[Dysphagia] Aggressive MR POC

[hillivie at xtn.net (Kathleen Wright)]

Marie - have you ever had a problem of someone accidentally ingesting 
the tubing when the staff person looks away?

Marie Isbell wrote:

>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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>