Issues in Social Skills & Sex Education

In this video, Tom Miller discusses social skills and sex education for children and youth who have sensory impairments.

In this webcast, Tom Miller talks about Social Skills and Sex Education for Children and Youth who have sensory impairments. Tom Miller has worked in the field of education of children who are blind, deafblind or with multiple disabilities since 1974.

He is currently the Education Director of the Educational: Early Intervention and School Age Services (Birth-22). Over the course of his professional life, Tom has had a great deal of involvement in the development and implementation of social/sex education programs and consults and lectures both nationally and internationally on this topic.

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Presented by Tom Miller

Length of time to complete: approximately 30 minutes

Attached File(s)


  1. Introduction
  2. The Early Development of Social Skills
  3. Modeling Behavior for Children Who Are Blind, Visually Impaired or Deafblind
  4. The Importance of Developing a Sexual Identity
  5. Sexuality and Social Development
  6. Teaching Self-Protection
  7. Challenges

CHAPTER 1: Introduction

Issues in Social Skills and Sex Education with Tom Miller.MILLER: You really can’t separate out sexuality and social skills, because sexuality is really your maleness or your femaleness, and it’s how the world relates to you in those roles, the expectations that society puts on you relative to behavior, you know, simple things like how a man and a woman react to one another or treat each other in public, things like that.

So really, you can’t separate the two. And one of the biggest problems in this area is that everybody concentrates on the little word “sex,” and actually, you know, sex is who we are, not what we do.

NARRATOR: In a photograph, three adolescent friends who are visually impaired share a laugh. A girl with braces wears a broad smile as she stands between two male classmates.

MILLER: I think one of the bigger challenges is, many times, getting both educators and families to understand that the very young child, when you’re starting to talk to preschoolers about this topic and talking to parents, is that they will become adolescents.

And I think that’s the bigger challenge, because socially we tend to think of people with disabilities as not ever growing up, and they do grow up, and many times, that’s when people think about the topic of sexuality education and social skills, because it becomes more problematic.


CHAPTER 2: The Early Development of Social Skills

MILLER: We begin to pick up social cues and develop social skills from birth. I mean, the bonding of the parent and the child develops a sense of trust, mutual respect, turn-taking, communication, all the things that we build on throughout our lives to enhance our social skills.

NARRATOR: Two young girls who are visually impaired sit on the floor facing one another and play with a ball. Sitting behind each of the girls is a teacher, and the teachers prompt the girls to take turn.

TEACHER: Ready? One, two, three.

MILLER: Well, if you have vision and hearing, you develop social skills through observation, primarily. You know, you’re able to see what other people do and begin to make judgments. And you see things over and over again, so you see… in the playground, you’ll see kids playing games and you’ll learn the rules from your interactions, many times just by watching, whereas if you don’t have sight or hearing, you miss all those cues.

NARRATOR: We see several blind and visually impaired children playing on a swingset and other playground equipment.

MILLER: Social cues and how we see them relative to ourselves or reactions of others to us and how we react to others are really essential. If you can’t pick up on social cues, you begin to– you’ll see it in regular education, too– you begin to lose friends, because all social relationship is based on the ability to give feedback and, you know, for many of us, that feedback comes visually. So I can look at someone, they’re nodding their head, you know, I can look at them and they’re sitting like this, then, you know, I know they’re not listening. And I use those cues to interpret things all the time.

NARRATOR: In a series of photos, we see three teenage friends who are blind sitting on a low stone wall, chatting with a young woman in a motorized wheelchair.

In the next photo, a boy who is visually impaired approaches the group. We then see him engage the girl in the wheelchair in a conversation about the contents of a box he is holding.

MILLER: I think the challenges of not learning social skills early on and then not having them when you reach adolescence is that you can tend to become more and more isolated. I go into public schools all the time, and you observe– and it can happen even at a residential school– but you can observe isolation among students because they don’t know how to reach out to others, or their social skills have fallen so far behind their peer group that they’re not able to connect with them.

