[Dysphagia] chewing and DD adults

[SuzMorris at aol.com (SuzMorris@aol.com)]

Safety is the most critical criteria that any piece of equipment must meet if 
it is used in the mouth.   It is amazing to me that we think of this in 
relationship to our own kids, but so often ignore it or "pooh-pooh" it when we are 
talking about older children or adults with oral sensorimotor issues.

The type of "chewy" that the recreational therapist is using is not safe for 
a child or adult with teeth and strong biting patterns.    Actually there are 
very few mouth toys/tools that meet these safety criteria.    The only thing I 
would use with an adolescent, adult or "intense chewer" with teeth is the 
Grabber XT made by ARK Therapeutic Services.    You can see a picture of it and 
order it online at their website:  
http://www.arktherapeuticservices.com/Merchant2/merchant.mv?Screen=PROD&Store_Code=ATSI&Product_Code=GA100XTR&;
Category_Code=Chew

No mouth tool should ever be just given to a client for unsupervised chewing, 
but should always be used under professional supervision and guidance.   In 
addition, any tool should be thoroughly checked each time it is given to a 
client for chewing.    Even under the best of circumstances, the Grabber XT or any 
other mouth tool can develop weak places or tears.   If there are any 
irregularities in the tool, it should be discarded.

A need for intense chewing certainly can be related to reflux, but in my 
experience it it more indicative of sensory needs.   Especially when an individual 
is in a residential facility, sensory levels c an be very high and chaotic.   
If there are any sensory processing issues in the client, chewing can be a 
highly effective way of helping the individual become better organized and 
focused.    Since that is the case, using additional sensory organizing strategies 
(e.g. vestibular or proprioceptive input, deep touch-pressure, specific types 
of music and sound) can also be helpful and reduce the need for constant 
mouthing and chewing.



Suzanne Evans Morris, Ph.D.
New Visions
1124 Roberts Mountain Rd.
Faber, VA 22938
(434) 361-2285 ext. 5
www.new-vis.com


In a message dated 8/11/04 8:11:40 PM, v.cooper@sbcglobal.net writes:

> I saw a 43 yo DD adult this weekend in his ICF. He had something the Rec 
> Therapist called "Chewlery". It is? one of those plastic springy things that 
> you might hold your keys on. He was chewing on it and I had him open his mouth. 
> A few inches of this "thing" was rolled up inside his mouth and since he as 
> all his teeth, it was almost bitten off. I told the staff to take that out of 
> his mouth because he could choke on it. They said that he does frequently 
> "bite thru" them and they have to remove pieces from his mouth. What do you all 
> think of this? The rec therapist is angry w/me that I dont like her 
> "chewlery". I think it is dangerous and frankly ridiculous.
> 
> Can someone please send me some references re: the chewing behaviors of DD 
> adults and how it frequently means there is pain from reflux. (he has SEVERE 
> reflux).I need to talk some sense into this rec therapist before someone 
> chokes to death. Any help most appreciated. Is there anything that they can use 
> for chewing since they seem compelled to use something????
> 
> Virginia Cooper, MS, CCC
>