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Date: Thu, 9 Sep 1999 07:23:23 -0400From: "Burkhart, Michael"

Subject: suggestions for alternatives to frustration behavior

Our son has this really annoying behavior of grabbing up his shirt and chewing on it and making a little growly noise when he gets frustrated. I'm trying to think of a more appropriate way for him to express his frustration or anxiety. We see this behavior way too much in drills as well as any time things aren't 'going his way'. He's imitating single words now so I thought I might redirect it to saying "mad!" and clapping his hands. Also, thinking that maybe I can look more closely at the antecedents to the behavior and work up some appropriate phrases like "No", "want ...",etc. Any ideas?
Thanks.

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Date: Thu, 9 Sep 1999 12:37:33 -0700From: Terri Mykland

Subject: Re: suggestions for alternatives to frustration behavior

I'm sure you'll get responses to this question, as many of us have seen the shirt-chewing thing. We certainly have. Last year in kindergarten, my son started out doing things like chewing his fingers, sucking his shirt, drooling, picking his nose, etc. etc. as soon as we extinguished one behavior, another would pop up, and the shirt-chewing was the most persistent, especially when frustrated or excited. We decided that his need to chew probably wasn't going away, so started looking for acceptable ways for him to do it. During the summer we figured out a thing for him to chew on that he now wears around his neck every day during school. It looks pretty inconspicuous - a lot like the neck-bands that older boys wear, and he does use it to chew on when he needs to, after some encouragement from us, of course.
Here's what we did. We got some black nylon cord, about the thickness of a shoelace, plus some of the rubber tubing that the OT uses (about 3/8" thick) and a small clip fastener from the hardware store. We fed the cord through the tubing, double-thick (use some vegetable oil to lubricate), tied the clip on one end, and left a loop sticking out the other end. Make it just long enough that he can get it up to his mouth to chew, but not much longer. To put it on, just clip the clip end onto the loop end. I'm not sure this is a clear enough description, so if you want to try this, feel free to write back for more detail.
We've been using this at school for a week now, and it really has eliminated this issue from his classroom behavior. We even use it at home, if he's real excited or mangling his shirt for some reason. Sometimes I'll ask him if he wants it, and he will either say yes, or if he says no, I say then stop chewing your shirt. Kind of like a choice to manage his behavior one way or the other. In class, we just leave it on all the time. One thing: the tubing starts out tasting not great, so it helps to wash it with soap, then maybe rub a little peanut butter or something that tastes good on it, then wipe it off, so that it's not too bitter for him to want to use.
Hope this helps, Terri in Santa Cruz Mom to Zane, 6yo hfa
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Date: Fri, 11 Feb 2000 00:04:44 -0000From: Nick Mortell

Subject: Shirt Sucking

This is my first attempt at posting to the list after several months of lurking, so I hope this works.
Sucking and chewing on clothing (and soft toys previously) is a behaviour that has come and gone with my son - usually lasting 2-3 weeks. However he recently persisted with his chewing for 3 month plus, had his clothing in his mouth for 90 percent of the day, making verbal responses very indistinct and absolutely ruining a large number of jumpers and pyjama tops in the process! They were torn to shreds.
Our supervisor recommended we start 'Self Management of Behaviour' with Alex to tackle this. For a timed period (initially 20 secs) he was instructed to refrain from chewing his clothing. Once the timer went 'ping' his therapists would then ask :'Did you chew your shirt?' Alex had to reply 'yes' or 'no' so we knew he understood what was happening...if he had been chewing but denied it we'd just say 'But you did chew -I saw you!' or 'Oh yes you did, your top's all wet!' He worked for 'stars' on his star chart (3 initially) and had a good reinforcer for 'not chewing'. The idea was that we gradually do timed 'self management of behaviour' for longer periods and while we were out of the room etc... building up to whole chewing-free days. This was coupled with a social story about playing nicely while leaving his cuffs and sleeves alone.
It may have been coincidental, but after we had reached the stage where he was doing self management of the behaviour for 2/3 mins at a time the behaviour just stopped. It just made him very aware of what he was doing.
Alex is in mainstream school now for part of the week and his shadow reports it's a behaviour a few of the other children also indulge in ...but we did see it in the extreme though, entirely sodden sleeves... ugh!
Rachel ( from UK) Mum to Alex 4.9 (ASD) and Beth 2.6
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Date: Thu, 10 Feb 2000 12:08:38 -0800From: Terri Mykland

