A New Bit on Toddler Biting: The Influence of Food, Oral Motor Development, and

Sensory Activities
Author(s): Pamela Ramming, Caroline S. Kyger and Stacy D. Thompson
Source: YC Young Children , March 2006, Vol. 61, No. 2 (March 2006), pp. 17-18, 20-23
Published by: National Association for the Education of Young Children (NAEYC)

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 Innovative Practice

Pamela Ramming, Caroline S. Kyger, and Stacy D

A New Bit on Toddler Biting

The Influence of Food, /
Oral Motor Development, 'à
and Sensory Activities

My son ran to me at pickup time, crying out "Ack bite Ack bite."
Although my toddler's language skills did not allow him to pro-
nounce Jack , it was clear he had been bitten. This was not the first
time Jack had bitten my son.
My son's child development center followed confidentiality
rules, but toddlers tend to talk and tell all they know. I am a
generally calm mother with an understanding of
children and child development, but this was my
baby and normal parenting protectiveness kicked ^
in. So I took some chewy snacks to the center
and asked my son's teacher to start offering
them after breakfast and at afternoon snack. Y j
The results: his classroom went from an ^ tri I Â j
average of six biting incidents a week to ' ! Ir
zero, and my colleagues and I began to ' ' #
research the links between oral 1 ' / #
development and biting. 1 | ' I
Illustrations © Marti Betz

The research and literature on how to handle biting be consistent in the use of separation, redirection, and
has remained consistent over the last 20 years. Most follow-through. Preventive models remind early childhood
publications and seasoned professionals focus on inter-
educators to keep a close eye on children who have a
vention and tell us to attend to the child who was bitten, history of biting, provide more than one of particularly
reinforce the idea of "using our words" with the biter, popular and toys, and teach young children to use their words
to express their feelings. We also learn what to do should
Pamela Ramming MS, is a child development specialist with we, as adult caregivers, lose control.
the Oklahoma State Department of Health, Soonerstart Early Rather than challenging the intervention practices that
Intervention Program, in Clinton. Pam works with families and we know to be best practice, this article examines preven-
children from birth to three who have or are at risk for develop-
tion of biting from a developmental perspective. It consid-
mental delay. She coordinated the Oklahoma Child Care Warm-
ers oral development as another possible cause of biting
line for child care providers and is active in educating providers
and families about children's development of oral motor skills during the toddler years. This perspective gives adults an
and the effect on biting and prevention. additional way to understand and respond to biting in
Caroline S. Kyger, MS, is a counselor at Edmond Family early child care settings.
Counseling, Inc., a nonprofit counseling agency serving indi- Oral motor development, sensory integration, and
viduals, families, and groups in Edmond, Oklahoma. Caroline is
behavioral organization are not new ideas or theories, but
under supervision to earn her LMFT. Her specialization is in
practices based on them are relatively new in the early
marriage and family therapy.
childhood field. All have long histories in occupational
Stacy D. Thompson, PhD, is an assistant professor of child
development at Southern Illinois University in Carbondale. Her
therapy, speech pathology, and related fields. Bringing
principal research interests include children who are at riskthese
and theories and practices to early childhood education
in early intervention programs and adolescent parenthood. helps professionals understand the causes for biting and

Young Children • March 2006 1 7

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use early intervention in a developmen-
tal context. To have a clear understand-
ing of how foods, oral motor activities,
and sensory activities can prevent biting, up,
we must understand the neurological
and developmental processes young
children experience.
What we know about biting
In investigating biting, a few
facts are accepted by most
child care providers. For in-
stance, biting is a typical,
frequent developmental phe-
nomenon in toddlers, much like
temper tantrums and separa-
tion anxiety. In early childhood
settings, biting is a highly
charged issue because a child is
being hurt and parents of both
the biter and the child bitten
feel concerned.
When biting happens, it is
scary, frightening both the child
who bites, the child who has
been bitten, and other children
o
z
more varied types of foods (see "Growth
Stages and Levels of Feeding Skill" on p. 21).
As stressors build
As children's feeding skills develop,
toddlers may biting other children can become a form of
active stimulation. For instance, at one
bite as a way to child care center, we observed more biting
relieve stress or to incidents on the days oatmeal was served
than we saw on bacon-for-breakfast days.
meet a develop- Therefore, when we began our survey of
mental need. research on biting, we hypothesized that
the more opportunities children
have to crunch and chew, the
less likely they are to bite an-
other child on any given day.
In support of our hypothesis,
we begin here with a summary of
the literature on oral develop-
ment, sensory integration, and
biting prevention and interven-
tion. Next, we describe our
experiences with children's
development and biting and
recommend practices that can
reduce biting behavior because
they help to meet the child's
developmental needs.

