This document discusses special needs education. It begins by defining special education as instruction designed to meet the unique needs of exceptional students. It then outlines the objectives of a course on special needs education for teacher trainees, which include describing special needs, explaining the role of special needs education to teachers, modifying learning environments, describing different disability categories, devising intervention strategies, and explaining the differences between gifted/talented and disabled students. The document goes on to discuss the history, categories, objectives, assumptions, and state of special needs education in Uganda. It also describes learning disabilities, their identification and remedies.

1. Special needs
education.
Catering for the gifted and educationally
challenged in all inclusive and mainstreaming
classrooms.

2. What is it?
 Special education is specially designed instruction
to meet the unique needs and abilities of
exceptional students

3. Objectives of the course.
Teacher trainees working in either special or inclusive school
environment should be able to;
 -Describe the nature of and explain the key concepts in/of
special needs, in relation to educational teaching/learning field.
 -Reiterate and or stress the role of special needs education to a
teacher.
 -Use the knowledge of special needs education to modify the
learning/teaching environment.
 -Describe the different categories /classification of disabilities
that may directly or indirectly affect learning or teaching.

4.  Devise /suggest the intervention strategies for the special
needs situations.
 -Explain the difference between gifted /talented and
disabled students/children.
 -Sensitize and inform the different school stakeholders of
the need for the attention of individual learner’s needs.
 explain the relevance of rehabilitation to special needs
education.

5. Categories of special needs students.
 Having disability, i.e. absence of body structure.
 Having impairment, i.e. having a defective body structure.
 Having handicap, which is a result of either impairment or
disability, means having a problem that makes a person not to
manipulate or operate within the environment easily.
 Being at risk, which means that the problem cannot be seen but
it is likely to develop.

6. Objectives of special needs education
 Provide an early identification of children with special
needs.
 To prevent disabling conditions in the environment
 To develop and provide intervention strategies.
 To provide training to the teachers, parents and care-
takers in ways of meeting the needs of their children.

7. Assumptions of SNE provision
 All students are capable of learning therefore; students with
disability should be given the opportunity to learn.
 All students have intrinsic value and so students with special
needs can acquire skills, abilities competences and knowledge.
 Students with special needs are like the normal ones than a
difference. So the disabled and the normal students are the
same.

8.  The teacher for a disabled student should be
carefully and adequately trained.
 The disability in a student should be considered at
an individual level. Thus, attending to an
individual depend on the disability.
 Disability doesn’t mean inability.

9. History of special needs education.
Major developments in special needs education can
be traced in three eras:
- Pre- Christian era.
- Christian era.
- Post Christian era.

10. Pre-Christian era.
 During the Greek time 1500B.C, most cultures regarded
people with disabilities to be cursed by gods and were
bad omens in that family and thus ignored or killed
them or used as entertainers for the rich and powerful.
 Further, some persons with disabilities were locked up
in asylums believing they were demon possessed.
 This period is named dark ages, dominated by
ignorance and superstitions.

11. Christian era.
 During 13th century, the Catholic Church started providing
asylum for the disadvantaged people, especially for the
blind.
 This asylum was care oriented, no effort of education at
that time.
 The principle was following the ‘seven comfortable
works’; feeding, clothing and housing the poor, visiting
them when in prison or sick, offering drink to the thirsty,
burial and (spiritual) counsel and comfort for the sick.

12. Post Christian era.
 The early years of special education witnessed the
remarkable contributions of the likes of Jean Itard,
Edward Seguin, Valentine Howe, Thomas Hopkins
Gallaudet, Samuel Grialey Howe and a host of others.
 In the renaissance period 1500-1800 (in order era of
scientific living and observation by education and
humanitarians) for example, in 1785, the first school for
the blind was opened in Paris by Valentine Huay.

13.  Maria Montessori opened the first school for the mentally
retarded.
 Jean mark also in France started caring for the deaf.
 Pedro de Leon too, started to take care for the deaf.

14.  During the industrial revolution, especially in the
19th century, a big attempt towards the
production of special equipment was made. For
example, Louis Braille invented the machine
called the Braille, for the blind.

