Chat with us, powered by LiveChat   I attached 2 documents. One is the case where you hav - STUDENT SOLUTION USA

 

I attached 2 documents. One is the case where you have to answer all the questions and the other is a guide to help in the case.

It is necessary to mention and explain all the affected sensory areas and create a detailed schedule for the patient (This type of treatment has nothing to do with food. A sensory diet is a tailored plan of physical activities and accommodations designed to meet a child’s sensory needs)

Case Study Pediatrics

Sensory Diet

Body is a 10 year-old male child. He attends school near his home. His grandmother brings him to school every day. Body has never received any type of therapy prior to today as he was living in another country and ‘home schooled’. His grandmother reports her grandson was having a hard time making friends and was very bright, but his teacher did not know how to work with a child who was bright. It is noted that Body does not utilize utensils during feeding, but eats with his fingers and has only finger foods in his lunch box. Also Body has trouble holding a pencil during classroom work and prefers to write with a large crayon. He insists that the crayon is the only thing he can use. He also has an adversion to hot and cold food. He prefers only room temperature foods and drinks. He also prefers to wear a “favorite sweater” every day. He likes how it feels. During the observation the Occupational Therapist noted that Body was not able to complete his classroom work. He also had trouble with sitting quietly in the chair. He often wanted to tap his feet and was disruptive to the classroom. He could not attend to the teacher providing instructions. During reading you noticed that Body held the book out in front of him instead of having the book sit on the desk in front of him. He also seemed to read the same paragraph several times. Socially, Body does interact with the other children and seems to want to sit very close to them, or play rough with them.

1. List the problems

2. List the systems your will address

3. List the activities for the problems and how to incorporate Sensory Diet into the treatment

4. State how the evidence supports your treatment

5. Present your findings and demonstrate your treatment. Type the findings and attach your evidence

6.

Sensory Diet
Activity

Guide Book

Cindy Chuan
Occupational Therapist

yourkidsot.com

A “sensory diet” is a planned and scheduled activity program designed to meet a child’s individual
sensory needs (Wilbarger, and Wilbarger, 1991). It is related to activities that a child performs through
their day to help them to “modulate” their bodies – It is not food related at all! Think about some of the
activities you do to relax – Do you go for a jog? soak in a hot bath? go for a massage? drink a warm
drink? Think of the activities that give you energy. The activities that might relax some people may
actually energize others.

We live in a world full of sensory information and some kids have difficulty coping with the sensory
information they receive in their daily lives (visual, auditory, vestibular, proprioceptive, tactile, taste, etc).
Some kids can be seek sensory information and others will avoid it. This can change for a child
depending on their environment or time of day.

A “sensory diet” aims to help a child level it all out and cope. It aims to prevent sensory and emotional
overload by satisfying the child’s nervous system. If you are concerned that your child may have
sensory processing difficulties, contact an Occupational Therapist for an assessment. The assessment
typically involves an interview and questionnaire completed by parents and teachers as well as
observation of your child. This guide book is provided for those whose child’s sensory needs have
already been identified and is not a diagnostic tool.

This guide book is also written for occupational therapists looking for additional suggestions to help
with the formulation of a sensory diet for their clients.This guide book provides examples of activities
that may be included in a “sensory diet” in a home or school environment where specialized equipment
may not be available. These activities are generally suitable for all children, however, professional
advice should be obtained if you are uncertain (particularly with the vestibular system) about which
activities or combination of activities to try. Consideration should also be made regarding your child’s
age and cognitive abilities.

Whilst the activities in this guide book have been categorized, all the sensory systems are connected so
one system may affect another. After trialling the activities with your child, make note of the affect of
the activities. Does it calm your child, arouse them, over-arouse them? It should be noted that whilst
some activities may be calming for one child, it may alerting for another child. When creating a “sensory
diet”; you will need to consider which activities are appropriate, when they should be carried out, for
how long and how often.

