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Autism

Autism

10/13/2009

Question:

why my 13 year old continues to put things in her mouth, and chews on everything?

Answer:

Mouthing things is typical for infants as a way of exploring and learning about the environment. With maturity, the exploration is done more with the hands and in other ways and mouthing is confined to things identified as food. However, several things can cause the less mature mouthing to persist or return.

One, of course, is profound intellectual disability, in which the mental age is at an infant stage. This is not the most likely explanation for most individuals with autism. Autism can include sensory abnormalities, which can result in mouthing in several ways. First, the other senses may not be "comfortable" in that sights, sounds, and even touch may be experienced as overly intense and even painful. With the other senses causing discomfort, the child may prefer to substitute the more comfortable oral orientation.

Second, the oral sensation itself may be gratifying and comforting, self-reinforcing, regardless of the other sensations.

Third, the mouthing could be a form of stereotyped or repetitive behavior.

Fourth, the restricted and peculiar diets that some children with autism follow may leave them with mineral or other deficiencies that they are unconsciously seeking to replenish with various objects. Regarding the latter possibility, a multivitamin/mineral might be worth a try if she is not already taking such. You could consult her pediatrician about reviewing the possibility of a deficiency state, which a summary of her dietary preferences might suggest.

Regardless of cause, a behavioral program could probably reduce the amount of mouthing by substituting other, more acceptable behaviors. If she does not have a behavior specialist, her case manager should be able to arrange that. If she does not have a case manager, contact your local county Board of Intellectual and Developmental Disabilities to get one assigned. 

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Response by:

L Eugene Arnold, MD, MEd L Eugene Arnold, MD, MEd
Professor Emeritus of Psychiatry
College of Medicine
The Ohio State University