75+ Feeding Therapy Tips & Strategies

For any therapist seeking to specialize in feeding, the best piece of advice I could give you is to become a sponge.  Take courses and workshops, read as many articles as you can, talk to and learn from your colleagues, join special interest groups on Facebook and ASHA etc., follow blogs, observe other therapy sessions, and don’t forget – learn from the children you treat as well.  They will be your best teachers.

 

Feeding issues are complex.  So take in as much information as you can from as many outlets as you can.  But, take it all in with a grain of salt, because not every strategy will work for every child.  Over the past 35 plus years, a number of people have told me that their way was the only way.  Although that certainly would have made my job easier if it were true, I’ve never been able to use any one method “by the book.”  Each child is different, so it will be up to you to evaluate their needs and cater treatment accordingly.

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Tips for Toothbrushing with Oral Defensiveness

Oral defensiveness falls into two main categories: HYPOsensitivity and HYPERsensitivity.  Individuals with hyposensitivities have low oral tone and very little awareness of what’s going on inside their mouths.  This “oral numbness” so to speak can cause anxiety and fear when it comes to toothbrushing.  On the other hand, individuals with hypersensitivities are overly conscious of and sensitive to oral stimulation.  Even the slightest touch can be overwhelming and even painful.  In both cases, it is important to normalize sensation within the oral cavity in order to take care of those pearly whites!
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How to Teach Biting and Chewing Skills

For infants, learning how to bite and chew is a crucial stage of feeding development.  At approximately 5-6 months of age, babies begin using their fingers and teethers for oral exploration using a bite and release pattern.  The development of biting and chewing continues from this point on, with the baby refining the movements of the jaw, tongue, and lips.  When infants miss a part of this developmental process, intervention may be necessary to develop the ability to bite and chew.

 

Teach Biting & Chewing Skills

1.  One of the ways I like to begin is to provide the child with the opportunity to mouth ARK’s oral motor chew tools (the Grabber, Y-Chew, Probe, and/or Animal Tips).  These tools were specifically designed to increase oral awareness, to provide stimulation and tactile sensation, and to exercise the lips, cheeks, tongue, and jaw.  Through oral exploration, the child just might begin to bite on his/her own, and from there you can progress to chewing.

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Oral Defensiveness & Aversions with Sensory Processing Disorder (SPD)

Oral defensiveness falls into two main categories: HYPOsensitivity and HYPERsensitivity:
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•  Individuals with hyposensitivities have low oral tone and very little awareness of what’s going on inside their mouths.  This “oral numbness” so to speak can cause significant speech and feeding delays.  For example, the ability to create a food bolus is a critical oral motor skill necessary for swallowing.  But how can I teach this skill to an individual who cannot feel his tongue?  Lack of awareness can also lead to mouth stuffing, leftover food particles in and around the mouth, drooling, etc.  In these cases, it is important to increase oral awareness by providing varied oral input and sensation throughout the oral cavity.  It is at this point, however, that hyposensitive individuals can become orally defensive.  Because they are not used to new feelings and sensations inside theirs mouths, they may be afraid/unsure of the sensations and therefore refuse intervention.

•  On the other hand, individuals with hypersensitivities are overly sensitive to oral stimulation.  Even the slightest touch might be uncomfortable and even painful, which can lead to texture/food aversions, picky eating, and speech and feeding delays.  Let’s say, for instance, that an individual needs to work on tongue lateralization.  To do this, I usually use an oro-Navigator to guide the tongue to one side of the mouth and then to the other.  Or, I’ll place the Probe Tip inside the cheek area and tell the individual to touch it with the tip of his tongue.  But how can we do these exercises if the individual won’t allow anything near his mouth because it hurts?
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Although these two forms of oral defensiveness are different, intervention is quite similar for both – you need to get into the mouth and provide input in order to normalize sensation.  As you proceed with the strategies below, keep in mind that there is no one approach or one answer.  Each individual has different needs that will in turn require a different approach.
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