Ways to Incorporated More Oral Input at Home

Exploration of objects via the mouth is a typical part of development and for infants it is crucial for their oral motor and sensory development. However, as we age the amount of oral exploration and input we need typically decreases.

Our oral sensory system does many things; it helps us identify temperature, taste (sweet, bitter, sour, salty, savory), and texture (smooth, hard, crunchy, mixed…).  It plays a role in our food preferences, calming/regulating abilities, speech sounds, teeth brushing, and other areas of our daily lives.  Additionally, our muscles and joints of our mouth and jaw can send a large amount of Proprioceptive to our brains.  Proprioceptive input can play a key role in helping our bodies and brains regulate, attend, focus, and process other information.

Children’s oral sensory needs can vary from seeking to avoiding to mixed; however, today we are going to look broadly at the oral seeker and simple ways to incorporate more oral input at home.

In order to help satisfy the sensory needs of an oral seeker there are some easy ideas to try:

• Crunchy foods (carrots, jicama, pretzels, these increase the proprioceptive input that is sent to the brain which is a go to for regulation
• Gum (for your older children that demonstrate the oral motor skills and safety with it), provides repetitive proprioceptive input
• Straws (coffee straws, cups with straws, thick milkshake straws, crazy straws, you name it), these easy to add suction tubes are great ways to allow a child to utilize many muscles of their mouth to drink. **the thicker the beverage (think smoothie, applesauce or yogurt consistency) or the smaller the straw opening (think coffee straw) the more work the mouth has to do to pull it through the straw thus the heavier work they will require and input that will be sent to the brain.
• Chewy tubes or chewlery, these allow children an appropriate way to channel their NEED to chew verses chewing on objects, shirts, clothes, and other things.
• Vibrating toys or toothbrushes, these allow for increased input and stimulation (it can be as easy as incorporating a vibrating toothbrush into their morning and evening teeth brushing time or having a toy or z-vibe that provides the vibration and chewable surface).
• Allow opportunities for children to do heavy work (this is pushing, pulling, lifting, resistance activities against the body, running, swimming, and things that require muscle/resistance), often times where there are oral sensory needs, there are sensory needs elsewhere in the body as well (and heavy work is a great place to start)
• Change up the temperature, try providing frozen foods (frozen veggies, frozen fruits, smoothie popsicles, yogurt popsicles, etc.) or ice-cold beverages can be alerting and provide more input to the sensory systems of the mouth
• Use the mouth during activities (blow up balloons, blow bubbles, make silly/exaggerated faces, whistles/harmonicas/kazoos, hum, make sounds with the mouth, and use those muscles in different ways).
• And last but not least, know that oral sensory input is a typical way many of us regulate, focus or attend we do it to differing degrees (we all know the person that ALWAYS chews gum, or snacks while they study, or bites their pens/pencils, etc.). Find what works and is an appropriate method of receiving effective and safe input for your child.

If you have kids that overstuff their mouth at the table or seems to gravitate toward only crunchy or chewy foods, you can work on strategically providing increased oral input prior to mealtimes to stimulate, alert, and “feed” the mouth with sensory input.

Also, make sure you talk with your friendly Occupational Therapist or Feeding Therapist so they can individualize and more accurately provide additional strategies and education.

Allison Heitzinger MS., OTR/L

Occupational Therapist and Feeding Therapist

Often parents think that if their child gets in–school Speech and/or Occupational Therapy that their child would not benefit from in-clinic therapy. There are many advantages of getting therapy in-school and in a clinic based setting. Therapists welcome collaboration between school and clinic therapy, which in turn helps your child receive the best care.

The first benefit of your child receiving both in-school and in-clinic therapy is increased frequency. Therapy in the school is usually a group setting of children who are working on individual and group goals. These goals are often academic based and don’t touch on the entire scope of your child’s development.

When your child receives therapy in a clinic based setting, your child is getting one on one therapy. This therapy is based on the whole child’s wellbeing. Children attending multiple therapies per week benefit from having increased frequency of therapy. Children also tend to make greater gains in meeting their goals with multiple therapies and in a shorter period of time.

As your child starts to meet their goals, therapists look across each environment to see if your child has mastered a skill. Having children attend therapy in two environments can aid in their generalization.

Therapists in schools are often limited in regard to which skills they can work on with your child. Clinic based therapists are able to work on more of the functional goals which in turn addresses more areas. Often times clinic-based therapists will reach out to the school therapist and vis-versa. The collaboration between the two therapists can ensure that your child is receiving the best care possible.

As the parent/guardian, it’s important to let each therapist know all the places your child is receiving therapy. The more information given about your child, the more help your child gets to reach their goals!

