We have discovered that many children who are blind or visually impaired don't really rotate their hand and wrist properly. Some of this may be due to using the whole hand to find objects, rather than looking for an object - like a Cheerio - and picking it up with their thumb and one finger. The other problem is LEVEL. Many persons with visual impairments don't have a good sense of level - most of us have learned it by trying to carry a glass of water that was too full. So many of our kids have a tough time with soup or cereal with milk (many will eat their cereal dry just so they don't have to use a spoon) - they don't understand how and when to rotate their wrist in order to keep the spoon level. This takes a LOT of patience on the part of teachers, parents and occupational therapists, and a lot of willingness to try different approaches to see what works for your child.
One thing that does seem to work well is replacing our American system of using silverware (fork in right hand, switching to left when we need to cut something, so that our knife can be in our right hand) to the Continental method. The fork always stays in the left hand (for a right handed person) and the knife is always in the right hand and acts as a pusher - it's not just for cutting. The fork is held upside down. If you watch a lot of cooking shows, chefs on them often use the upside down fork to taste foods made on the show. I don't know if the Continental method is the only acceptable method of eating in cooking schools, but I have seen a lot of chefs eating this way. A piece of bread or a roll can also act as a pusher to move food to a good location for "loading" onto the back of a fork, which is being held - always - upside down (curved side facing up). As always, a TON of practice, rethinking and revamping, is needed to master either technique. We started Greg on the Continental style a little too late, so he kind of uses a mixture of both styles - mostly appropriately and mostly neatly. There are some foods that are always going to be difficult to handle. One frequent quip repeated in the blind community is to never order spaghetti on a date or a job interview! (unless, of course, the date or the interviewer is also blind, and you don't care what stains you get on your clothes, or you have no qualms about putting a huge napkin in the neck of your shirt!
Another thing kids need to practice is taking food from a community bowl - family style - and getting it to their plate neatly and in appropriate quantities. Again, tons of practice with level, feeling for the weight of the spoon, location of the plate and the bowl to prevent drips, having a place to put something when you are ready to put it down. We need to tell them when they have four servings-worth of mashed potatoes on their plate and only one green bean! Practice with tongs is important, too, as tongs are used in so many buffet restaurants these days.
Eating skills are some of the most difficult - and frustrating for parents and teachers alike - for your child to master. Be patient, be consistent, be expectant that your child will succeed. Be willing to try new approaches. Above all, love your child and assure him or her that they are going to be successful in this new skill and that it takes a long time and perservereance to reach their goal - and that they want to reach that goal!
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