Subject: Re: shirt chewing

Louise,

We have struggled with shirt chewing and other kinds of oral stims for over a year now. First we tried the behavioral approach, of course, but it only seemed to go so far. As far as I can tell, with Zane, it's a sensory craving, and if we extinguish one form of it behaviorally, it comes up another way.
We've seen finger sucking, finger chewing, drooling (and playing with it!), nose picking, pencil chewing and on and on. We decided at one point rather than telling him not to, to provide an acceptable thing to chew on and redirect him to this. It really seemed to defuse the situation. Zane (age 6.5, included in a regular 1st grade) now wears what we call his "chew" all the time he's in school. This is a sort of necklace, made of rubber ot tubing threaded over thick shoelaces, with a clasp on one end and a loop on the other. I wrote up detailed directions for our OT on how to make one, which I could send you if you want. The tubing I got is blue, and the chew doesn't look all that odd, although all the kids were curious about it at the beginning of the year, I don't think they much notice it now. When Z seems to have a real stimmy day, we encourage him to chew on his chew necklace rather than his shirt. Now, after wearing it all year, just having it on seems to calm the urge to chew on things, and we're seeing less and less of the craving. We wrote a short little social story about this at one point, encouraging him to do other 'sensory calming' things as well as to use the chew necklace:
Sometimes I need to bite and chew.When I need to bite and chew, I can squeeze my hands.When I need to bite and chew, I can take three deep breaths.When I need to bite and chew, I can use my chew.
When our therapist sees him using his chew spontaneously in the therapy room or elsewhere, she gives him verbal reinforcement, whenever possible.
By the way, something else that seems to help a little is to have him chew gum every morning before school. We also have an OT goal to teach him to self-monitor when his system is overloaded and do things to calm it down, which I think is a piece of this same puzzle. Feel free to write if you want to know more about the specifics of this part, too.
Hope this helps, Terri
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Date: Fri, 11 Feb 2000 18:43:58 -0800From: Terri Mykland

Subject: Re: chewing on things

Here are those instructions. Ignore the names of local stores to purchase stuff at, of course, but otherwise this should make sense. Feel free to ask if anything is confusing.
Terri
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- Materials:
- Blue therapy tubing 2 feet (this kind is about 3/894 in diameter -get at Horsnyders pharmacy)
- Black cord 4 feet 20 (Either thin black nylon cord at Bugaboo Mountain Sports or the longest thick bootlaces from Outdoor World. Can also buy bootlace-like cord from Beverly fabrics. See approaches A and B under step 5 below for when to use each type of cord)
- Clip (get at San Lorenzo lumber downtown smallest silver kind. You want it to be difficult for child to remove themselves)
- A Thin, smooth stick to guide the cord through the tubing (something like a thin chopstick or strong skewer, very thin dowel, or ???). You want it to be blunt rather than pointed, as it might pierce the rubber tubing. Must be thin enough to go through the tubing easily.
- A little Vegetable oil to lubricate
- Masking tape or clear package tape
- Matches to seal ends if you use nylon cord

1. Read all the way through the directions to #5 and decide if you want to do the 'loose ends' or 'ends concealed' approach before buying your supplies.
Depending on which you choose, buy either bootlaces or nylon cord.
2. Cut tubing to a little longer than finished length about 15 inches.
3. Fold cord in half (folded length should be at least 18 inches, longer is fine). Feed the folded 'loop' end of the cord through the tubing. The best way I've found to do this is to take a thin stick, tape the end of the cord securely to the stick, then 'grease' the stick and outside of the tape with vegetable oil before threading it through the tubing. Work slowly and gradually until the cord is all the way through the tubing and the 'loop' comes out the other end. Now remove the tape and the stick.
4. Tie an overhand knot at the 'loop' end leaving a loop of cord big enough to use. This is so that this end of the cord doesn't slip back into the tubing.
5. The 'non-loop' end is where you will attach your clip. Here is where you have a couple of choices:

This is how mine is made. My son likes to chew on the raw ends of the cords, so I tied the clip on this end with a secure overhand knot and cut the ends of the cords (I used bootlaces) at about 1.5 inches, leaving them to just fray and be there to chew on. This looks 'messy', but it turns out the cord ends are really his favourite part of the 'chew'
Approach B: Ends Concealed:
This was an 'innovation' that my son didn't like at all, but might work for some kids, and is definitely more hygienic and nicer-looking: Use the black nylon cord from Bugaboo. Put the clasp on the 'non loop' cord ends. Now pull some of the 'non-loop' end cord out of the tubing and tie the cord ends in a square knot, kind of 'off centre:, so you can stuff it back into the tubing to conceal the knot. After tying, cut the cord ends at the knot short and burn the ends to seal them well so they will never fray. Now gently slide the tubing over the knot and it will be concealed. This makes a much neater-looking necklace, but some kids may prefer the loose ends approach, which is also a little easier.

- Buy at least twice as much of everything as you need. The materials are cheap and you want to have enough to play with and not run out even if you blow it.
- Decide on which approach to do before you start, or try one of each and see which the child prefers
- The therapy tubing tastes pretty awful when it is new. I've tried various things, with limited success, to improve the flavour of it, to make it more appealing to the child when he starts wearing it, to encourage use. See what you can figure out for this. I tried washing it with soap and water, putting flavored stuff on it (lip balm, etc.). The tubing does naturally taste better over time, but you may want to see if you can think of a better way to make it more palatable sooner.
Hope this is useful. Terri
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Date: Thu, 11 May 2000 16:21:27 -0500From: "Steven I. Rapaport"

Subject: oral stim/ gum chewing

I was reading the articles on oral stimming and it got me to thinking --Has anyone had any success teaching their child to chew gum??
My son eats for oral gratification, even when he is not hungry. Obviously, he is heavier than he should be as a result. I would love to teach him how to chew gum, but he always swallows it. Any advice??
Thx, Steve Rapaport
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Date: Thu, 11 May 2000 18:59:37 EDTFrom: "Tonya B (P)"

Subject: Re: ME-LIST Digest - 10 May 2000 to 11 May 2000 - Special issue (#2000-97)

To Steve on "gum chewing"...Try putting the gum in some cheesecloth and holding the excess while your child chews for short periods of time (make sure it doesn't chew through)..let your child begin holding the cloth, then remove the cloth for increasing periods of gum chewing while monitoring for swallowing, slowly increasing and ALWAYS throwing away gum in a paper into the trash when the timer rings.
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Date: Thu, 11 May 2000 19:12:01 -0700From: zenobia perry

Subject: gum chewing

I taught my son age 2.5 to chew gum. I had half a piece of gum and let him chew about 4 times, then told him to spit it out (showed him by my spitting out mine), and immediately gave him another half. WE did this about 4-5 times. For some reason he got it that he wasn't supposed to swallow, but he knew he'd get another piece if he did give me the chewed one after a while.
We had a few mistakes, in the carpet, in the car, etc. but he got it. Zenobia
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Date: Thu, 11 May 2000 20:59:29 EDTFrom: "Teri Rankin (P)"

Subject: Re: oral stim/ gum chewing

Steve,

My son also has an oral fixation. He started chewing gum in short time slots during his ABA trials. When he would come to the table he placed his gum in the wrapper on the table, once the trial was over he was allowed to put the gum back in his mouth.
When outside the classroom, I timed his gum chewing.....at first only allowing 5 minutes. We taught him to save the wrapper so that the gum can be disposed of inside of it.
This has worked well, and has really cut down on his inappropriate oral stims. Teri Rankin
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My son has recently started biting his shirt in frustration (during drills) and has actually been putting holes in his shirt. We say to him, 'No biting' and either force him to open his mouth by holding his cheeks or giving him baby biting toys to bite. Does anyone have any good recommendations on how to deal with this?
Also, my son loves to sing and sometimes he doesn't want to stop. He goes from one song to another. We say, "OK, I don't want to hear anymore singing" or "All done singing" and try to change the subject, but he gets mad because this is his way of 'communicating' and I guess he thinks we're being rude because we're shutting him down. Any recommendations on this? Sometimes we use the singing to motivate him. i.e. we'll say do you want to work for singing ..."
Thanks
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Date: Wed, 2 Aug 2000 20:31:27 GMTFrom: Leah Greenblatt

Subject: Shirts, socks, pants and other clothing biting . ..

