Lesson 4.

c Learners with Difficulty in Seeing,

Hearing and Communicating

Learning Outcomes
At the end of the session, student can…
 define and characterize the different types of learners with difficulty seeing, hearing,
and communicating.
 create safe, inclusive, culturally responsive learning environment for learners with
difficulty in seeing, hearing and communicating.
 discuss the different implications of trends and issues in teaching learners with
difficulty in seeing, hearing and communicating.

Introduction
Inclusive education is essential to a program where all types of
learners with and without disability participate in the life and work of
mainstreamed environment to meet their unique needs. It gives equal
opportunity for those who have difficulties to learn without discrimination and
feel they belong to the society. The understanding of the definition,
characteristics, types and how to accommodate them inside the classroom
not only will help us handle them but also provide better instruction that is
beneficial to them.
Most teacher no longer use the traditional style due to the diverse
needs of our students nowadays. They need to accommodate to learning
styles of the learners. Introducing learners with difficulties in seeing, hearing
and communicating into educational setting needs a rigid panning to ensure
the inclusive education is implemented well. There are things that we have to
consider in planning for this unique education such as the different types, the
characteristics of this unique learners and the adaptations and
accommodations that are suited for them.

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Engage!
Do one of the following activity
A. Orientation and Mobility Activity
Find a partner. One person will be blinded folded. The other one will
guide their partner in walking around the room. After you return switch roles
with your partner and do the task again.

B. Language and Literacy Activity

Assign a teacher in the group. The rest will act as students. The
teacher will give instruction on how to make origami. While doing the activity
the assigned student will wearing the simulation glasses.

C. Decoding Activity
Work as pair doing this activity. Get one encrypted message (Braille)
inside the envelope and decrypt the message using the Braille Alphabet

D. Encoding Activity
Work as pair in doing this activity. Get a message inside the envelope
and encode the message using the Braille Slate and Stylus.

Discuss!

A. Learners with Visual Impairment

1. Definition
There are number of terms that are often used to describe
learners that has difficulty seeing. The following are the legal definitions:
a. Visual Acuity - refers to the ability to distinguished forms among
details. It is usually measured by reading letters, numbers or other
symbols from snellen eye chart.
b. Legal Blindness - refers to having a visual acuity of 20/200 or less
in the better eye with the use of corrective lens.
c. Partially sighted - refers to individuals whose visual acuity in the
better eye after correction falls between 20/70 and 20/200.

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 d. Tunnel vision - a condition of having a perception of viewing the
world through a narrow tube. The central vision is good but
peripheral vision is poor at the outer ranges of visual field.

2. Types of Learners with Visual Impairment

The different types of visual impairment:
a. Amblyopia - reduction in or loss of vision in the weaker eye from
lack of use. It is cause by strabismus, unequal refractive errors or
opacity of the lens or cornea.
b. Astigmatism - Distorted or blurred vision cause by irregularities in
the cornea or other surface of the eye that produce images on
retina not in equal focus (refractive error).
c. Cortical Visual Impairment - impaired vision caused by damage to
or malfunction of the visual cortex or optic nerve (or both). It can
be caused by anoxia, head injury and infections of nervous
system. The visual of those who have this impairment may
fluctuate and vision sometimes improve over time. The person
with cortical visual impairment may use their peripheral vision,
attracted to bright light and may fail to blink at a threatening
motions.
d. Hyperopia - This is known as farsightedness. A person with
hyperopia has difficulty seeing near objects clearly and able top
focus on distant objects. It is cause by shorter than normal eye
that prevents light rays from converging on the retina (Refractive
error). They have a loss of accommodation when objects are
brought close to the face and they avoid long periods of reading.
For these people close task are discomforting.
e. Myopia - Known as nearsightedness. The person with this
impairment find distant objects are blurred or not seen at all but
near objects are seen clearly. It is caused by elongated eye that
focuses images in front of the retina (Refractive error). The person
is encourage to wear prescribed glasses or contact lens and near
task are comfortable.

