management- oral motor

Management is guided by goals for:

• Adequate nutrition and GI function

• Stable pulmonary function

• Age-appropriate oral sensorimotor and feeding skills

what type of input is essential?

Multidisciplinary input (medical, surgical, nutrition)

_______ is a tool for growth/safety—not failure

Nonoral feeding

what type of factors influence management?

Child’s age, condition, environment, and psychosocial factors

Oral Motor learning applies _____ to swallowing/feeding

broadly

principles include:

• Use it & improve it: active training is key

• Repetition & intensity matter: builds functional gains

• Specificity: task relevance boosts learning

• Age matters: early experience influences outcomes

expected oral motor deficits

• Poor ____: ___ or ____

• Reduced ______ or ____in ___, ___, ___

• Incoordination of ____

• _____ abnormalities (e.g., _____, _____)

• ________ challenges

• Inefficient _______ or ______

• Difficulty with ______ and ______

• Poor ____ stability for ______

• Delayed or uncoordinated ______

• Risk of ____ due to poor __________

• Poor muscle tone: hypotonia or hypertonia

• Reduced range of motion (ROM) or strength in lips, jaw, tongue

• Incoordination of oral structures

• Reflex abnormalities (e.g., persistent tonic bite, exaggerated gag)

• Sensory processing challenges

• Inefficient oral bolus formation or manipulation

• Difficulty with lip closure and anterior spillage

• Poor jaw stability for biting/chewing

• Delayed or uncoordinated oral transit

• Risk of aspiration due to poor oral-pharyngeal timing

what facilitates oral control?

Optimal postural alignment

key components of positioning”

• Head/trunk alignment

• Pelvic stability

• 90/90/90 position (hips/knees/ankles)

positioning adaptions

towel rolls, footrests, side supports

For children with severe motor impairments consider what for positioning?

tilt-in-space, headrests, or specialized seating

oral motor interventions aims to improve:

• coordination of respiration, phonation, and oral-motor control

• whole-body and oral sensory processing

• readiness for feeding (e.g., preterm infants)

Oral motor treatment should:

• Align with ________

• Include ____, _____, _____ considerations

• Be consistent across ______ (____, ____, _____)

• Align with total child development

• Include posture, position, tone considerations

• Be consistent across environments (home, daycare, restaurants)

Direct approaches (e.g., oral exercises):

• Stimulate structures

• Encourage exploration

• Caution: may be invasive or increase secretions

Indirect approaches:

• Environmental alterations: reduce distractions

• Position/seat: improve trunk and head control

• Communication cues: touch, verbal signals

• Food changes: texture, temp, timing, bolus variation

oral motor strategies to improve lip closure

• Deep pressure to orbicularis oris

• Tactile cueing (e.g., “kissy lips”, lip blocs, straw drinking)

• Play with bubbles or resistive straw drinking

oral motor strategies to increase cheek tone and control

• Tapping or vibration to buccal area

• Cheek stretches and cheek puff games

oral motor strategies to promote jaw grading and strength

• Supported spoon feeding with downward pressure

• Use of chewy tubes or resistive chewing tools

• Biting games with resistive textures (e.g., rubber tubing)

• Jaw support via external hand or adaptive equipment

oral motor strategies to promote tongue lateralization and elevation

• Use of flavored tongue depressors or lollipops

• Tongue "games" (e.g., lick lips, touch nose/chin)

• Spoon placement to encourage midline cupping

• Encourage tongue-palate contact with cold stimuli

Use of ____, ____, and _____

____ or ____ depending on need

vibration, temperature variation, and oral play

Oral alerting or calming strategies

Always pair sensory input with what??

functional feeding tasks

Don’t separate _____ from ____ — integrate when possible

example?

oral motor from feeding

Example: chew tube pre-feed warmup → chewing practice during meal

Modify ____ and ____ based on current motor abilities

textures and pacing

Always monitor ____, ______, and _____

fatigue, tone changes, and safety

when goal writing:

• Tie motor behavior to __________

• Consider level of _______ (e.g., _______, _______)

• Include type of ______ (e.g., _____, ______, _______)

• Avoid vague goalsl like “________” without context

• functional feeding outcomes

• support (e.g., with jaw support, verbal cueing)

• texture/input (e.g., puree, chewable solid, straw drinking)

• “improve oral strength”