Local Offer - Sensory and/or Physical Needs

A hearing impairment means that a person cannot hear as well as someone with normal hearing (hearing thresholds of 20 dB or better in both ears). Hearing loss may be mild, moderate, severe or profound. It can affect one or both ears and be temporary or permanent.

Hearing losses can also affect pitches of sound differently, for example, a child may be able to hear some sounds better than others.

Most children with permanent hearing loss are identified shortly after birth through the NHS newborn hearing screening test and then through monitoring during regular health and development reviews and routine hearing tests.

A child or young person may:

• Show no reaction to sounds
• Mishear words or instructions
• Have difficulty in understanding peers in group discussions or in noisier environments
• Have delayed language development
• May struggle to concentrate

Take a look at the Newborn hearing screening: making and reacting to sounds checklists.

Temporary hearing loss

Glue ear is very common with nursery aged children. It is caused by a build-up of fluid in the middle ear cavity which affects the ability of the ear to conduct sounds to the inner ear. For some children and young people who have persistent glue ear, health services may suggest grommets or temporary hearing aids.

Unilateral deafness (hearing loss in one ear)

Unilateral deafness means that your child has a hearing loss in one ear – it’s sometimes called one-sided hearing loss or single-sided deafness (SSD). The deafness can range from mild to profound in the affected ear.

Permanent hearing loss

Most people (including babies and children) who are identified with permanent hearing losses will be offered hearing aids to help them to hear sound. Using hearing aids as soon as possible gives children and young people with permanent hearing loss the best chance of developing good speech and language skills.

Find out more about childhood deafness.

Some children and young people will manage their hearing loss without the need for specialist attention and support. They will simply require reasonable adjustments made by thoughtful and supportive key adults.

This might include:

• Talking to you and your child to understand their hearing loss and how it affects their understanding and social opportunities
• Consideration of seating arrangements
• Management of the environmental noise and acoustics
• Offering a quiet working environment, particularly for specific listening work

Children and young people who have severe to profound hearing loss may need more tailored support. For example:

For children and young people with severe to profound hearing loss, they may need more tailored support. For example:

• Assistive listening devices, such as radio aids
• Visual resources
• The use of British Sign Language (BSL)
• Access to specialist teachers
• Intensive hearing or language support

Some children and young people may need a personalised SEN plan or Education, Health and Care Plan to support their learning.

Doncaster Royal Infirmary Children’s Audiology

• Phone: 01302 642763 (call and leave a voicemail with your child's name, DOB and what you need)
• Text: 07542 028058 (do NOT call this number, they have no facility to answer or listen to voicemails)
• Email: dbth.childrens.audiology@nhs.net

The Children's Audiology service offers a wide range of therapies and treatments, including:

• Hearing therapy
• Tinnitus counselling
• Balance rehabilitation
• Relaxation training
• Training aspects of hearing impairment and communication
• Hearing aid repair clinics
• Hearing aid fitting service
• Newborn infant hearing loss screening.

Find out more about Hearing Services in Doncaster.

Sheffield Children’s Audiology

Sheffield Children’s Audiology are able offer some limited telephone appointments and provide some postal service. You can contact them via email if you feel it is urgent: sch.audiologyreferrals@nhs.net.

The Service for Children with a Hearing Impairment supports children, young people and their families across the age ranges from birth to 25 years. Referrals are taken from NHS Audiology and the Newborn Hearing Screening Programme.

Visual impairments can affect one or both eyes and can affect children and young people very differently. Visual difficulties can range from relatively minor problems to having significant or total loss of sight.

Visual impairments may be diagnosed in babies or young children through the routine NHS vision screening programme. The aim of the programme is to detect problems so that treatment can be started as early as possible.

All children and young people should have regular eye tests to ensure their eyes are working correctly and to detect and manage any problems as soon as they arise. If you are worried that there may be a problem with your child's vision, you can arrange for a free NHS eye test at your local opticians. Children do not need to know how to read to have an eye test. You can also speak to your child's health visitor or school nurse.

All children under the age of 16, or 19 if full time education, are entitled to a free NHS sight test carried out by an optometrist at a community opticians and vouchers are available assist with the purchase glasses if needed. Find out more about eye tests for children.

Signs of a possible eye or vision problem can include:

• Headaches or eye strain
• Problems reading, for example, they may need to hold books close to their face and they may lose their place regularly
• Problems with hand-eye co-ordination, for example, they may struggle to play ball games
• Being unusually clumsy
• Regularly rubbing their eyes
• Sitting too close to the television

Some children and young people will manage their visual impairment without the need for specialist attention and support. They will simply require reasonable adjustments made by thoughtful and supportive by key adults and educational setting staff.

This might include:

• Keeping environments free from clutter
• Adjusting the size of fonts and labels
• Considering seating plans to ensure that they have a clear view

Other children and young people with more significant visual impairment may need:

• The use of alternative methods of reading and writing
• Use of appropriate ICT
• Improved access to activities
• More time to complete tasks

Some children and young people may need a personalised SEN plan or Education, Health and Care Plan to support their learning.

Ophthalmologists are specialist doctors based at the hospital. Their qualifications and experience make them experts in diagnosing and treating eye conditions. They often refer patients on to optometrists and orthoptists for low vision support and in some cases, they may also recommend a particular medication plan or surgery to help resolve any presenting issues.