I have a kid right now who had been dong a lot of eating of his clothing. The first thing the consultant told us was that we shouldn't label the action and that we also shouldn't use 'no' as it doesn't tell him what TO do. If we said " No shirt biting" than he would know that #1, it's something we don't like and also that #2 he knows he shouldn't do it, but he is not being told what he should do instead of biting his clothes. I would suggest either ignoring the behavior - if it's for escape from working purposes - or, if you're doing verbal drills and he won't talk ( mine has answered questions with his sock in his mouth before ) move on to something physical like gross motor but be sure and return to the initial drill later on so he doesn't feel like he got out of it.
If that doesn't work ( and I've tried pulling things out of his mouth, too. ) try just removing the article of clothing. We used to work in a very hot room which had a fan blowing on us all the time and he didn't like the feel of the air on his skin when I just removed his shirt ( without a word ) in between presenting Sds. He worked to earn the privelege of having his clothes back on and after that he left them alone. Of course, this wouldn't work if the kid likes not wearing clothes. I don't know what to suggest in that situation.
For sure don't try to force him not to do it or even offer other toys- this actually does reinforce the biting because he's getting attention for the behavior and by you stopping the drill to offer him alternatives he's manipulating you very well.
I also have another kid who loves to sing and what we have been doing recently is really pouncing on him breaking into song at inappropriate times. If he's eating his lunch and he starts doing that - or scripting from videos or books - we pounce on him with alternative, appropriate things to say. For instance I get his attention while he's eating and prompt him to say, " I like this lunch" or "This cheese is good. " Also works if he's staring out a window blankly I pounce on him with " I see a tree" or whatever I can see that is out the window. IN the past week it has really worked out well and since he echoes anyway it's to his advantage to be repeating appropriate phrases.
Actually we had a breakthrough today when I came in and he looked up from breakfast and said " I'm eating!" We definitely don't want him to stop talking, we just want him to say things that are appropriate. ( There are also times when we just let him script- for instance, it's perfectly normal for a kid to look at a book and 'read' outloud or sing while listening to a song on tape or watch a video in which echoing is encouraged.
What I do during drills if he starts off on it is either prompt him to say "I'm working" or "This is fun" or "I like sorting" or something else which fits. If he's supposed to be listening and he's off and running I start with a finger on his lips. He usually gets the hint then but if it doesn't work than I put a hand over his mouth. (Gestures and physical prompts are easiest to fade later on ) and if that doesn't work I keep my hand on his mouth and say in a very stern tone "Quiet mouth." That generally takes care of it.
Also, if you feel that this is an attention getting behavior than maybe ignoring it would work as well. It seems, though, from your post, that if he feels that this is his way of communicating than he may easily take to substituting the stims for appropriate language- whether he understands what he is saying or not is irrelevant at first. But it's much nicer to hear him going around commenting about things around him than singing songs to himself all day long.
I had my guy repeating things like "I love pancakes' and he probably doesn't know what love means- but he'll learn that later on.
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Date: Wed, 2 Aug 2000 17:09:17 EDTFrom: "No Name (Pr Ther)"

Subject: Shirt biting

For the shirt biting, you could try throwing in easy task distractors to calm him down (clap hands, touch head), so he is not escaping from work and then present "say ah" so you are removing the shirt non chalantly and he isn't escaping from the work. I actually work w/ a child that we do this for and it has helped.
I wonder if switching to easier tasks could reinforce task avoidance. He engages in biting his shirt, gets easier tasks and therefore escapes the original task. Just a thought. Perhaps thorough analysis of the function of the biting behavior would allow you to implement consequences that will not reinforce the behavior.
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Date: Thu, 3 Aug 2000 08:21:13 -0500From: "Liza E. Bergman"

