Sensory Discussion with an Occupational Therapist

Guest Blog written by: Jaclyn Bender, OTR/L

Jaclyn Bender is an experienced Occupational Therapist with experience working in the hospital & health care industry with some experience in the schools. She has a focus on Developmental Disabilities and Pediatrics, Ms. Bender obtained her Master of Science (M.S.) focused in Occupational Therapy from the University of Wisconsin-Madison where she is employed by the UW-Madison Waisman Center as a clinical staff member and Training Coordinator for the LEND program.

Question: 

 A mom asks, “Our newest behavior is constant licking of everything. It frustrates the siblings when they find their toys all wet, and frustrates mama when every window in the house and furniture is wet. Chewy things don’t seem to be of interest. What can I do?

Answer:

While I cannot provide medical advice not knowing the family or child, I can provide general thoughts or things to consider in this situation. Whenever I encounter this, I do typically recommend their Primary Care Physician (PCP) be made aware of this behavior in order to consider lab checks. But also, this could lead to increased exposure to other substances, such as lead, so it is important to have the PCP looped in. When it’s licking and not chewing, I wonder more about vitamin deficiency than seeking oral input.

He/she may also be seeking oral input in other ways that aren’t as noticeable than this obvious behavior.  From an OT standpoint, I attempt to provide prevention and replacement strategies. Sometimes kids lick or chew on items when they are looking for more oral input. If we, as the caregiver, can provide that to them in more appropriate and consistent ways throughout the day, we might see the behavior decrease as they would theoretically seek it out less often.

In addition, you could have specific tools ready to provide to the child in order to replace the licking/chewing. I generally suggest giving a simple cue with this as well: “It looks like you need to chew something, you can have this, not the table.” Then provide them with praise when they utilize the replacement.  Here are some of the tools to consider as prevention as well as replacements:

• If the child eats orally, consider foods that are chewy, crunchy, have strong flavors, or are cold to provide (which also need to be age and ability appropriate). Using temperature, texture, and flavor to provide additional input can be helpful. This could include bagels, granola bars, fruit leather, beef jerky, pumpkin seeds with spice on them, nuts, pickles. Use all of these with supervision and according to your child’s oral motor capabilities. Check with a speech therapist, occupational therapist, or feeding therapist first, if you have one.

• Consider chewelry or chew tubes. There are many options that offer different textures including rubber and cloth. This particular question mentioned that this is not an effective tool for them. For others, it might be.

• Use something like a Camelbak water bottle with ice water or lemon water to promote a bite-suck pattern or use thin straws, silicone straws to give the same type of input.

• Blowing activities through straws, pinwheels, bubbles, etc.

• Allow certain toys to lick that you know are safe. Provide a “lick basket” that you can place those toys in there. Again, redirect them to this basket to let them know that these are safe options if he/she needs to put something in their mouth.

It is always good practice to check with the PCP in exploring all of the medical reasons and follow their recommendations. Use these tools, as needed, to begin replacing the habit.