University of Edinburgh
 

Vision for Doing

Assessing Functional Vision of Learners who are Multiply Disabled

Chapter 6 The Other Senses

Section 7 Learner's Sense of Taste

Aims of Section 7

In this section we have four categories of items. You will be using these to give some idea as to the learner's level of responsiveness to taste. From this you can be more precise in selecting which of the intervention strategies outlined in Chapter 6 and Chapter 7 are most relevant to your learner.

How to use Section 7

Refer to the diagram on the previous page. For each of the items under the four broad headings to the left you will want to record whether the learner responds in a manner that is Consistent, Occasional or Never.

While carrying out the items in this section, remember that both smell and taste are involved in eating and drinking. Sections 6 and 7 might quite happily be scored by observation made during snack or mealtimes. The distinction between them may often be blurred but we think it still a useful task to try and isolate the responses being made. However, do not worry if you feel you cannot be one hundred percent sure.

Transferring Results to Section 18

For this to be the case you may not have found any specific response. Instead, you will observe only vague and non-specific responses to taste. Pleasant/unpleasant refers to the learner's response, not to your own preferences!

If, therefore, your results show that the learner responds Consistently to the 4 items, go to the Summary Chart (at the end of PART TWO), find the row for Section 7 'Taste' and put a tick in the box for Awareness. Then move on to the next topic (Learner attends to..)

If instead the learner responds Occasionally, try again on different occasions. If the result is still Occasionally use Awareness as the level of responsiveness. If so, go to the Summary Chart, find the row for Section 7 'Taste' and put a tick in the box for Awareness.

If the learner Never responds to any of the items under this heading then for the moment do not go any further with the assessment of the learner's sense of taste. Note that you should not have results in which the learner Attends, or Recognises or Understands taste but is still not Aware of taste. A learner has to be Aware of tastes in order to Attend, Recognise or Understand a taste.

Learner attends to..

In order for you to observe an ability to Attend, you must first have found that the learner is Aware. If you are uncertain, read over the previous information on "Learner is aware..">

For the learner to Attend you will have observed a more specific response to items of food or drink. The response should continue over a period of time no matter how short in duration. If your results show that the learner Consistently responds to each of the items on the checklist under Attends, go to the Summary Chart, find the row for Section 7 'Taste' and put a tick in the box for Attending. Then move on to the next topic (Learner recognises taste..)

If the learner responds Occasionally to one or more of the two items, and one of these two results is Consistent, take Consistent as the level of response. In this case too, tick Attend in the Summary Chart and move on to "Learner recognises taste..">

If all are Occasionally try these out on different occasions. If the result is still Occasionally use Awareness as the level of responsiveness. The Summary Chart should already have been ticked.

If the learner Never responds to any of the items under this heading then do not continue with the assessment of 'Taste'. Note that you should not have results in which the learner Recognises or Understands tastes but does not Attend to them. A learner has to be able to Attend to a taste in order to Recognise or Understand it.

Learner recognises taste..

In order to observe an ability to Recognise taste, you must first have found that the learner is Aware of Attends to taste.

For the learner to Recognise you will have observed specific responses to a wide range of food and drink (and perhaps objects) which indicate clearly that the learner is familiar with these tastes. If the learner has particular preferences or aversions it will be easy to complete this section! A response might also indicate the detection of a new and unfamiliar taste or texture in food or drink. In order to score Recognise you must be certain that the is Consistent response to a wide range of tastes.

If your results show that the learner Consistently responds to each of the items on the checklist under "Learner recognises taste.." go to the Summary Chart, find the row for Section 7 'Taste' and put a tick in the box for Recognises. Then move on to the next topic (Learner explores objects orally to help understanding..)

If the learner responds Occasionally to one or more of the items, even if there is an item which is Consistent, still take Attend as the level of response. In this case tick Attend in the Summary Chart. Do not move on to "Learner explores objects orally to help understanding..">

If all are Occasional try these out on different occasions. If the result is still Occasionally use Attend as the level of responsiveness. The Summary Chart should already have been ticked in the appropriate box. Do not tick Recognise.

If the learner Never responds to any of the items under this heading then, for the time being, do not continue with the assessment of 'Taste'. Note that you should not have results in which the learner explores objects orally to help understanding but is not first Aware of, Attends to and Recognises taste.