NARRATOR: In a photograph, we see a young boy who is nonverbal and in a wheelchair being introduced to a young girl in his new classroom. The boy’s interpreters are positioned on either side of the wheelchair. One uses tactile signing to communicate with the boy, and the other talks to his classmate.

MILLER: So I think the danger of not getting social skills early on is that the gap gets broader, you know. We know that if we have students here, say, at Perkins or at other schools that take a long time to learn something, if we wait until adolescence to try to teach them appropriate social skills and behaviors, they’ve already lost a big chunk of time. They’ll get some skills, they’ll be able to succeed, but they’ve missed a lot of opportunities.


CHAPTER 3: Modeling Behavior for Children Who Are Blind, Visually Impaired or Deafblind

MILLER: You know, people give… develop social skills through what parents say, you know, like, my own little eight-year-old, we’re in the restaurant, you know, you don’t lay down in the booth, you sit up in a restaurant. The waitress comes over to you, you say please, you say thank you, and we develop those skills through, again, repetition.

What happens if you’re without sight and/or hearing is that unless people model it and facilitate your involvement in a situation, you don’t get that degree of repetition that we get through vision and hearing.

I guess social behaviors, or sexual behaviors, may evidence themselves among students who are blind or deafblind, one of them being, you know, proximity to people, that, you know, we, again, learn the rules of social distance through observation, sometimes being told by our peers that we’re too close, and those are all things that have to be taught, all right?

We do a lot of work on using role play, you know, to encourage the concept of what distance is. If a child has more… multiple disabilities, you do it again, through role play but also through how the staff interact with them. So if you have an 18-year-old that’s constantly coming up and grabbing you and hugging you, the staff learn to shape that into a more appropriate behavior, and over time, the student then learns that.

(knocking at the door)

A student enters a classroom and is reminded by the teacher about appropriate personal space.TEACHER: Come in!

NARRATOR: A student enters a classroom and is reminded by the teacher about appropriate personal space.

TEACHER: How about a side hug?


TEACHER: So nice to see you.

STUDENT: Nice to see you again.

MILLER: It’s going to depend on the level of the student. Sometimes it’s just through, again, our actions as staff being consistent, so not confusing them more by us touching them or patting them too much, or using cues that were okay when they were little, but are no longer good when they’re teenagers or young adults.


CHAPTER 4: The Importance of Developing a Sexual Identity

MILLER: Development of a sexual identity is crucial, because so much of society centers around sexual identity. You know, the rules — and I don’t always agree with it — the rules for men in certain societies are different than the rules for women, all right? Not that they’re right or wrong, but that they are different. And so if you are a male child with a disability, you’re going to have to fit it within certain social rules, you know, until you learn to break the rules or do something different. But we have those expectations, you know.

A teenage couple dances at a prom.Simple ways that people dress their children are all centered around sexual identity. Understanding gender is important for later relationships, making relationship decisions around, “Who do I want to partner with?” And what does that partnering mean?

NARRATOR: In a photograph, a teenage couple dances at a prom. The girl, who is visually impaired, wears a bright red dress and a pearl necklace. Her date, who is blind, is dressed in a tux and sports a rose boutonnière.

MILLER: So sexual identity is crucial, and again, that can start very young. Saying, you know, “You’re a boy, I’m a girl,” all these things where you give the child the information on a regular basis which, if they had sight and vision, they would get pretty much without even thinking about it.


CHAPTER 5: Sexuality and Social Development

MILLER: If you look at sex education in general, most of the time that people object to sex education, it’s because of the issues of reproduction, contraception, all those things. Well, that’s such a small piece of what we teach when we talk about sexuality and social skills, and it’s one of the easiest things to teach, even to people with disabilities.

But what is more important is understanding that you’re a boy or a girl, that you have feelings that are okay and what those feelings are and how to label them, that you have body parts other than head, shoulders, knees, and toes, because, again, the more information they have as they grow up, if there are problems in young adulthood, they have the vocabulary, the language, to help resolve those problems quicker.