There are over 100 activities that I have put together here so if you are overwhelmed don’t feel like you
need to try them all in one day. Not all the suggestions will be suited to your child. It is best to look over
this list with your occupational therapist.

A Sensory Diet…

Cindy Chuan is a registered Occupational Therapist practising in Sydney Australia. She has two young children
who are a constant source of inspiration and learning. Cindy loves working creatively to help children to reach
their potential, finding opportunities in everyday living and making learning fun. Cindy is the author of the
Occupational Therapy blog Your Kids OT (https://www.yourkidsot.com).

© 2018 Your Kids OT. Sensory Diet Activity Guide Book

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

Proprioception tells us about the movement and position of our bodies. Proprioception is
sometimes called “position sense” or “muscle sense” as information from receptors in our
muscles and skin help to inform us of where are body parts are in space, how they relate to
each other, how much and how quickly they are stretching, the speed and timing of
movement as well as the amount of force exerted. Proprioception helps us to be aware of
our bodies and directs our motor control and planning.

Proprioception can be both subconscious (automatic) and conscious awareness of joint
position we use in learning. This conscious awareness is also described as “kinesthesia”.

Proprioceptive input can help to modulate arousal levels (ie. may help to increase arousal
or may help to calm and organize sensory systems). Heavy work activities can provide
proprioceptive input to the muscles and joints of the body. This may involve lifting,
pushing, pulling objects and a child’s own body weight.

Proprioception helps integrate touch and movement sensations (tactile and vestibular).
The following activities are categorized into those that involve the whole body, hands and
fingers or oral proprioception.

PROPRIOCEPTION

PROPRIOCEPTION: Whole Body
Jumping on the trampoline
Jumping from one stepping stone to
another
Jumping off the stairs onto the floor
Jumping from a bench onto the grass
Leapfrog over another child
Swinging on the monkey bars
Swinging on an overhead flying fox
(zipline)
Pulling wet clothes from the washing
machine
Pulling dry clothes from the dryer
Tug-of-war pulling on a rope
Pulling against a towel (someone else
pulling back)
Pulling rubbish bins to and from the kerb
Pulling a garden hose
Pulling toys (eg. wagon, sled, etc)

Animal walks (crab, bear, snake, etc)
forward or backwards)
Wheelbarrow on hands with someone else
holding legs
Commando crawling
Crawling on knees
Stamping feet
Hopscotch
Marching
Vacuuming
Rolling over a ball
Wiping the table
Wiping a whiteboard
Running (forward, backward, sideways)
Log rolling (body stretched out)
Clean the windows
Digging in dirt or sand with spade, hands or
feet

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

PROPRIOCEPTION: Whole Body

Carrying heavy shopping bags
Carrying heavy books
Carrying a backpack with heavy contents
Carrying beanbags on head
Carrying sand/water in a bucket
Carrying furniture around the house or
classroom (appropriate size)
Carrying pot plants
Carrying watering can
Carrying small pets
Lifting furniture at home or school (eg.
chair onto a table)
Climbing up a slide
Climbing over furniture or pillows
Climbing up a ladder (suitable for child)
Climbing on nets or frames at a
playground
Indoor rock climbing
Chin ups on a horizontal bar
Being wrapped in a blanket or towel and
being squeezed (standing or lying on the
floor)
Being squeezed between pillows or
mattresses (standing or lying on the floor)
Using a weighted product (eg. blanket,
vest, bag, toy)
Being massaged by someone else
Being squashed under a therapy ball or
foam roller
Giving or receiving a bear hug
Hiding under heavy blankets on bed
On the floor, pushing feet against a grown-
up pushing their feet back (straight or
cycle motion)
On the floor, pushing feet against a
therapy ball, wall, theraband, etc
Chair push-ups (lift whole body up from a
chair with arms straight)

