Chapter 6

Types, Characteristics, and Identification of

Learner with Difficulty Seeing, Hearing and
Communicating
Baldoza, Daniel A.
Learners with Difficulty
Seeing
 Learners with Difficulty Seeing
There are a number of terms that are often used in
association with having difficulty seeing. According to Heward
(2017), the following are the legal definitions of some of these
terms:
1. Visual Acuity
2. Legal Blindness
3. Partially Sighted
4. Tunnel Vision
 Learners with Difficulty Seeing
1. Visual Acuity - refers to the ability to distinguish forms or
discriminate among details. It is usually measured by reading letters,
numbers or other symbols from the Snellen Eye Chart. When one is
said to have a vison of “20/20”, this means that at a distance of 20
feet, one can see what a normal seeing eye at that distance.
2. Legal Blindness - This refers to having a visual acuity of 20/200 or
less in the better eye with the use of a corrective lens. When one’s
field of vision is restricted to an area no greater than 20 degrees, one
can also be considered legally blind.
 Learners with Difficulty Seeing
3. Partially Sighted - These are the individuals whose visual acuity in
the better eye after correction falls between 20/70 and 20/200.

4. Tunnel Vision - Is a condition of having a perception of viewing the

world through a narrow tube. In this case, central vision may be
good, but the peripheral vision is poor at the outer ranges of the
visual field.
 Characteristics of Learners with Difficulty
Seeing
Cognition and Social Adjustment and Motor
Language Interaction Development and
Mobility
Learners with difficulty
seeing usually perform more Children with visual impairment may
poorly compared to those with engage in less play, which could affect
normal vison in terms of their social skills development. Among
Blindness may also
cognitive tasks that require adolescents, having visual impairment
result delays and deficits
comprehension relating may increase social isolation, and more
in motor development.
various kinds of information. effort on the part of individual w/ visual
impairment is needed to be able to make
and keep friendships.
 Those with visual impairment are prone to develop
STEREOTYPIC BEHAVIOR, such as repetitive body
movements, including body rocking, eye pressing and poking,
hand flapping, and head weaving. While they usually do not
cause harm, these behaviors could place a visually impaired
person at a social disadvantage as they may be misinterpreted
and may call negative attention to others. Furthermore, dealing
with negative attitudes of sighted people may also pose a
challenge to individuals with visual problems.
 Types and Causes of Visual Impairment
Condition Definition and Cause Remarks and Implications
AMBLYOPIA Reduction in or loss of vision in the Close work may result in eye
weaker eye from lack of use; caused fatigue, loss of place or poor
by strabismus, unequal refractive concentration; seating should favor
errors, or opacity of the lens or the functional eye.
cornea.
ASTIGMATISM Distorted or blurred vision caused by Loss of accommodation when
irregularities in the cornea or other objects are brought close to the face;
surfaces of the eye that produce avoid long periods of reading or
images on retina not in equal focus close tasks that cause discomfort;
(refractive error). child may complain of headaches
and fluctuating vision.
 Types and Causes of Visual Impairment
Condition Definition and Cause Remarks and Implications
CORTICAL Impaired vision caused by damage to Visual functioning may fluctuate
VISUAL or malfunction of the visual cortex depending on lighting conditions
IMPAIRMENT or optic nerve (or both); causes and attention; vision usually does
(CVI) include anoxia, head injury, and not deteriorate; improvement
infections of the central nervous sometimes occurs over a period of
system; many children with CVI time; some are attracted to bright
have additional disabilities, such as light; may fail to blink at threatening
cerebral palsy, seizure disorders, or motions; visual images should be
intellectual disabilities. simple and presented singly.
 Types and Causes of Visual Impairment
Condition Definition and Cause Remarks and Implications
HYPEROPIA Difficulty seeing near objects clearly but Loss of accommodation when
able to focus on distant objects; caused by a objects are brought close to the
shorter than normal eye that prevents light face; avoid long periods of
rays from converging on the retina reading or close tasks that cause
(refractive error). discomfort.

