To Mouth or Not to Mouth.

By Tara L. Koker-Noia, MS, CCC-SLP

Mouthing is something most think is a stage that babies go though to explore their environments and then to soothe the pain of teething. After the teeth are in and the child is able to explore their environment physically, mouthing should be no more…right?

The truth is that many of us still mouth! Take a minute and think back. Do you remember the kids in elementary school who practically ate their pencils, those that couldn't put a cap on their pens in high school because they had chewed them during class and others that were never without gum in or, much to their parents' dismay, getting their tongue pierced? You may have been one of those. You may still be...examine your work area! All of the fore mentioned actions are a form of mouthing; just one that is more acceptable than a hand, finger, thumb, block, or toy.

Essentially, I have found that most of us never truly out grow the need for mouthing. Mouthing is not only a way to explore the environment it is more essential for awareness of the tongue, jaw, and lips; a way so sooth and calm oneself when tired, angry, irritated, upset, scared, anxious, bored, etc.In addition, mouthing assists with focusing and concentration in learning situations. Children and adults evolve with their environment searching out more acceptable ways to satisfy this need.

It is essential for children learning to talk or eat, to mouth. I ensure that the children I treat go through this stage and encourage them to remain here for as long as possible. It is a great way to maintain muscle tone once it has been developed; practice proper resting postures and movements once they are achieved improve sensation to produce intelligible speech, etc.

The key is to locate age acceptable/appropriate items for children to utilize as they mature and grow. Children need items that will not make them stand out in a crowd or at school. There are many ways to achieve this. What you pack for lunch can be a great way to stimulate and satisfy their oral needs. For example, if it is a high allergy day, pack items that are high in flavor and crunch such as carrot sticks, celery sticks, V-8 juice, buttermilk, dill pickles, sour juice boxes, etc. Allergies increase pressure within our sinus cavities and can cause discomfort and pain. By chewing, mouthing, or grinding one will avert the pressure within their head/facial area. The children I treat for therapy, especially those with low tone which generally equals a low arousal rate do eat these items. They actually prefer them much to the shock of their parents. Once the strength, coordination, and endurance have been developed they can be presented with items such as these to help maintain and ensure oral sensory motor arousal. What children eat makes a great impact to their sensory systems. Food is the best tool to utilize to provide the input an oral child needs several times a day.

There are also many items on the market that can allow your child to meet his oral requirements and remain accepted. For the infant crowd, there is a vibrating star teether that you can pick up at stores like Toys R' Us, Wal-Mart, etc. Other companies are coming out with a few other designs; however I have found these are too big to get into the mouth. There is also an item called a safety feeder net which allows you to place virtually anything in it and present it to children without the fear of choking on large pieces of food. Some therapist have voiced that they do not like them, however I have had excellent success with training families how to utilize them. I also like to say this is a time for feeding targets not occupational therapy. I discourage allowing and encouraging the child to independently utilize the bag until they have been conditioned to place it in the back over the molar area. This is essentially one of the only items that can easily and safely be used for feeding and chewing techniques and there are many other items that can be utilized for working on hand to mouth skills. I also stay away from fruits and foods that are juicy. My favorite item to start with is prunes. Before, you say yuck! Remember your child doesn't know the bad rap prunes have been given. They simply find a very flavorful, chewy, sweet treat. Prunes are great for so many reasons and even my pickiest eaters start with them! You can squeeze them out through the holes in the bag so the child gets a taste of what is in there so he will be enticed. Don't stop if they make a face. It doesn't mean the child didn't like it, but simply that it acknowledges a taste not experienced before. If you get a strong reaction, be sure to continue to introduce the prune for 10 consecutive days. This will work through the novelty of the taste and the more experiences had the easier it becomes… just like riding a bike!

Now for the items to order…

Integrations Catalog
This is the best one-stop resource that I have located thus far. They Elephant jigglers, 'Chew'lery, pencils toppers (rubber tubing that fits on top of your pencil or pens), chewy tubes, etc. The down side is that you cannot order on the internet with them.

Ark Therapeutic Services
They have the wonderful z-vibe and double z-vibe that I feel is a must for any child with oral needs. They have a variety of tips to put on it including a bite n' chew tip. This tip can fit opposite a pen or pencil adaptor and be utilized during class! This is great for nearly any child void of special needs that is chewing on their hair, shirt, fingernails, pens, pencils, gum, etc. You can reach them through the resources page on my website.

Super Duper Publications, Inc.
These guys have free shipping, but not as great a variety. They do carry the z-vibe, chewy tubes, and thera-tubing, however it is less expensive through Thera-Pro. Figure the amounts though as when shipping is added, it may be nearly equal.

Thera-Pro
You can order several different levels of chewy tubing. This is very beneficial if your child is low tone and is just beginning. You can graduate them up through the levels as they increase their strength, tone, and endurance though their therapy sessions. (Hopefully they and you will be getting good oral sensory motor tasks).

Talk Tools
They carry the jigglers, z-vibe, chewy tubes, and ARK grabbers.

I have links for all of these companies on the resources page of my site. I strongly recommend that you research what you may think will be good for your child and then present your therapist with questions about them. Your therapist should be able to assist you in knowing what would be appropriate for your child and what is not. These tools are primarily to facilitate the therapy program, not replace one. However, if you are a parent of a child that does not have therapy needs, then observe what your child's oral, mouthing/chewing, behaviors are and purchase appropriately. You should also be able to place a call to any location that provides therapy, ask if they have an oral sensory motor specialist on staff, and either speak with or leave a message for a therapist for suggestions.