Subject: shirt biting as a means of escaping task

I wonder if switching to easier tasks could reinforce task avoidance. He engages in biting his shirt, gets easier tasks and therefore escapes the original task. Just a thought. Perhaps thorough analysis of the function of the biting behavior would allow you to implement consequences that will not reinforce the behavior. It has been my experience that if a child is engaging in any inappropriate behavior, and you switch to an easier task and then reward them for that task, sing a quick song, and then go right back into the original drill, the child will either forget that he tried to get out of it, or he realizes he would rather be rewarded with something more fulfilling, and will then do what he is asked to do for the remainder of the drill.
Liza
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Date: Thu, 3 May 2001 20:37:30 -0400From: Richard Freeman

Subject: Chewing shirt and moving to Atlanta

Sharon,Our son, now 13, was chewing his shirt, his pants leg, his belt, other people's clothes, and any other threads he could get in his mouth when he was 7. This behavior escalated to the point where by age 9.5 we were having to replenish his entire set of clothing on a monthly basis. We went through hell trying to figure out why this was occurring.
This behavior finally ceased when we took him out of public school and placed him in a school where he is comfortable with himself. I did not know then the extent of these children's anxiety. To make matters worse, we were giving him Ritalin 10, then 15, then 20 mg daily. As regular as clockwork, about an hour after he took his ritalin in the am he would start picking. After lunch when he got his second dose, he would go at his clothes again...So, we conveniently blamed ritalin...cause and effect you see. What we missed was just how miserable Daniel was in the setting he was forced to endure in the school room he was in. We also missed the fact (obvious) that the ritalin, among other things, allowed him to focus on that which made him anxious.
Your child is trying desperately to tell you something. I suggest you look closely at ALL the antecedents to her picking. Try changing each of her environmental factors one at a time to see if any of them make a difference.
Hope this helps Richard, father of Daniel
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Date: Sat, 26 May 2001 23:26:02 -0700> From: Donna

Subject: chewing

I have a question about chewing and teeth grinding. My son who is almost 4, is really doing a lot of chewing on his pants legs, mouthing toys, and grinding his teeth. Has anyone dealt with this successfully? Our consultant has sugested some kind of tubing for chewing. Anyone know about his and were to find it?
Thanks Donna
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Date: Mon, 28 May 2001 20:05:10 -0400From: Melody Magnus

Subject: chewing tube

Hi,

To the parent who wanted something for her child to chew on or anyone with a kid who hums and chews things, I had an OT recommend refrigerator tubing. I bought two feet for 10 cents at a local hardware store. It's just clear plastic tubing about a 1/4 inch wide. Anything similar is probably fine. The OT suggested attaching it to one of those curly, stretchy key chains so he could clip it on to a belt loop to have all the time. I haven't gotten that far but he does like the tubing and it looks better than a baby chew toy.
Melody

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Date: Mon, 28 May 2001 06:31:30 -0700From: Barb Sweet

Subject: Re: ME-LIST Digest - 26 May 2001 to 27 May 2001 (#2001-203)

Donna

Our daughter went through several chewing stages - better now, but still a stimulation source that she seeks. Our OT got "plumbing tubing" from the hardware store, the type you might use to hook up your dishwasher or ice maker. Several types, colors, hardnesses; mostly 1/4 inch to 1/2 inch diameter. They really smelled bad, and she soaked them in something that took out the odor - I don't know what, but another OT recommended toothpaste. Anyway, about a foot-long segment of tube, with a knot tied in the middle, is a good chew "toy".
We also found that blowing toys helped oral simulation - like party blow horns, harmonicas, etc. Also, beef jerky, licorice. Mint can be a good source of oral stimulation, so little powerful mints might help. We also got a toothbrush (not a long one - there are smaller ones that have kind of triangle-shaped handles) to keep in the car, and she would enjoy chewing on that. A long one might be dangerous in that situation.
We have also found that sometimes when she's REALLY oral that you can massage her gently around her jaws and mouth (lotion helps) and that gives her some needed stimulation - do this while your son is watching TV.
Good luck!
Barb Sweet
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Date: Mon, 28 May 2001 09:24:29 -0400From: ROBERT J BENCO

