Sensory and Physical
Vision
What you might see
You might see a child who:
- has eyes that look different from what is usually expected (for example, unusual colour, eyes turning in or out, wobbling, redness, swelling, watery eyes, or discharge).
- holds their head in an unusual way, such as tilting or turning it to look at things.
- appears clumsy or has difficulty moving safely around the environment.
- struggles with activities that need hand-eye coordination, such as writing, catching, or using tools.
- finds it difficult to organise their belongings, work, or themselves.
- moves very close to books, objects, or screens to see them clearly.
- When asked “What can you see?”, they may describe seeing very little or missing details.
What you can try
Encourage parents/carers to take their child to a local optician for an eye test, even if the child has been seen before, as vision can change over time.
Make sure the child is wearing their prescribed glasses or contact lenses consistently in school.
Use clear, bold writing tools such as dark pens or pencils to improve visibility.
Provide larger print books, worksheets, and resources where needed.
Use dark lined books and low vision aids, such as magnifiers, if these have been recommended.
Provide large print calculators and bold or larger rulers and protractors.
Use high contrast or adapted equipment in subjects such as science, PE, and DT.
Provide access to a tablet, Chromebook, or laptop where this supports access to learning.
Where appropriate, link the child’s device to the whiteboard so learning content can be seen more clearly.
Ensure equipment is easy to access and set up, including WiFi access and simple logins.
Show the child how to use helpful apps and tools on their device to support learning.
Use built in accessibility features such as zoom, text size, or colour contrast, adjusted to the child’s needs.
Make sure learning materials are clear, uncluttered, and well contrasted, using an appropriate font size.
Avoid poor-quality photocopies or reducing work onto small paper sizes.
Allow the child to use technology to adapt their own learning materials where appropriate.
Plan visual rest breaks during the school day, particularly in the afternoon, to reduce visual fatigue.
Keep classrooms and shared spaces tidy, organised, and laid out consistently.
Ensure good lighting and use blinds where needed to reduce glare.
Clearly mark steps, doorways, pathways, and changes in level to support safe movement.
Use high contrast colours in the environment and learning resources.
Seek advice from a Qualified Teacher of Vision Impairment (QTVI), as support will depend on the child’s diagnosis, type and level of vision impairment, and whether their vision is stable or changing.
Hearing
What you might see
You might see a child who:
- does not always respond when spoken to, including when their name is called.
- appears to find it difficult to focus or engage when the environment is noisy (e.g. busy classroom, group work, lunchtimes).
- often seems to misunderstand spoken instructions or needs information repeated or simplified.
- spoken language appears behind that of peers, or their speech is unclear and difficult to understand.
- may become frustrated, withdrawn, or disengaged when trying to communicate with adults or peers.
- shows reduced participation in conversations or group activities with peers.
- appears to become tired or fatigued more quickly than peers, particularly during listening-heavy activities.
- sometimes arrives at the setting or school without their prescribed hearing equipment.
- wears hearing aids or cochlear implant processors but may require reminders or support to use them consistently.
What you can try
Ask parents/carers to speak to their GP if a child does not have hearing equipment. If hearing loss is confirmed, make a referral to the Hearing Support Team.
Make sure any hearing equipment provided by audiology is worn every day and is working properly (for example, charged batteries and clean ear moulds).
Encourage and praise the child for wearing their hearing equipment.
Get the child’s attention before speaking to them and make sure they can see your face. Do not cover your mouth when talking.
Create a good listening environment by seating the child near the front and where they can clearly see the adult and any visual resources.
Remember the child may rely on lipreading and visual cues. Face the child when speaking and avoid moving around the room while talking.
Reduce background noise where possible by considering room acoustics, lighting, and seating.
Keep the child away from noise sources such as windows, corridors, fans, or projectors.
Give instructions clearly and slowly, and allow time to check the child has understood what to do.
Use visual support alongside spoken language, such as pictures, objects, subtitles, transcripts, and visual timetables.