15. Personalities contributions.
 Edouard Seguin; known for physiological method through sensory
training (touching and utilization of materials) and motor training
with material graded basing on age, simple to complex, functional
activities, work and play.
 Maria Montessori emphasis on flow of experience, age specific, single
concept per study, systematic flow on continuum, set environment
facilitating independent learning and exploration by the child.
 Decroly advocate for learning centered on learner needs, globalization
of learning (general picture before analysis of particular constituent
parts).

16. Benefits from early special needs
psychologists / specialists.
 Educability of special needs children:
- Without education, no humanity.
- There is no human and half human; equality between man.
- All knowledge comes through the senses (John Locke and
Etienne Condillac).

17. Genesis of special needs education in
Uganda.
 By 1988, private and charity organizations catering for 40s
for hearing problem, 80s for mental problems, 100s for
physical and 210s for visual problems.
 In 1989, the UN declaration (convention) was held, which
advocated for education for all.
 In 1990, the Jomtien Conference was held in Thailand in
which all the countries advocated for education for all
(EFA).

18.  In 1991, DANIDA extended its support in Uganda to promote education
for the disabled.
 In 1992, the white paper was produced, which planned for the
education of the disabled.
 In 1993, the UN established and urged all member countries to ensure
that people with disabilities were catered for.
 In 1995, the Uganda-DANIDA project was established which led to the
establishment of the important projects; namely, UNISE (Uganda
National Institute of Special Education) and EARS (Educational
Assessment and Resource Services) under the ministry of education.
The work of EARS was to visit homes and schools to assess them.

19.  By 1996, many government ministries have now been involved in the
delivery services; namely education ministry, ministry of gender and
community development, ministry of health and ministry of labor and
social welfare.
 By 1999, many new schools had been opened and about 4000
students had been enrolled in the tertiary institutions. About 5000 are
in secondary schools and 165,000 in primary schools.
 There are also many organizations formed in the country such as
NUDIPU (National Union of Disabled Persons of Uganda), association
of the blind, association of the mentally retarded, Uganda society of
the disabled, among many.
 There are about 50 NGO’s in the country working on children with
disabilities.

20. State of special needs in Uganda.
 Negative attitude towards people who are disabled.
 Lacking clear policy, especially in areas regarding the
handicapped.
 There are poor and few trained people to handle the
disabled.
 There is acute shortage of materials.
 Lacking adequate funding since there is no clear policy by
the government.
 Lacking non-formal education at home; i.e. parents and
caretakers of these people are not sensitized.

21. Functions of EARS.
Education ministry through EARS is charged with:
 Sensitizing parents and community and teachers on
disability.
 Assessment of children with special needs and identifying
what their problems are.
 Organizing education placement of children with disability
i.e. where different children with different disabilities
can be taken.
 To offer parental guidance.
 To promote learning and training of SNE
 To provide in-service training of teachers in terms of
seminars, workshops and demonstrations.

22. Other service ministries.
 Ministry of health provides medical rehabilitation services, for
instance, through departments that provide psychiatry and
psychotherapy services.
 The ministry of gender and community development providing
SNE services for the youths, elderly and women with disabilities
through;
-Evolving policies to provide privileges and rights to the disabled.
-Training persons with disability in various skills e.g. at Kireka
rehabilitation organization, Oloko-Gulu, Rutti-Mbarara, Rwera-
Ntungamo
-Training of national district and sub-county parents.

23. - Developing and generating activities in those
rehabilitation organizations aimed at teaching and
training the disabled; for example carpentry, income
saving, tailoring, bricklaying, crafts, shoe making among
others.
- Home sensitizing those with disabilities.
- Making referrals to experts and professionals.

24. Educational placements (settings) for
exceptional(deficient) students.
i) Inclusion (regular classroom placement)
ii) Resource room placement with specialized teacher for specific skill/
aspect, but later absorbed into mainstream.
iii) Self-contained placement, special self contained room for disability
students, may use different graded content and texts.
iv) Special school placement, specifically designed for disability in
structure routine and consistency.
v) Home-bound and hospital bound placement, complete isolation
from learning environment.
vi) Itinerant (consultative) teacher placement, where special needs
teacher visits and guide teachers handling special needs students.

