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Over it, Under it

Noah's getting his oral motor skills evaluated by an occupational therapist on Monday.

He's made incredible progress over the past month and a half -- it's been hard to know what necessitates an update or not. Sit? Dessert? Hop, tick-tock? Clue? Big truck? The way he imitates Cesar Millan's patented TSSST! sound when Ceiba barks?

But. One problem. I'm the only one who can understand him.

(Car + Truck = Cahck = Noah joyfully shrieking BIG COCK! at every possible occasion)

His speech therapist doesn't think he's like most children she treats, since he's clearly ready and willing to communicate at a much higher level than he is. (Based on the way he plays and the signs he uses.) But something is stopping him. Something is causing him to make an M sound with his front teeth sticking out over his lip, and to go out of his way to avoid sounds that create vibrations in his mouth. Something is definitely up with his pronunciation.

He won't pucker his lips or make a fish face or eat with a spoon. Food must be extremely crunchy (cracker-like) or practically mush. He won't let us touch his mouth and brushing his teeth takes two people holding him down and ends with at least two people crying. He still won't blow on the damn bubble wand.

Once again, we're back in Squishy Diagnosis Land, since I imagine 99.9% of you read that paragraph and went, "Uh, honey? He's TWO."

His speech therapist thinks, when you put the whole picture together, that Noah is not processing sensory input from his mouth correctly. Oral defensiveness. Eh. Fine.

I'm not worried about Monday's assessment -- his regular therapist will be there, she hand-picked the OT and I am confident in her ability to advocate for Noah. (She's pushing for weekly OT sessions.) It will be here at home, and mostly consists of me feeding Noah a snack while the OT watches. (Although I AM a bit concerned about serving the best snack -- what IS the proper menu for showing off poor oral motor skills? Cheerios? Granola bars? Duck l'orange served with herbed mashed potatoes and paired with 2007 Green Juice?)

The assessment will hopefully tell us more about the nature of Noah's delay and I'm sure I'll get more handouts on strategies and activities and checklists. Make Mealtime Less of a Wartime! Better Speech Through Stickers! 101 Things You Should Be Doing With Your Child Every Single Day If You Want Them To Not Flunk Kindergarten! Ready...Set...Bribe!

I'm encouraged and discouraged and neutral and anxious and tired and ready to fight some more. Again.



Hang in there. it will finally all make sense. or at least that is what I keep saying to myself as I deal with a very quirky 11 year old.


A friend of mine's son just had surgery to correct the same problems you're describing. There was a muscle behind his vocal cord that was too tight and it was preventing him from making those same sounds and blowing bubbles from the bubble wand. He has other physical handicaps so it was even more difficult to diagnose but at 7 years old, he just blew his first bubbles!


While I don't recall having pronunciation problems as a child, nearly all of the issues listed at the top of that Oral Defensiveness link are VERY familiar. Not only did I have gagging issues with certain foods and desperately drank milk to swallow, but I hated anyone touching my face (no makeup play, and I still rarely wear it now, plus when VERY young I was a horror at the dentist's office) and I rarely fingerpainted or got muddy (I still don't like icky stuff on my hands and even putting lotion on kinda grosses me out). Certain food textures really bug me still, and I'm VERY sensitive to tastes and smells.
The info you linked to may just have helped me more than Noah! Not that it matters- my parents helped me cope as best they could with what we all thought was me being picky and over-sensitive. Plus it didn't hamper my communication as far as I know. But no matter at what age (27!), it's still cool when the light dawns on some of my long-standing quirks.
Growing up DOES help temper some of this- so some of that stuff will definitely fade as Noah gets older and he'll develop his own unique coping skills (I moisturize every day now!:)
-Sorry this was so long, but I definitely think that with all Noah's rapid progress and strong desire to communicate, he can totally kick this, too. With flying colors and maybe some bellydancing thrown in.


You know, I didn't think "he's two." I thought, I hate the confusion of having a child who needs something and not knowing what that is. BTDT. It isn't fun.

Li'l Foot's Mommy

Good luck on Monday.


Good luck! It looks like things are moving in the right direction!


I hope it goes well for him and there is an easy solution to this. Good luck!


Oh I would totally be nervous about what to feed him too! Social comparison, eek! Good luck!


Thanks for that story, Liana. Extremely encouraging to remember that hey, even if you never know the whys and follow all the rules and just do your best, things turn out just fine.


