Transcript Slide 1

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:
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Dyslexia,
Dyspraxia or Development Co-ordination Disorder,
Dyscalculia,
Attention Deficit Disorder
• Highly variable profile
• Strengths and weaknesses
Common difficulties in SplDs
Memory &
concentration
Sensory
sensitivity
Communication
skills
Information
processing
Direction &
navigation
Literacy
Organisation &
time
management
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 selfesteem
Areas of Strength
• Specific Learning Difficulties are linked to a range of skills:
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'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’:
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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/aboutdyslexia/adults-and-business/dyslexia-andspecific-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