9 Language and Social Development

Language development

Although there is some evidence for communication difficulties in blind and low vision children, research is limited (Mosca et al., 2015). Most information is based on experience in clinical practice or case studies rather than empirical evidence.

Language development in blind and low vision children has some differences compared to sighted peers. These differences begin at an early age. Babbling emerges at about the same time as sighted peers but may be less in quantity (Lewis, 1975, as cited in Brouwer & Gordon-Pershey, 2021). Babbling to a caregiver is an important part of establishing early attachment. The lack of response to a parent’s interactions may be a stress to a parent of a child who is blind or who has severely low vision. Intervention programs continue to stress the importance of interactions despite the lack of response. There is also evidence for potential delayed speech sound development given the importance of observing lip movements to the perception of speech sounds (Perez-Pereira & Conti-Ramsden, 2019). In spite of the early differences, blind and low vision children tend to begin to speak at approximately the same age as their peers (summarized in Webster & Roe, 2002).

As they develop, many people have noted ongoing differences in the language of blind and low vision children. Some note a more frequent misuse of pronouns, and echolalic language is also more common (reviewed in Ludwig et al., 2022). All children have periods of echolalic language as they develop language. However, periods of echolalia tend to last longer and are often more persistent for a blind or low vision child. The echolalia may become more meaningful as the child becomes older. For example, a child may learn to say “Johnny, do you want milk?” to ask for milk. Echolalic language may also function as a means for the blind or low vision child to ascertain who is nearby by eliciting a response from the receiver (Peters, 1994; Urwin, 1983). In this way, echolalic language may represent an early strategy for establishing and maintaining social interaction.

Another difference is the frequent use of words for which the blind and low vision youth have little or no understanding. An adult listening to the large vocabulary of a student with limited or no vision may overestimate the child’s abilities. It is always important to check for understanding of words that are being used.

Social use of language and social skills

So much of communication is visual – blind and low vision children may be less able to observe the social behavior of others. Without the ability to use vision to gauge the interest of others in a conversation, blind and low vision children are deprived of a critical source of feedback. As a result, they may need help initiating and maintaining the conversational flow. This may include direct instruction in strategies for determining a listener’s engagement level through their responses and vocal intonation. There is some research evidence that parent-reported pragmatic language skills are weaker in school-aged blind and low vision children with average verbal intelligence (Tadić et al., 2010) despite core language skills being stronger than their sighted peers.

Research has shown that adolescents with visual impairments are more likely to engage in passive (e.g., online communication) as opposed to active forms of social engagement and that the degree of vision impairment is not predictive of the degree of social isolation experienced by a student (Gold et al., 2010). These language issues can contribute to the social isolation of blind and low vision children and may contribute to the students being overly reliant upon adults in their environment for both support and socialization.

Blind and low vision children require that the social world be made accessible through the direct instruction of the knowledge and skills for social interaction and belonging (Sacks, 2014). Social interaction skills need to be taught to all blind and low vision children, regardless of the extent of their visual impairment, as this will impact their functioning in various areas (Botsford, 2013). For example, seeking out meaningful and engaging social interactions with peers can be an important motivator for blind and low vision children to elaborate their skills for safer, independent, and more effective travel (i.e., Orientation and Mobility skills).

Examples of social interaction skills

• Joining in a playgroup and initiating conversations.
• Maintaining an appropriate social distance and understanding how this can vary between familiar and unfamiliar individuals.
• Sharing toys, games, and activities with others. Allowing others to select a play activity.
• Having reciprocal interactions and conversations, not dominating a conversation or perseverating on personal preferred topics.
• Complimenting and encouraging the efforts of others. Understanding the concept of “being a good sport.”
• Recognizing and interpreting sarcasm and other forms of non-literal language.
• Engaging in self-advocacy.

References

Botsford, K. D. (2013). Social skills for youths with visual impairments: A meta-analysis. Journal of Visual Impairment & Blindness, 107(6), 497-508. https://doi.org/10.1177/0145482X1310700610

Brouwer, K. & Gordon-Pershey, M. (2021). The relationship between speech perception and speech production in children with visual impairment. Journal of Visual Impairment & Blindness, 115(3), 251–257. https://doi.org/10.1177/0145482X211018876

Gold, D., Shaw, A., & Wolffe, K. (2010). The social lives of Canadian youths with visual impairments. Journal of Visual Impairment & Blindness, 104(7), 431-443. https://doi.org/10.1177/0145482X1010400706

Ludwig, N. N., Jashar, D. T., Sheperd, K., Pineda, J. L., Previ, D., Reesman, J., Holingue, C., & Gerner, G. J. (2022). Considerations for the identification of autism spectrum disorder in children with vision or hearing impairment: A critical review of the literature and recommendations for practice. The Clinical Neuropsychologist, 36(5), 1049–1068. https://doi.org/10.1080/13854046.2021.2002933

Mosca, R., Kritzinger, A., & van der Linde, J. (2015). Language and communication development in preschool children with visual impairment: A systematic review. The South African Journal of Communication Disorders, 62(1), e1–e10. https://doi.org/10.4102/sajcd.v62i1.119

Pereira, M. P., & Conti-Ramsden, G. (2019). Language development and social interaction in blind children. Routledge.

Peters, A.M. (1994). The interdependence of social, cognitive, and linguistic development: Evidence from a visually impaired child. In H. Tager-Flusberg (Ed.), Constraints on language acquisition: Studies of atypical children (pp. 195–219). Erlbaum.

Sacks, S. Z. (2014). Social interaction. In C. B. Allman & S. Lewis (eds.) ECC Essentials: Teaching the expanded core curriculum to students with visual impairments (pp. 324-368). AFB Press. https://www.aph.org/product/ecc-essentials-teaching-the-expanded-core-curriculum-to-students-with-visual-impairments/

Tadić, V., Pring, L., & Dale, N. (2010). Are language and social communication intact in children with congenital visual impairment at school age? Journal of Child Psychology and Psychiatry, 51(6), 696–705. https://doi.org/10.1111/j.1469-7610.2009.02200.x

Urwin, C. (1983). Dialogue and cognitive functioning in the early language development of three blind children. In A.E. Mills (Ed.), Language acquisition in the blind child: Normal and deficient (pp. 142–161). College-Hill Press.

Webster, A., & Roe, J. (2002). Children with visual impairments. Taylor and Francis. https://doi.org/10.4324/9780203440971