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AHEAD: Association for Higher Education Access & Disability
AHEAD: Association for Higher Education Access & Disability
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Inclusive Teaching Strategies

All students bring a unique set of strengths and experiences to the lecture room and students with disabilities are no exception. The key to teaching a single curriculum to a diverse group of students who learn differently is to be flexible with the delivery of information and to provide the same content in different formats. For example, many students like to digest information in the form of concise bullet pointed text, while others (e.g. students with Dyslexia) might prefer to receive information as a visual representation such as a mind map or graph/chart. So why not provide the same information in both formats giving students with different learning styles an equal chance to process the information - this is essentially what Universal Design for Learning is all about.

Students with certain disabilities are likely to have certain learning patterns and we’ve compiled some teaching strategies to play to each group’s strengths below.

Click the disability type to have learning strategies drop down.

General Considerations

Dividing the Responsibilities

To the extent to which it is manageable, students with disabilities bear the primary responsibility not only for identifying their disabilities but for making necessary adjustments to the learning environment for reading and taking notes, for example. For testing arrangements and the use of department resources, the cooperation of academic staff is vital.

Staff-Student Relationships

Dialogue between the student and lecturer is essential early in the term and follow-up meetings are recommended. Staff should not feel apprehensive about discussing the student's needs as they relate to the course. There is no reason to avoid using terms that refer to the disability, such as ‘blind’, ‘see’ or ‘walk’. However, care should be taken to avoid generalising a particular limitation to other aspects of a student's functioning. Often, for example, wheelchair users are spoken to very loudly, as if they were deaf. The student will probably have had some experience of the kind of initial uneasiness you may bring to the relationship. The student's own suggestions, based on experience with the disability and with school work, are invaluable in accommodating disabilities in college.

Attendance and Promptness

The student using a wheelchair or other assistive devices may encounter obstacles or barriers in getting to lectures on time. Others may have periodic or irregular difficulties, either from their disability or from medication. Flexibility in applying attendance and promptness rules to such students is helpful.

Lecture Room Adjustments

A wide range of students with disabilities may be better served during lectures by making book lists available prior to the beginning of the course, by thoughtful seating arrangements, by speaking directly toward the class and by writing key lecture points and assignments on the board.

Functional Problems

In addition to the adjustments that will be discussed in detail for each disability, some understanding is required in working with more subtle and sometimes unexpected manifestations of disability. Chronic weakness and fatigue characterise some disabilities and medical conditions. Drowsiness, fatigue or impairments of memory or speed may result from prescribed medications. Such difficulties should be distinguished from the apathetic behaviour it may resemble.

Note-taking

Students who cannot take notes or have difficulty taking notes adequately can be helped by allowing them to record lectures, by permitting them to bring a note-taker to lectures, by making an outline of lecture materials available to them or by assisting them in borrowing classmates' notes.

Testing and Evaluation

Depending on the disability, the student may require the administration of examinations orally, the use of readers and/or scribes, extensions of time for the duration of exams, a modification of the test formats. For out-of-class assignments, the extension of deadlines may be justified. The objective of such considerations should always be to accommodate the student's learning differences, not to water down scholastic requirements. The same standards should be applied to students with disabilities as to all other students in evaluation and awarding marks.

Deaf/Hard of Hearing

Students who are Deaf or hard of hearing face difficulties unfamiliar to the hearing population. They may use and require a wide range of support services depending on the language or communication system they use.

Culturally, people who are Deaf are members of a distinct linguistic and cultural minority. The members of this cultural group use Sign Language as their first language. Therefore, members of this cultural group are bi-lingual and English is their second language. As with any cultural group, people who are Deaf have their own values, social norms, and traditions. Because of this, sensitivity and attention to culturally based information in the course is important. Students who are Deaf may require a Sign Language interpreter during lectures.

