Sensory Problems

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Hypersensitivity

Gagging on textures, throwing up at the sight of food, these are extremes of sensory feeding problems.

 The most common problem is the inability to tolerate textures.  This can include gagging on lumpy food or food with chunks in it.  You do need to see an Occupational Therapist to determine if it is a sensory problem or an oral motor problem because they can look similar.

 Some kids have such an extreme aversion to certain textures that they will throw up if they just see that texture.

 The most important aspect to treating hypersensitivity is patience.  You have to go at a very slow pace so that the client is comfortable with the changes you are making.  During therapy and feedings, you are trying to change what the client perceives as a negative experience, and make it a positive, enjoyable experience.  Your first goal is to make meal time pleasant and not horrible.  You play games and make it fun, and go at the client’s pace with just a little bit of pushing.

 If you push too hard and go too fast, and the experience becomes negative, you may actually make it worse and cause regression.  The client has to develop trust in you.

 A skilled OT is important to get it just right.  There are some people that think that force feeding will work.  I can tell you from experience that it can make it worse.

 Also important is to do an oral desensitization program 3-5 times a day at non mealtimes.  This gets the mouth used to having things in it.  It may help to count while doing the desensitization program in order to let the client know when it is going to be over.

 Some kids will enjoy and respond to vibration, but others will be too sensitive to it.

Hyposensitivity

Some kids have the opposite of gagging on foods in that they hardly recognize that food is in their mouth.  They don’t chew because they don’t feel the food.  If they just let the food sit in their mouth, the food can slide back in their mouth uncontrolled, which can pose a danger for aspiration.

 Many times, people that are hyposensitive need strong flavors.  Try adding dips and spices to food, such as ranch dressing, ketchup, salsa, syrup, etc, and try spicier foods in general.

 Vibration can help wake up the mouth in the case of hyposensitivity.