INFORMATION SHEET

TRAINING: INSTRUCTOR TRAINING CODE: EGED 2101

CO COURSE: DITTE
MODULE: SPECIAL NEEDS EDUCATION Prepared by: AKUMBA PAUL
DETAILS: INTRODUCTION TO SPECIAL NEEDS EDUCATION Date of Execution:
Introduction:

Children need care and protection by virtue of their tender age and development needs. They require proper
nutrition, clothing, shelter, training in life skills, education, time, space and equipment for play. They also
require a place for rest and sleep and need protection from all types of adversaries. If not cared for, children are
vulnerable to serious suffering, developmental deficits and even death. This is because they .lack knowledge,
skills, resources and even physical strength to take care of and protect themselves. Those are the children
usually referred to as having special needs in education. The difficulties may .arise from problems) within the
child or outside the child. An example of a problem within a child it is a disability. An example of a problem
outside; the child is a poor learning environment. Both situations require early childhood care for meaningful
and timely intervention,

Children who differ significantly from the others in terms of physical, mental and socio-emotional aspects of
development, as well as those who, for different reasons, lack reliable care are said to be in need of special
protection. The term children in need of special protection, therefore, refer to children in special needs and
those in difficult circumstances

Definition of Key concepts in Special Needs Education

Concepts describing factors that inhibit learning;
Impairment;
This happens when a bodily or sensory part is lost or damaged either through accident, disease, heredity or
other factors. This leads to loss or weakening of the affected part, For example, if one lost fingers in an
accident, or have in. Injury to the brain or on the nervous system. That affected part may not be able to
function properly. Such loss or damage to part of the body means that a person has impairment.

Disability
This is the loss or reduction of functional ability of an individual resulting from-impairment. This is when
people who have impairment are unable to perform certain tasks in their daily life that most people can do. For
example, a person who lost one or both legs or paralyzed cannot play football, one who lost his/her eyes (s)
cannot see. Deafness, blindness, being crippled and mental retardation are examples of disability.

Handicap;
.A handicap is a disadvantaged or restriction of an activity that result from a disability plus society's attitude
towards the disability. A child who is deaf, for example, cannot detect dangers posed by animals such as dogs
by hearing them bark. Such a child cannot also participate in play that involves the use of sounds. Handicaps
prevent the fulfillment of roles and participation in activities that are appropriate to the age, gender, society and
culture of the individual.
A handicap can be avoided if the society provides help to enable a person with a disability to be independent.
Concepts describing educational provisions or interventions;
Special education

Special needs
The word 'special' refers to something that is not ordinary but is of particular importance. 'Needs' on the
other hand has to do with what is necessary, wanted or required.
Special needs in children, therefore, describe important requirements, necessities or wants. When used
in relation to children with special needs, it refers to the requirements that should be provided with more
than ordinary help if the children are to realize their developmental potential.

Children with special needs

Children with special needs are those who significantly deviate from the average or normal children in
mental, physical, social and emotional characteristics. They are children who require a modification of
school practices or educational services in order to develop their capacities to the maximum. Such
children's performance and abilities differ noticeably from those of their peers in physical,
psychological, social and cognitive aspects of development. Sometimes these exceptional children are
referred to as handicapped children.

Special Education
Is a term used to refer to educational provision which is designed to meet the needs of learners with
special educational needs, either in a special school or unit or in a mainstream (ordinary) school.
Recently, the term Special Education has been replaced with the term "Special Needs Education"
emphasizing! that other learning problems. may call for special adjustments, i.e. recognizing the reality
of special needs in the (regular/normal) classroom, Today Uganda, Universal primary Education(UPE)
encourages all school going age children to learn in schools within their neighborhood irrespective of
their beliefs, Condition, etc. The UPE provision supports the concept of special needs education but not
special education; this was the beginning of transition to Special Needs Education (SNE),

Special Needs Education

Whereas Special Education focused on disability only, it was noted that there can arise other problem in
the classroom that can inhibit learning. This type of education was intended to provide appropriate
modifications in order to meet Special Educational Needs in an individual. It is learner centred, flexible
and adjustable lo individual needs arid abilities. For example, sign language should be used for
communicating with learners who are deaf.
Note: special educational needs are a result of a barrier to learning. These needs may be the result of
under-stimulation, socio-emotional problems or abuse a traumatic experience, impairment or other
conditions that make it difficult for a child to follow the regular curriculum and/or ways of teaching and
learning materials, or medium of communication instruction.

Identification
This term describes the process of gathering relevant information to determine if a child has special
needs (impaired) and if therefore he or she is eligible for special education
Screening
Screening is a procedure in which groups of children are examined or tested in an effort to identify
children who are most likely to have a disability. Identified children are then referred to more intensive
examination and assessment (diagnostic assessment)

Assessment
The term assessment in this context refers to gathering, sifting and weighing information for the purpose
of making decisions based on the assessor’s judgment and conclusion.

Integration
Integration refers to participation of learners with disability in regular. Schools with their non-disabled
peers without necessarily making changes in the curriculum provision or learning environment

Children with learning disabilities

These are children that display a significant discrepancy between their actual performance and their
potential. They may be enthusiastic and strike people as having potential in all areas fail to perform to
expectation in some specific areas.
Learning

Psychological definition:
Learning is a process through which one gain knowledge or skill or behavior or attitude and emotional
responses by studying or from experience through interactions with peer and adults.

Education definition
It traditionally tends to focus on learning as a process by which people acquire skills, knowledge,
understanding and attitudes,

Learning it can also be understood as a set of cultural, social, and institutional process that occurs
throughout an individual’s life (life- long learning). Learning in this sense occurs both within the
education sector (early childhood, schools, tertiary and adult education) but is also a key element in
work place where learning is an integrated activity that takes place both within and between people.
Learning has thus been extended from the individual learner to the learning organization and even to the
learning society, which is a vital concept for the knowledge economy

A person is said not to be the same as before after the learning experience. And individual is born with
the potential to mature and at successive age level, grasp and learn. Through maturation and learning the
growing individual acquires a culture as a process in which an individual is taught (enculturation) and
learns his/her social norms. In this process an individual is modeled to adjust his/her innate biological
characteristics to the prevailing culture practices of the society in which he/she live.

Development
Development describes the growth of human throughout the lifespan from conceptual to birth. It is thus
increase in quality – expansion of cells-emergence of psychological attributes, ideas involving all
aspects of human growth both structure and functioning of the following domains physical, motor,
language, cognitive/intellectual, social, emotional, perception and personality development.
CATEGORIES OF CHILDREN WITH SPECIAL NEEDS
a) Children with cognitive differences
 The gifted and talented
 The mentally challenged
 Children with specific learning difficulties

b) Children with sensory differences

 Children with visual impairment
 Children with hearing impairment
 Children with multiple difficulties (deaf-blind)

c) Children with physical difficulties

 Children with orthopeadic (skeleton) difficulties
 Children with neurological difficulties Cerebral Palsy
 Spina bifida
 Degenerative diseases

d) Children with communication difficulties

 Speech and language difficulties

e) Children with emotional, social and behavioural disorders

 Emotional disturbances
 Social maladjustments

f) Children living under especially difficult circumstances

 Children who are traumatized
 Children from pastoralist communities
 Children who are abused
 Child labourers
 Refugee and displaced children
 Children living and working in the streets (street children)
 Children affected and infected with HIV/AIDS
 Orphaned children living in poverty
 Children with mothers in prison

CHILDREN WITH COGNITIVE DIFFERENCES

Cognitive difficulties are very wide In that they cover many situations of thinking and problem solving.
Cognitive differences, as the term suggests, refers to variations in mental abilities. When used in the
context of special education, the term refers to both extremes of the mental ability continuum, that is,
very high and very low abilities as well as learning difficulties that cannot be explained by physical,
environmental or sensory challenges.
Children with cognitive differences therefore fall into three groups including:

The gifted and talented, the mentally retarded and those with specific learning difficulties
 1. The gifted and talented
These are children who, by virtue of outstanding abilities are capable of high performance and require
Special Educational programmes and/ or services in order to realize their potential
Educators believe that approximately 3 to 5 % of school-age children are gifted. These children have
superior abilities and consistently perform remarkably well in their area of giftedness. Such individuals
are found across gender, culture, ethics, linguistic and disability groups. They achieve or have potential
in any one or more of the following areas:
 General intellectual ability
 Specific academic aptitude
 creative or productive thinking in areas such as art, music and craft
 Visual and performing arts such as drama
 Leadership, for example oratory skill
 Psychomotor ability, including athletics and gymnastics

a)The gifted children

Gifted children may be good in one area like language, mathematics or science or may excel in all
academic areas. They are also widely informed about many things. Their characteristics fall into two
categories:
i) Academic or learning characteristics
 Gifted children read above grade or class level, they have exceptionally high cognitive abilities.
 Have long attention span and good memory for the things they hear or read.
 They have an ability to rapidly acquire, retain and use large amounts of information,
 Relate one idea to another and make sound judgments.
 They are able to reason and think abstractly,
 Acquire information easily and enjoy learning.
 They are also keen and alert observers, who learn rapidly, easily and with less repetition.
 These children usually learn more storytelling, poem or lesson than others, and are able to deal
with facts and their relationships.
 Further, they display high curiosity about many things and constantly ask probing questions in
an attempt to understand causes and reasons for things.
 They also give clear and many times, non-traditional responses to questions. They have
unusually advanced vocabulary for their age or class level, use terms in a more meaningful way
than their peers, and are more mature in the ability to express themselves through various
communication skills.
 In addition, these children spend time beyond the ordinary assignments or schedules on things
that are of interest to them, are original, initiative and independent workers

ii) Social and emotional characteristics

 Gifted children are usually self-confident and exhibits qualities of leadership.
 Socially, they relate well with older classmates, teachers and adults and are sensitive and
empathetic. They display keen sense of humuor or see humuor in situations that others may not
see
 In addition, they are quite concerned with right or wrong, good or bad, and often evaluate and
pass judgment on events, people and things
 Consistently, they strive towards perfection, are self-critical and easily satisfied with ordinary
speed or products.
  They also get bored with routine and sameness.

b)The talented children

These are children who do exceptionally well in music, fine mechanics, dancing, singing, athletics or
sports. These skills may r necessarily matched by academic achievement.
Like Gifted children talented children are usually self-confident and exhibits qualities of leadership

General characteristics /identification of gifted and talented children

Apart from impairments/disabilities discussed above, there are also children referred to as gifted and
talented. These children may show superior abilities compared to their peers of the same age. these
children can identified by some of the following features/behaviors
 The highly motivated and selfdriven children
 Being a head of others in class work and other activities.
 Showing a lot of creativity and always coming up with new ideas.
 Showing leadership abilities.
 Showing special/superior ability in manipulating, materials from the environment in making
unique models.
 Higher reasoning abilities and passing judgment, about people and events.
 Asking no usual questions for their age, which may at that time not have ready answers
 Showing special talents in music and arts.
 Has good power or reasoning, good memory of places and things such as shapes, symbols, of
numbers, objects etc.
 Can talk with adults, more than other children and is able to grasp ideas and do things
independently
 Displays sharp power of observation, wanting to find out things and is always asking questions.
 She or he is able to solve puzzles of some problems and has extensive vocabulary
 Has ability to describe events and situation; in sequential manner and with some reasonable
detail and accuracy
 Is likely to give answers to most questions,

Helping the gifted or talented child

Sometimes the child is looked at as stubborn because she or he is very active, gets bored easily, create
games to occupy him/her self and is restless if not well occupied, therefore;
 Involve the child in everyday tasks.
 Encourage and support any specific talents she or he may have such as drawing painting,
singing, and role-playing.
 Prepare and provide him/her with challenging tasks; that would enable her/him to become more
creative and active.
 Use appropriate methods that include play, discovery and experimentation.
 Prepare activities that may enable him/her to relate with others.
 Encourage him/her to interact with adults,
 Let the child play freely and avoid interrupting him/her too much, The caregiver should
however, encourage him/her to ask questions, if you do not know the answer, help him/her to
look for information from other people or books.
 Read for him/her stories relating to his or her experience that will enrich his/ her imagination.
c) Slow learners
This is another cognitive /learning difficulty. As other children are gifted with exceptionally high
performing levels, others have low performance level
Slow learners are those whose educational achievements do not deviate significantly from their
potential, but they achieve below their age or class level. The poor performance results from their slower
rate in processing information. They take a much longer time to understand concepts than is often
expected.

Identification of children with slow cognitive learning difficulties

Some of the following behaviors may be seen among children with slow cognitive difficulties;
 Being slow at acquiring and developing skills such as speaking, walking
 Being unnecessarily slow in carrying out tasks, .
 Not able to transfer the same activities into different situations.
 Unable to understand what is staid or follow instructions
 Failure to acquire:, understand and use language to express needs.
 Difficulty in remembering experience or things learnt,
 Excessive purposeless movements, in class, home or play field.
 Difficulty in paying attention or focusing on an an activity to its completion.
 Difficulty in judging consequences of their action
 Some children have specific learning difficulties in academic areas. This is a result of a learning
disorder that affects speech as well as written language, reading and spelling called Dyslexia.
The most noticed signs in a child with dyslexia are difficulty in reading and writing. A child has
problems in telling the differences in letters and their correct order. Letters such as b and d,
while m can be confused with w, and s with z. the child may also confuse similar shapes such as
a tree and a flower a square and a rectangle. The child may also show;
 Difficulty in remembering lists of words, numbers or letters of the alphabet, pictures, etc.
 Difficulty in remembering the order of everything such as the days of the week.
 Failure to tell right from left
 Difficulty in learning rhymes.
 Difficulty in basic reading and writing spellings, number concepts, expressing oneself, listening
and comprehending
 This problem may even affect formation and development of number work ideas, and make the
child have poor memory and behave carelessly.

Helping the children with cognitive/learning difficulties

Encourage the child to participate in activities through calling him/her to perform a task. Ask him/her
questions and acknowledge his or her contribution.
Pay more attention to the child to make him/her loved
Encourage him/her to complete the task.
Select a very simple and short activity for the child.
Seek advice from other caregivers, officers in- charge of special needs and parent where possible,
Involve the parent/guardian and discuss the problem with him/her,
Make referrals and advise parents or guardians lo seek further help from experts
You need to accept that the child has a problem but do not label him/her as a dull, slow or stupid learner.
Patiently encourage the child to do things, she or he is good at and allow him/her do things for
him/herself.
Let the child practice saying rhymes aloud together with others. This will enable him/her to hear
rhyming words.
play games that encourage the child to ask questions involving relationship such as under, on etc.
Introduce Idea' which seem to puzzle the child thorough rhymes and songs
Give the child groups of words or pictures or shapes and ask him/her to pick the odd one out
Make him/her play sound games.
Encourage the child to trace words, pictures, letters, and. shapes or molds of letters, objects and shapes
out of clay, sticks, straws, sand paper or plastic

2) FUNCTIONAL ASSESSMENT OF DYSLEXIA

Introduction to Dyslexia
Dyslexia is a specific learning difficulty that originated from a Greek word Dys - meaning difficult with
and lexia meaning words or language.
The World Federation of Neurologists defined dyslexia as:
“A disorder manifested in children who, despite conventional classroom instruction, adequate
intelligence and socio-cultural opportunities, fail to attain the language skills of reading, writing,
spelling commensurate with their intellectual abilities"
Dyslexia is a specific learning difficulty that can hinder a person's ability to read, write, spell, and
sometimes speak.
Dyslexia refers to specific reading difficulties or disability. Literally means difficulties with words read,
spelt, written, pronounced and the association of words and their meanings. Dyslexia does not directly
include difficulties in mathematics except in as far as speech, reading and writing affect the numeracy
skill.

