You may have seen some of the oral motor problems posts in a recent series we've had here on The OT Toolbox.  We've been talking all about oral motor skills and today brings another in that series.  If you missed any of those posts, you can find all of the past posts on oral motor skills and how they relate to feeding here.   

Below you'll find information related to jay clenching oral motor issues and the reasons that this particular oral motor problem occurs.  You'll also find feeding issues that may ensue from jaw clenching.

Jaw Clenching Oral Motor Problems

Jaw clenching occurs when the jaw moves into a tight position as a result of body movements and the ability to open the mouth occurs. Jaw clenching can result in shortening of jaw musculature and contractures.  This leads to anatomical inability to open the mouth.

It's possible that the observation of a clenched jaw in feeding may be confused with stability biting and tonic bite response. 

Teeth grinding can occur as a result of a clenched jaw.

Jaw clenching occurs because of several reasons:

Poor posture with overall flexion

Over-Stimulating sensory environment

Increased stress

Impaired control of jaw movements

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Feeding issues related to jaw clenching:

When a child presents with a clenched jaw, their ability to develop the skills needed for feeding are greatly impacted.  

They cannot utilize rhythm in eating and drinking. 

Initiation or sustained movement patterns during eating and drinking are impacted.

Oral Motor Exercises

Looking for oral motor exercises?  Grab this FREE printable pack of oral motor exercises, including 20 different feeding therapy ideas AND 20 oral motor exercises.  These are treatement ideas for oral motor problems that professionals can utilize over and over again. 

If you are looking for more information on pediatric feeding, you will be interested in a pediatric feeding course being offered by my occupational therapist friend, Alisha who writes at Your Kid's Table.  

Pediatric Feeding 101 is an online course designed for therapists and professionals supporting or working with families that are facing feeding challenges.  This is an entry level course and is an introduction to pediatric feeding in general, but focuses on 3 different areas of early childhood eating:

1. Milestones (transitioning to table foods, how to drink from a straw, how to use utensils, etc.)
2. Structure and Routine at Meals (the foundation to creating healthy eating habits that last a lifetime)
3. Picky Eating (how to help picky eaters using no-pressure techniques and exploration)

Each of these areas are taught in its own module through a video lesson and accompanying slides that are downloadable and printable. You will also receive 6 additional handouts that you can keep and share with the families you work with.  These handouts include:

1. The Feeding Milestones Checklist
2. Feeding Schedules Template (for children from 6 months to 12 years old)
3. How to Create A No-Pressure Eating Environment Quick Guide
4. The 5 Step Picky Eater Solution Plan
5. Resources Guide (list of links and additional literature)
6. Feeding History Form (for Parents and Caregivers to fill out)

Click here for more details about the Pediatric Feeding 101 Course

School based Occupational Therapists are busy bees!  The jobs of a school based OT are many: supporting academic, lunchtime success, development of skills needed throughout the day, social skills development, math, reading and writing (i.e., literacy), behavior management, recess participation, participation in sports, organization and executive functioning skills, self-help skills, prevocational/ vocational participation, transportation, and more.

One of the biggest strategies to improve productivity is organization for the school based occupational therapist.  The ideas listed below are designed to help with organization in order to help the school based OT through their day.

Most school based OTs have a full caseload that involves several or many school buildings within a school district and/or a variety of school districts.  Each building has it's own schedule, lunch times, special events, and holidays that must be tracked.

Within each building, the students who receive therapy services have a schedule of classes, special scheduling needs, and teacher preferences that require specific scheduled OT treatment timing.  parents, school principals, and other professionals have input into therapy scheduling as well.

Scheduling for the school based OT is a yearly nightmare of charts, calendars, lists, erasers, and crumbled papers.

Once schedules are finished, it's time to begin treatment as each week and month brings new intervention minute requirements.  However, there are school delays, special assemblies, and sick kids to keep in mind.  Fitting make-up times into those already jammed schedules is a continual round of nightmares!

Some school based OTs are lucky to have a designated space to house all of their supplies, tools, charting, and supplies.  Others need to cart their intervention from school to school and work from the trunk of their vehicle as they think ahead to the needs of that particular day's student needs.  Then they drop their supplies at a hidden desk in the stairwell and make their way through the schedule, pushing into classrooms, intervening in gym class, or addressing needs in the lunchroom or playground.

The school based OT's day is never the same and always changing.

With all of these scheduling, planning, equipment, and space issues that interfere with productivity standards, any hack that makes us more organized can help!

These tools for productivity may help keep the school based OT organized and on track for a successful school year..  They are intervention strategies, productivity ideas, and generally tricks to help the school based OT get through their day in an easier way.

Tools for Getting Organized as a School Based OT

Affiliate links are included in this post. 

