Ask a Therapist: Unsupervised Chewing

Posted by Deborah Grauzam on

Hello, My patient was evaluated by you in June of 2014.  We are currently using the red chewy tube and yellow chewy tube in therapy and at home to improve jaw strength and stability. However, the patient is now seeking ‘input’ orally- especially with chewing, now more than ever before.  How can we support this sensory need without promoting undesirable skills like jaw sliding?  Is there something else she can chew on- unsupervised? Thank you!

The situation you describe is one I see with many of my clients.  Once the clients "feel" jaw mobility using the "Bite Tube Hierarchy" and are thereby receiving the needed temporo-mandibular joint stimulation for calming they often increase their need or desire to mobilize the jaw (seeking oral input).  The Bite Tube Hierarchy will eventually incorporate four tubes as described in the book, "Oral Placement Therapy for Speech Clarity and Feeding."  The goal of the tools is to give the needed stimulation to increase jaw stability so that the client will then transition that skill into feeding and speech thereby eliminating the need for the tool and the need to chew on non-food items.  For this reason I do ask therapists to not give these tubes to the kids as then they may use them with an inappropriate jaw slide or jut.

With that said, however, you do ask an important question, " Is there something else she can chew on - unsupervised?"  Since I do not know the name of your client I cannot refer to the Program Plan I wrote for her/him I can only list for you the additional options: Slow Feed for snacks, Gum Chewing (without swallowing the gum) and Jaw Grading Bite Blocks. Each of these therapy techniques is taught in that same book, "Oral Placement Therapy for Speech Clarity and Feeding."  In addition, they are taught in the class, "A Three part Treatment Plan for Oral Placement Therapy" which will give you the gestalt of why and how to work on muscle-based speech clarity deficits.

Our goal for anyone with jaw weakness and instability is to increase the skill so that the jaw can support the independent movement of the lips and tongue for speech clarity and feeding safety so that is why I am focusing on the therapy suggestions above.

However, I still have not answered your question.  There are many sensory tools sold by TalkTools and other companies that allow the child to hold the tool without supervision as they are not working on jaw grading but are instead focusing on sensory feedback.  They include the Star Vibrator, Chewy Tubes, and ARK products.  As long as you are not using the tools used in the "Bite Tube Hierarchy" your client can hold and chew on any of the other options.

Sara Rosenfeld-Johnson, MS, CCC-SLP

Ask a Therapist bite tube hierarchy bite tube set bite tubes chew chew tool chew toy chewies chewing chewing skills chewy tubes Massaging Action Teether red chewy tube Sara Rosenfeld-Johnson sensory tools temporo-mandibular joint TMJ TMJ stimulation yellow chewy tube

← Older Post Newer Post →



Leave a comment

Please note, comments must be approved before they are published