Possible causes of dyslexia

Dyslexia is caused by impairment in the brain's ability to translate images received from the eyes or ears
into understandable language. Thus common causes of dyslexia include:
 Minor brain damage (before or during birth) in the left hemisphere where language and listening
skills are developed and processed.
 Developmental delay in the maturation of the central nervous system.
 Hereditary factors frequently found in families often accompanied by left handedness and history
of learning difficulties,
 Hearing problems at an early age caused by frequent colds and throat ' infections in the first 5
years,
 A combination of hearing problems and hereditary factors,
 Unknown factors.
It is important to note that, in addition to the above, there are other predisposing factors that may
influence the development of children's ability to read and write. For example; teaching approaches,
sizes of classes, influence of other dialects and the learning environment generally.
Characteristics of children with dyslexia
A suspicion on whether an individual may be dyslexic is based on the presence of certain characteristics
in an individual. It is very important to look out for some indicators of any given learning difficulty. The
term characteristics has been used to refer to possible indicators a teacher can observe or find out either
in the course of teaching, informally interacting with' a child or deliberately conducting a functional
assessment exercise. Those indicators have been explained in two levels or categories as indicated
below
a) Some possible characteristics that can be observed before the child is introduced to actual
reading and writing may include the following:-
 Low production of words.
 Limited spoken language.
 Difficulties in understanding especially what others say.
 Attention and concentration difficulties with or without hyperactivity and concentration
difficulties: This is the inability of the child to stay on a task for a given period of time.
 Difficulties with concepts directly related to understanding numbers such as;
a) Concept of relation e.g. Size = big/small, breadth = wide/narrow, weight = Heavy/light,
length = long/short
b) Concept of shapes e.g. circle, square, rectangle, cross, triangle, etc.
c) Concept quantity e.g. full, Half full, three quarter full, Quarter full, More/less;
much/little.
 Difficulty with fitting jigsaw puzzles.
 Perceptual problems- These include visual and auditory discrimination dificulities
 Inability to imitate and interpret gestures, facial expression and body movements.
 Difficulty with visual and auditory perception.
 Confusing shapes e.g. circle, square, rectangle, etc.
 Difficulty in matching colours, shapes, pictures.
 Difficulty in identifying missing parts of the object or picture
 Confused spatial orientation e.g. the child finds difficulty with differen¬tiating right from left, up
from down.
 Much confusion of the left and right
 Difficulty maintaining body balance.
 Difficulty with eye-hand coordination.
 Difficulty with holding a pencil;
 Difficulty with walking on a chalk line.
Note: Left handedness may not necessarily qualify a learner to be dyslexic. Problems for these children
arise for example from infrastructure that do not favour left handedness
b) possible characteristics that can be observed in children with dyslexia who have attained
certain level of literacy may include the following:
 Low production of words
 Inability to imitate and interpret gestures, facial expression and body movements.
 Difficulties in understanding especially what other people say.
 Difficulty with remembering past experiences.
 Attention and concentration difficulties with or without hyperactivity.
 Inclusion of few details when drawing a person or pictures.
 Much confusion of the left and right.
 Child may lose his place on the page or skip a line or two.
 Difficulties with jigsaw puzzles.
 Difficulties with concepts directly related to understanding numbers such as;
 a) Concept of relation e.g. Size = big/small, breadth = wide/narrow, weight = Heavy/light, length =
long/short
b) Concept of shapes e.g. circle, square, rectangle, cross, triangle, etc..
c) Concept quantity e.g. Full, Half-full,three quarter-full Quarter-full, More/less; much/little and
fractions e.g. whole, a half, a quarter, a third etc. •
 Difficulties in decoding letters and words.
 Weak sequential memory skills e.g. Jumbled letter sequences in 3: spellings of words such as
“people” instead of "people", “hungry” instead of "hungry”
 Difficulties in connecting single letters with each other to form words e.g. “Man” as “ma n,
“tree as “tr e e” and "boy" as "b oy".
 Or figures with more than one digit e.g "88" as "8 8" and "35" as "3
 Frequent reversals of letters, words and numerals (static and kinetic reversals i.e reversing letters
when reading for example, "b" as "d" and W as "F or transposition of some or all the letters
within a word such as "was" as "saw" and "girl" as girl" respectively.
 Confused numbers e.g. "6" and "9", "12" and "21", "13" and "31", "14" and "41".
 Minor writing e.g. of letters such as R, P, w, s and t.
 Poor comprehension skill
 Inability to associate words with corresponding letters symbols
 Ignorance of word details e.g "dog" as "boy" or "bag", "bad" as "bud", "bod" or "bed", "picture"
as "piutre".
 Insufficient word attack skills that lead to mere guessing of the words.
 Omission of letters and sound e.g. "head" as "hed", "hurt" as "hut", "rain" as "ran", "tree" as
"tre".
 Auditory perceptual difficulties (e.g. difficulties with identifying sounds within words and
blending sounds into words)
 Misuse of upper and lower case letters e.g. the word "writing" as "wRitlnG" and "brain" as
"bRaiN".
 Difficulties with writing on the line or between two lines or shading within borders.
 Difficulty with holding a pencil or walk on a chalk line. Note: All these signs must not
necessarily be present.

Effects of dyslexia on learning and development

Dyslexia affects information processing i.e. receiving, holding, retrieving, structuring and the speed of
processing information. It therefore has an impact on skills such as reading, writing, using symbols and
carrying out calculations. This affects the individual's full participation in learning and development, for
example:
 Learners with dyslexia experience great problems when more complex language skills are
required such as grammar, understanding reading materials and writing essays,
 Affects self-esteem,
 People with dyslexia can also have problems with spoken language,
 Frustration and suffering arises when a child struggles with steps involved in reading and
comprehension,
 Develops truancy tendencies among learners,
 The learners experience difficulties with phonic awareness, phonic and rapid word recognition,
 Speech or language development is delayed,
  May find it hard to express themselves clearly or fully comprehend what others mean when they
speak,
 May experience a great deal of stress due to poor academic performance and may become
discouraged in continuing in school leading to drop out.
However, as aforementioned, the impact that dyslexia has differs from one person to another and
depends on the severity of the condition. In addition, it is also important to note that dyslexia can
manifest more in one learning aspect than another. E.g. Difficulty with reading (dyslexia), Difficulty
with number (dyscalculia), difficulty with writing (dysgraphia), difficulty with spelling
(dysorthographia), difficulty with speech (dysphonia). If there are severe problems in more than two
areas, the child may be classified as having severe dyslexia.

3. The mentally handicapped/intellectual impairment

Introduction:
Mental handicap involves significant limitation in intellectual functioning and in two or more adaptive
skills such as communication, self-care, social skills, self-direction, health and safety. Children who are
mentally handicapped may face challenges such as poor memory, slow learning rates, attention
problems, difficulty generalizing what they learned and lack of motivation..
Intellectual impairment/mental retardation is more related and more associated with autism, cretinism,
epilepsy, behavioral and emotional disorders.
Intellectual impairment is not an illness and therefore cannot be cured.
|In most cases teachers; parents and community members often confuse learners with intellectual
impairment with those who have mental illnesses. As such, they think that learners with intellectual
impairment are uneducable, mad or possessed by evil spirits.
In, educational settings, learners with intellectual impairment/ mental retardation can be. Educable or .
trainable depending on their priority needs that are achievable after a thorough functional assessment or
screening is done to find what they need most so as to live as acceptable members of the community.

Causes of intellectual impairment / mental retardation

The most common cause of mental or developmental disability is damage to the child's brain. The
damage to the brain may be due to factors relate to the three possible stages of its onset. These include
the prenatal, per natal and post-natal periods.

Prenatal stage (Period between conception and birth)

Factors that may lead to mental retardation at this stage include:
1. Chromosomal abnormalities leading to Down's syndrome, fragile X syndrome and Turner's
syndrome; advanced age of the mother, anaemia, drugs, thyroid problems and exposure to
radiation.
2. Metabolic and nutritional disorders that may lead to phenylketonuria and galactosemia among
other disorders,
3. Maternal Infections such as rubella, syphilis, HIV/AIDs, Rhesus factor incompatibility, and
Toxoplasmosis
4. Environmental conditions like Fatal Alcohol Syndrome (FAS and use of drugs.
5. Unknown influences like those that cause ancephaly, hydroceph and microcephaly.

Peri-natal stage (during delivery).

Mental handicaps occurring during this stage maybe due to such fad as:
1. Gestational Disorders particularly low birth weight and premature birth.
2. Neonatal complications surrounding the birth process including anoxia (oxygen deprivation),
hypoxia (insufficient oxygen), birth trauma (for example excessive pressure on the skull due to
improper use of forceps) and breech presentation (where the baby exits birth canal buttocks first)

Post-natal stage (period after birth).