Teach new words and ideas in advance and revisit them afterwards, especially in core subjects.
Use assistive listening equipment such as radio aids or remote microphones every day, if advised by the Teacher of the Deaf.
Provide listening breaks when needed to reduce tiredness.
Put Speech and Language Therapy support in place where appropriate, working together with SALT.
Keep regular contact with parents/carers to support learning at home and school, for example by sharing key words or vocabulary lists.
Share positive information and resources about hearing loss and being deaf to promote understanding and confidence.
Physical
What you might see
You might see a child who:
- has difficulty using their hands for small tasks compared to other children of the same age.
- finds mark making, letter formation, handwriting, or presentation difficult.
- struggles to pick up small objects using their fingers (pincer grip).
What you can try
Reduce the amount of writing needed to show learning.
Use writing frames, sentence starters, cloze activities, lists, mind maps, highlighted notes, or verbal questioning instead of extended writing.
For older pupils, provide copies of notes or PowerPoint slides where helpful.
Offer alternative ways for children to record their work, such as using a tablet, laptop, or other ICT.
Provide different types of keyboards and mice, including large key keyboards or one-button mice.
Allow extra time for children to complete tasks.
Build in regular fine motor activities within the classroom, such as using a fine motor box.
Include short hand or finger exercises and breaks during learning or writing tasks.
Provide activities that encourage children to practise handwriting, letter formation, and fine motor skills in motivating ways, including classroom jobs.
Offer a range of adapted equipment, such as pencil grips, adapted scissors, or ridged rulers, for children to choose from.
Provide different mark making tools such as chunky brushes, chalk, pens, and crayons.
Allow children to mark make on a range of surfaces, indoors and outdoors, including chalkboards, light boxes, sand, or pathways.
Provide opportunities to mark make on vertical surfaces.
What you might see
You might see a child who:
- finds it difficult to use cutlery independently.
- struggles to carry a food tray safely.
- has difficulty opening food packets or containers.
What you can try
Encourage independence at lunchtime, such as pouring drinks, serving food, or scraping plates.
Plan fine motor activities that support eating skills, for example practising cutlery use in play or roleplay areas.
Provide adapted or age appropriate cups and cutlery with good grips.
Ensure seating supports good posture and safe use of cutlery.
Reduce the need for children with physical difficulties to wait in long queues at lunchtime.
What you might see
You might see a child who:
- finds it hard to follow the steps involved in getting dressed.
- struggles to put clothes on the right way round.
- has difficulty managing fastenings such as buttons, zips, or laces.
What you can try
Talk with parents/carers about reasonable uniform adjustments, such as easy fastenings or looser clothing.
Allow extra time and provide appropriate support when children are changing, for example, for PE.
Teach dressing skills step-by-step within familiar and supportive routines.
What you might see
You might see a child who:
- has difficulties with movement or mobility compared to other children of the same age.
- appears physically vulnerable or cautious during movement or play.
- has difficulty with balance during play activities.
- struggles to bend down and pick objects up from the floor.
- is hesitant or anxious when approaching new outdoor or play equipment.
- may be unsure or anxious when managing changes in level, such as steps, slopes, or uneven ground.
What you can try
Teach and reinforce simple safety rules, such as holding a handrail when using stairs, as part of everyday routines.
Adapt PE activities by allowing extra time, more space, and using equipment that is easier to grip or catch.
Provide time and space for outdoor play and breaktimes, including safe opportunities to practise moving over different surfaces.
Allow children to move at their own pace around the setting.
Reduce walking distances and provide rest breaks when needed, for example on school trips.
Adapt seating where needed, such as providing chairs with arms, footrests, or seating near exits.
Offer a small chair as an alternative to floor sitting where appropriate.
Make adjustments to support movement around the school, such as using lifts, alternative routes, or shortcuts.
What you might see
You might see a child who:
- is still developing independence with toileting routines and is below age-expected levels.
