Oral Facial Hypersensitivity

Disclaimer: This information sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is it?

Hypersensitivity is when a child's sensory threshold is lowered causing their system to try and cope with too much information at any one time. Problems occur when the central nervous system is unable to control or process the appropriate amount of sensory information.

Hypersensitivity is characterised by strong and abnormal reactions to specific sensations. Examples of such reactions may include, touching the teeth or gums and causing a significant bite reflex, food touching the back of the tongue or throat and causing a gag reflex, touch to the cheeks causing head withdrawal and retraction.

Hypersensitivity may occur both inside and outside of the mouth. Areas that may be effected include physical areas and sensory sensations:

Physical	Sensory
Cheeks and neck	Taste
Lips	Temperature
Gums	Texture
Teeth	Touch eg. soft/hard touch
Throat
Tongue
Palate

Effects of hypersensitivity

Hypersensitivity will make feeding very uncomfortable and unpleasant for the child, also making it extremely difficult for a carer to effectively feed a child.

Hypersensitivity may also cause other reactions in the body, such as, generalised muscle stiffening (hypertonicity) which limits the bodies movement patterns.

Children with severe or long term hypersensitivity may develop adverse reactions to feeding eg. the sight of a spoon may cause a spasm or turning of the head, the smell of food may cause a gag reflex. Some children may also develop an emotional or learnt response to meal times and refuse all food, regardless of touch being initiated.

Causes

• Neurological damage/brain damage which lowers the sensory threshold
• Increased tone/posture and hyper reflexive patters that reduce the touch threshold and the bodies movement patterns
• Lack of oral stimulation (primarily when tube fed)
• Overactive gag or cough reflex

Treatment

• Optimal seating and positioning to ensure a stable base and good posture. This allows the child to concentrate more on feeding than on balance alone.
• Oral desensitisation exercises
• Removal of overt or extra stimuli
• Gradual introduction of different stimuli eg. taste, texture, temperature etc
• Oral play and exploration

Who do I see and how is it diagnosed?

A Speech Pathologist will be able to assess whether a child is experiencing hypersensitivity or is possibly having other difficulties with their swallowing.

A paediatric speech pathologist experienced in looking after children with brain injury or swallowing in infants is highly recommended.

Rehabilitation Department The Children's Hospital at Westmead Cnr Hawkesbury Rd & Hainsworth St, Westmead Locked Bag 4001, Westmead, 2145 Tel: (02) 9845 2132 - Fax: (02) 9845 0685 http://www.chw.edu.au/rehabilitation/