MUSCULAR Central area of the retina gradually Tasks such as reading and writing
DEGENERA- deteriorates, causing loss of clear vision in are difficult; prescribed low-vision
TION the center of the visual field; common in aid or closed-circuit TV; provide
older adults but fairly rare in children. good illumination; avoid glare.
 Types and Causes of Visual Impairment
Condition Definition and Cause Remarks and Implications
MYOPIA Distant objects are blurred or not seen at all Encourage child to wear
(nearsightedne but near objects are seen clearly; caused by prescribed glasses or contact lens;
ss) an elongated eye that focuses images in for near tasks, child may be more
front of the retina (refractive error). comfortable working without
glasses and bringing work close to
face.
 Types and Causes of Visual Impairment
Condition Definition and Cause Remarks and Implications
NYSTAG- Rapid, involuntary, back-and-forth movement of Close tasks for extended
MUS the eyes, which makes it difficult to focus on period can lead to fatigue;
objects; when two eyes cannot focus some children turn or tilt
simultaneously, the brain avoids a double image head to obtain the best
by suppressing the visual input from one eye; the focus; do not criticize this.
weaker eye (usually the one that turns inward or
outward) can actually lose its ability to see; can
occur on its own but usually associated with
other visual impairments.
 Types and Causes of Visual Impairment
Condition Definition and Cause Remarks and Implications
STRABIS- Inability to focus on the same object Classroom setting should favor
MUS with both eyes because of an inward or student’s stronger eye; some students
outward deviation of one or both eyes; may use one eye for distance tasks;
caused by muscle imbalance; and the other eye for near tasks;
secondary to other visual impairments. frequent rest periods may be needed
during close work; may need more
time to adjust to unfamiliar visual
tasks.
 Identifying Learners with Difficulty Seeing
There are number of indicators of visual impairment that
parents and teachers need to be aware of. These indicators may
be observed from the student’s eye appearance and complaints
when using eyes during desk work. There are also behavioral
signs such as deficits in eye teaming abilities, eye-hand
coordination, visual form perception, as well as refractive
status indicating visual impairment.
 Identifying Learners with Difficulty Seeing
1. In terms of eye appearance, turning of one eye in or out at
any time; reddening of eyes or lids; excessive tearing of
eyes; having encrusted eyelids; of frequently developing
styes on lids could be signs of developing eyes and visual
problems.
 Identifying Learners with Difficulty Seeing
2. Behavioral signs indicating visual problems; deficits in eye
movement abilities (ocular motility) could signal visual
impairment (turning of head as one reads across the page;
frequently losing place during reading; needing the use of
finger or marker just to keep place when reading; having
short attention span in reading or copying; frequent
omission of words; writing in uphill or downhill direction
on paper; rereading or skipping lines without being aware
of it; and poor page orientation of drawing).
 Identifying Learners with Difficulty Seeing
3. Behavioral signs that could indicate dysfunction in eye
teaming include: complaining of having double vision;
repeating of letters within words; omission of letters,
numbers or phrases; misalignment of digits in number
columns; frequent squinting, or the need to close or cover
one eye to see better; extreme tilting of head during desk
work.; and consistent gross postural deviations when doing
desk work.
 Identifying Learners with Difficulty Seeing
4. Other behavioral indicators of visual impairment include
deficits in eye-hand coordination abilities such as
handwriting that is crooked; poorly spaced, and inability to
stay in crooked lined; not using the eyes to “steer” hand
movements, etc.
5. Problems with refractive status (e.g., nearsightedness,
farsightedness, and focus problems may also be inferred
from behavioral indicators of visual problems.
 Identifying Learners with Difficulty Seeing
The Snellen Eye Chart
The Snellen Chart is used to test
visual acuity. It was developed by a
Dutch ophthalmologist in 1962, and
still a widely used tool in measuring
visual acuity today. It consists of rows
of letters, with each row corresponding
to the distance that a normally sighted
person could discriminate letters.
 Identifying Learners with Difficulty Seeing
The Vision Services Severity Rating Scale (VSSRS)
It was developed by the Michigan Department of Education (2013)
in order to assist the Teacher Consultant for the Visually Impaired
(TCVI) or Teacher of Visually Impaired (TVI) in making
recommendations for services to students who are blind or visually
impaired. The VSSRS is intended for use with students in general
education settings and may be applicable for some students with
additional blind impairments .
Learners with Difficulty
Hearing
 Learners with Difficulty Hearing
The Decibel Scale
Decibels (dB) refer to the
intensity or loudness of sound.
Zero hearing-threshold level is
the smallest sound a person with
normal hearing can perceive; also
called the audiometric zero. Hertz
(Hz) pertain to the frequency, or
pitch, of sound. (Heward, 2017)
Learners with Difficulty Hearing
Learners with Difficulty Hearing
Learners with Difficulty Hearing
 Learners with Difficulty Hearing

Deafness
Is defined as severe hearing loss in hat the learner is
impaired in processing linguistic information through
hearing, with or without amplification, and which
negatively affects a learner’s educational performance.
 Learners with Difficulty Hearing

Hearing Loss
Pertains to loss in hearing, whether permanent or
fluctuating, that negatively affect the learner’s
educational performance, other than those that qualify as
deafness.
 Learners with Difficulty Hearing
Residual Hearing
Refers to some sounds perceived by most deaf people.
However, those who are deaf still use vision as their
primary mode of learning and communication.
Individuals who are hard of hearing are those who can
use their hearing to understand speech, generally with the
help of hearing aid.
 Learners with Difficulty Hearing
Deaf Culture
While person-first language is the appropriate way to
refer to individuals with disabilities, people who identify
with the Deaf culture prefer terms such as Teacher of the
Deaf, School for the Deaf, and Deaf Person.
 Characteristics of Learners with Difficulty Hearing

Students with difficulty Social

Learners with Speaking
.
hearing loss are at a
hearing usually Functio-
perform poorly than
great disadvantage There is a tendency their peers with normal ning
of acquiring for the learners to hearng. Hearing loss may result
language skills. speak too loudly or to feelings of isolation,
not loudly enough, or having no friends, and
have problems in unhappiness in school,
Literacy terms of having Academic as this limits
abnormally high pitch, socialization with
or improper stress or
Achieve-ment
peers.
inflection.
 Types and Causes of Hearing Loss
Conductive Hearing Sensory Hearing Neural Hearing
Impairment Impairment Impairment

Refers to the damage to Refers to the abnormality of

It involves a problem with
the cochlea the auditory nerve pathway.
the conduction or
transmission of sound
vibrations to the inner ear.

Mixed Hearing Unilateral Hearing

Impairment Loss Bilateral Hearing Loss
Refers to any This is hearing loss in one This is hearing loss in
combination of ear. both ears.
conductive, sensory, and
neural hearing loss.
 Types and Causes of Hearing Loss
Congenital Hearing Acquired Hearing Loss Prelingual Hearing
Loss Loss
This is hearing loss present This is hearing loss that This is hearing loss before
at birth. develop after birth. the development of spoken
language.

