Challenges and Subjects – this link takes you to challenges and subjects associated with this disability.

Brief description of Dyspraxia

Dyspraxia is a specific learning difficulty that affects the brain’s ability to plan sequences of movement. It is thought to be connected to the way that the brain develops, and can affect the planning of what to do and how to do it. It is often associated with problems of perception, language and thought. The effects that dyspraxia have on a person’s ability to function in a day-to-day environment, as well as in a learning environment can vary, depending on the degree of difficulty.

Detailed description of Dyspraxia

Some people with dyspraxia have tactile defensiveness – they are over-sensitive to touch. Others may have articulatory dyspraxia, which causes difficulties with speaking and pronunciation. People with dyspraxia often have low self-esteem. They may experience depression, have mental health problems and experience emotional and behavioural difficulties.

Characteristics Impacting on Learning and Teaching

Students with dyspraxia can possess the following strengths:
  • Creative and original thinking.
  • Good strategic thinking and problem-solving.
  • Determined and hard-working.
  • Highly motivated.
  • Able to develop their own strategies to overcome difficulties.

Students may experience difficulties in some, or all, of the following areas:

  • Gross motor skills: poor performance in sport, general clumsiness, poor balance, and difficulties in learning skills involving coordination of body parts, e.g. riding a bike or swimming.
  • Manual and practical work: problems using computer keyboards and mice, frequent spills in the laboratory and elsewhere, difficulty measuring accurately, slow, poor or illegible handwriting, messy presentation/work and problems with craft-work, cookery, etc.
  • Personal presentation and spatial skills: untidy and rumpled appearance, clumsy gait, poor posture, frequent bumping into things and tripping over and can be poor at sport, especially team and ball games.
  • Memory and attention span: poor attention span, poor short term memory, easily distracted in class, especially by noise and bright lights, difficulty following class discussions, slow retrieval of information, especially when under stress; may become disorientated e.g. getting lost in buildings and in new environments.
  • Written expression: erratic spelling and punctuation, awkward and confused sentence structure, poor proof-reading, inclusion of irrelevant material in essays and may be slow to complete work.
  • Visual and oral skills: trouble keeping place while reading and writing (tracking problems), poor relocating – cannot easily look from blackboard/overhead to notes, difficulty word finding, and wrong pronunciation of newly-introduced words, speaking indistinctly, loudly, fast or slowly, interrupting inappropriately and difficulty learning foreign languages.
  • Numerical and mathematical skills: tendency to reverse and mistype numbers, signs or decimal points, frequent and apparently careless mistakes, particular difficulty with geometry – both drawing and using equipment such as a compass or protractor and difficulty with spatial awareness e.g. drawing shapes, graphs, tables, etc.
  • Social, communication and emotional difficulties: problems with oral interaction and communication, low self-esteem and lack of confidence, frustration, defensiveness or aggression, over-talkative and excitable behaviour, withdrawn and reserved or may experience anxiety, stress and depression.

Medical Conditions

Challenges and Subjects – this link takes you to challenges and subjects associated with this disability.

Brief description of Medical Conditions

The term Medical Condition includes asthma, epilepsy, diabetes, chronic pain and heart disease. Most people have experienced ill health of one kind or another from time to time, but this has probably been temporary in nature. Some people, however, have long term or permanent conditions which have been present from birth or acquired during life. The effects of these depend on the person’s age, circumstances and the nature of the conditions and/or treatment.

Detailed descriptions of some Medical Conditions

Allergies and Asthma

Increasing numbers of people are affected by some kind of allergy or by asthma. With regard to asthma, the National Asthma Audit 1999/2000 found that at least 1 in 25 adults in the UK aged 16 and over – over 1.9 million adults – has asthma symptoms currently requiring treatment. Approximately 1 in 7 children aged 2-15 (over 1.5 million children) are also estimated to have such symptoms http://www.asthma.org.uk/infofa18.html . This is the equivalent of over 3.4 million people with asthma in the UK. These figures are higher than in past years, supporting the various studies which have shown that asthma is on the increase.

Most adults with asthma are able to establish methods of controlling their condition so that it does not normally affect their daily life. They know possible triggers and therefore are often able to prevent asthma attacks. However, it is still necessary for colleges to ensure that there are proper procedures for dealing with substances – called respiratory sensitisers – that can cause asthma or other allergies, those most relevant to the industry are animal allergens, chemicals and latex rubber.

Chemicals and latex rubber

It is normally possible for precautions to be taken so that individuals known to have some allergy to chemicals, latex rubber or other substances can avoid using them.

Dysosmia – Impaired Sense of Smell

An impaired sense of smell is usually associated with ageing. However, it can also occur in younger people and can be present from birth.

Apart from the need for extra safety precautions with regard to detecting smoke and gas, there is also the need to compensate for the fact that, for example, someone cannot detect food which has decayed.


It is estimated that in the UK, 1 in 200 people have epilepsy and 1 in 20 people will have an epileptic seizure at some time in their lives. 300,000 people in the UK are currently thought to have epilepsy. Given the high incidence of epilepsy, it seems likely that there may be many veterinarians who have epilepsy.

The UK National Society for Epilepsy http://www.epilepsynse.org.uk provides advice for employers on the issues relating to someone who has epilepsy. The Society’s literature states that:

”If someone has uncontrolled epilepsy, it will be necessary to take into consideration any risks that a particular type of seizure might present in the workplace to themselves, their colleagues and clients”

According to the Society’s information, some occupations are barred by statutory provision for people with a history of epilepsy. These are:

Teaching posts involving physical education, science and technology, work with young children, jobs in the prison service involving close contact with inmates and some areas of nursing.

