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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

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specific learning difficulties splds
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
information processing
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

Memory & concentration

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 concentration1

Memory & concentration

Memory & concentration
  • Weak listening skills, a limited attention span, problems maintaining focus
  • A tendency to be easily distracted, inability to remain focused
communication skills
Communication skills

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
literacy
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
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
Direction & navigation
  • Difficulty with finding the way to places or navigating the way round an unfamiliar building

Direction & navigation

sensory sensitivity
Sensory sensitivity

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
visual stress1
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
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
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
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
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 11
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 12
Case Study 1
  • What reasonable adjustments would you suggest for this student on their second placement ?
case study 2
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 21
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 22
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 23
Case Study 2
  • What do you think the problem is ?
  • How are you going to manage it ?
case study 24
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 25
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
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
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
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 strategies1
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
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
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