The term hard of hearing refers to those individuals who may use lip reading and hearing aids to enhance oral communication. Hearing aids or amplification systems may include public address systems, induction loops and transmitter/receiver systems with a clip-on microphone for the lecturer. For those who use lip reading only 30-40% of spoken English is comprehensible even for those who are highly skilled. Indications that a student has a hearing loss may include a student's straining to hear, use of loud or distorted speech and consistent failure to respond.

For people who are Deaf or hard of hearing and who choose to speak, feedback mechanisms are limited; therefore, vocal control, volume and articulation may be affected. These secondary effects are purely physical, but are often misinterpreted as intellectual weakness, which they emphatically are not.

Below are several suggestions for teaching strategies for use with students who are Deaf or hard of hearing. The appropriate strategy will depend on the teaching situation and the needs of the individual student.

It is therefore vital to check with students, well in advance, as to which strategies may be appropriate and what support services or equipment are required.

  • Lip-reading: Lip-reading is a demanding activity requiring great concentration. Three quarters of it is guesswork, and thus clear speech and contextual clues are vital. The following practices facilitate the lip-reading student.
  • Clear speech at a reasonable, natural pace: Speaking too slowly, over-enunciation and shouting distort sounds and lip patterns for a lip-reading student.
  • Clear view of lips and face: Disciplining yourself not to speak while facing away from the student (e.g. while writing on the board) also helps. Remembering to avoid nodding too much and walking around the room also cause difficulties.
  • Good seating: The optimum distance for lip-reading is about two meters, so front row seating, usually to one side of the speaker, is often an optimum position. However, the student will know best.
  • Presentation: It is important to remember that a lip-reading student, or one using an interpreter (see below), can only access a fraction of your speech. Therefore all other context information and structure cues are vital.
  • Context cues: Writing the title of a discussion or a new subject on the board helps a student to minimise the guesswork involved in lip-reading or may help an interpreter.
  • Logical structure: Following a logical structure in a lecture or argument helps lip-readers, as does a periodic review or summary. A copy of written notes before the lecture provides similar support.
  • Pauses: Lip-reading and interpreting are strenuous activities, therefore periodic pauses are important to permit quick personal reviews for assimilation purposes. They also facilitate the very human need for a rest. Pauses need not interrupt the natural flow or structure of a lecture since looking at a detailed slide while you are not speaking or the distribution of handouts provide some opportunities.
  • Repeating questions: Comments or questions from behind the student will be missed if you do not repeat them. Without the question, the answer loses its context.
  • Visual aids: Visual aids are usually a great help to students who are Deaf or hard of hearing, but they can also be used or neglected so that valuable information is not conveyed.
  • Vital Information: Changes of meeting times or venues can be written on the board or overhead projector (OHP) so that the Deaf student is always included.
  • New Vocabulary: Unknown words or acronyms are impossible to lip-read so making them available in advance or writing them on the board or the OHP is vital.
  • Reading Time: It is impossible to read and lip-read at the same time, so allowing the student time to read OHP slides or flipcharts is also vital.
  • Using the OHP: An OHP is helpful since it permits the lecturer to face the class while writing. However, reading and lip-reading cannot be done simultaneously. A noisy fan in an OHP can make it difficult to hear. It is important to remember to keep the lecturer's face well lit especially if the room has been darkened to facilitate projection.
  • Video: Obtaining subtitled videos where possible, or a transcript, or even a brief outline helps the student to follow the session.
  • Handouts and Notes: Well prepared handouts or copies of lecture notes or OHP slides in advance will increase what the student gains from your lecture, by giving advance notice of the structure of the lecture and new vocabulary. Sometimes a note-taker may be appropriate, or help obtaining a photocopy of a good set of classmate's notes. However, it usually is best to give as much help in advance as possible.
  • Booklists: A Deaf student may rely more heavily on textbooks than other students, so advance notice of essential reading lists is very helpful.
  • Seminars and tutorials: It is important to consider the needs of the Deaf or hearing-impaired student in the management of tutorials or seminars which involve a lot of student participation. The following suggestions may help…
    • Group size: Large groups make it unlikely that everyone will be near enough for lip-reading. The optimum group size is between six and ten. Deaf students find it easier to lip-read if the group is smaller.
    • Seating plan: A circular or near-circular seating plan allows a lip-reading student to see everyone. Silhouetting speakers makes it difficult to lip-read. Seating a Deaf student next to the chairperson may facilitate lip-reading too.
    • Laboratory work: Laboratory work and demonstrations are a little easier for deaf students. Nevertheless similar strategies help. Demonstrations should be done so that the student can see what is being done and lip-read. He/she should not have to do both simultaneously. Stand where the student can see you when you are speaking. Attract the Deaf student's attention before explaining a teaching point which rises during the laboratory session. Facilitating a Deaf student engaged in fieldwork or on placement may present special problems. Flexibility and advance planning with the student are the key to success here.
    • A student using an interpreter: The interpreter's role is to facilitate communication, not to participate, so all remarks should be addressed to the communicating parties and not the interpreter. The following points should be borne in mind when working with an interpreter:
    • Time Lag: One should expect a time lag while the interpreter translates. Thus a student should not be expected to respond immediately.
    • Pace: Speak at your normal pace. An interpreter will tell you to slow down if that is necessary. Pause or repeat a sentence if you are going too fast.
    • Questions and Discussion: The lecturer is responsible for controlling discussion. However, an interpreter may point to the contributor to indicate who is speaking. As with lip-readers, it is important to ensure that there are no interruptions and contributions are properly serialised as the interpreter can only translate for one contributor at a time. Time lags should be borne in mind when expecting a deaf student to respond.

