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When the leaky faucet won’t turn off: dealing with drooling

November 2, 2010 in Ask the Occupational Therapist, Insider Insight by Dr. Tiffany Showalter

By: Dr. Tiffany G. Showalter, OTD, OTR/L

Drooling occurs as part of natural development in almost all young children, however not every child will stop drooling on their own. Did you know that our mouths are able to produce 2-4 pints of saliva every single day? Now imagine that you are not able to control what happens with all that liquid. Excessive drooling that occurs beyond the “cute” stage can be a real problem. It not only impacts a child socially, but is messy, can lead to dehydration, cause skin breakdown, result in infection, soil people and things nearby, and can smell pretty bad. Most children stop drooling after 18 months or when all of their teeth have come in, but some neuro-typical children will surprisingly continue to drool until they are 4 years old. Drooling is most common in children who suffer from disabilities that impair the nerves or muscles in their throats and mouths. Some examples include Cerebral Palsy, Down Syndrome, head injury, hypotonia, mental retardation, Muscular Dystrophy, seizures, stroke, and/or enlarged tonsils. Many sudden onset illnesses also can cause drooling, so a physician should always be consulted to determine the cause. They may suggest treatments like speech therapy, occupational therapy, biofeedback, medication and/or even surgery.

As I have mentioned, many different conditions can result in the problematic water works, but maybe some specific strategies can tighten the valve if not close it off completely. To understand how to manage it, let’s investigate it further. Saliva is produced around the clock in our mouths to aid in speech by providing moisture to the mouth, eating by moistening food, and digestion by beginning the breakdown of food. Drooling occurs when saliva falls from the mouth as a result of an overproduction of saliva and/or problems controlling that saliva inside the mouth. Researchers have proposed four main reasons this might happen:

  1. Awareness: Some children are not aware that they are losing saliva from their mouth
  2. Frequency of swallow: Some children do not swallow often enough
  3. Efficiency of swallow: Some children do not clear the mouth efficiently when they swallow.
  4. Poor seal formed when lips are closed: Some children maintain an open mouth posture or fail to form a tight seal when closing their mouth

These children may need a little help developing the coordination, awareness, and lip strength/flexibility in order to stop or reduce drooling and I have come across some activities which may help do just that.

First, gather some things you will need:

  • ➢ Straws
  • ➢ Cotton balls
  • ➢ Whistles, horns, kazoos
  • ➢ Lollipops
  • ➢ Chewy, sour tasting candy**
  • ➢ Peanut butter**
  • ➢ Bubble fluid
  • ➢ Dental floss and life saver shaped candy
  • ➢ Most of all PATIENCE!
  1. STRAWS require a child to use lower lip control and develop the facial muscles required to stop drooling. When appropriate, allow the child to drink from a straw, rather than a Sippy cup which can make drooling worse. Make it a fun challenge, like putting pudding or apple sauce in a cup with a straw. Milk shakes work great too. If your child needs help learning to use a straw, try using a juice box. Put the straw in your child’s mouth and squeeze enough to give them a taste of what’s inside.
  2. WHISTLES, HORNS, and KAZOOS are another way for your child to practice the lip control they need to stop drooling. It may not be music to your ears, but the result, a dry child, will make it worthwhile. Some earphones might not be a bad investment for your ears either.
  3. Blow! COTTON BALL races are a great way to help stop drooling and have fun at the same time. Place a cotton ball for each racer on a smooth, flat surface. On your mark! Get set! BLOW!!! It’s a great lip exercise disguised as fun.
  4. BLOWING BUBBLES is another great way to help stop drooling. Again, by practicing lip control, children develop the strength, lip range of motion, and skill required to help with the problem of drooling.
  5. For children without peanut allergies, PEANUT BUTTER can be a great tool. Wipe your child’s lower lip free of drool, and smear a LITTLE (not enough to choke on) peanut butter on your child’s lower lip. The child then licks the peanut butter off the lower lip. As they lift their lip to get all the peanut butter, they will be performing strengthening and range of motion exercises.
  6. Sucking on a LOLLIPOP promotes active lip stretching and lip closure which may reduce drooling.
  7. Chewing is a great activity for those children without swallowing difficulties to increase awareness within the mouth. Add sour flavors for the added POW! Sour flavoring has also been shown to increase the frequency of swallowing as well.
  8. Lace a LIFE SAVER TYPE candy with DENTAL FLOSS. While you hold both ends, place the candy inside the child’s mouth and play “tug-o-war”. Instruct the child to close their lips to keep from losing the piece of candy.