Also other professions Police and Armed Services are included in this exemption.

Each of the above professions has specific regulations, some of which allow them to accept people who have not had seizures for a specified number of years and have not been taking medication during that time. Other occupations listed as being those where difficulties may be experienced even though there are no statutory barriers include:

Aircraft pilot, ambulance driver, merchant seaman, LGV, PCV or Taxi driver, train driver and jobs in the armed services, fire brigade or police.

There is therefore a well-trodden path and an acceptance of the fact that it is not only perfectly legitimate but also a grave responsibility to exclude people with certain types of epilepsy from certain professions.

Photosensitive epilepsy is a rare condition in which seizures may be triggered by flashing or flickering lights or by certain geometric shapes and patterns. People with this condition are most likely to react to lights which flicker between five and thirty times per second (5-30Hz). An area of research currently being carried out by the US Access Board concerns producing fire alarm strobe lights which do not provoke an epileptic seizure in someone with this condition.

Another area for consideration is the issue of holding a driving licence. Whilst knowing how to drive is not an essential requirement for a vet, as stated earlier, it could be for someone who wanted to go on to work in a rural setting. In the UK, current regulations state that a person needs to be seizure free for a period of one year, either with or without anti-epileptic medication in order to hold a Group 1 driving licence (cars and motorbikes). Even if it is not essential for qualifying in the profession, therefore, not being able to drive because of epilepsy could affect someone’s future career path.

Characteristics Impacting on Learning and Teaching


Conditions such as chronic pain, epilepsy or psychiatric conditions can seriously affect a person’s daily routine. In many ways, it can be the side effects of the condition itself which causes difficulty. For example, a student may be prone to fatigue or stress or special medication may cause drowsiness and/or poor concentration.


Students can also be affected by the environment, e.g. students with epilepsy, diabetes or asthma. For some these cause physical or sensory disabilities but for many others stamina can also be affected. This means that planning an evenly distributed workload with the possibility of delayed/staggered deadlines is important. This consideration is particularly significant when students have had time off and need to catch up as well as cope with the demands of new studies.


Students with these conditions many not see themselves as having a disability and may not have indicated on application that they have a particular need. Students may also have faced previous prejudice from those around them and this also may restrict their disclosure of their condition. It is therefore particularly important that it is known that tutors will be sympathetic to students with such hidden disabilities or medical conditions.

Attention Deficit Hyperactivity Disorder (ADHD)

Challenges and Subjects – this link takes you to challenges and subjects associated with ADHD

Brief description of Disability

Inattention, hyperactivity and impulsivity are the main characteristics of Attention Deficit Hyperactivity Disorder (ADHD). As a student’s academic success is often dependent on their ability to attend to tasks and tutor expectations with minimal distractions, a student with ADHD may struggle within the typical HE academic environment. Activities associated with acquiring necessary information for completing tasks, completing assignments and participating in discussions with their tutors and peers are all activities that can potentially be problematic for the student with ADHD.

As students with ADHD may experience difficulties with the structured environment of a tutorial or lecture or focusing on their assigned work, they may need adjustments to the learning environment to help them remain focused on the task in hand. Students may need to be questioned about where they prefer to sit within the learning environment to help them to focus on what is being said, they may also benefit from working closely with another student who can help them to develop their cooperation skills or, if space permits, work in separate learning areas, away from other students. Different students will find different scenarios work better for them and open communication with the student about this is essential.

Detailed description of ADHD

ADHD is one of the most common disorders of childhood and adolescence and is characterised by impulsivity and hyperactivity and/or inattention. The characteristics are not seen to the same degree in all people diagnosed with the disorder and healthcare professionals recognise that there are 3 main combinations of characteristics:

  • Some people have predominantly hyperactive-impulsive type.
  • Some have predominantly inattentive type.
  • And some have a combined type (this makes up the majority of ADHD cases.

Hyperactive or impulsive behaviours may include: fidgeting, having trouble interacting quietly, interrupting others and always being ‘on the go’. Characteristics of inattention may include: being disorganised, being forgetful and easily distracted and finding it difficult to sustain attention during tasks or learning activities. These behaviours are usually first noticed in early childhood, and they are more extreme than simple misbehaving. Whilst ADHD behaviours occur to some extent in all of us, the difference between ADHD and normal behaviour is the degree of the problem and the difficulties it causes. Individuals with ADHD show this behaviour to a significantly greater extent and severity.

Students with ADHD are starting to outnumber students with psychological disorders in US universities, although their numbers are still small in the UK. ADHD remains controversial, in that although it is recognised as a specific condition, there is often the feeling among staff that it is not so much on the increase as being massively over-diagnosed. Whatever the reality, students who have a condition that is, or is similar to, ADHD frequently do pose major problems for staff dealing with them because they often experience serious difficulties with their studies.

The current situation

Psychological difficulties are, in some ways, the hidden disabilities of the veterinary medical colleges and of universities in general. Students may often decide not to disclose their difficulties and this one must respect. At the same time, whether they disclose their difficulties or not, the effects of having a psychological difficulty can remain and may have an enormous even if hidden impact on others.

Official figures for students with psychological difficulties can sometimes be low or nonexistent. The result is that senior staff are sometimes led to assume that the problem does not exist within their institution. The reality is that many faculty staff are dealing with a problem which officially does not exist.

Individuals with ADHD may exhibit behaviours that cannot be explained by any other psychiatric condition and are not in keeping with the individual’s age and intellectual ability. Mood swings and social clumsiness are common. Parents and tutors may report that these individuals often misread the accepted social cues, saying or doing inappropriate things. Social difficulties often hit a peak in primary school and start to ease in secondary school, although in adolescence any remaining insecurities make the normal social uncertainties of this age even greater.

