Re: Need advice on mouthstuffing & insufficient chewing

[Guest guest]

Have you used an OT for your son, my son used to gag on everything but he

never stuffed his mouth, he would choke on a pea!!! Anyway the OT really

helped, they do amazing things. I don't think the stuffing his mouth is an

issue that the slp should be dealing with(but not sure). Kate.

[Guest guest]

My first reaction is to give him each bite yourself, one at a time.

That said, our EI therapist used to tell me that overstuffing is

common with apraxic kids. She said it has to do with oral

stimulation, and them needing to get enough food in there to be able

to feel it and control it in their mouths. For example, my son

(diagnosed apraxic at 18mos - now 3yo) has muscle weakness in his

mouth. He does much better with bigger bites - but not huge. He

also will swallow gum - I think it's just too small for him to

control. He has food texture issues, and will gag if the texture

isn't just right - mashed potatoes are the worst, no matter what size

the bite is.

Try giving him each bite at whatever size you think is good, and see

how he does with controlling it in his mouth.

I'm not an SLP - just a mom sharing my thoughts.

Take care,

TJ

> Any tidbit of info ANYONE can give me would be greatly appreciated.

My

> 27 mo old son has been diagnosed with hypotonia and dev delay. I

also

> have just requested a behaviorist to assist with his ongoing

> speech/feeding and spec. ed. sessions. Beyond the speech and dev

issues

> my son does not chew properly and insists on stuffing his mouth

with way

> more food than he can safely handle without risk of choking. You

can see

> that his eyes water when he swallows because it hurts. His SLP told

me

> today that she has no idea how to get him to chew more.

[Guest guest]

Hi Dani,

My son, 5, also has global delays and hypotonia, but also apraxia. I

will think on this problem you mentioned a bit more. I just wanted you to

know that I am there, too. also takes bigger bites than he should and

used to gag a LOT, but he seemed to outgrow a lot of it. will not eat

crackers, raw carrots, potato chips, or anything that is very crunchy. But

what he does eat he tends to put too much in his mouth. Someone once said

in this group (I think) that these children are maybe UNDERsensitive around

the mouth area and truly can't tell how much food is in their mouths. With

, I have tried to DEsensitize him over the years by constantly touching

in and around his mouth area using massage or with a toothbrush, brushing

the insides of his cheeks. When your son is maybe laying quietly in your

lap or watching TV, you could start him on this. If I think of anything

else, I'll let you know!

~~

in PA

[Guest guest]

Dear TJ,

Thank you so much for responding! I do try to feed him as often as I

can but he usually INSISTS on feeding himself or he won't eat at all.

Even when he does let me, the anticipation of the next bite makes him

swallow what he has without chewing it at all. I completely agree with

your theory on mouthstuffing. I have always felt that it was maybe a

satisfaction issue especially because I have to cut his food into

" swallowable " pieces just in case he decides not to chew at all. Does

you son still overstuff if he feeds himself? Are there any chewing

exercises that you found to have worked? Please let me know, and thanks

again for the advice!

Sincerely,

Dani (mom of , 27 mos)

[Guest guest]

My 5 year old was a total mouth stuffer! We had to sit with him when

he ate and put one or two bites on his plate at a time so he could

still feed himself. I still have to " watch " him if I load his plate

with food. At this point certain foods are more likely for him to

stuff- waffles, meat, beans etc.

Work with your child everyday to use a straw and blow bubbles. He

can do it.

My other 6 year old wasn't a " chewer " . He told me he hated the way

the food felt on his tongue- so he'd just slip it down his throat,

but he got chubby from that technique!

If you really think that he isn't " absorbing and gaining weight "

because of his unchewed food, then give him some pureed type food too-

apple sauce, mash potatoes, in addition to foods that will give him

practice chewing. If that doesn't help, you should look into

his " absorbtion " issue further. Absorbtion problems can cause

developmental delays, so it might be the other way around for your

child.

> Any tidbit of info ANYONE can give me would be greatly appreciated.