Problem Feeder vs Picky Eater

Many families often question their child’s food preferences. It is very common for children to become very unpredictable and many go through a picky eating phase.   Sometimes it can be more serious than that and can be more of a feeding problem.  If you suspect it is more of feeding difficulties the best thing to do is keep a food journal and track your child’s eating behavior. You can then bring up your concerns with your healthcare provider. You may be referred to an Occupational Therapist or Feeding Therapist who can provide therapy to discover new and healthy foods. This can also help to improve your child’s overall nutrition so they can continue to grow and thrive.

Here are some great tips to look for when trying to figure out if it’s your child being a picky eater or your child being a problem feeder.

Problem Feeders

• Cannot tolerate being around people eating foods they don’t like.
• Refuses to eat particular food textures or colors.
• Eats less than 20 foods.
• Gags or even vomits when eating certain foods.
• If your child is progressively phasing out foods and their diet is becoming extremely limited in variety and color.

Picky Eaters

• Can manage new food on their plate and will try new food with encouragement.
• If your child gets tired of one particular food, it can usually be reintroduced at a later time,
• Your child may not like a variety of food groups or textures but will eat at least one from each food group.

With a child who is being a picky eater, limit snacks and try meal times at the same time every day. You should never bribe or force your child to try a new food. Simply serve new foods alongside familiar foods and encourage your child to try it. It can take up to 10 times to get a child to try something new and that’s okay!

This information has been sourced from: Copyright 1997 / 2019 – Dr. Kay A. Toomey

Therapist favorite picks

Often as parents of children with special needs you are looking for tools or activities that can keep your child busy while learning. Here is a list of some top therapist picks that are used every day in therapy treatment for children that can also be great to have at home.

Favorite board games for fine motor skills and visual motor:

Jenga

Connect Four

Chutes and Ladders

Eye Spy Games

Operation

Headbandz Game

K’nex

Legos

Rubix Cube

What’s in Ned’s Head

A great sensory calming game is Lite Brite. That’s right, the original Lite Brite game is a great activity your child can sit down and play with quietly.

Other tools that help with sensory sensitivity are Sensory Brushes, Theraputty, Vibration Jigglers and Chewy Tubes.

The soft bristles of the sensory brush provide a therapeutic combination of deep pressure and tactile stimulation to help calm down and improve focus. Theraputty can improve fine motor skills and decrease stress. Vibration Jigglers and Chewy Tubes are also used to assist in calming and regaining focus.

All these items can be found on the internet and are reasonably priced.

No one wants to say the “D” word…..DEDUCTIBLE!

Most everyone knows that their insurance plan has a deductible. A deductible is a set amount of money that is the patient/member/subscriber’s responsibility before the insurance will begin to pay towards covered services.

They either reset every Calendar year (every January) or Fiscal year (anniversary of the effective date of the insurance plan). It is important to know your insurance benefits and deductible amounts. Deductibles range from $50 to $6,000 and sometimes more depending on the company and the plan you choose.

For services that are considered covered benefits of the insurance plan, there will usually be a coinsurance (coinsurance is a shared cost with the insurance company) that comes into effect after the deductible is met. For example, say you have a $500 deductible and it has been met (meaning you have spent $500 on covered services). The out of pocket cost for covered services after $500 has been met, turns into a 90/10, 80/20, 70/30, etc., This means that the insurance company will cover 90% of the charges/costs and you are responsible for the remaining 10%. This will vary depending on the plan you have. If it is the 80/20, insurance covers 80% and you are responsible for 20%….etc.

Don’t confuse coinsurance with a co-pay. They are two different things. Coinsurance is a percentage of the cost for a health service and a co-pay is a flat fee for a service.

Be prepared in the new year for your medical expenses and check your insurance plan’s benefits!

The Benefits of Feeding Therapy

Feeding therapy can help children with special needs such as Autism Spectrum Disorders (ASD), Down Syndrome or Sensory Processing Disorder (SPD) or with a child who may be a “picky eater”. Therapy can also help children with fears of trying anything new. The goal of feeding therapy is to establish regular nutritious meals.

Feeding Therapy can help your child be a more varied eater and have harmonious mealtimes. Therapy can be beneficial to help you get to the root of why your child may be refusing foods. Some children have anxiety about mealtime and that there won’t be foods that they like to eat.

Eating is a developmental process for children. When a child has difficulty eating, it means they have stalled in the midst of learning a new skill.  Regardless of your child’s age, the feeding therapist will begin to teach the step by step process wherever your child is having trouble (e.g. chewing) as a means to reaching the long-term goal of independent, healthy eating.