Mental Health Difficulties

Students with psychiatric disabilities present some of the most difficult challenges to a lecturer. Like those with other disabilities, their impairments may be hidden or in fact, latent, with little or no effect on their learning. Unlike others however, their emotional disturbances may manifest themselves in negative behaviour ranging from indifference and recalcitrance to disruptiveness. Such conduct makes it hard to remember that they have as little control over their disabilities as do students with physical disabilities.

Among the most common psychological impairments among students is depression. The condition may be temporary, in response to inordinate pressures at college, at work, or in one's social life. It may be manifested as a pathological sense of hopelessness or helplessness which may provoke, in its extreme, threats or attempts at suicide. It may appear as apathy, disinterest, inattention, impaired concentration, irritability, as fatigue or other physical symptoms resulting from changes in eating, sleeping or other living patterns.

Anxiety is also prevalent among students and may also be the transient reaction to stress. Mild anxiety may, in fact, promote learning and improve the student's performance. Severe anxiety, however, may reduce concentration, distort perception and weaken the learning process. Anxiety may manifest itself as withdrawal, constant talking, complaining, joking or crying, fantasising, or extreme fear, sometimes to the point of panic. Bodily symptoms might include episodes or light-headedness or hyperventilation.

Students are just as susceptible to the myriad of other psychiatric disorders as others are, some of which express themselves as inappropriate behaviour in lectures or inadequate performance of coursework. Some troubled students who are undergoing treatment take prescription medication to help control disturbing feelings, ideas and behaviour. This medication might cause undesirable side effects such as drowsiness and disorientation.

Suggestions

  • Discuss inappropriate behaviour during lectures with the student privately, directly and forthrightly, delineating if necessary the limits of acceptable conduct.
  • In your discussions with the student do not attempt to diagnose or treat the psychological disorder but only the student's behaviour in the course.
  • If you sense that discussion would not be effective or if the student approaches you for therapeutic help, refer the student to the Counselling Service or to the Health Centre.
  • If abusive or threatening behaviour occurs, refer the matter to appropriate (disciplinary) College authorities.

Physical/Mobility Disability

A wide range of conditions may limit mobility and/or hand function. Among the most common permanent disorders are such musculoskeletal disabilities as partial or total paralysis, amputation or severe injury, arthritis, active sickle cell disease, muscular dystrophy, multiple sclerosis and cerebral palsy. Additionally, respiratory and cardiac diseases that are debilitating may consequently affect mobility. Any of these conditions may also impair the strength, speed, endurance, coordination and dexterity that are necessary for proper hand function. While the degree of disability varies, students may have difficulty getting to or from lectures, participating in lectures and managing out-of-lecture assignments and exams.

