CVI and the ECC: Focus on Social Interaction Skills

Learn about Social Interaction Skills in the ECC, how CVI impacts the development of social skills, and ideas for supporting students with CVI learn social skills

The Expanded Core Curriculum (ECC) is a nine-area curriculum to help bridge the gap between a standard school curriculum and what a student who is blind or visually impaired would miss with reduced access to incidental learning—the skills sighted peers learn from observing the world around them. The ECC levels the playing field for blind and visually impaired students. Each of the ECC’s nine areas must be individualized to the unique needs of the child with CVI. One of these areas is Social Interaction Skills.

In this article, we will dive into:

What are Social Interaction Skills in the ECC?

Social Interaction Skills centers on learning how to read and respond to social situations without the benefit of visual cues. All children with a visual impairment need individualized instruction in developing social skills based on whole-child assessments. When it comes to CVI, a whole-child approach that understands the student’s communication, motor, cognitive, and behavioral skills and how they use compensatory strategies for access is essential for building an individualized approach. 

As children with visual impairments grow and develop, their initiation of social interactions is less than their sighted peers. 

Kim Zebehazy and Thomas Smith

As parents, educators, and trusted friends of people with CVI, it is our role to provide accessible social situations while developing life-long skills. 

Social interaction skills of the ECC include (skills and needs are prioritized and individualized based on a comprehensive assessment): 

What is the impact of CVI on social interaction skills?

There is no simple, clear-cut guide to how CVI impacts an individual, and no two individuals are affected in the same way. CVI can impact all aspects of the visual processing system, including detecting a face, recognizing that face orientation to movement, and connecting movement patterns to a specific individual. Visual processing challenges could impact the auditory, tactile, or language skills connected to associated social skills. For example, a person with CVI may rely on auditory input to gain emotional cues from a conversation partner; however, in a complex environment, those auditory cues are less accessible, impacting the person’s processing speed and ability to interpret tone and emotion accurately. 

Social interaction skills for people with CVI may be challenging for many reasons. Some include:

Difficulty with facial recognition

Difficulty with perceiving and processing emotions

Reliance on changing factors for identification

Difficulty with distance vision, crowding, and clutter

Difficulty processing motion (speed, direction, distance) of

Visual recognition and form accessibility 

Visual guidance of upper and lower limbs 

Visual-spatial perception: can include difficulty seeing spatial relationships between things,
organizing visual space, and creating a visual mental map of 3D space.

Visual field loss, not being able to see people on the right or left side as they approach

These difficulties are exaggerated when situations are: visually cluttered and busy; have multiple sensory inputs; are too far away; and unfamiliar, without the supports of context clues or verbal descriptions.

Children with CVI need direct and explicit instruction to support the development of social skills. Hands-on activities, real-life experiences, and learning social rules and expectations strengthen these learning experiences. Individualized assessment of functional vision, learning media, CVI evaluation, and ECC screening tools are vital to developing appropriate social skill instructional strategies (along with speech, OT, and PT assessments).

How are social interaction skills included in the IEP? 

The short answer, they should be included in all areas. For sighted peers, social interactions happen throughout the day. Social interaction skills include our understanding of ourselves even when we are not interacting with others. The accommodations and social methods of access for an individual with CVI will vary between time of day, place, and familiarity. This is why individualized evaluations to determine the levels of support needed are essential to aid students’ consistent access. 

Don’t forget—an ECC checklist should be completed to help guide the IEP development and what areas of the ECC and social interaction skills to include. This checklist will guide:

The essential parts to include in all IEPS:

What is the role of the TVI and school team?

All team members should own social interaction skills and incorporate them throughout the student’s day. When a teacher or specialist greets the individual, that is a natural opportunity to practice social interaction skills. Class peers and school staff must know how to have productive and positive interactions with their fellow students with CVI, which also creates a sense of community, understanding, and safety. When others understand that their classmate or student with CVI cannot recognize them up close, in a group, or from 5 feet away, they know why a simple wave is not enough. Instead, saying, “Hi, Emily, it’s Susan,” is accessibility in action. Small changes in the school community can significantly affect the accessibility of the environment for an individual with CVI. 

