Toolkit: Physical and Sensory Needs

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Stargardt’s disease causes central vision loss affecting the ability to see fine and sharp detail, causing problems with reading normal-sized print, recognising faces and distance vision. Please note the following:

  • With Stargardt’s Disease, people may experience issues with dark to light adaptation and vice versa.
  • Visual fatigue is to be expected with the need for adequate rest breaks
  • They will have a slower working pace, having to put more effort in than their peers due to the visual fatigue and scanning magnified text.
  • They may be photophobic (sensitive to light) and therefore need sunglasses on when outside or when it is particularly bright.
  • UV light can speed up the progression of Stargardt’s disease, so it is recommended that sunglasses / UV protected eyewear is worn all year round.
  • Colour perception may be affected, especially difficulty with shades of the same colour.
  • Depth perception may be affected, including spatial awareness and navigating steps.

Here are some suggestions to support the various physical and sensory needs.

Allow frequent rest breaks when needed (in the classroom as well as exams).

Consider having a quiet space within school which the student can access to reduce visual fatigue.

A change in activity can often provide the visual break the student needs.

  • Encourage them to move around (complete an errand for younger child).
  • Adapt the method of working (listening rather than reading for older students).

Consider reduced workload but not reduced challenge. For example, option of completing every other question in a maths activity rather than the first five, to allow them to access the same increasing range of challenge as their peers.

Where possible, excuse the student from copying tasks, which will help to reduce visual fatigue. The exception is where the action of copying is intended as the main learning within the exercise.

Provide access to teacher notes / key concepts to reduce the need to take notes and enable the student to concentrate on content and reduce fatigue.

When setting homework consider extending deadlines or reducing tasks, or allowing the student to provide their work in an alternative format (e.g. audio recorded essay, to reduce fatigue).

Ensure that resources are streamlined and clutter-free (e.g. photocopies with main diagram, or clutter-free white board).

Bear in mind that the student may need time to adapt to lighting when entering classroom from outside, or going from classroom to outside area where it may be brighter.

There may be issues with contrast. Be aware of background colours. Yellow background may be more suitable than white - but preferences may vary.

Ask and check with the student.

Blinds in classroom can help reduce glare. Consider where the student is seated in the classroom in order to reduce impact of glare.

The student may struggle to see their handwriting and it could be difficult to read. Consider the use of word processor to help with this. As soon as a Stargardt's diagnosis is made, it is recommended to learn to touch type.

Encourage the student to try out different types for pens for when they need to write by hand. Usually dark or black pens with a thicker nib will work best, rather than light blue or green which may be harder to read and see.

Some suggestions are

  • Berol pen
  • Spectrum Broad pen
  • Stabilo pen
  • Pilot Liquid Ink Sign pen 2.0mm tip
  • Edding Handwriter pen

Some of these can be found via the RNIB

Ask and check with the student about what suits them best.

Add contrast / reflective strips on steps / entrance / change in level. For example,  yellow taping on the edge of steps.

Ensure lights in classroom are switched on when possible, but be aware that the student may have issues with glare so their positioning in class is important.

Ask the student what they prefer.

Allow the student to wear a cap or hat, and / or tinted glasses in school to reduce glare if necessary.

Ensure that there is good lighting throughout the school (including teaching rooms and communal spaces). And that lighting is switched on in all spaces as a general rule.

Some student may benefit from task lighting for close-up tasks.

Consider using a backlit keyboard and larger font keys e.g.

All teachers and support staff should have annual training on needs of the student.

In their own words

Visual fatigue is a real thing. Having English last lesson can be a killer for my eyes if I have had a text-heavy day.

By the end of the day my eyes are completely finished, and I have to sleep or rest them before I can do anything that I want to do. It gets worse as the week goes on.

I ask the teacher to give me a warning when lights are about to go on so my eyes have time to adjust.