Getting to and from lectures

Physical access to lecture rooms is a major concern of students who are physically disabled. Those who use wheelchairs, braces, crutches, walking sticks or prostheses or who fatigue easily, find it difficult moving about especially within the time constraints imposed by lecture timetables. Occasional lateness may be unavoidable due to transport problems, inclement weather or lift or wheelchair breakdown. Getting from lectures may pose similar problems, especially in cases of emergency. Being prepared to change lecture venue if no other solution is possible.

In lectures

Some courses and lecture rooms present obstacles to the full participation of students who are physically disabled. In seating such students, Even such apparently insurmountable barriers as fixed seating may be overcome by arranging for a chair to be unscrewed and removed to make room for a wheelchair. Laboratory benches too high for wheelchair users to reach or transfer to, or with insufficient under-bench knee clearance, may be modified or they may be replaced with portable benches. Otherwise, the assistance of an aide to follow the student's lab instructions may be necessary. Students with hand-function limitations may have difficulties with in-laboratory writing (as in lectures). The following strategies may help…

  • Allowing the use of a note taker or recording device.
  • Teaming the student with a laboratory partner or assistant.
  • Allowing in-laboratory written assignments to be completed with the assistance of a scribe or out of the session if necessary.

Out-of-lecture assignments

For students who are physically disabled or who have hand-function impairments, the use of the library for reading or research assignments may present obstacles. Arrangements for assistance with library personnel may have to be made for access to card catalogues, book shelves, microfiche and other equipment, or for manipulating the pages of publications. Because the completion of required work may thus be delayed, the extension of deadlines may be appropriate. Off-campus assignments and fieldwork may pose similar problems of access to resources. Lecturers should consider such expedients as advance notice to students who rely on special transport, the extension of deadlines and the provision of alternative assignments.

Specific Learning Difficulties

A specific learning difficulty is any of a diverse group of conditions that cause significant difficulties in perceiving, processing and/or producing either auditory, visual and/or spatial information. Of presumed neurological origin, it covers disorders that impair such functions as reading (dyslexia), writing (dysgraphia) and mathematical calculation (dyscalculia). Difficulties experienced may include problems with word recognition, aspects of reading comprehension, aspects of writing and/or spelling. The exact nature, range and extent of these difficulties will vary from one case to another as will the actual learning profile or style.

A specific learning difficulty may exist in the presence of average to superior intelligence, as evidenced by the extraordinary achievements of numerous people with specific learning difficulties. Richard Branson, Leonardo da Vinci, Thomas Edison are just some prominent individuals with dyslexia. However, the condition has only recently been identified and it still often goes undiagnosed. That is why it is often misunderstood by people as an intellectual deficiency, which it emphatically is not.

In fact, the marked discrepancy between intellectual capacity and achievement is what characterises a specific learning difficulty. Assessment of the condition is required not only to establish the need for special services, but to determine the kind of special services that are required. Thus, it may be appropriate to refer for assessment students who are believed to have a specific learning difficulty that has not been previously or reliably identified.

In working with a student with a specific learning difficulty, it is important to identify the nature of the condition in order to determine the kind of strategies that might accommodate it. Drawing upon the student's own experience offers invaluable clues to the types of adaptation that work.

While a specific learning difficulty cannot be ‘cured’, it can be circumvented by various lecturing strategies. In general, a variety of instructional modes enhances learning for students with learning disabilities, as for others, by allowing them to master material that may be inaccessible in one particular form.

Study skills courses covering note-taking, efficient reading strategies, reading comprehension, brain-storming, essay-planning, study and revision planning, all help to reduce anxiety and improve performance of students with dyslexia, as with the general student population.

Below are some of the difficulties experienced by students with specific learning difficulties, together with suggested strategies for making material more accessible to them.