Pushing a therapy ball up and down a wall
Pushing a wheelbarrow (real or toy
wheelbarrow depending on age)
Pushing toys (eg. toy lawnmower,
shopping cart, stroller, etc)
Pushing hands against a grown-up who
pushes back
Pushing furniture
Pushing a box of toys
Pushing against a wall
Push ups on the floor
Pushing a shopping trolley
Pushing arms and legs in a plank position
Pushing arms and legs whilst lying on a
scooter (prone) board.
Pushing a laundry basket of washing
Pushing a sibling in a stroller/pram
Hanging washing on a line to dry

Many sports allow your child to
receive whole body proprioceptive

and vestibular input.
Here are a few examples:

Soccer
Football
Gymnastics
Swimming
Hockey
Track and field
Dance
Horseback riding
Martial arts
Golf

Basketball
Netball
Table tennis
Skiing
Snowboarding
Surfing
Paddleboarding
Canoeing/kayaking
Cycling
Scootering
Tennis

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

PROPRIOCEPTION: Hands and Fingers

Cooking in the kitchen (eg. rolling, sifting,
stirring, shaking, pushing, rolling, etc)
Wringing a wet towel
Squeezing a wet sponge
Squeezing a soft toy
Squeezing a squirting bath toy
Squeezing a water pistol
Squeezing a water spray
Playing with a hand fidget
Pinching pegs (clothespins)
Playdough and theraputty play
(squeezing, pinching, pulling, etc)
Pulling theraband
Pulling elastic bands (eg. loom bands)
Playing “thumb wars” and other finger
games
Push pin poke drawing
Usng tongs and tweezers to grasp and
release

Finger play nursery rhymes and songs
Finger puppets
Finger push-ups on the table
Finger painting
Catch, throw and bounce a ball
Clapping games
Sharpening a pencil
Punching a pillow or mattress
Feeling “Mermaid” cushions
Messy play with rice, cloud dough, kinetic
sand, sand, etc
Popping with fingers
Q-tip painting

Many of these activities will
also help with the

development of fine motor and
bilateral coordination skills.

PROPRIOCEPTION: Oral
Chewing on bubble or chewing gum
Chewing on commercial silicon grade
“chewy” products (eg. pendant, chewlery)
Eating crunchy food (apple, carrot sticks,
corn on the cob, rice crackers, celery
sticks, dry cereal, pretzels, ice, froze ice
blocks, etc)
Eating chewy food (steak, fruit roll ups,
etc).
Chewing on bubble or chewing gum
Poking out tongue
Pushing tongue into cheeks
Puffing up cheeks and squeezing out air
Using a vibrating toothbrush (to brush
teeth or for massaging mouth)
Sucking water from a sports drink bottle

Blowing popper toys
Blowing bubbles
Blowing a harmonica
Blowing a party blower
Blowing a whistle
Blowing up a balloon
Blowing bubbles in water (eg. with a
straw)
Blowing a straw to push along a items
(eg. pom pom, cotton wool ball, ping
pong ball)
Blowing a feather and keeping it up in
the air
Breathing in/out of brown paper bag
Make silly faces
Sucking a frozen ice block (popsicle)

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

TACTILE SYSTEM: SENSE OF TOUCH

Touch sensations can include light touch, deep pressure, skin stretching,vibration,
movement and pain activated receptors.The tactile system may be classified into two
components: discriminative touch (what and where touch occurs on the body) and
defensive touch (fight or flight response).

The tactile system is closely related to the proprioceptive system (through deep pressure
input to the skin, muscles and joints). Both the tactile and proprioceptive systems work to
help with body awareness and motor control.

Many of the activities that are listed in the proprioception section of this reference sheet
will also help those with difficulties with the tactile system. Some of these activities will need
to be graded for those who are defensive to touch sensation.

The following suggestions relate to modification of the environment to assist with
processing tactile input and then there are suggestions for exploration of different textures
through touch.

