Chewing Gum as a Treatment for Rumination in a Child With Autism

Abstract

Rumination involves regurgitation of previously ingested food, rechewing the food, and reswallowing it. In the current study, a child with autism displayed chronic rumination, resulting in the decay and subsequent removal of several teeth. After several treatments failed, including thickened liquids and starch satiation, the participant was taught to chew gum. His rumination decreased significantly when gum was made available. Results suggest that access to chewing gum may be an effective treatment for rumination in some individuals.

Behavioral treatment of rumination: Research and clinical applications

“…Another key research finding is that the most positive effects of food and liquid on rumination may be dependent on delivering them rapidly (Woods et al, 2013) and for a prolonged period of time after meals (Kliebert & Tiger, 2011;Lyons et al, 2007). Also, with few exceptions (e.g., Rhine & Tarbox, 2009), the long-term outcome from rumination treatment is unknown. Accordingly, future research might profitably compare and contrast the immediate and long-lasting results of various reinforcement and FT schedules.…”

“…Therefore, studies must continue to explore strategies for reducing implementation barriers and constraints to researchsupported methods of rumination treatment. These alternatives include gradually reducing the amount of food and liquid quantities while simultaneously extending the duration of treatment sessions (Lyons et al, 2007), using a relatively low-effort procedure such as chewing gum (Rhine & Tarbox, 2009), and teaching individuals to self-administer the intervention (Wilder et al, 2009).…”

Review article: the pathophysiology, differential diagnosis and management of rumination syndrome

“…Alternatively, chewing gum has been proposed as a treatment of rumination in the paediatric population. A number of case studies reported a positive effect of chewing gum, which led to a reduction of the number of rumination events in young children and adolescents 37, 38 …”

Managing a patient with rumination

“…PPIs may, in fact, lengthen the period of rumination following a meal, which usually ceases when the food in the stomach becomes acidic 10. Chewing gum in the postprandial period has been shown to reduce rumination in the paediatric population 24 25. Baclofen (an agonist of gamma-aminobutyric acid receptor) has recently been shown to be effective in reducing the symptoms of rumination syndrome 26.…”