Auditory Processing

Some students may experience difficulty integrating information presented orally, hindering their ability to follow the sequence and organisation of a lecture. The following may help…

  • Provision of a course syllabus at the start of term outlining lectures at the start and writing new terms and key points on the board.
  • Periodic summaries of the lecture so far and summaries at appropriate points in the course.
  • In dealing with abstract concepts, paraphrase them in specific terms and illustrate them with concrete examples, with personal experiences, with hands-on models and such visual structures as charts and graphs.

Reading / Visual difficulties

Many students with dyslexia experience word-recognition difficulties and some find it difficult to keep their place in dense text. These difficulties, together with poor reading speed and poor memory, result in reading comprehension problems. Thus, use of library materials, references and digesting large quantities of text become obstacles. Extra time and effort may be required to digest a text fully. For such a student, comprehension and speed are improved dramatically with the provision of auditory formats. The following suggestions may help …

  • Early availability of booklists to allow students to begin the reading early or to have texts put on tape.
  • Provision of chapter outlines or study guides that direct the student to key points in their readings.
  • Reading aloud material that is written on the blackboard or that is given in handouts or transparencies.
  • Arranging access to course material in Mp3 format.

Memory difficulties

Some students with dyslexia have poor auditory sequential memory which makes rote learning and the execution of complicated tasks difficult. The following may help…

  • Keeping oral instructions concise and reinforcing them with brief cue words.
  • Simplifying complicated directions or providing them in alternative formats.

Writing difficulties

Many students with dyslexia have difficulty preparing written work. Difficulties include poor handwriting, misspelling, poor sentence structure, poor punctuation, misuse of connecting words and omission of suffixes and prefixes. Handwriting may show letter reversal, mid-word capitalisations to disambiguate similar letters (e.g. B/D not b/d) and handwriting may deteriorate readily under pressure. Spelling may exhibit transposition of letters, failure to apply common rules and the omission of prefixes and suffixes. Students may habitually avoid words they cannot spell. All these have clear implications for style, order, structure and fluency. Consequently, a student's written work may not be a true or fair reflection of their ability or mastery of the course. Allowing students to use the following appropriate tools and assistance may permit a student to demonstrate comprehension of the course material:

  • Use of a dictionary or thesaurus when preparing written work or in an exam.
  • Use of a computer with assistive technology.
  • Assistance of a proof-reader.
  • Transcription of illegible handwriting.
  • Amanuensis (dictation facilities).
  • Use of a recording device (Smart Pen).
  • Use of a supplementary oral examination to clarify content of manuscripts. Extra time during examinations.

Note-taking difficulties

As outlined above, some students with learning disabilities need alternative ways to take notes because they cannot write effectively or assimilate, remember and organise the material while listening to a lecture. The following suggestions may help…

  • Permission for note-takers to accompany the student to lectures.
  • Permission for recording of lectures or making notes available for material not found in texts or other accessible sources.
  • Assistance, if necessary, in arranging to borrow classmates’ notes.
  • Provision of photocopies of lecture notes and presentations.

The Science Laboratory

A laboratory can be especially overwhelming for students with learning disabilities. New equipment, exact measurement and multi-step procedures may demand precisely those skills that are hardest for them to acquire. The following suggestions may help…

  • An individual orientation to the laboratory and equipment can minimise student anxiety.
  • The labelling (possibly colour-coded) of equipment tools and materials is helpful.
  • The student's use of cue cards or labels designating the steps of a procedure may expedite the mastering of a sequence.
  • Specialised adaptive equipment may help with exact measurements.

Other difficulties

Some students with learning disabilities may have poor coordination or trouble judging distance or differentiating between left and right. Such devices as demonstrations from the student's right-left frame of reference and the use of colour codes or supplementary symbols may overcome the perceptual problem.