TACTILE SYSTEM: Environmental Modifications

Make sure your child can see you before
approaching or touching your child
Avoid clothing fabrics which are irritating
Consider “seam free” clothing
When using guided physical prompts or
instruction use firm touch
Use markers to help designate personal
space when sitting on the floor or standing
in a line (eg. coloured dots)
Provide a quiet space for your child to
retreat to when required
Try a progression of touching undesirable
texture (eg. place progressively smaller
objects on top of the surface)
Try a progression of body parts to touch
undesirable texture (eg. finger, hand, arm)
Encourage your child to initiate touching
when needed (eg. dance class, holding
hands with another child to line up, etc)

Allow your child to say “no” when
touching others is required (eg. dance or
sports class)
Allow your child to go first or last in the
line to minimize tactile contact with
others
Allow your child to wear gloves when
handling textures they are
uncomfortable with touching
Try tools made from different materials
(eg. different grips on a pen, mechanical
plastic pencil, wooden pencil)

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

TACTILE SYSTEM: Exploring textures

Provide different textures to explore with various body parts. This could be provided in a
confined space such as “sensory bin or bucket” or a small portion affixed to a hard surface
(eg. board, box). Try textures on hands, feet, arms, legs, backs, faces, etc.

Textures to try
on a sensory board.

Textures to try in a”sensory bin”.

Slime
Packaging peanuts
Salt
Leaves
Feathers
Jelly
Kinetic sand
Cloud dough
Shells
Stones
Dry pasta
Dried beans
Dry cereal
Rolled oats
Cooked spaghetti
Shredded paper
Mud
Felt blanket pieces

Goop
Jelly crystals
Buttons
Wood bark
Sand
Raw rice
Water
Pom poms
Foam pieces
Sponges
Water beads
Dirt
Cotton wool
Shaving cream
Straw/hay
Glass beads
Scrubbers
Bubble bath

Carpet squares
Foam pieces
Tuille
Cellophane
Shredded paper
Sand paper
Fake fur
Felt
Vinyl

Try different actions with the textures.

Pointing
Touching with one finger
Touching with whole hand
Placing whole hand into sensory bin
(immersing)
Rubbing object between both hands
Try applying different amounts of
pressure placed on a texture
Using short tool to touch
Wrap body inside texture
Rubbing object onto skin
Step on texture
Crawl over texture
Jump on texture
Roll over texture
Climb on texture

Examples of Progression
for Exploring Textures

1. Place a toy car on sand for child to drive
2. Half-bury toy car on sand for child to drive
3. Fully- bury toy car in sand for child to drive

Sequinned
material
Shells
Rocks
Feathers
Wood bark
Bbuttons
Cotton wool
Glitter material

Let your child be in control.
Encourage your child to rub a variety

of textures against their own skin.

Try vibrating toys, massager
and cushions for

tactile stimulation.

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

TACTILE SYSTEM: Fidget Tools

Fidget tools are used for children who seek sensory input from their hands to help them to
focus on other tasks. Fidgeting may occur with a child moving their own body (eg. wiggling,
interwining fingers, tapping fingers, scratching, twirling hair etc.). Generally a child does not
need to look at the item that they are fidgetting with as it is an automatic response to a need
for tactile input.

When a child can not get enough tactile sensory input, then an external “fidget tool” may be
used. These tools should not distract the child from the main activity of focus and should not
distract others around them.

In recent years, mainstream shops have sold “fidget toys” which offer tactile input for
children. Fidget tools are not toys. They should not be “played with” as the fidget is used to
help focus on the main activity.

A child will often need to trial several fidget tools to find what best suits them and if it is
needed to help with attention and focus. There are usually other signs of fidgeting
observed. A child may only need a fidget tool for short periods of time. If they are fidgeting
throughout a whole lesson or over a long period of time, then other sensory systems may
need to be addressed.

Fidget Tool Rules

1. Fidget tools should be held with my
hands.
2. Fidget tools should help me to focus
on a task or my teacher.
3. Fidget tools should be discreet.
They should not distract me or other
children from a task.
4. Fidget tools should be used for short
periods of time.
5. When I need my hands for other
activities, I don’t need a fidget tool.
6. Fidget tools should not be noisy.

