Role of Social and Emotional Development

Two young girls who are deafblind, sit next to each other and explore pumpkins using their hands.
Two young girls who are deafblind, sit next to each other and explore pumpkins using their hands.

Many children who are congenitally deafblind are very slow to develop the social and emotional skills they need to have rich and fulfilling lives unless we directly teach them these skills. Their lack of vision and hearing along with other challenges mean they will not acquire these skills incidentally, the way most children do.  The ability to interact with others and the world at large from a place of confidence and curiosity is vital to good mental health, learning, and belonging.

Social and emotional development addresses skills that include:

    • Ability to establish basic trust and emotional security within consistent, loving relationships with one or a small number of caregivers;
    • Ability to have a clear and positive sense of identity and recognize and talk about their own feelings;
    • Ability to modulate one’s own behaviors and expression of emotions as appropriate for different situations;
    • Ability to show an interest and develop empathy for others.

(Texas Infant, Toddler, and Three-Year-Old Early Learning Guidelines)

Child’s perspective of other humans

Who are people from the perspective of a child who is congenitally deafblind with multiple additional disabilities or medical issues? Are they thieves who take things away and don’t return them? Bossy, controlling, and always in a hurry? Creatures that you can never find when you really need one? Are people mostly all the same so you can’t tell them apart? Are they helpful tools at time, but also frequently loose cannons – unpredictable and untrustworthy?

This snapshot from child’s perspective is very negative, and it can also be true. It is critical that we recognize how we interact with the child guides the development social and emotional skills. Too often our interactions can be like a Zoom meeting on a sketchy internet connection. The child is missing critical pieces of information we might be giving if we are not communicating through his or her available sensory pathways. For a child who is congenitally deafblind, this means through the tactual sense.

Hello, goodbye, and wait

Hello and goodbye rituals are important, very important, for a child who is deafblind. If the child is primarily a tactile learner or uses touch to support vision or hearing, greeting the child and letting him know who you are and that you are interested in engaging with him removes the startle factor.  Gently touch the child on a neutral part of the body such as the arm or leg to alert him to your presence. Some people will offer the child the opportunity to tactually explore some of their distinguishing features such as very curly hair, a unique ring or bracelet, or beard. Greet the child by name (again a tactile sign or signal) and tell the child your name. One feature of creating a healthy self-identity is having a name. You may want to have a unique handshake, kiss, or hug depending on your relationship with the child as a family member or professional.

When we are interacting with the child, we need to keep our focus and attention with the child. When there are unavoidable interruptions, we should maintain physical contact with the child so he/she knows we have not disappeared. If we have to leave for a moment, let the child know we will be back. Introducing the tactile sign for “wait” might be a way to begin to help the child understand the concept of a delay or a pause in activity; place your hands under the child’s hands and wiggle your fingers.

If you have to leave for a longer period of time, use a goodbye ritual to let the child know they will not see you for a while. Like the hello ritual, it can include information such as waving bye-bye under the child’s hand, combined with tactile signs such as later, tomorrow, etc. The hello and goodbye rituals do not need to be complicated. They are meant to be a way for the child to anticipate an interaction or recognize the end of an interaction with someone.

 Building Security – Greeting Ritual

In this video, the teacher sings a song to the child as she moves his hand. It is evident that, by the end of the song, the little boy recognizes his teacher and is looking forward to their time together. The teacher sings, “Good morning Peeper, good morning Peeper, good morning to you” as she gently moves his arms to allow it to pat her hand placed under his.

It is not your agenda

We can become better playmates by offering, sharing, and letting the child show us what they are interested in and can do, rather than imposing our agenda on them. As we design our interactive activities we must keep these things in mind. We need to demonstrate empathy for the child’s emotional state and engage them socially at their developmental level. For example, the child may not initially be ready for interactive turn-taking until they feel safe with us. We can develop trust by not pushing them to do things on our schedule or in our way, but rather imitate the child and follow their lead.

Our goal should always be about a positive interaction. Instead of making demands offer them the opportunity to take a step in a familiar activity using skills they have demonstrated readily in various environments. If they choose to take an action, don’t overly praise but instead, briefly comment and go on.

Let the child make many choices in each activity, and be willing to change tracks based on  those choices. We can have an activity in mind focused around an object, action, or experience, but we need to keep the interaction flexible and allow the child to lead what happens.

Rubbing Faces

A young child who is deafblind and his teacher rub lotion on his face; notice how she follows his lead. The teacher rubs the child’s face after he guides her hands to his face. He watches intensely as she draws a picture of a face and then puts lotion on the picture as directed by the boy. He then takes a turn rubbing the lotion onto the picture then rubs his own face.
 

Help the child to develop a healthy self-identity

Dr. Nielsen suggests that until a child is 2 years old in social and emotional development, they are not ready to deal with demands and consequences (See Five Phases of Educational Treatment). The child first has to develop a sense of self-identity and build confidence in his/her own ability to be successful.

Let the child to do as much as they can do within the context of familiar activities and routines. Give them plenty of time to take a step since there may be both physical and emotional reasons they delay. If they are not ready after a short time, don’t make a big deal of it; just go on with the activity in the usual way.

Let the child have ample opportunities to play independently and repeat movements and behaviors without our comments or interference. The child will gain awareness and confidence in his/her ability to make things happen, a key to a strong self-identity.

Make sure the child has ownership of at least a few things. When you offer objects to the child, it can be helpful to have duplicate items so that one is ‘yours’ and one is ‘hers’. Use gestures, signs, or speech for concepts like yours and mine, his, her, etc.