25. THE TYPES OF SPECIAL NEEDS CHALLENGES
 Learning disability characterized as disorder in one or more of
the basic psychological processes as in understanding or in using
language, spoken or written, manifesting inability to listen, think,
speak, read, spell or to do mathematical calculations.
 Should not be visual, hearing or motor handicaps, nor due to
mental retardation, emotional disturbance, or because of
environmental, cultural or economic advantage.

26. Learning disability.
 Or achievement not commensurate with age and ability levels.
 Students with learning disability have average or above average
intelligence.
 Therefore, a person has learning disability when with normal
intelligence, but academic achievement is poor/weak.
 Or a discrepancy that is not caused by hearing, vision, or motor
handicaps, mental retardation, emotional disturbance or
environmental disadvantage, but rather by a presumed underlying
neurological difficulty.

27. Types of learning disability.
 Dyslexia:
 Dyscalculia:
 Dysgraphia:
 Dyspraxia:
 Attention deficits:
 Hypo activity.
 Emotional instability:
 Higher order thinking deficiency:
 Lack of self-esteem.

28. Dyslexia:
 A dyslexic student has difficulty processing language (i.e. problems
with reading and speaking). Signs include poor in articulating words.

29. Dyscalculia:
 A child with a math based learning disorder may struggle
with memorization and organization of numbers,
operating of signs, and a number “facts” (like 5+5=10 or
5x5=25). Children with math learning disorder might also
have trouble with counting principles (such as counting by
2s or counting by 5s) or have difficulty telling time.

30. Dysgraphia:
 Difficulty with writing and drawing (i.e. problems with
handwriting, spelling and organizing ideas).
 Symptoms of a written language disability revolve around
the act of writing and include problems with neatness and
constancy of writing, accurately copying letters and
words, spelling consistency and writing organization.

31. Dyspraxia
 Difficulty with fine motor skills e.g. cutting

32. Attention deficits:
 He or she has trouble in concentrating and remaining “on
task”.
 He or she rarely finishes what is started, frequently jumps
from one activity to another, and is easily distracted by
competing stimuli.
 It may be hard for him or her to decide what to focus on
while listening to a teacher, reading a text, or looking
over a mathematics problem.

33. Hypo activity.
 A student may be passive, rather than active learner.
 He or she tends to be quiet and not participating in the
learning activities.

34. Hyperactivity:
 The student often acts without thinking, has poor planning
and organizational skills, responds quickly and makes
many errors and lacks self-regulation skills.
 Such behaviors cause him or her to perform poorly when
he needs to slow down and plan work before doing it.

35. Emotional instability:
 The student is moody and often is isolated or rejected by
his or her peers.
 He or she may have low self-esteem and is more likely to
violate social norms.
 He or she may exhibit inappropriate ways of getting
attention, elicits more negative reaction from others, and
may lacking in social cognition skills.

36. General coordination deficits.
 The students may be uncoordinated and have difficulty
with fine and/ or gross motor skills (e.g. tying shoes,
running, hopping and skipping).
 Some students have muscle coordination problems that
make their writing slow and sometimes hard to read. For
example, they may have an awkward pencil grip that is
difficult to correct.
 Many teachers notice that these students have much
better ideas when they speak than when they write.

37. Higher order thinking deficiency:
 Some students find it hard to understand concepts (such as
photosynthesis or democracy).
 Others get confused when learning gets abstract or uses too many
symbols.
 Still others fail to use learning strategies. (Techniques that could
make learning easier for them), do not understand rules (such as
grammar or math) and have poor problem solving skills.
 The disorders are actually weaknesses in the mind’s highest abilities,
which is why they are called higher order thinking capacity.

