Specialist assessment

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 (below).

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 (see below) 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.

Auditory / visual / tactile / communicative responses (circle appropriate one)


Date12 Feb
What did the child respond to?Brian's voice from across the room (approx. 3m)
Where was the child?classroom; her quiet corner
Who was the child with?Gina
What activity was happening?Gina singing and rocking her on lap; a gap between songs
How did the child respond?Stilled then said 'Aah'. (Brian greets her by saying 'Aah, aah, aah!')
Any special circumstances?Just after her massage; very relaxed and attentive. First time she's said 'Aah' without Brian being next to her.

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

Assessments for Social Care (Deafblind Guidance assessments)

When a child is going to be assessed for what social care they might receive*, a suitably qualified person can provide an assessment of how the child is developing and what social care services might be suitable for them.

See also our information for families on Children’s assessments which sets out why we use holistic assessments and what to expect from an assessment day.

Related links

Information about appropriate qualifications for people assessing children:

Suitably qualified - qualifications for assessing deafblind people's support needs

Deafblind guidance

* Children are assessed under the Local Authorities Social Services Act 1970, Deafblind Guidance, Section 7:- Social Care for Deafblind Children and Adults LAC (2009) 6, in conjunction with local social services departments under the core assessment framework. Please contact Sense if you would like further advice about this.

First published: Tuesday 12 June 2012
Updated: Tuesday 4 July 2017