By Deborah Lee OTR/L
Does your child appear to have difficulties with feeding skills such as chewing their solid foods thoroughly or closing their lips securely when trying to utilize a straw? If you do notice these difficulties, there is a high possibility that your child is presenting with oral motor delays due to several reasons such as: poor motor planning or muscle weakness of the jaw, lips, cheeks, or tongue. Poor motor planning indicate that our mouth region is unable to follow what our brain tells it to do such as puckering your lips to make an “O” in preparation for blowing bubbles through a bubble wand. In addition, oral motor skills are crucial for your child’s speech and language skills as a lot of coordination is required for sound production as well as articulation.
Just like how we motivate children to learn and adopt new skills through play in therapy, we can encourage them to engage in oral motor exercises too by making it fun and playful!
Here are a few strategies:
The first exercise will be of making silly faces! Grab a mirror or stand in front of a mirror with your child and start making silly faces together by sticking your tongue out, try touching your nose with your tongue, or blow air into your cheeks and move air along from one cheek to another. Keep in mind that this exercise will also only be successful if your child already demonstrates good imitation skills.
The second exercise is to blow bubbles, which not only targets oral motor skills but also sensory play skills! If your child has difficulty with making an “O” shape with his or her mouth, you can provide him or her with a visual demonstration of puckering your lips or exaggerate inhaling and exhaling of your breath in attempt to blow bubbles. If you also do not own bubbles at home, you can tear napkins into small pieces and blow onto it as if it is “snowing”!
The last exercise is playing tug of war with a teether. You can place the appropriate sized teether onto your child’s back molar teeth and have him or her bite down onto it for you to pull on it for at least 1 to 3 seconds. You can start slowly then eventually increase the time past 3 seconds once you notice that your child’s strength and endurance can tolerate more than 3 seconds. If your child is also having difficulty with following instructions, you can provide a demonstration first by having him or her pull onto the teether in your mouth to get a feel of what they need to do for the task.
To put things into perspective through a case study, a 2-year-old toddler was experiencing choking incidents during almost every meal. The child was able to imitate silly faces as well as blow bubbles so, it was easy to rule out that the lip muscles or tongue muscle were not necessarily weak or the problem in this situation. Therefore, we targeted jaw strength and endurance and implemented the tug of war oral motor exercise as a preparatory method before mealtime to assist the child with their chewing skills. After approximately a month of starting this exercise not only during therapy sessions but also being implemented daily in the home setting, the parent noticed that the choking incidents have decreased, as the child was able to chew their solid foods more thoroughly into smaller pieces before swallowing.
Occupational and speech therapists may provide targeted interventions to address oral motor skills for feeding. We first identify the underlying cause of the difficulty and work with children and families to address the concern.