38. Lack of self-esteem.
 Self-esteem refers to the sense of self respect, confidence, identity, and
purpose found in an individual.
 Afraid to take risks for fear of failure, ridicule and repercussions; lack of
ability to knowledge their own strengths; respond to challenges by blaming
others or excusing themselves; and lack the resources for achieving their
goals.

39. Others may include.
 Slow in processing information: a student takes
long time reading, writing, talking or thinking.
 Poor peer relationships: difficulty in relating;
interpersonal relationship; has few friends; often
in fights.
 Perseverates: repetitive, resists changes in
routines.
 Difficulty in making decisions.

40. Causes of learning Disability.
 Problems during pregnancy and birth.
 Accidents after birth or incidences after birth.
 Poverty of motivation, resources, modeling, exposure.
 Genetic influences.
 Environmental impacts of environmental toxins (poisons)
and poor nutrition.
 Teacher’s ineffectiveness.
 Mode of instruction.

41. Identification of learning disabilities.
 Early identification is difficult not until schooling begins.
 With schooling, achievement assessment in comparison with the rest can be
used for identification.
 Common ones include:
i) Norm-referenced assessment.
ii) Criterion-referenced assessment.
iii) Process-ability assessment.
iv) Informal reading inventory.
v) Direct observation.

42.  Norm-referenced assessment; where a student’s score is
compared with the scores of the other students in the
same group.
 Criterion-referenced assessment; where a student’s score
is compared against an already set standard. E.g.
University pass mark.

43.  Process-ability assessment; where one tends to measure a
student’s ability in all perceptual or psycholinguistic
areas.
 Informal reading inventory; which deals with the testing
of the reading ability. The aim is to check proficiency,
omission, substitution, and reversion.
 Direct observation; where a student’s behavior is
repeatedly assessed in a natural situation by directly
watching and hearing him or her.

44. Remedies to learning disabilities.
 Task training; which involves modifying learning through
breaking tasks into smaller units. These people cannot
conceptualize (understand) when a lot is taught.
 Learning strategies instruction, which is designed to teach
a student specific learning skills, such as strategies to
enhance memorization or problem solving skills.
 Individualized instruction in which the teacher should
endeavor to have the student to learn individually.

45.  Using concrete examples and demonstrations to help the
student get the message better.
 Remedial learning; allowing learning-disabled students to
manage their learning at their own pace so that they can
participate actively and often.
 The teachers may also help students to work around
individual learning disorders. For example, teachers may
allow a student with memory problems to use a tape
recorder to dictate notes and record class lectures.

46. Mental retardation (MR)
 Mental retardation (MR) refers to the significant sub-
average general intellectual functioning resulting in or
associated with concurrent impairments in adaptive
behavior, manifested during developmental period of an
individual.

47. Key concepts in definition.
 A learning deficit, generally characterized with IQ below
70 %.
 Impairments (limitations) in adaptive behavior, as in
deficits in communication, self-care, socialization and
mobility. Hence, MRs cant live independent life.
 A disorder which is recognized during the developmental
or growing years, generally considered earlier than 18
years of age.

48. Categories of mental retardation.
 The criteria for labelling is IQ, that is:
- Mild mental retardation: persons with mild mental
retardation have an IQ scores ranging from 55 to 70.
- Moderate mental retardation: moderately (trainable)
retarded people with IQ scores ranging from 40 to 54.
Trainable in adaptive or self-help skills such as feeding,
dressing, toilet training, through repetitive methods, in
special schools. They can perform semi- skilled tasks through
strict supervision.

49. Severe mental retardation:
 Characteristics:
- IQ scores ranging from 25 to 39.
- able to learn only the most self-care skill.
- may learn to talk during childhood.
- As adults can perform simple tasks with close supervision.
- live in group homes or with families.
- display more behavioral problems, far less socially
developed.

50. Profound mental retardation.
 Characteristic of:
- IQ scores below 25.
- Understand some language, but they little ability to talk.
- Neurological condition that accounts for their retardation.
- Require life-long care and supervision.
- Often confined to institutions.

