Q: This child is nine years old, medically fragile, functioning in the severe-profound cognitive level, blind, deaf, and on a feeding tube. We want to teach him to cough in order to clear his lungs regularly. Do you have suggestions?

WARNING!! I am not a medical professional and all of the following should be taken with extreme caution.  This is what I was taught to do by an OT years ago.  Get medical clearance for these procedures before using them with any of these types of clients.  For more information, search under methods to treat bronchitis.

Encourage the Movement of Phlegm

1. Place the child in prone over your lap, so that his head is to your left and his hips are to your right.  This will put his head lower than his chest and his hips.
2. Then cup your right hand and tap firmly (somewhere between tapping and pounding) on the back, from the bottom of the lungs to the top of the lungs. This is called chest percussion.
3. The tapping/pounding loosens the phlegm, and the position and the tapping upward causes it to more forward and out.

Encourage Deeper Inhalation and More Forceful Exhalation

1. Place the child in a flexed supine position on a mat or on a large firm therapy ball.
2. Bring his knees up to his chest and press them down onto his chest to cause exhalation.  Hold the position for few seconds.
3. Then bring the legs away from the chest.  This should trigger deep inhalation.
4. Then return the knees to the chest for more pressure and repeat the sequence.