One of the jobs of the TVI is to ensure that areas of the ECC are being addressed for the student with CVI in a way that uniquely matches the student’s needs—this includes a holistic understanding of how CVI affects the student. We know that each student with a visual impairment is different from the next, but it is important for the TVI to understand specifically how the student is affected by CVI in particular, and how to best approach the ECC. 

The TVI needs to be able to consult with other school staff, including but not limited to the Speech Therapist, Occupational Therapist, Physical Therapist, general/special education teacher(s), Orientation and Mobility Specialist, and the school counselor. The TVI working with the student should be able to explain how their diagnosis of CVI affects the student’s ability to learn social skills relevant to their school day so that these skills can be worked on across settings with different staff. 

What are some ideas to support students with CVI learn age-appropriate social skills?

As parents, we are our children’s biggest advocates. Discussing social skills development with IEP team members is essential, as social skills overlap in multiple areas of the ECC, instruction, and learning. Social skill development is also important when considering transition and post-secondary goals and priorities. 

As always, there is no one specific focus or goal that is perfect for all children with CVI to help develop social interaction skills—all strategies should come from individual assessment results. Here are some ideas for promising practices that are meant to inspire inquiry (all supports and accommodations must be based on a student’s assessment results).

How do social interaction skills overlap with other areas of the ECC?

Areas of the ECC often overlap. For individuals with CVI, social interaction can affect self-determination skills, recreation and leisure, independent living skills, and career education. For example, CVI can affect a child’s development of play skills, including imaginary play, group play, or organized gameplay, as these are all skills that sighted children learn through observation and imitation. 

Social interaction skills are essential for all children to begin learning early and continue developing these skills into adulthood. These skills require extensive teaching to those with visual impairments (which includes the diverse manifestations of CVI) who do not experience incidental social learning. The CVI visual behaviors impact how a person with CVI experiences social interactions differently, which can include difficulties with facial recognition, smooth and easy eye movements, visual attention, visual recognition, motion processing, clutter, and sensory integration. 

A team effort must be made from a very young age to target social interaction skills across multiple settings, including the home, school, and community.  As a team, determine the student’s strengths and areas of need and think of what skills would be functional and appropriate for the upcoming IEP year.  And most importantly, value and prioritize the student with CVI and their family’s input and goals for social skill development. 

Keep the learning going!


Bhargava, D. (n.d.). Vision impairment: Chapter 6: Social Skills. Vision Impairment | Chapter 6: Social Skills | Trinity University. Retrieved May 17, 2022, from 

Blackstone, S. W., Luo, F., Canchola, J., Wilkinson, K. M., & Roman-Lantzy, C. (2021). Children with cortical visual impairment and complex communication needs: Identifying gaps between needs and current practice. Language, Speech, and Hearing Services in Schools, 52(2), 612–629.

Chokron, S., Kovarski, K., & Dutton, G. N. (2021). Cortical visual impairments and learning disabilities. Frontiers in Human Neuroscience, 15, 713316-713316.

Chokron, S., and Streri, A. (2012). Comment Voient les Bébés? Paris: Editions LePommier Duchaine, B. C., & Nakayama, K. (2006). Developmental prosopagnosia: a window to content-specific face processing. Current opinion in neurobiology, 16(2), 166–173. 

Duttun, G. N.  (2015). Disorders of the Brain and How They Can Affect vision. Lueck, A.H., & Dutton, G. N. (Eds.) Vision and the Brain: Understanding Cerebral Visual Impairment in Children.(pp. 39-82).New York, NY: AFB Press.

Dutton, G. N. (2006). Cerebral visual impairment: Working within and around the limitations of vision. Proceedings of the Summit on Cerebral/Cortical Visual Impairment New York, 3-26.

Fazzi, E., Molinaro, A., & Hartmann, E. (2015). Potential Impact of Visual Impairment and CVI on Child Development. Lueck, A.H., & Dutton, G. N. (Eds.) Vision and the Brain: Understanding Cerebral Visual Impairment in Children. (pp. 83-104) .New York, NY: AFB Press.