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 f. Muscular Degeneration - The central area of the retina gradually
deteriorate and it is caused by loss of clear vision in the center of
the visual field. It is common in older adults but rare in children.
The person find reading and writing difficult. They need prescribe
low-vision aid, avoid glare and good illumination.
g. Nystagmus - It is a rapid involuntary, back and forth movement of
the eye which makes it difficult to focus on an object. When two
eyes cannot focus simultaneously, the brain avoids double image
by suppressing the visual input of one eye. The weaker eye can
lose its ability to see. It can occur on its own and be associated
with other visual impairment. Close task for extended period can
lead to fatigue and the person tilt its head to focus.
h. Strabismus - Inability to focus on the same object with both eyes
because of inward or outward deviation of the eyes.It is caused by
muscle imbalance and is secondary to other visual impairment.
The person should be seated in the favor to the stronger eye, one
eye is for distance task and other eye is for near task.

3. Characteristics of Learners with Visual Impairment

The following are the characteristics of learners with difficulty
seeing (Heward, 2017):
a. Cognition and Language they usually perform more poorly
compared to those with normal vision in terms of cognitive tasks
that require comprehension or relating to various information.
Because of the poor vision, it is difficult for them to make
connections and understand the relationships of what they
experience.
b. Motor Development and Mobility - blindness may result to delays
and deficits in motor development. A baby who has problem in
vision may not be motivated to perform movements that may
affect their development.
c. Social Adjustment and Interaction - learners that have vision
problems may engage in play less that would affect their social
skills development. An adolescent having visual problems may

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 increase their isolation and could find it difficult to keep friendships.
Also the condition may keep them from befitting to role modeling
due to they cannot observe other people. It will also difficult for
them to response to social signals .
Those with visual impairment may develop stereotypical
behavior such as rocking their body, eye pressing and poking
and hand flapping.

4. Teaching Strategies for Learners with Visual Impairment

Because the students in the classroom is diverse, it is important
that our instruction also response to the diverse needs of our learners.
The following are some approaches that can be used when having a
student with difficulty in seeing.
a. Learners with blindness - Teaching learners with difficulty seeing
are done through the use of non visual senses such as sound, tactile
and manipulative materials.
 Braille - it is a tactile reading and writing system means of
literacy for learners who are blind. It consists of letters,
number, punctuation marks and other systems arranged in
raised dots. The six dots are arranged and numbered from top
to bottom. Braille is read by moving the fingers from left to
right along each line.
 Braille Technological Aids - These are materials that develop
Braille system made readily available to those learners with
blindness.
 Tactile Aids and Manipulative - these are materials used to
describe the objects and the world around us. Learners with
blindness can quickly identify different values by feeling the
lengths and tactile markings associated with each set of rods.
The following are the tactile aids and materials that foster
development of literacy skills of learners with blindness.
1. Experience book - based on the learner’s experience
2. Object book - containing real objects taken from
learner’s activities.

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 3. Routine book - organizer of learner’s classroom
activities where step by step procedure is done.
4. Theme book - focuses on an area and is used to
supplement instruction on a particular topic such as
demographic information.
 Expanded Core Curriculum - This curriculum includes
orientation and mobility, listening skills, social interaction skills,
independent skills, recreation and leisure skills and career
education. Orientation is about knowing where you are
headed and how will you reach a place with the use of
information available in the environment. Mobility refers to the
ability to move safely and effectively from one place to
another. The student can use canes, guides and sighted
guide when travelling.
 Listening Skills - may be developed since learners with
blindness obtain information by listening.