Feeding therapist can also give you small goals/home programs for you to work with your child each week.

The Benefits of Occupational Therapy

Occupational therapy can help kids with physical, sensory or cognitive disabilities. Therapy can help kids with their school performance and daily activities.

For kids needing help with fine motor skills occupational therapy can help them with grasping and releasing toys and help them develop good handwriting skills. Occupational therapy can also help kids with hand-eye coordination to improve kids play and school skills.

Occupational therapy is especially beneficial for kids with severe developmental delays and can help with learning basic tasks. Tasks like bathing, getting dressed, feeding themselves and brushing their teeth. Occupational therapist can also create in home programs for you to practice with your child at home. Therapy can help kids who have sensory and attention issues, which can help improve focus and social skills. Kids with behavioral disorders can benefit from learning positive behaviors for all environments.

Occupational therapy can last for months or even for a few years. It all depends on your child’s individual needs and goals. Matching your child with the right therapist is important to. If your child was in need of any type of specialized equipment, your occupational therapist can evaluate and help you in the direction of how to get the equipment needed.

The Benefits of Speech Therapy

Speech therapy can help kids learn to speak more clearly and be able to communicate with others. This helps kids feel more confident and less frustrated about speaking. Kids who have language issues can benefit socially, emotionally and academically from speech therapy.

For kids with reading issues such as dyslexia, speech therapy can help them hear and distinguish specific sounds in words: the word cat breaks down into c, a, and t sounds. This can improve reading comprehension skills and encourage kids to read.

Speech therapy is especially beneficial when kids start therapy early in life. Studies have shown that the earlier kids went through speech therapy the sooner they can improved their language skills.

Speech therapy may last for months or even for a few years. It depends on your child’s needs. Your involvement can make speech therapy more effective for your child. Your child’s therapist can give you and your child strategies to deal with obstacles more effectively. Therapist can provide activities to practice at home to reinforce the skills your child is learning. Kids who make the most progress tend to be those who get involved in their treatment.

It’s important that you find a speech therapist that is a good match for your child. The speech therapist should have experience working with kids with your child’s specific issue. Speech therapy is just one way to help a child with learning issues related to language and speech.

Torticollis

Our Occupational Therapy Department at Sonoran Sun Pediatric Therapy can help treat children with Torticollis. Infant Torticollis, also known as “wry neck” or “loxia,” occurs when a baby’s neck is twisted, resulting in the head tilting to one side while the chin points upwards. In newborns, Torticollis can happen due to positioning in the womb or after a difficult childbirth. This is called Infant Torticollis or Congenital Muscular Torticollis (CMT). It happens when your child’s neck muscles are especially tight on one side, or if something has caused scarring on one side of the neck. The tight muscles or scarring can cause your child’s head to tilt to one side.

Torticollis is relatively common in newborns. Boys and girls are equally likely to develop the head tilt. If you infant has a difficult time turning their head to one side but not the other side, this could be a sign of Torticollis. Infants with Torticollis may also have developed flat spots on their head (Plagiocephaly) or have Facial Asymmetry meaning their ears may be at unequal levels or it may appear that one of their eyes is more pronounced then the other.

If your infant does have Torticollis your doctor may teach you how to do stretches at home with your infant. It is also recommended that you receive an Occupational Therapy Evaluation for your child to help treat their Torticollis. The good news is that through intensive therapy (typically 2-3 times per week), Torticollis can typically be treated. The sooner you are able to come in the better when it comes to Torticollis treatment.

Commercial Insurance Plans

With the New Year can come Insurance changes for you and your family. If you have a Commercial Insurance plan, be aware of your plan on whether it is based on a calendar year or different. If you have a calendar year plan then your deductible will reset for the New Year. Don’t be afraid to call your Insurance Company if you ever have questions on your medical insurance coverage. Insurance coverage and plans can be complicated. Stay in the know of your individual coverage and your family coverage. Typical Commercial Plans have a deductible, co-pays and then a co-insurance. Which means after your deductible is met, you then share the financial responsibility of covered services with your Insurance Company. There is a lot of plans out there and it all can be confusing. Stay educated and know your policy coverage so there is no unknown cost to you that you don’t know about. Sometimes your Insurance will say a service is covered but there may be “exclusions”. If you ever have billing questions don’t be afraid to ask for help on your coverage from either your Insurance Company by calling their customer service or even speaking to someone in the billing department of your medical office that you currently go to.

If you have a HSA account, don’t forget to use it up before the beginning of the New Year. Insurance policies can be complicated but if you stay educated on your policy you will be able to plan ahead.