51. Causes.
 May occur:
- Congenital.
- During delivery, like asphyxia, brain injury, etc.
- Post natal as in disease effects and accidents or
poisoning.

52. Congenital.
 This can be due to:
- Genetic inheritance.
- Chromosomal abnormalities.
- Cranial anomalies such as macrocephaly, microcephaly
and hydrocephaly.
- Teratogenic factors

53. Chromosomal defects.
 Down syndrome Down syndrome occurs when an egg or sperm with an extra
number 21 chromosome fuses with a normal gamete.
 The result is a zygote with three copies of chromosome 21 (trisomy 21).
 Down syndrome individuals bear various abnormalities, including mental
retardation, heart defects, respiratory problems, and deformities in external
features
 Klinefelter syndrome (xxy)
 Turners syndrome (xo) Individuals with Turner syndrome are physically
abnormal and sterile.

54. Genetic predispositions.
 Such as fragile X syndrome, affecting boys with
extra copy or part of chromosome 21 (trisomy
21).(mosaic, translocation or simple)
 defective gene unable to produce enzymes or
proteins needed for critical cell functions. They
include the PKU and Tay-Sachs disease.
 Tay-sachs caused by Hex-A enzyme, prevents the
build-up of a fatty substance, called GM2
ganglioside, in the brain and spinal cord.

55. Teratogenic factors
 malnutrition,
 alcohol and other drug abuse,
 viral infections like rubella and untreated diseases like
diabetes mellitus among other.
 environmental toxins like lead and mercury or radiation
affecting mutation.
 viral encephalitis or genital herpes.
 Rarely, immunological agents such as ant tetanus serum or
typhoid vaccine.

56. Post natal conditions.
 exposure to lead, reaping off paint.
 Low exposure to valuable experiences.
 blows to the head,
 malnutrition,
 Poisoning and chronic diseases.
 birth injury
 and early alcoholism

57. Common characteristics of MR.
 Sub average mental skills and intellectual sub
functioning.
 Slow learners with below average performance compared
to age group.
 learning, poor in academic achievement. They generally
perform poorly in all academic areas.
 They lack adaptive skills.
 They lack motivation, due to frustrations of comparing
with others.

58.  They may experience retarded and delayed speech due to
diminished intellectual functioning and associated neurological
conditions.
 Retarded physical growth, and physically handicaps.
 They have difficulty with the generalization of skills, cant think
abstractly.
 They tend to experience fragile health. They are always sick and
weak.
 They may always experience behavioral deficiencies such as
aggression, emotional instability, social incompetence (being
antisocial).

59. Identification.
 Using IQ tests, such as the Stanford-Binet and Wechsler
intelligence tests.
 Adaptive behavioral scales, which are used to assess the
daily living skills of people such as eating, dressing skills,
toilet skills etc.
 Direct observation of the physical symptoms, such as very
short stature, very big or small heads.

60. Educating mentally retarded.
 Given their status are special need students, they need
special education and instructional methods.
 They are capable of developing specialized skills like
normal students.
 With such effort expended, they may become
indistinguishable adults capable socially and economically.
 Often they may be mainstreamed to acquire core learning
competencies and concepts before joining all inclusive
education.

61.  Task analysis that is breaking down the task, success on one
step leads to another.
 Using visual aids, and tactile and kinesthetic aiding.
 Giving timely feedback which aid connection between their
answers, behaviors, or questions and teacher’s responses.
 Providing constant practice and adequate time for work.
 Using slow and simple pacing of lessons.
 Using the individualized education program.
 Active learner engagement.

62. VISUAL IMPAIRMENT
 It is the inability of the eye to focus images and the brain
to make meaning of these images.
 For vision to occur, various parts work interdependently in
a specialized way.
 Malfunctioning of any part is termed as visual impairment.
 Common visual impairments include myopia, blindness,
night blindness, etc.

