Sensory Awareness and Social Work

Michelle Evans,Andrew Whittaker

• Publisher: Learning Matters
• Year: 2010
• ISBN:
  9781844457281
• Edition: 1
• Topic: Scienze sociali
• Subtopic: Lavoro in ambito sociale

Understanding sensory needs is fundamental for social work and care management practice. Social workers are trained to reflect on their own practice, make useful application of theory and promote anti-discriminatory practice at all times. This book will assist students in identifying people who have a sensory need and enable them to have the knowledge, skills and values to address this. Designed specifically to encourage students to build confidence and develop skills essential to best practice, this book is specifically structured to address all aspects of sensory need.

Chapter 1

What are sensory needs?

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ACHIEVING A SOCIAL WORK DEGREE

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This chapter will help to meet the following National Occupational Standards.

Key Role 2: Plan, carry out, review and evaluate social work practice, with individuals, families, carers, groups, communities and other professionals.

• Interact with families, carers, groups and communities to achieve change and development and to improve life opportunities.
• Work with groups to promote individual growth, development and independence.

Key Role 6: Demonstrate professional competence in social work practice.

• Work within the principles and values underpinning social work practice.
• Identify and assess issues, dilemmas and conflicts that might affect your practice.
• Devise strategies to deal with ethical issues, dilemmas and conflicts.

This chapter will also be of assistance to you to follow the General Social Care Council (GSCC) Codes of Practice for Social Care Workers.

GSCC Code 1: As a social care worker you must protect the rights and promote the interests of service users and carers.

• Treating each person as an individual.
• Respecting and, where appropriate, promoting the individual views and wishes of both service users and carers.
• Supporting service users’ rights to control lives and make informed choices about the services they receive.
• Respecting and maintaining the dignity of the service users and carers.
• Respecting diversity and different culture and values.

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Introduction

In this chapter, we will discuss definitions of sensory needs and what actually constitutes a sensory need and this will set the scene for the remainder of the book. While sensory need incorporates various facets of sensory loss, for the purpose of this book we will be focusing on sensory need in terms of Deaf/deafness, visual impairment and deafblindness. We will explore definitions for visual impairment, deafblindness, deafness including big ‘D’ deafness (which takes a politicised stance), small ‘d’ deaf (profoundly deaf, but more often speech used instead of BSL), hard of hearing and deafened. We will consider the registration process and what this means for a person with sensory needs. Within the field of sensory practice, equipment plays a significant role so we will be looking at equipment and technology that can contribute to empowering a person with sensory requirements. The role of linking theory to practice will also be introduced, as will the significance of service user perspectives/involvement and legislation.

What are sensory needs?

‘Sensory’ is defined as a sensation of the senses (Thompson, 1996). This term is based on the Latin sentire sens, literally meaning ‘to feel’. Needs are defined as circumstances requiring some form of action; necessity (Thompson, 1996). Therefore it could be argued that a sensory need is a circumstance which necessitates action in relation to the senses. This could mean that a sensory need is a need for information, advice and/or provision of services in relation to a sensory issue. This could be in connection with hearing and/or sight issues, touch (perhaps because of stroke), taste (dysgeusia) or smell (anosmia). However, as highlighted earlier, for the purpose of this book we will be focusing on sensory needs in terms of deafness/Deafness, hearing impairment, visual impairment and deafblindness.

It could be argued that sensory needs can vary not only medically but also according to how individuals perceive themselves. To illustrate, we will consider two case studies of individuals who are both profoundly deaf/Deaf.

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CASE STUDY

Didier was a successful foreign journalist. After contracting meningococcal infection (meningitis) he subsequently experienced a profound hearing loss. Didier’s previous world had revolved around being able to hear and receive audible information at a quick pace, interpret the information and act on information received (Shannon and Weaver, 1949). Didier experienced feelings of bereavement, anger, depression and isolation and felt disabled by his hearing loss as his ability to function as a hearing person diminished overnight.

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A person in Didier’s situation who has acquired deafness as a result of illness, accident, trauma or infection would most likely consider themselves to have sensory loss (Hearing Concern, 2007). People in this situation are often referred to as small ‘d’ deaf. However, some ‘Deaf’ people take a politicised stand on deafness and do not consider themselves to have a sensory loss.

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CASE STUDY

Vincenta was born profoundly ‘Deaf’ to parents who were also profoundly culturally Deaf. Vincenta’s first language was British Sign Language, which her parents taught her from an early age. Vincenta did not consider herself to be disabled. She was proud to be part of the Deaf community which was rich in culture and history.

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Culturally ‘Deaf’ people are often referred to as ‘D’ Deaf. Sacks (1991) describes Deaf people who have been part of a Deaf community as a linguistic minority with their own culture and history. The Royal National Institute for Deaf People (2001) was prominent in campaigns to establish British Sign Language (BSL) as an official language in a similar way to Welsh. The government concluded that ‘D’ Deaf people who considered themselves to be a linguistic minority were justified in their argument and in 2001, British Sign Language was recognised as an official language. Organisations such as the Royal National Institute for Deaf People (RNID) ensure people are well informed about their rights and how to use legislation such as the Disability Discrimination Act 1995 to promote change. An example of this is that all public information is now available in BSL (RNID, 2007). Later in the book, the politicised stance on Deafness will be explored further.