in the group. It is also a major>>c

Oral development
concern for teachers. Most 03
S
reports on biting injuries in Biting is linked to oral devel-
early childhood settings cite opment, specifically to develop-
that biting is common. One estimate (Wien 2004) is that ment of the suck, swallow, and breathe (SSB) synchrony.
one out of 10 toddlers are biting. Strauman, Lie, and TheKempfSSB synchrony "coordinates sucking, swallowing, and
(1993) indicate that 35 to 51 percent of all injuries in breathing
child so we can eat and breathe without choking"
care are due to biting incidents. Solomons and Elardo (Frick et al. 1996, 4). This synchrony takes time to develop.
(1989) found that the number of biting incidents wasAs children move through the feeding skill levels, they
greatest in September and lowest in the summer and learn that to coordinate and further develop the synchronistic
bites peaked at around 10:00 a.m., declining thereafter SSB by experiencing different types of foods.
through nap time. Some researchers see biting as part of oral development
Teachers often observe that biting occurs more fre-because children use biting as a way to change their envi-
quently when children experience stress, such as changes ronment. For example, when a child is not getting his or
in their environment or a lack of adult attention (Claffey,
her way or is frustrated, he or she may be more likely to
Kucharski, & Gratz 1994). Biting may result from childrenbite or show other forms of aggression. Claffey, Kucharski,
being at a significant stage of development, such as whenand Gratz (1994) describe biting as an act of frustration
learning to walk and falling more often or when learning because,
to although children become more able to influence
talk and feeling frustrated in their attempts to communi-their environments as they get older, they are not able to
cate. When children are learning and transitioning from do as much as they would like. These researchers found
that as toddlers develop, they gain increasing mobility and
one feeding level to the next, they tend to bite more often.
For example, infants who are ready to eat pureed foods independence but still need family and caregivers. This
often begin to bite their breast-feeding mothers. This continued dependence can frustrate a child. As stressors
biting behavior does not mean the child is ready to stop build up, toddlers may bite as a way to relieve stress or to
meet
breast-feeding but instead signals that the infant is ready a developmental need because they have few outlets
to practice higher-level feeding skills and to experiencedue to limited language and motor skills.

1 8 Young Children • March 2006

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 Sensory integration

Sensory integration is defined as "neurological organization of our

Prevention . . .
In Addition to Intervention
To address child biting, teachers and
caregivers need to use both intervention
and prevention. A teacher might look for children can respond behaviorally, emotionally, and intellectually.
situations that have triggered biting
incidents in the past. For example, is the for moving, learning, speaking, and interacting with the environment"
child more likely to bite when uncomfort- (Kranowitz 1992, 26). An example is when a child interprets informa-
able or sick, hungry or sleepy, anxious/
frustrated or bored? Perhaps the child's
frustration comes from having witnessed stand if the smell is pleasant or scary
a fight at home, lost a loved one and
feeling sad, or experienced other stress- adults, if we smell smoke, we react.
ful events (Garcia 1999).
Prevention also includes steps that
apply to all of the children in the group.
Teachers can provide duplicate toys to
avoid fights, because toddlers are not yet
ready to share; have flexible meal- and
nap times to meet the individual needs of
each toddler; offer developmentally
appropriate toys to reduce frustration
and stimulate growth; verbalize
children's feelings as a model for how to
express feelings appropriately; and
demonstrate being nice and gentle to
help toddlers learn appropriate behav-
iors. These steps are preventive helps,
but when a child appears likely to bite
another, intervention may be necessary.
Greenman suggests that teachers pay
attention to possible "congestion, confu-
sion, and disorder; child waiting; com-
motion and competition for toys and
senses, like vision, hearing, taste, smell, and touch" (Kranowitz 1992,
25). In addition to the five basic senses, Kranowitz discusses three
other senses: the proprioceptive sense, which gives a person informa-
tion about body position through muscles, joints, and ligaments; the
vestibular sense , which relates to gravity and space, balance and
movement, and the body in juxtaposition to the surface of the earth;
and the tactile sense , which helps a person distinguish between threat-
ening and nonthreatening sensations.
When all of these senses work well together and are integrated,
Sensory integration (how the senses work together) "is the foundation
tion from one sense, such as a smell.
Sensory integration helps us to under-
When all of these
and to respond to the situation. As
senses work well
This comes from years of sensory
experience that teaches us that smoke together and are
is dangerous and we should respond. integrated, children
Young children have less experience,
can respond behav-
so even pleasant smells can seem
fearful until the sensory experience is iorally, emotionally,
understood to be good.
Behavioral organization is defined as and intellectually.
"a person's ability to behave or
respond in a way that matches the
situation" (Frick et al. 1996, 4). For
example, a child's table behavior
changes when eating dinner with
only his siblings compared to
when parents sit down at the
table. With this ability, an indi-
vidual can adjust his or her re-
sponse based on the changing
demands of the situation (Frick et
al. 1996). Development of behav-
ioral organization means that
children are able to use their

