Eat & Drink

For children with visual impairment, food is a way to explore their other senses

Sahiya Garcia, 5 (from left), Trina Morrison, Michelle Stump, Josie Pritchard, 5, and Levi McPeak work on a classroom project assembling Chef Creole, a character from a children’s book, at the Children’s Center for the Visually Impaired.
Sahiya Garcia, 5 (from left), Trina Morrison, Michelle Stump, Josie Pritchard, 5, and Levi McPeak work on a classroom project assembling Chef Creole, a character from a children’s book, at the Children’s Center for the Visually Impaired. The Kansas City Star

It was Fat Tuesday at the Children’s Center for the Visually Impaired in Kansas City, and bead-bedecked students gathered around their teacher, Hillary Joy-Sims, as she began the morning’s project: reading “Chef Creole” while using iconic Louisiana foods to re-create the main character.

As Joy-Sims turned the pages, support staff helped pass bowls of rice to make Chef Creole’s hair; pickled okra (his nose); red beans (eyes); pralines (mouth); a king cake (body); Cajun-style boudin sausage (arms); cayenne peppers made from red tissue paper (fingers); French bread (legs); and pastries called beignets (feet).

The group of 5- to 8-year-olds touched and squeezed, smelled and tasted each ingredient as Chef Creole took shape. The activity was about more than fun, though. For the kids in the center’s Classroom 4 — all visually impaired, most with multiple disabilities and some unable to eat by mouth — food is a way to explore their other senses and enjoy a feeling of trust and community.

“We as people gather around food,” Joy-Sims said. “It’s about inclusion.”

But that’s just the starting point for the center’s teachers, who routinely incorporate food into classroom lessons, and for students’ families, who often use cooking as a form of occupational therapy. It also expands kids’ food repertoire and strengthens self-care skills while creating social and vocational opportunities, building self-confidence and laying the foundation for a successful future.

“It’s about more than getting together three meals a day,” said Lisa Lind, the center’s director of children and family services. “It helps them lead a self-sufficient, independent life.”

Almost 660,000 Americans under the age of 20 have a degree of visual impairment, according to the U.S. Census Bureau’s 2012 American Community Survey. It’s hard to say how many of them live in the Kansas City area, but the Children’s Center for the Visually Impaired’s roster includes more than 200 from Kansas and Missouri.

Of those, 51 are enrolled in preschool and kindergarten at the organization’s midtown campus (those classes also include 26 sighted peers). Another 41 participate in its outreach program, and the infant program serves 110 babies and their families.

Beginning therapy in infancy is crucial for visually impaired children, especially those with multiple disabilities or health concerns. The center’s therapists work with babies who have feeding tubes to ensure they develop the sucking, swallowing and other oral motor skills they’ll need as they grow. Therapists also help those who are underweight or suffer from digestive problems, or who are reluctant to touch anything, even a bottle.

“Therapists start at the beginning before these behaviors get really intense,” Lind said.

Early intervention is also important because more than 85 percent of what a child learns is acquired before the age of 5 through visual and incidental learning (watching other people).

Not being able to see well, or at all, makes even basic developmental milestones, such as a baby’s learning to pinch and grasp, harder to achieve, said Christy Dow, an occupational therapist at the center.

“Every motion of their hands — pinching, turning, grasping — those have to be taught individually,” Dow said.

“The learning curve is so much greater,” agreed Joanna Nickson, a nurse at Research Medical Center who connected with the Children’s Center for the Visually Impaired shortly after the birth of her now 3-year-old son, Jude. “(His brothers) knew how to drink out of a cup because they saw people drinking out of a cup. Almost everything Jude does, he has to be taught.”

That’s because Jude was born with bilateral microphthalmia (characterized by abnormally small eyes), which caused underdeveloped optic nerves and rendered him blind. He began home therapy at 2 months and now works with a teacher for the visually impaired; occupational, physical, speech, and orientation and mobility therapists; and a Braille teacher. Jude also attends preschool at the center three mornings a week.

Nickson’s older sons — Peter, 6, and Thomas, 4 — were already helping her in the kitchen when one of Jude’s therapists suggested she start cooking with him. The benefits were immediately clear, Nickson said.

