MEALTIME INDEPENDENCE

​By: Carmen Willings
teachingvisuallyimpaired.com
Updated October 30, 2017

Mealtime can be a struggle for many students, but can provide unique challenges to students with visual impairments. Although it may be easier and possibly neater to feed the student or to provide extra assistance, it is not appropriate when the student has the ability to feed themselves. It is essential to promote mealtime independence not only to build independence, but to promote social acceptance as well. To help the student develop the skill of feeding themselves, place the food on a table or tray in front of them.  At first, assist the student by using verbal cues and hand-under-hand assistance to help them locate and pick up the food. Provide finger foods: pieces of cracker, ice cream cone, spaghetti to promote finger sensitivity. Peel eggs, fruit, and wrapping on some containers to develop skillful hands.

There are a number of adaptations that can be made to make mealtimes easier. Use high contrast utensils and dishes for students with low vision. Bowls and plates with suction cups can help them stay in place. Similarly, Dycem or other non-skid materials can be used as mats to prevent sliding.

Exposing children to a variety of foods with a variety of textures and flavors can help develop tactual discrimination skills. When assisting students in eating, guide the student by sitting behind them and provide hand under hand support. Younger children can be taught to spear with a fork by using their opposite hand to assist in touching food that needs to be speared and aid in the placement of the fork. As students get older and more adept, they can be shown how to use a piece of bread or the edge of a knife or spoon as a “pusher”. A common strategy to teach students to locate food on their plate is to have the student imagine the plate is the face of a clock. Foods can be described as being located at specific hours (e.g., the green beans are located at 2 o’clock). Students will need to understand clocks for this method to be effective. Many school trays are now rectangular and divided. When a student is using this type of a tray, using “top”, “bottom”, “left”, “right”, and “center” are easy points of reference so long as the student knows those spatial concepts.

​Dependent Eaters

For the student that is not yet eating independently, talk to the student with every interaction.  Even when the student is not able to understand your words, they will learn to recognize your voice.  Tell them what is happening before placing food in their mouth. Be sure and tell them what you’re offering them:  “here’s a graham cracker.  It’s on the table in front of you.  Can you find it?” Do not simply put food in the student’s mouth. At the very minimum, provide the student with a verbal prompt that you are going to give him another bite. Preferably, have the student be a part of the process. Either provide hand under hand assistance the student can anticipate the spoon, or have the student hold onto your wrist as you bring the food toward their mouth. You may find that some students are less resistive when they are given elbow support.

​Participate in Serving

As much as possible, encourage the student to be actively involved in preparing, selecting or setting out the food.  Avoid having food just “appear”.  Remember the students will learn best through hands on experiences. As the student grows, continue to give him verbal information about the location of his food and utensils.  Incorporate instruction in basic spreading skills, using a knife safely, stirring skills, pouring a drink, getting a bowl of cereal.

Consider providing the opportunity for the students to pour their own drinks.  Begin by letting the student pour from another cup into his own.  As he becomes more proficient, let him begin to pour from a small pitcher. When it is possible, foster independence by teaching students how to serve food from a bowl or platter and a variety of other serving dishes. The student may also need instruction in using a knife for spreading foods, cutting foods, and how to use a knife (or piece of bread) as a “pusher” to push items onto the spoon. Encourage the student to eat neatly in order to promote social acceptance.

​Presentation of Food

When presenting food to a student with low vision use a high-contrast patterned cover, reflective material, or visually interesting ponytail holder on the cup may help a student with low vision to visually attend to the cup. Use a patterned sock around a cup to encourage visual attention in younger students. Use high contrast materials to call his attention to finger foods; for example, place a banana slice on a dark place mat or a pea on a white mat. Avoid busy patterns in tablecloths or place mats. For students with Cortical Visual Impairment, use the students preferred color or use reflective materials to draw their attention to the cup.

When presenting food to a student who is blind or has minimal functional vision, consider the following suggestions. When the student first starts eating at the table, put the food on a plate with an edge or rim that curves up.  This will help to keep the food within the center area of the plate, scoop the food, and make it easier to avoid scattering it on the table. Encourage the student to hold his own cup. It may be helpful to use a cup with handles. Try to give the student opportunities to learn to use the spoon, as it will assist in developing his independence and coordination. Place dishes on a tray with raised edges so the student can push the food around without knocking it off the table. Show the student how to use one hand to hold his plate while scooping the food with the other hand.

Embedded Language Opportunities

There are many opportunities for socialization and language during meals. Conversations should be encouraged including explanations of the mealtime activities. The student needs to know that they aren’t the only ones who spill or drop things!

