Chewing Hierarchy Level Number 3 for children with Down Syndrome

Once again thank you to Lori Overland for sharing her knowledge and information…I have taken many of her classes offered through  So a very big thank you to her for helping me to help so many children and mamas!

Below you will find information regarding chewing hierarchy level three….remember you will do level #3 as a pre-feeding exercise while you are working on level #2 as a feeding exercise.  This means if you are working on level #3 as a pre-feeding exercise you are using chewy tubes not food…..because you are developing the muscle memory for chewing…and when your little one is ready….you will do this level during feeding…and addressing chewing hierarchy level #4 in your pre-feeding.



Present a stick shape bolus-like a veggie stick or a pretzel…I also like the Snikkidy Cheese Fries…they are the same shape as a veggie stick..and the same consistency…but are very cheesy…and give lots of good sensory information…they are in the chip aisle….I love them too! 

What to do:

Present the food on the lateral incisor.  Be sure to provide support to your little one’s jaw to prevent jutting or sliding…if needed.  Encourage your little one to bite.  Quickly present the bolus to the opposite lateral incisor.  Alternate the side you start on as well. 

What does this level work on?

~Tongue tip pointing

~Tongue lateralization across midline

I plan to post about level number four tomorrow…the five point bite…which addresses the rotary chew…tongue lateralization across midline.

Have fun and post with any questions.



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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