My

> 27 mo old son has been diagnosed with hypotonia and dev delay. I

also

> have just requested a behaviorist to assist with his ongoing

> speech/feeding and spec. ed. sessions. Beyond the speech and dev

issues

> my son does not chew properly and insists on stuffing his mouth

with way

> more food than he can safely handle without risk of choking. You

can see

> that his eyes water when he swallows because it hurts. His SLP told

me

> today that she has no idea how to get him to chew more. She works

very

> hard to get him to cooperate but to no avail. I know of so many

> exercises to strengthen his jaw but none can be used until he

learns the

> basics. I've been told of chewing gum - he swallows it. Eating

bagels -

> he doesn't chew them well and chokes. Drinking thick liquids

through a

> straw - we haven't been able to teach him to drink from a straw

yet. He

> loves food and is a very good eater. At most meals he eats more

than the

> adults. Unfortunately, his lack of chewing hinders the absorption

of a

> lot of what he eats so he doesn't weigh nearly as much as he should

for

> his caloric intake. Does anyone know what to do? The SLP is at the

end

> of her rope and so am I. I don't think my nerves can handle another

> heimlich. Any suggestion?

>

> Sincerely,

> Dani (Mom of , 27 mos)

[Guest guest]

Hi Dani,

You only want a tidbit of information? OK-I'll try to keep this

short like I always do.

When Tanner was three years old he was diagnosed by SLPs and neuro

doctors (a few of both) with verbal and oral apraxia (severe)

hypotonia (most in truncal area and face) and sensory integration.

Tanner's five years old now and we still sometimes have to remind him

not to put so much in his mouth. He was a big time mouth stuffer all

the time when he was two or three years old though. Tanner's

therapist told me there are a few reasons why Tanner would do this.

One was for stimulation-and one was that he didn't sense the food in

his mouth the way we would. What helped stop this was increasing the

stimulation in other ways. There are a number of suggestions from

Tanner's therapist Ortega MA CCC SLP at

http://www.apraxia.cc under index-and then under therapies-and then

look for mealtime or feeding tips. (Dr. Katz's intro to EFAs is

there now too!)

In addition to what is at the website - we used to use the massage

vibrators on Tanner's face and lips. I know some children may hate

this-but Tanner still loves this. He pushes his face and lips into

the vibration. We used the Dr. Scholls vibrator which looks kind of

like a base ball cut in half. It's just this flat round thing that

you can hold in the palm of your hand. I also found this Garfield

one where the feet vibrated. Then of course there is the vibrating

tooth brushes. This is in addition of course to all the Oral Motor

Therapy.

A really good thing was these lollypop holders that play music or

sounds which the child hears when they have the lollypop in their

mouth. Below is an old post of mine from last Halloween about these

cool lollypop holders -I'm not sure if they are still available or

not.

=====

[Guest guest]

You have gotten some really great advice!

I just wanted to note that my son has sensory issues with food

textures - he prefers crunchy, gags on mushy.

I agree that an OT should be first to deal with these issues. The OT

who evaluated my son said his SI wasn't enough to disrupt his day to

day life (or anyone else's), so we didn't receive OT. The speech

therapist through EI worked with him on EVERYthing, though. She was

wonderful - I wish EI went longer than just 3 years, especially when

you only get them at 2yo!!

I also agree with the mouth stimulation with the toothbrush. We also

used a Nuk - I guess it's an infant type of toothbrush. My son LOVED

that, and chewed on it constantly. He still would today, but he

figured out how to make the end pop off, so we don't give it to him.

He's either constantly chewing on something, or asking for something

to eat or drink. He just craves that oral stimulation.

Again, Good luck!

TJ

> Any tidbit of info ANYONE can give me would be greatly appreciated.

