Oral Fixation vs. Oral Mouthing — Is There A Difference?

Development of Oral Motor & Oral Sensory Skills

Early development of oral motor and oral sensory skills is critical to reaching many childhood milestones. The oral motor and sensory experiences a child has as an infant and toddler can directly impact development in the following areas:

  • Oral-motor strength and coordination
  • Speech and language
  • Feeding and eating behaviors
  • Self-soothing and sleep
  • Emotional regulation
  • Dental health

All typical children go through an oral mouthing stage as infants so they can learn to interpret and interact with things in their environment and explore the textures, tastes, and other properties of objects they encounter.  Infants and young children will often bite and chew hands, blankets, books, toys, and anything in her/his immediate environment. These oral behaviors can also serve as self-soothing or calming as a child seeks out a bottle, pacifier, fingers, or even a stuffed animal or blanket to suck or chew on to help calm down or fall asleep.  However, typically developing children begin to replace oral mouthing behaviors as they develop the gross and fine motor skills necessary to explore and the coping skills to self-soothe.

If toddlers continue to explore their world by placing anything and everything in their mouths, there comes an age when many parents start to wonder whether this is typical oral mouthing behavior or if this may be the possible development of oral fixation behaviors and a cause for concern.

Difference Between Oral Mouthing and Oral Fixation

For typically developing children, the “normal” oral mouthing phase can last from birth through about age 18-24 months. But as a child gets older, persistent oral mouthing/biting of toys and objects can create problems related to hygiene, safety, and appropriate social interactions.

After about age 24 months, oral-mouthing behaviors can become oral fixation if a child has an intense or obsessive desire to place non-food objects in her/his mouth. Children may be exhibiting oral fixation if they are persistently biting fingernails, putting hands or fingers in her/his mouth, or putting shirts/toys/books in the mouth constantly. If a child has a pattern of ingesting or eating non-food materials such as dirt or paper that lasts for at least one month, which could be considered “pica,” a physician should be contacted.

Throughout the transition away from typical oral mouthing, parents can redirect mouthing behaviors in a variety of ways. For example, during mealtimes parents can provide more crunchy or chewy foods and opportunities to drink from a straw. During playtime, parents can even direct children to specific objects that are deemed appropriate to chew on such as a strong teether. However, if parents find that a child is still seeking oral input that is intense and unable to be redirected, this behavior may fit into the category of oral fixation and a consultation with a skilled occupational therapist could be beneficial for both parent and child.

References: Hutton, T. L. (2009) . I think my child might have an oral fixation. Retrieved from http://www.handyhandouts.com/pdf/216_OralFixations.pdf Pica. (2012) . In A.D.A.M. Medical Encyclopedia online. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002505/ Siegler, R., DeLoache, J., Eisenberg, N. (2011) . How children develop (3rd ed.) . New York, NY: Worth Publishers. Wilson, E. M., Green, J. R., Yunusova, Y. Y., & Moore, C. A. (2008) . Task specificity in early oral motor development.

By Flo Angelo, MOTR/L