Allow time to develop skills for dealing with disappointment and change

Some people have asked, how the child will learn to cope with things they don’t like if they never have to deal with them? Life is sometimes boring and sometimes it can be scary. While this is true, learning is our goal and trust is key to learning. As educators we can be the source of fun, security, comfort, and interest, or we can be the source of boredom and distress.

Before making demands, the child must trust you and know that interactions and activities you provide will be positive experiences. Once they feel safe and successful in these experiences, and as they mature emotionally, they can begin to experience things that are not preferred. But only in small doses. When they are developmentally ready to experience some of life’s challenges, we empathize with their distress or confusion about what will happen if they don’t meet the demands of the situation. We offer choices and help them cope with the consequences of their own choices. For example, “I know you don’t really like this life vest. But if you want to go swimming, you must put on this life vest first. Would you rather go play on the swings instead?”

All humans go through a process of learning to deal with and regulate their responses to stress and demands. Children who are deafblind are no different, though the development of a sound self-identity and the ability to deal with life’s disappointments may take a bit longer to develop.

Engage in playful and humorous interactions

We also might think about ways to add humor and playfulness to our interactions.  Have fun with the individual. Look for times when the child offers you a playful or teasing response to something familiar. Humor is a powerful tool in evoking a bodily emotional trace between individuals.  (See Humour and playfulness within social cognition webinar from Nordic Welfare Center, Apr 29, 2021 https://www.youtube.com/watch?v=zauO3Vi1uIk&t=4980s )

Often times, parents are great at creating interactions that are playful. Vocalizing, rough and tumble, nursery rhymes that include specific body movements….all of these can be elements of playful and humorous interactions. Whatever you do with your child that gets them smiling or laughing can be turned into an interactive games. Look for times when you child does something unexpected and exaggerate your response in a comical or silly way.

Teach emotions and empathy

Because children who are congenitally deafblind cannot have access to incidental learning like a child who is sighted and hearing, we need to be sure to teach emotions and help the child develop their natural empathy. Emotions are one thing all humans share and feeling empathy for another’s emotional state is critical to connecting.

We need to teach these children names for emotions and show them emotions that we can share in common. For example, commenting on their emotional state when they are crying, sad, silly, angry, or scared can be a good place to start. Trace their tears and sign cry on their face. Trace their smile and sign happy. Imitate the actions or movements they are making that indicates excitement, and use the tactile sign for excited.  When the child is startled or frightened by something, offer the sign for that.

Use your whole body to express emotions by increasing or decreasing tension, speed of movement, and even repetition (happy, happy, happy). Pay attention to the child’s emotional state and mirror it with your body. Point out your own emotional state or that of peers. For example, if another child is crying or acting silly…support the child in recognizing and acknowledging what is going on and offering support like a soft pat or a laugh.  This may mean that the child has to have actual physical contact with you or their peers face or body—-something that may not always be possible. So you have to grab those teachable moments when things happen to teach emotions.

Support the development of self-regulation skills

All humans (well, at least most) develop the ability to self-regulate over time; we aren’t born with these skills. Initially a child who is deafblind may be very reliant on an adult or caregiver to help them regulate their biobehavioral state. It is important to have clear strategies in place for calming or arousing the child when they are demonstrating emotional stress of lack of engagement.

Some children develop their own ways of regulating themselves through behaviors such as rocking, vocalizing repeatedly, making repetitive movements and so forth. We all do this, but some of these behaviors can become self-injurious or habitual — often referred to as self-stimulation. Though we may find these behaviors unusual, they serve a purpose. We may want to replace these behaviors with other activities that can serve the same purpose but be less dangerous or more socially acceptable. For example, if the child uses rocking to calm themselves, can we offer them a rocking chair or swing? If rapid movement helps, can we put on some music and dance? Or maybe go for a swim? Throw things into a bin or at a target?

Acknowledge the child’s emotional state and offer options that are safe and acceptable so they can begin to address their emotions.

Offer opportunities to engage peers and others

Children who are deafblind often have very limited interactions with peers and others in their world. Sometimes this is because they are fearful of others and sometimes we just don’t give them the opportunities to be with others. A child may need the support of an intervener or someone who can be a bridge to others by supporting communication and interactions.

Initially the child may only be able to play alongside another child or interact only with siblings. That’s okay. Small group activities that include one or two children and are facilitated by a trusted adult can be beneficial as long as the adult doesn’t become a barrier between the child who is deafblind and his/her peers.  The more other children and adults learn about the individual child’s preferred ways of engaging, the more positive the experience for the child who is deafblind. As the adult or intervener, offer suggestions or model interaction strategies that are preferred to the people who want to engage with the child.

A young boy and girl interact with each other as they tactually explore a large therapy ball.
A young boy and girl interact with each other as they tactually explore a large therapy ball.

Resources

Want to  learn more about social and emotional development? Here are some additional resources.

Behavioral Supports  section of the Texas Deafblind Project website related to social and emotional development and its impact on behavior.

Cameron, Judy. (2017). The Impact of Stress on Brain Architecture and Resilience., 2017 Texas Symposium on Deafblindness, Austin, TX. 

Cameron, J., Zeedyk, S., Blaha, R., Brown, D., van den Tillaart, B., (2017). What Harvard Research Means for Children with Deafblindness, 2017 Texas Symposium on Deafblindness, Austin, TX. 

Miles, Barbara., Riggio, Marianne. (1999). Remarkable Conversations A Guide to Developing Meaningful Communication with Children and Young Adults Who Are Deafblind, Published by Perkins School for the Blind, 175 North Beacon Street, Watertown, Massachusetts.

Van Dijk, Jan, no date. The Role of the Emotional Brain. Perkins School for the Blind.