Postlingual Hearing
Loss
This hearing loss
happened after the
development of spoken
language.
 Possible Causes of Hearing Loss
CONGENITAL ACQUIRED

 Genetic Factors – e.g., Autosomal dominant hearing  Otitis media – a temporary, recurrent infection of the
loss, when one parent passes on a dominant gene for middle ear.
hearing loss to a child; autosomal recessive hearing  Meningitis – a bacterial or viral infections of the
loss, when both parents have recessive genes for hearing central nervous system and is the leading cause of
loss; X-linked hearing loss, when the mother carries the postlingual hearing loss.
recessive trait for hearing loss on the sex chromosome  Meniere’s Disease –sudden and unpredictable attacks
and passes it to a male offspring but not to females. of vertigo, fluctuations in hearing, tinnitus (perception
 Maternal Rubella – when a pregnant woman of sound when no outside sound is present).
contracted rubella, which could cause deafness in the  Noise Exposure – repeated exposure to loud sounds.
developing child.
 Congenital Cytomegalovirus – when a woman
contracts cytomegalovirus, which risk deafness in the
developing child.
 Prematurity
 Classification of Hearing Loss
Degree of Classification Impact on Speech and Language
Hearing Loss
Slight • No difficulty understanding speech in
27 to 40 dB quiet settings, but noisy environments
pose problems to learning
• May benefit from favorable setting and
sound field amplification
 Classification of Hearing Loss
Degree of Classification Impact on Speech and Language
Hearing Loss
56 to 70 dB Moderate • Without hearing aid can hear conversational
speech only if it is near, loud, and clear
• Finds it extremely difficult to follow group
discussions
• Full-time amplification is necessary
• Speech noticeably impaired but intelligible
• May benefit from time in a special class where
intensive instruction in language and
communication can be provided.
 Classification of Hearing Loss
Degree of Classification Impact on Speech and Language
Hearing Loss
71 to 90 dB Severe • Can hear voices only if they are very loud and 1 foot
or less from the ear
• Wears a hearing aid, but it is unclear how much it
helps
• Can hear loud sounds such as slamming door, vacuum
cleaner, and airplane flying overhead
• May distinguish most vowel sounds but few if any
consonants
• Communicates by speech and sign
• May split school day between a special class and a
general education classroom with an educational
interpreter
 Classification of Hearing Loss
Degree of Classification Impact on Speech and Language
Hearing Loss
91 dB or more Profound • Cannot hear conversational speech
• Hearing aid enables awareness of certain very
loud sounds, such as bass drum
• Vision is primary modality for learning
• American Sign Language likely to be first
language and principal means of communication
• Has not developed intelligible speech
• Most require full-time special education program
for students who are deaf
 Identifying Learners with
Difficulty Hearing
Identifying learners with hearing problems may be challenging for
parents and teachers. It can be mistaken as another problem and may be
misdiagnosed (e.g., attention deficit disorder (ADD), specially if
hearing loss is unilateral, or it can go undiagnosed and thus, may affect
a student’s learning. A number of indicators that may signify hearing
difficulties, which teachers, and parents need to pay attention to, have
been identified (People Hearing Better, 2014). The following describe
the signs that indicate a child has hearing problems.
 Identifying Learners with
Difficulty Hearing
Signs that a child has hearing problems:
1. Speech Problems
2. Inattentiveness
3. Increasing Volume
4. Not Following Directions
5. Learning Difficulties
6. Social Withdrawal
 Assessment of Hearing Loss
Assessment of Infants
The following table shows the expected auditory behaviors during the baby’s first year.

Age Expected Auditory Behavior

Birth to 3 • Startles to loud noises
Months • Coos and makes pleasurable gurgling sounds
• Turns to voices
• Quiet downs or smiles when spoken to
• Stirs or awakens from sleep to a loud sound relatively close
 Assessment of Hearing Loss
Assessment of Infants
Age Expected Auditory Behavior
4 to 6 Months • Engages in vocal play when alone; gurgles
• Babbles with speech-like sounds
• Turns eyes towards direction of sounds
• Notices toys that make sounds
• Laughs and chuckles
 Assessment of Hearing Loss
Assessment of Infants
Age Expected Auditory Behavior