b. Learners with Low Vision - these are the learner that can read
through print materials , but have limited vision and with some
difficulties.
 Optical Aids - The most used and famous aids used by learners
with low vision. The professionals assess, treat and
recommend these aids based on the visual needs. These can
be glasses, contact lenses, handheld telescope and
magnifiers.
 Large Print Materials - Books, handouts and visuals aids posted
that are readable by all learners. Large print materials can be
printed or handwritten with bigger fonts size, legible font style
and wider spacing.
 Classroom Adaptation - classroom lighting is important for
those learners that have difficulty in seeing. Additional lighting
can be better for those who have difficulty reading.
Photocopied notes are sometimes difficult to read so it is
better to give them originally printed. Let the student use

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 darker pen to write and give them freedom to choose where to
sit in the classroom

5. Current Trends and Issues

Teaching learners with visual impairment is challenging and
recent issues on how to help these learners participate in inclusive
education are through technological advancement that was created for
them so that their unique needs will be addressed. Researches and
studies were being implemented to see how this technologies impact
the learners and how it affects their performance in their lives.
A study of Montenegro-Rueda (2022) titled the “Impact of ICT on
University Students with Visual Impairment” created a new horizon in
educational responses to students who have disability in higher
education. This study provides an opportunity for a student with low
vision or blindness to be in a academic community with the support of
ICT. The result of this study indicate that research on ICT and visual
impairment in the higher education remains scarce and focuses on
educational needs of students with visual impairment in accessing and
transitioning to higher education. ICT in teaching-learning process
allow student to access information through digital however it questions
the use and the sufficiency of these tools. Teachers do offer this
education however they have limited training in digital competencies
that cause the barrier to the development of the inclusive education.
Blind and visually impaired people frequently encounter
challenges in their daily lives. Kaplan-Rakowski (2022) research study
“ Emerging Technologies for Blind and Visually Impaired Learners: A
Case Study” stated that some of the challenges of these learners
decreased but some become evident during pandemic time.
Another study from Cebu Normal University by Becalla (2024)
“Challenges and Opportunities of Students with Visual Impairment in a
State University: A Multi-case Study” gives hope for those who are
under privilege students that encountered several challenges in their
educational and community experiences. The findings of the study
showed that 3 college students with visual impairment experienced

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 five main challenges regarding accessibility, instruction, educational
compliance, socialization and assistive technology.

A. Learners with Hearing Impairment

1. Definition
There are various terms that are related to learners with difficulty
hearing. The following terms are associated to difficulty of hearing.
a. Deafness - This is a severe hearing loss and impaired in
processing linguistic information through hearing with
amplifications and negatively affects educational performance.
b. Hearing Loss - refers to the loss of hearing whether permanent of
fluctuating that affects the student's educational performance.
c. Residual Hearing - refers to the sound perceived by most deaf
but still use vision as primary mode of learning
d. Hard of hearing - refers to those who use hearing to understand
speech generally with the use of hearing aid
e. Decibels - refers to the intensity of loudness of sounds
f. Zero Hearing-threshold level - this is the smallest sound a person
with normal hearing can perceive. This is also called audio metric
zero
g. Hertz - this refers to the frequency or pitch of the sound

2. Types of Learners with Hearing Impairment

The following are the different types of hearing loss
a. Conductive Hearing Impairment - it is a problem of conduction or
transmission of sound vibrations to the inner ear.
b. Sensory Hearing Impairment - It is a damage of cochlea. The
problem is within the nerve pathways from your inner ear to your
brain. Even louder sounds may be unclear or may sound muffled.
c. Neural Hearing Impairment - It is an abnormality of auditory nerve
pathway. It occurs from damage to the inner ear, the place of
origin of the nerve that runs from the ear to the brain (auditory
nerve), or the brain