Blue tak
Velcro
Feather
Elastic band
Screws/Nuts/Bolts
Paperclip
Dice
Small stone
Eraser
Coin
Small zipper
Stress ball
Pom pom

Here are some objects that you may have in
your home or classroom that may be used as

a fidget tool.

Beaded necklace
Craft stick
Paint brush
Qtip
Bangle/bracelet
Buttons
Pencil

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

VESTIBULAR SYSTEM:
Sense of Gravity, Movement and Balance

The brain processes vestibular sensations received through the hair receptors in the inner
ear. These inner ear receptors are stimulated by gravity. The vestibular system tells us
about our head and body position in relation to the earth and sends information to our
central nervous system about balance and movement. The vestibular system also tells us
whether we or objects around us are moving or standing still. It tells us about direction
and speed of movement too.

The outer ear and cerebral cortex also help to process precise vestibular and auditory
sensations through the sensations produced by vibrations of movement and of sound.

The vestibular system has been described as necessary for the entire nervous system to
function effectively (ie. to help with the interpretation of other senses such as vision and
the feedback from the muscles and joints through proprioception).

There is a self-protective (defensive) component of the vestibular system that matures as a
child grows. As a child grows they can coordinate their body movements together with
visual information, learning to discriminate what they see and how they move.

Vestibular movement can be described as linear (up/down, forward/back and side to side
movements). Slow and low linear movements can have a soothing affect and often
parents introduce this to their babies in the form of rocking or gentle bouncing. Linear
movements which move in a bigger or faster arc may be more stimulating.

Vestibular movements can also be rotational (spinning around) and are enjoyed by most
children as they stimulate the vestibular system and feel good.

Vestibular movements may involve a child being upside down (defying gravity).

Encourage but never force vestibular movements.
Experiment with different speeds.
Vestibular input will change for one activity
depending on the child’s head and body position
(for example: sitting vs lying prone).

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

Linear Movement: Side/Side

Swinging on a hammock
Rocking/Swaying from side to side
Dancing
Side steps
Crab walking sideways
Adult hugs child’s torso whilst rocking
child from side to side

Zip line or flying fox
Swinging at the park sitting or lying over the seat
Swinging on a rope or tyre swing
Scooter board activities (sitting or prone)
Rocking forward and backwards on a rocking horse
Skate boarding, riding a bicycle, or scooter
Roller blading, roller skating or ice skating
Sliding down a slippery slide (forwards, backwards,
lying down, sitting up)
Jogging or running
Relay races
Crawling through a tunnel

Linear Movement: Forward/Backward

Spring see-saw
Ball hopper
Bouncing on a grown-up’s leg
Bouncing on a gym ball
Zip line or flying fox
Jumping
Skipping with a rope
Trampolining
Pogo stick
Piggy back ride

Linear Movement: Up/Down

VESTIBULAR SYSTEM: Linear Movement

VESTIBULAR SYSTEM: Rotational Movement

Spinning Movements

Spinning self in circles
Adult hugs child’s torso whilst spinning child
Sitting on a swivel chair and spinning around
Scooter board spinning on stomach rotating with hands to push
Twisting around on park swing and then untwisting
Merry-go-round or spinning playground equipment
Sitting on a spinning toy (eg. Sit ‘n spin, Wobbel360 or Bilibo)
Rolling activities (eg. log roll, forward roll, rolling down a hill)

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

Upside Down

Walking or crawling on unstable surfaces will require a child to adjust their
body as they move. Try a sandy beach, playground suspension bridge,
grassy field, waterbed, foam filled mattress or path of pillows.

T-Stool
Walking/crawling on unstable surfaces
Sitting, kneeling or lying on a gym ball
Standing on foot pods
Walking on a balance beam
Balancing rope courses
Move n sit cushion
Balance boards
Hopping games
Climbing on rope ladders

Balance challenges

VESTIBULAR SYSTEM: Gravity Challenges

Forward and backward somersaults
Handstands supported by a wall
Handstands unsupported
Cartwheels
Hanging upside down from a horizontal bar
Wheelbarrows on hands
Lie backwards over a gym ball and roll so head tips backwards
Lie backwards with legs on sofa and head on the ground
Sitting on chair then look for something under the floor

You could also try having your child pass things
over and under their heads whilst looking at it.