Learner explores objects orally to help understanding..

In order for the learner to do this, you must first have found that the learner can recognise tastes.

In looking at oral exploration at this level we will be considering a coming together of the sense of touch and taste. For example, a learner might examine a shape from an inset board to help her understanding of the shape and hence where it should be inserted; or the taste of chocolate on a biscuit might enable a learner to understand that this is a special reward, as opposed to getting a non-chocolate-coated biscuit. A learner might realise he has taken his neighbour's cup by mistake if he tastes orange juice instead of the milk he poured. In short it has to be very clear to you that there is Consistent and meaningful understanding being made through the use of taste.

If your learner Consistently responds to each of the items on the checklist under "Learner understands tastes..", go to the Summary Chart, find the row for Section 7 'Taste' and put a tick in the box for Understands. You are now ready to go on to Chapter 7.

If the learner responds Occasionally to one or more of the items, use Recognise as the level of responsiveness. If this is so, do not tick Understands.

If the learner Never responds to any of the items under this heading go on to Chapter 7 dealing with assessment of vision. Note that you should not have results in which the learner uses oral exploration to help understanding but is not first Aware of, Attends to , and Recognises tastes. A learner has to be able to Recognise taste before using it to help understanding.

Where to go now?

Having noted the results of your observations and transferred these to the Summary Chart, you are then ready to tackle the assessment of functional vision! If you wish you could read over some suggestions on using taste in the remainder of this section.

Food and drink are the source of immense pleasure for many human beings. As flavour is usually accompanied and enhanced by the appetising aroma and attractive look of foods and beverages it is sometimes hard to isolate the information coming through our taste buds alone.

Taste and smell are particularly closely related with the brain responding to, and combining information from the sense of smell and the taste buds to enable greater appreciation of the flavour and hence pleasure derived from it.

The texture and consistency of food and drink contribute to their acceptability and attractiveness, or otherwise, especially for young children or those who have difficulty chewing or swallowing. Temperature, too is another factor to be considered.

FIo Longhorn1 considers in detail taste range, consistency, texture and temperature in her advice on developing a taste curriculum and taste bank.

All of the above can be positive or negative factors in determining a learner's response to food. Introducing solids can be a traumatic experience for both child, parent and educator. Patience and ingenuity are often necessary to get new flavours, consistencies, texture and temperature accepted.

For some learners texture may be the main motivator and facilitate the introduction of new flavours. On the other hand, a favourite flavour might just provide sufficient encouragement for a learner to accept a new more challenging texture of food. It is advisable, however, not to introduce new flavours and textures at the same time.

It is not our intention here to enter into details of a feeding programme. Many good examples already exist and you may well have your own favourites among them or a well worked out feeding programme to suit the needs of your own learners. We mention three here which we felt would be helpful for further reading2,3,4.

Improving awareness:

Although the major attention to developing the taste and smell curriculum will centre around meal and snack times use can made of other activities and times of the day. In fact, if feeding times are stressful, other times such as relaxation periods or passive listening to music might provide opportunities to put a touch of a new flavour on lips, tongue or inside of cheek. The flavours need not always be pleasant or insipid. A tangy touch of lemon or nip of peppermint might stimulate awareness.

If the learner has started to explore with hand and mouth, no matter how fleetingly or seemingly reflexively, then some of the items laid around the learner on a resonance board could for example be smeared with flavoured yogurt or honey. As the learner brings object or fingers to her mouth she might become aware of the smell, the feel of wetness or stickiness and the taste.

Occasionally hanging edible items among more usual ones in a mobile might also result in arousal of awareness. Dale3 suggests toast and orange.

Improving attending:

It might be instinctive to compare the range of flavours, consistencies, textures and temperatures of food and drink which we experience in a week to that available to the learner. If our staple diet was mushy cereal and liquidised mince and potatoes, we also might not pay too much attention to what we were eating. Eating can also be one of the main social and bonding events throughout life. So as well as considering the type of food presented it is important to look at the whole experience surrounding the intake of food.