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 d. Mixed Hearing Impairment - It is the combination of conductive
and sensory hearing loss. This means there is damage to both the
outer and inner ear.
e. Unilateral Hearing Loss - Hearing loss in one ear. Hearing is
normal in one ear but there is hearing loss in the other ear.
f. Bilateral Hearing Loss - Hearing loss in both ears. Hearing loss
that affects both ears is referred to as bilateral hearing loss.
g. Congenital Hearing Loss - Hearing loss is present at birth. It is
caused of hearing loss in newborns include: infections, such as
rubella or herpes simplex virus. premature birth. low birth weight.
h. Acquired Hearing Loss - Hearing loss develop after birth. A
hearing loss which appears after birth, at any time in one's life,
perhaps as a result of a disease, a condition, or an injury.
i. Prelingual Hearing Loss - Hearing loss before the development of
language. One who is either born deaf or who lost his or her
hearing early in childhood, before acquiring language.
j. Postlingual Hearing Loss - Hearing loss happened after the
development of spoken language. The effects of a prelingual
hearing loss are usually much more significant than a postlingual
hearing loss. The challenge faced by a young child with a
prelingual hearing loss is to develop normal spoken language
skills.

3. Characteristics of Learners with Hearing Impairment

The following are the characteristics of learners with difficulty in
hearing.
a. Literacy - Learners with difficulty in hearing has great
disadvantage in terms of vocabulary and knowledge grammar, word
order, idiomatic expression and other aspects of language that require
listening. They learn concrete words more than easily than abstract
ones and have difficulty with function words such as linking verbs.
They also have the tendency to omit word endings and learning words
with multiple meanings. They also have difficulty is differentiating

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 questions from statements and understanding and writing sentences
in passive voice.
b. Speaking - It is common for learners with difficulty in hearing to
have atypical speech. They could not hear their own speech, which
makes it difficult to assess and monitor. They have the tendency to
speak loudly or have abnormally high pitch.
c. Academic achievement - They perform poorly than their peers
with normal hearing. Academic performance is not equated with
intelligence. It doesn’t mean that learner’s with difficulty in hearing has
less cognitive abilities but with their difficulties, it is hard for them to
excel in their studies.
d. Social functioning - Hearing loss may result to feeling isolation,
having no friends and unhappiness due to socialization. Sometimes,
they will have behavioral difficulties in school and social situations
compare to those who are normal hearing. They may tend to feel
depress, withdrawn and isolated.

4. Teaching Strategies for Learners with Hearing Impairment

The learners have diffident level of hearing loss and residual
hearing that may be intensified by using the modern technology.
a. Hearing aids - This is a device developed to improve hearing for
those people with difficulty in hearing. The volume and tone can
be adjusted to fit in to the need of the learner who will use this
device. It can be worn either one or both ears.
b. Assistive Listening System (ALS) - This is a device that amplifies
directly connected to the radio link from the teacher to the one
using it.It reduce the unnecessary noise background for the
learner to stay focused.
c. Cochlear Implants - This is an electronic medical device that is
implanted to the learner to provide sense of sounds with severe to
profound hearing loss. It may not not restore normal hearing but
can give useful auditory understanding of the environment that
can help a person learn speech.

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 d. Sign Language - Filipino Sign Language (FSL) is the national sign
language of the Philippines. It has its own grammar, syntax and
morphology that are based on manual hand signal supplemented
by body and facial gestures. FSL is not the same as American
Sign Language (ASL).
e. Oral-Aural Approaches - Views speech as essential if learner with
deafness will function in the hearing world. This approach trains
the learner to produce and understand speech and language
using auditory, visual and tactile methods.
f. Auditory Training - This is commonly given to young learners with
residual hearing to get them used of the sounds around them.
This training has three levels: detecting, discriminating and
identifying sounds.
g. Speech reading - This is done by retrieving spoken message by
looking at the speaker’s lip movement, facial expression, eye
movement and body gesture. This has its own limitation such as
misinterpretation.
5. Current Trends and Issues
Though programs and services were implemented to help
learners with difficulty in hearing, they continue to face unique
challenges with the advancement of technology, evolving educational
practices and the awareness of the society regarding special and
inclusive education.
A study of O’Malley, (2021) Deaf and Hard of Hearing students
Struggle with Accessibility Issues during Pandemic stated that for deaf
and hard of hearing academic academic has been a struggle for them
and it is not as simple as understanding a classroom lecture whether it
is online or in person. Using a face mask prevents them from lip
reading and learning remote those times become a struggle for them.
Aluent Support, (2021) stated that deaf and hard of hearing
learners that are mainstreamed are growing and can be challenging for
educators. They struggle with the reasons of limited knowledge and
education of professional regarding their disability, not enough
researches specific to deaf and hard of hearing, teachers use generic