- needs more support than expected to manage toileting independently.
- is not stable when sitting on the toilet.
- has difficulty wiping themselves after using the toilet.
- is unable to pull clothing up or down independently for toileting.
What you can try
Plan personal care support in partnership with the child and their family, with respect for privacy, dignity, and self-esteem.
Use visual cues and quiet verbal prompts to support toileting routines.
Ensure staff are available to support discreetly if needed, for example following an accident.
Use equipment such as toilet trainer seats or steps to support independence.
Make sure taps, soap, and paper towels are easy for children to use.
Provide appropriate toilet facilities, such as lower toilets or grab rails, where needed.
Resources
Practical Resources
Practical Resources
- National Deaf Children’s Society (NDCS) – information, advice and resources to support deaf children and young people and those who work with them
www.ndcs.org.uk - BID Services – support, information and services for people with hearing loss
www.bid.org.uk - PDNet Accessibility Toolkit – supports schools with accessibility planning and developing inclusive environments
https://pdnet.org.uk/accessibility-toolkit/ - ERIC (Intimate Care Guidance) – guidance and resources to support toileting and personal care
https://eric.org.uk/ - Awareness Materials – resources to support staff and pupils to understand a range of medical, sensory and physical needs and promote inclusive practice
Guidance and Policy Resources
- Supporting Pupils with Medical Conditions at School (DfE) – statutory guidance for schools on supporting pupils with medical needs
https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions - Management Plans (Hearing Needs) – guidance and example plans to support pupils with mild and unilateral hearing loss
https://www.localofferbirmingham.co.uk/mild_hearing_loss/
https://www.localofferbirmingham.co.uk/unilateral_hearing_loss/ - Personalised Management Plans – developed by specialists (e.g. Teacher of the Deaf or QTVI) outlining strategies and support required in school
- Personal Care Matters – guidance to support effective and dignified personal care (link to be added)
- Sickle Cell and Thalassaemia Guidance – guidance to support pupils with specific medical conditions (link to be added)
- Medical Needs Policy Template – example template to support schools in developing their own policy (link to be added)
Specialist Support and Tools
- Deaf Awareness Training – supports staff to develop understanding of hearing needs and inclusive classroom practice
- Additional Sensory Training – training to support understanding of hearing, vision and physical needs may be provided by specialist teams
- PDNet Training – professional development to support understanding of physical disability and inclusive practice
https://pdnet.org.uk/pdnet-level-1-training/ - Assistive Listening Devices (e.g. radio aids) – support access to spoken language in the classroom. Daily checks of audiological equipment should be carried out by a trained member of staff, with independence promoted where appropriate
- Environmental Audits – assessment of the school environment to identify and implement adjustments to support access and inclusion
- Assistive Technology – may include iPads, laptops and specialist software to support access to learning, communication and independence, guided by specialist advice
- Specialist Additional Curriculum (Vision) – supports development of skills such as use of low vision aids, independent learning, organisation and safe movement around school
- Habilitation Support – supports development of mobility, independence and life skills for pupils with vision impairment, following referral from a QTVI
- Assistive Equipment and Adaptations – may include specialist seating, writing aids or adapted resources to support access to learning and independence
Support Available
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- Sensory and Physical Support Team (SPST) – provides specialist advice, assessment and support for children and young people with sensory and physical needs Specialist SEND Support Services – Local Offer Birmingham
- Teacher of the Deaf (ToD) – provides personalised advice, assessment and management plans for pupils with hearing needs
- Qualified Teacher of Vision Impairment (QTVI) – provides assessment, environmental advice and guidance on curriculum access, assistive technology and independence skills
- Habilitation Specialist – supports pupils with vision impairment to develop mobility, independence and life skills
- SEND Occupational Therapy (BCHC) – advice, strategies and resources to support physical development, sensory processing and functional skills
https://www.bhamcommunity.nhs.uk/paediatric-occupational-therapy