Innovative Therapy Services

Dealing with oral motor issues at home is quite complex and can be very frustrating, particularly if everyone around is convinced that your child is just faking the problem or seeking attention. Childhood oral sensory disorders and feeding related issues that may accompany this disorder can go undetected for several reasons, especially if the child does not exhibit other delays. It is often thought that the child will out grow the problem. Now let be clear there are certain times children will just refuse to eat certain foods, especially around ages 3-5, when they are learning to exert their new found “will” power. Kids exerting their will power and also going through the “I am not hungry stage,” may take few bites and if parents add their favorite snack along with it a little ketchup etc., the child may willingly eat the food with no other symptoms. Some children at times may need a little more bribery during this phase. This is also considered normal childhood behavior. However, children with oral sensory disorders will continue to exhibit very difficult behaviors around meal times and things having to do with input to the facial mask areas (cheeks, face, lips mouth tongue, palate etc). Typically the behaviors may include:

1. Prefer only one type (e.g., dry, crunchy) of textured foods
2. Exhibit excessive oral habits (e.g., bite sleeves and buttons from shirt and other toys)
3. Abnormal tongue posture ( often sucking their tongue)
4. Mouth breathing
5. Teeth brushing is a nightmare
6. Face washing is a disaster
7. Easily gags on food

Looking at the above list you can see why some children with oral sensory related issues may go unidentified, given that some of the listed behaviors can apply to any child at any given time in their life. That is very true! While some of the above behaviors can be seen during the infant years, and even at early toddler years, it is expected as the child’s motor system matures, so should the oral sensory system.

While I believe that all children have their own internal developmental time line, based on current research and findings it is important to take a second look at a child’s oral motor skills at each developmental stage, just like we check their weight, height and other developmental milestones. Looking at a child’s oral motor developmental history can help parents address feeding related issues early on and prevent oral motor behaviors that may result from unresolved oral sensory issues. A good oral motor examination will also explore the following:

1. Birth history
   Breastfeeding/bottle feeding history
   Motor developmental history
   History of reflux
   Prolonged illness
   Frequent upper respiratory infections
   Frequent allergies
   Adverse reactions to different textures to the body and face
   History of choking (as infant)
   Difficulty transitioning to different textured foods (stage 1, stage 2 etc.)
   Tongue thrust

If you truly suspect your child’s refusal to eat his vegetables/food, brush teeth and mouthing things goes beyond just normal typical child behavior it is OK to seek professional support. Oral motor sensory difficulty can be hard to diagnosis in normal children who do not exhibit neurodevelopmental delay. Oral motor sensory issues can occur with children who have had prolonged hospitalization, Tube feeding, neurodevelopmental delays and it can occur without the existence of other developmental disabilities.

The following books are recommended to parents:
 Childhood Motor speech Disability, by Russell J. Love
 Just Take a Bite, by Lori Ernsperger (Author), Tania Stegen-Hanson (Author)
 How to Get Your Kid to Eat: But Not Too Much (Paperback) by, by Ellyn Satter

If you are interested in more information on oral motor feeding or oral sensory issues please contact me by e-mail.

By Uduak Osom,
Owner/Director,
Innovative Therapy Services