Please explain the concept of habituation as it relates to oral feeding.
Habituation occurs when the nervous system responds with reduced intensity to repeated stimuli. For example, if you hear a noise in the background and you keep hearing the exact same noise, you will soon stop paying attention to it. In fact, you may not even notice it. You will habituate to it, so that it is no longer in your consciousness, unless perhaps you make a special effort to pay attention to it. Another example is found in experiments psychologists did when they would put a dot on a contact lens so that it would continuously occupy the same place in a subject’s visual field. The psychologists found that a person would cease to perceive that stimuli after they had initially seen it when they habituated to the stimuli. If you think of the first time you eat something or really have any experience, the novel experience may be more intense, which is great for avoiding hazards in the environment, but if every sensation still has that strong priority of a novel sensation, then it could easily overwhelm someone. When eating, if each bite of food was like you bit into it for the first time, the intensity of that sensation might make it difficult to keep eating.
Different therapeutic approaches seem to be geared towards improving habituation. One example of that would be approaches that start with somebody eating a food that they already accept, and then increasing the variety of food that they will eat -- foods that are a little bit different -- and adding that to the foods that someone will recognize. When someone cuts themselves off from sensation, they make the problem of reduced habituation worse, perhaps, because they're avoiding sensations; thus, everything seems like a novel experience. The more a person can make sensations habitual, the easier it may be for that person to accept them.
George Fluharty is an SLP with more than 30 years experience treating neurogenic communication disorders. His work has been published in Brain Injury, Clinical Rehabilitation, and Advance for SLPs. In 2003, he received the Clinical Service Award from the Brain Injury Association of Wisconsin (BIAW) for outstanding clinical service.