Developing social skills in children with vision impairment and additional needs

Post date: 
Monday, 3 October 2016
Billy on a swing

Explore ways to support social inclusion in children with vision impairment and additional needs. Penelope Eyre, a teaching assistant at a special needs school, shares learnings from her experience.

Billy (pictured on a swing) was four when he first started school in Wales. At that time he had some vision in his right eye, but was extremely photosensitive and bright lights considerably impaired his vision, causing him significant pain. Billy has Glaucoma and Rubinstein-Taybi Syndrome, a condition characterised by short stature, moderate to severe learning difficulties, distinctive facial features, and broad thumbs and first toes.
Billy would hide under the hood of his buggy during outside playtimes, preferring to play with his VTech toys rather than interact with others. Inside the school building, Billy would play alongside his peers, rather than with them. However, he was very happy in his own little world and the time spent with those toys was valuable – as a result Billy learnt his numbers, the alphabet and how to spell. Eventually, he was provided with prescription sunglasses which reduced his photosensitivity, allowing him more freedom to explore outside. Billy always had one of his toys with him at playtimes, as they were used as an incentive for him to walk. Staff frequently tried to persuade him to leave his toys in the classroom, but this was met with outbursts of stubborn behaviour.

I started working with Billy nearly two years ago, when he was twelve and had just lost his remaining vision.

He was still very dependent on his toys to move anywhere and once outside, all he wanted to do was sit on the nearest bench and play with them. I felt that his lack of mobility during playtimes was an issue that needed addressing; not only to improve his cane skills, but to increase his awareness of others (a lot of the time Billy would be on his own at one end of the playground, whilst the fun and games would be happening at the other end). Once he was up and moving around, everyone else was much more aware of Billy's presence, providing him with greater opportunities for interaction from his peers and staff.
Slowly, Billy started to show some interest in what was happening around him. He began joining in with the playground games and eventually, he would initiate them. Through this, he formed a friendship with a pupil in a different class. Now when it came to playtimes, his first reaction would be to ask for her and she eventually became his motivation for walking, not his toys. She would (and still does) stop him in the corridor to say hello and ask what he was doing. Billy's speech is not always clear or intelligible, so I needed to interpret his responses for her. When doing this, I always modelled the appropriate response for him to repeat; eventually, he learnt and remembered the right phrases to answer her questions. Sadly, when Billy moved classes last year, it meant he no longer shared the same playtime as his friend. However, his new-found confidence and increased mobility skills have meant that he has been able to develop friendships with pupils in his own class.

Now that Billy is more adventurous, he is able to follow his friends across the yard and even onto the surrounding grass – changes in terrain have always been a huge barrier for Billy, preventing him from joining in the fun. I have done a lot of work reassuring him that he is safe when walking over uneven ground. His love of counting songs came in useful to encourage him to 'swish' his way across the grass.

Recently, Billy's peers have also shown more interest in him at snack and dinner time. For the last fourteen years, Billy has survived on a diet of milk and custard due to his syndrome making it difficult for him to tolerate lumpy food. At his last annual review meeting, Billy's mother asked if a feeding programme could be tried again. After just a few weeks of trying, Billy was eating squashed down strawberries, then small pieces of mango and mashed bananas. Seeing him eat proper food caused great excitement with his friends and they have been encouraging him ever since. However, Billy's mother is not having the same success at home, despite trying with the same food. I have provided his mother with precise details of the techniques I have developed to get Billy to eat in school, such as asking him how many spoons he is going to eat and accidentally-on-purpose forgetting the number and starting again, or putting headphones on him and playing music while he ate, pausing the song every time he stopped.
Billy has a few anti-social behaviours that need working on – nose picking, inappropriate fiddling and self-absorbed rocking. It is tricky because his level of cognition makes it difficult for him to accept and understand correction. Also, by trying to prevent him from doing these actions, it can exacerbate the situation. It is important to be consistent in the approach to stopping him, yet it is equally important to know when to ignore his behaviours. Distraction is the way to go with Billy, I usually count or sing a song. His peers are very good at accepting him for who he is and not passing unfavourable comments, so his behaviours don't really impair his social interaction. With Billy attending a special needs school, his peers also have difficulties regarding their social development and inclusion. Therefore, adult intervention is needed to model correct and acceptable behaviours.
Billy has an amazing smile that lights up the room and a wonderful sense of humour. This has, without doubt, helped his social inclusion massively; people are drawn to him as he is such an engaging young lad. He rises to every challenge and has made such wonderful progress with his social skills. I am confident that this will continue with ongoing support.

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