As an occupational and physical therapist, I have the pleasure of working with young families. Recently a mom and her nearly-two child visited me. Mom’s concerns were her child’s tendency to place non-edible items in her mouth, occasional biting others, and a habit of banging her head against the wall. This is how our session went; I hope it can help other parents:
Jane expressed a concern regarding Lisa’s tendency to place “everything” in her mouth as well as some reduced coordination and sensory stimulation such as head banging. Recently, head banging against the wall has been replaced with firmly taping her arm against the wall when seated with her back toward the wall. Interestingly, the same rhythm for head banging is reproduced with the arm tapping action.
We discussed the tendency for head and arm banging as a form of sensory stimulation that is allowing Lisa to get a sense of her body’s position in space. Lisa is seeking this heavy bumping in order to find her body parameters. Jane also reported Lisa’s tendency to bite down hard and this was also seen as an attempt of Lisa to establish her body sense through co-contracting muscles.
We need to take cues from Lisa regarding what her brain is needing at the present time. Through her banging and heavy biting, she is demonstrating the need to really “feel” where her body is in space. We can help her with this developmental milestone through more socially and physically acceptable activities. Rolling, jumping and safe rough-house playing are all methods that young children utilize in order to establish knowledge about their body’s height, width and depth. Lisa is craving this type of information and you can augment her learning by applying squishy, gentle pressure as circumferential squeezes on her legs and arms. Giving full body hugs as well as pretending Lisa is a sandwich filling and have her lie between two pillows, pretending to squish down the pillows [bread] so that her whole body can feel mild compression. Some parents will utilize weighted blankets or have their child perform activities that involve somewhat heavy resistance such as pushing or sliding a weighted laundry basket across the floor.
In terms of Lisa’s tendency to “eat everything”, Lisa is telling us that she is learning about her world through her mouth. Small children will mouth objects before their sense of touch has developed. We need to do two things, allow Lisa to utilize her mouth, lips and teeth to explore safe objects at the appropriate time and place and, at the same time, also work to develop her sense of touch so that she will no longer need to learn about her world through using her mouth.
When you are able to intervene and prevent objects from going into Lisa’s mouth, automatically substitute that activity with an actual chew toy. Give Lisa a lot of positive feedback for using the chew toy. Keep in mind, that Lisa is placing objects in her mouth to learn about her world. Learning new skills is calming for all of us. We can’t just remove objects from her mouth and expect her to be calm. We need to appreciate that this is the developmental stage that she is at and, until the time comes that her touch centers in her brain are more active, she will continue to need to learn about the world through her mouth and calm herself through mouthing actions.
Ideas to facilitate Lisa’s sense of touch are all kinds of tactile input to the skin over her entire body. As we discussed, consider using toweling after her bath or after a swim and spend extra time softly rubbing the towel material over her skin. Give her lots of hugs and kisses, play games that involve interacting with her skin such as pretending to have toys walk or drive over her body. It is important that she explore different textures and degrees of firmness of items.
It is also important that Lisa, and all children, be given time and space to mature in their own way. Sometimes learning from your child is the best solution. You may still need to give “timeouts”, but use the timeout time for yourself to think through what could be done next time.