The child may experience or show problems after delivery. Problems to which a child may be exposed
to after delivery include:
1. Infections and toxins like lead and mercury. Lead poisoning for example, can cause seizures,
brain damage and disorders of the central nervous system. Brain cancer may also result.
Infections that are likely to lead to mental retardation on the other hand are meningitis,
encephalitis, high fever with fits, severe diarrhea and dehydration.
2. Environmental and psycho-social factors, mostly nutritional problems; adverse living conditions,
inadequate health care; accidents; and lack of cognitive stimulation.

1 causes of intellectual impairment

intellectual impairment can occur before, during and after birth as a result of genetic and environmental
factors. These include the following among others:
1. Genetic disorders (abnormal genes inherited from parents), syndrome disorders and
developmental disorders of the brain formation resulting into chromosomal disorders e.g Down
syndrome, fragile X ,etc
2. Malnutrition (for both the mother and the child)
3. Diseases and infections e.g. German measles for the mother, syphilis, gonorrhea, meningitis for
the child etc . ,
4. Intoxication and drug abuse (use of toxic drugs during pregnancy)"
5. Emotional state of the mother
6. Exposure of pregnant mother to powerful radiations such as x-rays
7. Iodine deficiency causes stunted growth and results into intellectual impairment.
8. Complications at birth that may lead to insufficient supply of oxygen or me of forceps
9. Extreme prematurity {failure to grow)
10. Accidents
11. Consequences of seizures and high fever e.g. epilepsy/fits
12. Environmental deprivation
13. Exposure to poisonous substances like lead or mercury may also affect intellectual ability.

Characteristics of learners with Intellectual impairment

Children with intellectual impairment may exhibit the following characteristics.
Language and communication,
 Difficulty with following verbal and non verbal instructions
 Difficulty with receptive and( expressive language.
 Difficulty in language acquisition
 Difficulty in understanding written language

Cognitive processing Skills

 Difficulty with recalling past experiences
  Difficulty with interpreting instructions
 Difficulty with thinking in abstract
 Short attention span
 Hypoactive and hyperactive
 Difficulty with learning social skills Difficulty with solving problems
 limited curiosity ... -..
 Limited analysis skills
 Limited ability to think logically
 Difficulty with retention of knowledge and skills
 Difficulty with retaining and applying knowledge in new situations
 Difficulty with Pre-reading, writing and number skills e.g. (left to right, eye movement,
discrimination of; shapes, color , matching, sorting etc).
Manipulative/ motor functioning
 Difficulty with sitting, walking, crawling, e.t.c.
 Difficulty with buttoning, tying shoe laces, e.t.c.
 Limited ability to explore the environment
 Difficulty in holding writing material
 Difficulty in holding tooth brush, combing, battling, e.t.c
Adaptive behaviour
 Limited self help skills ie. washing, toileting. '-
 Persistence of child like behaviours e.g. speaking style
 Difficulty in understanding social rules
 Difficulty in identifying .his/her property
Social emotional development
 May have low level of interaction
 Social - emotional behaviour
 May have low self-esteem
 May not play with the peers
Perceptual skills
 Difficulty in the use of sensory skills such as seeing, hearing
Effects of Intellectual impairment on learning and development
 Intellectual impairment makes a child lose self-esteem
 The child is unable to make appropriate friends as a result of intellectual .impairment.:
 A child with intellectual impairment may fail to observe rules and procedures in activities hence
left out by friends or teachers which may lead to withdraw and isolation.
 It affects memory hence the learner cannot remember what s/he learnt leading to poor academic
performance.
 The child is unable to reason, think and therefore unable to process information from his/her
environment.
 As result of intellectual impairment the ability of the child to solve day-today problems is
impaired.
 The learner is unable to comprehend what is taught due to impaired intellectual processes
 The learner lacks analysis skills due to the effects of intellectual impairment
  A child develops "more slowly than a. typical child hence delays to acquire language, motor,
social skills and self help skills such as dressing, eating e.t.c
 They have problems in both receptive an expressive language leading to limited social
interaction.
 They may find abstract concepts difficult to grasp or understand and therefore: miss out what is
being taught.
 They may have problems manipulating their environment thus limited knowledge about their
environment.
 They may have problems in reading and writing due to failure to process mental information
thus loss of interest in studies and school dropout.
 They may have very slow academic progress compared to their peers
 May be exposed to child abuse and exploitation by the community or opportunists. .-. ;

CHILDREN WITH SENSORY DIFFERENCES

 Children with visual impairment
 Children with hearing impairment
 Children with deaf-blind impairment
Some children experience difficulties that have affected their senses, these disabilities are referred to as
sensory impairment. These are difficulties in hearing, difficulties in vision or a combination of both
referred to as deal blindness.
1) Children with visual impairment
Visual impairment refers to a significant limitation of visual capability caused by eye disease, accident
or eye condition present from birth. Some conditions can be treated of corrected to improve vision some
due to degenerative condition cannot be corrected by conventional means, such as refractive correction,
medication, or surgery
Visual impairment is in two levels; 'the Low vision and Blindness'. Some children with low vision can
read largo print. A child who is blind will require Braille when they are ready to read
Braille is a mode of communication for learners with visual impairment especially the profound visually
impaired also referred to as totally blind. It is a system which uses embossed character in different
combinations of dots arranged in a cell, two dots wide and three dots high. The dots form a Braille Cell.
The dots of the cell are used to emboss different characters that formulate the letters of the alphabet
formulate letters and punctuations using six keys that are typed in almost the same manner as one uses a
typewriter.

Commonly concepts used with visual impairment are:

Low vision: This is a significant reduction in vision (one's inability to see clearly). It may also refer to
severe vision loss that interferes with a person's ability to perform daily tasks or activities; and that
cannot be corrected to normal by conventional eye glasses or lenses.
Blindness: A person's inability to see.
Visual acuity: This is a measure of the ability of the eye to see details.
Visual field: The whole area that is seen when looking straight ahead when the eyes, head and body are
still.
Contrast: It is the difference in tightness and darkness between objects. Things are easier to see when
contrast is greater e.g. a white piece of chalk on a blackboard.
Glare: This is the effect of too much bright light on an object.
Common causes of Visual Impairment
Visual impairment can occur before, during and after birth. Hence can be classified according to time of
consent.
i) Pre-natal causes (before bith)
Several factors play a role in the development of visual impairment before a child is born. These
include:
 Genetic/heredity factors eg in the family like squinted eyes /small tiny eye (endali)
 Poor nutrition especially lack of vitamins during pregnancy
 Venereal diseases such as syphilis, gonorrhea and HIV/AIDS
 Diseases such as rubella, river blindness (Onchocerciasis) and those involving very high fever
like measles, trachoma, also contribute to visual impairment.
 In addition, misuse of certain medical drugs, for example, quinine, aspirin and antibiotics as well
as use of narcotics and social drugs such as cigarettes and alcohol play a role in visual
impairment.
 Other causes are exposure to x-ray, especially during the first 3 months of pregnancy (first
trimester). Rhesus factor incompatibility and accidents involving expecting mothers.

(ii) Perinatal causes (during bith)

These comprise of factors like:
 Prolonged labour during delivery.
 Cord strangulation and breech birth resulting to deficiency of oxygen in the brain.
 Trauma, injury caused by improper use of delivery instruments such as forceps
 Venereal diseases particularly syphilis, gonorrhea and poor hygiene.
 Children born pre-maturely with low birth weight and having neo-natal jaundice are also likely
to develop the problem.