7 months to 1 • Responds differently to a cheerful voice versus an angry voice

year • Responds to music or singing
• Vocalizes emotions
• Babbling acquires inflection and contains short and long groups of speech
sounds (“tata, upup, bibibi”)
• Tries to imitate the speech sounds of others
• Turns head in the direction of the source of a sound
• Ceases activity when parent’s voice is heard
• Responds to own name and request such as “Want more?” or “Come here.”
• Uses a few words (e.g., mama or dada, doggie) by first birthday
 Assessment of Hearing Loss
Pure Tone Audiometry
It is used to assess the hearing of older children and adults by
determining how loud sounds at various frequencies must be for one to
hear them. An audiometer is used, which is an electronic devise that
generates pure tones at different levels of intensity and frequency. The
results are plotted in an audiogram.
 Assessment of Hearing Loss
Speech Reception Test
It tests a person’s detection and understanding od speech sounds.
Phonetically balanced one - and two syllable words are presented at
different decibel levels, and the speech threshold, or the lowest decibel
level at which one can repeat half of the words listened to, is measured
and recorded for each ear.
 Assessment of Hearing Loss
Alternative Audiometric Techniques
It includes;
1. Play audiometry - the child is taught to perform simple but distinct
activities whenever one hears the signal speech or pure tone;
2. Operant conditioning audiometry - the child receives tokens when a
button is pushed in the presence of a light paired with the sound; and
3. Behavior observation audiometry – a passive assessment procedure in
which the child’s reaction to sounds is observed.
Learners with Difficulty
Communicating
 Communication
Refers to all aspects which make up any exchange of meaning,
including speech, language, voice, fluency, and nonverbal and
pragmatic communication behaviors.
It is the interactive exchange of information, ideas, feelings, needs
and desires.
The elements of communication are: (1)message; (2)sender; and (3)
receiver.
 Language
Is a formalized code used by a group of people in order to
communicate with one another.
It has five (5) dimensions:
1. Phonology
2. Morphology
3. Syntax
4. Semantics
5. Pragmatics
Speech refers to the oral production of language.
 Communication Disorder
Refers to impairment in the ability to receive, send, process
and comprehend concepts or verbal, nonverbal, and graphic
symbol systems.
 Speech or Language Impairment
Refers to communication disorder, including stuttering,
impaired articulation, language impairment, or voice
impairment that negatively affects one’s educational
performance.
Speech Impairment pertains to deviations so far from the
speech of other people that it calls attention to itself;
interferes with communication; or provokes distress in the
speaker or listener.
 Speech or Language Impairment
Language disorder refers to impaired comprehension
and/or use of spoken, written, and/or other symbol systems.
This could involve the form of language; the content of
language; and/or the function of language in communication.
 Receptive Language Disorder
Is the lack of ability to make sense of or identify sounds and
words.
It is also called “audio processing disorder”.
 Expressive Language Disorder
Is the difficulty in expressing language.
An example of this is Aphasia, in which one has difficulty
forming and relaying phrases, thoughts, even though hearing
and auditory processing are intact.
 Fluency Disorder
Refers to difficulty of forming sounds, words, and phrases
because of neurological reasons.
This includes cluttering or stuttering

Speech Sound Disorder

Pertains to difficulty in making specific sound even though
there is no physical reason for it.
 Oral Muscular Disorders
Are physical disorders wherein the muscles controlling
speech are impaired, injured, or developmentally abnormal

Dysarthria
The lack of ability to execute movements involved in
speech, which is a motor planning disorder.
 Apraxia
The inability to coordinate speech movement; also a motor
planning disorder.

Mutism
The inability to produce speech wherein muscles are unable
to move.
 Delayed Language
Pertains to the language of a child who is slow to develop
language skills, in the context of typical development of
motor and other cognitive skills.

Specific Language
Impairment
Pertains to the language of a child who is developing skills
in a different pattern, but typically in terms of motor and
other cognitive skills.
 Phonological Disorder
Is the difficulty with phonological rules that govern the
patterns of speech production.

Developmental
Articulation Disorder
Pertains to the difficulty with particular sounds that may
relate to structural differences, such as cleft palate, or learned
movements, such as lisp.
 Umbrella of Communication Disorders
Aphasia

Speech – sound – Lisp

Expressive Phonological
Speech Disorder
Disorders
Stuttering
Language
Disorders Fluency
Processing Cluttering
(guessing)
Receptive –
Communication Auditory Noise
Disorders Processing Filtering
Dysphonia

Physical
Disorders Voice Esophageal Voice

Oral Mutism
Muscular Dysarthria
Neuromuscular
Apraxia
 Characteristics of Learners with Difficulty
Communicating
Speech-sound Errors
This could include the following:
1. Distortions – when speech sounds like the intended phoneme other than
another speech sound but is conspicuously wrong.
2. Substitutions – when one sound is used as substitute for another.
3. Omissions – when certain sounds are omitted.
4. Additions – when extra sounds are added.
Characteristics of Learners with Difficulty Communicating

Articulation Disorder
When one is not able to produce a given sound physically because
that sound is not in one’s repertoire.

Phonological Disorder
When one has the ability to produce a given sound but does so
inconsistently.
Characteristics of Learners with Difficulty Communicating

Stuttering
when there is a rapid-fire repetitions of consonants or vowel sounds,
especially at the beginning of words, prolongations, hesitations,
interjections, and complete verbal blocks.
Characteristics of Learners with Difficulty Communicating

Cluttering
When there is excessive speech rate, repetitions, extra sounds,
mispronounced sounds, and poor or absent use of pauses.
Characteristics of Learners with Difficulty Communicating

Voice Disorders
It is characterized by having abnormal production and/or absences or
voice quality, pitch, loudness, resonance, and/or duration that is
inappropriate for one’s age and/or sex. It could involve phonation
disorder, which causes the voice to sound breathy, hoarse, husky, or
strained, or resonance disorder, in which too many sounds come out
through the air passages of the nose, or not enough resonance of the
nasal passages.
Characteristics of Learners with Difficulty Communicating

