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Why it’s challenging for kids with CVI to eat

The CVI visual behaviors and characteristics make it hard for kids with CVI to access mealtime.

Girl eating outside looking at her AAC, drinking out of her water bottle

As a parent of a child with CVI, you most likely deal with feeding challenges. 

Many CVI families are not only on a CVI journey but a feeding journey as well. Some children with CVI had difficulty gaining enough weight early in their lives; some use feeding tubes; some require years of feeding therapy; some have difficulty chewing. Add CVI into this complicated mix, and eating becomes one of the biggest challenges for many kids with CVI. 

The CVI visual behaviors and characteristics make it hard for kids with CVI to access mealtime. This can result in outward behaviors or only being able to eat for just a few minutes. 

Let’s talk about why CVI visual behaviors and characteristics make it so hard for kids with CVI to eat. 

Visual-motor and visual guidance of the upper limbs
Eating is a substantial visual-motor task that requires upper limb precision. Many children with CVI have difficulty with reaching while maintaining visual attention, reaching accuracy, and looking while exploring an object. You might notice your child never looking at their food while picking it up with a hand and placing it in their mouth. Cluttered table tops can further reduce hand-eye coordination. Learning to use utensils can be extremely difficult because it involves a tremendous amount of eye-hand coordination. A young adult with CVI shared that she can’t use a fork or a knife, but spoons are easy for her. You might notice your child putting their face close to the plate to support visual attention and reduce the amount of reach needed. 

Impact of spacing, object arrangement, clutter
Various food items bunched together on a plate are visual clutter. Many individuals with CVI are not able to tolerate too many objects at once. The food can blend together, and the scattered array on the plate can make the presentation of food too visually complex. 

Visual field abilities
Many children with CVI have visual field loss—left and right peripheral fields, upper visual field, or lower visual field. While eating, your child may miss food on a particular side of the plate, the cup placed on the table, or a utensil next to the plate. 

Sensory environment
If there are any competing sensory inputs—noise, TV, talking at the dinner table, movement of others, pets running around, distracting lights—a child with CVI may have difficulty maintaining visual attention. A busy environment can cause frustration, agitation, and increased fatigue while a child with CVI is trying to engage in the complicated process of feeding. Eating in new and busy environments, such as a restaurant, can further increase anxiety and stress.

Visual recognition
Imagine all the different forms and shapes of food. Let’s take sweet potatoes, for example, and all the different presentations: mashed in a little heap, mashed while still in the skin, roasted in cubes or long strips. Visual recognition of food is a challenge for children with CVI. Some CVI parents share that their child prefers the same foods, foods that look a certain way or are cut in specific ways. Many kids with CVI will request only their favorite cup, spoon or plate, and refuse to use anything different. 

Lack of access to incidental learning 
So much of eating includes all that happens before sitting down in front of a plate of food. Children with average visual processing abilities can observe food preparation and explore foods in a variety of ways. For children with CVI, often their first experience with what they are about to eat is when they touch it or when a caregiver places it in their mouth. Imagine eating something without looking at it first, it is unsettling, and no wonder some kids have food texture defensiveness. Children who use a feeding tube or require pureed foods may miss the interaction with whole food items.

Children with CVI also miss being able to observe the motor skills used to eat—chewing, waiting for the mouth to be empty before taking another bite, using utensils, drinking, and so on. All of this is learned through observation. Many kids with CVI need to be directly taught how to eat. 

Learn about 9 CVI adaptations for mealtime to support a more productive eating experience!

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