On “Teaching Social Skills to Children and Adolescents With Visual Impairments: A Systematic Review”

In the recent JVIB article entitled, “Teaching social skills to children and adolescents with visual impairments: A systematic review,” Caron and colleagues presented a review of 32 studies of social skills instruction for children who are blind or have low vision, conducted across eight countries between 1983 and 2020 (Caron et al., 2023). I came to this review article in a unique position, as both the director of research at the American Foundation for the Blind (AFB) and as a woman who has been totally blind since birth and grew up receiving itinerant instruction during the 1990s. With this dual perspective as both a researcher and as a former blind child, I urge JVIB readers to consider two important but distinct metrics of research quality: the scientific validity of the evidence, and the practical impact of its application. The article begins with a review of evidence demonstrating social participation challenges for individuals who are blind or have low vision in comparison to their sighted peers, such as “tending to spend more time in solitary occupations” than sighted peers and reduced social role participation among adolescents and adults. A review is then presented of 32 investigations of various interventions that target specific behavioral outcomes in blind or low vision students, ranging from initiation of play for young children to asking questions during job interviews for older adolescents. The scientific quality of studies varied, but most studies were of moderate to high quality. The authors concluded that “Given the high rate of social skills difficulties reported in this population and the effect of these difficulties on all stages of development, it seems particularly relevant for practitioners to integrate social skills assessment and explicit teaching into intervention programs.” A systematic review is a great tool for evaluating the scientific quality of a body of evidence. Researchers can use objective criteria to evaluate the strength, reliability, and reproducibility of an intervention’s effects on a specific outcome variable (or series of outcome variables). A scientific quality evaluation is value neutral. However, research is never value-free; the questions being asked and the conclusions drawn from the data are always influenced by the underlying beliefs and biases of the researchers and the wider community. In addition to scientific quality, any body of evidence can be judged subjectively by the individuals it impacts. There is clear evidence of the fact that individuals who are blind or have low vision face challenges to social participation. However, these challenges are not necessarily attributable to limited social skills within these individuals. Structural and attitudinal barriers in the environment may also contribute to social exclusion. The environments in which young children typically play, such as playgrounds and open parks where children run or play with balls, are often partially or wholly inaccessible to blind or low-vision children. This could explain why such children may prefer “solitary occupations.” Furthermore, Children or teens with any visible difference are often excluded due to biases held by their peers. When reading the systematic review, I was struck by the absence of interventions acting on the sighted peers or the social environment. Instead, most of the interventions focused on making the blind or low-vision child conform to social norms, such as playing with same-age peers, approximating Letter to the Editor