Social Communication Skills With Your Child Who is Blind or Low Vision

Article by Carla A. Brooks

Successful communication depends a great deal on what we see around us. In the absence of vision, blind children learn to recognize what is in their world through touch and sound and the language input offered by others. The language that you use to support your blind child's understanding and to help build and support communication skills is more than labeling what you see. Labels build vocabulary but describing or even translating social interactions into words is more complex.

The Role of Vision in Social Contexts

Social skill development is one of the core foundational skills related to communication development. It is sometimes difficult to separate out what is a social skill and what is a communication skill when we consider language development. And something called joint attention is one of the most important skills that is required for the development of communication, including receptive and expressive language and pragmatic language or social communication skills.

Joint Attention

Joint attention can be both receptive and expressive. What does that mean? When an adult uses eye gaze and sometimes gesture and body language to direct a child's attention, the child "receives" that information and looks at the object/person/action being referenced or labeled. When a child does the same thing to direct the adult's attention, the child is "expressing" his interest in the object/person/action.

These skills are developed in infancy and become more refined and more specific during the toddler years. Gaining attention, directing attention, and responding to that attention is a very powerful and foundational skill. In the absence of vision, language can help your child attain and direct that attention.

Visual Terms

Here are some of the visual terms used to describe communication skills related to receptive and then expressive joint attention:

• Attends to and follows another's eye gaze and uses gaze shifts to gain attention
  
• Attends to another's gestures or body movements and uses gestures or body movements to direct attention, share interest, or to communicate wants/needs
• Attends to another's facial expression and uses facial expression to communicate emotions
  
• Attends to objects, agents, and actions in the context and uses eye gaze to direct attention, share interest, or to communicate wants/needs
  
• Attends to actions performed by agents on objects and performs actions with objects and agents for enjoyment, to share interest and to communicate needs and wants
  
• Shares affect through eye gaze and facial expression
  
• Takes a turn when the other person stops their turn
  
• Watches faces/mouth when another person is speaking
  

Tips for Adapting Your Language to Convey Social Information

Adapting your language to support social communicative interactions for your blind child will require more than labeling or even describing and relating. You will need to fill in some information about your intent and the intent of others. And, you will need to make some inferences about what your child's intentions might be. In other words, what are you meaning to communicate? These are called communicative intentions or functions.

We all have reasons for communicating, and they are primarily to manage the behavior of others (get them to do what we want) or to share pleasurable activities and talk about favorite topics. Even before a child understands or produces language, they can communicate non-verbally. There is even a stage of development that occurs before your child can communicate their intent. Logically, this is called "pre-intentional communication."

As the parent and caretaker of your blind child, you watch and listen to see if they are uncomfortable or need soothing, and you automatically meet their needs. When they are comfortable and seem happy, you extend their playtime with you. Crying, body movements, and facial expression communicate those states and needs.

In the early intentional stage, your child's different cries, body movements, and facial expressions help to make their communication more specific. Then gestures develop so that your child can bring even more attention to what they are interested in or want.

Enhancing Social Interactions

In sighted children, eye gaze is combined with these gestures to gain your attention so that their needs can be communicated. Your blind child will probably have his or her own "personalized" gestures but can be taught to give and show and even point, but eye gaze will be missing.

Helping your child turn towards voices or the location of people or desired objects can be a goal. And once your child is at the intentional stage and they are producing single words and two- or three-word combinations, they will use that language to engage and communicate socially.

Focusing on "Who, What, and Where" Questions

Here some ideas for adapting your language to support intentional communication. The "WH-concepts" can be helpful here as well—questions or ideas that start with "What, Who, and Where." Your focus will be on the social and the non-social aspects of the context and the relationship between them all. Who is in the setting? Who are the agents? What are the objects? And what are the potential actions? What might your child be thinking, wanting, needing and/or
enjoying?

You can still use words like "look" and "see" with children who are blind. They learn that this means "pay attention" to this.

If you are bringing attention to others who want your child to attend or engage or participate, you might say something like this:

• Look who is here. Grandma's here. Grandma brought "Frisky." He's on his leash. Do you want to pet "Frisky?" Oh, it looks like you're not sure. It's okay. You don't have to touch him now. I'll keep "Frisky" with me, and Grandma will come and play with you with your blocks.
• I hear you. I'm in the kitchen. I'm getting your water bottle. Hear the water? I'm filling your bottle. It's cold water. Here I come. I've got your water. Want water? Here, it's in front of you on your table.

Guiding with Verbal Narration and Interaction

If you are responding to your child's reaction or response to sounds or objects in the reachable or unreachable space, you might say something like this:

• You hear the musical toy. It made a sound when I opened your toy box. You want to come and find it. Come on over. We'll get it out of the box.
• Uh oh. You dropped your spoon. It's on the floor. Let's reach for it. Stretch your arm. You almost touched it. I'll pick it up and get it for you. Here it is (put in hand). Uh oh. You dropped the spoon again! Maybe you're full. No more cereal? Okay, all done cereal.

These are just a few examples of how you might adapt your language input in the absence of visual information. You will help your child not only learn language and expand meaning but also support social communication skills.

Help Your Child Fill in the “Missing Pieces”

Our world is filled with visual information that supports our communication skills. In the absence of vision, your child will learn about natural contexts based on what they hear and what they touch. You can add information by using your language to fill in the missing pieces.

Your words will describe objects, people, actions, and how they might relate with each other and with your child. Adapting your language input is one of the ways you can help your child develop intentional and enjoyable social communicative interactions during their first two years of life.

There are more ideas about supporting your blind child's nonverbal communication in the article "Communication Skills for Children Who Are Blind or Visually Impaired" if you are interested. When communication is difficult behavior issues may appear, and there is a series of articles available on this topic.

Article by Carla A. Brooks, APH. Click HERE for PDF.
photo: PVRCI