The ability to tell your body how to move smoothly and efficiently to do what you want it to is called motor planning. Children who can’t plan how to move their mouths to chew and speak may have oral Apraxia or other difficulty with sensory feedback. This third category of children stuff too much food in their mouths, and/or don’t know how make their tongue or jaw move in order to eat chewy foods. They might chew a mouthful for a very long time, or parents will find that they are pocketing food in their mouth and will spit it out or be chewing it hours later. They typically have good appetites and like to eat, although they may be selective to taste and texture. I find these children frequently have delayed expressive speech. They may also have other motor problems with tone, postures, or moving around in space with more generalized motor planning problems.
- Be very attentive during mealtime to monitor that your child is not overstuffing his mouth with too much food. He may need reminders at every or every other mouthful to give him the verbal feedback of how much he should be chewing, information that he doesn’t get from his mouth.
- Practice taking tiny bites of food. Make a game of taking turns taking small bites.
- Remind him to continue to take small bites and chew it up completely before taking another one.
- He may not know if his mouth is empty or full of food. Use a mirror to show him the difference and reinforce a clean mouth.
- Make faces in a mirror- see if he can stick his tongue out to either side, to the inside of his cheeks, to his upper and lower molar surfaces, to his upper lip, and swipe his tongue across his lips.
- Make funny faces in a mirror. find pictures of other people making funny faces, and try to imitate them.
- Place a dab or peanut butter or other sticky food on his top lip and have him get it off with his tongue tip.
- Provide textures within each meal, like fruit in oatmeal or cereal in yogurt.
- Provide lots of variety during the meal. Alternate a bite of crunchy food with soft food, or alternate a mouthful of solid food with a swallow of a liquid like water or juice.
- Encourage conversation during the meal, with instructions to wait to talk only after swallowing. Apply this mantra to the whole family.
- Drink thick liquids through a straw;
- Get different types of straws to vary the strength needed to get the liquid up to his mouth.
- Bubble blowing
Foods to stimulate tongue protrusion
- Lollypops and suckers on a stick
- Frozen yogurt or ice cream on a stick
- Hold the iced treat perpendicular to the baby’s mouth so that he has to stick out his tongue to lick it.
Specific oral motor techniques can be helpful for children with oral apraxia. Ask your OT for the exercises best for your child
Children with oral apraxia may also have general apraxia, and may not be aware where their body is in space. They may be very squirmy in a chair because they do not feel supported enough. Helping them to brace their leg against a supporting surface like a foot rest, the table leg or the wall, or will brace their leg inside the high chair will provide some sensory feedback and needed stability.
