Dear TalkTools,
My son, David, is 4 years old and has Down syndrome. He has, in the last year, started chewing on his tongue. I have tried giving him the P & Q to chew on and also the Gator Jiggler. The Gator works for a time and the P’s and Q’s do not seem to help at all. I looked on your website for potential ideas to no avail and was wondering if you have additional thoughts/ideas. We are a very oral family — I chew on my pens (usually when I’m thinking), my two oldest daughters were thumb suckers until older, my 2nd daughter bites her nails, my 3rd daughter chews on her shoelaces… thanks for any ideas that you may have!!
Robyn
P.S. Sara has seen David informally the last two years at NDSC.
Hi Robyn,
I’m so glad you reached out. Tongue chewing is often seen in children with Down syndrome and in other children with low tone and associated muscle weakness. In my book, Assessment and Treatment of the Jaw – Putting it all together: Sensory, Feeding and Speech, I devote an entire chapter to why children with jaw weakness develop these habits. Tongue sucking is only one; others include teeth grinding, finger sucking, sucking on clothing, biting self/others, prolonged pacifier or sippy-cup use, and nail biting.
What these habits share is a drive for temporomandibular joint (TMJ) stimulation for calming. The TMJ—where the upper and lower jaw meet just below the ears—has a dense concentration of nerve endings. Rhythmic up-and-down jaw movement helps many of us self-organize (as you noted with pen- and shoelace-chewing in your family).
Because David needs input that directly activates the masseter muscles, the P & Q and the Jiggler aren’t providing the targeted stimulus.
At TalkTools, we’ve developed several ways to deliver the necessary TMJ stimulation. A particularly appropriate option for David is the Bite Tube Hierarchy—a set of four tubes used not only to satisfy the TMJ input need, but also to build jaw stability and improve chewing skills and speech clarity. Instructions for implementing the hierarchy are included with the tools. Additional substitution strategies for tongue sucking are outlined in the book mentioned above.
I hope this helps!