Language Disorders
When there are problems w/ one or more of the five dimensions of
language (i.e., phonology, morphology, syntax, semantics, or
pragmatics). It could be receptive, which involves understanding of
language; or expressive, which involves the production of language.
 Types of Communication Disorders
Psychological and Behavioral Characteristics
Limitations in communications skills could have an effect on other
developmental domains including social, cognitive, and academic
development. In some cases, delinquent behavior can occur. They may
also have difficulty acquiring metalinguistic abilities.
 Characteristics of Learners with Difficulty
Communicating
Language Disorders
Persistent difficulties in the acquisition and use of language across
various modalities, including spoken, written, sign language, or others,
as a result of deficits in comprehending or producing language. This
could include reduced vocabulary, limited sentence structure, or
impairments in discourse.
Those with language disorder have languages abilities that are
substantially and quantifiably lower than those expected for their age.
 Characteristics of Learners with Difficulty
Communicating
Speech Sound Disorder
Involves having persistent difficulty with speech sound production
that interferes with the understandability of speech prevents verbal
communication of messages. This results to limitations in
communicating effectively, participating in social situations, achieving
academically, or performing well in one’s work.
 Characteristics of Learners with Difficulty
Communicating
Childhood-Onset Fluency Disorder (Stuttering)
This involves disturbances in the normal fluency and time patterning of
speech that are inappropriate from what is expected of one’s age and
language skills; and endures over time.
The occurrence of the following could indicate stuttering: sound and
syllable repetitions, sound prolongations of consonants and vowels, broken
words, audible or silent blocking, circumlocutions, words produced with
excess physical tension, and monosyllabic whole-word repetitions.
 Characteristics of Learners with Difficulty
Communicating
Social (Pragmatic) Communication Disorder
Refers to difficulties in the social use of verbal and nonverbal
communication. These difficulties are manifested in the following:
1. Deficits in the use of communication for social purposes;
2. Lack of ability to change communication to match context or the needs
of the listener;
3. Difficulties following rules for conversation and storytelling;
4. Difficulties understanding what is not explicitly stated.
 Characteristics of Learners with Difficulty
Communicating
Unspecified Communication Disorder
This pertains to having symptoms that are characteristics of
communication disorder that cause significant distress to an individual
or impairment in social, occupational, or other areas of functioning but
do not meet the full criteria of the abovementioned disorders.
 Causes of Communication Disorders
Environmental
Aphasia
. Phonological disorders Factors
The loss of the ability to and stuttering could be
linked to genetic causes. For instance, when
process and use speech. children are punished for
This could be due to a talking, gesturing, or
cardiovascular event trying to communicate, or
among adults, or head the lack of stimulation and
injury among children. motivation to participate in
communication or interact
Genetics with others at home.
 Identifying Learners with Difficulty
Communicating
Case History and Physical
Examination
Articulation
The child’s history is documented. The specialist assesses speech errors
Biographical information as well as and records sounds that are produced
milestones of child’s development is incorrectly, types of
asked from parents, and the specialist mispronunciation, and number of
does a physical examination of the errors.
child’s mouth palate, or other
structures that could affect speech
production.
 Identifying Learners with Difficulty
Communicating
Hearing Phonological Awareness and
Processing
The child’s hearing is evaluated in When children lack phonological
order to identify whether it is a child’s awareness and processing skills, they
hearing problem that is causing the could have problems w/ receptive and
communication disorder. expressive spoken language, as well as
difficulties in learning to read.
 Identifying Learners with Difficulty
Communicating
Overall Language Development Assessment of Language
and Vocabulary Function
This includes the identification of a
Tests that measure a child’s vocabulary learner’s strengths and weaknesses in
(e.g., Peabody Picture Vocabulary various language functions, then
Test-4 (Dunn & Dunn, 2006) as an comparing them to language and
indicator of language competence can communication skills of typically
be administered. developing children.
 Identifying Learners with Difficulty
Communicating
Observation in Natural Settings
Language Samples

Samples of child’s expressive speech Children’s use language are observed as

and language are taken and examined. they engage in everyday activities.
Learners with Autism
Spectrum Disorder
 AUTISM
It is a developmental disability that affects one’s verbal and
nonverbal communication and social interaction. This is
usually evident before a child turns three, and it negatively
affects a child’s educational performance.
 Autism Spectrum Disorder (ASD)
Refers to persistent deficits in social communication and social
interaction across various contexts. This is manifested through problems
with social-emotional reciprocity, lack of use and understanding of
nonverbal communication behaviors, and difficulties in developing and
maintaining relationships.
 Autism Spectrum Disorder (ASD)
Those with ASD also have restricted, repetitive patterns of behavior,
interest, or activities indicated by at least two of the following:
1. Stereotyped or repetitive behavior;
2. Insistence on sameness;
3. Highly restricted, fixated interest; and
4. Hyper- or hypo-reactivity to sensory input or unusual interests in
sensory aspects of environment.
 Characteristics of Learners with Autism
Spectrum Disorder
The following are the characteristics of learners with ASD (Pratt, Hopf, Larriba-Quest, 2017).

Domain Characteristics
Social Social difficulties include:
Communication • Demonstrating appropriate play skills
Impairments • Some may reject or ignore the social approaches of others
• Responding to and initiating joint attention for social purposes
• Using and interpreting body language
• Staying on topic, turn-taking, asking related or appropriate questions
during conversations
• Taking other people’s perspective
 Characteristics of Learners with Autism
Spectrum Disorder
Domain Characteristics
Speech/ Language For those who are nonverbal:
Impairments • Delay in, or lack of, spoken speech/language
• Lack of an effective way to communicate
For those who are verbal:
• Delayed or immediate echolalia
• Stereotyped or repetitive use of non-echolalic language routines
• Use of idiosyncratic speech
• Immature grammatical structure
• Abnormal use of speech, intonation, rhythm or stress
 Characteristics of Learners with Autism
Spectrum Disorder
Domain Characteristics

For both verbal and nonverbal:

• Delayed vocabulary development
• Difficulty following directions
• Difficulty understanding abstract concepts
• Difficulty interpreting social language
 Characteristics of Learners with Autism
Spectrum Disorder
Domain Characteristics

