Episode 210: SCREEN THE PEDS with Hallie Bulkin

Quick Disclaimer all information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified healthcare provider. Welcome to the Untethered Podcast. I am your host, Holly Balkan. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to to bring you the most up to date information in the orofacial myofunctional therapy, airway tether, dural tissue and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide. If you've been around since June 2019, thanks for being a loyal listener. As we jump into today's episode, remember to listen with correct oral rest posture, tongue up, lips closed, teeth apart, breathe through your nose. Let's get started. Hey friends. Hallie and Mia. Mia here and Mia was giving you a nice lingual pallo suction demonstration. If you're watching this on YouTube, you'd see that. Nice job, Mia. Welcome to episode 210 of the Untether podcast. Cannot believe it's been 210 episodes. Is that crazy? Mia? 210. We've been doing this since July 2019 and it's just incredible to see how much this has grown. And it's really. I love doing this. I love speaking to you guys. And the thing that I want to focus on today is screening our pediatric patients. Right? Screen the peds. Why? Because children are born with orofacial myofunction disorders. They are born with pediatric feeding issues and so I want to dive into that briefly and quickly today. This is not going to be a super long episode, but you know, I do have to give a little shameless plug for the free five hour training that's coming up on how to screen your first pediatric feeding patient. You'll get a certificate of completion. If you end up joining feed the PEDs afterwards, SLPs and OTS, you can get a bonus five hours of additional continuing education credits. That's five hours of ASHA and AOTA CEUs formally submitted, added to your registry for you, or accounted for you. But basically what I want to talk about is the need to screen and why it is such a need. Right? We have children who are born, right? They come out of the womb and guess what happens, Mia? They have an open mouth posture. Can you tell everybody what is our mouth supposed to do is supposed to be open or closed when you're breathing. She's showing everybody. So she's not telling us. She's showing us. If you're watching on YouTube. And where do we breathe from? Mia, can you tell us with your words, where do we breathe from our mouth or our nose? Oh, we're not talking. Okay. We're going to be shy today. That's okay. My little helper here. So we want to be breathing through our nose. And that's true even at birth. Yes. Maybe a baby needs to clear their. Their nasal airway, you know, after being born. And. And we might assist them with that. It may also take a week or two for some secretions to clear. Truly. But babies should not have these wide open mouths following birth. It's extremely important that our tongue rest up on the palate even at birth. Yes. And that that tongue one is there for several reasons. One of the reasons is to guide the shape of the palate and to support. Support the roof of the mouth, the shape of the palate. Right. Which also happens to coincide with the floor of our nose. And so if we do not have a tongue that is nicely resting up in the top of the mouth, shaping that palate, then we're also going to have nasal collapse. Right. We're going to see that the nasal cavity is going to start to struggle a bit. That's going to lead to mouth breathing. And then we're going to see a whole host of other issues and symptoms that follow, whether that be, you know, enlarged adenoids and tonsils, lots of congestion that could involve struggles with feeding. We may have a infant who is not able to use their tongue in the way that it's designed. Right. They may not be able to draw milk from a breast or a bottle nipple. They may not be able to support their nasal breathing. Right. There's a whole host of things, like I said, that can happen. And so. And the other issue, honestly, which tends to be a bigger issue, and I think the thing that gets a lot of our attention is that these children, when their mouth breathing and their tongue is resting low and forward in their mouth, they will also tend to get sick more frequently. Things are not draining the way they're supposed to be. Their immune system will be lower when they're exposed to germs. They just. They have a harder time either overcoming those pathogens and. Or they just get stuck in this cycle of always. Sorry. Of always, you know, getting sick and then finally getting better and then getting sick again. And it's Just like this, this circle of illness that they can't seem to kick, right. You know, and then enter in daycare and other children and adults in their environment, and it's just this constant cycle of illness. And I noticed this when I was working with preschoolers very early on. You know, I figured, oh, it's preschool. Everybody gets sick. That's. That's what they tell you, right? Well, why are there some children who never seem to get sick? Or why are there children if they're exposed to something, they don't, they don't get it, or maybe they get it, but they're better within like 24, 48 hours max, right. They don't go through this cycle of illness always, constantly needing antibiotics