Is there generally a happy relaxed atmosphere conducive to attending to what is being eaten and to the social aspect of meal times? Or is it a tense, hurried routine which feels like an assembly line? Ratio of staffing to learners has a bearing on this, but more important is the philosophy behind the design of the curriculum and the timetable.

When a learner is beginning to attend to what is being eaten, it is vital to provide variety in the range of flavour, texture, etc as it is at this point that either openness or defensiveness to change will be established.

Remember the four main groups in taste: salt, sweet, bitter and sour; the range of foods and flavours coming under each of these categories; the different consistencies, textures and temperatures in which they can be presented; the glorious range of aromas and smells which can accompany them5.

If a child or learner starts to attend to taste and thereby gets pleasure from it, the motivation provided will contribute to the general development of the child.

FIo Longhorn (ibid) lists some of the main goals in planning a taste curriculum as follows:

  • toleration and enjoyment of tastes;
  • stimulation and awareness of tastes;
  • increased awareness of tastes linked to smell;
  • acceptance of different flavours;
  • improved feeding;
  • desensitisation of the face and mouth;
  • beginning of a controlled range of mouth movements;
  • beginning of a controlled range of tongue movements;
  • increased body movement;
  • beginning of vocalisation;
  • simple discrimination of tastes;
  • beginning of a taste memory, ie remembering and recognising tastes.

Improving recognising

As has already been indicated, a taste curriculum must be developed within the broad curriculum of daily life. A learner will be helped in the recognition of a taste not only by its aroma and texture, but also by the time and context in which it is presented and the action, words or signs which accompany it.

Helped by all these clues, as the learner tastes apple fresh, pureed, in a pie, as flavoured yogurt or baked, the "appleness" of the flavour may eventually be recognised. Recognition of flavours can also have its drawbacks. It can be very challenging to try and disguise flavours and textures such as egg when trying to produce a balanced diet!

As recognition improves it can be linked to association eg; the type of biscuit or sweet that a special person, such as a grandparent, always brings. Routine and association can help form anticipation. Certain activities may be linked in the learners mind to flavours or foods. Tomato soup and a sandwich may be the usual lunch before going horse-riding. A warm, sweet drink might come after bath time and before a bedtime story or song.

These routines should follow the same guidelines as for any other: they are helpful if they do not become "unalterable". Flexibility and openness to change are more important in the long run.

Improving understanding (through oral exploration of objects).

This item is different from the others we have looked at when considering a learners response to taste. Perhaps it could have been placed just as well in the sections on smell or taste. We are close here to the realms of synaesthesia which might be defined as a sensation of a kind other than that which one would expect from a particular experience. The name of a book by Oliver Sachs, "Seeing Voices">6 is an example. Perhaps more familiar to those who have worked with blind learners would be the claim that some people can feel colours.

In the areas of tactile and oral/taste perception we are still at the beginnings of knowledge. We know that congenitally blind learners can decipher tactile information and produce artistic tactile representations. We do not understand what type of mental representation results from the deciphering of say, raised diagrams, but we do know that the aesthetic products in clay, wood or stone are startlingly different in their emphasis7,8. Moreover, what would these blind children or artists produce if they were not schooled by seeing teachers and had not been brought up in a visual culture?

All developing infants learn from combined manual and oral exploration of objects. Able blind learners continue to use this method, sometimes throughout their whole lives. Is there such a thing as the 'taste" of a shape? The sensitive areas of cheek, lips and tongue reveal much about texture and temperature which cannot be felt by the hand or seen with the eye. We all of us use this method from time to time. We are taking in the washing from the line; how do we know the sheets are dry? We put them against our faces and mouths. We see perfect-looking fruit in a bowl; how do we find out whether or not it is real? We smell it and touch it with lips and tongue.

Consider a learner with multiple disability and visual impairment. He has been given the task of sorting shapes in a posting box or inset tray. This could, in theory, be accomplished by manual exploration only. However, exploring with mouth, tongue, nose and cheek will give much more information. It may also compensate for limitations in manual dexterity, factual perception and more importantly may ensure that a piece of chocolate, crisp or fruit, is not "posted" by mistake.

This is a lighthearted look at an activity which might some times be confused with repetitive mouthing. As an exploratory method it should never be totally discouraged, though as with other behaviour which might be deemed socially unacceptable in older learners, it has to be channelled appropriately.