materials; and competition for adult senses to react appropriately, like

attention" (1995, 65-66). In addition he the infant sucking on a pacifier to
suggests that teachers avoid working experience calmness.
with children in large groups, engage
children in effective one-on-one encoun- Link between behavior
ters, calm children after high excitement, and senses "S
2

and avoid pairing children who fre-

c
>>
In discussing the link between
quently have conflicts with each other «3

behavioral organization and

S sen-
(Greenman 1995). sory integration, Frick and col-
©

leagues (1996) recommend engag-

ing children in sensory activities to help the child feel comfortab

20 Young Children • March 2006

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 Innovative Practice

use self-control. Activities such as blowingbite. on aGreenman

whistle, and Stonehouse (
crunching on ice, and using straws stimulatecan be rooted in a child's lack of d
coordination
of sucking and swallowing and help the touchyoung child sense re- and the integration of
children seek
spond appropriately to situations. The mouth is stimulation
the quick-
est route for providing sensory informationor copeto with
the behavioral
brain
and organizing higher cognitive thought organization
processes. by biting
These To preven
researchers also stress serving children others.
foods Food choices
with a vari-
ety of textures, tastes, and temperatures, offered
for to example,
them did not related to
foods to suck, gum, munch or crunch, chew, satisfy their
and tactile
to pro-needs needs, we
vide sensory stimulation (for examples, and see higher-level
"Toddler feeding
Oral
Motor Develop- skills nor provide enough mend off
ment Food List" sensory stimulation. For dlers foods with a
on p. 22). example, a child may need
more texture or stimula- variety of textures
tion from food choices, as well as providing
Special needs
such as something
Some children
crunchy, but may not be appropriate objects
have slower or
getting it in her diet. As a on which to chew.
immature neuro-
result, the ability to react
logical systems, appropriately in a given
so their brains do
situation falls apart as the child focuses on meeting devel-
not process sen- opmental needs. The sensory stimulation of biting "plays a
sory information role in organizing and supporting the child to achieve
well. For example, success" (Frick et al. 1996, 4).
children with

tactile dysfunc-
tion may be unre- Meeting sensory and developmental needs
Õ sponsive or over-
z
c sensitive to To prevent biting related to sensory needs, we recom-
touch, which can mend offering toddlers foods with a variety of textures
©
make a child (NAEYC 2005) as well as providing appropriate objects on
irritable and an-which to chew. In our observation of children in early
gry. Children with proprioceptive dysfunction may not childhood settings, those who had recent histories of
know how to interpret sensations from their bodies, thus biting spent more time at the table eating chewy snacks
not know how hard to push on a crayon to color or how tothan those who did not bite. These same children also
balance their bodies, and consequently are clumsy. chose more chewy snacks when the breakfast foods
Children having vestibular dysfunction may be over- or served were mushy (oatmeal) than they did if breakfast
undersensitive to movement, so they have difficulty with foods were crunchy or chewy. (Chewy snacks, including
speech and eye movement.
Kranowitz (1992) points out that
some children may develop their
senses better on their own as they Growth Stages and Levels of Feeding Skill
grow older, but others may re-
quire occupational therapy to Age Developmental Feeding Food type
catch up with their peers. task skill level (examples)
Birth to 6 months sucking liquid breast milk, formula
4 to 9 months gumming pureed baby food, cereal, yogurt,
A biting hypothesis mashed foods

Our hypothesis is 9that

to 15 months
some munching soft cooked vegetables,
breads, cheese
children may bite because they
are trying to respond
1 2 to 1to a situa-
8 months crunching hard raw vegetable slices, toast
tion appropriately but may lack
15 to 32
the ability. To quickly months
gain sen-chewing chewy diced meats, fruits,
raw vegetables
sory input for organization, they

Young Children • March 2006 21

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 bagels, oranges, and apples, should be cut in small pieces
and served with adult supervision to avoid choking .)
In another prevention approach, we tried tooth brush-
ing and using oral stimulation brushes (e.g., Nuk brushes)
to give children developmentally appropriate choices in
meeting their oral motor needs, because children might
Toddler Oral Motor Development choke on most higher-textured foods. As with teething
Food List rings, most infants and toddlers like to chew on these
brushes. The difference between brushes and some chew-
Foods to suck action objects, like teething rings, is that children can use
grapefruit/orange wedges their molar teeth. The sticklike brush is an appropriate
juices object to bite on or
yogurt smoothies chew, unlike a toy
milkshakes i or another child.