Warning

DROOLING can also be caused by an underlying physical condition, such as enlarged tonsils, or by facial structure. If your child cannot stop drooling, speak to his or her pediatrician. Sometimes the problem requires more intensive medical intervention. Additionally, swallowing difficulties can result in life threatening problems, so always consult a physician to rule out any complications.

Read more

How to Help a Child Stop Drooling | eHow.com

How to Stop Drooling by Pam Marshalla

Disclaimer: I hope you enjoyed reading this article. Please remember you are reading this information of your own free will and are taking the information at your own risk. The author is the legal copyright holder of this material it may not be used, reprinted, or published without my written consent. This information is for entertainment and informational purposes only and is not intended to provide or circumvent medical, legal or other professional advice.

Yoga doesn’t have to be a four letter word

October 13, 2010 in Ask the Occupational Therapist, Insider Insight by Dr. Tiffany Showalter

I will be the first to admit that I am not a fan of yoga.  I remember in OT school learning how to use “alternative” activities to assist patients with life threatening, progressive illnesses.  How through breathing, meditation, and control over your body, one could lessen their pain and help improve their overall function for persons suffering from Cancer for example.

We were actually required to take a brief course every Tuesday and Thursday for an hour during an 8 week period so we too could experience what some of our patients might be doing.  Our instructor was a former physics instructor of mine, Sigfried Blair, who reminded me of Gumby with an afro.  Not the best start, I’ll admit, but I digress.  For three weeks, I remember hearing “clear your mind, breathe, and let your body be one with the movement”.  Those who know me can sympathize that I have never been a “clear your mind type of person” and hearing those words really stressed me out.  I am a multi-tasker and proud to claim my “gift”.

I left each session with a migraine headache and set out to find a way out of there.  I easily obtained a permission slip from a doctor who said my headaches and stress were a direct result of these yoga sessions and for medical reasons I should be excused.  See, you can get a doctor to say about anything!

Last year I attended a continuing education conference entitled, “Motor Coordination Disorders:  Impact on Education” where one of the treatments investigated was using yoga to facilitate motor coordination.  The speaker showed us some cute programs with color coded cards and child friendly activities.  I thought I might give yoga another try.

I have since come to accept that even though yoga is not for me, it is definitely for some of the children I serve.  Yoga teaches children to breathe effectively which can improve concentration, learning, and vocal support.  It can also help with self-regulation.

Moreover, yoga encourages body awareness.  Most yoga programs for children focus on slow controlled body movements which require a body awareness of what the muscles are doing as they practice assuming different postures.  It can also help with strengthening, range of motion, and flexibility.  Finally, yoga may help children learn to grade their movements since many of the poses require children to hold at the midrange.

So, yoga may not be for me, but it might be a great activity for your kids.  Give it a try and let me know how it goes.

Disclaimer:  I hope you enjoyed reading this article.  Please remember you are reading this information of your own free will and are taking the information at your own risk.  The author is the legal copyright holder of this material it may not be used, reprinted, or published without my written consent.  This information is for entertainment and informational purposes only and is not intended to provide or circumvent medical, legal or other professional advice.

What can I do when my preschooler is in a fine motor funk?

August 19, 2010 in Ask the Occupational Therapist, Insider Insight by Dr. Tiffany Showalter

Why are fine motor skills important anyway?

Grace is a hardworking kindergarten student who loves school…and why not? She enjoys and is successful at many activities that kindergarteners do everyday. She cuts out pictures from worksheets and glues them appropriately on paper. She colors within the lines and can write her name all by herself. During art, she molds clay into wonderful figures and she strings beads to make a necklace for her mommy. That’s all before lunch. At lunch, she opens her milk carton and uses her utensils effectively. After lunch, it’s off to the playground after she puts on and buttons her coat. Jenny uses fine motor skills all day long.

