[AERNet] need help with 2 year old with ONH

[Ayala Ballonoff]

Dear Jenny, 

Just a few quick thoughts 

First, I think this is a really hard one.  I can remember seeing the look in a kid's eyes at a few months old when they would look at something & just think"Wow if I can just get that in my mouth I could really know all about it!"  THis was a baby with vision looking at 
a fluffy piece of feather. 

It is much more rewarding to feel those things with the mouth& I think the kid needs an appropriate time & setting to do that-- you could, for instance, provide a distinctive time/place for doing oral motor exploration--ie--seated with a work tray & some edible & mouth able items like ice,spoons, hard salty pretzels, hard & soft fruit.

Reward & reinforce mouth exploration in that setting.  

"you can taste and lick things at the Tasting Table" Maybe use a distinctive (bumpy?) place mat to differentiate from later "hand touching activities" at the table.  

Then try a "Touching area"  with things that are not so satisfying when mouthed--- dishpan full of sand, for instance.   Sit on the floor in a confined area (use gates, or a small room, or a play 

 yard.)  Use hands to explore the sand.  "NO mouth, touch with hands"  "Good boy, you are using your hands"   Introduce other items in the area, sand digging toys,  do other  hand activities like rolling a jingle ball.  Establish floor play as a "hand touching time"

Discuss w/ parents & caregivers how to reinforces & how to discourage behaviors.

Expect this to take a while to decrease.  

Also, try sensory activities to stimulate body and finger awareness & finger differentiation. .  Discuss surgical brushing programs w/ the OT.  Massaging lotion, into arms & hands, finger plays where you squeeze & touch fingers & toes (This little Piggy, counting the ducks, monkeys, etc in songs by  gently  squeezing fingers in succession)  

Just a few thoughts.  Everything works some of the time.

Ayala 

 
 
 
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