Q: I just was assigned a three-year-old child who is blind and who has no expressive language. I have never worked with a child like this before. I am looking for general guidance.

I am not an expert on working with blind children, but I have some experience and these are my thoughts––

Blindness effects language development in certain ways mostly by limiting the child’s experiences and related vocabulary and concepts.  How does he develop concepts of size and space to comprehend phrases like “here” or “over there”?  How does he learn to answer simple questions like “What’s this?” if he cannot see the object or picture?  How does he comprehend the color “blue” or the words “bright” or “foggy”?  Teaching has to be done via the auditory, tactile, proprioceptive, olfactory, and taste senses more than for other children.  You also will have to give her more time to process what is going on.

One child who was blind taught me a lot many years ago.  This five-year-old girl had only a few words, and she would do nothing for me until I stopped “teaching” her and stepped back to allow her several weeks just to crawl around the entire physical space in which we worked. I was sharing a space with other SLPs and OTs at the time, and I could not get this child to focus on anything I said in or did in my room until I gave her several weeks to piece together in her mind the entire physical space.  She did this by crawling in and around virtually every nook and cranny in our joint rooms, including the OT equipment, the closets, the administration office, the front and back doors, and the bathroom (luckily it was very clean).  Once she had a physical sense of where she was, and what and who was there, she began to settle down and listen to me.  I had to start with language about the rooms themselves as we played on all the equipment, and I had to make sure she knew all the other people before we settled down to specific toys in my room alone.  That means that we worked for 5-6 months outside my room first.  I worked with her for about two years before I moved on to a different job, and she was speaking in phrases by then.  She was still very much “on her own agenda” though.