[Dysphagia] Aggressive MR POC

[Marie.Isbell at state.tn.us (Marie Isbell)]

I work with adults with developmental disabilities.  One option we use
is acrylic water fountain tubing you can get at hardware store.  It
comes in various diameters, is clear and quite firm, and will not absorb
food if dipped.  There is also a whitish opaque tubing sold in the same
area, but that is not FDA approved.  I usually cut a piece about 8" long
for the person to chew on.

Marie M. Isbell, MA, CCC-SLP
West TN Regional PNM Team
West TN Regional Office
8383 Wolf Lake Drive
Bartlett, TN 38133
(901) 213-1847
Fax: (901) 372-3460
Marie.Isbell@state.tn.us

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>>> "Pressman, Hilda" <pressmah@sjhmc.org> 5/19/2004 8:35:30 AM >>>
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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