[Dysphagia] Aggressive MR POC

[JSilverman at dhmh.state.md.us (Jill Silverman)]

     Hi All!  I would first like to thank those who provided me with helpful suggestions for completing the gum trials with the individual I described in my e-mail last week - against my better judgement - per Senior Management's directive.  As I expected, he swallowed the gum immediately and engaged in SIB - biting his arm and hitting his head - even with the gum...Needless to say, we are thankfully NOT moving forward with that idea...Thank G-d!!!
   However, the Team (or in other words me and the Psychologist) are now left with the difficult mission of designing another plan.  Please remember this man is violently aggressive, nonverbal, profoundly mentally retarded, h/o seizure disorder, & Diabetic - so edibles would certainly complicate things - even though I do not habitually prefer to use edibles.  With this group of developmentally disabled individuals who reside in an ICF/MR, often food is the only natural motivator that is effective...I researched and suggested mouthing tools (or, chewy toys, tubes, teethers) as something we might try and was honestly "heckled" and told they were not age appropriate.  Now, yes, this man is in his 40's, but cognitively, he functions at approximately 6-12mos...Others "prefer" squeeky toys, activity boxes, mobiles, etc...Why then is my idea so preposterous?!  ANY other ideas anyone could offer will be sincerely helpful!!!  
Respectfully yours, and awaiting your suggestions, Jill Silverman