Ask A Therapist: Bite Tube Compression

Hi to TalkTools, I am an SLP who has taken the Three-Part Treatment Plan for Oral Placement Therapy course and am incorporating OPT into my practice. I greatly enjoy this as it benefits my patients! Thank you!

I have a question regarding the bite tube hierarchy. I want to make sure I know if a patient is using a full compression. It seems that on the DVD, Sara says that we need to hear the “clicking” sound to know that the red tube is fully compressed. Is this true or is it merely a matter of seeing that the patient did bite down? Also, is this true for the yellow bite tube as I am able to make a “squeaking sound” when I bite down? What about the purple and green since they are harder and no sound is emitted?

Also, I have read the article Oral Habits: Why They Exist and How to Eliminate Them. I am aware that we can make the bite tubes available (they can have unlimited access and control over the bite tube themselves) to those who use an appropriate motor plan for chewing (up and down movement… gnawing, jaw sliding or jutting). I understand that this will satisfy the need for Temporomandibular joint (TMJ) dysfunction stimulation, but have concerns that they will want to spend an inordinate amount of time chewing on this ….that it will take on a “life of its own”, so to speak. How do you recommend dealing with this concern? Give them complete access to the bite tube or not?

Thanks for your response.


Dear Holly,

My name is Monica Purdy and I am one of the instructors for the Three-Part Treatment Plan for Oral Placement Therapy course. First let me say I am pleased you are enjoying using OPT. It has made such a difference in my practice as well!

Regarding your question about the bite tube hierarchy, we recommend that when you do an evaluation you use a new chew tube. Often when the chew tube is new, you will hear a clicking or a sound; however this may not always be the case. What you do want to see is a full compression and a full release of the chew tube. As for the purple and green, you are right and will not hear a sound, but again you should be seeing a full compression.

As for your question regarding oral habits, you are correct. If the child is able to motor plan and chew in an up and down controlled manner, and if I am not using the chew tube in the bite tube hierarchy, giving the chew tube to the child is a good option for them to replace their oral habit. Typically children will chew until they get the input they need from the chew tube. However, if you are using the chew tubes in the bite tube hierarchy, you will want to do the chew tubes with the child in a controlled manner when you see the child doing their oral habit. You may also think about putting them on the gum chewing hierarchy, as this is a great way for the child to get the input they need to the TMJ.

I hope I have answered your questions for you. If you have any concerns or questions please do not hesitate to let us know.

Talktool admin 12 May 15

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