Help Yourself. The following are free pages from. Mealtime Skills for Students Who are Blind or Visually Impaired. Sue Shannon, OTR/L

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1 The following are free pages from Help Yourself Mealtime Skills for Students Who are Blind or Visually Impaired by Sue Shannon, OTR/L This resource is made available to you by the Training and Educational Resources Program at Perkins School for the Blind. Visit for more information.

2 Help Yourself: Mealtime Skills for Students Who Are Blind or Visually Impaired Sue Shannon, OTR/L

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4 Mealtime Skills for Students Who Are Blind or Visually Impaired BY Sue Shannon, OTR/L 3

5 2011 Perkins School for the Blind. All rights reserved Every effort has been made to acknowledge commercial products mentioned in this publication whose names are trademarks or registered trademarks. Library of Congress Control Number: ISBN: Printed in USA Perkins School for the Blind Watertown, Massachusetts USA Photographers: Kathy Bull, Keri Johnson and Sue Shannon Layout by Betsy Martin-Richardson of Design By... 4

6 Acknowledgements I would like to thank the many people who contributed to this booklet including students at the Perkins School for the Blind who have inspired, tested and refined many of the strategies included in these pages. I am also grateful for collaboration and consultation with Home and Personal Management Teacher Kathy Bull, and Occupational Therapists Dianna DiPalermo, Monica Allon, Jen Feinstein, Julie Telep and Keri Johnson for their suggestions, feedback and assistance with photographs. Thanks also to Elizabeth Torrey, Speech and Language Pathologist and Marianne Riggio, Training Coordinator for Perkins international, at Perkins for their input and guidance in developing a booklet that could be helpful to a wide range of people who teach mealtime skills to children with visual impairments. 5

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8 Table of Contents Introduction 8 General Considerations 9 Pouring 10 Serving From a Platter or Dish 12 Spreading 14 Slicing 16 Utensil Grips and Using a Mature Grasp 18 Cutting Foods 20 Using a Knife as a Border or a Pusher 24 Using Condiments 25 Clearing the Table 26 Holding Things Level 27 Select Resources 28 7

9 Cutting Foods Significance of Skill This skill increases independence in the areas of fine motor and self-help skills. Cutting food is a difficult skill to learn, as there is so much variety in the size and texture of the foods we eat. Even the way one specific food (broccoli, for example) is prepared can vary significantly, so the student may need to learn a variety of techniques to be successful. Tips for Teaching When checking for the cutting edge of the knife, gently scrape the blade against the side of the fork or plate to feel the bumpy quality of the serrated edge. Use a sharp, large-handled knife with a little weight to it, such as a steakhouse knife, to help ensure success. It may help to serve the meat or other food to be cut first, so it is the only thing on the plate. Cut the food before adding other dishes to the plate. When giving hand-over-hand assistance for cutting, always use the same tactile technique to avoid confusion. Make sure the student s parents, siblings, and school staff know the technique. Alternative Methods/Adaptations There are many strategies and techniques for cutting foods. Some initial exploration of different methods may help determine what will work best for the student. Use a rocker knife or other adapted knife for students with limited use of one hand or decreased fine motor skills. Chicken on the bone is very difficult to cut. Get boneless chicken whenever possible, or students may want to ask someone at the table to remove the bone before attempting to cut it. At a restaurant, students may consider ordering entrees they know are precut. If necessary, you can request that difficult foods, such as steak, be cut before serving. Spaghetti is almost always messy to eat. Purchase or order easy-to-pierce pasta, such as penne or bowties, to avoid the mess that spaghetti creates. Using the grid method technique to cut spaghetti into small pieces allows the student to get the pasta on the fork more neatly. When using the grid method of cutting, some students have difficulty measuring a quarter turn. To help with this, instruct the student to grasp the left and right sides of the plate, and then turn it until his hands are at the front and back of the plate. 20

10 Cutting Foods Teaching Tips: Where to Start To begin teaching a student to cut food, start with a fairly dull, large-handled knife. This will help the student explore how the knife cuts through foods, the position of the knife (as well as the position of the fingers and wrist), and how much force is needed. Have the student slice a peeled banana or similar food. Have him hold the food with his non-dominant hand and the knife in his dominant hand. This is generally effective for most students, as small, skilled movements and sensory feedback are required when using a knife. Increase the resistance of the food, cutting, for example, zucchini or summer squash, which will add in the sawing motion. Some students may need a tactile marking on the knife to know where to position their index fingers. Using the Back of a Fork as a Guide for Cutting Orient the food with the fork and knife for effective positioning. Holding the fork upside down in the non-dominant hand, find the right edge of the food if right handed, or left side if left handed. Slide the fork over the food a bite-sized amount, and pierce the food with the fork. Run the edge of the knife across the fork or edge of plate to insure the knife is oriented properly. Hold the knife in the dominant hand with the index finger on top and wrist straight. Slide the knife down the back of the fork, and saw back and forth until the knife scrapes the plate. Place the knife on the other side of the fork to hold the food stable. Pick up the fork and place it on the other side of the knife. Slide down the back of the knife again, and repeat until the whole piece is cut. 21

11 Cutting Foods Using the Back and Sides of a Fork as a Guide for Cutting Slide the fork over a small amount from the edge of the food. Cut around the back and side of the fork. Continue to cut around the fork. This generally results in a bite-sized amount. More skilled wrist and finger movements are required for this method. Grid Cutting Method for Spaghetti, Salad, Lasagna, etc. When cutting spaghetti or salad, the student should cross her knife and fork and pull them apart, starting at the back of the plate or bowl, and moving toward the front (or from front to back). The knife and fork should be pressed tightly together at the tips to cut effectively. The student should then turn the plate or bowl a quarter turn. And repeat. The result is cutting the food completely into bite-sized pieces. 22

12 Cutting Foods If a Piece Is Too Big If one of the pieces is too big... Turn the fork over and place it back down on the plate. Slide the knife down the back of the fork and cut. This generally cuts the piece small enough to make it bite sized. Repeat if necessary. Adaptation and Other Methods Alternate Cutting Method Large-handled steak knife A Rocker T knife may be used by individuals who don t have the ability to use 2 hands in a skilled way. This knife cuts food with one hand using a rocking motion. 23 Measure bite-sized pieces with the knife laying flat. Place the knife flat on the food to measure out a bite-sized piece. More skilled wrist and finger movements are required for this method.