how to interpret and manage learning needs on placement sarah illingworth & louise goff
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How to interpret and manage learning needs on placement
Sarah Illingworth & Louise Goff
Specific Learning Difficulties (SplDs)• SplDs affect the way information is learned and
processed• They are neurological (rather than psychological),
usually hereditary and occur independently of intelligence
• They include:– Dyslexia, – Dyspraxia or Development Co-ordination Disorder, – Dyscalculia, – Attention Deficit Disorder
• Highly variable profile• Strengths and weaknesses
Common difficulties in SplDs
Information processing
Memory & concentration
Communication skills
Literacy
Organisation & time management
Direction & navigation
Sensory sensitivity
Information processing
• Difficulties with taking in information efficiently (this could be written or auditory)
• Slow speed of information processing - a 'penny dropping' delay between hearing something and understanding and responding to it
Information processing
Memory & concentration• Poor short term memory for
facts, times, dates• Poor working memory -
difficulty holding several pieces of information while undertaking a task e.g. taking notes as you listen.
• Mistakes with routine information
• Inability to hold on to information without referring to notes.
Memory & concentration
Memory & concentration
• Weak listening skills, a limited attention span, problems maintaining focus
• A tendency to be easily distracted, inability to remain focused
Memory & concentration
Communication skills• Lack of verbal fluency or precision
in speech• Word-finding problems• Inability to work out what to say
quickly enough• Misunderstandings or
misinterpretations during oral exchanges
• Over-loud speech or murmuring that cannot be clearly heard
• Sometimes mispronunciations or a speech impediment may be evident
Communication skills
Literacy• Lateness or difficulty in
acquiring reading and writing skills
• Erratic spelling, difficulty extracting the sense from written material, difficulty with unfamiliar words, an inability to scan text
• Particular difficulty with unfamiliar types of language such as technical terminology, acronyms
Literacy
Organisation & time management
• Difficulty presenting a sequence of events in a logical, structured way
• Incorrect sequencing of number and letter strings
• Tendency to misplace items• Chronic disorganisation• Poor time management:
particular difficulties in estimating the passage of time
Organisation & time
management
Direction & navigation
• Difficulty with finding the way to places or navigating the way round an unfamiliar building
Direction & navigation
Sensory sensitivity
• A heightened sensitivity to noise and visual stimuli
• Impaired ability to screen out background noise or movement
• Sensations of mental overload / switching off
Sensory sensitivity
Visual Stress
Visual Stress
• Some people with dyslexic difficulties may experience visual stress when reading
• Text can appear distorted and words or letters appear to move or become blurred
• White paper or backgrounds can appear too dazzling and make print hard to decipher
One size does NOT fit all…• Individuals vary greatly in their profile• Key variables are the severity of the difficulties and the
ability of the individual to identify and understand their difficulties
• Key is to develop and implement coping strategies• Strategies included: technology, reliance on others and
an array of self-help mechanisms - the operation of which require sustained effort and energy
• Strategies are prone to break down under stressful conditions which impinge on areas of weakness
Stress
• People with Specific Learning Difficulties are particularly susceptible to stress, compared with the ordinary population
• Leads to impairments becoming more pronounced
• As a result many people with Specific Learning Difficulties have little confidence and low self-esteem
Areas of Strength• Specific Learning Difficulties are linked to a range of skills:
– 'big picture' thinking– problem-solving – lateral thinking abilities– instinctive understanding of how things work– originality & creativity – exceptional visual-spatial skills
• Not all people with SplDs will have outstanding talents, but all will have comparative strengths and often demonstrate great perseverance and determination
Case Study 1
• Undergraduate student who has disclosed that she has dyslexia
• She was diagnosed at school and is engaged with her learning needs
• She has had little contact with disability support whilst at university and has not discussed her learning needs with her university lecturers
Case study 1
• The university disability support service has assessed that she requires the following adjustments:– 25% additional time for examinations– Examinations to be carried out in a separate room.– Two week extended hand-in for assessed
coursework– Lecture notes to be available one week in advance
Case Study 1
• What reasonable adjustments would you suggest for this student on their second placement ?
