Oral Motor Skills and Occupational Therapy

Occupational Therapy Amruta Tamboli March 4, 2022

Oral Motor Skills and Occupational Therapy

Oral motor skills develop before birth and continue to develop after birth. A sign of good oral motor development is easy chewing and swallowing of food by the child, without, coughing, choking, or gagging.

Sometimes, a therapist might wonder if the eating issues for a child are sensory processing based or Oral motor based issues? Would an Occupational Therapy intervention help or Speech Therapy help?

Occupational therapy (OT) teaches you how to adapt to different situations. It can assist you in completing any task at school, work, or at home. If you need them, you’ll learn how to use tools (also known as assistive equipment). If you have pain, injury, disease, or a condition that makes it difficult for you to accomplish your job or schooling, care for yourself, complete home duties, move around, or participate in activities, this type of treatment may be beneficial.

In Occupational Therapy for Oral Motor skills intervention, it is necessary to include a history of feeding concerns faced by the child if sensory issues are observed during the assessment. It is equally important to be aware of motor exercises for strengthening. Oral motor development begins in the womb and continues throughout a child’s first few years. Oral motor skills deficiencies in children can have an influence on speaking, swallowing, or both. Speech-language pathologists (SLPs) can assist children in these areas by focusing treatment on specific muscles or movement patterns.

Oral Motor skills include:

Feeding skills:

Firstly, the hold, strength, and tactile awareness of hand for a child to hold the spoon.

Secondly, eye-hand-mouth coordination is another skill. This helps with selecting food, picking it. Oral motor abilities are the most refined of the fine motor skills that humans develop. Other skill is, getting food towards the child’s mouth.

Eating skills include:

Chewing food, salivation, bolus formation and management, swallow.

Eating difficulties can be seen due to medical or structural or sensory deficits.

The oral motor strengthening, sensory discrimination sense as well as eating skills, all contribute to the skills of good articulation, sound production, awareness, and coordination between oral structures and musculatures.

Read more about oral motor exercises here

What contributes to efficient eating skills in children?

Sensory awareness and oral discrimination sense together help the child with an understanding of food textures, tolerance to food textures, realize the movement of jaw, lips, tongue to make certain sounds or chew different items and manipulate a variety of foods and drinks and according to textures.

If there is a Sensory discrimination issue with feeding, the child faces difficulties in tolerating different food textures, temperatures, and tastes. There may be aversions to tolerating any of these three things. The child’s awareness of food in the mouth is reduced too and there may be spillage.

Examples of Sensory issues affecting feeding:

An Occupational Therapist looks at the sensory history for a child with eating difficulties:

A child who is hyper-responsive to sensory stimuli may respond negatively to experiences of different food textures, temperatures or even biting sounds in the mouth. Aversive responses to certain textures limit the child to use the oral motor structures further limiting their development. These contribute to children limiting to only fluids or semi-solid foods.

As against this, a sensory-seeking child would prefer to bite or nibble on crunchy food items. However, once they have softened due to salivation, a youngster may limit these encounters and may abandon one biscuit in favour of a new one.

There may be limited tolerance to textures of cutlery too, plastic, metal, silicone, and so on. The child would either swallow or spill the food without exploring it.

Some more Feeding behaviors observed are:

A child prefers to stuff their mouth and swallow quickly. This is done to avoid the sensation of various food textures or tastes. Low oral tone and awareness may also contribute to inefficient chewing, management of food, bolus formation, or swallowing. Read More about Occupational Therapy and Oral motor skills
Rigid behaviors or stereotypes can contribute to the child preferring certain colored foods and tastes. Since the child never learns the motor demands of chewing, it contributes to limited development and strength of oral musculature
So, the sensory deficits and limited oral motor skills both contribute to difficulties in feeding, eating.
Inability to understand the force needed to chew may result in sloppy eating. This is a result of limitations in proprioceptive feedback.
Limited preferences in taste are seen in children with sensory feeders too. These contribute to a child limiting himself to either bland food, in case of avoidance. Otherwise, tart, hot, salty in case of sensory seekers.

Occupational Therapy for oral motor skills:

Calming exercises help with better body awareness, regulation, and attention. This helps with a sit-down activity of eating. Sensory Integration Therapy helps by reducing seeking behaviors. It also helps to increase alertness. Also, it addresses sensory discrimination and aversive responses seen towards food.

Thus, it is beneficial for a therapist to be aware and educated about oral motor strengthening exercises. A thorough sensory history helps in the treatment plan.