Two Learners, One Teacher, No SENCO
Mr. Tetteh teaches Primary 1 with 45 learners. Yaw, aged 6, leaves his seat every few minutes, climbs on desks, calls out, and cannot wait for a turn; he is academically able and reads above class level. Adjoa, also 6, holds books about 10 cm from her face, squints at the chalkboard, and copies letters incorrectly; her mother says she will 'grow out of it'. The school has no special educational needs coordinator. The district referral clinic has a five-month waiting list. Mr. Tetteh has 30 desks, one chalkboard, a 45-minute literacy block, and a teaching aide who comes on two mornings. He is worried about safety, about being blamed if he suggests a diagnosis, and about the other 43 learners who also need attention. Last week Yaw fell while climbing and was nearly hurt. Mr. Tetteh must act now without a diagnosis, decide what to say to each family, and keep records that will support referral later.
1. What immediate classroom adaptations can Mr. Tetteh make for Yaw and Adjoa without a diagnosis? Explain the priority order.
Read the worked answer
Act on access and safety first; diagnosis can wait. For Yaw: seat him near the teacher and away from climbing hazards; give a legitimate movement job, such as collecting books, every 10 minutes; break tasks into one instruction at a time; use a private hand signal and a 'wait card'; teach and rehearse a calm-down space; record ABC incidents. Do not use restraint or shame.
For Adjoa: seat her close to the board, write larger and with high contrast, read board work aloud, reduce copying from the board, use a dark marker on plain paper, and check her work privately. Request a vision screening through the school nurse or health service immediately - this is a health referral, not a diagnosis.
Whole-class: use a visual timetable and repeat instructions. These accommodations are low-cost, reversible and do not require a label; they also generate evidence for the referral. Safety is non-negotiable, so Yaw's climbing must be managed by supervision and environmental change while the clinic wait continues.
2. How should Mr. Tetteh raise concerns with each family and manage referral ethically?
Read the worked answer
Speak to each parent privately using observed behaviour, not labels. To Adjoa's mother: 'Adjoa holds her book very close and squints at the board; I have moved her forward and enlarged the print, but I would like the nurse to check her vision.' Avoid saying she is 'slow' or 'needs special school'. Ask consent for screening and referral; explain that a vision check is routine and does not label the child.
To Yaw's mother: describe specific incidents and what has been tried, ask about sleep, routine and home stresses, and explain that the clinic wait is five months so the class will use support now.
Keep records factual, dated and confidential; share only with those who need to know. If a parent refuses referral, continue classroom accommodations and document the offer. Do not diagnose ADHD or a visual impairment. Escalate to the head or safeguarding lead only if there is a risk of harm or an unmet health need.