and, and other medications, steroids and things to keep them healthy or get them back to health. Why is that? Right. Well, when I started to look at these children, I realized me is making funny faces. I realized that these kids are mouth breathing and they're intaking all of these germs into their mouth, right, Instead of through their nose. Right? And our nose is set up to filter, to soften, to warm, right? To bring in smooth air into our body, into our lungs. Our mouth doesn't do that. Our mouth is not going to stop those pathogens. It's not going to stop. Smooth, warm, filter the air. And so now we're just inviting all of these. They won't be able to hear mama if you do that. We're inviting all of these germs, you know, into our body when we mouth breathe. And we're really not giving our immune system the support that it needs to try and fight off whatever we introduce. So obviously, this is not my area of expertise. I am not an immunologist, I am not a pediatrician. I am not a general practitioner. I am a speech language pathologist. I'm a certified myofunctional therapist. I'm just reporting on what I've seen with my own family, my own children and my patients. The other thing I will tell you is that I was always wondering early on why the children that were on my caseload, right, the children that I was seeing for pediatric feeding disorders and severe speech sound disorders, why are like, why were those kids always sick? Why were they always draining? Why was there always constant, you know, nasal drainage, snot, if you want to call it that, coming out of their nose and they're coughing and sneezing on me, right? And we work as pediatric feeding therapists. We work close to a child's face. Why is it that those kiddos tend to be the ones who are always sick. Could it be related? And you know, in short, my theory, absolutely, yes. And again, this goes back to the way that we're intaking air and germs, right? Are we processing it through our nose? Are we processing it through our mouth? So we need to be looking at every single child on our caseload. Because if you go back and listen to past episodes, you will hear me talk about the various different symptoms of orofacial myofunctional disorders, pediatric feeding disorders, the connection between, you know, tongue ties and, and chewing and swallowing and, and speech and, you know, and sleep and then attention and behavior during the school day. There's. I've had cases of 3 year olds with obstructive sleep apnea who were sitting backwards at circle time. They did not respond to their name. Some people thought that they were on the spectrum or that they had a processing disorder. And when the child was treated, guess what happened? I mean, within weeks this child was sitting at circle attending to their name. They no longer seem to kind of be like a space cadet, like staring off into space, because now they were able to get sleep, they were able to repair their brain and their body while sleeping, and they were able to then function during the day. And so we really again need to be screening the peds, the pediatric cases from birth, but especially during the toddler and preschool and early elementary years. I think we should be doing these screenings always. However, it's vitally important that we be doing this at birth and as I said, in the daycares, preschools, like those infant toddler years, because if we can catch these things early, we can intervene early. When we can intervene early and get them back on track, it just makes for a much healthier child. And you're going to have just heard an episode with Dr. Felix Liao, who is actually local to my practice. He's in Virginia and he has a book called, he just released recently called your child's best Face. And I actually read it before it went out and I'm quoted in the book as well and gave him a review on the back, back of the book. But I share this because it's a really great resource for parents and for providers who may be new to this space. And I get. There's absolutely nothing that I get for sharing this with you all. I just think it's a fabulous, easy read with lots of examples and pictures, cases discussed that talks about the impact of everything that we're referring to as far as what happens when we don't intervene. Right. And what we can do to intervene earlier. And so I'm not going to go over all of those tips because you can go back and listen to Dr. Felix's episode that recently aired, but I think that was like two episodes ago. But I'm sharing this because like I said, we want. It's not just about your child having their quote, unquote, best face. What does that mean? A best face equals best health. We want to go for optimal health and optimal, you know, attention to school, you know, behavior, feeding skills. And when I say behavior, I don't mean compliance. I mean giving the child the opportunity to be rested, to feel good, to be able to sit in school and pay attention and learn and to be able to interact with their peers and not be impulsive and not, you know, struggle to make friends or interact with friends because of making funny faces again because of their sleep disordered breathing. So it's. This is very, very far reaching. And I invite you to downlo my free pediatric feeding screening packet. I have that. I