This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Q: When I try to use a tongue depressor or any other tool in my client’s mouth, he backs off right away and says, “It hurts.” He does this even before I use the tool to touch his mouth or do anything. I don’t think he’s hypersensitive. I think he’s refusing just to refuse. He is four-years-old and I am trying to elicit a K and a G.
I think you are right. A little guy like that may use the phrase “It hurts” as his way of saying, “I don’t know what you are doing, and I am unsure of this, so don’t.”
My advice would be to back off and make this a more friendly approach with a less invasive feel about it. For example, eat gummy bears in front of the mirror to help him get more used to manipulating an object in his mouth. Then hand him the tool you want to use and have him explore with it in his mouth. Then return to your stimulation, but let him do it to himself instead of you doing it to him.
The basic approach to “normalizing oral-tactile sensitivity” is the same whether this is true oral-tactile hypersensitivity or simple uncertainty on the part of the client:
- Start with a less-invasive and more friendly activity regarding the mouth
- Sit in front of a big wall mirror so he can see what’s going on
- Talk about what’s going on: “You are chewing on that old bear…”
- Let the client familiarize himself with the tool, even play with it, before you use it in a purposeful way to stimulate a specific oral movement
- Use a second tool yourself on your own mouth to model
- Let the client apply the method to himself with his tool instead of you doing it to him