My niece calls Crocs cocks. Which is funny when she sees them on dudes. And she doesn't know any level but LOUD.

He's made leaps and bounds it sounds like from what you've shared with us. And it sounds like his speech therapist really has his very best interests at heart. And that is good.

And I'd definitely go with the duck.


You're doing awesome with Noah, Mamalah. Good luck on Monday.


Wow, I think you may have just sent me on an internet journey. Reading about oral defensiveness explains some issues that I had and have - especially when it comes to food textures and my bizarre gag reflex. I am going to do some more investigating. Thanks!


You know, I didn't think "he's two." I thought, I hate the confusion of having a child who needs something and not knowing what that is. BTDT. It isn't fun.


OT has been great for us. KayTar is STILL on a stage two baby food diet (at 32 months) but we have seen improvements. She used to gag/vomit at the TOUCH of shaving cream, even a dot on her finger. Cra-zee. It is lots better, though.

Maybe Noah and KayTar can use Skype to watch each other pucker and smile. LOL!

A trick for the bubble wand is to blow and catch a bubble on it first, then it is easier for them to produce a bubble. Chances are they've already told you that, though.

anne nahm

Good luck! Hope you get some easy, positive answers.


Just two thoughts. Has Noah been looked at by a pediatric dentist? What about an Ear Nose and Throat doctor? Until you said how much trouble it is to brush his teeth, I was with you on the rest of it, but now I wonder if there is a physical problem...


Can't wait to hear the latest update. BTW, EVERYTHING he does warrants an update. ;)


Good luck on Monday! As frustrating as it's got to be that something is holding him back from busting out with a, "Good afternoon, Mother. Could I trouble you to refill my Green Juice whilst I assemble this lovely Thomas the Tank Engine Train Set you have so lovingly provided me?", he seems to have made incredible process, which is so exciting. Sounds like you have a great team and you're doing awesome.


I'll be thinking about you on Monday. Sensory issues, man. I swear, my brother (age 27)still cuts the tags out of clothes because his skin is so sensitive, and I (age 30)can barely manage to brush my molars because of gag issues. Where were these diagnoses when we were kids?


Regarding the tooth brushing, our OT suggested applying pressure to our son's jaws just before we started to brush his teeth. So when we are drying him off after his bath, we put a bit of pressure around his mouth. It helps to desensitize the area, apparently.
Also, we just started the GFCF diet with our son and noticed a definite reduction in sensory issues(crunchy food, loud noises, etc.). Not the right answer for everyone but another thing you could try.


You are doing the most important thing in being an ardent advocate for Noah. Nobody in the world is better equipped, and nobody will have the tenacity to fight for everything that he deserves and is entitled to. Go get em Amy!


It sounds like part of the sensory processing to me, not that I'm a trained professional. But the food textures are very similar to my son's preferences. He's been doing OT for about 6 months and has made definite improvements in just about everything. Plus, if you get good OT (like we're paying for out-of-pocket up here), it's often set up like a kiddie gym; my son goes to "play" with his therapist every week.


If it makes you feel any better, my oldest niece had significant speech issues at that age up until she was 5. I had her every Wednesday with my own daughter (same age, no speech issues), who was able to translate because at least 90% of what DN said was gibberish to us.

One day, we were out driving somewhere when my DN starts yelling and pointing:

DN: Yook! Yook! Itsa BITCH FUCK!

DD: What's so funny about a *big truck*, Momma?

She's 7 now, and has totally clear speech, BTW.

Hang in there.


thanks for the update...we're all pulling for him, and we're all so proud of the progress he's made already.
as for the snack? i say anything that doesn't require a mandolin will be just fine.


I just want to say, its a good day when I see pics of Noah. Seeing him through your eyes is such a joy each day

adele Richards

Ohhh sweetie! You are doing so well. xxx


I think the oral motor assessment is a fantastic idea. Is it possible he could be tongue tied? Yes, it's a *real* problem that can affect eating habits, the teeth, as well as speech. Here's a link if you would like to know a bit more about it: Good luck on Monday!


Honey, you are the bestest mom out there...I echo all those comments above. My son has a few "strange" responses to things and he is 10, although the sweetest boy in the land. I feel so much and can't put them into words for rock and make us laugh, cry and of everything to you!!!