ADHD is most commonly noticed around the age of 5, and according to medical guidelines, it affects 5% of school-aged children with the male to female ratio in diagnosed ADHD prevalence being at least 4 to 1. The observed prevalence of ADHD in boys and girls is skewed by the fact that characteristics of hyperactivity and impulsivity are more common in boys, whereas girls with ADHD more commonly have inattentive characteristics. Research suggests that 80% of children diagnosed with ADHD continue to experience characteristics during adolescence and 67% continue to have the characteristics into adulthood.

Some of the characteristics associated with ADHD can be seen as positive attributes that students bring to their academic experience. These can be summarised as follows:

  • An ability to see the big picture and good attention to detail.
  • Creativity and inventiveness.
  • Risk-taking can produce important discoveries.
  • An ability to process information and make broader observations.
  • High levels of energy.
  • Good negotiation skills.
  • Intuitiveness and reactivity.
  • Ability to hyper-focus.

Characteristics Impacting on Learning and Teaching

Potential areas of difficulty for students with ADHD may include:

  • Inattention – disrupted by their own thoughts or daydreaming, moving quickly onto a new topic of conversation before finishing the current one and producing work that is of variable quality.
  • Impulsiveness – an impairment of internal speech, finishing other people’s sentences and/or interrupting.
  • Short-term memory – poor note-taking ability, poor hindsight and forethought leading to an inability to learn from mistakes or draw on previous experience.
  • Independent adaptive functioning.
  • Mood swings – ranging from restlessness and fidgety behaviour to procrastinating (affecting coursework and revision for examinations).
  • Poor organisation and time management.
  • Risk-taking.
  • Problem-solving.
  • Interpersonal relationships and emotional functioning – students may appear sociable but friendships can be superficial.
  • Issues associated with medication – this can affect sleep patterns.

Visual Impairments

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Brief description of Visual Impairments

The term visual impairment covers a whole spectrum of people from those who are only slightly affected to the very small proportion who are totally blind and cannot distinguish light from dark. Only a small minority or partially sighted people have no useful vision.

The principle that every student is an individual with individual needs is particularly true for students with visual impairments, as strategies which suit one student may be irrelevant, even hampering, to another. Only the visually impaired person can really say what they can, or cannot, see.

Students may have developed their own coping strategies and techniques and so it is essential for the student to be closely involved in discussion of teaching strategies appropriate to their situation.

Blind and partially sighted students are more dependent on their hearing for information gathering. People who have been blind since birth may have missed out on informal opportunities for learning to read, for example through the experience of signs and labels in everyday life. They will also have a conceptual framework for such concepts such as distance, dimensions and scale that is not drawn from visual images. They might have missed out on gathering everyday practical information about the world around them, which sighted people take for granted, and may therefore need to be introduced to new situations in a practical experimental manner before moving on to form concepts.

Detailed description of Visual Impairments Impacting on Learning and Teaching

Receiving Information During Lectures

Students who are reliant on taping lectures as a way of receiving information will need a translation of visual material into an auditory form. Some thought needs to be given as to the best way of conveying information from diagrams, graphs, chars and other complicated visual material.If you have a Disability Specialist in your organisation, it would be sensible to discuss this with them.

Students with a range of impairments, such as those with a visual impairment, may want to record information by taping or Brailing. Referring students to a website will be useful if the information there is designed to be visually accessible, and if the student has the appropriate equipment or software for reading it. Lecturers should be able to provide students with a disk or hard copy of lecture material, or copies of overheads. Provision of these can enable students with language and comprehension difficulties to devote more attention to listening.

Taping lectures is not always an unqualified success, unless the student develops a system for retrieving information from the tapes, perhaps by tone indexing the tapes, and keeping a record of the main ideas of the lecture (it is much easier to skim visual material rather than listen to whole tapes). Taking home tapes of lectures for transcribing at a later stage can be very time-consuming, and students who do this may benefit from advice from lecturers about whether this is likely to be a successful strategy for study.

Participating in Seminars/Tutorials

Students who have visual difficulties that affect their ability to access text may be excluded when there is some reading to do in the tutorial. They may also experience difficulties with face to face communication if they are unable to read facial expressions or body language. It can take time for students to get used to the voices of other students in their seminar and it may be helpful for speakers to say their name prior to speaking. It is helpful to provide any textual material, in an accessible format, in advance of the tutorial, even if this is not the tutor’s usual practice.

Practical Classes

There are some fairly straightforward and low-tech ways of modifying or adapting equipment or activities to allow students with various impairments to participate in practical classes. Examples include: auditory displays of visual information (such as talking thermometers), tactical displays of visual information (such as beakers with raised markings), clamps and other devices for holding items of equipment, and hand held, illuminated magnifiers. Examples of such innovations are likely to multiply as more people who develop impairments while in employment are maintained and supported in their employment.

Students with visual difficulties working in laboratories can also experience problems with textual materials as well as equipment. In these circumstances, alternative formats, verbalising text or interfacing lab equipment with computer with large print or speech output can all be useful adjustments.

Students with visual difficulties can also experience problems with laboratory layout and may require extra assistance to help them familiarise themselves with layout and location of equipment.

Work Placements, Study Abroad and Field Trips

Departments organising placements, field trips or study abroad for students with impairments will need to consider, ideally in discussion with the students, the differences between the new context and environment and the more usual, and often more structured, context of study. Sometimes, the use of equipment, arrangements or personal assistance could, with a little planning, transfer to a different context.