frozen juice bars Teachers need to

gelatin cubes supervise the use of

these items as table
applesauce
activities to avoid a
pudding
child's falling with a

Foods to gum / brush and choking.

munch/crunch To respond to
biting by older
apple slices aI
blueberries children, ages O »
z :
three or more e

banana chunks _>>

years, one recom- Î3

whole-grain crackers mendation is to

S
©
rice cakes
first compare the
graham crackers
child's ability to pronounce words appropriately and to
oat O's cereals
eat, without problems, different types of foods, such as
soft tortilla strips
crunchy or chewy, with the abilities of other same-age
tofu cubes
children. Many children with weak oral motor systems
raw vegetable slices have not completed all of the stages of feeding (as noted in
salt-free pretzels "Growth Stages and Levels of Feeding Skill" on p. 21). Pre-
viously mentioned ideas in empirically supported research
Foods to chew on biting are also valuable responses.
jerky
cheese cubes/slices

bagels Summary and implications

raw veggies (zucchini,
Our goal in presenting this theory on biting is to de-
mushrooms, lettuce
crease classroom biting incidents. The results of our sur-
leaves)
vey of research and the literature can provide information
tender meat tidbits
for parents and educators, many of whom are anxious for
raisins
concrete ideas to help children who bite. After learning
oranges about oral motor development, many parents and teach-
ers can explore new food choices and expand children's
Foods to provide diets to provide a range of food textures and choices.
sensory stimulation Viewing biting behavior as a toddler's developmental
salsa need for oral sensory stimulation is beneficial because it
ice chips means that families and educators can address problem
lemon wedges behavior by adjusting food choices and offering appropri-
cinnamon sticks ate objects on which to chew. The developmental needs of
children who have a history of biting can be met through
food and appropriate chewing objects. Taking steps to
prevent biting leads to a safer child care environment.

22 Young Children • March 2006

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 Innovative Practice

By addressing biting from a preventiveReferences

perspective,
families and caregivers use hands-on techniques and ideas
Claffey, A.E., L.J. stage.
that can help children through this developmental Kucharski, & R.R. Gratz. 1994. Managing the
biting child. Early Child Development and Care 99: 93-101.
In acknowledging biting as a developmental need
Frick, A., andR.not
P. Oetter, Frick,a & E. Richter. 1996. Discovering the
discipline issue, parents and teachers avoid negative
developmental significance of the mouth: Out of the mouths of
babes.
labeling of children as "having problems." AsHugo, MN: PDP Press.
teachers
Garcia, V. 1999. Understanding and preventing toddler biting.
broaden their thinking about what is typical development
Texas Child Care (Summer): 12-14.
and learn the value of prevention, increased
Greenman,understand-
J. 1995. Reality bites (frequently): Biting at the center.
Part organization
ing of fine motor process and neurological 2. Child Care information Exchange (102): 65-66.
Greenman, J., & A.W. Stonehouse. 1994. Reality bites: Biting at the
will enhance the services we provide to young children
center. Part 1. Child Care Information Exchange (99): 85-88.
and their families. Kranowitz, C.S. 1992. Catching preschoolers before they fall: A devel-
The experience described at the beginning of this article opmental screening. Child Care Information Exchange (84): 25-29.
NAEYC. 2005. NAEYC Accreditation Criteria #5.B.14 and 5.B.15 for
led to a realization that teachers' understanding of oral health standard. In Health: A guide to the NAEYC Early Childhood Pro-
development could change early childhood practices. As gram Standard and Related Accreditation Criteria, 23-24. Washing-
educators, we tested the theory and adapted the informa- ton, DC: NAEYC.
Solomons, H.C., & R. Elardo. 1989. Bite injuries at a day care
tion to fit current trends. A workshop was created and center. Early Childhood Research Quarterly 4 (1): 89-96.
offered statewide in Oklahoma, receiving the support of Strauman, R.K., L. Lie, &B.J. Kempf. 1993. Creating a safe environ-
many child care providers and parents who began using ment for children in day care. Journal of School Health 63: 254-57.
Wien, C.A. 2004. From policing to participation: Overturning the
the information to help their children through this typical rules and creating amiable classrooms. Beyond the Journal.
developmental stage and sharing the tools they use to Online: www.journal.naeyc.org/btj/200401/wien.asp.
change practices in their child care settings. In these
settings no longer is a child removed from child care for
biting, and parents have grown in their skills in handling Copyright © 2006 by the National Association for the Education of Young Children. See
biting situations and perceiving their child's behavior. Permissions and Reprints online atwww.journal.naeyc.org/about/permissions.asp.

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