1991; Wood, 1998). Such impairments further delay the developmental process, and affect other crucial skills encountered in a developmental stage such as cognitive skills, physical and emotional skills, as well as neurological development (Day, 1997). Such lack of development further adds to the everyday struggle of children to effectively communicate and interact with those around them. The inability to interpret and understand their social environment significantly affects their ability to interact with the world in general (Alsop, 1993; Brown at al., 1998; Mamer & Alsop, 2002; APSEA, 2011; Chen & Haney, 1995; Chen, 1997; Hicks, 1996; Ware, 2003). For the purpose of this study, the definition provided by Stuart Aitken, will be used. According to Aitken (2000:11), the term multi-sensory impairment refers to a "congenital or early onset visual impairment plus additional disabilities, for example severe learning, communication and physical disabilities or congenital or early onset hearing impairment plus additional disabilities, for example, severe learning and physical disabilities.” This is because it offers a clear description of the complexities inherent in such impairment. My observation “Our pupils’ experience of the world may be very different (…). They may have limited awareness of the world around them because of sensory impairment or may be limited in their ability to explore what they can see, touch or hear because of restricted physical movement. Their world may be (…) difficult for them to grasp”. (Pease, 2011:4) I agree with Laura Pease that sensory impairment poses unique challenges to children. The visual and auditory impairment, along with various other learning and developmental setbacks, such as failure to effectively communicate and interact with those around them, affect their day-to-day learning. Hence, I believe it was crucial that I provided strategies for my pupils to experience and understand the world around them. Illustrations of pupils recently worked with Child Age Description of the problems faced Y 4 years frequent seizures, infantile spasm, abnormal visual behaviour and significant delays in motor, social, communication and language development Z 10 years delayed developmental issues, cerebral palsy, hearing loss, visual impairment Both children have been following the Pre-Formal Curriculum, which addresses the needs of pupils working at developmental levels well below the National Curriculum standards. Pupil Y has been working at P-level 1(ii), which implied that he was generally functioning at a very early developmental level. In this case, it means he has shown emerging awareness of environment - certain people, events or objects (Appendix 3 & 9). Recent results in the National Curriculum Assessment indicate that Pupil Z achieved P-Level 1(ii), which implies that he was functioning at an early developmental level. This means that he has responded to familiar people, events, and objects offered to him, and he has been proactive in his interactions, for instance, communicating his preference (Appendix 4 & 10). ‘Before arranging a specific environment, it is necessary to observe what the child is able to do (…)’. (Neilsen, 1997:65) From my observations of Pupils Y and Z, it is evident that there were consistencies between comments made in the statement, multidisciplinary reports, and what I was experiencing when observing them. For example, much of Pupil Y’s communication was unintentional (due to his frequent seizures and spasm), and so an adult had to watch him closely and interpret his change in breathing, eye movements, and facial expressions. The class staff has reported that, if he is well, he is able to communicate his needs and respond to familiar adults (dad and mum) through facial expression, body movements and the occasional vocalisation (Appendix, 1 & 9). My observation of Pupil Z has confirmed that he communicates his likes and dislikes to objects and activities by reaching out, laughing, smiling, or crying, becoming stiff or agitated (Appendix 6 & 10). In terms of mobility, both pupils do not have independent mobility; they are fully dependent on others for all care and mobility, and they require special sittings and adult-height level support to access class activities. The documentation in pupils’ files indicates that they have little control over their fine motor skills, due to the nature of their neurological difficulties (e.g. frequent spasm), which make it difficult for them to control movements (Appendix 7 & 8). My observations on pupils have confirmed that they have little control over their fine motor skills. Although it will take them a while to use hands, they will attempt to use them to explore or activate equipment (Appendix 9 &10). Implications of the study Based on my observations of Pupils Y and Z, it can be stated that, learning styles and progress of both the students were starkly similar with regard to their functioning at the early developmental stage. Both pupils had rising awareness of the environment around them, as well as people, events, and objects. Based on my findings, I have drawn the following intervention plan for pupils. Intervention plan ‘A (…) child will have difficulties developing accurate ideas about the world unless [s]he has at least one trusting, significant, meaningful relationship to serve as a centre from which to explore the world in gradually widening circles.’ (Nafstad & Rodbroe, 1999:7) I believed that early emphasis on security and stability, both in terms of social (sensitive and enabling staff) and physical environment (e.g. consist and well-cued routines), is essential in establishing behaviours in the multi-sensory impaired child. Barrage (1992:33) noted that, ‘establishing trust and security (…) may supply a framework from which the infant organises responses into a cognitive map of self in relation to someone else and knowledge that there is a larger environment.’ Barbara Miles, Debora Chen and Jan van Dijk advocate that, those children require a high degree of consistency, trust, and mastering communication skills before they can interact with multiple communication partners. Hence, providing one-to-one support from a variety of staff members may not work with these children because the number of people working with them creates a lot of novelty and confusion (Klein et al., 2001; Miles, 2011; Van Dijk, 1986 & 2001). This notion of ‘missed opportunities for communication’ is also supported by Nind and Hewett (2001:89) who argue that, ‘a person may have more communication abilities then we realise but we fail to see their signals among many uncontrolled movements.’ Liz Hodges (2000) emphasised that, ‘only one member of staff may carry out key tasks with a child’, gradually widening circle of people when a child feels secure and becomes confidante communicator (Hodges, 2000:172). I feel it is important to provide Pupil Y and Z with many opportunities each day, including activities involving personal interaction and close physical contact (e.g. offering massage) with a familiar member of staff in order to feel secure and develop their interaction and communication skills. As Laura Pease (2000) stated, ‘one of the most effective ways of establishing contact with (…) children and so encouraging a communicative response is to share activities with high levels of physical contact and pleasant sensations’ (Pease, 2000:47). Researches and practitioners working with children with multi-sensory impairment have also identified the importance of routine in the early stages of child’s development (McInners, 1999; McInners & Treffery, 2001; Pease, 2000; Chen, 1993; Barbara Miles, 2011, Miles & Riggio, 2011, etc). Hodges (2003:76) stresses that, ‘sensory impair children (…) must have familiar routines which are repeated daily until the child understands them and begins to isolate significant features.’ She further explains that using consistent routines (same place, time, and equipment) will help a child to recognise activities. Pease (2000) stresses that even ‘medically fragile’ child­­ must be involved in the process of an activity from the beginning to the end (Pears, 2000:51). From my observation of Pupils Y and Z, it is evident that medical difficulties (e.g. frequent spasms, seizures, etc.) enhance their ability to participate in activities. Hence, I feel it is important to provide Pupils Y and Z with a number of short repetitive patterns within each activity/routine, as well as well-cued routines (e.g. simple speech, sounds, smell, body signs, object cues, etc.) according to their sensory abilities, which will orientate them in the activity. Synder-McLean & McLean (1987:221) emphasize that, ‘a routine should work as a vehicle’ not only ‘for facilitating communication’ but ‘engaging interest and participation.’ Nind and Hewett (2001:75) further stress that, ‘it is often your job to win attention.’ I agree that it is down to well skilled adult, who is able to carefully observe a child at all times, to give knowledge of the specific child's response capabilities. Moreover, reinforcing preferences is crucial in facilitating more optimal arousal and shared attention. It is clear from my very first experiences of observing Pupils Y and Z that they have very short attention spam and need specific support to help them develop their attention skills, such as, intensive interaction approach. ‘Opportunities for experimental learning are crucial in order for child (…) to learn concept about the world around them’. (Miles & Riggio, 2011:33) I believed that, developing concept by providing great deal of reinforcement of objects is essential. Various professional approaches and strategies have been developed over time, with regard to imparting training and education to children with multi-sensory impairments through the use of touch. According to Barbara Miles (2011), Lillie Nielsen (1994), Mike McLinden and Stephen McCall (2002), learning and building concept about their surrounding are possible if children can discover, experiment, and explore a wider range of materials and objects. This is in addition to having sufficient time to explore and repeat an action as many times as necessary, having the opportunity to compare their experience, as well as somebody to share their interests. Nielsen (1991, 1996, 1997, and 2003) developed several pieces of equipment to provide children with opportunities to develop their tactile skills. One useful tool to start with is the resonance board in which both partners take turns to communicate. Another useful tool is the Little Room, which gives Pupils Y and Z the opportunity to experience different objects without adults interpreting that experience for them (Nielsen, 1991, 1997 & 2003). I believe that use of such equipments will help them in developing their tactile play skills, maximizing their residual hearing and sight, developing and improving their communication skills, helping them to interact with others effectively, and increasing their awareness, understanding and knowledge of the world around them. Conclusion This essay began with an overview of the fundamental concept of study (for instance, multisensory impairment), and proceeded towards a comprehensive discussion of various crucial aspects such as the meaning and definitions of key terms. Other areas discussed include the impact of multi-sensory impairment in children on their knowledge and understanding of the world around them; a brief discussion of personal observations by way of an exploratory study; and finally, conclusion with various strategies, which can be effectively incorporated by educators to enable such children to learn in a better and effective manner. On the basis of the study of literature on the subject in hand, as well as personal observations, it can be clearly stated that, children with multi-sensory impairments have highly complex needs and experiences, owing to various physical and cognitive developmental issues they face. Such complexities result in delayed responses in children with regard to learning, hence, effective and systematic strategies must be developed and incorporated within classrooms to enable them to learn and adapt to the world around them. Although most of such children may need adult support for executing their daily tasks, there are various alternatives available, which help in creating a sensory environment, which can be used to increase self reliance and introduce them to new objects that enrich their experiences. Such intervention strategies go a long way in developing their senses and improving their knowledge, ultimately helping them to communicate and interact in their social environment. My observation confirmed most of the information I found through interviewing the class staff. In the short term, I was able to highlight key strategies to use with Pupils Y and Z to help them connect with the environment. Overall, I feel the issues, which arose from this assignment need further investigation. Bibliography Aitken, S, ‘Understanding Deafblindness’ in Aikten, S, M Buultjens, C Clarke, J Eyre & L Pease (ed.), Teaching children who are deafblind: Contact, communication and learning, David Fulton, London, 2000. 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