In a photograph taken at a prom, a group of dancers is in a conga line. NARRATOR: In a photograph taken at a prom, a group of dancers is in a conga line. Some hold hands, others have their hands on the shoulders of the dancer in front of them.

MILLER: To deal with their feelings as they grow up– and they will grow up, and I think that’s one of the challenges that we always have to remember, because again, if you deal with them younger, it’s easier to deal with them later– there are a number of factors, one of them being their developmental level, okay?

But we’ve been able to find that children with even developmental disabilities can begin to relate to the words “appropriate,” “inappropriate,” “public,” “private,” if used consistently.

So an example is, you know, if a child is… or two young adults, you know, decide that they want to kiss, and you’ve taught them about a private place, and they go behind a bush, but they’re both blind and they don’t realize that it’s really not private, well, then, again, you have an opportunity to teach them that this is not a private place, this would be a more private place.

NARRATOR: In a photograph taken at a prom, a young woman in a bright patterned dress sits in a chair. A young man in a tuxedo stands behind her. The young man leans in towards his date, about to place his hands on her shoulders.

MILLER: If there are other inappropriate or questionable behaviors, like masturbation or things like that in public, again, using consistent language to teach them that this is a private place, this is appropriate in private, this is inappropriate in public, it works over time.

But again, it’s the consistency of the approach, and having families, having staff, having all the people involved with them use those words and help them frame an understanding of what the behaviors are and where they are appropriate or inappropriate.


CHAPTER 6: Teaching Self-Protection

MILLER: Exploitation and the risk of exploitation is definitely higher among the disabled population. Worldwide, the statistics are, you know, ten percent, but those are under-reported, because most of the time the person with disability can’t report. So that a lot of the education that we do with them is to teach them about friendships, all right, which is again part of your social-sexual development. You know, you have your family, you have your friends, you have strangers. What are the appropriate behaviors with those different people?

Yes, within your family, it’s okay to hug, you know. Once you begin to move outside the circle, well, a handshake might be good or sometimes just a wave, you know, things like that so that they begin to get the sense that there are boundaries of behavior, which hopefully decrease the risk. There’s also the need to teach individuals with disabilities to be assertive. Most of the time, they learn that if someone in authority, like a teacher or a family member, comes to them, then they feel that they don’t have a choice.

So if I was to sign to one of them, “Come with me,” they would probably come, okay? And what we have to begin to do from, again, a very early age is help them learn to make choices, learn to say “no,” and that if you say “no,” it’s going to be accepted by an adult, because again, as they get older and you teach them more safety techniques, assertiveness, saying no, walking away, and what we call self-determination become really crucial.

NARRATOR: In a photograph, a teenaged couple sit side-by-side in a tram. Both the young man and woman are blind. He is reaching to touch her arm, which rests on his knee.

MILLER: All right, now you have a learning opportunity to say that’s not appropriate, and what are the dangers about that, because many times, again, a child with disabilities can be so protected that they don’t have the opportunity to make the mistakes that you and I made growing up, and in not having those opportunities to make mistakes, you can’t learn. So sometimes you set them up with the risks that we went through and give them the opportunity to make a mistake, because that’s how we all learn.


CHAPTER 7: Challenges

MILLER: The challenge of this topic, I think, which makes everybody sort of move away from it or forget about it in some ways, is that it’s not static.

We can teach a child how to tie their shoes, okay, and when you teach them how to tie their shoes or use a fork, you don’t have to teach it again and again, but at every developmental level, we have to teach new rules, we have to teach new behaviors or adjust to the behaviors that the child shows and reinforce the appropriate social and sexual behaviors.

And I think that’s what makes it challenging. And then if those behaviors are behaviors that make people feel uncomfortable, it gets even more challenging, but one of the things, again, you try to emphasize is that it’s a group effort and that, you know, you may not be able to deal with a certain topic, but there’s probably someone in the classroom, in the school, in the community who can.

Well, we have to learn to find that between professional staff and between families that we can develop a sense of trust, that we’ll work together, honor the cultural differences and beliefs, and that we can teach this topic.

Issues in Social Skills and Sex Education with Tom Miller.

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