The way in which a person moves the body, makes a big difference in the way in which the mouth moves for communication or for eating. Many children have developmental problems that affect the coordination of the body. They also have problems that affect the coordination of the mouth for eating. We can call these movement patterns limiting patterns because they limit or make it more difficult for the child to move or eat in a normal way. It is vitally important to recognize tone and movement patterns of the body that influence movement patterns in the mouth. When we understand these body and mouth connections, we can reduce the severity of many feeding problems through changes in the physical environment.

Common Problems of the Mouth and Body

• The body is stiff or hypertonic.

  Tone means the amount of tension in the muscles. Hyper- means too much

  When the body is hypertonic, it is harder to control the movements of the jaw, tongue, lips, and cheeks for feeding. These become more uncontrolled as the body gets stiff.

• The body is floppy or hypotonic.

  Tone means the amount of tension in the muscles. Hypo- means too little.

  The tongue, cheeks, and lips are often floppy or low in muscle tone too. When this happens food sometimes falls out of the mouth or is pushed out by the tongue. It is also hard to learn to suck in a more advanced way or to chew food when the body and mouth are hypotonic.

• The head pushes backward into extension.

  This often causes the arms and legs to become stiffer and move in an uncoordinated way.

  When the head is back in extension, the tongue is often pulled back into the mouth and throat. This makes it harder to suck and swallow.

  Food that is in the mouth often falls over the back of the tongue and into the airway. Because the airway is open, the person may draw food into the lungs or aspirate. Coughing or choking is the body's way of trying to get rid of food that has gone into the airway. It is a sign that something is wrong.

  The child may try to get rid of food that falls into the back of the mouth. The tongue may push or thrust food forward to try to keep it out of the throat.

  Strong biting on the spoon or cup is usually increased when the head is back in extension.

  The jaw often pushes or thrust open with a lot of tension when the head is back. This makes spoon feeding and cup drinking very difficult.

• The head pulls down and forward into flexion.

  This often causes the arms and legs to become stiffer and move in an uncoordinated way.

  The breathing muscles cannot move well when the head and shoulders come forward. This makes it more difficult to breathe. It is also difficult to coordinate the breathing with swallowing. Because of this poor coordination, choking may occur as food accidentally goes into the airway.

  Food often falls out of the mouth because of the position of the head.

  It is often more difficult to open the mouth because the jaw tends to clamp or clench closed when the head is forward with tension in the neck and shoulders.

• The body pulls or flops to one side, causing the child to fall over in the chair.

  This usually happens when the head turns to the side. The head usually is pulled backward into extension or forward into flexion.

  The jaw sometimes pulls to the side, making eating more difficult.

  Food often falls out of the mouth.

Suzanne Evans Morris, Ph.D.
Speech-Language Pathologist
New Visions
1124 Roberts Mountain Road
Faber, Virginia 22938
(804)361-2285

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without prior written permission of the author
© Suzanne Evans Morris, 1997 All Rights Reserved