63. Parts of an eye.
 The cornea.
 The aqueous humor.
 The pupil.
 The iris.
 The lens.
 The retina.
 Optic nerves.

64. Visual efficiency
 This is the ability to see.
 This is made possible when there is light and light must
refracted properly, and the brain must receive it and
process it.
 There are two basic elements of visual efficiency, namely;
- Visual acuity
- Peripheral vision

65. Visual acuity
 It is a measurement of the ability to distinguish details and
shapes of objects.
 One way to measure visual acuity is with standardized chart
of symbols and letters known as the Snellen chart, invented
in 1862 by a Dutch ophthalmologist Herman Snellen.
 The range of abnormal visual acuity is the deviation from the
normal 20/20.
 One with visual acuity of 20/100, means that he /she must
stand 20m to see the same object a normal one can see in
100m.

66. Peripheral vision
 Peripheral vision is how wide a person can see and
distinguish the presence of color, objects or motion
outside the direct line of vision.
 How far in degrees can you see objects out of 90*?
 How many colors can you distinguish from a mixture?
 To what extent can you identify specific aspects of a
scene in motion?

67. Visual impairment.
 The term visual impairment is used to describe any kind of
vision loss, ranging from someone having no sight at all to
someone who has partial vision loss.
 There are two categories of visual impairment:
- Low vision
- Blindness

68. Low vision.
 A condition in which there is functional use of vision but
which requires a lot of adaptation using technology.
 People with low vision use a combination of vision and
other senses to learn, although they may require
adaptations in lighting or the size of print, and sometimes
Braille.

69. Blindness
 Blindness is a vision loss so pronounced that the child learns best
through touch and listening, rather than through sight, even with
adaptive aids.
 A blind person may be either:
- legally or
- totally blind.
 Legal blindness is defined as very little sight but with no functional
use of the sight. (20/200 ft.)
 Total blindness: The lack of light perception, can only learn with the
help of a brail machine and tactile experiences.

70. CAUSES OF VISUAL IMPAIRMENT
 Congenital blindness caused by diseases like rubella.
 Adventitious blindness caused by:
- Injury from accidents.
- Malnutrition.
- Infectious diseases, such as HIV/AIDS, meningitis, and
measles, trachoma, retinitis, pigmentossa, macular
degeneration, diabetic retinopathy, glaucoma, cataracts,
strabismus, myopia, hyperopia and astigmatism.

71.  Trachoma occurs when a very contagious micro organism called
Chlamydia trachomatis causes inflammation in the eye.
 Macular degeneration is a gradual and progressive deterioration of the
macula, the most sensitive region of the retina affecting central vision
(the ability to see fine details directly in front) though the person will
be able to see his peripheral vision leading to difficulty reading or
watching TV, or distorted vision in which straight lines appear wavy or
objects look larger or smaller than normal.

72.  Diabetic retinopathy occurs when the tiny blood vessels in
the retina are damaged due to diabetes.
 Cataracts are cloudy areas in part or the entire lens of the
eye. Cataracts prevent light from easily passing through
the lens, and this causes loss of vision. Symptoms include
double vision, cloudy or blurry vision, difficulty seeing in
poorly lit spaces and colors that seem faded.
 Retinitis pigmentosa is an inherited condition that brings
degeneration of the retina, and it frequently begins as
what is commonly called night blindness.

73.  Glaucoma is an increase in pressure inside the eye. The
increased pressure impairs or reduces vision by damaging the
optic nerve.
 Strabismus, or cross eyes is a condition in which both eyes are
unable to gaze at an object at the same time. It is caused by a
muscle imbalance.
 In myopia (nearsightedness or short sightedness), images are
focused in front of the retina, making far away objects appear
blurry. In simple terms, myopia is where the eye is large and
thus near vision is better than distance.

74.  Hyperopic results from an image being focused behind the
retina, meaning that the person will have trouble focusing
on objects that are close up. In other words, hyperopia is
where the eye is small and thus one’s distance vision is
better than the near vision.
 Astigmatism results from curvature of the cornea, which
keeps light rays from focusing properly in one area of the
retina. This conditions results in the inability to focus on
objects far or near.