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

VISUAL SYSTEM

A child uses their eyes to see in a variety of ways. These visual skills include acuity (details),
adjusting from bright to light, focus and accomodation as well as detecting movement around
them. Children use their eyes together (binocularity) to form a single mental picture that the
two eyes see separately.

Children also use their eyes in combination with motor skills (ocular-motor) and this includes
fixation (steady attention on an object), saccades (movements from one point to another) and
smooth pursuits (tracking a moving object).

At a higher cognitive level, children use their vision to discriminate and refine what they see.
These visual perceptual skills are discussed in more detail in the Your Kids OT “Visual
Perception Reference Sheet”.

Visual-motor skills include eye-hand coordination, eye-foot coordination and eye-ear
coordination.

A child’s visual discrimination and visual-motor skills are closely related tot he other sensory
systems (especially tactile, vestibular and proprioceptive). Visual dysfunction may involve poor
movement, posture, body awareness or coordination with motor skills. When a child is
experiencing visual discrimination difficulties which are not related to movement then it is
unlikely that this is caused by sensory processing issues.

VISUAL SYSTEM: Environmental Modifications

Reduce clutter
Wear sunglasses
Wear a cap or visor
Present one item at a time
Remove unnecessary information from a whiteboard
Position a child at the front of the classroom
Use coloured paper rather than white
Provide multi-sensory learning techniques so the child does
not rely only on their visual system for learning

Multi- sensory learning uses more than one “sense” to teach a child a concept
or a motor skill. This may involve seeing and touching an object, moving
through space with this object and listening to instructions.

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

Some children rely on their visual system to help them to organize and plan. These children
can use their vision to guide their other senses. Here are some ways to use the visual system
to guide behaviour and organization.

VISUAL SYSTEM

Social stories
Visual schedules
Colour coded timetables
Checklists
Maps
Writing plans
Calendars/diaries
First/then visual prompts
Visual timers
Desk strips
Placemats
Posters
Scheduling apps
Clock or watch

VISUAL SYSTEM: Using this strength

Some children will need to
have visual information

highlighted or exaggerated so
that they can respond. Mirrored ball

Strobe lights
Neon lights
Disco ball
Ocean Waves
Fingers
Glitter wand
Lava lamp/timer
Sand timer
Kaleidoscope

Some children find watching and gazing at
objects to have a calming affect on their
overall sensory systems.

Provide a tactile prompt to help with
writing on the line.
Highlight the left hand margin on a
writing page.
Use two coloured shoe laces on the
one shoe
Try different coloured paper for
worksheets
Use a ruler or finger to track words
when reading

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

AUDITORY SYSTEM

The hair cells in the inner ear process information about both sound and movement.
Therefore the auditory and vestibular systems are closely linked. The auditory system is
required to process what and how something is heard.

Babies develop a startle defensive sense of sound, reacting to loud or unexpected noises. As
they grow their auditory system develops so that they realize not all sounds will hurt them.
Over time children develop an understanding of where sounds are coming from
(localization), the ability to follow a sound (tracking), remember and recall sounds they have
heard before (auditory memory), place sounds in a logical order (auditory sequencing),
compare and contrast environmental sounds (discrimination), distinguish between
foreground and background sounds (figure-ground and the ability to relate to unfamiliar
sounds (association). All of these skills are then drawn together to find meaning to what is
heard which they can label with a name when speech has developed.

Auditory dysfunction may be due to a physical issue (eg. ear infection). A child’s hearing may
be functional, however they may have difficulty with processing the information heard.