(iii) Post-natal causes (after birth)

After birth, factors that may lead to visual impairment include:
 Poor nutrition in the child especially deficiency of iodine and vitamin A.
 Accidents injuring eyes, head or brain,
 Childhood diseases such as measles and meningitis as well as eye diseases like cataracts,
trachoma and glaucoma make a major contribution to this condition.
 Drug abuse including medicine,
 Exposure to poisonous agents and chemicals like pesticides and poor hygiene also impact
negatively to visual development,
 Accidents e.g. playing with sharp objects/instruments
 Refractive errors e.g. shortsightedness, long sightedness. etc.
 Old age
Characteristics of persons with Visual Impairment
Persons with visual impairment can be identified using the following symptoms
1. Poor balance when walking therefore stumble over objects or trip over things.
2. Excessive blinking, tearing/watery eyes
3. Hold reading materials very close to or very far from his/her eyes and sometimes with watery
eyes.
4. Cloudy eye balls (have white patches in the centre of the eye)
 5. Sunken eyes
6. They squint, frown, shut or cover eyes when trying to see things
7. Absence of eye balls reddish/itchy eyes
8. Capping to protect the eyes from bright light rays
9. Difficulty in following a path
10. Clumsiness in task performance
11. Complaints of headache
12. Writing off line
13. Double vision
14. Difficulty m recognizing objects visually
15. Difficulty in forming moving objects without losing track
16. Difficulty in changing from looking on near objects to 1hose that are far away (shifting gaze)
17. Difficulty m people and details in pictures
18. Difficulty in identifying and discriminating textures and surfaces
19. Difficulty in matching shapes, patterns, letters etc.
20. Difficulty in developing abstract concepts; e.g. sky, mountain (especially by those who are blind)
21. Extremely big or small ej^e ball
22. Difficulty in colour discrimination
23. Arrange items incorrectly.
24. React to bright light and show expression of strain as they try to look at the chalkboard.

Effects of Visual Impairment on learning and development.

1. Difficulty in reading print materials
2. Learners may not be stable in class as they look for better positions for reading
3. Low content coverage
4. limited social interaction
5. Delayed gross and fine motor development
6. Difficulty in understanding abstract concepts e.g. sky, lake, mountain; etc.
7. Emotional stress
8. Development of mannerisms e.g. eye pocking, rocking
9. Vulnerability
10. Stigma and discrimination
11. Delayed speech and language development
12. Difficulty in exploring and manipulation of the environment
13. Lack of self esteem

Factors that affect how well a person can see and recognize objects
a) Size: Larger Objects are not always easier to see; for instance, some children with reduced visual
fields only see parts of large objects.
b) Distance: Objects are usually easier to see when they are closer to the person seeing them. Objects
which are too small or have poor contrast may not be seen even when they are very close. Children can
usually see objects held very close (10 cm or even less) to their eyes. Adults (especially when over-35
years old) cannot see objects held very close to them.
c) Contrast: Good contrast is an important factor for people with low vision. Improving contrast can
make objects or print easier to see without changing the size or distance.
d) Colour: Some things can be recognized by their colour even if details cannot be seen; for example, a
banana may be recognized because it is yellow.
e) Position: The position of an Object may cause difficulty for some people. Different positions should
be used to have the person look straight in front, to one side,, up and down. The position of an object
can make it harder to see -on, beside, or under other objects.
f) Light: Some people prefer and see better, with bright light but others prefer dull light. Glare makes it
difficult for all people to see. The light in the environment and on the object can affect how well objects
can be seen.

Helping a child with visual impairment

Caregivers are advised to do the following;
1. Use different methods, which encourage the use of other senses such as hearing, tasting,
touching and smelling, through practical experience and use of materials.
2. Advise the parents and guardians' to consult a health worker (specialist) for check up of the child
who does not seem to see well
3. Write bold and large letters, figures and pictures,
4. Let such children sit close to the caregiver,
5. Provide impaired child with visual aid like Braille especially the profound visually impaired
(totally blind.

Braille is a mode of communication for learners with totally blindness. It is a system which uses
embossed character in different combinations of dots arranged in a cell, two dots wide and three dots
high. The dots of the cell are used to emboss different characters that formulate the letters of the
alphabet formulate letters and punctuations using six keys that are typed in almost the same manner as
one uses a typewriter.

2) Children with Hearing impairment

A hearing-impairment is a difficulty in hearing this impairment it occurs when any defect affects
transmission of sound in the hearing system, e.g. diseases, accidents, blockage in the ear canal due to
compacted wax and foreign bodies.
Hearing impairment occurs at two levels. One level is when a child is not able to hear spoken language
properly. This is a level called 'hard ‘of hearing.' Children who are hard of hearing are sometimes helped
to hear by wearing hearing aid.
The other level of difficulty in hearing is when a child may not hear spoken language at all even when,
wearing a hearing aid. "this is a level called 'deaf.' Children who are deaf will require sign language in
order to learn.
Educationists categorize conditions related to hearing impairment into two: the pre-lingual and the
post-lingual based on the age of on-set (the age at which the person becomes hearing impaired) as
important.
a) Pre-lingual deafness refers to hearing loss/impairment which occurs at birth or early in life before a
child acquires speech and language.
b) Post-lingual deafness refers to hearing loss/impairment which occurs at the stage when speech and
languages have been acquired. usually after the age of six. It may develop due to disease, trauma, or as a
side-effect of a medicine. Typically, hearing loss is gradual and often detected by family and friends of
the people so affected long before the patients themselves will acknowledge the disability. This is also
referred to as adventitious deafness.

Common causes of hearing impairment

1. Misuse of drugs, can cause hearing loss. This misuse happens when a drug is not used according
to medical instructions, over dose, under dose or use of expired drugs.
2. Diseases like measles, meningitis, malaria, and otitis media.
3. Exposure to excessive (environmental noise like from factories, gun shots, music studios.
4. Trauma from physical injury or torture.
5. Foreign bodies in the ear e.g. seeds, excessive wax.
6. Brain damage. ' .
7. Tumours. .
8. Hereditary
9. Birth abnormahties
10. Unknown causes.

Identification of hearing Impairment

Children who have hearing impairment may show this behaviour in different ways.
1. Do not respond to sound particularly when facing away from the source of the sound.
2. In some children the ears are infected and puss can be seen flowing out.
3. The child is not attentive and does not participate in class or group activities,
4. Other show stunned expression on their faces as they try very hard to hear what is being said.
5. They usually have too high or too low-pitched voice since they cannot hear themselves to adjust
accordingly
6. The child is usually the last one to respond to an instruction or respond to request She or he is
seemingly disobedient in behaviour.
7. Frequently ask for pardon or repeat what has been said.
8. He/she may be using a particular ear to hear, therefore turns the head in that direction In an effort
to hear what is being said.
9. Sometimes the child may appear to be quiet and probably rude and prefers to be alone
10. The child lends to do the opposite of what she or he is expected to do.
11. Sometimes gives extremely unrelated answer to a question asked.
12. Prefer to use gestures/signs;
13. Fear to participate in a conversation
14. Cap the pinna when in conversation
15. Demonstrate gaps in his/her knowledge and skills Have uncoordinated body balance during
movement

Effects of hearing impairment on learning and development

Generally, the functional condition of having a hearing loss creates a barrier in acquiring and processing
information to make meaning consequently leading to;
Low content coverage;
Low content coverage will constrain acquisition of knowledge and skills. Most of ten, learners whose
functional problems are not identified early enough and given due support will demonstrate poor
performance.
Limited social interaction;
When children do not interact with their peers, their emotions, behavior and learning styles are affected
hence, causing; isolation, stress, withdrawal, anti-social behavior, poor performance and sometimes
dropping out from school.
Low self-esteem;
A learner may show signs of less interest to participate in classroom and outside classroom activities
with the peers. Hence feels unloved and incompetent
Limited auditory perception
 Limited spoken vocabulary acquisition
 Difficulty in understanding abstract concepts
 Delayed speech and language development e.g a mild or moderate degree of hearing loss has an
adverse effect on language development and consequently on educational achievement. Children
with hearing loss in such a bracket may be able to hear the loud vowel sounds but have difficulty
discriminating the soft consonants like "s", "k", "th","p", "b", "d".
 Difficulty in discrimination and associations of sounds