Subject: Chewing

Hi Donna,

I have been battling the chewing/mouthing for almost 2 years. Before that my daughter did not put anything in her mouth. Her OT and Speech Therapists have suggested TheraTubing (comes in a variety of weight) you can get it from any ST or Sensory calalog like Samons and Preston, Abilitations, Super Duper Publications(www.superduperinc.com), Innovative Therapists Intl.(www.oromotorsp.com) or Speech Dynamics(www.speechdynamics.com).
Also I try to give her a wide variety of chewy toys with bumpy surfaces, vibrating/massaging toys, NUK brushes (you have to supervise these closely b/c they can come apart) and Infadent brushes also avail through these catalogs. We also introduced a gum chewing drill (I make my own b/c she is on GF/CF diet) to discourage her from swallowing the gum. It has gotten better over time. Good Luck, Val
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Date: Mon, 13 Jan 2003 21:51:39 -0500From: persistentC

Subject: Chewing behaviors -

Tina

I'm familiar with the chewing wood problem. Kenny used to chew the grids and window sills in his windows at night, and also the wooden rails on the staircases. That is usually a symptom of an iron deficiency.
Cindy Peters (Cary, NC)
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Date: Mon, 13 Jan 2003 18:12:22 -0800From: Theresa Rankin

Subject: Re: ME-LIST Digest - 12 Jan 2003 (#2003-25)

This behavior was typical with my son many years ago. I purchased a spray product called "Bitter Apple" from the pet store and sprayed it on his favorite chew sites........It's safe and tastes terrible. This was successful. Other things I sprayed was garlic juice(worked well) and cayenne powder(I didn't use it much, I felt quilty).
Good Luck, Teri Rankin
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Date: Thu, 5 Aug 2004 08:18:58 -0700 (PDT)From: MANISHA LAD

Subject: Mouthing objects and opening mouth wide

hello everyone

My 3 yr old son was mouthing on all the objects book, plastic container tops, toys etc. He started school last month and they started giving him chewing tube. It was good alternative!! After school when he comes home he does use chew tube. But when the chewing tube is not around he again starts using the other objects.
My major concern is "He keeps on opening his mouth wide (no sounds)." especially at night he keeps on moving his tongue on the above teeth (inside) and makes some noises.
He really needs something, its sensory requirement. The chewing tube is not exactly helping him, but preventing him from putting other things. All this makes him very uncomfortable at night...I have noticed this behavior after using the chewing tube extensively. O.T at school has advised to massage his cheeks and near the mouth. I am not sure whether this shows he is deficient of anything. We are looking into the bio medical intervention now and will be seeing DAN doc soon.
I would appreciate if anyone could advice me on this. Thanks Manisha
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Date: Fri, 13 Aug 2004 10:31:53 -0400From: "Kristine Quinby"

Subject: RE: [VerbalBehavior] Mouthing objects and opening mouth wide

Think of it as a behavior... not a sensory need. Why is he doing it? Look at what is or is not occurring before he chews and what happens after he starts chewing. It could be sensory, attention, escape, or a combination of two or three.
If it is a stim, then we teach alternate behavior. (The alternate behavior would NOT be chewing on something else but engaging in a more appropriate activity.) If it is attention, we do not react to the behavior. If it is escape, we do not allow him to escape when he is engaging in this behavior. (Just a short description here... there would be much more to the actual behavior plan.)
Going back to the "sensory need"... that may or may not exist. We cannot know since we cannot see it to measure it. An OT can recommend some things for you to try in addition to the behavior plan that you adopt for this behavior. Things that I feel would be appropriate (as in not interfering with the behavior plan) would include offering different textures of food during meal times and doing some sensory work in and around the mouth a few times a day on a regular schedule.
I do not agree with the use of a "chew tube" or other such replacement object. As you have stated, it is effective only in changing what is put in the mouth. The goal should be to reduce mouthing/chewing in general. I have not seen any "chewies" accomplish that goal.
Sincerely, Kristine Quinby, M.Ed. PS Please no flames from people who use "chewies" or other sensory integration methods. This post was not intended to offend anyone :0)