Nose to lips-ugh!

One of the wonderful things about being an occupational therapist is that we look at the whole person when we assess challenges. Recently, I had the opportunity to evaluate three year old girl who was referred for possibly eligibility for services in a Pre-K program. This little girl was born drug exposed. When speaking with her grandmother, who is now her adopted mother, she shared a troubling new behavior. This little girl, when anxious would put her finger into her nose and rub the mucus around her lips. The grandmother was at wits end and did not know how to get her to stop this behavior. An interesting puzzle indeed! Here’s where the creativity and depth of occupational therapy comes into play along with my mental health counseling degree!

First we look at the purpose of the behavior-there are many sensory receptors around the mouth, and rubbing this area can have a calming impact.

The mucus acts as a lubricant, making a smooth path around and around her mouth.

Since the behavior is calming we don’t want to eliminate it, rather replace the behavior with one that will have the same effect, but is also not harmful and is socially acceptable.

The recommendation: Provide the child with lip balm that has a scent of her choice. Each time she begins to move her finger to her nose and then her lips, give her the lip balm and have her use it. As time goes on, increase the child’s independence by allowing her to keep the lip balm in her pocket so she can use it at will.

Understanding the purpose of a behavior and developing a plan to replace a negative or harmful behavior with a socially appropriate, meaningful behavior that the client is capable of participating in one is one of the unique qualities occupational therapists develop.