Helping a child with a hearing impairment

Children with healing Impairment/difficulties should be helped to understand and follow
communication with minimum strain. The following are some guiding |X)ints;
1. Let a child with a hearing difficulty sit in a position where he/she sees the caregiver clearly
2. Do not shout, it is a common reaction, but it does not help. It only causes embarrassment
3. Speak slowly and cloudy and repeat important point
4. Do not exaggerate your facial movements or distort your face but use clear gestures
5. Try lo face the light as well as the person you are speaking to,
6. Cut out as much background noise as possible,
7. Use signs ('.sign language) where necessary. When signing, do anything else that involves
putting your hand in front of your face. Some learners may follow conversation when looking at
your lip movements. This is called lip reading
8. Use plain language. To some one reading your lips, many words look the same. The more
common the words you chose to use the better,
9. If you not not immediately understood, try to repeat rephrasing what you are saying in other
words
10. Write things down if you think it is necessary. Again it is easier for you both if you use common
and short words,
11. Use o lot of pictures and real objects while teaching.
12. Involve the child in game using toys to exercise his or her speech and listening skills
13. Find out more information from the parents/guardian on helping the child and refer him/her to
hospital for further help.
14. A child with hearing difficulties can use hearing aids like a hearing loop, FM system, infrared
system among others to enhance on his /her hearing
A hearing loop (sometimes called an audio induction loop) is a special type of sound system for use by
people with hearing aids. The hearing loop provides a magnetic, wireless signal that is picked up by
the hearing aid when it is set to 'T' (Telecoil) setting.
3. Children with deaf-blindness
Deaf-blindness can be described as a combination of both auditory and visual disabilities that causes
Hearing Loop FM System Infrared System
severe communication and other developmental and learning needs. Consequently, a deaf-blind child
may not be appropriately educated in special education programmes solely for children with hearing
impairments, visual impairments or severe disabilities. Such a child needs supplementary assistance to
meet his or her educational needs.
Deaf-blind can also be categorized as multiple disability which mean more than.one disability being
experienced by one child. Children with any combination of the disabilities are said to have multiple
disabilities,

Effects of multiple impairment

1. Majority of children who have more than one impairment especially visual and hearing
impairments at birth experience major difficulties in acquiring communication skills, motor and
mobility skills and appropriate social behavior.
2. These children do not receive clear and consistent information from either sense and they may
therefore appear to be passive, non-responsive and/ or noncompliant.
3. Again they may fail to respond or initiate appropriate interactions with others in their
environment.
4. Deaf-blind child's unresponsiveness can lead parents and caregivers to unwittingly contribute to
his or her communication difficulties as follows:
5. Parents are likely to find their deaf-blind baby's 'signals' difficult to read and may become
discouraged, especially if the child seems to reject them or show little interest.
6. With little encouragement to interact or to exert control with activities, the child may become a
passive recipient of care as 'learned helplessness' develops,
7. The combined effects of the dual impairments severely impede development of communication
and social skills.

Helping learner with multiple impairment

1. Parents and caregivers may find it easier to do things for the child without waiting for his
responses so that activities which fit typical children and are full of fun, and communication
become a quiet routine for the deaf-blind infant.
2. Parents and caregiver should apply the knowledge and skills for each impairment/disability in
supporting each area or sub area of disability, a caregiver should be able to apply that
information to some multiple disabilities or seek appropriate support

4. Children with physical (motor) impairment

Children with physical motor impairment have difficulty in movement/mobility. This is the weakness in
the limbs (legs, hands) that prevent children from functioning normally and with ease.

Causes of physical/mobility impairment

This impairment can be caused by a number of factors which include:
Heredity factors, accidents, diseases like polio, Poor nutrition, drug abuse by pregnant mothers
Identification of mobility problems
The following may be observed in some children with mobility problems;
1. Difficulty in walking, running, or holding things firmly.
2. Difficulty in using learning material
3. Limitation in body co-ordination.
4. Poof balance and posture.
5. Body deformation
6. Poor head/neck control.
7. Missing body parts

Effects of physical mobility on learning and development

1. Some may develop learning and language problems as a result of lack of experience.
2. Stiff and week muscles hence denied in participating social activities like sports and games
3. Some may have speech problems.
4. Some experience problem in writing hence poor academic performance
5. Problems carrying out .activities of daily living; feeding, toileting etc.
6. Lack of self-esteem they feel not loved
7. Stigma. They are segregated from the community

Helping a child with mobility problem

A child who has such a disability needs to be enabled to learn like any other child. Caregivers should do
the following;
1. Allow the child to work at his/her own pace.
2. Encourage them to participate in as many activities as they can and support them where they fail.
3. Give them activities that suite their condition and ability.
4. Provide a wheel i bait.
5. Encourage other children to appreciate him/her other than avoiding or calling him/her fanny
names.
6. Avoid giving the child too much attention
7. Provide impaired child with movement aids such as wheelchairs, scooters, walkers, canes,
crutches
8. At school special walk ways should be provided to enable them reach required places
9. Special toilets should be put in place to provide easy ease for mobility children.
HEALTH BARRIERS TO LEARNING DEVELOPMENT

Children with serious health problems

Some children may be suffering from complicated health problems. These health conditions can last for
short time or for life. The condition can be autism, epilepsy, asthma, heart problems, HIV/AIDs sickle
cell, aneamia or hypertension. Children with health problems may have difficulties to perform in daily
activities including learning.

1. AUTISM, OR AUTISM SPECTRUM DISORDER (ASD

Autism, also called autism spectrum disorder (ASD), is a complicated condition that includes
problems with communication and behavior. It can involve a wide range of symptoms and skills. ASD
can be a minor problem or a disability that needs full-time care in a special facility. Autism appears in
infancy and early childhood, causing delays in many basic areas of development, such as learning to
talk, play, and interact with others.

Causes of Autism
The exact cause of ASD is unknown. The most current research demonstrates that there’s no single
cause. However, some of the suspected risk factors for autism include:

 Heredity: having an immediate family member with autism

 genetic mutations
 fragile X syndrome and other genetic disorders
 being born to older parents
 low birth weight
 metabolic imbalances
 exposure to heavy metals and environmental toxins
 a history of viral infections
Identification of child with autism
1. Children/people with autism have trouble with communication.
2. They have trouble understanding what other people think and feel.
3. This makes it hard for them to express themselves, either with words or through gestures, facial
expressions, and touch.
4. People with autism might have problems with learning.
5. Their skills might develop unevenly. For example, they could have trouble with communicating
but be unusually good at art, music, math, or memory. Because of this, they might do especially
well on tests of analysis or problem-solving.
6. Irregular school attendance
7. Often feeling sick
Early symptoms include:
The baby or toddler doesn’t:
 Make eye contact, such as looking at you when being fed or smiling when being smiled at
 Respond to his or her name, or to the sound of a familiar voice
 Follow objects visually or follow your gesture when you point things out
 Point or wave goodbye, or use other gestures to communicate
  Make noises to get your attention
 Initiate or respond to reach out to be picked up
 Imitate your movements and facial expressions
 Play with other people or share interest and enjoyment
 Notice or care if you hurt yourself or experience discomfort

Challenges children with Autism face in learning and development

Children and adults with autism have difficulty with verbal and non-verbal communication. For
example, they may not understand or appropriately use:

 Spoken language (around a third of people with autism are nonverbal)

 Gestures
 Eye contact
 Facial expressions
 Tone of voice
 Expressions not meant to be taken literally

Additional challenges may include difficulty with:

 Recognizing emotions and intentions in others

 Recognizing one’s own emotions
 Expressing emotions
 Seeking emotional comfort from others
 Feeling overwhelmed in social situations
 Taking turns in conversation
 Gauging personal space (appropriate distance between people)

HELPING CHILDREN WITH AUTISM

Be consistent. Children with ASD have a hard time applying what they’ve learned in one setting (such
as the therapist’s office or school) to others, including the home. For example, your child may use sign
language at school to communicate, but never think to do so at home. Creating consistency in your
child’s environment is the best way to reinforce learning

Stick to a schedule. Children with ASD tend to do best when they have a highly-structured schedule or
routine. Again, this goes back to the consistency they both need and crave. Set up a schedule for your
child, with regular times for meals, therapy, school, and bedtime

Reward good behavior. Positive reinforcement can go a long way with children with ASD, so make an
effort to “catch them doing something good.” Praise them when they act appropriately or learn a new
skill, being very specific about what behavior they’re being praised for. Also look for other ways to
reward them for good behavior, such as giving them a sticker or letting them play with a favorite toy.