also have a myo one, but the pediatric feeding screening packet, which we will link in the show notes, that is, like I said, it's free. It gives you a checklist and a pediatric, a pediatric development chart. And it's really focused on birth to 36 months of age because that is when we develop most of our oral, our sensory, oral motor skills for feeding. So it has like 50 of the most like, you know, common concerns or symptoms that we need to screen for. And you can do this screener in a matter of five minutes. Right. Like when we do speech, language and occupational therapy screens in preschools that my team goes into and we have let's say a 15 minute window to do us to a speech screening or an OT screening. We will actually do this in the last like three minutes of this, the screening period. We will do our normal like OT or SLP screen and then we'll give the child a snack. And usually that's like maybe a Dixie cup with some water and a graham cracker or whatever they've provided that we've kind of given guidance on. And yeah, it's a very quick insight into what they're doing. Are they chewing with their mouth open? Is the food falling out of their mouth? Are they struggling to chew it? Do they still have food all over their tongue after they swallow? Are they gulping and swallowing air when they drink from the cup? Can they drink from an open cup? Does the tongue come forward to take a bite of the Food. Where do they place the food when they take a bite? There's so much that can be gleaned just from observing a very quick snack. And this is something that thousands and thousands of SLPs and OTS have now actually gone through. This free training. This will be the 11th time that I'm doing it. It'll take place, let's see, May 1st through 5th. So if you go to feedthepedes.com backslash training, you'll be able to, you'll be able to access the information in joy be between maybe first through fifth. And like I said at the very beginning, you can get five free hours on a certificate of completion. If you end up joining the C. The Pete's course when doors open May 8, you can also get a bonus of five additional CEUs or those five hours will be submitted and count as official Asha and AOTA ceus. All right, so here's what I want you guys to do. Clearly you have to watch the YouTube episode because Mia has been making some funny faces and everybody needs to see them, number one. Number two, go download the pediatric feeding screener so that you can use this chart with your families and then join me because what we're going to do May 1st through 5th is we're going to use Mia when she was two. I have a video of you in year two as one of our screening cases. And then I have a video of my other daughter when she was 4. And she's going to be the case that we use together over the course of the week to fill out the screener and learn about all the signs and symptoms, how you can use the development, the pediatric development feeding chart as a tool to educate families and other providers. And just as a, it's very cool visual. And then we're going to go over the symptoms, make sure you understand them. But again, even bliss you, Mia, even though we're going to spend five days together on this and it's going to be like an hour a day, it will be recorded for anybody who can't make it live. And like I said, five hour training that you can, you'll be able to do this in five minutes. After you're trained, we will make sense of all the findings together. We're going to focus on like the jaw, the lips, the tongue, the cheeks. We'll know if further assessment is needed, we'll know if other referrals are needed. And it's a free tool and a free training. So join me. I hope this has opened up your eyes just a little bit to what could be going on and a bit of the need to be getting in there early so that we can intervene early and get these children on the right trajectory to optimal health and optimal function. So this is Hallie and this is Mia. We are signing off. Mia, can you say bye everybody? Bye Bye. Oh, one more thing I almost forgot. We do give out scholarships to Feed the Peds the week of the free training. So definitely want to join. If you want to have opportunity to enter into a full scholarship to the Feed the Peds course at feed the peeds.com and students and CFs. By the way, you get a 50% automatic scholarship. Military gets an automatic 10% discount if you are active duty military or a spouse of active duty military. Email support@feedthepedes.com and send proof whether you're a student f or military and we will definitely be able to help you and assist you with getting those automatic scholarships applied. All right guys, like I said, free training is the week of May 1 through 5 and you can go to feedthepedes.com backslash training. Sign up for that so you get all the reminders and then doors to the next Feed the Peds course will open on May 8th. See you guys there. Bye Bye. Thanks for listening to this podcast. If you found value in this episode and want to hear more of these Myotots, Airway and Feeding related episodes, be sure to leave a review on Apple Podcasts and share this episode on your social media platforms. You can access free resources and all I offer@halliebulcan.com or pop over to Hollybulcan on Instagram to get all the latest updates.