Restricted • Stereotyped or repetitive motor movements such as hand flapping or

Repetitive and finger licking
Stereotyped • Excessive adherences to routines and sameness
Patterns of • Ritualized patterns of behavior
Behavior, • Highly restricted, fixated patterns that are abnormal in intensity or focus
Interests, and
Activities
 Characteristics of Learners with Autism
Spectrum Disorder
Domain Characteristics
Sensory • Visual input sensitivities – staring at spinning objects, being bothered by
differences fluorescent lights
• Auditory input sensitivities – covering ears during loud noises, preferring
loud music or none at all in the car
• Tactile input sensitivities – disliking getting hands or feet messy,
avoiding/preferring certain surfaces, textures or fabrics
• Taste/smell sensitivities – not eating certain foods, licking or tasting non-
food items
• Proprioceptive input sensitivities – difficulties interpreting sensations
from muscles, joints, ligaments, and tendons.
 Characteristics of Learners with Autism
Spectrum Disorder
Domain Characteristics
• Vestibular input sensitivities – over or under sensitivities to balance and
movement situations.
Executive • Difficulty with executive functioning tasks such as sequencing the order
Function in which to dress oneself, completing a homework assignment
Impairments • Rigid, inflexible thinking
• Executive functioning difficulties at basic levels such as sustaining
prolonged attention to an activity, or dividing attention between two
activities at once
 Characteristics of Learners with Autism
Spectrum Disorder
Domain Characteristics
Common Learning • Demonstrate exceptional rote memory skills
Characteristics • Being better able to process information when presented visually
• Difficulty with unstructured time or extensive waiting
• Difficulty generalizing learned skill from one setting to another
• Difficulty with organization of materials and activities
• Highly achieving in some specific areas and doing poorly in the rest
 Causes of Autism Spectrum Disorder

Environmental Genetic and Physiological

Risk factors include the parental age,

low birth weight, or fetal exposure to Autism Spectrum Disorder (ASD) is
substances such as valproate. heritable to some extent, and having a
family member with ASD increases
the risk of developing it.
Identifying Learners with Autism Spectrum
Disorder
Social Communication Questionnaire (SCQ) (Rutter,
Bailey, & Lord, 2003)
A 40-item scale accomplished by a parent or primary caregiver.
 Identifying Learners with Autism Spectrum
Disorder
Autism Spectrum Screening Questionnaire (ASSQ)
(Ehlers, Gillberg, & Wing, 1999)
A 27-item scale accomplished by parents and teachers. It is used for
screening high functioning ASDs in children.
 Identifying Learners with Autism Spectrum
Disorder
Autism Diagnostic Interview – (ADI) Revised (ADI-R) and
Autism Diagnostic Observation Schedule (ADOS) (Lord, Rutter,
& Le Couteur, 1994)
ADI-R is a semi-structured interview of the primary caregiver of the
child or adult suspected of having autism administered by a trained
examiner. ADOS is a supplement to ADI-R wherein the child is
prescribed with a set of interactions designed to evoke behaviors that
indicate autism.
 Speech and Language Developmental Milestones
Yes No Birth to 3 Months
Reacts to loud sounds
Calms down or smiles when spoken to
Recognizes your voice and calms down if crying
When feeding, starts or stops sucking in response to sound
Coos and makes pleasure sounds
Has a special way of crying for different needs
Smiles when he/she sees you
 Speech and Language Developmental Milestones
Yes No 4 to 6 Months
Follows sounds with his/her eyes
Responds to changes in the tone of your voice
Notices toys that make sounds
Pays attention to music
Babbles in speech-like way and uses many different sounds, including sounds that
begin with p, b, n, m
Laughs
Babbles when excited or happy
Makes gurgling sounds when alone or playing with you
 Speech and Language Developmental Milestones
Yes No 7 Months to 1 Year
Enjoys playing peek-a-boo and pat-a-cake
Turns and looks in the direction of sounds
Listen when spoken to
Understands words for common items such as “cup”, “shoe”, or “juice”
Responds to requests (“come here”)
Babbles using long and short groups of sounds (“tata, upup, bibibi”)
Communicates using gestures such as waving or holding up arms
Imitates different speech sounds
Has one or two words (“Hi”, “dog”, “Dada”, or “Mama”) by first birthday
 Speech and Language Developmental Milestones
Yes No 1 to 2 Years
Knows a few parts of the body and can point to them when asked
Follows simple commands (“Roll the ball”) and understands simple questions (“Where’s
your shoe?”)
Enjoys simple stories, songs, and rhymes
Points to pictures, when named in books
Acquires new words on a regular basis
Uses some one- or two-word questions (“Where kitty? Or Go bye-bye?”)
Puts two words together (“More cookie”)
Uses many different consonant sounds at the beginning of words
 Speech and Language Developmental Milestones
Yes No 2 to 3 Years
Has a word for almost everything
Uses two- or three-word phrases to talk about and ask for things
Uses k, g, f, t, d, and n sounds
Speaks in a way that is understood by family members and friends
Names objects to ask to them or to direct attention to them
 Speech and Language Developmental Milestones
Yes No 3 to 4 Years
Hears you when you call from another room
Heats the television or radio at the same sound level as other family members
Answers simple “Who?” “What?” “Where?” and “Why?” questions
Talks about activities at daycare, preschool, or friends’ homes
Uses sentences with four or more words
Speaks easily without repeating syllables or words
 Speech and Language Developmental Milestones
Yes No 4 to 5 Years
Pays attention to short story and answers simple questions about it
Hears and understands most of what is said at home and in school
Uses sentences that give many details
Tells stories that stay on topic
Communicates easily with other children and adults
Says most sounds correctly except for a few (l, s, r, v, z, ch, and th)
Uses rhyming words
Names some letters and numbers
Uses adult grammar
 Chapter 7
Principles and Strategies of Teaching and
Designing IEP for Learners with Difficulty
Seeing, Hearing and Communicating

Acosta, April Jeanna B.