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TVI’s Guide to Teaching the ECC: An Activities Based Curriculum for Teaching Students who are Blind or Visually Impaired
The TVI’s Guide to Teaching the ECC is a digital pdf available for download. It is designed specifically for fellow itinerant Teachers of Students with Visual Impairments (TVI’s), and consists of over 400 activities and topic areas of discussion for instructing students in the Expanded Core Curriculum. The activities are age-neutral and multi-sensory and therefore can meet the needs of the broad range of students served on an itinerant caseload serving. The activities can be individualized to the students various learning modalities and scaffold in order to challenge students but ensure success. Select those activities that align with the student’s learning objects based on the student’s unique visual needs and academic and developmental level. In addition to the core activity areas, each of the 32 Thematic Units incorporates additional unique ECC concepts and skills providing you with a years’ worth of activities. These units are cyclical and can be used repeatedly to help students build on prior knowledge and develop a deeper understanding of concepts. Each unit includes suggestions for activity adaptation associated with the unit. These include lists of objects, possible community-based experiences, environmental print, poems, children & young reader books, children's songs, pop culture songs, movies, and websites.


In addition to the book, the following two supplements are included:
·      TVI’s Guide to the ECC Concept Checklist
·      TVI’s Guide to the ECC Activities Checklist


For complete product details and additional images, visit the TVI's Guide product page.


TVI's Guide to the ECC Product details
·      Digital pdf download: 346 pages (11 pt font)
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide to the ECC Grab and Go Supplements
The Near Magnifier Fluency Worksheets is a Grab and Go supplement to the TVI's Guide to Teaching the ECC. This workbook is a pdf download that can be printed on demand for use with students. It contains five different types of worksheets for developing visual motor skills and near magnifier fluency skills particularly with the use of a video magnifier. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to each of the 32 ECC Thematic units. The worksheets, along with a list of environmental print for each thematic unit, are designed to help students refine their visual motor skills while reinforcing ECC concepts presented in the thematic units.  


For complete product details and additional images, visit the Visual Efficiency & Near Magnifier Product Page.


Visual Efficiency & Near Magnifier Fluency Worksheet Details:
·      Digital pdf download: 210 pages
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Keyboarding & Braille Fluency and Maintenance Worksheets: A TVI’s Guide to Teaching the ECC Grab & go Supplement
The Thematic Keyboarding & Braille Fluency and Maintenance Grab and Go ECC worksheet packet is a print on demand workbook that contains worksheets in print and simulated braille to use for data collection. Present the student with a hard braille copy and use the worksheets to document accuracy and fluency in reading braille. As a companion to the TVI’s Guide to the ECC, the worksheets correspond to the ECC Thematic activities presented in the curriculum guide. These word lists and sentences will help the student refine their keyboarding or braille reading skills while bridging ECC concepts presented in the thematic units. Although the lists and passages can be produced using a manual braillewriter, you may also copy and paste the passages into any braille translation software for quick production on an embosser. They may also be entered into a typing program such as APH’s Talking Typer to build keyboarding fluency.


For complete product details and additional images, visit the Thematic Keyboarding & Braille Fluency & Maintenance Product Page


Thematic Keyboarding & Braille Fluency Worksheet Details:
·      Digital pdf download: 338-page print and simulated braille worksheets
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


Thematic Vocabulary Cards and Checklists: Grab & Go ECC Supplement
The Thematic Vocabulary Cards and Checklists Grab and Go ECC supplement is a 446 page pdf downloadable print on demand workbook that includes 2940 vocabulary card on 3 1/2" x 2" templates divided by each of the 32 Thematic Units along with a checklist of each unit words in print and simulated braille. As a companion to the TVI's Guide to the ECC, the vocabulary cards correspond to the ECC Thematic activities presented in the curriculum guide. 


Additional Use:
Teachers of Students with Visual Impairments can have a extremely varied caseloads. It is possible to go several years without having a student on your caseload who requires braille instruction. Like other skills, if you do not practice your braille regularly, it is easy to lose those skills. Use these checklists and cards to maintain your braille skills. Fold the checklist along the line dividing the print from the braille. Choose to either read the print and produce the word in braille using a braillewriter or read the simulated braille and decode it. Finally, these vocabulary cards and checklists may be used with family members or peers who are interested in learning and practicing the braille code.


For complete product details and additional images, visit the Thematic Vocabulary Cards & Checklists Product Page


Thematic Vocabulary Cards and Checklists Details:
·      Digital pdf download: 446-page print on demand resource
·      Publisher: Teaching Students with Visual Impairments
·      Author: Carmen Willings
·      Language: English


BONUS!
Lotto Cards
The LOTTO Cards Grab and Go Supplement includes 37 theme related unit cards along with activity suggestions that support activities within the TVI's Guide to Teaching the ECC.


On My Way File Folder Cards
Print and use these cards to represent locations the student may visit that are related to the current thematic unit. Use these with the On My Way File Folder Game outlined in the TVI's Guide to Teaching the ECC p. 27.

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