Biting in Children: A Speech-Language Pathology Differential Diagnosis

Abstract

Biting behavior in children is a clinically significant sign that requires careful differential assessment rather than rapid classification as aggression. It may express frustration, weak functional communication, emotional dysregulation, oral sensory seeking, or oral-motor and feeding difficulties related to chewing, swallowing, and speech production. This article aims to construct a speech-language pathology framework for the differential diagnosis and management of biting in children. The study adopts a descriptive analytical method based on Arabic and international literature, with special attention to communication, sensory processing, oral-motor control, pediatric feeding disorder, autism spectrum disorder, and attention-deficit/hyperactivity disorder. It proposes a multidimensional assessment sequence, an observation grid, differential diagnostic tables, clinical red flags, and an intervention plan that integrates functional communication training, augmentative and alternative communication when needed, safe oral-sensory regulation, feeding-oriented oral-motor work, and family-school collaboration. The study concludes that effective intervention should not depend on punishment or behavioral suppression alone. It should begin with identifying the function, context, communicative meaning, oral-sensory indicators, and oral-motor signs associated with biting.