Some equipment or educational support may not be so easily transferable. Taping lectures may be acceptable in a way that taping interviews with clients in a setting requiring confidentiality may not be. Portability may also be a factor to be considered for field trips and study abroad. Some non-medical, personal help, such as communication support for lectures, could be regarded as obtrusive during one-to-one work involving clients. A laptop with speech synthesis linked to a data projector could allow a blind trainee tutor to do the functional equivalent of writing on a chalkboard. This latter arrangement could clearly have uses in other work contexts involving presentations.

The fact that funding may need to be found to purchase additional equipment for placements, field trips or study abroad, underlines the necessity to plan and prepare long before the placement start date.

Students with impairments are positive assets on courses, where a reminder of the diversity of human experience is important. It can be instructive to be reminded of substantial gains for all students from organising placements in such a way that students with impairments are safely included, and not to think exclusively about problems.


For students who have impairments of various kinds, the usual assessment format may need to be modified to achieve the assessment objectives. Clarity about the latter will be very helpful in determining acceptable modifications, which will be different for different types of assessment, or for different parts of the assessment, e.g. a student may be considerably disadvantaged by part of an exam paper with a heavy concentration of text, such as multiple choice questions, but have no additional difficulty in reading and understanding brief essay titles.

Students with visual difficulties may require examination papers in formats such as Braille, tape or enlarged print. Alternative, the questions or titles of the assignment could be provided on disk, if appropriate access technology is available. Or they could be read to the student.

Some students may rely on equipment to meet the needs of the assessment, whether in a formal examination environment, or the less formal setting in which assignments are prepared for continuous assessment. A tape recorder, computer, or amanuensis or assistant, may be needed to enable a student to complete an assignment. There is a need for clarity over the role and involvement of equipment or assistant, so that arrangements are identified which ensure that the student maintains control over producing what it is that is to be assessed.

An amanuensis can be regarded as an efficient writing machine, responsive to instructions and free from the mechanical complexities of keyboards or tape-recorders. It is usually necessary for the amanuensis to be literate in the subject s/he is scribing. This is particularly true of subjects with terminology and symbols unfamiliar to most people.

Working with an amanuensis takes practice, for both parties, as decisions have to be taken about such matters as spelling, punctuation, and, especially in a timed examination setting, the speed of dictation. Negotiations may also need to take place regarding how visual material is to be conveyed to and from a student who is unable to see or produce it. Where the assessment is carried out may affect how it is carried out. Students relying, in a formal examination setting, on either speech-to-text software or an amanuensis, will obviously have to be accommodated in a room separate from other candidates.

Many departments mark anonymously. Where students produce assignments in an alternative way, departments may have to consider whether the goals of anonymous marking can be achieved in some other way. If departments regard anonymous marking as a protection against marker bias, then it may be possible to achieve this end by some other way of monitoring standards in marking.

Characteristics Impacting on Learning and Teaching

  • Provide sufficient time to discuss needs with the student before their initial teaching session.

    Large Print

    Some students may require material to be produced in large print format. A minimum of 14 point and preferably 16-18 point is recommended for this. It can be produced by photocopy enlargement or by producing larger print directly from a PC – the latter is preferable as the quality of the print is better. However, some students can find it difficult to scan large print and may find their concentration is quickly depleted.


    Some students may need to use a tape recorder to record lectures/discussions. This means the student has to rely on auditory input which requires skills of concentration and memory, and practice. Also, it is more difficult to scan material and the student therefore has to be well organised. Some students may also require the use of a note-taker. Students should be encouraged to sit in a position where they can hear/see (for those with some residual sight). Everything written on OHPs should be stated orally. Course and reading materials should be available well in advance of the session – in extra large print if required. Providing materials in advance (such as reading lists) allows students to make Braille/taped copies of the content if required.

  • Physical Disabilities

    Challenges and Subjects – this link takes you to challenges and subjects associated with this disability.

    Brief description of Physical Disabilities including Neurological Disabilities

    Physical disabilities affecting students can take many different forms. They can be temporary or permanent, fluctuating, stable or degenerative, and may affect parts of the body or the whole of it. Some students with physical disabilities, neurological conditions or acquired brain injury may have perceptual difficulties. Students may have experienced barriers to learning that relate to negative perceptions of their disability and low expectations. They may also have missed out on vital stages of learning during their schooling, affecting language acquisition and the development of literacy.

    Characteristics Impacting on Learning and Teaching


    The initial barrier experienced by many students with physical disabilities is physically accessing the learning environment itself. For many the inaccessibility of buildings is a problem, so there are important questions to ask: Can students get into the building? Can they get around when in it? Is there somewhere for students to rest or take breaks? Is the student able to reach the teaching and learning materials?

    Perceptual Difficulties

    Students with physical disabilities, neurological conditions or acquired brain injury may have perceptual difficulties, and these can take different forms. Some students have difficulty actually receiving information by seeing or hearing, while others can see or hear but cannot process the information they receive. This can cause difficulties with reading and writing, for example in locating the correct place on the page, or moving from left to right when reading or writing.

    Speech/Communication Difficulties

    Students with a neurological impairment, who stammer or have other speech and language difficulties, along with students who are deaf or who have partial hearing, may all have difficulty communicating through speech.

    People with communication difficulties are often thought to be far less able than they really are. It is important to check personal responses to ensure there are no automatic assumptions being made concerning a student’s intelligence and ability if their speech is very slow or slurred. The potential of these students often goes unrecognised.

    Memory Difficulties

    Memory difficulties may be a major issue faced by students who have acquired brain injury. Responses will need to relate directly and explicitly to individual learning goals, programmes of study and contexts. Early guidance should be given in relation to alternative ways of learning.

