Sensory Strategies to Help Decrease Texture Aversion and Hypersensitive Gag

Before mealtime:

• Play with sensory-stimulating toys, such as koosh balls, peanut balls, bubbles, play-doh, massagers, any toys/books with interesting textures, etc.
• Give the child sensory input through physical sensory-stimulating activities, such as bouncing on a ball, jumping, swinging, etc.

In preparation for mealtime:

• Put the child in a highchair/booster seat.
• Offer the child a Z-Vibe, textured massager, sensory chewies, etc. to play with before food is presented.
• Use other sensory-stimulating techniques, including, but not limited to, a Sensory Mitt (rub on child’s legs, arms, head, and cheeks) and therapeutic brushes (rub on child’s legs and arms).
• Use the “rough” side of a washcloth to wipe the child’s hands and face prior to the meal.

During mealtime:

• Use textured spoons for feeding.
• Use the Z-Vibe with various tips.  The Cat, Dog, & Mouse Tips tips can be used to “scoop” food, explore textures with the tongue, and introduce “new” textures to familiar foods.  There are also Textured Spoon Tips for the Z-Vibe.
• Maroon Spoons add a smooth texture to familiar foods.

There are many ideas/options to try with children who have aversions to textures.  Please remember that each child is different and there is no “one way” to decrease these aversions.  Helping a child to eat/touch/tolerate textures can be a long process and therefore “trial and error” is often the best way to “figure out” each individual child.  Parents, hang in there!

Good luck!

Leila

This is a guest post by Leila N. Bressler, M.Ed., CCC-SLP.  Leila is a pediatric speech-language pathologist who has been working with the Birth to Three population for almost ten years.  She has worked in the school setting and the clinical setting in both Georgia and South Carolina.   Leila is also a mother to a toddler and has learned a lot of her knowledge from her daughter.

For more tips on normalizing sensitivities, this article is also helpful.

Q&A – Jaw Grading & Stability

Q:  Can you please tell me how to use (oral exercises) ARK’s Animal Tips for jaw grading and stability?  Also, where are the bite blocks? Please explain the different levels of thickness on the tips. I am working with a 20-month-old with limited sounds including vowels and consonants and low tone.

A:  Dear therapist,

I am glad you emailed me with such a great question.   The Animal Tips have bite blocks on their reverse sides to work on jaw grading and stability.  They are of three distinct thicknesses to increase the level of difficulty as the individual progresses.  The Dog Tip has the thickest block; the Mouse Tip a thinner block; and the Cat Tip the thinnest.  They also come in two different resiliencies (soft and hard) to accommodate various sensory preferences.

Q&A – Vibration with the Z-Vibe

Q:  I use the Z-Vibe in therapy daily.  I was wondering if there are any guidelines re. overuse of the Z-Vibe.  Can it be harmful?  Is it more effective to use it on and off?

A:  Dear SLP,

My guideline has always been to check with the individual’s physician about using vibration intra-orally if there are any doubts or concerns.  Since each individual is wired differently, how you use the Z-Vibe can vary.   I am sure you know that some individuals dislike vibration.  In this case, I still use the Z-Vibe, just without vibration.  The length of time varies, depending upon what your goals are.  If I am working on tongue tip elevation, I place the Probe Tip or Mini Tip at a 45 degree angle to place on the alveolar ridge.  I apply pressure (not hard) and remove from the mouth to see what response I get.  If I don’t get elevation, I repeat this,  but only  if the individual allows.  I’ll do that one more time and wait for elevation.   Then I’ll move on to something else, such as feeding or sound production, then I’ll repeat the Probe/Mini exercise.  If there isn’t a response, I’ll continue again with feeding or sound production and repeat a little later.  So, I am really not inside the mouth very long for this exercise.   The same would apply for stroking the sides of the tongue for lateralization, applying pressure on the back of the tongue to assist elevation, applying pressure mid-tongue for a tongue bowl, etc. With the Cat, Dog, and Mouse Tips, I can be in the mouth longer, perhaps up to 30 seconds having the child close their lips around the animal’s face, explore the bumps and ridges with their tongue, bite the blocks on the back of the tip for jaw work, and so forth.  Then I’ll remove to stimulate babbling, sound production, or feeding.  I’ll repeat a few more times  based on necessity, acceptance, needs,  and tolerance.

Another technique that may work is to slowly introduce the Z-Vibe to the individual.  I use the unit without vibration first.  Then I turn on the vibration and show the Z-Vibe to the individual, letting them feel the vibration perhaps in their hand or on their arms, slowly working towards acceptance into the mouth.  The Z-Vibe is very alerting.  It provides the tactile stimulation that non-vibratory tools may not be able to do.  I recommend that you use any oral motor tool on yourself to see how it feels.  Is your pressure too firm, too light?  Does the tool provide enough texture and interest?   Remember, overuse of any oral motor tool may result in refusal, just as an individual may refuse to eat certain foods.  Your questions indicate that you are a very caring and perceptive therapist.  Keep the questions coming.

I hope this helped,

Debbie