The OT is most likely going to recommend an electric toothbrush. Electric toothbrushes help with all kinds of sensory defensiveness in the mouth.


I'm a speech-therapy student in canada, and would just like to say: feed him whatever you want, but make sure it's not something he hates. (though she'll probably want a list of things he won't touch) We were watching a video on feeding skills of preemies, and analyzing how one little girl ate from a spoon. Problem was, her mom didn't want the speech therapists to see her feeding the kid pudding, so she brought yogurt, which would have been find, except the kid hated the yogurt and wouldn't eat it, meaning they couldn't get any results from watching her (not) eat. As for the comment about a pediatric dentist or an ENT, they will probably require an OT or SLP referral, because unless he has a cleft palate or is in need of a root canal or has teeth rotting from the inside out, which he doesn't, then it's not really physical; it's sensorineural. It's how his brain is processing the 'touch' sense in his mouth (not: ouch ouch ouch, i have gingivitis!), which is something the SLP or the OT will be more than able to deal with.
It's so wonderful that you're on top of this; most children who need to see an OT or an SLP wouldn't be able to dream of seeing one once a week, let alone once a month. Noah is very very lucky to have parents like you.


and by 'find' I mean 'fine'....


Nothing in the future will ever come as close to all the emotions and fears you had the first time someone confirmed that, yes, there may in fact be something wrong with your perfect child. You are doing the work and thankfully you are blessed with professionals who are on task and proactive. Emotionally, however - it's all downhill from here. That mommy-vulnerability blister is now a callous. It may act up when you have to wear new shoes, but not for long.


And by "callous" I mean "callus."


My daughter pronounced (TR) as (F), so imagine what she said when there was a big truck, or a fire truck, or a dirty truck.

Jenny H.

I erased so many responses to this post. I don't know exactly what you are going through.

But as a mama? I read you every day. Noah is a beautiful child, in every way. He is obviously well-loved and cherished. It must be difficult. My thoughts are with you.

He WILL be okay. He is okay.

Keep the faith.


Good luck to you guys on Monday!!

Lisa M

Yes, he's going to be fine. It just takes time!


No matter what they say Monday, you can take comfort in the obvious support you have from the EI program.
Btw,thanks to your link I've now self-diagnosed as having oral defensiveness. And I'm 31 and living life just fine - the sensitivities have become less of an issue the older I get (but I still can't touch my lips to a utensil - EW!).


No advice, here. I've been in the space that you are and I know how hard it is. It is BRUTAL.

Living with two people that have sensory issues, I can completely relate to what you're talking about (although their sensory issues are different from Noah's)

All I can say is that once you know, you gain strategies. Once you have strategies, it does get better...especially as the child gets older. Unfortunately, people who don't get it are still a real pain in the butt to deal with.

I often forget now that my ds HAS sensory integration issues, so I don't write about it much. Maybe I should start. :)

Wacky Mommy

We had crazy words over here that only I could understand. "Bach" for "milk," "ursh" for "nurse," "neek" for "look."

Then she turned 7 and started making sense. Hang in.

Heather B.

I have the maturity of a 12 year old, I'm still giggling over big cock.


If he is diagnosed with oral defensiveness, they will probably want to do a more thorough assessment for other sensory issues as well. Oral defensiveness is an SPD issue, and while right now might be a very daunting time for you, I can promise you that a diagnosis is not the end of the world. OT does the most amazing things for kids with SPD these days, and it can make an enormous difference in your child's life. My son at almost 9 was recently diagnosed with SPD (late, I know, but that's another story), with hypersensitivity in several areas and hyposensitivity in some others. Our OT has just been fantastic, helped us personally, assisted us with getting appropriate cooperation at school, and I have been amazed to see almost instant results in his coping with daily life. It's not the end of the world, and can provide an answer to much of the bewildering behaviour one agonises over. Read "The Out of Sync Child", and fret not. Noah is lucky to have such strong advocates as his parents, and you will reach the end of this diagnostic road with so much more valuable insight to your son than you had at the start. And BTW, try using an electric toothbrush instead of manual, and start with massaging the gums instead of the teeth. Sorry so long, but just wanted to cheer you on and encourage you as someone with personal experience. be strong, and keep us updated!


Will be thinking about you guys on Monday. Good luck, and don't obsess too much, it's gonna work out just fine. Will be looking forward to the next update...