    Students with short-term memory difficulties may find it very hard to remember instructions. Some students may have fluctuating memories, being able to complete a task in one session, but be unable to do it in another, making it difficult to record progress. Memory also affects students’ ability to sequence. Some students with long-term memory difficulties may not learn even after many repetitions and much practice, and appear to ‘start again’ each time. It is important to remember that memory difficulties do not correlate with a student’s intelligence.

    Mental Health Difficulties

    Challenges and Subjects – this link takes you to challenges and subjects associated with this disability.

    Brief description of Mental Health Difficulties

    The term mental health describes a sense of well being. It implies the capacity to live in a resourceful and fulfilling manner, having the resilience to deal with the challenges and obstacles that life and studying present.

    Depression, stress and anxiety are the most common types of mental illness experienced by students. It is common for students to lack confidence and have low self-esteem despite having the same full range of intellectual abilities as the population as a whole.

    Detailed description of Mental Health Difficulties

    Definition of Mental Health Difficulties and Mental Illness as included in AMOSSHE Publication Students with Mental Health Difficulties, 2002

    • Those with a pre-diagnosed psychiatric condition for which the person may, or may not, be receiving medical or psychological treatment. For such individuals the difficulties arise when their condition becomes unstable in some way and symptoms recur, which may be as a result of external factors or changes in response to treatment.
    • Those without any diagnosed condition who experience the onset of emotional or psychological difficulties which significantly affect their capacity to function. These may be a temporary reaction to a painful event, being under external pressure of some sort, induced by physiological factors such as use of drugs, lack of sleep, change in diet or physical illness, or they may signal the onset of a psychiatric condition.

    Indicators of depression amongst students may include: low mood, lack of motivation, sense of emptiness, withdrawal, change of appetite, self neglect, self loathing, or thoughts of hurting or killing oneself. However, it should be recognised that many people experience some of these symptoms at some points in their lives, indeed some are typical reactions to certain circumstances.

    The degree of severity is reflected by the intensity of symptoms and the impact on the individual’s capacity to function. For example one person feeling depressed may mean feeling temporarily low in mood whereas someone else may use this term when they are completely debilitated and unable to take care of basic personal physical needs.


    Student life is a transitional period and it can cause a lot of anxiety. Symptoms of anxiety can include: agitation, disturbed sleep, change of appetite, headaches, digestive difficulties or panic attacks. These symptoms are easily mistaken by anxious people for evidence of serious physical illness – their worry about this can make the symptoms even worse.

    Sudden unexpected surges of anxiety are called panic, and usually lead to the person having to quickly get out of whatever situation they happen to be in. Anxiety and panic are often accompanied by feelings of depression.


    There are many ordinary situations that can make students feel stressed for periods of time. For example, if workload is allowed to build up, during exam preparation or during a work placement.

    The effects of stress depend on the severity, the length of time it goes on for and the individual concerned. How an individual deals with stress depends on their personality, ability to cope with situations, and whether there is someone supportive to talk to.

    Characteristics Impacting on Learning and Teaching

    Students with mental health difficulties may experience greater anxieties about learning that other students. Some may take medication that affects their concentration, memory and their ability to participate. Short-term memory may be especially affected.

    For many students their mental health may be variable, with good and bad days. This may affect attendance, punctuality and behaviour. Some students may be unable to engage in the learning process until relevant emotional issues are resolved. Progress will be variable, and regression can be common. Success can mean that some students may be reluctant to move on.

    Discussion of learning support needs should not involve diagnosis or labelling. It is not necessary to do either in order to ask the student what might assist them. The educational experience may be the first opportunity a student with a history of mental health difficulties has had to put labels aside and concentrate on their academic potential.

    People with mental health difficulties can often lack confidence, if tutors can recognise this and promote the student’s self esteem; it will have a positive outcome in terms of effective learning.

    Group Work

    Problems may arise in a group situation for students with mental health difficulties including prejudice from other group members, communication difficulties or incompatible working practices, especially as some students with mental health difficulties may appear withdrawn or disruptive.

    As an important component of many group activities is to devolve responsibility and control to students. Tutors may be concerned that their scope for intervention and to take measures to include all students is necessarily compromised. To mitigate this, systems to encourage groups to take responsibility for the inclusion of all students need to be in place.


    Given that periods of examination and assessment are generally the most stressful experiences for students, those with mental health difficulties may need special support at such times. This needs to be discussed and agreed with the student as early as possible.

    When accommodations are used or modifications made to assessment, educational providers will also be concerned to ensure parity between disabled students and their non-disabled peers. It is always useful to consider carefully the core requirements of the course and the role assessment plays within it.

    Hearing Impairments

    Challenges and Subjects – this link takes you to challenges and subjects associated with this disability.

    Brief description of Hearing Impairments and Auditory Difficulties

    Students with hearing impairments may depend on their sight for communication e.g. speech reading, lip reading, British Sign Language (BSL) or a form of English using BSL vocabulary called Sign Supported English (SSE).

    The DDA states that an ‘inability to hold a conversation with someone talking in a normal voice’ or an ‘inability to hear and understand another person speaking clearly over the voice telephone’ counts as a ‘substantial adverse’ effect under the Act.

    When the consequences of someone’s deafness or hearing loss are being considered, the effect of background noise should be taken into account. Any attempts to treat or correct a person’s deafness or hearing loss are ignored for the purposes of the DDA. Importantly, this means that even if a person uses a hearing aid, his or her hearing without that equipment aid is what counts.

