Running head: QUINNS COOKBOOK

Quinns Cookbook
Faith Wilkins
Touro University Nevada

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Quinn

Quinn is a unique and loving 27 year old man who happens to have Down syndrome and
Type 1 diabetes. He lives at home with his mother in Fayetteville, AR. Quinn is responsible for
helping care for his two cats and two dogs. He attends an adult day center that focuses on
developing living, work and social skills. He recently began participating in a reading class.
Since his involvement in this course he has begun to demonstrate an interest in books although
he has not yet mastered the skill of reading.
Quinn has a best friend named DJ. Quinn and DJ have a goal to eventually move in to
their own apartment together. Due to numerous challenges, Quinn is not yet able to live apart
from his mothers care. A few of these challenges include Quinns inability to prepare his own
meals, manage his diabetes and respond appropriately to emergency situations. Nonetheless,
Quinn wants to begin making strides towards independence. These challenges stem from the
complications of Down syndrome and the effects an extra chromosome has on the brains ability
to function (Reed, 2014).
Down syndrome
Down syndrome is a genetic disorder in which the 21st chromosome has a three
chromosomes compared to the typical paired chromosomes. Down syndrome results in
intellectual disabilities and abnormal development (Reed, 2014). Quinns doctor has classified
Quinns intellectual disability as moderate. Individuals with Down syndrome have spectrum of
abilities, some can read, others can write, while some can do neither (Global Down Syndrome
Foundation, 2015). Quinns abilities include, but are not limited to, the ability to speak, interpret
words up to a second grade level, interpret photos, and engage in dynamic conversations.

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Diabetes Mellitus

Type 1 diabetes mellitus also complicates Quinns daily regime. Type 1 diabetes occurs
when there is a breakdown in the bodys ability to secrete insulin, an enzyme that is responsible
for breaking down glucose (Reed, 2014). Quinn utilizes an insulin pump for the delivery of
insulin to his body. Quinn requires insulin when his blood glucose level is too high, or he is
eating food with carbohydrates and his blood glucose level is just below average, average or
above average. There are numerous factors that play into the amount of insulin Quinn should
receive, because if he receives too much his blood glucose will drop dangerously low risking
sending him into a grand mal seizure. There are also risks for if he does not receive enough
insulin. Due to the gravity of medical management, Quinns mother takes full responsibility for
managing his insulin intake. Type 1 diabetes is one of the biggest limitations impacting Quinn
from achieving independence. However, Quinn and his family have decided to take it one step at
a time and address issues that can improve his quality of life and pursuit of independence.
Therefore, when Quinns sister asked him if he would like to learn how to cook, Quinn was
ecstatic and eager to learn. When cooking Quinn struggles remembering verbal one to two step
directions and requires demonstration of most steps. Quinns mother is a single woman, who
teaches middle school and is currently finishing an online masters program, needless to say, she
has limited time and patience to teach Quinn the skill of cooking. Quinn has an older sister that
is willing and able to teach him cooking skills; however, she lives in Nevada. In order to make
up for the distance and inability to be with Quinn as he practices cooking, his sister has designed
this pictorial based cookbook.

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Quinns Cookbook

The purpose of this invention is to help Quinn become more independent in meal
preparation, an instrumental activity of daily living. Quinn has the ability to interpret pictures,
the desire to learn how to cook and a goal of increasing his independence. With an
understanding of Quinns abilities and limitations, this pictorial-based cookbook was designed to
serves as visual guide for each step needed to prepare some of his favorite meals and snacks. The
more occupations Quinn can complete for himself, the closer he will be to reaching his goal of
living in an apartment with his best friend.
Each recipe is broken down into step by step pictures
that will enable Quinn to prepare his meal using visual aids.
Figure 1 is a photograph of Quinns cookbook. The recipes are
located in a three ring binder with each page inside a protective
sheet. This allows opportunity for additional recipes, room to
edit or clarify existing recipes, and replacement of recipes shall
Figure 1. Photo of Quinns
cookbook.

the pages become damaged. Behind each tab there is a different

recipe. The following recipes are included in Quinns cookbook
for breakfast, lunch, dinner and snack: waffles, egg and cheese
sandwich, bagel with cream cheese, salad, turkey and cheese
sandwich, peanut butter sandwich, noodle soup, southwest

chicken, hamburgers, chips and salsa, Fritos, banana, and strawberries. The difficulties of the
recipes range from a three step process (such as preparing a banana) to a 21 step recipe of
preparing a hamburger.