Ferrell, K.A. (1997). Preface. What is it that is different about a child with blindness or visual impairment? In P. Crane, D. Cuthbertson, K.A. Ferrell, & H. Scherb (Eds.), Equals in partnership. Basic rights for families of children with blindness or visual impairment (pp. v-vii). Watertown, MA: Perkins School for the Blind and the National Association for Parents of the Visually Impaired.

Goren, C. C., Sarty, M., & Wu, P. Y. K. (1975). Visual Following and Pattern Discrimination of Face-like Stimuli by Newborn Infants. Pediatrics, 56(4), 544–549. 

Hadders-Algra, M. (2022). Human face and gaze perception is highly context specific and involves bottom-up and top-down neural processing. Neuroscience and Biobehavioral Reviews, 132, 304-323.

Hyvärinen L, Walthes R, Jacob N, Chaplin KN, Leonhardt M. Current understanding of what infants see. Curr Ophthalmol Rep. 2014;2(4):142-149. doi:10.1007/s40135-014-0056-2. Video films are visible @

Hensch, T. (2016). The Power of the Infant Brain. Scientific American, 314 2, 64-9 InBrief: The Science of Early Childhood Development. Center on the Developing Child at Harvard University. (2020, October 29th). 

Itzhak, N., Kooiker, M. J. G., van der Steen, J., Pel, J. J. M., Wagemans, J., & Ortibus, E. (2021). The relation between visual orienting functions, daily visual behaviour and visuoperceptual performance in children with (suspected) cerebral visual impairment. Research in Developmental Disabilities, 119, 104092-104092.

Itzhak, N., Vancleef, K., Franki, I., Laenen, A., Wagemans, J., & Ortibus, E. (2021). Quantifying visuoperceptual profiles of children with cerebral visual impairment. Child Neuropsychology, 27(8), 995-1023.

Macintyre-Béon, C., Young, D., Dutton, G. N., Mitchell, K., Simpson, J., Loffler, G., Bowman, R., & Hamilton, R. (2013). Cerebral visual dysfunction in prematurely born children attending mainstream school. Documenta Ophthalmologica, 127(2), 89-102.

Merabet, L. B., Mayer, D. L., Bauer, C. M., Wright, D., & Kran, B. S. (2017). Disentangling How the Brain is “Wired” in Cortical (Cerebral) Visual Impairment. Seminars in pediatric neurology, 24(2), 83–91.

Mindick, N. (2011). Understanding facial recognition difficulties in children. London, United Kingdom: Jessica Kingsley

Pawletko T., Chokron S., Dutton G. N. (2015). “Considerations in behavioral diagnoses: issues, cautions, and potential outcomes,” in Impairment of Vision Due to Disorders of the Visual Brain in Childhood: A Practical Approach, eds Lueck A. H., Dutton G. N. Huntington, WV: American Foundation for the Blind (AFB) Press.

Philip, S. S., & Dutton, G. N. (2014). Identifying and characterising cerebral visual impairment in children: A review. Clinical and Experimental Optometry, 97(3), 196–208. 1111/cxo.12155

Roman-Lantzy, C. (2019). Cortical visual impairment: Advanced principles. APH Press, American Printing House for the Blind. 

Sacks, S. Z. & Wolffe, K. E. (2006). Teaching social skills to students with visual impairment: From theory to practice. New York: AFB Press, American Foundation for the Blind

Siu CR, Murphy KM. The development of human visual cortex and clinical implications. Eye Brain. 2018 Apr 24;10:25-36. doi: 10.2147/EB.S130893. PMID: 29760575; PMCID: PMC5937627.

Steendam, M. (2015). Improving functional use of vision for children with CVI and multiple disabilities. A. H. Lueck & G. N. Dutton (eds). Vision and the Brain : Understanding Cerebral Visual Impairment in Children (pp. 571-612). American Foundation for the Blind Press.

Zebehazy, K. T., & Smith, T. J. (2011). An Examination of Characteristics Related to the Social Skills of Youths with Visual Impairments. Journal of Visual Impairment & Blindness, 105(2), 84-95. 

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