Autism and Oral Fixation

Oral fixation is very common among autistic children and people who have Sensory Processing Disorder (SPD). This may result in repetitive chewing behaviours, such as chewing clothing, biting pens and random objects, and is often an automatic, uncontrollable, and subconscious reaction for many that experience it.

What is oral fixation?

Oral fixation falls under a category of behaviour called stimming. Stimming is described as self-stimulating behaviour involving repetitive physical body movements or noises. By providing one focal point , stimming provides a calming and comforting effect to help regulate emotions and manage a stressful situation and ease overwhelming stimulation such as external sources or internal overthinking. And it’s often done subconsciously, and the person doing it is rarely aware of it.

Autism and oral fixation are linked through sensory processing disorders, a condition that affects how your brain processes sensory information or stimuli (things you see, hear, smell, taste, or touch). Oral fixation is an intense or obsessive desire to chew, suck, or hold an object in your mouth and in autistic people involves chewing on things to alleviate anxiety and stress. This behaviour is common for babies and is an entirely normal part of early development. As babies explore their new world, they tend to fixate on toys, faces, mirrors and put whatever they get their hands on in their mouth. Typically, children outgrow this behaviour as they mature. However, for some autistic children this behaviour may persist unless they are given alternative strategies to answer their oral sensory needs.

Oral fixation may include:

Thumb sucking
Difficulty weaning a child off their dummy or bottle
Nail biting
Chewing on fingers or inside of their cheeks
Chewing on clothing until soaked saliva
Chew on pens or pencils until they break
Chews on a batteries
Licking non-food items
Teeth grinding

It’s important to remember that whilst all children will go through the same stages of development, they will do so at different rates, and some children therefore just take longer to move away from orally fixated behaviours.

Is oral fixation a cause for concern?

Stimming behaviour is often associated with autism and for many autistic people it is completely an essential and very normal part of everyday life. Stimming can also be a normal part of child development during infancy and toddlerhood as they explore the world around them. It can also be confused with teething in babies or children experiencing stress and/ or anxiety. Self-stimulatory behaviour is also not unique to individuals on the autism spectrum and can be seen in neurotypical individuals as well. “Atypical” adults also stim in some way. For example, many people tap their foot when impatient or anxious, twirl their hair when bored, or tap their fingers when intensely thinking.

Chewing on objects becomes a noticeable “problem” or fixation when a child begins daycare/ preschool or nursery and as a parent you start to notice that your child’s behaviour falls outside of what is typical for their age.

If your child continues to demonstrate stimming behaviour past the toddler years, it’s possible that it may be related to one of the following:

Autism – For many children with autism, chewing is a calming self-regulating repetitive behaviour, often to cope with anxiety and/ or stress.

Sensory Processing Disorder – Chewing and sucking on things and objects for children with Sensory Processing Disorder provide a way of regulating their emotions or managing stress as a response to the difficulties they have processing and responding to sensory information from the environment.

Positive effects of oral fixation

The heavy input given by chewing on things helps to calm our overstimulated nervous system
Help to filter incoming sensory information
Allows for one focal point, easing overwhelming input
Improves focus
Calming and relaxing
Helps reduce stress and anxiety

Negative effects of oral fixation

Some oral fixation habits may result in the need for extensive dental treatment. Choking hazards are a concern and putting dirty or potentially dangerous items in their mouth can lead to illness and introduce harmful bacteria to their body and increase their risk of coming to harm. Other negative impacts of prolonged oral fixations in children include:

Hindered expressive speech skills
Crooked teeth
Chips or fracturing of the teeth
Constant objects in the mouth can wear down tooth and periodontal structure
Gum damage and gum recession
Bone loss just to severe receding gums
Constant movement of the mouth can promote temporomandibular joint (TMJ) issues such as jaw pain, headaches, limited opening of the mouth, jaw popping, lockjaw, and arthritis
Separation anxiety
Poor eating habits
Tantrums past the typical age range
Poor oral hygiene including drooling resulting from lingual weakness
Oral motor issues that affect the tongue, lips, jaw, and placement of adult teeth
Excessive chewing, sucking, or drinking of sugary products can cause an increased risk for tooth decay
Putting dirty items in their mouth increases the risk of infection and illnesses
Regular chewing of non-food products could contribute to diarrhea, bloating and digestive distress, especially for those who have IBS

Managing Oral Fixation in Children

If your child has a oral sensory need to chew, trying to force them to stop isn’t going to help. If they do have a oral sensory need to chew, they may be using it as a coping mechanism to self-regulate. Trying to force them to stop a behaviour that is largely sub-conscious is counter productive if the long term objective is help your child decrease the chewing.

