Children's assessments

Sometimes families of deafblind and multi-sensory impaired children struggle to understand just how much their child can see and hear. 

A child lying on its back on the floor, playing with a toy held by an adultMany deafblind children have some useful vision and / or hearing, while some multi-sensory impaired children may initially appear to be deafblind but have just not yet learned to properly use their senses. Other children may have fluctuating vision and hearing levels, or the results from testing may be unclear.

A holistic assessment like those carried out by the Children’s Specialist Services team will help a family to see what their child can do and how they can be supported to develop further. 

Purpose of the assessment

To look at the child as a whole, identifying their strengths and how they can be built upon. Our team works with families to identify priority areas before the assessment day so they know what areas to focus on. These might include early communication or ideas for play and learning.

Who attends?

  • The child and their family, including siblings and grandparents
  • Local professionals involved with the child, such as a teacher of the visually or hearing impaired, physiotherapists, intervenor
  • The day is run by members of the Children’s Specialist Services team

What happens on the day?

  • Informal observations are undertaken throughout the day
  • It is a child-centred / child-led day
  • Play-based assessment
  • Sharing observations and informal discussion throughout the day
  • Video and digital photos will be taken
  • Time for reflection and questions

What happens after the day?

  • The family will receive a video and written report containing observations and photographs
  • The report will suggest activities to help develop your child
  • Reports will be sent to the professionals the family feel are important to their child

Getting in touch

If you think your child may benefit from a holistic assessment talk to your Sense key contact. 

If you are new to Sense then please contact Sense’s information and advice service who will ensure that you are put in touch with the right person. 

Holistic and observational assessments

When we talk about holistic assessments we mean that we are going to look at the whole of a child or young person, not just at individual elements of their physical make-up like their eyes or their ears. 

Many of the assessment conclusions are reached through our observing how a child reacts. There are some suggestions about what and how to observe below, and a sample observation grid.

If you have a visual and / or hearing impairment then environmental conditions such as lighting or background noise levels can hugely affect your residual vision or hearing.

Most people with single-sensory impairments (sight or hearing) learn to change their environment, or tell others how to help them, so that they can see or hear as well as possible. Most children who are multi-sensory-impaired, however, are unable to explain how they see or hear best, or how they are affected by hindering conditions.

These issues, and others such as which activities the child prefers, usually need to be determined by observing the child's responses in a range of different situations. In turn, this information is valuable to specialist assessors in planning and interpreting their assessments.

Detailed observation can tell us many things, including:

  • How children use their senses in everyday situations - what motivates them and how they respond
  • Which factors affect their use of their senses and their ability to function throughout the day in different environments and situations
  • Their likes and dislikes - giving a basis for communication
  • How well they access and interpret information - for example, whether they anticipate steps in a familiar routine

What and how to observe

A good place to start is by noting down what children respond to, the circumstances and how they respond. A simple observation grid can be used to note responses as they happen. It is important to include information about the child's surroundings, the activity and the behaviour of the person working with the child.

Video recording is extremely useful because it allows an episode to be frequently viewed, perhaps by different people, allowing layers of understanding to develop.

Over time, patterns of circumstances or responses may emerge. For example, you might suspect that the child prefers rough textures to smooth, or cannot use sight and hearing at the same time, or freezes at the sound of the dinner trolley. These suspicions can be checked for accuracy, and the information used in deciding appropriate targets or teaching strategies.

Structured approaches

An alternative approach is deliberately to present children with a range of objects or activities and to note their responses. The Affective Communication assessment uses this approach to identify patterns of behaviour meaning "I like …", "I don't like …" and "I'm not sure about …".

Video recording is almost essential, as otherwise small responses are very easily missed. The approach can also be used to assess responses to specifically visual, auditory or tactile stimuli.


A number of assessment frameworks and checklists are available, although very few have been developed specifically for deafblind children.

Those developed for other children should be used with great caution, because the very different information available to children who are multi-sensory-impaired will affect their behaviour and hence the significance of checklist items.

Where to get help

Most local education authorities have specialist teachers, qualified in the education of children who are multi-sensory-impaired, often as part of their visiting teacher service or sensory support service. These teachers will be able to help with assessment, interpretation and intervention. 

Further information

  • Vision for Doing, by Stuart Aitken and Marianna Buultjens, discusses visual assessment with a wealth of more general information and ideas. Available online at the Scottish Sensory Centre's website.
  • The Affective Communication Assessment is available from Melland High School, Holmcroft Road, Gorton, Manchester M18 7NG

First published: Tuesday 12 June 2012
Updated: Monday 26 June 2017