Thank you for the out-loud laugh over the pronunciation of truck. I think I peed my pants a little over that one. I can just picture all the places Noah must see (and announce) big trucks!!!


Every kid had/has something. My youngest is blind and hates to touch/eat anything that's slimy/sticky/gooey. My oldest will only willingly eat peanut butter & jelly sandwiches (with the crusts cut off. Somehow I'm assured they'll get over it when they become teenage boys.

You are a wonderful advocate for your son. Just the fact that that both you and Noah are willing to work at it pretty much insures success.


Mmmkay, my nephew used to be unable to pronounce p sounds and tr became f for him. Anyway, thanks to my sister (his aunt, NOT his mom) he called a lot of people "Dump Truck" but they just thought he was a really rude little boy with very bad parents.

Anyway, he had a lot of speech development and eating issues. At age 9 he is in all accelerated classes and also, very funny even at that annoying age of 9. And his speech is normal.


Well, I've found that generally, pediatric speach therapists ROCK! So good luck. BTW, I can no longer go into Barnes & Nobles without thinking of Sir Topham Hat and the great Sodor fuel spill of '07. Thanks.


I don't think what Noah is experiencing is "typical two year old behavior". Tantrums are typical, refusing to have someone else brush their teeth, preferring certain textures of foods are typical, but not the strong aversions you are describing. Good thing you are getting him checked out. Good luck.

kim at allconsuming

I always feel weird commenting on your posts that talk about this stuff because all of us with kids with speech delays/disabilities/issues/quirky nuances have our own journey and experiences and things said can be seen as assvice or holier than thou 'derr Freddie' type scenarios. They can also give you too much information and can kill your spirit and hope in one fell swoop.
Oscar is orally defensive and so clearly wants to say more communicate better than his speech will let him. He's now nine (see). People still ask me, 'so will he ever talk properly'. I swap between wanting to kick them in the teeth (or shins) and wanting to say, 'who knows, but if he ever does I hope he has better manners than some people I know who ask rude, insensitive questions'.
But that last line? that sentiment? That is it.

kim at allconsuming

Oh, and all those people who do the whole, 'he's two, cut him some slack'?
Idiots the lot of them. They're normally the ones who argue there's no such thing as ADD.

a mom 2 one

I also thought tongue tie should be ruled out. It is sadly overlooked or discounted too often as a cause of problems.

As I remember he had trouble breastfeeding, it can all be related!

You are a great mom with good instincts, and so fortunate to be trying to figure him out while he is still a very very young child.
Keep on seeking out answers.


Hope you get answers soon!

From your Command Center you can organize your family’s medical information & create wellness reminders, find & rate local service providers, plan & book the perfect vacation, get a handle on your photos, create & plan events and parties, stay in touch with your community using the innovative “HeadsUp” local broadcast feature, plus find inspiration for tonight’s dinner.


Hope you get answers soon!

From your Command Center you can organize your family’s medical information & create wellness reminders, find & rate local service providers, plan & book the perfect vacation, get a handle on your photos, create & plan events and parties, stay in touch with your community using the innovative “HeadsUp” local broadcast feature, plus find inspiration for tonight’s dinner.


We have our first speech evaluation next week. Thanks for all of the insight. My son will be 2 in a few weeks, and though we have seen progress, something isn't right.


Keep hanging in there. I compared my Son's process of getting help to that of peeling an onion. Get one layer off, treat it, etc and then peel another off and keep going until all issues are managable.

Food - let the OT see what he will eat willingly and put something out that he will not - so she can see the reaction herself.


Keeping you all in my thoughts today.


Big cock! Hee! (I too have the overwhelming urge to scream that, only mine is directed toward not cars, but their drivers. Curious!)


Good Luck. You seem to have lots of support here on your site which is awesome. To anyone who says "he's 2", your job is to be his advocate in everything he does so never question yourself or think you are over reacting. It's your job and your right as his Mom.!


Amy - Last winter, my son (at around 20 months) pronounced "hat" as "ass". [Meaning that in our house, we used the phrases "hathole," "get off your hat", etc. quite a bit] In any case, I was relieved when he finally started saying Hs so that I didn't have to loudly cry "Yes! Your HAT! Let's put on your HAT! Where is your HAT?" when we were in public so that people didn't think my son had early-onset potty mouth.

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