Structured, step-by-step Chewing Therapy Program used in pediatric feeding therapy.
This is appropriate for children with chewing delay, oral motor weakness, or sensory-related feeding challenges (including those with Autism spectrum disorder).

⚠ Always rule out medical issues (reflux, enlarged tonsils, structural abnormalities) before starting intensive oral work.

🦷 PHASE 1: Foundation Skills (Jaw Stability & Awareness)

Goal:

Improve jaw strength and oral sensory tolerance.

Duration:

1–2 weeks minimum before progressing.

1️⃣ Jaw Strengthening (Daily – 5 minutes)

Exercise A: Chewy Tube Biting

• Place chewy tube on molar area.
• Ask child to bite and hold for 3–5 seconds.
• Repeat 5 times each side.

If no chewy tube:
Use folded clean washcloth (supervised).

2️⃣ Side Placement Practice

Children often chew only in the front.

Exercise:

• Place a soft meltable food (like puff snack) on molar area.
• Gently guide jaw to close.
• Repeat both sides.

Goal: Teach back-teeth chewing.

3️⃣ Blowing Activities (Builds Oral Muscle Control)

• Blow bubbles
• Blow cotton ball across table
• Blow whistle
• Blow through straw into water

5 minutes daily.

🦷 PHASE 2: Tongue Lateralization

Goal:

Teach food movement side-to-side.

4️⃣ Tongue Side Exercise

• Put small smear of peanut butter (if safe) or thick paste on side of lips.
• Ask child to lick it off.
• Repeat both sides.

5️⃣ Food Transfer Drill

• Place small soft cube (banana) on molar.
• Prompt child to move it with tongue.
• Practice 5 reps per side.

🦷 PHASE 3: Controlled Chewing Pattern

Goal:

Develop rotary chewing (circular motion).

6️⃣ Soft Solid Practice

Start with:

• Steamed carrot
• Soft paneer
• Boiled potato cubes

Steps:

1. Place on molar.
2. Cue: “Chew on this side.”
3. Count 5 chews before swallow.

7️⃣ Alternate Side Chewing

Encourage:
Right side → Left side → Right side

This prevents one-sided chewing habit.

🦷 PHASE 4: Texture Advancement (Hierarchy)

Progress slowly:

Do not jump stages.

🦷 PHASE 5: Sensory Regulation Before Meals

If child is sensory-sensitive:

Before meal:

• Deep pressure hug
• Wall pushes (10 reps)
• Chair push-ups
• Calm breathing

Regulated body = better chewing control.

📅 Sample 10-Minute Daily Routine

1. 2 min blowing
2. 3 min chewy tube
3. 3 min side placement food drill
4. 2 min soft chewing practice

Consistency > intensity.

🚩 Stop If You See

• Frequent gagging
• Choking
• Crying distress
• Refusal escalating
• Food pocketing without awareness

Consult feeding therapist.

⏳ Expected Timeline

Mild delay → 4–8 weeks improvement
Moderate delay → 2–3 months
Severe sensory feeding issues → longer, structured therapy needed

🧠 Important Clinical Reminder

Chewing delay can be:

• Oral motor weakness
• Sensory defensiveness
• Motor planning difficulty
• Behavioral rigidity

Correct intervention depends on root cause.