Therapy included thermal tactile stimulation, which increases sensory awareness in the oral cavity and decreases the delay between oral stage
of the swallow and the onset of the trigger of the pharyngeal swallow.
He stresses the importance of an oral stage
that is never entirely overcome, and that finds its echoes in the sounds uttered by infants, in the gurgles and rumbles of the body, and in dialect (151).
The clinician will: (1) visually inspect and assess ROM, strength, and coordination of individual oral structures, including lips, tongue (anterior, middle, and posterior), and soft palate; and (2) assess the functional movement patterns required for the oral stage
of swallowing, including food bolus manipulation during chewing, cohesive food bolus formation, anterior-to-posterior transit of cohesive food bolus, and transfer or dropping of food bolus into pharynx.
After an oral stage
, human cultures gradually adopt writing systems (chirography or hand-writing first, then print).
The stage two impersonal, obsessive organization reflects the oral stage
and focuses on bureaucratic order, control, and rules.