Multi-Sensory Impairment

This page will explain what a multi-sensory impairment is and the support that is available to you if your child has this condition.  

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Multi-sensory impairment 

Children and young people with multi-sensory impairment (MSI) have impairments of both sight and hearing. MSI can also be known as Deafblindness or Dual-Sensory Impairment. Having more than one sensory impairment has a combined impact on the person and each individual will connect with and experience the world in a unique way. There are many causes of MSI and there are an estimated 4,000 children with MSI in the United Kingdom. Most children with MSI have some residual vision and / or hearing; only very few children are totally blind and deaf. Children with MSI may also have medical conditions or physical disabilities.  

Children may be born with MSI (Congenital MSI) or acquire it following illness or injury. Common causes of congenital MSI are genetic conditions such as CHARGE and Ushers syndromes. They may have MSI as the result of a progressive condition which, over time, causes changes as to how well the child can see or hear.  

It’s often difficult for doctors to make a diagnosis and for other practitioners to get a clear picture of the child’s abilities and needs which can be very hard for parents. Some causes of MSI may also affect other family members. If this is the case for you, you may be referred to a genetic specialist to learn more. Practitioners working with the families of children with MSI will be able to provide help and support directly or refer to other specialists. Every child with MSI will experience the world uniquely and differently than that of a sighted and hearing person.  This will impact on their communication, how they access information and how they move within their environment. 

Signs of vision or hearing loss in childhood 

Vision Loss  

  • constant eye rubbing or chronic eye redness 

  • extreme light sensitivity 

  • squinting, closing one eye, or misaligned eyes 

  • poor focusing or trouble following objects 

  • inability to see objects at a distance 

  • inability to read a whiteboard or blackboard, etc., or trouble reading 

  • eyes look cloudy  

  • one eye is bigger than the other, or the pupils are different sizes 

  • you notice a change in how your child’s eyes usually look 

  • your child seems to consistently tilt their head when they look at things 

Hearing loss 

  • inattentiveness - your child doesn’t acknowledge when you speak or sounds around the house 

  • having to be closer to a speaker or television 

  • not reacting to loud sounds 

  • surprise when the child hears their name  

Hearing and vision aids 

Hearing aids and / or glasses may be prescribed for your child depending on what kind of sight or hearing they have and the severity of their impairment. For children with MSI any prescribed aids for eyes or ears will help but even when wearing their aids, they may still not see or hear as well as other people. You can ask the person prescribing how much they’re likely to help. A child needs time to get used to glasses and hearing aids – both to the feel of the aids on their face, and the difference the aids make to levels of sight and hearing. Your child may need to wear the aids for very short periods to start with, building to longer periods of time. This may start with just a few seconds initially. 

A cochlear implant can make a big difference to some children with MSI. A cochlear implant has two parts: one is worn like a hearing aid, behind the ear or clipped on to clothing, and the other is surgically implanted. A cochlear implant turns sound into electrical signals, providing a sensation of hearing by directly stimulating the auditory nerve. It can provide access to environmental sounds and spoken language. With appropriate post cochlear implant care and support, children have the opportunity to develop a much greater appreciation of the “sound” world around them. A series of medical assessments can establish how suitable an infant or child is for this procedure as not every child will benefit. 

Assessment 

Multisensory impairment may be detected soon after a baby is born, or after tests carried out later in life. If your baby is born deafblind, this will usually be picked up during newborn screening. These are a series of checks carried out to see if your baby has any serious health problems from birth, including any problems with their eyes or hearing. The School Nurse Service offers health screening as part of the early years health checks delivered in primary schools during a child’s reception year. Speak to your GP if you have any concerns about your child's hearing and/or vision at any point. 

Deafblind guidance assessment  is for any child or young person who has a visual and hearing impairment that impacts on their daily life, this includes communication, access to information and mobility.  A request for a Deafblind guidance assessment can be submitted to the local authority regardless of whether you are already receiving services or this is your first assessment.  You should request to be assessed in accordance with the Deafblind guidance assessment. 

 It is important to note that with babies and very young children it may be better to “watch and wait” before completing a full assessment so it is a true account of their learning and development and is able to inform future services they may need more accurately. 

Government guidance is available for Local Authorities Deafblind assessments .  You can also contact the charity SENSE for a copy of the guidance. 

Support in education 

If your child has a multisensory impairment, they will need additional support to help them achieve their potential. You can raise any concerns with your child’s education setting, ask to speak to the Special Educational Needs Coordinator (SENCO) or Head Teacher. 

A referral may be made to the sensory support service  who aim to promote the achievement, inclusion, well-being and quality of life of children and young people with a sensory impairment, whether that is hearing loss, sight loss or multisensory impairment. 

Help to get around 

There are various shemes that can assist you or your child in getting around. 

Platinum Travelcard – This travel card is for residents of South Gloucestershire, who are severely sight impaired or sight impaired. 

A child aged 5-11 can travel for free but their accompanying adult will pay, as it is expected that children of this age would not travel independently. 

 A child aged 11+ can apply for a companion card which will allow themselves and one other person free travel. 

Assistance Dogs UK is a coalition of 8 assistance dog charities that help disabled people in the UK -helping with practical tasks, emotional support and independence. There are charities that can help you with guide dogs and hearing dogs.   

Dual purpose dogs are specifically trained to help people who have more than one impairment or additional need / medical need. Assistance Dog organisations are able to team up to train a dog to meet the dual needs of a person such as; vision impairment, significant hearing loss, epilepsy, physical disability or use of an electric wheelchair. 

Further support and information  

Sense provide services for individuals who are deafblind and / or complex disabilities. Sense has a specialist service for children and families, regional branches and a national family network. Sense may be able to advise you on the possibility of accessing a local parent and toddlers group or similar. 

The National Sensory Impairment Partnership is a partnership working to improve outcomes for children and young people with sensory impairments.

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