75. IDENTIFICATION OF VISUAL IMPAIRMENT
 Low vision can be identified by:
- Difficult to read.
- Writing less clearly and having trouble writing on a line.
- Excessive rubbing of the eye.
- Shutting or covering one eye while trying to see something
- Experiencing trouble identifying or differentiating colors
- Having difficulty identifying faces or objects
- Complaints of eyes itching and double vision.

76. - Corking or tilting the head in order to see or read
something.
- Not blinking at sudden bright lights
- Blinking the eyes more frequently than normal
- Not looking at others in the eyes (not making eye contact)
- Feeling for objects on the ground instead of looking with
one’s eyes.

77. - Having squinting (cross) eyes in the case of strabismus or
“heteropia” which is a condition where eyes are not aligned
properly.
- Eye signs which are very common and recurring, such as
swellings, inflamed or watery eyes.
- constant eye pains and headaches, dizziness or nausea.
- Eyes bouncing around, dancing eyes or strange eye movements.
- Eyelids not completely covering the eyes when one closes
them.

78. Snellen chart.
 To measure attention, capacity and processing abilities.
 The chart is used to detect the ability to read letters,
figures and objects with different sizes, shapes and in
different positions.

79. CHARACTERISTICS OF STUDENTS WITH
VISUAL IMPAIRMENT
 Verbalism-talking and asking questions a lot.
 High tactual and synthetic touch and feeling.
 Mobility limitation, movement and orientation.
 Can be easily taught in the regular classroom, but may
need assistive technology.
 Experience feelings of isolation and limited interaction,
but most of them are friendly hyperactive, talkative and
humorous.

80. Education services to the visually impaired
students
 Visually impaired students can be taught in schools for
blind as well in inclusive schools, but assisted with:
- Use of corrective lenses.
- Use of reading and writing equipment such as braille
machine, cameras that can san lines of print which
computers can then convert to synthesized speech,
typewriters, computers equipped with screen readers
or synthetic speech systems.
- Use of walking devices.
- Orientation training

81.  Mobility training.
 Exposing them to medical services like surgery, medicine
use, grafting among others.
 Use of a reading and walking buddy.
 Periodic examination

82. HEARING IMPAIRMENT
 What is hearing? What happens for one to hear?
 This is primarily done by the ear.
 The ear has specialized parts for performing different
functions.
 The capacity of the ear to detect sound waves depends on
its functioning and sound intensity.

83. Sound intensity.
 This is how loud or soft sound is.
 Compare softness and loudness of sound on hearing.
 Sound intensity is measured in decibels (dB).
 10 dB represents the smallest sound a person with normal
hearing can perceive.
 Suitable conversation should be about 30 – 65 dB.
 Automobile sound (lorry) is about 80 dB.
 A sound of 125 decibels causes pain and the inability to
hear.

84. Frequency
 Frequency of sound is how high or low a sound is. Frequency is based
on the number of vibrations per second.
 A low sound indicates few vibrations per second while a high sound
indicates many vibrations per second.
 It is measured in units called hertz designated as hz.
 The lowest normal hearing can perceive is 20 hertz and the highest is
40000 hertz.
 Normal hearing (conversational sound) can perceive sound between 20
and 20,000 hertz.

85. Hearing impairment.
 The inability to detect sound in the normal range (25 dB) is referred to
hearing impairment.
 Unable at around;
 30 – 45 dB loss is mild,
 46 – 60 dB loss is moderate,
 61 – 90 dB Loss is profound.
 This can be categorized as:
- Hard of hearing, with ability to perceive or hear some sound. It is
sometimes called residual hearing because one respond to some sound.
This condition may be static or seasonal.
- deafness., inability to receive sound at all, hence communicating with sign
language.

86. History of education for hard to hear.
 Education for hard to hear begun in 1578 in Spain Pedro
pons Deleon teaching speech, writing, reading and
arithmetic.
 More advocacy by 1700 by henry baker and Thomas
Hopkins in England, Michel in France, Samuel Heinickle in
Germany.
 By 18th century many school had been opened in Europe.
 Uganda got the first school for hard to hear in 1968 at
Ntinda.

