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Sensory changes in school students with an ABI fact sheet

Sensory changes in school students with an acquired brain injury

Changes in vision

Following a brain injury, a number of disturbances of vision can occur. The type of visual disturbance will depend on the location and extent of the brain injury and any complications that may occur. The visual deficit may be temporary or permanent and eye specialists will determine if any treatment is necessary.

Visual Field Loss

Children who have gaps in visual fields, or “blind spots” are often not aware that they have a visual problem. The most common pattern is called hemianopia, where part of the visual field is lost in each eye:

Vision field loss diagram

For example, in a right hemianopia, the blindness affects the right side of both visual fields. This is represented in the above diagram, where the darkened area indicates the area of visual field that is unable to be seen. By turning their eyes or head, the child would be able to see the “hidden area”. A visual field loss is likely to persist over time.

What you might see

What this could mean

Strategies to assist the student

Student closing one eye They could have double vision.
  • This may resolve over time or the student may need eye drops or glasses to correct this.
Misreading one side of the page/blackboard They are missing part of the written work resulting in decreased comprehension.
  • Use verbal prompting or finger pointing from one edge of a page to the other to encourage scanning from left to right so that the whole page is seen.
  • Place coloured markers on the blackboard/worksheets to guide where to start and finish looking.
  • Seat the child to ensure maximum visual input. For example, the child with a right hemianopia should be seated on the right side of the room.
Trouble looking from desk to the board Eye gaze difficulties resulting from changes in the eye muscles.
  • Provide a slope board for the desk so the student doesn’t have to move their eyes as much when looking from board to desk.
  • Provide written handouts so don’t have to read from the board.
Trouble finding items in the classroom Not scanning appropriately to find objects around them.
  • Have clear locations where items belong
    Prompt child to move their head to “search” for the item.
Bumping into objects when negotiating the environment or have difficulty getting through crowds and doors They may have difficulty moving from place to place in the school, lack the confidence to do things independently.
  • Encourage the student to move their head to scan the environment.
  • Choose times for the student to move around the school environment when there are not as many children to navigate around.
Not being aware of people or objects approaching from the affected side They may become easily startled and not be aware of balls approaching them in the playground or during sport.
  • Approach the child where possible on the non-impaired side OR provide a verbal cue that you are approaching the child.
  • Position them in the sport field with their visual field used to the best advantage.
  • Buddy them with someone who can be their “spotter” who can provide warning or approaching objects

Changes in hearing

Hearing loss can sometimes occur with brain injury. This can be the result of damage to the tiny bones in the middle ear or a fracture of the inner ear or cochlea. Even if the hearing in the ear itself is not damaged, a person with brain injury can have a loss in hearing that is caused by the way sound is understood in the brain.

What you might see

What this could mean

Strategies to assist the student

Student turning their head to one side to hear Hearing loss on one side.
  • Position them in the classroom so that their hearing ear is closes to the teaching.
  • Be mindful of noise occurring in the background and the impact that this may have on the students ability to listen and understand the teaching.
Student not following instructions They have not heard the instructions.
  • Ensure you have the student’s attention before giving instructions.
  • Ask them to repeat instructions.
  • Provide written instructions.

Changes to touch and temperature

Students with brain injury may also experience changes to their touch and temperature system.

What you might see

What this could mean

Strategies to assist the student

Ignoring one side of their body They have a “hemiplegia” where they have decreased sensation and movement on one side of their body.
  • Refer to information provided on managing a hemiplegia.
Student exploring their environment through touch They have decreased feeling therefore increased need to explore and learn through touching items more.
  • Provide fiddle toys.
Increased burns or accidents Students not aware of sense of pain.
  • Increased supervision during at risk activities e.g. cooking.

Contact us

Queensland Paediatric Rehabilitation Service
Queensland Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Developed by the Queensland Paediatric Rehabilitation Service, Children’s Health Queensland. Updated: October 2017. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.