“Fine motor skills, language expansion, and the sensations and textures — hot and cold, sticky and dry — it just really has a lot of pieces to it,” she said.

Jude clearly enjoys it. On a recent January morning, he and his little brother, 15-month-old Simon, clamored onto step stools in the family’s Overland Park kitchen while his mom heated water for Jell-O.

Nickson gently held Jude’s hand a few inches above the measuring cup so he could feel the water’s warmth. He then freed his hand, found the top edge of the Jell-O packet and ripped it open, giggling at the hissing sound the powder made as it poured out.

Jude grabbed a whisk and mixed, his mom’s hand guiding his, before finally asking if it was ready to pour into the sports-themed mold.

Throughout it all, Nickson provided steady commentary on what Jude was doing, feeling and hearing — verbal cues that are a key part of his learning process. Nickson also cues Jude when feeding him with a spoon so he knows what to expect and when to open his mouth.

Playing with peg puzzles is helping him develop the pincer grasp necessary for finger foods, but he still has difficulty with utensils and sandwiches.

Jude is gradually expanding the range of things he enjoys, although he’s sometimes reluctant to try everything Nickson serves. That’s not unusual, given that visual impairment only heightens toddlers’ and preschoolers’ natural suspicion of new foods, Lind said.

“A lot of times, eating is a very scary process,” she said. “Food presents so many different textures that can be startling, uncomfortable and unfamiliar.”

That’s why the center starts early and slowly builds healthy food skills, Lind said. Classroom teachers begin with sensory play using materials such as shaving cream, so children can get used to feeling different textures before transitioning to edibles they can touch, smell and sample.

“We have a lot of baby steps that we build on, and playing with a bowl of blue Jell-O might be Step 5,” Dow said. “It involves a lot of time and patience.”

Teachers work up to assembling snacks or baking cookies, and they combine food with other lessons, as when teacher Ann Cummins made fruit pizza with her kindergarteners in January. Her class was learning the letter “P” and had been talking about healthy eating, so the project made perfect sense.

Cummins passed smooth-skinned bananas, fuzzy kiwi and rough, unpeeled pineapple around the table and invited students to taste their peeled counterparts, along with more familiar berries and grapes. They then cut the fruit into bite-size pieces with plastic knives, spread cream cheese frosting on a cookie “crust” and decorated their own slice with the fruit.

Most reached for a mixture, one piled her slice with only kiwi and another skipped the fruit completely. Not that it mattered. Consuming fruit wasn’t the point. Trying something new, practicing skills and enjoying a shared snack was.

“We want food to be pleasurable,” Lind said.

Unfortunately, the road to those pleasures can be a bumpy one if you can’t see, said Craig Phillips, a licensed orientation and mobility specialist and teacher of the visually impaired.

“Our kids with visual impairments, the way they eat and their exposure to different foods is really limited,” Phillips said. “They don’t know what’s out there.”

That’s why Phillips makes cooking a priority for clients such as Brooke Petro, a former student at the center who is now in second grade at Nativity Parish School in Leawood.

The pair works together four times a month. One session is typically devoted to shopping, so Brooke can practice navigating a store, selecting items, moving through the check-out line and paying. They cook together in another, and the remaining two focus on traveling safely through Brooke’s environment.

The kitchen, though, is perhaps Phillips’ favorite teaching space.

“It’s huge,” he said. “It’s a great laboratory.”

Kids practice academics such as math and Braille reading (Brooke topped her age division in the recent Kansas Regional Braille Challenge at the Kansas State School for the Blind) in the kitchen while learning to crack eggs, measure ingredients and wash dishes. They also learn to use tools such as a blender, food processor, pasta maker, hand-held electric mixer and knives with adult supervision.

Since connecting with Phillips, Brooke has made everything from pizza to smoothies for her family — not that she was a stranger in the kitchen before then. Brooke began helping her mom, Lyn Petro, unload the dishwasher, wipe the counters and line muffin tins when she was a preschooler.

She and her 4-1/2-year-old sister, Carly, who is sighted, still love baking with their mom and together recently made 1,000 Gooey Butter Cookies for a family wedding. Brooke’s next goal: to fix an entire dinner in celebration of her first communion in April. She and Phillips have already made pasta from scratch and meatballs (they’re in the freezer). Now she’s learning to assemble a salad, and she’ll bake a cake for dessert.

