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[Dysphagia] gum chewing and Profound MR



I think there are heaps of issues here. I work in a residential setting 
for adults with intellectual disabilities and this issues has come up a 
number of times and again recently.
I guess the answer will partly lie in the reasons why the biting and 
PICA are occurring in the first place. Sometimes there can be a medical 
reason behind it (?reflux etc?), other times behavioural, 
communicative, sensory.
In our recent case it is considered to be behavioural and sensory (ie. 
providing oral stimulation and a distractor during times of boredom). 
In collaboration with the OT and the psychologist, we are looking at 
replacing the current item of choice (which was a piece of bread that 
was played with for a few hours and then eaten) with something safe 
(that will not be ingested) and more hygienic (can be sterilised).
Dont know if any of this applies to you but...
Regards,
Harmony
Speech Pathologist

On 12/05/2004, at 10:31 PM, Jill Silverman wrote:

> Hi All...I need some advice.  I work in an ICF/MR for adults and I 
> have just been instructed (by Senior Management) to complete trials of 
> gum chewing with a 40-something Profoundly MR individual with an 
> extremely high incidence of aggression, biting Staff and self, PICA, 
> etc...
> Individual presents no overt dysphagia and is presently on a Regular 
> consistency with thin liquids without signs and symptoms of 
> penetration/aspiration; however, I am quite uncomfortable providing 
> him gum when other "chewys" are safer and constructed solely for this 
> purpose of redirecting biting and chewing.  Can anyone offer 
> suggestions or refer me to any literature?  Respectfully, Jill 
> Silverman
>
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