Gag reflex or not?

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I have done many evaluations for feeding and oral motor skills where I am called in because the child is gagging on solid food.  Many times this is the case, and we have to work on desensitizing to lumpy food, and work on oral motor skills so that they can move the lumps around in their mouths better.  There have been several cases though where the child eats lumpy and crunch food, but still gags sometimes.  It turns out that the child wasn’t truly gagging, but he had weak oral muscles and just got tired of chewing, so once he was tired, he just started spitting food out.  This didn’t mean that he was full though, it just meant that he was done chewing.  In cases like this, it is important to give the child a combination of foods so that he has easy to eat in order to get enough nutrition and calories, and harder to eat foods so that he can practice chewing and strengthen the oral muscles.  The challenge is getting the combination right so that you give enough of a challenge without the child wanting to give up.  This takes skill.