    There are four types of hearing loss:

    • Conductive hearing loss (affecting the conduction pathways for sound to reach the inner ear). Conductive hearing losses usually affect all frequencies of hearing evenly and do not result in severe losses.
    • Sensorineural hearing loss (from damage to the delicate sensory hair cells of the inner ear or the nerves which supply it). These hearing losses can range from mild to profound and they often affect the person’s ability to hear certain frequencies more than others.
    • A mixed hearing loss refers to a combination of conductive and sensorineural loss and means that a problem occurs in both the outer or middle and the inner ear.
    • A central hearing loss results from damage or impairment to the nerves or nuclei of the central nervous system, either in the pathways to the brain or in the brain itself.

    Detailed description of Hearing Impairments and Auditory Difficulties

    For severely and profoundly deaf people, acquiring language is a different process from the way in which hearing people develop language. Usually language is acquired through plentiful exposure to meaningful linguistic interaction in early childhood. Severe deafness drastically reduces both the quantity and the quality of linguistic input available to the deaf person.

    For a deaf student, English language development is rarely natural and automatic, but can be a laborious process with numerous obstacles and pitfalls.

    For many prelingually deaf students (those born deaf), English is their second language and BSL is their first. However, unlike other students who do not have English as their first language, prelingually deaf students are physically unable to learn English the way a German or French native speaker learns English. They cannot be immersed in the language around them for they cannot hear it. In addition, since BSL is entirely visual, deaf students do not have a written or spoken language on which to base their second language learning.

    Characteristics of Hearing Impairments Impacting on Learning and Teaching

    For the deaf student who has English as a second language, it is not surprising if they are experiencing linguistic problems. Difficulties manifest themselves most obviously in written work, where mistakes may be found with sentence structure, verb tenses, word omissions, etc. To exacerbate the problem, carrier language is often hidden in fluent speech and therefore difficult to lip-read.

    The lack of hearing and auditory memory means that students may be unable to rehearse what is put down on a page. Furthermore, BSL has a grammar and syntax that is quite different to that of spoken English, which can also confuse the student.

    Research shows that the reading age of deaf students leaving school is below the national average, therefore it is likely that deaf people reaching Higher Education are already functioning at a relatively advanced level. However, reading can remain a laborious task for some deaf students, as their vocabulary can be considerably restricted in comparison with their hearing peers. Unfamiliar words, or words which have not been specifically introduced to the student, cannot be lip-read. Consequently, deaf students often have to research not only the technical jargon relating to the subject, but also language that is commonplace for hearing peers. An exceptional amount of time can be spent on reading and preparing assignments, often with the support of an individual language/learning support tutor.

    In comparison to hearing students, the pathway to general knowledge may have been significantly blocked for the hearing impaired student. Hearing students absorb general knowledge through reading newspapers, listening to the TV or radio and holding discussions with other students. This incidental information often helps to form the opinions and develop the skills necessary for Higher Education. Yet, deaf students can be denied access to this whole wealth of general knowledge and life experience. The knock-on effect is often reflected in deaf student’s written work, which may be judged to be lacking in depth, containing immature and sometimes uninformed opinions and exhibiting problems with sequencing and overall structure.

    Group work can be problematic for students with hearing impairments and a number of enabling strategies may need to be adopted by the rest of the group.

    As an important component of many group activities is to devolve responsibility and control to students, tutors may be concerned that their scope for intervention and to take measures to include all students is necessarily compromised. To mitigate this, systems to encourage groups to take responsibility for the inclusion of all students need to be in place.

    Tutors need to think carefully about the structure of their course, tutorial support, resources, staff development and learning environments, as replacing large lectures and seminars by more accessible resource based learning using small tutorial groups and computer based learning can reduce the need for communication support.

    Providing lecture and course notes in advance can be a great help to the student and support worker, and providing these in electronic form may be the most flexible approach. Using visual aids (e.g. PowerPoint) can also help support the understanding of spoken information.

    Characteristics of Auditory Difficulties Impacting on Learning and Teaching

    Receiving Information During Lectures

    Students who are deaf or hard of hearing may need to lip-read, and if this is the case, then the lecturer’s face – of the face of any other speaker in the lecture theatre – needs to be visible.

    Spot lighting may be needed for lip-reading (and sign language interpretation) when the room is darkened, e.g. for showing slides or video. Where students use the services of a lip-speaker or an interpreter, such educational support workers are likely to need short breaks during lectures. They may also need help with provision and positioning of seating.

    Both student and signer or lip-speaker will derive great benefit from being given an outline of the lecture material beforehand. Signs for new terminology need to be devised in advance: signs for specialised vocabulary such as heterocyclic compounds or hermeneutics are not instantly available to signers. In general, it is helpful to supplement aural information with visual information for students who are deaf or hard of hearing.

    Participating in Seminars/Tutorials

    For students who lip-read, furniture might need to be rearranged so that the faces of everyone can be seen. A horse-shoe seating arrangement is helpful for this, ideally with none of the participants silhouetted against the light.

    If a student with auditory difficulties is being excluded because of several people talking at once (which makes lip-reading impossible), the tutor could control the situation by passing a pencil or baton from person-to-person, with only the holder of the baton being allowed to speak. Prior notice of the topic and main ideas provides the context which is crucial for successful lip-reading. If the subject matter is not sufficiently structured to allow this, the main ideas could be recorded in a textual way as the seminar progresses.

    Background noise can be amplified by hearing aids where room loops are not installed. Students might use equipment, such as radio aid systems, to get round the problem, and in these cases, speakers might be asked to wear a radio microphone, which is not a difficult request to comply with. Alternatively, a change of room to a quieter side of the building may help. Rooms with soft furnishings can also help as they reduce echo.