Behaviour

Because of a long and painful history of struggling with their difficulties, apparent under-achievement and continued experience of ‘failure’, students with dyslexia often have low self-esteem and lack confidence in themselves and their abilities. If the source of their difficulties has not been identified, or identified only recently, students may be experiencing anxiety and frustration. They may have acquired a reputation for laziness or being difficult, disruptive or un-cooperative. Students that have not been assessed are often afraid of being assessed for fear what they might find out about themselves. Mature students might fit into this category.

Even when students have made significant progress in overcoming their difficulties, low self-esteem and self-confidence may remain. The following suggestions may help…

  • Creating an environment of acceptance and a supportive atmosphere in which difficulties can be dealt with in an open, positive manner.
  • Awareness among academic staff of the difficulties and symptoms described above.
  • Confidential access and referral to counsellors familiar with these difficulties and ways of coping with them.
  • Study skills courses can be a valuable way of building confidence as well as learning useful skills.
  • Dealing firmly but tactfully with disruptive behaviour and allowing for under-developed social skills may be helpful to the student making an effort to overcome their difficulties.

Participation

  • It is helpful to determine the student's ability to participate in classroom activities. While many students with learning disabilities are highly articulate, some have severe difficulty in talking, responding or reading in front of groups.

Evaluation/Assessment

A specific learning difficulty may affect the way a student should be evaluated. In many cases, written work will not be a true or fair indication of a student's ability, their mastery of material or their depth of understanding. If so, a special arrangement may be necessary. Some tasks may be deemed to be an essential part of a course and may not be readily modified. The following suggestions may help…

  • Permission for students to take examinations in a separate, quiet room with an invigilator. Students with specific learning disabilities are especially sensitive to distractions.
  • Time extensions on exams and written assignments when there are significant demands on reading and writing skills.
  • Avoiding overly complicated language in exam questions, leaving plenty of clear space between them on the examination paper.
  • Avoiding the use of answer sheets, especially computer forms, relieves the student with perceptual deficits of unnecessary burdensome work while transferring answers.
  • Allowing sufficient time between the end of lectures and the sitting of the examination allows the student with a learning disability to properly assimilate material covered at the end of the course.
  • The use of a dictionary, thesaurus, spell-checking programme, a proof reader or, in mathematics and science, a calculator. In mathematics the student may understand the concept, but may make errors by misaligning numbers or writing equations.
  • When necessary, allowing students to use a reader, scribe (amanuensis), recording device or computer.
  • Provision of alternative test designs / formats. Some students with learning disabilities may find essay formats difficult and a student with a perceptual impairment will always have trouble with pattern-matching type tests.
  • Consideration of alternative or supplementary assignments that may serve evaluation purposes, such as taped interviews, slide presentations, photographic essays or handmade models. A supplementary interview may help to clarify ambiguous or indecipherable manuscript contents.
  • Where English is a carrier language and not a core learning outcome, it is appropriate to grant a spelling and grammar waiver in examinations. 

Making the accommodations listed above will ensure compliance with current Irish Legislation. 

Speech & Language Difficulty

Speech impairments range from problems with articulation or voice strength to complete voicelessness. They include difficulties in projection such as chronic hoarseness and aeosophagal speech; fluency problems such as stuttering and stammering; and the nominal aphasia that alters the articulation of particular words or terms.

Some of these difficulties can be managed by such mechanical devices as electronic speaking machines or computerised voice synthesisers. Others may be treated through speech therapy. All of them can be aggravated by the anxiety inherent in oral communication in front of a group.

Patience is the most effective strategy in teaching students with speech impairments. The following suggestions may also be appropriate and helpful

  • Giving students the opportunity, without compelling them, to speak in class. Permitting students the time they require to express themselves without unsolicited aid to fill in gaps in their speech. Do not be reluctant to ask the student to repeat a statement.
  • Address students naturally.
  • Where appropriate, considering course modifications, such as one-to-one presentations and the use of a computer with a voice synthesiser.
  • Here is a document on Supporting Students who stutter

Blind/Visual Impairment

Visual impairment varies greatly. Persons are considered legally blind when visual acuity is 20/200 or less in the better eye with the use of corrective lenses. Most persons who are legally blind have some vision. Others who have low vision may rely on residual vision with the use of adaptive equipment. Persons who are totally blind may have visual memory, its strength depending on the age when vision was lost. Whatever the degree of impairment students who are visually impaired should be expected to participate fully in class activities, such as discussions and group work. To record notes, some use such devices as laptop computers or computerised Braillers. They may confront limitations in laboratory sessions, field trips and internships, but with planning and adaptive equipment their difficulties can be minimised.