The optometrist or ophthalmic optician specialises in measuring your child’s sight and may prescribe glasses. They can identify eye diseases and are based in a hospital or local opticians. The dispensing optician will help you choose frames and make sure they fit properly but cannot test your child's sight or prescribe glasses. It is important that if your child needs glasses, they are encouraged to wear them.

Your child may be supported by a Qualified Teacher of Children and Young People with a Visual Impairment (QTVI). A QTVI has additional qualifications in and experience of working with children with a visual impairment. They are part of Doncaster's Service for Children with a Visual Impairment (SCVI) team and work with children in many different schools in the area.

A person who has a multi-sensory impairment has both visual and hearing impairments. The impairments may be identified at different times, or a child may be born with a multi-sensory impairment.

A child or young person with a sensory impairment of this nature with usually require support with:

• Communication
• Mobility
• Learning

Multi-sensory impairments will be diagnosed in the same way as individual hearing or vision impairments, as outlined above.

• Multi-sensory impaired children in hospital - Sense
• Information about multi-sensory impairments
• A parents’ guide to oral health and dental care for children with a learning disability, autism or both | SeeAbility

Everyone needs to see a dentist, even if your mouth doesn’t hurt or you don’t have any teeth. Most children and young people with SEND will be able to access regular NHS general dental services along with the rest of their family. Use the NHS website to find a dentist, if you don't have one.

However, children with greater or more complex needs may need to be referred to the Community Dental Services for their care.

The aim of the Community Dental Services is to provide dental care for those from vulnerable groups whose needs may not be accommodated in NHS general dental services or may require consultant/specialist led care due to the complex dental needs.

Who may be referred to the Community Dental Services?

Children may be referred to the Community Dental Services if they have:

• a moderate or severe chronic mental health condition
• moderate or severe behavioural problems
• a moderate, severe or profound and multiple learning difficulty
• a moderate or severe physical and/or communication disability
• complex medical conditions
• other additional needs such as substance misuse.

Who can refer a child to the Community Dental Services?

The Community Dental Services would accept children into the service following a referral. Referrals are accepted from general dental practitioners and other health professionals for example: GPs, health visitors, social workers, carers, school nurses, paediatricians.

What happens after a referral is made?

Once a child has been referred to the Community Dental Service, they would then carry out a dental assessment and treatment as required. Children who have been referred to the Community Dental Service will usually continue accessing their ongoing dental care through this service. However, some children may only need to see the Community Dental Services for a course of treatment to get them dentally fit. After this, children can see a general dental practitioner for their regular check-ups.

The Children's Community Nursing team are a team of experienced children’s nurses providing nursing care and support to children, young people (0-18 years) and families within the community setting.

They work alongside other professionals and take referrals for children with:

• Short term conditions
• Long term conditions
• Disabilities and complex health needs
• Life limiting and life threatening conditions including those requiring end of life care.

The Children's Continence Service offer advice, assessment and support to children aged 4 years to 19 years with continence issues (bladder and/or bowel problems). Children must be registered with a GP in Doncaster to access this service.

Once you have referred your child into the service, you will be sent some documents to complete. When the documents are completed and sent back to the team, your referral will then be processed.

If your child attends a special school, the first point of contact should be the school nurse who can then refer your child into the Continence Service if they are unable to support you directly.

If a young person continues to require support from the Continence Service, their care will be transferred to the Specialist Continence Service. Transition will start from age 17 years and 9 months for young people who have complex health needs, or 17 years and 11 months for those that don't.

The Children and Young People's Specialist Epilepsy Nursing Service supports children and young people aged 0-19 years who have epilepsy. The service is part of the Community Long Term Conditions Team.

Once a young person reaches 19 years old, their care will be transferred to the Specialist Adult Epilepsy Nursing Service. This service also works with adults aged 18+ years, for new referrals.

Both the children and adult epilepsy services provide support to people with epilepsy to help them manage their condition. This includes regular check-ups to review and assess the person's condition.

Physiotherapists assess and treat children and young people with a wide variety of conditions. These range from neurological conditions such as cerebral palsy, to respiratory conditions including cystic fibrosis, and input following surgery, fractures and soft tissue injuries. Physiotherapy helps with difficulties that affect physical development, walking, movement, balance, coordination and posture; and supports and promotes independence and active lifestyles to improve quality of life.

Input varies from just one appointment to some children being seen for episodes of care throughout their childhood. Children are seen within the hospital setting or within their homes, schools and nurseries.

Occupational Therapy (OT) can help babies, infants, children and young people grow, learn, have fun, socialise and play so they can develop, thrive and reach their full potential. OT’s work with children and young people, aged 0-16 years, who are born with or have experienced either a physical illness, mental illness or injury as inpatients, outpatients and in the community.

Occupational therapists concentrate on enabling children and young people to manage and maintain as much independence as possible within their daily living activities (occupations/function) including self-care, play, leisure and school based skills.

Doncaster Wheelchair and Specialist Seating Service provides manual and powered wheelchairs, buggies and specialist seating services to children and adults with temporary or permanent mobility problems, and/or associated postural needs.

The service can be accessed by children (aged 3+ years) and adults in Doncaster who have a permanent disability which affects their mobility.

Services users will have an assessment to determine what mobility aids/equipment is needed. The assessment will give consideration the lifestyle, medical conditions, and on-going needs of the individual, to determine the most appropriate aids/equipment.