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 strategies, little systematic professional development and minimal
collaboration for teachers.
In 2016, Weber published 10 challenges deaf students face in
the classroom. These are classroom acoustics, lighting, language
deficiencies, experiential shortages, teachers assume that all deaf
knows how to lip read and have residual hearing. Teachers have
inadequate knowledge and awareness, social concern in a sense the
they feel uncomfortable when drawing attention of their hearing
problem, collaboration due to hectic schedule, curriculum and
instruction and lack or resources.

B. Learners with Speech and Language Impairment

1. Definition
Communication refers to all aspect that make up any exchange
of meaning, including speech, language, voice, fluency and nonverbal
and pragmatic communication behavior. It is the interactive exchange
of information, ideas, feelings, needs and desires.
Elements of Communication
1. message
2. sender - the one expressing the message
3. receiver - the one respond to the message
Language - is the formalized code used by the group of people
to communicate with each other.
Five Dimension of language
1. phonology - production/arrangement of sound. This is
the linguistic rules governing a language’s sound system.
2. morphology - This is the meaning and how these units
combine into word. In other word, this refers to word
structure. It is the language’s basic units of meaning and
how these units are combined into words.
3. syntax - This is the arrangement of words and the
sentence structure. This is the system of rules that
govern the meaningful arrangement of words.

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 4. semantics - This is the meaning of word and
combination of words. This is the meaning in the
sentence or the meaning of words and combination of
words.
5. pragmatics - This is known as the social use of
language.

Other terms that are associated in learners with difficulty in

communicating
a. Communication Disorder - refers to the impairment in the ability to
receive, send, process and comprehend concepts or verbal,
nonverbal and graphic symbol system.
b. Language Impairment - refers to the communication disorder,
including stuttering, impaired articulation, language impairment or
voice impairment that negatively affects the performance of the
child in the school. This refers to impaired comprehension and
use of spoken, written or symbol system. This could be the form
of language, content of language and function of language in the
communication
c. Speech Impairment - pertains to deviations so far from speech of
other people that call attention to itself: interferes with
communication; provoke distress to the speaker or the listener.
This includes the articulation disorder, fluency disorder and voice
disorder.
d. Receptive Language Disorder - it is the lack of the ability to make
sense or identify sounds and words. This is also called auditory
processing disorder.
e. Expressive Language Disorder - This is the difficulty in expressing
language.
f. Fluency Disorder - refers to the difficulty forming sounds, words
and phrases because of neurological reasons
g. Oral muscular disorder - physical disorder where in the muscles
controlling speech are impaired, injured or developmentally
abnormal.

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 h. Dysarthria -refers to the lack of ability to execute movements
involved in speech, which is motor planning disorder.
i. Apraxia - Inability to coordinate speech movement and also a
motor planning disorder.
j. Mutism - inability to produce speech where muscles are unable to
move.
k. Delayed Speech - pertains to the language of the child that is slow
to developed in the context of typical development of motor and
cognitive skills
l. Specific Language Impairment - pertains to the language of the
child which is being developed in a different pattern.
m. Phonological Disorder - difficulty with phonological rules that is the
pattern of speech production.
n. Developmental Articulation Disorder - pertains to the difficulty with
particular sounds that may relate to structural differences such as
cleft palate.