Create a home safety zone. Carve out a private space in your home where your child can relax, feel
secure, and be safe. This will involve organizing and setting boundaries in ways your child can
understand. Visual cues can be helpful (colored tape marking areas that are off limits, labeling items in
the house with pictures).
CHILDREN WITH ASTHMA
Asthma is a chronic respiratory disease that transport air to and from the lungs. No full cure is available,
but management methods can help a person with asthma lead a full and active life.
In a person with asthma the inside walls of the airways, known as bronchial tubes, become swollen or
inflamed. This swelling or inflammation makes the airways extremely sensitive to irritations and
increases their susceptibility to an allergic reaction.
In an allergic reaction, the airways swell, and the muscles around the lungs tighten, making it difficult
for air to move in and out of the lungs

Types of asthma
 Childhood asthma
 Adult on-set asthma
 Occupational asthma occurs as a direct result of a job or profession. Symptoms will become
apparent after attending a particular workplace.
 Difficult-to-control and severe asthma: These types involve consistent, debilitating asthma
symptoms and breathing difficulties.
 Seasonal asthma. This type occurs in response to allergens that are only in the surrounding
environment at certain times of year, such as cold air in the winter

CAUSES OF ASTHMA
Childhood asthma causes aren't fully understood. Some factors thought to be involved include:

 Inherited tendency to develop allergies

 Parents with asthma
 Some lungs infections at a very young age
 Exposure to environmental factors, such as air pollution
 Increased immune system sensitivity causes the lungs and airways to swell and produce mucus
when exposed to certain triggers.
 Viral infections such as the common cold
 Exposure to air pollutants, such as tobacco smoke
 Respiratory conditions, such as a chronic runny or stuffy nose
 Allergies to dust mites, pet dander, pollen or mold
 Obesity (state of being grossly fat or overweight)
 Heartburn (gastro esophageal reflux disease, or GERD)
 Physical activity
 Weather changes or cold air
 Pregnancy. If a woman smokes tobacco or illicit substances while pregnant, an unborn child might
grow less in the womb, experience complications during labor and delivery, and have a low birth
weight.
 Stress People who undergo stress have higher asthma rates.
 Emotional responses, including laughter and grief, might trigger asthma attacks.
Characteristics of asthma case

Asthma signs and symptoms vary from child to child, and might get worse or better over time. They
include

 Frequent coughing that worsens when your child has a viral infection, occurs while your child is
asleep or is triggered by exercise or cold air
 A whistling or wheezing sound when breathing out
 Shortness of breath
 Chest congestion or tightness

EFFECTS
Asthma can cause a number of complications, including:

 Severe asthma attacks that require emergency treatment or hospital care

 Permanent decline in lung function
 irregular school attendance resulting to poor academic performance
 Poor sleep and fatigue
 Symptoms that interfere with play, sports or other activities
 Asthmatic child experience breathing problems like wheezing, coughing, and shortness of breath.
 asthma emergencies can be life-threatening


SUPORT TO ASTHMATIC CHILD

1. Create action plan: Caregiver should help a child stay organized with an asthma action plan
that records symptoms, medications, and other data,
2. Involve your child in their own care. Sit down with your child and review their action plan
with them, explaining things at an age-appropriate level. Help your child learn self-management
skills to empower them and encourage them to stick to their care plan
3. Track child’s asthma symptoms consistently. Record when, how often, and the duration of
when your child experiences symptoms like coughing, shortness of breath, and wheezing. Note
times when symptoms interrupt school, playtime, and sleep. You can Use a wall chart, journal,
or anything that helps you stay organized
4. Provide inhaler to asthmatic child and train him/her to use it properly (a portable device for
administering a drug which is to be breathed in, used for relieving asthma and other bronchial or
nasal congestion.)
5. Never smoke around a child with asthma. Tobacco smoke is a big asthma trigger.
6. Give them activities that suite their condition
7. Give extra time to enable him / her complete the task given

CHILDREN WITH EPILEPSY

Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal,
causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. It affects
children and adults of all races and ethnic backgrounds.
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your
behavior, movements or feelings, and in levels of consciousness. If you have two or more seizures or a
tendency to have recurrent seizures, you have epilepsy

Causes
Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the
condition may be traced to various factors, including:

 Genetic influence. Some types of epilepsy, which are categorized by the type of seizure you
experience or the part of the brain that is affected, run in families. In these cases, it's likely that
there's a genetic influence.
 Head trauma. Head trauma as a result of a car accident or other traumatic injury can cause
epilepsy.

 Brain conditions. Brain conditions that cause damage to the brain, such as brain tumors or
strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35.

 Brain damage caused by toxic agents

 Infectious diseases. Infectious diseases, such as meningitis, AIDS and viral encephalitis, can
cause epilepsy.

 Prenatal injury. Before birth, babies are sensitive to brain damage that could be caused by several
factors, such as an infection in the mother, poor nutrition or inadequate supply of oxygen the brain.
This brain damage can result in epilepsy or cerebral palsy.

 Developmental disorders. Epilepsy can sometimes be associated with developmental disorders,

such as autism and neurofibromatosis.

 Abnormal levels of substances such as sodium or blood sugar

IDENTIFICATION OF EPILEPSY CASE

Symptoms may include:

 Temporary confusion
 A staring spell
 Uncontrollable jerking movements of the arms and legs
 Loss of consciousness or awareness
 Psychic symptoms such as fear, anxiety

EFFECTS OF EPILEPSY
Having a seizure at certain times can lead to circumstances that are dangerous to yourself or others.
  Falling. If you fall during a seizure, you can injure your head or break a bone.
 To learners it can highly affect ones academic performance
 Drowning. If you have epilepsy, you're 15 to 19 times more likely to drown while swimming or
bathing than the rest of the population because of the possibility of having a seizure while in the
water.
 Pregnancy complications. Seizures during pregnancy pose dangers to both mother and baby, and
certain anti-epileptic medications increase the risk of birth defects. If you have epilepsy and you're
considering becoming pregnant, talk to your doctor as you plan your pregnancy.
 Emotional health issues. People with epilepsy are more likely to have psychological problems,
especially depression, anxiety and suicidal thoughts and behaviors. Problems may be a result of
difficulties dealing with the condition itself as well as medication side effects.
 Status epilepticus. This condition occurs if you're in a state of continuous seizure activity lasting
more than five minutes or if you have frequent recurrent seizures without regaining full
consciousness in between them. People with status epilepticus have an increased risk of permanent
brain damage and death.
 Sudden unexpected death in epilepsy (SUDEP). People with epilepsy also have a risk of sudden
unexpected death. The cause is unknown, but some research shows it may occur due to heart or
respiratory conditions.
 Segregation: people with epilepsy are sometimes segregated from the community
 difficulty understanding and remembering what you hear and/or what you read
 problems with speaking clearly
 problems with expressing ideas or finding specific words.

HELPING A CHILD WITH EPILEPSY TO LEARN OR FIT IN THE SOCIETY

1. Parents, teachers and other care givers should help them learn and understand that there is more
to epilepsy than medicine.
2. The teacher needs to be able to teach in different ways. Teaching with an auditory style [by
lecturing] is not a good fit for a child who does best by looking—a visual learner
3. Teachers and other caregivers also need to consider whether problems happen only at certain
times of the day or in certain classes. If they happen only at certain times of the day, the
medicine may be peaking at that time. If it's certain classes, maybe the child has a learning
disability that needs to be checked out focus on your child’s other skills and talents
4. Find a supportive playgroup environment for epileptic child to play and learn in
5. Advocate to create a supportive environment in school with your child's teacher and classmates,
which will make school easier for your child
6. Talk to the child’s doctor or the epilepsy care team and ask their advice about evaluating and
treating any problems, especially after a medication is started
7. Positive self-talk Remind the children about good ways to treat our friends. How do we talk to
our friends? Would we want to be friends with someone who always said or did negative things?
8. Learn as much as you can about epilepsy.
9. Discuss epilepsy openly and honestly with epileptic child and help your child talk openly and
honestly with others about epilepsy.
10. Avoid saying things that could make your child feel like a problem or burden.
11. Be positive. And patient with the child’s condition

CHILDREN WITH SICKLE CELL

What is Sickle Cell Disease?