87. Categorization by cause.
 Conductive hearing impairment (hard of hearing or deaf), from
damage or dysfunction of the outer ear or middle. It is usually
unilateral, light, temporally and therefore, can be corrected.
 Sensor neural hearing impairment, damage of the inner ear
(such as the damage of the cochlea and the auditory nerves. It is
usually severe permanent and bilateral.

88.  Mixed hearing loss, a situation in which the inability is
affecting all the three parts of the ear. It is usually
bilateral and in most cases quite severe.
 Functional hearing loss, a condition of hearing
disability with no organic causes.

89. Identification of hearing impairment
 Observation of certain symptoms, such as;
- Titling the head at an angle in order to look for the
direction of the sound.
- Failing to respond when questioned or responding in
another way.
- Difficulty in following instructions.

90. - Deformity of the outer ear.
- Discharge (white staff or bad-looking substance) from the
ear.
- Inattentiveness when spoken to.
- Erratic responses to situations (i.e. making un coordinated
responses).

91. Identification of hearing impairment is usually done
by audiologists in order to determine the degree of
one’s response to sound.
The instrument used is called the audiometer.
The teacher’s task therefore is to observe the
symptoms of hearing impairment and encourage the
patient (student) to visit the audiologist.

92. Characteristics of hearing impaired people.
 In the area of language, they manifest poor speech
development.
 academically challenged in language oriented subjects but
can do better in mathematical related areas.
 they usually feel isolated and frustrated because of lack
of interaction.

93.  a tendency of an aggressive and emotionally unstable and
erratic.
 limited intellectual functioning( conceptualization),
because thinking depends on language and language is a
product of hearing.
 no significant physical abnormality except some erratic
movements in the environment.

94. Common Causes of Hearing Impairment.
 Infections of the ear by ear diseases which
destroy the functioning of the ear cells.
 Viral diseases, such as German measles.
 Bacterial infections, such as meningitis, that
affect the sensitive acoustic mechanism of the
ear.

95.  Toxic drugs that can damage the hearing cells in the
cochlea.
 Environmental influences, such as noise and pollutions.
 Birth complications

96.  Excessive accumulation of wax in the auditory canal which
blocks the movement of sound.
 Perforations (spots) in the ear drum
 Heredity due to false mutation commonly associated with
Otosclerosis, Usher’s syndrome and Pendred syndrome.
 Accidents and drugs

97. Categorization of causes.
 Berg(1986) advances four types:
- Conductive hearing loss, faulty transmission of sound
from outer ear to inner ear due accumulation of ear wax,
ear infection causing malformation of the auditory
canal.(otitis media)

98. Sensory neural hearing impairment
- Sensory neural hearing impairment; a permanent and severe
condition caused by:
i) Use of toxic drugs (mycin) such as gentamycin, streptomycin,
Cana, etc.
ii) Premature birth complications with conditions of immature
auditory system.
iii) Bacterial infections destroying sensory acoustic system. E.g.
Meningitis, mumps, rhesus incompatibility.
iv) Genetic inheritance (GJB2 ( Gap Junction Protein Beta 2)related
hearing loss).

99. Mixed hearing impairment.
 From both conductive and sensory- neuro causes.

100. Functional hearing impairment.
 A person has difficulty in perceiving sound but with no
found cause.

101. Educational services for students with
Hearing impairment.
 Auditory training in which students are helped to develop awareness
of sound and speech by discriminating among sounds using signs.
 Lip or speech in which the affected student is taught how to use visual
ability to understand what is said by studying and watching the
movement of the lips of the speaker.
 Environment modification, which usually involves instructional
strategies that a student’s learning fairly easy.
 The use of overhead projectors.

102.  Amplification (using a loud speaker)
 Use of a hearing buddy to help him in interpretation
 Sitting position in such a way that he/ she can easily get access to the
teacher’s lips
 Use of hearing aids
 Non-verbal communication, which involves the use of natural body
movement, facial expressions, and head movements as well as eye
contact.
 Sign language is the visual gestural language of eyes and fingers.