    Work Placements, Study Abroad and Field Trips

    Departments organising placements, field trips or study abroad for students with impairments will need to consider, ideally alongside the students themselves, the differences between the new context and environment and the more usual, and often more structured, context of study. Sometimes, the use of equipment, arrangements or personal assistance could, with a little planning, transfer to a different context. It will sometimes be necessary to identify additional items of equipment for specific purposes. For example, a sound monitor could be used as a visual indicator of classroom noise for a trainee tutor with auditory difficulties. The fact that funding may need to be found to purchase additional equipment for placements, field trips or study abroad, underlines the necessity to play and prepare long before the placement start date.

    Students with impairments are positive assets on courses, where a reminder of the diversity of human experience is important. It can be instructive to be reminded of substantial gains for all students from organising placements in such a way that students with impairments are safely included, and not to think exclusively about problems.


    For students who have impairments of various kinds, the usual assessment format may need to be modified to achieve the assessment objectives. Clarity about the latter will be very helpful in determining acceptable modifications, which will be different for different types of assessment, or for different parts of the assessment, e.g. a student with auditory difficulties may have no additional difficulty in completing a written exam paper, but invigilators may need to provide oral information during the examination, e.g. about changes to the exam paper, in writing.

    Achievements which are being assessed may be capable of being demonstrated in a variety of ways. Responses can be conveyed by a student using sign language, which can then be verbalised by an interpreter, and written by an amanuensis. For some students who are pre-lingually deaf, written English may be deaf English, i.e. in the word order of sign language, which is very different from the word order of English. If the subject of the assessment is what is understood rather than how this is expressed, then signed responses may be acceptable.

    Many departments mark anonymously. Where students produce assignments in an alternative way, departments may have to consider whether the goals of anonymous marking can be achieved in some other way. If departments regard anonymous marking as a protection against marker bias, then it may be possible to achieve this end by some other way of monitoring standards in marking.


    Challenges and Subjects – this link takes you to challenges and subjects associated with dyslexia.

    Brief description of Dyslexia

    Dyslexia affects the area of the brain that deals with language, leading to differences in the way information is processed and affecting the underlying skills needed for learning to read, write and spell.

    Detailed description of Dyslexia

    Dyslexic students can often perform a range of complex tasks, such as solving complicated problems in electronics or design, yet cannot do the seemingly simple: learning to read and spell, organising writing, taking notes, remembering instructions, telling the time or finding their way around. A way of regarding this pattern of strengths and weaknesses is as a cognitive or learning style, in fact many dyslexic students themselves experience their dyslexia as a difference in the way they think or learn.

    Students with dyslexia can possess the following strengths:

    • Creative and original thinking.
    • Good strategic thinking and problem-solving.
    • Determined and hard-working.
    • Highly motivated.
    • Many have developed their own strategies to overcome some of their difficulties.

    Because of their language processing and short-term memory difficulties, dyslexic students rely heavily on meaning and understanding, which requires:

    • A highly personalised approach to learning,
    • A need to have the learning process and conventions made explicit,
    • A need to understand how and why in order to learn.

    Many, but not necessarily all, of the following learning styles could apply to dyslexic students:

    • Thinking holistically (all at once) rather than step by step.
    • Needing to see the whole ‘picture’ first before learning the steps or details.
    • Difficulty remembering sequences but not patterns.
    • Good at seeing how lots of things are connected, how things work.
    • Difficulty memorising things except when something is really understood or there is a personal connection.
    • Learning by experience, not from being told.
    • Concrete tactile learning and learning better with the help of colour, humour, stories, images, etc.
    • Difficulty learning or applying rules or generalisations – learning from the particular to the general.
    • Finding it easier to read and write if there is a personal interest in the subject matter.
    • In mathematics, often understand concepts but not calculation processes or mathematical language.

    Characteristics Impacting on Teaching and Learning


    Reading forms a major part of most curricular activities and if a student has, for instance, half the reading speed of other students, this may put an immense strain on their studies, affecting their ability to remember what has been read. Vocabulary levels may also be poor and so comprehension suffers. Students with dyslexia may experience any or all of the following:

    • Visual stress.
    • Reading overload.
    • Lack of speed with reading.
    • Difficulty summarising.
    • Difficulty sorting and selecting materials for study.
    • A lack of understanding and retention of what has been read.
    • Difficulty extracting the main points from what has been read.
    • Misreading (assignment or examination questions).

    Dyslexic students can experience problems with written expression and vocabulary to the point where it affects a tutor’s understanding of their work.


    The difficulties experienced by some students with dyslexia might include some or all of the following:

    • Difficulty writing and listening simultaneously.
    • Difficulty making detailed notes and understanding what has been written when reading it back.
    • Difficulty extracting the main points during lectures.

    Problems copying quickly and correctly.


    Students with dyslexia may experience problems with their written work including some or all of the following:

    • Poorly constructed and slow handwriting interfering with their ability to get ideas down.
    • Difficulty planning and structuring written work.
    • Problems with the transition of ideas.
    • Difficulty relating theory to practice.
    • Poor written expression and/or sentence structure.
    • Difficulty understanding conventions in writing.
    • Difficulty relating abstract to particular.

    Problems editing and proof-reading.

    Oral Language

    Certain difficulties, experienced by students with dyslexia, can be associated with language as well as written work and reading.

    Students may experience problems taking in information given orally quickly or accurately enough, misunderstanding instructions or information, assimilating what has been said in a group situation, word-finding problems or with pronunciation of polysyllabic words.

    Organisational Skills/Time Management

    Some dyslexic students experience short-term memory problems which can affect note-taking, reading, writing and organisation but can also make it difficult to organise their time and meet deadlines.

    These difficulties tend to be the ones that are most often ignored and, because of this, dyslexic students can sometimes be judged as being lazy, unmotivated, sloppy or careless.