Before or early in the course

  • Provide reading lists or syllabi in advance to allow time for conversion into an alternative text format for example Braille or an electronic text.
  • In cooperation with Disability Support Services, assist the student in finding readers, note-takers or tutors as necessary or team the student with a sighted classmate or laboratory assistant.
  • Reserve front seats for low-vision students. If a guide dog is used it will be highly disciplined and require little space.

During the course

  • Face the class when speaking.
  • Convey in spoken words whatever you put on the board and whatever other visual cues or graphic materials you may use.
  • Permit lectures to be recorded and/or provide copies of lecture notes where appropriate.
  • Provide large print copies of lecture materials.
  • Be flexible with assignment deadlines.
  • Plan field trips and such special projects as internships well in advance and alert field supervisors to whatever adaptations may be needed.
  • If a specific task is impossible for the student to carry out, consider an alternative assignment.

Examinations and evaluations

Students should not be exempt from examinations or be expected to master less content or a lower level of scholastic skills because of a visual impairment. Alternative means of assessing their course achievements may be necessary. The students themselves, because of their experience in previous learning situations and the Disability Support Service, may offer suggestions on testing and evaluation strategies. The most expedient alternative examinations arrangements can include (oral, large-print Braille or taped), the extension of time for exams and the use of such aids as print enlargers, specialised computer programs or recording devices.

Other adaptations suited to specific instructional situations - such as tactile materials in presenting diagrams or illustrations in certain subjects may be helpful.

Seizure Disorders

Students with epilepsy and other seizure disorders are sometimes reluctant to divulge their conditions because they fear being misunderstood or stigmatised. Misconceptions abound about these disorders - that they are forms of mental illness, contagious and untreatable. There is evidence that hereditary factors may be involved and that brain injuries and tumours, occurring at any age, may give rise to seizures. What is known is that seizures result from imbalances in the electrical activity of the brain.

Three distinct types of seizures exist

‘Petit Mal’ means ‘little seizure’ and is characterised by eye blinking or staring. It begins abruptly with sudden dimming of consciousness and may last only a few seconds. Whatever the person is doing is suspended for a moment but resumed again as soon as the seizure is over. Often, because of its briefness, the seizure may go unnoticed by the individual as well as by others.
‘Physcomotor’ seizures range from mild to severe and may include staring, mental confusion, uncoordinated and random movement, incoherent speech and behaviour outbursts, followed by immediate recovery. They may last from two minutes to a half hour. The person may have no recollection of what happened, but may experience fatigue.

‘Grand Mal’ seizures may be moderate to severe and may be characterised by generalised contractions of muscles, twitching and limb jerking. A few minutes of such movements may be followed by unconsciousness, sleep, or extreme fatigue. Students with seizure disorders are often under preventative medication, which may cause drowsiness and temporary memory problems. Medication makes it unlikely that a seizure will occur in lectures.

In the event of a ‘Grand Mal’ seizure, the following procedure should be followed…

  • Keep calm. Although its manifestations may be intense, they are generally not painful to the individual.
  • Remove nearby objects that may injure the individual during the seizure.
  • Help lower the person to the floor and place cushioning under his/her head.
  • Turn the head to the side so that breathing is not obstructed.
  • Loosen tight clothing.
  • Do not force anything between the teeth.
  • Do not try to restrain bodily movement.
  • After a seizure, a lecturer should deal forthrightly with the concerns of the class in an effort to forestall whatever negative attitudes may develop toward the student.

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