My

> 27 mo old son has been diagnosed with hypotonia and dev delay. I

also

> have just requested a behaviorist to assist with his ongoing

> speech/feeding and spec. ed. sessions. Beyond the speech and dev

issues

> my son does not chew properly and insists on stuffing his mouth

with way

> more food than he can safely handle without risk of choking. You

can see

> that his eyes water when he swallows because it hurts. His SLP told

me

> today that she has no idea how to get him to chew more. She works

very

> hard to get him to cooperate but to no avail. I know of so many

> exercises to strengthen his jaw but none can be used until he

learns the

> basics. I've been told of chewing gum - he swallows it. Eating

bagels -

> he doesn't chew them well and chokes. Drinking thick liquids

through a

> straw - we haven't been able to teach him to drink from a straw

yet. He

> loves food and is a very good eater. At most meals he eats more

than the

> adults. Unfortunately, his lack of chewing hinders the absorption

of a

> lot of what he eats so he doesn't weigh nearly as much as he should

for

> his caloric intake. Does anyone know what to do? The SLP is at the

end

> of her rope and so am I. I don't think my nerves can handle another

> heimlich. Any suggestion?

>

> Sincerely,

> Dani (Mom of , 27 mos)

[Guest guest]

Dani,

Hi - Where do you live? I'd be happy to give you the name of SLP's who

specialize in

oral-motor/feeding/ sensory issues. Safety is so very important, as you know!

There are oral-motor exercises and feeding protocols that can assist, &

consulting with a behavorist who can collaborate w/ an SLP & OT is a good

plan. " Stuffing " is common among many of our 'low tone' kids, seeking

increased sensory input - a SI program (sensory integration) may prove to be

helpful...There are specialists to guide you & your son on a specific therapy

treatment program. Feel free to email me or I'll check this list serve

again, to see where you are located.

Best regards,

PS: Suggestion - go w/ your instinct & don't give foods that he

chokes on, until you have an oral-motor/feeding therapy program in place.

Oral motor exercises to facilitate strength, & jaw-lip-tongue disociation

typically proceed feeding more " challenging " foods - please email me if this

doesn't make sense! zimetslp@...

Any tidbit of info ANYONE can give me would be greatly appreciated. My

27 mo old son has been diagnosed with hypotonia and dev delay. I also

have just requested a behaviorist to assist with his ongoing

speech/feeding and spec. ed. sessions. Beyond the speech and dev issues

my son does not chew properly and insists on stuffing his mouth with way

more food than he can safely handle without risk of choking. You can see

that his eyes water when he swallows because it hurts. His SLP told me

today that she has no idea how to get him to chew more. She works very

hard to get him to cooperate but to no avail. I know of so many

exercises to strengthen his jaw but none can be used until he learns the

basics. I've been told of chewing gum - he swallows it. Eating bagels -

he doesn't chew them well and chokes. Drinking thick liquids through a

straw - we haven't been able to teach him to drink from a straw yet. He

loves food and is a very good eater. At most meals he eats more than the

adults. Unfortunately, his lack of chewing hinders the absorption of a

lot of what he eats so he doesn't weigh nearly as much as he should for

his caloric intake. Does anyone know what to do? The SLP is at the end

of her rope and so am I. I don't think my nerves can handle another

heimlich. Any suggestion?

Sincerely,

Dani (Mom of , 27 mos)

[Guest guest]

>Any tidbit of info ANYONE can give me would be greatly appreciated.

>My 27 mo old son has been diagnosed with hypotonia and dev delay. I

>also have just requested a behaviorist to assist with his ongoing

>speech/feeding and spec. ed. sessions. Beyond the speech and dev

>issues my son does not chew properly and insists on stuffing his

>mouth with way more food than he can safely handle without risk of

>choking.

Hi Dani and Welcome,

Last month this discussion came up and I posted this information to

the group list. Perhaps you can find some answers at these Feeding

Disorder Websites I posted below. Also check the archives for

additional information and see what comes up on this topic. To search

the archives go to

In your search, I hope you find the answers you are looking for!

