[Dysphagia] Aggressive MR POC

[pressmah at sjhmc.org (Pressman, Hilda)]

The chewy tube is not a toy so the age appropriate question does not seem
appropriate.  Do you think that he will hold onto it or through it away?  I
consulted on a youngster recently for whom the chewy tube was too soft and
we found a harder plastic ring (from a toy) which he accepted.  Hilda
Pressman

-----Original Message-----
From: Jill Silverman [mailto:JSilverman@dhmh.state.md.us]
Sent: Wednesday, May 19, 2004 8:31 AM
To: dysphagia@b9.com
Subject: [Dysphagia] Aggressive MR POC


     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

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