How to improve tongue movement and rotary chewing in children with Down Syndrome

This post is specifically in reference to a pre-feeding exercise that can be done in order to improve lingual lateralization and rotary chewing in children with Down Syndrome. 

Lingual lateralization refers to your tongue moving to the side of your mouth.  When we eat a solid food….we bite through the solid with our front teeth….lateralize the food with our tongue to the side…..chew and then swallow.  Children with Down Syndrome may have difficulty with the ability to lateralize the food to the side of their mouth.  They also may fatigue during chewing due to lower muscle tone, therefore, may have difficulty with the rotary chew. 

The exercise described below is a pre-feeding exercise….it should be used to maintain the lateral tongue reflex, stimulate lingual lateralization and help with the rotary chew (the diagonal movement of the jaw).   So….prior to eating solid foods we can work on lingual lateralization and the rotary chew…..this way when your little one is ready to eat solid foods… she will be able to move the food to the side and demonstrate the rotary chew.  When you stimulate the sides of the tongue you will naturally see movement because this is the lateral tongue reflex.  So maintaining this lateral tongue reflex will help with lingual lateralization and also will help with the rotary chew.

The first thing you need is a toothette.  You can buy these at  or your local surgical supply store should have them as well.  The very first step before this enters your baby’s mouth is to cut the wings off the toothette.  If you look closely at the picture….you should be able to see the protrusions on the toothette.  With your scissors…remove all of the wings.  The only reason for this is because the toothette is too big for your little one’s mouth.  I have not seen toothettes in any other size. 

So after you cut the wings off….dip it in water….or formula….or breast milk…. or a little juice….just to get the toothette a little wet.  It is a sponge…but the texture of it is a bit course if it is not wet.

Now the following exercise is going to be done five times on the right side and five times on the left side. 

Start at the back of the tongue with the toothette…..and run the toothette along the side of the tongue until you reach the tip of the tongue… should start to see your little one’s tongue moving to the side as you are doing this exercise.  This should be done five times on the left side of the tongue and five times on the right side of the tongue.

Remember the goal of this exercise is to maintain the lateral tongue reflex, improve lingual lateralization and help the rotary chew.


About Kim

My name is Kim Marino and I have been practicing as a licensed speech and language pathologist since 1993. I work on Long Island providing diagnostic evaluations and services to children from birth to age 21. My experience is vast and am proud to say that I work with children that may present with articulation and phonological concerns, oral motor feeding concerns, Down Syndrome feeding, cognitive rehabilitation, auditory processing delays, receptive language delays, cleft palate feeding and sound development and expressive language delays. Most importantly, I am the mother of four amazing children and am happily married to my childhood sweetheart. I feel blessed to have my four children and so lucky to share this journey in life with my husband. I always had it somewhere in my head that I wanted to develop a blog or a website of some sort so that I could provide families with an additional that parents could help their little ones become a better communicator. And as I was developing this blog....I realized that I also needed to share the stories about my life and my children....and the funny things along the way that help to keep me smiling. Whether you are a working mother or not...finding balance between home, children and life can be a challenge....I hope that my blog helps to bring a smile to your face..and also some tools to help you help your little or big one. I hope you enjoy! Kim
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2 Responses to How to improve tongue movement and rotary chewing in children with Down Syndrome

  1. Rekha says:


    My son is 2 Year sand 8 months old. Still not chewing food. I am currently giving him semi Mashed food. He can anything that is soft. He hates Brushing. If I give my fingers, he know its to byte. But for food, he brings his tongue first.

    • Kim says:

      Hi there follow the chewing hierarchy I have posted about. The link is to the right of my home page. You can follow this model to develop the rotary chew. Are you able to get small pieces of food such as a cheerio or a Gerber puff on his back molar ridge to encourage the chew. Here is my email I find it easier that way for Best, Kim

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