Sickle cell disease (SCD is a group of inherited red blood cell disorders. Healthy red blood cells are
round, and they move through small blood vessels to carry oxygen to all parts of the body. In
someone who has SCD, the red blood cells become hard and sticky and look like a C-shaped
farm tool called a “sickle” Hemoglobin is a protein in red blood cells that carries oxygen from the lungs to
the organs and tissues in the body .

The abnormal hemoglobin in SCD can cause the red blood cells to have a sickle or banana shape under certain
conditions. People with SCD often have a decreased number of red blood cells, a condition called anemia, which
can cause lack of energy, breathlessness, and pale color of the skin and lips. There are many forms of SCD and
the most common type is Hb SS, known as sickle cell anemia, which is inherited when a child receives two “S”
genes (one from each parent). Hb SC is a form of disease that is inherited when a child receives one sickle cell
gene, “S” from one parent and from the other parent, a gene for an abnormal hemoglobin called “C”. Another
type of SCD, sickle beta-thalassemia, occurs when a child inherits one sickle cell gene and one gene for beta
thalassemia (another type of abnormal inherited hemoglobin that causes anemia). What is Sickle Cell Disease?

. The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they
travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain
and other serious problems such infection, acute chest syndrome and stroke.

Sickle cell anemia is a disorder affecting red blood cells, the cells that carry oxygen from the
lungs to tissues throughout the body

CAUSES

A genetic disease
Sickle cell anemia results from a mutation in a gene called HBB, which contains the blueprint for cells
to make part of a protein called hemoglobin. The hemoglobin protein is made up of two alpha chains
and two beta chains. Each chain includes an iron-containing “heme” portion. The iron gives red blood
cells their color. It also allows the hemoglobin molecule to bind to and then release oxygen molecules.
The mutation in the HBB gene in sickle cell anemia changes one of the amino acids, the building blocks
of proteins, in the beta chain of hemoglobin. This defect causes the hemoglobin protein to stick together
and form stiff fibers. These fibers distort the shape of the red blood cells and make them more fragile.
The hemoglobin in sickle cell anemia patients is called hemoglobin S, whereas those unaffected by the
disease have the hemoglobin A form of the molecule.

Inheritance
Sickle cell anemia is inherited in an autosomal recessive manner. This means that the disease
develops when someone receives two copies of the mutated HBB gene: one from the mother
and one from the father. A person with just one copy of the mutated gene is said to have
the sickle cell trait. Although they are a carrier of the disease, these people generally do not
display any symptoms but can pass the disease to their children.

How is sickle cell anemia inherited?

Sickle cell anemia is inherited as an autosomal (meaning that the gene is not linked to a sex
chromosome) recessive condition. This means that the gene can be passed on from a parent carrying it to
male and female children. In order for sickle cell anemia to occur, a sickle cell gene must be inherited
from both the mother and the father, so that the child has two sickle cell genes. The inheritance of just
one sickle gene is called sickle cell trait or the "carrier" state.

Signs/symptoms
• Signs and symptoms of sickle cell disease usually begin in early childhood. Characteristic
features of this disorder include
• repeated infections, and periodic episodes of pain.
• Anemia. Sickle cells break apart easily and die, leaving you without enough red blood cells. Red
blood cells usually live for about 120 days before they need to be replaced. But sickle cells
usually die in 10 to 20 days, leaving a shortage of red blood cells (anemia).
• Episodes of pain. Periodic episodes of pain, called crises, are a major symptom of sickle cell
anemia. Pain develops when sickle-shaped red blood cells block blood flow through tiny blood
vessels to your chest, abdomen and joints. Pain can also occur in your bones.
• Painful swelling of hands and feet. The swelling is caused by sickle-shaped red blood cells
blocking blood flow to the hands and feet.
• Frequent infections. Sickle cells can damage an organ that fights infection (spleen), leaving you
more vulnerable to infections. Doctors commonly give infants and children with sickle cell
anemia vaccinations and antibiotics to prevent potentially life-threatening infections, such as
pneumonia.
• Delayed growth. Red blood cells provide your body with the oxygen and nutrients you need for
growth. A shortage of healthy red blood cells can slow growth in infants and children and delay
puberty in teenagers.
• Vision problems. Tiny blood vessels that supply your eyes may become plugged with sickle
cells. This can damage the retina — the portion of the eye that processes visual images, leading
to vision problems.
• Unexplained episodes of severe pain, such as pain in the abdomen, chest, bones or joints.
• Swelling in the hands or feet.
• Abdominal swelling, especially if the area is tender to the touch.
• Fever. People with sickle cell anemia have an increased risk of infection, and fever can be the
first sign of an infection.
• Pale skin or nail beds.
• Yellow tint to the skin or whites of the eyes.
• Signs or symptoms of stroke. If you notice one-sided paralysis or weakness in the face, arms or
legs; confusion; trouble walking or talking; sudden vision problems or unexplained numbness; or
a headache.
• Children with sickle cell anemia are often smaller in size, have delayed puberty, and experience
jaundice or yellowing of the skin and eyes.
• Sickle cell anemia patients frequently experience pain
• Infections • Cold and/or damp conditions • Air pollution • Dehydration • Extreme physical
activity • Stress • Sudden changes in temperature • Use of alcohol or caffeine • Smoking

EFFECT OF SICKLE CELL ON LEARNING

 • Sickle cell anemia is an inherited disease that involves red blood cells. Patients affected by the
disease have a reduced number of red blood cells, which results in anemia and fatigue.
• the body can't get the oxygen it needs to feel energized,.
• Children with sickle cell anemia do not have learning difficulties, but fatigue and recurrent pain
can influence their ability to concentrate in school. They are also more frequently absent from
school compared to other children because they must attend doctors’ appointments or because
they are having painful episodes. Children with sickle cell anemia, therefore, may require extra
help or adaptation  to the usual school routine.
• have delayed puberty,
• shortness of breath, fatigue, and delayed growth and development in children
• A vaso-occlusive crisis is a common painful complication of sickle cell anemia in adolescents
and adults
•
HELPING A CHILD WITH SICKLE CELL
1. Sufficient hydration and bathroom breaks
Dehydration can trigger VOC and drinking regularly is better than drinking large amounts at
once, so children with sickle cell anemia should be allowed to drink water during class.
Children with the disease may also have to go to the bathroom frequently and should be allowed
to do so whenever they need to.
2. Extreme temperatures
VOC can also be triggered by cold and very hot temperatures. The classroom should, therefore,
be well heated during winter, and the sickle cell child should not sit in front of a fan or under air
conditioner vents. He or she should also be permitted to wear multiple layers of clothing when
feeling cold. In case of an injury, a cold pack must not be applied to the pain site.
3. Adaptations during physical education
Children with sickle cell anaemia can do moderate exercise but need regular breaks because of
fatigue. Teachers should try to find an activity that is less tiring and at the same time does not
draw too much attention to the individual needs of the child, which they may find embarrassing.
4. Recognize signs of a stroke
strokes sometimes occur in children with sickle cell anaemia. A stroke is a blockage of a blood
vessel in the brain that causes damage. When a stroke affects only a small part of the brain, it can
easily go unnoticed. A typical sign of a stroke is a decline in school performance or difficulties
in concentrating. Because teachers see the children every day in the classroom, they are in a
good position to spot small changes in performance or behavior. Teachers should immediately
contact the parents if they notice any difference in learning.
5. Emotional well-being
Children with sickle cell anemia are often smaller in size, have delayed puberty, and experience
jaundice or yellowing of the skin and eyes. Teachers may try to organize team building activities
that allow these children to socialize and build relationships with their peers.

6. Communication with parents

It is essential that teachers talk about the children’s school performance with the parents. Regular
communication is also necessary to discuss alternative ways to complete assignments and catch
up with missed schoolwork when the child is not able to attend class.
7. Recognizing pain
Sickle cell anemia patients frequently experience pain, and it is essential that teachers know how
to react
8. School personnel and caregivers play an important role in a student’s health and academic
success. For students living with a chronic health condition like SCD, communication between
parents and school officials is essential in supporting positive academic outcomes
9. Develop an individualized care plan. An individualized care plan is a written document that can
be tailored to the specific healthcare needs of a student with SCD. An individualized care plan
requires input from the teacher, school nurse,