Facilitating Oral Sensorimotor Function

In the first three years of a child’s life, their oral sensorimotor function rapidly changes in structural growth and neurological control (Arvedson, Brodsky, & Lefton-Grief, 2020). Feeding skills issues often emerge when the neonatal reflexes disappear. This can be confusing and frustrating for parents who thought feeding was typical and now has changed. Advancing oral sensorimotor skills using interventions based on motor learning principles is considered best practice (Khamis, et al., 2020). 

Interventions that are based on motor learning principles and offered in the first two years of life when the brain is most plastic, yield the best outcomes (McIntyre, Morgan, Walker, & Novak, 2011). The avoidance or limitation of oral feeding may unintentionally add to feeding skill impairment. 

Management strategies, when paired with feeding and swallowing food and liquids, support children to:

• improve chewing and swallowing
• maintain or prevent decrease in oral sensorimotor function    
• continually progress diet with consideration of safety and skill level

General motor learning principles and experience-based plasticity for feeding interventions (Homer, 2016); (Khamis, et al., 2020):

• address specific neuro-muscular impairments that negatively impact chewing and swallowing
• follow typical developmental order of oral sensorimotor function
• provide consistency and intense repetition in functional and motivating tasks
• may utilize food or liquids
• facilitate speed and endurance, focusing on movements related to bolus management and swallowing
• simplify tasks and provide maximal support during early stages of learning (practice desired skills with one food or drink)
• taper support as tolerated and increase contexts and environments as skills reach mastery
• continually reassess to upgrade goals and reduce support while maintaining safety