Oral Tactile Defensiveness
Babies and children who have a sensory processing difficulty often show signs of oral tactile defensiveness. The typical features which would be noted, would include:
Marked avoidance of certain textures in the mouth. As babies, they might not be inclined to mouth toys and objects as is usual for babies, because they find the tactile input unpleasant.
These children often have feeding difficulties as babies, and may have difficulty with latching on, or may object to using certain bottle teats. It is not uncommon for them to reject a dummy. These babies sometimes have difficulties in handling solids when they are introduced. Such babies might show a preference for breastfeeding and may gain huge comfort from being breastfed. Their mothers respond to this need, and may sometimes even continue to breastfeed well beyond the usual weaning age.
Avoidance of textured foods such as yoghurt containing bits of fruit, or other smooth textured foods containing bits of other food, is common. Sometimes, sloppy textured foods are avoided, for example, mashed pumpkin, avocado. Slimy textures e.g. custard, are often also avoided. At times, the child might even gag if he is forced to eat such foods, or may display an exaggerated unpleasant reaction when such foods are offered. It should be emphasised that the avoidance is on account of the texture, rather than on account of the taste.
Oral defensiveness can result in poor development of tactile discrimination of the tongue, and may impact adversely on the child’s ability to manipulate food in the mouth.
The child who refuses to eat foods which need to be chewed, might do so on account of lowered muscle tone, rather than on account of any sensory preference or sensory avoidance. In this case, the child’s lowered tone in the jaw and oral musculature, makes it difficult for him to cope with chewing of tough textures.
How to improve the situation….
Gentle oral desensitisation is advised. Your baby’s therapist will show you how to do this. Use of oral vibration is also recommended. This should only be done under the direction of your therapist.
Encourage a variety of textured toys for the baby to explore, using his hands. (The chances are that he will not want to play with unusual textures either.) Reassure him and provide him with firm pressure and massage his little body as he explores the textured toys. Remember, deep pressure helps to calm the baby and is likely to lessen his inappropriate reaction to uncomfortable tactile or oral input.
Theratubing, available from www.sensorystuff.co.za, offers a chewy texture which provides much-needed resisted input as the child can bite and tug on the lovely rubbery texture of this tubing. Theratubing is a latex-free, non toxic substance.
Toddlers and children :
Your therapist will introduce you to the tactile brushing programme which you should follow carefully. Ensure that you brush your child 4 – 5 times a day and that you instil calm, using deep pressure while brushing your child.
Remember also to “read” the cues, which your child provides you, regarding his need for calming or organising sensory input. This will also have been discussed with you during therapy sessions. Ensuring that your child learns to “self-regulate” his reaction to sensory and movement input is a most important part of the process.
Encourage play with textured toys. Provide opportunities for play with a variety of textures. This should be done gradually, beginning with only one or two toys at a time. Slowly introduce new textures, and increase the variety and the number of textures to which the child is exposed.
Provide foods which offer texture. These will need to be introduced gradually.
Also ensure that meal times are calm and peaceful, because the child will not be prepared to try out new foods much if he is not feeling safe and secure in the situation. (Also be aware of your own levels of anxiety, and tone of voice!) It may even be helpful to eat out of doors “picnic style”, as this could be more restful.
Mushy foods : Slowly begin to add more texture to mushy foods. Add bits of other foods which the child enjoys. You might have more success with this if you allow him to mix the textured food into the mushy food himself. Sometimes, playing with his food can make a child feel more relaxed while eating, and he may then display a less aversive response to his food.