Organization Tricks for the School Based OT A therapist who travels from classroom to classroom or building to building needs to stay organized! Try these tricks to stay sane.

Use Google Drive to create folders for each student as a way for  students would save multiple documents to a folder in Google Drive.

Create an organized caseload list and adjust to fit workload with time for consult services.

Create tracking tools for therapy attendance, contact information, assessment dates, consult records, daily and weekly schedules, school contact information (secretaries, teacher extension numbers and emails), equipment records, data sheets, goal sheets, etc.  Use Google Docs to create record sheets that meet specific needs.

These Google Sheets Caseload Management, Lesson Planning, and Data collection were made for SLP, but they could work for the OT, too. 

Printable Sheets for the School Based OT:

Create a file of regularly used printable sheets like:
Back to School OT Folder Covers (free download)
The Therapy Planner with tracking sheets, schedules, note pages, treatment planners, calendars, planning templates, IEP trackers, and more. 
Visual Processing Problems School Checklist
Occupational Therapy Tool: Perception, Executive Function, Motor Control (free download)
Parent/Therapist Communication Log (free download)
End of the Year Parent Letter (free download)

Tools for help the school based Occupational Therapist with monitoring goal achievement:

Using Rubrics to Monitor Outcomes in Occupational Therapy  Improve Critical Thinking and Clinical Reasoning by Adding Rubrics to Assess Goal Progress with this book to improve data collection methods and documentation style with teachers in order to enable concise development of the IEP and goals targeted toward the student’s individual needs.  The book provides rubrics but also shows how to design your own for improved organization planning and data collection. When annual review time comes around, goal progress is also easy to report.

The Therapy Planner is a tool that can be printed and used year after year to track progress.

Sensory Strategies for the School Based Occupational Therapist:

Provide parents, teachers, and paraprofessionals with this Sensory Processing Disorder information packet (free printable)

A Buffet of Sensory Interventions provides solutions for older children in middle school and high school age ranges.  The book emphasizes the importance of fostering independence, self-advocacy and self-regulation in a period of growth that transitions into adulthood. 

Free Sensorimotor Classroom Activities (free printable)

Handwriting Tools for the School Based Occupational Therapist:

Handwriting Speed Norms by Grade Level

Keyboarding Speed Norms

The Ultimate Free List of Printable Adaptive Paper

Google Chrome Extensions for Struggling and Special Needs Students

Activities for Handwriting Problems- Tons of creative ideas to work on handwriting skills 

Additional Information for the School Based OT:

Check out all of the resources on our School Based OT Pinterest board.  There are a ton of intervention strategies, tools for getting organized, and more. 

School Based OT Resources from AOTA

Productivity Tricks for the School Based OT on scheduling from Tx Source

Understand the Special Education Process (Go To For OT)

Caseload to Workload from AOTA

So many school based OTs have purchased and used the Printable Therapy Planner.  It's back for the new school year and for a limited time, is bundled in a can't-be-beat package of school-based therapy tools:

The Back to School Bundle will include:

• Wiggle Worms: A Guide to Alternative Seating for the Classroom (ebook)
• The Inspired Treehouse Printable Therapy Planner (digital download)
• Creative Pediatric Treatment Strategies Based on the Evidence (webinar)

These three products together would regularly cost $62.97, For one week only (8/15 through 8/21), the bundle will be only $34.99!

Get the Back to School Bundle while it lasts!

The printable planner includes:
-Data collection sheet
-Monthly attendance log
-MFE/IEP date tracker
-Daily and weekly schedule formats
-Monthly and weekly calendars
-To do lists
-Equipment order list
-Therapy supplies inventory
-Home exercise sheet
-Classroom suggestion sheet
-Treatment planning form
-Blank notes pages
-Student information sheet
-Caseload tracker
-Family contact form

The planner, webinar, and alternative seating guide are perfect tools for the school based OT's productive and organized days in the classroom.

Click here to get your bundle. 

SPECIAL BONUS: If you order the school based OT bundle listed above through this link or the links in this post, let me know at theottoolbox@gmail.com.  I will send you a special bonus offer of 31 printable pages that can be used by the school based OT.  These include:

Cursive writing letter order

Cursive handwriting practice ideas

Fall Sensory Experiences activity guide

Fine Motor Skills needed in the classroom

Playdough Fine Motor Activity

Shoe Tying Step by Step

Visual Processing Problems Checklist

Farm Themed Brain Breaks

Bear Themed Brain Breaks

Calm Down Strategies for the Classroom

Free Classroom Sensory Motor Ideas

Strategies to Help with Impulse Control in the Classroom

Sensory Coping Strategies

Keyboarding Club Guide

Pre-Writing Skills in Preschool

Dinosaur Visual Perception Sheet

Monkey Visual Perception Sheet

These include free and for-sale items bundled in a digital PDF format that can be printed off and added to a file folder to be pulled out and easily used or distributed to teachers and parents. 