Whether your child’s oral fixation is related to a neurodevelopmental disorder or if it’s just a stage that they are taking a bit longer to outgrow, there are different methods you can take to reduce and manage the repetitive behaviour.

We recommend the following steps to help your child with their stimming behaviours:

Why does your child chew?

It is important to understand the core issue behind the chewing. Why are they chewing in the first place? This is something that the medical professionals will look into in more depth, but parents are best place to get to the bottom of the root causes of the chewing. Take practical steps to study when and how they chew. Keep a record in diary or your mobile phone. Record the times and days, and describe the situations when they chew. Perhaps they’re bored, tired, stressed, upset, lonely, frustrated, angry, etc. For instance, if they have had a stressful day at school, look to see if this precedes chewing. Stress is a normal part of life, but if stress is a main factor, look at ways at better managing the stress and reducing it’s negative impact. If the school environment is a trigger, then it would be useful to speak to your child’s teachers about this to try and ascertain what specifically triggers the chewing.

There are many reason why an autistic person might develop an oral fixation, including:

Medical: ease pain or other physical discomfort
Sensory:seeking texture and taste, overwhelming environment, sensory overload, sensory processing disorder
Behavioural: lack of understanding, relievingstressandanxiety, avoiding something, looking for attention, noisy thoughts, uncontainable emotion

Consult with your child’s GP and dentist

It is always advised to first consult your GP about your concerns, who will then do an evaluation or suggest the next steps. This may involve a referral to a specialist, such as a pediatrician, occupational therapist or speech therapist, who will look at identifying the root cause of your child’s oral sensory behaviour and discuss options and potential solutions. Speaking to your child’s dentist could also be useful and provide you with some answers.

Find a chew replacement

Autistic babies and autistic young children will often chew on what is available to them, which sometimes may be very dangerous, so look to give them a safe alternative to chew on instead. Finding a proper replacement will reduce the likelihood of them chewing holes in their clothes or putting dirty items in their mouths.

Chewy snacks such as dried or hard fruit like apples, dried mangos, and raisins, celery or carrots sticks, crackers and popcorn, can also be useful in providing more resistance and make the jaw really work, giving the child the sensory input they crave.

Using a straw for drinks is also another simple way to fulfill the oral sensory need that the child may be craving.

Redirect your child’s behaviour

Parents use verbal and physical redirection all the time to help promote desirable behaviours in their children. Parents may direct (or distract) their children’s attention to a different activity, toy, or behaviour. It is these parental strategies that help teach appropriate behaviour, prevent or reduce injuries, reduce punishments, remove children from dangerous situations, and promote learning and exploration. The same redirection techniques can be used for children with oral fixation. It can be particularly useful when parents notice a negative aspect of oral fixation and especially useful when the child’s behaviour is unsafe (such as chewing on a object they may choke on.) Redirection may involve offering a chew replacement or redirecting the child to something else to do.

Moving forward

Stimming and oral fixation is very common among children on the autistic spectrum, and whilst at times it can be detrimental to the health of the child, even annoying for parents, if done safely, stimming is way of coping and processing information from a world that is often very confusing and scary for autistic children. The language around stimming and oral fixation can often be negative, and there is often a stigma attached to it, but children should not be treated as if they are doing something “bad.” Instead encourage your child to seek out better substitutes or redirecting their chewing behaviour in a more positive and healthier way.

To find out about how I AM can offer support contact us at admin@i-am-autism.org.uk or give us a call on 0161 866 8483

Autism and Oral Fixation - I AM (2024)