Therapeutic Listening is an evidence-based auditory intervention intended to support
individuals who experience challenges with sensory processing dysfunction, listening,
attention, and communication. Further information about therapeutic listening should be
sought from a trained professional.

Here are some suggestions to assist with developing auditory skills and some environmental
modifications for those who are sensitive to auditory input.

Play commercial listening games (eg.
Cock-a-Doodle Moo)
Play listening games with sounds from
the environment (eg. garbage truck, siren,
bell, clapping)
Find soothing sounds for your child (eg.
music, waves, white noise, etc)
Listen to audio books (with or without
headphones)

Help your child to manage unpleasant
sounds by anticipating them (eg. turning on
the vacuum, counting before using hand
dryer at shops or hair dryer)
Use headphones to listen to instructions
and block out other noises
Find a sanctuary in a noisy environment if
possible (eg. lift, library)
Reduce the sound in a room by placing
carpet or a rug
Seat child away from possible sources of
noise (eg. fish tank, clock)

Listening activities
Try these at different volumes, with

headphones, in a small space (eg. car).

Environmental Modifications

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

Whilst an overall “sensory diet” is not food related, the oral system is an important sensory
system. The mouth is the gateway to eating and many children who are fussy or picky eaters
may have difficulty with sensory motor experiences. They require coordinated oral motor
skills such as sucking, swallowing and breathing. An over responsiveness to tactile
sensations in the mouth (oral defensiveness) can make eating uncomfortable and
unpleasant. An oral desensitization program might involve increasing deep pressure to the
jaw, lips, cheeks, tongue and mouth.

If your child is a picky eater consult with a therapist trained in the SOS (Sequential Oral
Sensory) approach to feeding. This approach to feeding addresses the whole child, their
physical, oral motor, sensory, digestive and psychological needs when it comes to feeding. It
is an approach that works on increasing exposure to improve acceptance and then increase
dietary repertoire / quantity. It is a life skill building therapy.

Some children find the mouth a way to seek sensations to help with calming and
organizational skills through biting, chewing, sucking and blowing. They may chew
inappropriate objects (eg. pencils, shirt collars, etc).

ORAL MOTOR SYSTEM

Bundy, Lane and Murray (2002) recommend providing infants and young children with
deep pressure to the roof of the mouth or gums with the therapist’s fingers or other soft
rounded object (eg. Nuk toothbrush). They also suggest that older children and adults may
be taught to provide deep pressure to their own mouths using a variety of oral motor toys
(eg. using whistle, biting on knotted rubber tubing, blowing on a rubber strip).

Oral Desensitization

Apply firm pressure symmetrically to the area outside the child’s mouth (from the forehead to
the chin and mouth) using hands or different materials.
Encourage your child to apply pressure (massage) to the roof of their mouth and gums (with
their finger or a soft, round object). This may begin with placing the child’s finger on their lips
and then by rolling the finger inside the lip.
Encourage the child to dip the end of the toothbrush into a small cup of water and brush
their tongue, teeth, inside of the cheeks and roof of the mouth. Additional input with an
electric toothbrush may provided.
When the child is coping well with touch to their face and inside of their mouth, further oral
motor activities may be introduced involving sucking, blowing, biting, crunching, chewing or
licking.

The Paediatric Occupational Therapy Department from Abertawe Bro Morgannwg University
Health Board (2014) describe a protocol of oral desensitisation. This includes the following
progressive steps:

© 2018 Your Kids OT. Sensory Diet Activity Guide Book.

Chewing on chewing gum
Chewing on commercial “chewy” products
(ie. chewlery, pencil covers, theratubing)
Eat crunchy food
Eating chewy food (steak, fruit roll ups, corn
on the cob, etc)
Poke out tongue
Puff up cheeks and squeeze out air
Push tongue into cheeks
Use a vibrating toothbrush
Blow bubbles in water, with a bubble wand,
using a straw
Blow bubbles in substances with different
densities (eg. jelly)
Blow up a balloon
Blow into a straw to push a table tennis ball
Blow down …

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