Remember: First,  Buy the Back to School Bundle HERE. 

Then email Colleen at theottoolbox@gmail.com and I will email you the School Based OT Handouts.  Be sure to let me know your email address when you email me so I can confirm your purchase.

Children today are experiencing less and less physical activity and more and more sedentary lifestyles that limit participation in many motor experiences. Children are spending more time in front of screens and less time climbing trees, rolling down hills, and in general less time outdoors.  Physical activity is a vital part of health but for the student, movement in the classroom can have a big impact on learning.  Gross motor games and activities can help. 

There is much evidence of the link between movement and learning.  For some students, movement breaks in the classroom are an essential part of regulation of sensory needs.  Most students need a quick energizer to beat lethargy in a long school day at some point and brain breaks are a great answer to meet that need.   

Below, you'll find easy ways to incorporate movement into the classroom.  

These are easy strategies that can be added at little cost.  As much as most teachers and school based professionals would love extensive equipment or alternative seating and cushions in their classroom, these ideas are not always feasible.  For these and other reasons, I've put together this list of ideas to add movement into the classroom environment.

Easy Ideas to Add Movement into the Classroom

Add movement into learning- Incorporate gross motor movement into math when repeating math facts by incorporating whole-body games such as Simon Says (Students can perform specific motions when math facts are true, and perform other motor tasks when math facts are false.)

Daily Stretches

Afternoon Yoga Stretches

Dance Party Breaks

Themed Brain Breaks- Some ideas are these Bear Brain Breaks or these Farm Brain Breaks. 

Role Play Activities for history, science, geometry, etc.

Large item manipulatives- Use creative items such as large cardboard boxes, printer paper boxes filled with newspapers, old phone books, etc.

Add in walks during the day.

Incorporate action rhymes into the morning routine or circle time. 

Try these sensory motor activities for the classroom.

As students to move around the room to learn about specific items.  Fall back on those places by asking the students to recall the part of the room they were in when they learned about that particular topic.

Move books or other items from the desk to a different part of the room so that students need to get up and walk to the back of the room to get their math workbook.

Try inexpensive seating tools such as this DIY sensory seating idea. 

Utilize extra recess as a reward.

Create a fidget toolbox in the classroom for movement needs while sitting at desks. 

Try a ball toss game with partners when working on learning facts or spelling. 

Ask students to perform jumping jacks, clapping, running in place, or hopping when spelling words as a group.

Add movement requirements within a multi-step project- Students can complete a worksheet, then get up and place it in a bin across the room, then walk to another center to gather materials needed for their next assignment, then return to their desk.

Ask students to assist in handing out materials and papers.

Place a math problem at each student's desk.  Each child can copy the problem to another sheet of paper and complete the problem.  Then, they can move to the next desk and complete that problem.  Ask them to move to each desk until they have solved all of the problems.

Students can place their chairs on their desks at the end of each day and remove them at the beginning of each day.

When walking from classroom to classroom, students can all walk on their toes.  Other ideas: walk toe to heel (for short trips down the hall), penguin waddle, walk with extra large steps, or other creative movement ideas.

Students can carry bins of materials needed for each day from their cubby to their desk.

Borrow a swivel seat from the computer lab or office.  Use the seat as an alternative seat for different students throughout the day.

Try Indoor Ice Skating before a learning task- In the classroom, use a sheet of paper under each foot as students "skate" in the classroom for 5 minutes. 

Raise the desks and allow students to stand for reading/writing/worksheets/learning activities.

Use easels in the classroom.

Encourage wall writing by taking paper to the walls and asking students to write at the wall.

Allow prone writing and reading (lay on stomach on the floor).

Use a therapy ball as a seat or as a movement area in the classroom.

What are your favorite ways to add movement to the classroom?

Have you been following along on our oral motor series this past week? You can find all of the posts related to oral motor skills and how they relate to feeding on the site. Each area will be addressed along with reasons why abnormal oral motor problems occur and their influence on eating and drinking. Be sure to check out the past oral motor problem posts and come back as the remaining areas are addressed in upcoming posts.

Jaw Instability and Oral Motor Problems

Jaw instability is observed when the jaw slips and shifts due to inefficient tone and control, resulting in a child who opens and closes the mouth to reset positioning.  Jaw instability is also observed in the child who holds their mouth closed in a tense open position or closed by biting.

Jaw instability occurs because of several reasons:

• Laxity of the temporomandibular joint
• Delayed development of jaw stability due to hypotonia
• Structural problems at the temporomandibular joint
• Poor control of the jaw
• Poor grading of movement patterns
• Poor isolation of jaw movements from the body

Feeding issues related to jaw instability:

When a child presents with jaw instability, every aspect of eating and drinking are affected.

