Wednesday, January 6, 2010

Helping Young Kids Accept Touch To Their Mouth

So many of the little kids that I have worked with over the years are sensitive to touch in their mouth as well as being picky eaters. This is accompanied by a dislike for teethbrushing and not mouthing toys age-appropriately. Well, it is no wonder some of these kiddos dislike touch to their face and mouth after hearing their medical history. So many of these children have had tubes down their mouths and had syringes of medicine forced in their mouth many times! That is a recipe for an oral aversion!

One way to help these children to tolerate and accept touch to their mouth is through play. This can be playing with the toothbrush, their food, and mouth toys. Definately not forcing the objects in the child's mouth, but allowing the child to go at his own pace. This may mean that initially the child only touches the toothbrush and food with their fingers. Then, eventually the child sticks it in his mouth. This may progress to eating more foods and enjoying teethbrushing, then again it may not. But whatever the outcome, children like to initiate what goes in their mouth, not have objects or foods forced upon them. This leads to a power struggle and usually the child wins...not so good if the child needs to gain weight in order to receive a surgery or prevent him from getting a G-tube.

I am thinking back on a time that I showed a mom how to make toothbrushes and teethbrushing fun. I had her get two new toothbrushes. After taking them out of the packages, I pretended that they were drumsticks while singing this little toddler boy's favorite song. Just by singing this song I had his attention. A few minutes went by and he grabbed the toothbrushes from my hand and started playing with them in a drumming manner. I ignored him as I was talking to his mother, and what do you think happened? You guessed it, the toothbrushes went to his mouth for a few seconds. We ignored it, and he did it again. Now, keep in mind I wanted to squeal and clap, but I refrained because that might have distracted or over-whelmed him. Within five minutes time, he had put the toothbrushes in his mouth 7 or 8 times...yeah! This scenario sure beats his mom holding him down and forcing it in his mouth.

This same little boy was also a very picky eater and underweight in addition to other developmental problems. He had a limited low fat diet. So, the dietician and I had given his mom numerous dietary suggestions and I worked on oral-motor skills as well. I also suggested food chaining strategies in which the family barely alters his food in terms of texture or taste. For example, he likes a soup dish from his native country in which it contains soft vegetables, noodles, and chicken. I suggested adding vegetables that were slightly firmer. I suggested that his mom let him play with food and to relax if it doesn't make it to his mouth or lips. He is a little boy who feels the anxiety, therefore everyone around him needs to relax. So what if the kitchen tile or his hands have food all over them! Do we want him to eat or be clean?

One other strategy I often teach is infant massage. Often, massaging the whole body and then moving toward the neck/face/mouth is helpful. Once the child is relaxed, then he may accept facial touch.

Another strategy is song motions or play involving touch to the face/head such as having the child cover his face with his (or your) hands during peek-a-boo. Singing and performing motions to "Head, Shoulders, Knees, and Toes" is a good one, because the emphasis isn't just on the face, but is also on other body parts. This is a bit sly and tricky, but it is amazing how many kids accept touch to the face while being sang to or singing along.

Kids also like mouth toys such as whistles, bubble blowers, and teething rings. I especially like the teether toys that can also be a manipulative such as a cell phone or key ring; kids are smart enough to know what is solely for the mouth, and for that reason some kids may be turned off by a gel teether toy and not by a teether key ring.

There are numerous ideas on how to play with a child and use touch during games and reciprocal interaction between adult and child. Yet, the common thread is having fun and not forcing anything upon them! Quit when the child is over-whelmed and watch for symptoms of over-stimulation such as grimacing, hiccups, turning red or pale, and faster heart rate. For more information on sensory processing problems in babies and strategies for calming the young child, visit

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