Feeding therapy tip: if a child won’t eat with a spoon, use whatever he/she WILL accept. In this feeding session, for instance, his favorite spoon was at home and he didn’t like any of the other spoons we had. So, we tried a twizzler and voila! He ate the entire container of food.
You can also try dipping a Grabber, Y-Chew, or ARK Probe into whatever the child’s eating. Getting them to eat the food comes first. Getting them to use the right utensil can come later. For ideas on how to de-sensitize kids to plates, cups, utensils, etc., click here.
This friendly turkey is a quick and easy craft, both for Thanksgiving and beyond. You’ll need:
• Play dough of your choice (funky colors welcome)
• Two eyeballs
• Pasta of your choice
If you don’t have eyeballs, you can substitute for beads, etc. If you don’t have the pasta shown, you can substitute for almost anything you do have. There’s no “right way” to do this. The beak we made from a broken shell-shaped pasta piece.
Have the child pick up each piece individually and place it in the play dough to practice fine motor skills. Use textured pasta to add a sensory component to the activity. Give the child one or two step instructions to practice following directions and sequencing. And of course, this turkey is a great opportunity to practice language skills as well!
Having a child with feeding issues is one of the hardest problems to handle both for therapists and parents, and it’s stressful for the child as well. Our lives often revolve around food! And so does healthy growth and development. I commend you for looking for more information on this topic and hope that you find this post helpful. So, take a deep breath and let’s roll up our sleeves.
Before we begin, please keep in mind that only a speech language pathologist (SLP) who can evaluate your child in person will be able to tell you why he/she is refusing foods. If you are concerned that your child has eating problems, please consult with your pediatrician and ask for a referral to see a SLP with feeding experience. If it’s sensory-related, you’ll likely want/need an occupational therapist (OT) involved as well.
In the meantime, I can tell you that the children who I see with feeding issues typically fall into one of two camps (or a combination of the two): oral motor issues and/or sensory issues. Below is some information that you may find helpful, along with strategies that have proven successful with the children I personally see and treat (assuming that all medical issues, such as reflux, GI problems, medication side effects, etc. have been ruled out / managed already):
Question: I have a 2 year old on my EI caseload, our program purchased the z-vibe kit for him. He is demonstrating some sensory aversion, drooling, and an open mouth posture with tongue protrusion. His tongue protrusion is beginning to affect production of his speech sounds. Are there any specific exercises I can have him do to decrease tongue protrusion? Thank you so much for your help!
The issues you mentioned are likely all connected. Let’s tackle the tongue protrusion first. In order to help you visualize what he needs to work on: hold your mouth open, bring your tongue forward between your teeth, and have the tongue tip/blade rest on your lower lip. Now pull it back into your mouth with your tongue tip and front part of the tongue blade positioned on alveolar ridge (the gum area right behind the upper front teeth). Commonly known as “SPOT,” this is where the tongue tip should be when we’re not eating, drinking, or speaking. It’s also where the tongue tip sounds (t,n, d, s, z, l) are made.
There are many strategies you can use to get the tongue toned, tightened, and retracted so that it’s on SPOT. The first thing I always recommend is to get him on straws, as these naturally encourage oral motor skills and decrease tongue protrusion. If he doesn’t drink from a straw yet or if he has a weak suck, our Bear Bottle Straw Cup makes the transition easier.
We drew up some spooktacular FREE printables for you all! Introducing: Frankenstein (“Frankie”) and his Bride. Each character is available in both blank and colored in, all of which can be downloaded here. Read below for ideas on how to use them for Halloween-themed learning activities:
To encourage speech and language:
• Print off the blank characters and have the child color them in. Let them use their imagination, or throw in one or two step prompts to practice following directions (“color his hair first and then his nose”)
• Put the two characters next to each other and work on pronouns (his versus hers), body parts, etc.
• Put a blank piece of paper underneath the heads and prompt the child to finish drawing the rest of their bodies (this is called visual closure).
• Give them names and come up with a story behind them.
• Talk about what’s silly (their hair, coloring, bolts, etc.).
• Make them into masks (cut out the faces, punch holes in the ears, and tie a string from ear to ear).
For fine motor fun:
• Use Frankie and Mrs. Frankenstein for a lacing activity. Laminate them, punch holes around the edges of the paper, and then have the child lace through the holes with a shoelace. Lacing is also an excellent bilateral coordination activity.
• Use wikki stix to outline their eyebrows, the stripes in their hair, lips, blush, etc.
For sensory play:
• Let the child fill in the faces with various textured objects/items: shells, beads, small crumpled up bits of paper, cotton balls, etc.
• Use them as a template for food play to help kids with food aversions become more comfortable with different textures. Put cheerios in their hair. Cheese doodles for the bolts. Veggie sticks for Frankie’s smile. Give Mrs. Frankenstein fruit loops or licorice hair.
With just over two weeks left before Halloween, now is a good time to help children get ready for trick-or-treating. Some of my kids say “fick or feet” or “sick uh seat” or “twick or tweet.” So we’ll spend time practicing how to say “Trick or Treat” correctly (or the best way they can to be understood).