Best Wishes, Mustafa

Khalid ( will be 15 yr. just 2 days! ) Jadd ( 7.6 ) Danya ( 10 )

( Both my sons are apraxic and doing well )

Oral Motor Excercises:

http://www.suite101.com/article.cfm/speech_language_disorders/41710

Oral motor excercises are occasionally necessary for weak articulators

or muscles in the mouth and face for speech production. They sometimes

need strengthening, need to move farther and/or have better

coordination. These can help a child make speech sounds better

as well as help with the eating/feeding/swallowing problems some

children have difficulty with. Below are listed some things you can do

with any child just for fun to help improve their oral motor skills.

These are some of the excercises I have used in therapy and you can

usually use them with kids aged three and up. If the child is not too

good at following directions you may not want to try these until they

can follow simple directions well. They do not even need to be in a

speech therapy program either because these are things all children

would love to do.

1) Blowing bubbles. This works on working the muscles that make our

lips round like for the /w/ sound. It also makes us use better breath

control.

2) Licking peanut butter or marshmallow crème with the tongue only (no

fingers) after a glob of it has been placed on the roof of the mouth

or behind the top front teeth. Works on tongue elevation/lifting and

if you put it over in one cheek for example, it works to help

lateralize the tongue/move it to the side.

3) Put cheerios or apple jacks on the table and have the child " spear "

one with his tongue. No hands or lips can be used. Child has to learn

to aim and protrude tongue past the lips.

4) Roll little round suckers like " dum dums " around the mouth back and

forth from in one cheek to inside the other using only their tongue.

Should be able to see the sucker pushing against the cheek if they did

it successfully. Also works on lateralization and coordination of

tongue movements.

5) Rub syrup or frosting or peanut butter on outside of lips (red/pink

part) so child must lick lips with tongue to clean them off. No hands

for this either.

6) Lick ice cream as it drips down the side of the cone on a hot day.

Can't use lips- tongue only.

7) Pretend to make faces at one another while you look in the mirror.

Make the silliest ones you want.

These are a lot of fun and a way to get the family involved in therapy

too if your child has been tested and could benefit from some oral

motor therapy. If your child has feeding/swallowing /eating

difficulties do not try this unless approved by your therapist.

Chances are he/she will personally train you in tasks to help them

anyway. If your child does not need speech therapy it is just a way to

have goofy fun together time. Enjoy!

( may need to cut and paste links )

Information on Feeding Disorders:

Kennedy Krieger Feeding Disorders Specialists:

Bart Sevin, Ph.D.

Email: sevin@...

http://www.kennedykrieger.org/

S. Gulotta, Ph.D.

E-mail: gulotta@...

http://www.kennedykrieger.org/

Dr. M. Katz, M.D., M.S.B., F.A.A.P.

http://www.kennedykrieger.org/

Kennedy Krieger Institute Pediatric Feeding Disorders Program

http://www.kennedykrieger.org/

Feeding Young Children with Special Needs

http://www.hs.state.az.us/cfhs/ons/defi-e.htm

New Visions:

The Development of oral motor skills

in children receiving non oral feedings

http://www.new-vis.com/ws/p-orlmtr.htm

New Visions:

Why Evaluate and Treat Mild Feeding Delays and Limitations

http://www.new-vis.com/fym/papers/p-feed6.htm

New Visions:

Feeding and Speech Relationships

http://www.new-vis.com/fym/papers/p-feed8.htm

Feeding and Related Medical Issues

http://members.home.net/dinack/feeding.htm

Feeding Disorders Clinic

http://www.chob.edu/Clinical_Services/feeding.html

Book:

The Educator's Guide to Feeding Children with Disabilities CCC-SLP

http://www.brookespublishing.com/store/books/lowman-3750/index.htm

Nutrition and Feeding for Persons with Special Needs: A Practical

Guide and Resource Manual. Nutrition Education and Training

Program, South Dakota Department of Education, Child and Adult

Nutrition Services, 1992. To order contact: Child and Adult Nutrition

Programs; (605) 773-3413.

[Guest guest]

Hi Kate,

Thank you for your response. I am really seeing that this has all been

handled the wrong way. I'm calling my EIP coordinator first thing Monday

morning to ask for an OT eval.

Dani (mom of , 27mos)

L.I.,NY