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Using Gross Motor for Oral Motor: How Trunk Turning Exercises Can Improve Tongue Lateralization

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Tongue lateralization is the ability to move the tongue from side to side inside the mouth. It’s an important skill for feeding therapy and development, as the tongue lateralizes to manipulate food to be chewed and formed into a ball (or bolus) before swallowing. It’s also how we go “fishing” for leftover food particles in the cheeks, around the gums and teeth, and on the lips.

To teach the concept of tongue lateralization, I usually start with trunk-turning exercises. The idea here is to start the gross motor and teach the child how to reach across the midline, physically moving their arms from side to side. Once the child understands this concept of moving side to side, it’s a lot easier for them to understand that concept on a smaller scale inside the mouth. In a few cases, I have observed tongue lateralization beginning to develop after we do trunk turning for three weeks (WITH the parent following through with this exercise at home—very important).

  1. In the beginning, sit behind the child so you can best direct his or her movements. Have the child seated with their back to you, between your legs.
  2. You can use a classic peg board, but any number of games/objects would work. You can use a cup of cherries to eat, puzzle pieces, building blocks, etc.
  3. Put the activity directly between the child’s legs (so make sure the game isn’t too big), and the peg pieces off to the left side by his hip. You want the pegs/pieces to be far enough to the left so that he really has to reach across his body (aka across midline) to pick them up with his right hand.
  4. What I do is hold his left hand so that he can only use his right hand. Once he returns to the midline position, it is okay for him to then pass the peg/piece to his other hand.
  5. Repeat about 15 times. Then repeat with pegs to his right side/hip, reaching across his body with his left hand.
  6. Home practice is a must! If the parent/caretaker is not present in therapy, make a video explaining the activity and email it to them.

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(The blog post is provided by Beth Marpe, Capernaum SLP)

Beth Marpe, SLP at Capernaum