2. Types of Learners with communication Disorder

Communication disorder include Language Disorder, Speech Sound
Disorder, Social Communication Disorder and Childhood-Onset Fluency
Disorder.
a. Language Disorder - Persistent difficulties in the acquisition and
use of language across various modalities including spoken, written or
sign language as a result of deficits in comprehending or producing
language. It has its limitations such as reduced vocabulary, limited
sentence structure, limits them to communicate in social situations
and limits achieve academically.
b. Speech Sound Disorder - Persistent difficulty with speech sound
production that interferes with the understand ability of speech or
prevents verbal communication of messages. It has is limitations such
as limits communicating effectively, limits participating in social
situations and limits achieving academically.
c. Childhood-Onset Fluency Disorder - This is the disturbance in
the normal fluency and time patterning of speech that are

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 inappropriate from what is expected to one’s age and language skills.
Indications of this disorder are sound and syllable repetition, sound
prolongations of consonants or vowels, broken words, silent blocking
and whole word repetition. It has its limitations such as
communicating ineffectively, can not participate in social situations
and limits achieving academically.
d. Social (Pragmatics) Communication Disorder - This is the
difficulty in social use of verbal and non verbal communication. It
manifest in the following deficit in the use of communication for social
purposes, difficulty in following rules for conversation, lack of ability to
change communication to match context and difficulty in
understanding what is not explicitly explained. It has it’s limitations
such as communicating ineffectively, can not participate in social
situations and limits achieving academically.
e. Unspecified Communication Disorder - This pertains to having
the symptoms of significant distress to an individual or impairment in
social, occupational and other areas of functioning that do not meet
the criteria of the communication disorder. This is also known as
neuro developmental disorder.

3. Characteristics of Learners with Speech and Language

Impairment
The following describes the learners with difficulty in
communicating.
a. Speech-sound Errors - This includes distortion when speech
sound like the intended phoneme other than another speech sound
but is conspicuously wrong. This include the substitution where one
sound is used as a substitute for another sound. Omission is when
sounds is being omitted and addition when an extra sound are added.
b. Articulation disorder When one is not able to produce a given
sound physically because that sounds is not in one’s repertoire.
c. Phonological Disorder - When one has the ability to produce a
given sound but inconsistency

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 d. Stuttering - When there is a rapid fire of repetition of consonant
or vowel sound at the beginning or the word, prolongations,
hesitations, interjections and complete verbal blocks.
e. Cluttering - when there is excessive speech rate, repetitions,
extra sounds, mispronounced sounds and poor or absent use of
pauses.
f. Voice disorders - having abnormal production o absences of
voice quality, pitch, loudness, resonance that is inappropriate for
one’s age or gender.
g. Language disorder - when there is a problem with the five
dimension of language. It could be expressive or receptive.
h. Psychological and Behavioral Characteristics - Limitation in
communication skills could have been an effect on other
developmental domains. It include social, cognitive and academic
development.

4. Teaching Strategies for Learners with Speech and Language

Impairment Specialist in communication disorder gives therapies to
help learners speak in the best way possible. These are the activities
that will help lessen the learner’s articulation and phonological errors
a. Discrimination Activities - This was developed to help learners
produce and discriminate between similar sounds like pin and bin,
cheap and jeep, cheese and she’s. Activities can be done through
creating stories, drawing large /p/ and /b/, visualization of sounds
through mirror modeling.
b. Vocabulary Building - these includes of using graphic organizer,
mnemonics, repetition, word walls, vocabulary journals and using
context clues.
c. Augmentative and Alternative Communication (AAC) - includes
different ways of sharing thoughts and emotions to the receiver
without taking. Unaided AAC techniques do not require physical aid or
device such as speech, gesture and facial expression while aided
AAC use external device such as pen and paper and computerized
voice-input device.

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5. Current Trends and Issues
Current trends and issues for learners with difficulty in
communicating reflect on the challenges of education and evolving
accessibility and technology.
In January 2024, the US Department of Education releases
2024 National Educational technology Plan to call to action for closing
the digital access. It highlights the importance of ensuring equitable
access to the technological tool that support students with
communication disorder.

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