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This cookbook is not expected to replace the need for adult supervision when Quinn
cooks; rather, is it expected to serve as a guiding visual aid that will allow him to practice
problem solving, sequencing and execution of tasks needed to prepare food. With time, Quinn
may be able to cook without the need for supervision; however, safety risks and concerns need to
be addressed, such as Quinns ability to safely use a knife, operate a stove top, oven and grill,
before supervision is decreased.
Literature Review
There are numerous articles published regarding effective teaching styles for individuals
with intellectual and developmental disabilities. However, one of the biggest inhibitors to this
research pertains to the fact that each individual is unique and has their own spectrum of
abilities. There is not one specific way that will teach all children with Down syndrome how to
learn an objective. Two particular articles were found when reviewing literature to better
understand Quinns ability and the most effective way to help him learn.
The first article focused on individuals with Down syndrome ages 11 to 19 and their
reading skills compared to their comprehension skills. This took place over a one year time
frame. The results showed that reading and comprehension are independent of one another.
Meaning that if a person has the ability to read, this does not mean they have the ability to
comprehend. Results also showed that listening comprehensions is the best indicator of reading
comprehension. Therefore, poor reading comprehension was paralleled with poor ability to
comprehend auditory input (Roch, Florit, & Levorato, 2011). This published research is
particularly pertinent in Quinns case because it proves the correlation between Quinns poor
ability to read along with his poor ability to comprehend auditory input. Quinn struggles to be

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successful when direction is given verbally. Thus, supporting Quinns need for a pictorial based
cook book opposed to an auditory-based cooking guide.
Researchers are also studying the effects of visual aids in combination with naturalistic
teaching strategies. This pilot study assessed the effectiveness of parents implementing visual
aids and reminders within the natural context of the childrens home. The children in this study
were ages two to five with a developmental disability. Parents placed visual schedules in the
bedrooms of the children to prompt them to complete their morning routine and visual tasks
analysis in the bathroom to complete activities such as hand washing. The results concluded that
when naturalistic teaching strategies are combined with visual strategies, the children had more
success in following guidelines, and that communication skills for the children improved
(Meadan et al, 2014). This article was particularly relevant to Quinns cook book as his photos
were taken in two kitchens of which he is familiar. The more advanced meals that required stove
top or a microwave had photos taken directly from his home kitchen utilizing the dishware he
had available. Quinn also took part in modeling for the photography. Quinn is likely to have
more success in learning how to cook as his cook book photos he modeled within his natural
environment.
Similar Devices
Table 1 highlights related products, vendors, costs and limitations of each product. The
first product is the Photo Cookbook Application by a German company (Ditter Projektagentur,
2015). While the cost is very low, there are limitations. These limitations include the necessity
of a smart phone or device, yet Quinn has neither, and it is also not individualized. There is a
selected menu that has step by step photos; however, the measurements and details of the recipe
are not expressed through words. The ScanDo is an application not yet available to the general

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public. However, this application just received the Autism Speaks Investment App PitchJam
award for its innovation and relevance to people with autism spectrum disorder (Autism Speaks,
2015). This application scans bar codes and QR codes and directly links to YouTube how to
videos. For example, a code on the back of a pizza box will directly link to a video of that
product and how to cook the pizza. It will take time to establish a video bank, but with time this
will be a great option for people that learn best through video. Lastly the website,
www.picturetherecipe.com is a free web based site that has pictures for each step of the menu
(Tasteful Theme, 2015). However, this site would not be sufficient for Quinn as it requires
reading to ensure proper measurements and time for the recipe.
Table 1
Comparison of Similar Devices

Conclusion
Quinns cookbook is not a cure all, fix all occupational therapy intervention. Rather, this
cookbook will serve as a catalyst beginning Quinns pursuit of independence. There are similar
devices available on the market; however, none of them are specifically designed for Quinn and
his abilities. This is the first cookbook designed for Quinn. Future cookbooks or cooking videos
may be made dependent on Quinns interests and desire to pursue cooking.

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References
Autism Speaks. (2015). Autism app developers compete at autism speaks autism investment
conference. Retrieved from: https://www.autismspeaks.org/science/science-news/autism
app-developers-compete-autism-speaks-autism-investment-conference
Global Down Syndrome Foundation. (2015). About down syndrome. Retrieved from:
http://www.globaldownsyndrome.org/
Ditter Projektagentur. (2015). The photo cookbook: Quick and easy. Retrieved from:
http://www.thephotocookbook.com/
Meadan, H., Angell, M. E., Stoner, J. B., & Daczewitz, M. E. (2014). Parent-implemented
social-pragmatic communication intervention: A pilot study. Focus on Autism & Other
Developmental Disabilities, 29(2), 95-110. doi:10.1177/1088357613517504
Reed, K. (2014). Quick reference to occupational therapy (3rd ed.). Austin, TX: Pro-Ed.
Roch, M., Florit, E., & Levorato, C. (2011). Follow-up study on reading comprehension in
Down's syndrome: the role of reading skills and listening comprehension. International
Journal of Language & Communication Disorders, 46(2), 231-242.
doi:10.3109/13682822.2010.487882
Tasteful Theme (2015). Picture the recipe. Retrieved from: http://picturetherecipe.com/