 Having difficulty seeing, hearing and communicating makes
perceiving and interpreting the environment a struggle, most importantly
when the environment is inaccessible. This makes mobility,
communication, social interaction and learning academic skills more
complicated compared to that of nondisabled learners. In teaching these
groups of learners, it is important to understand that there is a wide range
of levels of visual, hearing and communication difficulties, which
implicate varied strategies and programs to fit their educational needs.
 DepEd Order 72, series of 2009 – Inclusive Education as Strategy
for Increasing Participation Rate of Children

Regular schools with or without trained SPED teachers shall be

provided services to children with special needs. These schools shall
access educational services from SPED Centers or SPED trained
teachers.
“INCLUSION is an ATTITUDE not
a PLACE.”
-Powers, 1999
 Wherever the learners may be,
Attitudes for Beginning
Teachers are Suggested Below:
Make a background check. Make sure to make a background check of all your students
(talent, skills, and medical conditions).
Establish rapport. Let your learners know that you can be trusted and that you will not
harm them. Determine routines and prepare them in your teaching styles, sequence of lessons
and types of classroom evaluations.
Adhere to the People First Policy. Look at every learner with individual skills, talents,
capacities and limitations.
Treat them as you treat other regular students. This goes with assigning seats
(except for low vision and hard of hearing students that should be assigned in front seats), and
other schools assignments.
Educational Approaches
(Learners with Blindness)
 Braille
• Braille is a tactile reading and writing system, and is the primary means of literacy
for learners who are blind.
• It consists of letters, numbers, punctuation marks, and other systems arranged in
raised dot.
 Braille Technological Aids
• These are materials that develop Braille system made readily available to those
learners with blindness
 Tactile Aids and Manipulatives
• These are materials used to describe objects and the world around us.
• An example of this is the Cuisenaire rods (Belcastro, 1993) where learners w/
blindness can quickly identify different values by feeling the lengths and tactile
markings associated with each set of rods.
• This also includes manipulative aids such as braille math blocks, Digi-Blocks,
Cranmer abacus, Speech-Plus talking calculator, embossed relief maps and
diagrams, and three-dimensional (3D) models.
 Types of Tactile Books
1. Experience book – based on the learners’ experience such as attending birthday
parties and field trips. This is used to capture the best moments the learners
remember. This could also be used to help develop their language skills since
they explain the contents of their experience book.
2. Object book – contains real objects taken from the learners’ activities, such as
baking where some materials are pasted on each page of the book. This
introduces tactile learners to read as they move on to more abstract levels like
tactile symbols and/or braille.
 Types of Tactile Books
3. Routine book – is an organizer of learner’s classroom activities where step-by-
step procedure is done., turning one page to the next, so routines could easily be
established. After each activity, learners are taught to remove an item attached
to the book through Velcro, and place it in a box to indicate that an activity in
the routine was already accomplished. This could also be used as story books,
turning page as the story succeeds.
4. Theme book – focuses on an area and is used to supplement instruction on a
particular topic such as demographic information, regions in the Philippines,
flags, and others.
 Expanded Core Curriculum
• This curriculum includes orientation and mobility, listening skills, social interaction
skills, independent living skills, recreation and leisure skills, and career education.
• Orientation is about knowing about where you are headed and how to reach a place
w/ the use of information available in the environment.
• Mobility is the ability to move safely and effectively, from one place to the next.
• Learners with blindness often use the aid of canes, guide dogs, electronic travel aids
and sighted guides when travelling.
• Sighted guide technique (American Foundation for the Blind, 2018) enables a
person w/ visual impairment to use another person w/ sight as a guide. The technique
follows a specific form and has specific applications as listed in the Sighted Guide
Technique.
 Sighted Guide Technique
 Offer to guide a person who is blind or visually impaired by asking if he/she would like assistance.
Be aware that the person may not need or want guided help; in some instances it can be
disorienting and disruptive. Respect the wishes of the person you are with.
 If your help is accepted, offer the person your arm. To do so, tap the back of your hand against
his/her hand. The person will then grasp your arm directly above the elbow. Never grab the
person’s arm or try to direct him/her by pushing/pulling.
 Relax and walk at a comfortable normal pace. Stay one pace ahead of the person you are guiding,
except at the top and bottom stairs and cross streets. At these places, pause and stand alongside the
person. Then resume travel, walking one step ahead. Always pause when you change directions,
step up, or step down.
 It is helpful, but not necessary, to tell the person you are guiding about changes in terrain, stairs,
narrow spaces, elevators, and escalators.
 Sighted Guide Technique
 The standard form of sighted guide technique may have to be modified because of other
disabilities or for someone who is exceptionally tall or short. Be sure to ask the person you are
guiding what, if any, modifications he/she would like to use.
 When you are acting as a guide, never leave the person in “free space”. When walking, always be
sure that the person has a firm grasp on your arm. If you have to be separated briefly, be sure the
person is in contact with a wall, railing, or some other stable object until you return.
 To guide a person to a seat, place the hand of your guiding arm on the seat. The person you are
guiding will find the seat by following allowing your arm.
 Listening Skills
• Must be developed since learners with blindness obtain information by listening.
A widely held misconception is that people who are blind automatically develop a
better sense of hearing to compensate for their loss of sight but they don’t have
heightened sense of hearing compared to their sighted peers.
• Functional Life Skills include cooking, personal hygiene and grooming, shopping,
and transportation are skills needed before learners reach adulthood. These skills
are taught in the expanded curriculum for learners w/ reach adulthood. These
skills are taught in the expanded curriculum for learners w/ blindness.
Educational Approaches

