Occupational therapists know the importance of not taking for granted our most essential bodily functions. After all, they may be natural to us, but for some, it’s not so simple. Want to know how life feels when you don’t know how to eat or swallow right? Just try to drink a glass of water while laying down flat—it’s pretty difficult and you’re likely to get your shirt all wet. Kids with difficulties eating and swallowing are a particular challenge.
Autism, cerebral palsy, gastrointestinal conditions, heart disease, cleft lip/palate, muscle weakness, head and neck abnormalities, low-birth weight, and others can contribute to making meal time a challenge.
When someone has problems maintaining the control of food and/or fluid in the mouth and swallowing they are normally assigned to an occupational therapist as part of an intervention team. Nutritional problems are the main concern for children. Nurses have to administer tubes to help in severe cases. Feeding and swallowing disorders put children at risk for poor nutrition, dehydration, pneumonia, or embarrassment.
Developmentally, the act of swallowing (suck-swallow-breathe) happens in the prenatal period as one of the very first self-regulatory actions we learn. Many times occupational therapy practitioners will help premature babies in the NICU to get the complex process of maturing their swallowing and eating. Other times, you can work in a program for children that need to work on their swallowing. OTs usually join teams that intervene alongside SLPs, physicians, nurses, and their caregiver to help children engage in sensory exploration.
OTs might choose to check a child for symptoms of aspiration during mealtime at their school or help a kid that might have suffered a jaw injury. Intervention included oral sensory programming, rehab for their jaw through strength programming, and team education.
Signs of Dysphagia in Childhood
- Body stiffening or arching when eating
- Food/liquid refusal
- Coughing or gagging while eating
- less than normal weight/growth
- Frequent vomiting
- Not accepting certain food textures (like only eating pureed foods)
Tips to Promote Good Swallowing Techniques for Children
- Work slowly. There may be a delay time before the child is able to swallow. Be patient as they may need a moment.
- Use thicker liquids as these are easier for kids to swallow and be able to control. Try Thick-It to make swallowing disorders less of a challenge.
- Position toddlers/teens in an upright sitting position and have them slightly flex their neck forward.
- Hold infants in semi-reclined positions and gently hold the fat of their cheeks to give them jaw-control for babies unable to suck on bottles.
- If a child has low oral-motor musculature, give them oral-motor stimulation.
- DON’T ever force anything into a child’s mouth.
- Quickly stroking on the cheeks and above the mouth (creating vibration) can help in swallowing.
- Cut out distractions and work in a relaxed environment.
- Give children a cracker and encourage them to eat it with both sides of the mouth to promote tongue lateralization.
- Provide children with a popsicle or sour lollipop to suck on.