    Many students with dyslexia are mathematically very able; however, some may have difficulties resulting from visual perceptual or short-term/working memory problems. Dyslexic students may also experience some or all of the following mathematical difficulties:

    • Visual problems such as reversals and substitutions.
    • Transcription errors between media.
    • Losing place in multi-step calculations or failing to hold all aspects in mind.
    • Difficulty remembering sign and symbols.
    • Problems remembering formulae and theorems.
    • Difficulty retrieving specialised vocabulary.
    • Difficulty with arithmetic and basic numeracy.
    • Difficulty moving from concrete to abstract.


    Autistic Spectrum Disorders

    Challenges and Subjects – this link takes you to challenges and subjects associated with autistic spectrum disorders.

    Brief description of Autistic Spectrum Disorders


    Autism is a lifelong developmental disorder that affects the way an individual communicates and relates to people around them. Children and adults with autism experience difficulties with everyday social interaction. Their ability to develop friendships is generally limited due to their capacity to understand other people’s emotional expression.

    Detailed description of Autistic Spectrum Disorders

    People with autism often have accompanying learning difficulties but all individuals share the same common difficulty in making sense of the world around them.

    Students with autistic spectrum disorders can experience a number of difficulties which may affect their studies.

    People with autism generally experience three main areas of difficulty; these are known as the triad of impairments:

    • Social interaction – difficulty with social relationships, e.g. appearing aloof and indifferent to others.
    • Social communication – difficulty with verbal and non-verbal communication, e.g. not fully understanding the meaning of common gestures, facial expressions or tone of voice.
    • Imagination – difficulty in the development of interpersonal skills and imagination, e.g. having a limited range of imaginative abilities, possibly copied and pursued rigidly and repetitively.

    In addition to this triad, repetitive behaviour patterns and resistance to change in routine are often also characteristic.

    Asperger Syndrome

    Individuals with Asperger syndrome find it difficult to read communication signals that most of us take for granted and, as a result, find it more difficult to communicate and interact with others. Asperger syndrome is a form of autism, and a number of traits of autism are common to Asperger syndrom, including:

    • difficulty communicating – individuals may speak fluently but they may not take much notice of the reaction of the people listening to them; they may talk on an on regardless of the listener’s interest or they may appear insensitive to their feelings. Despite having good language skills, people with Asperger syndrome may sound over-precise or over-literal jokes can cause problems as can exaggerated language, turns of phrase and metaphors.
    • difficulty forming social relationships – unlike the individual with classic autism, who often appears withdrawn and uninterested in the world around them, many people with Asperger syndrome want to be sociable and enjoy human contact. Although they do still find it hard to understand non-verbal signals, including facial expressions, which makes it more difficult for them to form and maintain social relationships with people unaware of their needs.
    • lack of imagination and creativity – while they often excel at learning facts and figures, individuals with Asperger syndrome often find it hard to think in abstract ways.

    However, people with Asperger syndrom usually have fewer problems with language than those with autism, often speaking fluently, though their words can sometimes sound formal or stilted. People with Asperger syndrome do not usually have the accompanying learning disabilities that can be associated with autism.

    Because of this, many individuals who have been diagnosed with Asperger syndrome as children, have often been through mainstream schooling and, with the right support and encouragement, have made good educational progress.

    Individuals with Asperger syndrome often develop an almost obsessive interest in a hobby or collecting. Usually their interest involves arranging or memorising facts about a special subject, such as train timetables, Derby winners or the dimensions of cathedrals, for example. With the right encouragement, interests can be developed so that people with Asperger syndrome can go on to work or to study their area of interest.

    Individuals can also find change unsettling and upsetting and often prefer to order their day according to a set pattern. If they work set hours then any unexpected delay, such as a traffic hold-up, or a late train, can make them anxious or upset.

    These are the main characteristics of the condition, but it is important to remember that all individuals are different and these characteristics will vary greatly and some may be demonstrated more strongly than others.

    Characteristics Impacting on Learning and Teaching

    Students with autistic spectrum disorders may have certain advantages over other students in relation to some areas of their university experience, for example:

    • Most students find that a busy social life interferes with their studies. This is one problem that students with Autistic Spectrum Disorders generally don’t have.
    • Some individuals with autistic spectrum disorders have unusual memories and/or a natural affinity with computers – both of these can give a student a head start.
    • The formal style required for academic essay writing is usually a lot easier to master than casual conversation.
    • They generally have the ability to study an area in great depth.
    • They can be very motivated and independent in their study.
    • They can be very single minded in working to set goals.
    • Students are often original and creative in their thought patterns and have good attention to detail and precision.

    However, students with autistic spectrum disorders may also have a number of characteristics that have a negative impact on the way they learn; these can include any or all of the following:

    • Difficulty interacting with other students and tutors.
    • Misunderstanding or naivety within social interactions.
    • Anxiety within social interactions.
    • Reliance on routines and a dislike of sudden changes.
    • Poor organisational skills.
    • Easily distracted.
    • Confusion of relevant and irrelevant information.
    • Focusing on inappropriate details.

    Students with autistic spectrum disorders may find group work situations problematic due to their difficulties with social interaction, specific group work difficulties might include: missing unspoken messages given through body language, facial expression, or tone of voice, making remarks that appear to be inappropriate to the context of the conversation, and difficulty accommodating to different audiences.

    Students with autistic spectrum disorders are more likely to use language literally, finding it difficult to understand metaphors, jokes or abstract concepts. Their difficulty with the abstract and their inflexibility in thinking can extend to other areas, for example reliance on fixed routines or demonstrating repetitive behaviour, such as wishing to sit in the same seat, they may experience distress when these routines are disrupted.