I also role play to help them be better prepared. We take turns re-enacting how they will walk up to the door, knock or ring the doorbell, say trick or treat, follow directions (such as to pick one or two pieces of candy), AND say thank you with good eye contact.
It takes a while the first session to get it down, but only 2-3 minutes to review it in following sessions. And it gives the child a sense of accomplishment, decreases any anxiety they may have, and gives them confidence so Halloween can be all about fun!
This puzzle wasn’t early-intervention-friendly enough for me – the insets were just a boring tan / wooden color! So I colored in the insets to give kids more of a visual cue to complete the puzzle. Now they can match the blue dog puzzle piece to the blue dog picture, the green fish piece to the green fish picture, etc.
If the puzzle doesn’t have any images in the insets at all, just take a picture of the puzzle piece, print and cut it out, and tape/glue it in the inset. In the above picture, for instance, the small beach ball and bear are cut out of paper.
You can also added velcro for an extra fine motor, tactile, and sensory element. Simply attach a fuzzy piece of velcro to the back of each puzzle piece, and a corresponding scratchy piece of velcro to the insets. This way the fingers have to work a bit harder to remove the pieces. Velcro is also very sensory – both in the sound it makes to pull it off, and in how it feels to the touch. As an added bonus, the puzzle pieces are less likely to get lost now, too!
These Cork Button Castles are a fun and effective DIY fine motor activity. Not only are the fingers and the fingertips in charge, but the Velcro also provides an added level of resistance to really make their intrinsic muscles work. A big thank you to the amazing blog No Time for Flashcards for the inspiration!
What you’ll need: Velcro circles, tapered corks, and buttons (these cute ones are from Michael’s)
This young man has a jaw slide, meaning that his jaw shifts either to the left or to the right when he talks. Since the tongue is connected to the jaw, the tongue follows the jaw, also shifting to the left or right. Why is this a problem? Speech sounds are properly articulated when the jaw and tongue are midline and symmetrical. If the jaw and tongue shift to the side during speech, certain sounds may seem slushy and unclear. So in order to clearly articulate sounds, we’ll need to stabilize his jaw at center. To work on jaw stability:
1. Put the extension of the Grabber (or Y-Chew or Probe) in between the molars, as shown in the pictures above. Ask the child to bite down and hold for a count of 10. Repeat a total of 3 times on each side. If necessary, provide support to the chin with your free hand.
2. As you try this exercise, check to make sure that the space between the upper front teeth is lining up with the space between the lower front teeth. If it’s not, switch to using the loop of the Grabber instead, and place it in the front of the mouth (see the picture above). This position will force the child to bite on both sides at the same side so the jaw can’t shift and will instead stay centrally aligned.
3. You can also do this with the extension of the Grabber (or Y-Chew) placed laterally in front of the mouth (as shown above).
4. Finally, another way to stabilize the jaw is to use two Grabbers (or Y-Chews or Probes) simultaneously – one of either side of the mouth in between the molars. This is essentially step 1, only with a tool on both sides of the mouth.
As always, keep in mind that you may have to start with a shorter count, and work up to 10. If you only get a couple counts, that’s okay! Make a note of the progress, and try to do more in the next practice session.
A note on counting: you’ll notice that I don’t always have the same beat to my counts in the video. If I sense that the child is losing interest, I mix things up to refocus their attention. You can change the beat, count faster or slower, say it with a deep voice or a high voice or anything in between, count backwards, use funny voices, and so forth. Just have fun
Finger isolation is the ability to move certain fingers independently from the rest of your fingers. It’s an important skill in a variety of everyday activities, such as pointing, activating toys, pressing the button in the elevator, dialing a phone, writing with an efficient grasp, etc. And also for more complex tasks such as typing or playing the piano.
The index/pointer finger is what we focus more on in OT for the development of appropriate play and the pincer grasp. Isolating just the index finger is usually developed by 9 or 10 months. Isolating all fingers should be developed by age 5.
One of my favorite ways to practice finger isolation is with the DIY below. It’s simple yet effective, and has been in my OT bag for years.
1. Source a cute container. This particular one was perched on a shelf at JoAnn’s Fabric. The Dollar Store is also a great place to look. Technically any container with a flexible lid will work, but character-themed ones tend to be more appealing and motivating for kids. With this one, for instance, we can say, “It’s time to feed Mr. Owl!” Or, “Mr. Owl is hungry, he needs his lunch!”
The information contained in this blog is offered in good faith and represents only the author's current understanding of best practices in speech, oral motor, and feeding therapies. Please keep in mind that the content presented here is not all-inclusive. In most cases, it is best to see a Speech-Language Pathologist, Occupational Therapist, or another trained professional in person for a full assessment, individualized treatment plan, and appropriate intervention strategies.
Links / references to this site are welcome and encouraged, but please give credit back to www.ARKTherapeutic.com.
ARK Therapeutic Services, Inc. is a leading manufacturer of speech therapy products, oral motor tools, and other healthcare products. All products manufactured by ARK are made from medical grade resins that contain no lead, phthalates, PVC, BPA, or latex. ARK Therapeutic is registered with the FDA and its products, where applicable, are registered with the FDA.