Case Study 2
• A student is half way through C placement and isn’t progressing as well as you would expect
• She ‘can’t quite pull it together’ and you have no idea why
• Her pre-placement form states that she achieves an average academic performance
• Her performance on B placement was unremarkable.
Case Study 2
• During a visit by the university tutor you identify the following as areas that need improvement:
• Lacking consistency in gathering and interpreting patient information required to perform an assessment
• Difficultly in remembering key facts. Your concerned that the student has knowledge gaps/deficiencies
Case Study 2
• The student seems very disorganised. Work is sometimes handed in late, the student is often late or in the wrong place
• Her portfolio is poorly organised and lacks sufficient evidence demonstrating clinical and reflective skills
• She finds recording information challenging, making many errors and this process is very time consuming
• She is very, very stressed and anxious at times which limits her ability to perform
Case Study 2
• What do you think the problem is ?• How are you going to manage it ?
Case Study 2• What will the university do ?– Arrange diagnostic tests for a possible specific
learning disability– Work with the placement site to develop
reasonable adjustments– Work with the student to support them– Facilitate stress management support at the
University– Provide additional contact for both the student
and the placement site– Facilitate post-placement discussions of
experiences
Case Study 2
• What do you have to do:– Facilitate and support reasonable adjustments– Reasonable adjustments have to be agreed by the
placement site, student, university– Document your decisions and rationale
Reading strategies• Allow extra time for reading.• Present essential reading well in advance of meetings –
highlighting important parts if appropriate.• Provide opportunities to discuss reading.• Make word processed documents ‘dyslexia friendly’:
– write in a logical sequence– avoid small print (use font size 12 or above)– use a dyslexia friendly font (arial, verdana, tahoma or lucinda sans are best)– use bullet points in preference to sentences where possible– use simple words/avoid overuse of jargon or uncommon words– do not justify the right hand margin – this makes the spaces between words
uneven and harder to read if you are dyslexic– space the information so it is not cramped, use short paragraphs to break up
dense text– where possible print documents on off white/cream paper
Writing strategies
• Allow individuals enough time to write up their notes.
• Try not to disturb individuals when they are concentrating on their documentation.
• Allow them to write a rough draft on scrap paper which you can check before they write it into the notes.
• Help students to devise a checklist of key areas to include in certain types of documentation.
• Consider devising a ‘sample’ or ‘model’ for different types of documentation to show them the level and content expected
• Allow word processing of reports etc where possible
Memory Strategies• Help the student to invent and use mnemonics.• Encourage the individual to use ‘to do’ lists rather
than trying to remember.• Don’t give too many instructions at once.• Prepare printed ‘handover sheets’ covering core
information – the individual can add to these but it will reduce the amount they need to write down and avoids things being missed.
• Help a colleague to draw up a plan highlighting important tasks/ deadlines.
Memory Strategies• Set clear, measurable targets.• Allow enough time for the person to grasp key
information, try not to rush them.• In the case of procedures allow the person a chance
to practice (ideally as close as possible to when you explained it or demonstrated it).
• Explain things more than once if required.• Where possible give instructions in written and
verbal form (you could consider using a digital voice recorder to record sets of instructions).
Liaising with colleagues
• Try to create an environment which helps colleagues to feel comfortable• anxiety will only make problems worse.
• Don’t let people draw attention to mispronounced words, even inadvertently
• Try not to use abbreviations as some people find them difficult to interpret and they may mean different things to different people
Useful resources
• http://www.bdadyslexia.org.uk/about-dyslexia/adults-and-business/dyslexia-and-specific-learning-difficulties-in-adu.html
• Dyslexia, dyspraxia and dyscalculia: a toolkit for nursing staff http://www.rcn.org.uk/__data/assets/pdf_file/0003/333534/003835.pdf
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