Key definitions

This section aims to clarify sensory definitions for:

• deafness and hearing impairment;
• visual impairment;
• deafblindness.

Deafness and hearing impairment

The World Health Organisation (WHO) defines deafness in terms of the average hearing threshold at three frequencies: 500Hz, 1KHz, and 2KHz. This is the case because these three frequencies cover the main speech spectrum of 300–3000 Hz. Deafness is often used to describe a profound loss in one or both ears and hearing impairment is a loose term used to describe a loss of hearing in one or both ears (World Health Organisation, 2009). There are two types of hearing impairment depending on where the hearing loss occurs. Conductive hearing loss often occurs in the outer or middle ear and can be medically or surgically treatable. Sensorineural hearing loss is usually as a result of a problem in the inner ear. Sensorineural loss can often be permanent and frequently occurs as a result of exposure to excessive/prolonged noise or advancing years. A hearing aid may be useful to someone with sensorineural hearing loss. Hearing loss can be mild, moderate or profound. People can experience deafness or hearing impairment at any time in their lives. Some people are born deaf/Deaf/hearing impaired, otherwise known as congenital deafness, and other people acquire it. Acquisition of deafness/hearing impairment can be at any time throughout life for a whole host of reasons, as highlighted in the case study of Didier.

Deafness/hearing impairment are referred to in different ways:

• big ‘D’ Deaf;
• small ‘d’ deaf;
• hard of hearing;
• deafened.

Deafness/hearing impairment is as unique and individual as the person themselves. While two people may be deaf/hearing impaired, they may perceive their deafness/hearing impairment, their method of communication and their social interactions differently.

Within the Deaf/deaf community, there are divided views with regard to deafness being classified as a disability. Someone who has acquired deafness would most likely consider themselves disabled (Hearing Concern, 2007) but ‘D’ Deaf people take a politicised stand on deafness and do not consider themselves to be disabled (Peters, 2000). A person who is small ‘d’ deaf would more often communicate using lipreading, residual hearing, speech or hearing aids. However, some deaf people will choose a mixture of communication methods often referred to as ‘total communication’, which may include British Sign Language, Sign Supported English, simple signs and gestures (see Chapter 2). Big ‘D’ Deaf people will most likely use British Sign Language.

There are also various genetic disorders that can affect hearing, for example, neurofibromatosis, also known as Bilateral Acoustic NF (BAN). This largely genetic disorder often manifests the first symptoms in the early teens or early twenties.

A person who is deafened may have become deafened by exposure to loud music, heavy machinery or prolonged loud noise (sensorineural). When we use the expression that noise is ‘deafening’, this can literally mean that the noise is so loud that abnormalities occur in the hair cells of the organ of Corti in the cochlea and prevent sound being transmitted.

The time of life in which a person experiences deafness/hearing impairment can affect their social interactions, education, access to employment, relationships and so on. For a person who has previously experienced hearing, the loss of this sense can be devastating. However, as highlighted, this is not the case in all areas of Deafness.

Visual impairment

According to the World Health Organisation, blindness is the inability to see due to physiological or neurological factors (WHO, 2009). Previously people with visual impairment/sight difficulties were referred to as ‘blind’ and ‘partially sighted’; now the terms used are ‘sight impaired’ and ‘severely sight impaired’. While these changes have been made, many people still refer to people as blind and partially sighted, so we will be using both terms throughout this book. Blindness can incorporate various aspects of blindness, for example, total blindness, which is the complete lack of form and visual light perception and therefore clinically recorded as ‘NLP’, which literally stands for ‘no light perception’. Blindness is also often used to describe severe visual impairment with residual vision. People described as having ‘light perception’ only have the sight ability to differentiate light from dark. People who have ‘light projection’ are able to locate the general direction of a light source. ‘Peripheral blindness’ is due to a lesion in the optical apparatus peripheral to the optical cortex, including lesions in the optic chiasma, optic nerve, retina, anterior and posterior chambers, lens and cornea. The term ‘blindness’ may indicate a total loss of vision or may be used to describe certain visual limitations, e.g. colour-blindness (tritanopia).

There are numerous causes of visual impairment. However, the primary causes of chronic blindness include cataract, glaucoma, age-related macular degeneration (AMD), corneal opacities, diabetic retinopathy and trachoma. As people are living longer, age-related blindness is increasing, as is blindness caused by uncontrolled diabetes. Additionally, there is a host of eye conditions associated with children, for example, conditions caused by vitamin A deficiency. A percentage of eye conditions can be treated or controlled but some eye conditions are permanent. Where visual impairment is permanent, statutory support is offered.

A significant aspect of support for an individual who is sight impaired or severely sight impaired is that of registration. We will look at the registration process and the legislation that supports it later in this chapter.

Deafblindness

The term ‘deafblind’ usually refers to children and adults who have both a hearing and vision impairment. This combination of sensory loss is often described in various terminological formats, including:

• deafblindness (DB);
• dual sensory loss (DSL);
• multi-sensory impairment (MSI).

Throughout this book you will see all three terms used. However, DSL is more likely to be ...