Difficulties present in the use of cheeks, lips, and tongue in coordinated eating and drinking when jaw instability is present.

Controlled biting and chewing occur.

Positioning the jaw when not chewing can be uncomfortable, painful, or difficult.

Graded biting and chewing can be difficult.

The child might experience more stability with biting and chewing motions when approaching food from the side of the mouth.

Looking for ways to address jaw instability?

Oral Motor Exercises for the Jaw

If you are looking for exercises related to common oral motor problems, this FREE printable pack of oral motor exercises goes along perfectly with the series I have planned for you.  Get your free download printable packet of 20 different feeding therapy ideas AND 20 oral motor exercises.  These are treatement ideas for oral motor problems that professionals can utilize over and over again.  

Get the free printable pack HERE. 

You might be following along with our series related to oral motor problems that relate to feeding. In it, we are covering all of the specifics about oral motor problems that translate to difficulty with eating and drinking. So far, we've covered jaw thrust but have more oral motor problems that will be covered in the coming days. Today, exaggerated jaw movements are addressed, along with the cause of these movements and how they relate to feeding issues.

Exaggerated Jaw Movements Oral Motor Problems

Exaggerated jaw movements are different from jaw thrust in that the movements are not forceful.  When exaggerated jaw closure occurs, it can be a compensation strategy for jaw instability or 

There are several reasons for these exaggerated jaw movements:

Fluctuations in muscle tone
Impaired oral control
Decreased muscle tone
Exaggerated excursions can be an overflow or organizing movement
Increased oral tone
Oral hypersensitivity to the teeth touching teeth, utensils, tongue, food, straw, or a drinking cup
Poor sustained jaw closing
Jaw instability
Poor graded movement patterns

Feeding issues related to exaggerated jaw movements:

Exaggerated jaw movements interfere with stability needed for drinking from a straw, cup, or bottle, removing food from a spoon, biting, or chewing. 

 Stability in the jaw is necessary for efficient swallowing and controlled eating. 

 When the jaw’s movement patterns are exaggerated, an individual spills food and is at risk for aspiration due to difficulty with swallowing.

Graded movements on a cup or utensil are difficult, resulting in food spillage or drooling. 

Oral Motor Exercises for the Jaw

If you are looking for exercises related to common oral motor problems, this FREE printable pack of oral motor exercises goes along perfectly with the series I have planned for you.  Get your free download printable packet of 20 different feeding therapy ideas AND 20 oral motor exercises.  These are treatement ideas for oral motor problems that professionals can utilize over and over again.  

Get the free printable pack HERE. 

You might have seen the last post put up here on the site where I shared a list of common oral motor problems.  These issues are the underlying areas that cause kids to have trouble with eating and look like food falling from a child's mouth, trouble moving food within the mouth, difficulty sucking on a straw or many other common feeding issues.  Below you'll find more information on jaw thrust and how this oral motor problem relates to difficulty in eating and drinking in kids. 

Jaw Thrust Oral Motor Problem

Jaw thrust is an abnormal movement pattern of the jaw and occurs when the jaw and mouth opens or moves suddenly and with force.  Typically, the jaw is able to move up and down, shift, move laterally, rotate, and hold patterns in various graded positions and strengths.  

These movements enable sucking, biting, chewing, and develops to more defined movement patterns.  As a result, we are able to bite with graded motions, hold jaw positioning, move food within the mouth, manage various food textures, and control the tongue, lips, and cheeks.  When jaw thrust is present, the jaw is held in a downward and outward position.  

A strong jaw thrust can occur for several reasons:

• ·        Increased patterns of muscle tone
• ·        Poor sitting posture
• ·        Neck hyperextension
• ·        Impaired breathing patterns leading to compensatory positioning resulting in jaw thrust
• ·        Over-stimulating sensory environment
• ·        Hyper-reaction to input from teeth contacting each other during biting and chewing

Feeding issues related to jaw thrust:

Jaw thrust impacts components of eating, including sucking, biting, swallowing, and chewing food.  

Jaw thrust impacts the movement and use of the tongue, cheeks, and lips as a result of jaw thrust. 

When a child eats, jaw thrust interferes with the rhythm of eating and drinking. 

Children may present with a strong jaw thrust during meals and the person who is feeding the child views the jaw thrust as food refusal or being through with eating. 

Jaw thrust may result in drooling, food droppage or spilling, spilling or leaking of fluids. 

If you are looking for exercises related to common oral motor problems, this FREE printable pack of oral motor exercises goes along perfectly with the series I have planned for you.  Get your free download printable packet of 20 different feeding therapy ideas AND 20 oral motor exercises.  These are treatement ideas for oral motor problems that professionals can utilize over and over again.  

Get the free printable pack HERE.