Petro, an occupational therapist herself, admits cooking with kids — whether they can see or not — isn’t always pretty, but its importance far outweighs any inconvenience.

“Messes can be cleaned up. She’s not going to learn skills without real life experience,” Petro said of Brooke. “We want her to be independent not only in the kitchen, but also in life.”

Anne Brockhoff is a freelance writer. Email her at ninemilefarm@gmail.com.

Gooey Butter Cookies

Lyn Petro and her daughters, Brooke and Carly, made 1,000 of these cookies for a recent family wedding.

Makes 3 to 4 dozen cookies

1 stick (8 tablespoons) butter, softened

8 ounces cream cheese, softened

1/2 teaspoon vanilla

1 egg

1 (15-ounce) box cake mix (see note)

Powdered sugar, for rolling

Combine butter, cream cheese, vanilla and egg; beat until light and fluffy. Mix in the dry cake mix. Chill for several hours or overnight.

Preheat oven to 350 degrees. Lightly coat a baking sheet with cooking spray. Scoop small balls out of the chilled dough and roll each in powdered sugar. Place balls on baking sheet and bake for 10 to 12 minutes. Be careful not to let cookies brown; they should still look wet when removed from the oven (that’s so they taste gooey).

Notes: Petro prefers using Betty Crocker SuperMoist Cake Mix Butter Recipe (either yellow or chocolate flavor).

For fluffier, more cake-like cookies, buy two boxes of cake mix and use a total of 18 ounces in the recipe, reserving the remainder of the second box for another use.

For Gooey Butter Cookies that taste like applesauce cake doughnuts, Petro suggests substituting a regular spice cake mix with a little added cinnamon.

Per cookie, based on 3 dozen: 94 calories (57 percent from fat), 6 grams total fat (3 grams saturated), 20 milligrams cholesterol, 9 grams carbohydrates, 1 gram protein, 124 milligrams sodium, trace dietary fiber.

Creamy Pralines

Hillary Joy-Sims made a batch of this Louisiana specialty for a Fat Tuesday activity in her classroom at the Children’s Center for the Visually Impaired in Kansas City. She adapted the recipe from “The Little New Orleans Cookbook,” subbing 1 cup of Kashi Go Lean Crunch cereal for the pecans to make the pralines nut-free. You will need waxed paper to make this recipe.

Makes about 2 dozen pralines

1 stick (8 tablespoons) butter or margarine

2 cups sugar

1 cup buttermilk

1 teaspoon baking soda

1 teaspoon vanilla

1 to 1 1/2 cups shelled pecan halves or Kashi Go Lean Crunch cereal

Place two 3-foot pieces of waxed paper over sheets of newspaper on a countertop (wax could transfer to the counter if you don’t provide the buffer of newspaper). Run the stick of butter you will use in the recipe over the waxed paper.

Put the sugar, buttermilk and baking soda in a large Dutch oven and bring to a boil while stirring constantly. Have the butter, vanilla and pecans (or cereal) ready beside the pot. Lower heat slightly when mixture rises to the top of the pot, and stir, watching as the bubbles change color from white to yellow to beige before subsiding and turning light brown. When the mixture begins to thicken slightly after about 7 minutes, dribble some into a cup of cold water. When your fingers can make a little ball of the cooled syrup (called the softball stage), carefully add the butter, vanilla and pecans or cereal. It may splatter; carefully continue stirring. Heat while stirring for another minute, and then test to see if the mixture has returned to the softball stage. It’s very important to let it come to this stage again.

Remove pan from heat and let it sit for 1 minute, no more, while you rest your stirring arm. Begin stirring again and stir like mad with a wooden spoon for just a couple of minutes, until you feel the mixture becoming thick. Tilt the pot so that you can dip spoonfuls onto the waxed paper from the side of the pot where it hardened more quickly. Allow pralines to harden.

Per praline: 139 calories (46 percent from fat), 7 grams total fat (3 grams saturated), 11 milligrams cholesterol, 18 grams carbohydrates, 1 gram protein, 102 milligrams sodium, trace dietary fiber.

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