(Learners with Low Vision)

 Optical Aids
These are the most famous used aids used by learners w/ low vision where
professionals such as ophthalmologists and optometrists assess, treat and
recommend these aids based on the visual needs. Some optical aids includes glasses,
contact lenses, handheld telescopes, and magnifiers.

Large Print Materials

Books, handouts, most especially visual aids posted on the board should be
readable by all learners in the classroom. Large print materials are printed or
handwritten w/ bigger font size, legible font style, w/ wider spacing.
 Classroom Adaptations
Classroom lighting is important for learners w/ low vision. Additional lighting
can better assist learners who find it difficult to read compared to their peers.
Photocopied handouts and worksheets can also be difficult for them, so it is better to
give them original copies, if possible, or assign someone who can go over the letters
or diagrams w/ a darker pen. It is also recommended that the learners be given
freedom in choosing their seats in the classroom.
Educational Approaches

(Learners with Hearing

Impairment)
 Hearing Aids
This device was developed to improve hearing of those people w/ difficulty
hearing. Its volume and tone could be adjusted to fit in the needs of its user and can
be worn in either one or both ears.

Assistive Listening System (ALS)

ALS work as amplifiers directly connected through a radio link from the teacher
to the learners. It reduces the unnecessary noise or background sound for the
learners to stay focused only to the speaker.
 Cochlear Implants
This is an electronic medical device surgically implanted to provide a sense of
sound to learners w/ severe to profound hearing loss. It however does not restore or
create normal hearing but can only give useful auditory understanding of the
environment that can help a person learn speech.

Sign Language
Filipino Sign Language or FSL is the national sign language of the Philippines.
It has its own grammar, syntax, and morphology that are based on manual hand
signals supplemented by body and facial gestures. FSL is not the same as American
Sign Language and is neither based on Filipino or English. It has no written systems
and is governed by purely visually motivated grammatical devices found in
nonmanual signal of the face and body.
 There are also other technological aids such as Speech-to-text Translation,
Television, Video and Movie Captioning, Text Telephones, and other Computer
Technologies.

Oral/Aural Approaches
This approach views speech as essential if learners deafness are to function in
the hearing world. This approach trains the learners to produce and understand
speech and language w/ auditory, visual, and tactile methods of input.
 Auditory Training
This is commonly given to young learners w/ residual hearing to get them
acquainted w/ sounds. The three levels of auditory training includes detecting,
discriminating and identifying sounds.

Speechreading
This process is done through retrieving spoken message by paying attention to
the speakers’ lip movements, facial expressions, eye movements, and body gestures.
This approach however has many limitations like faulty interpretations on lips.
Walker (1986) estimates that even best speechreaders detect only about 25% of
what is said through visual cues alone; and the rest is contextual piecing together of
ideas and expected constructions.
Educational Approaches
(Learners with Communication
Disorders)
 Discrimination Vocabulary Building Augmentative and Alternative
Communication (AAC)
Activities

These activities are developed to Specialists as well as classroom AAC includes different ways of
help learners produce and teachers use variety of techniques sharing thoughts and emotions to
discriminate b/w similar sounds in building learners’ vocabulary. the receiver without talking.
like pin and pin, cheap and jeep, Among these include development Unaided AAC techniques do not
cheese and she’s. activities could of graphic organizer, mnemonics, require physical aid or device such
be done through creating stories, repetition, word walls, vocabulary as speech, gestures, facial
drawing large /p/ and /b/, journals, and using context clues. expressions, body posture, and
visualization of sounds through manual signs while aided AAC
mirror modeling, and producing techniques use external device
sounds in front of a lighted candle. such as pen and paper, and
computerized voice-input device.
Educational Approaches
(Learners with Autism Spectrum
Disorder or ASD)
 Applied Behavior Analysis The Picture Exchange
(ABA) Communication System
Is a therapy based on science of learning and The PECS aims to help learners to request
behavior w/ the goal of increasing positive things or activities from others w/ the use
behaviors and decreasing harmful ones that of pictures. Learners exchange picture or a
negatively affects learning. It includes symbol representing an item or activity for
something that they would like.
behavioral principles such as positive
reinforcement & modeling that yield
beneficial outcomes for learners w/ ASD.
Some practices derive from ABA include
Picture Exchange Communication System
(PECS), peer mediated interventions, and
self-management tactics.
 Social Stories Jigsawing

This is a form of visual support to learners This approach provides opportunities to

w/ ASD as social stories explain concepts, learners w/ ASD to work collaboratively
social situations and expected behavior of w/ their peers as everyone in the class
completes one particular task. Following
people in a format that matches their level of
the format of a jigsaw puzzle, tasks are
comprehension.
divided among each puzzle piece, w/ each
piece essential to the overall success of the
task. This leads the individual learners and
groups to become independent, relying on
everyone’s participation to complete the
task.
Thank you for listening!