Why do some children have problems with fine motor skills?

Happy kidSome children may demonstrate difficulties or delays with fine motor development due to developmental delays or medical diagnoses such as Cerebral Palsy, Autism, or Down Syndrome. Other children may develop fine motor difficulties from a lack of opportunity and practice. Children are spending much less time playing with fine motor manipulatives and constructing crafts, instead choosing to play video games and watch television. This can result in poor development of the muscles in the arm and hand which further leads to handwriting and cutting difficulties when in school.

What can I do at home?

1. Provide lots of opportunities to engage in fine motor activities.

2. Utilize vertical surfaces. When a fine motor activity such as coloring or painting is taped to a vertical surface, it engages a child’s small muscles of the hand and promotes a good position in the wrist as well as improving the use of larger muscles in the arm and back. These large muscles provide stability while the small muscles provide refined coordination when performing fine motor tasks. Think about how hard it would be to thread a needle if you were riding a roller coaster! Using an easel, chalk board, or taping a project to the wall is the easiest way to provide a vertical surface, however with some creativity you can probably come up with some more interesting ideas. Other activities I often use include shaving cream on the bathtub wall during bath time, “painting” the fence outside with water, gripping the sponge while helping to wash the car, or playing with a Lite Brite.

3. Tearing and crumpling items in the home can be both fun and help to strengthen those small hand muscles. You can have your child tear pages from a magazine or newspaper and crumple them into balls. Next, the child could stuff crafts with the balls or toss them into a waste basket and keep score. Once your child masters this task, have the child try it using only one hand. Pounding, pinching, and rolling putty or Play Doh in the hands can also help strengthen the hands.

4. In-hand manipulation requires some of the most skilled fine motor movements. We use in-hand manipulation when placing coins into a bank, turning a pencil over to use the eraser, or lace a shoe. Your child can work on these skills by doing the aforementioned activities or by playing games like Connect Four, jacks, or similar games with small pegs or pieces that need to be inserted elsewhere.

5. Children are often provided with pencils, crayons, and markers before their little hands are ready for such items leading to development of inefficient pencil grasps and poor fine motor refinement with tool use when they get to school. To encourage proper development, try giving your child broken crayons, golf sized pencils, small pieces of chalk, and Pip Squeaks from Crayola.

Been there, done that. Is there anything else I can do?

Talk with your child’s teacher or contact your school’s occupational therapist for suggestions. You can also visit the American Occupational Therapy Association at www.aota.org for more information.

References

American Occupational Therapy Association, Inc.

Mary Benbow (1999), Fine Motor development, Columbus: Zaner-Bloser, Inc.

Disclaimer: I hope you enjoyed reading this article. Please remember you are reading this information of your own free will and are taking the information at your own risk. The author is the legal copyright holder of this material it may not be used, reprinted, or published without my written consent. This information is for entertainment and informational purposes only and is not intended to provide or circumvent medical, legal or other professional advice.

Making physical education fun for children with autism

July 26, 2010 in Special Needs News by Admin Dawn

Betty always had lots of energy for the children in Room 103. She was the adapted physical education teacher for the special education program there. Betty came every Tuesday and Thursday, rarely missing even a day with these children. At the beginning of the year, she saw that the class had a couple of new students.

Betty noticed that one of the new students seemed to have a lot of gross motor skill issues. The boy’s coordination was off and he really didn’t seem to understand directions. Betty asked, “Is this one of the new children you spoke about?” The teacher answered, “Yes, he is. This is Austin. He’s just beginning first grade. Austin doesn’t follow directions well yet. In fact, the boy isn’t really up to what most first graders can do physically during gym class either. I was thinking of asking for a meeting to see if he might qualify for your services. Let me know what you think.”

read more at Making physical education fun for children with autism | education, children, betty – Local – Brownsville Herald.

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