What Is Multi-Sensory Impairment?
Multi-sensory impairment (MSI) occurs when a person has both a vision impairment and a hearing impairment, and both are educationally significant. This is sometimes also referred to as deafblindness, though this term can be misleading as most people with MSI have some remaining sight and/or hearing.
The two impairments may be at different levels of severity. For example, a child might be profoundly deaf and partially sighted, or moderately deaf and severely vision impaired. The combination creates unique challenges that are different from, and often greater than, the sum of each impairment alone.
MSI exists on a wide spectrum. Each person's experience is unique, depending on the degree and type of their vision and hearing impairments, when they acquired them, and what support they have received.
The Impact of Multi-Sensory Impairment
The combination of vision and hearing impairment has a profound impact on how a child experiences and learns about the world:
- Access to information: Both vision and hearing are distance senses that allow us to gather information about our environment. When both are impaired, access to incidental learning is significantly reduced.
- Communication: Many strategies used to support hearing impairment (lip-reading, visual cues) rely on vision, while strategies for vision impairment (verbal descriptions, audio information) rely on hearing. MSI requires alternative approaches.
- Mobility and independence: Safe navigation becomes more challenging when both distance senses are affected.
- Social interaction: Understanding social cues, engaging in group activities, and forming relationships can all be more difficult.
- Emotional wellbeing: The isolation that can result from MSI requires careful attention to ensure pupils feel connected and included.
Sense UK and Specialist Support
Sense is the leading UK charity for people with complex disabilities, including multi-sensory impairment. They provide specialist advice, support services, and resources for children, families, and professionals.
Pupils with MSI typically require highly specialised support from professionals trained in this area. This may include:
- Specialist teachers with MSI qualifications
- Qualified Teachers of Vision Impairment (QTVI)
- Teachers of the Deaf (ToD)
- Communication specialists
- Habilitation and mobility specialists
These professionals work together to ensure the pupil can access education and develop communication, mobility, and independence skills.
Communication Methods
Children with MSI may use a variety of communication methods, often in combination:
- Tactile signing: Sign language adapted for touch, such as hands-on signing or deafblind manual alphabet
- On-body signing: Signs made on the child's body to help them understand
- Objects of reference: Real objects used to represent activities, places, or people
- Braille: For pupils with sufficient vision impairment and good tactile skills
- Amplified speech: If the pupil has residual hearing that can be supported with technology
- Visual communication: Large print, symbols, or sign language if residual vision permits
The most appropriate methods will depend on the individual child's remaining vision and hearing, and should be determined in consultation with specialist professionals.
Strategies for Teachers: Using Remaining Senses
Because both distance senses are affected, teaching approaches must focus on maximising the remaining senses:
Touch
- Use tactile resources, real objects, and hands-on learning experiences
- Allow the pupil to explore objects and materials through touch
- Use textured materials to create meaningful learning resources
- Provide tactile markers and labels in the environment
Residual Vision and Hearing
- Optimise lighting and contrast to make the most of any remaining vision
- Use amplification and reduce background noise to support residual hearing
- Position yourself close to the pupil when communicating
- Allow time for the pupil to process information through their remaining senses
Movement and Proprioception
- Use movement and body awareness activities to support understanding
- Provide opportunities for physical exploration of spaces and concepts
- Use resonance boards or vibrating equipment to provide additional sensory feedback
Environmental Adaptations
- Create a predictable, consistent classroom layout
- Use tactile markers to help the pupil navigate the space
- Minimise clutter and background noise
- Ensure optimal lighting without glare
- Provide a consistent place for the pupil's belongings
- Use schedules with objects, symbols, or tactile cues to show the structure of the day
- Allow time for transitions; give advance warning of changes
- Create a quiet space where the pupil can focus without sensory overload
- Use consistent routines and approaches across all staff
- Establish clear start and end signals for activities
Working with Specialists
Supporting a pupil with MSI requires close collaboration with specialist professionals. Schools should:
- Follow advice from specialist teachers and therapists
- Attend training on the pupil's specific communication methods
- Implement strategies consistently across all staff and environments
- Regularly review and update the pupil's provision as their needs change
- Work in partnership with the pupil's family, who are experts on their child
- Ensure the pupil has opportunities to interact with peers and develop friendships