Episode 258: Myo is NOT The Wild Wild West! with Hallie Bulkin, MA CCC-SLP, CMT®, COM

Hello and welcome to episode 258 of the Other Untethered Podcast. It's your host, Hallie Balkan, and we're going to talk about another maybe unpopular opinion today. Mayo is not the Wild Wild West. Let's dive in. 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 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 bring you the most up to date information in the orofacial myofunctional therapy, airway.

Tethered oral 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 coral rest posture, tongue up, lips closed, teeth apart, breathe through your nose. Let's get started.

Okay, so I just dropped this whole, you know, topic, Anya, here. Mayo is not the wild Wild West. What do I mean by that? Well, when you go online, you will often see people make comments like, oh, you know, myofunctional therapy. Like, it's just the wild Wild West. Anything goes, anybody can treat it. It's. No, no, no. Like, how did we get here? I don't understand, like, who marketed this so incorrectly over time that it all of a sudden became even like, speech pathologists are saying it, but it became like, oh, well, Maya is the wild wild West. Everybody's doing it. And just because that's become the truth does not make it legal or, okay, okay, it's not ethical, it's not legal, and we need to have a discussion about this, so let's dive in. What I want to start with saying is, as I said already, it's not the wild Wild West. What do I mean by that when I say, like, MYO is regulated. Orofacial myofunctional therapy is. And we're going to talk about, like, the whole, like, term and also OMT and certifications and stuff briefly.

This is.

This shouldn't be too long, but MYO is a modality. It's an area that we assess and treat. For example, as a speech language pathologist, I Have a license that allows me to do myo. Okay? Mayo requires a license. Not anybody can do mayo. So there's organizations out there. I caution you all, because there's organizations who will teach anybody, like a music therapist or a massage therapist or, Or. Or. Or. Right. And look, I'm not. I'm not downplaying anybody's ability to do something. But just because you're able or because you've taken a course, it does not qualify you to assess entry without a license. Like, I can go take all the courses in the world. If I don't go to dental school, I can't do what dentists do with patients. Right. It's the same thing when it comes to mayo. But for some reason, in the online space, people have marketed hard enough that we seem to turn a blind eye to this. And at the end of the day, this is happening at the expense of patients. So my. My sole purpose here and goal in having this conversation, because I know a lot of patients listen to this, is. Is to educate patients in knowing who to seek out for the best medical care. Okay? My license as a speech language pathologist in the state of Maryland, in the state of Florida. I've given up the other states. I only am licensed in those two states right now. Those licenses, they basically. I'm licensed as a speech language pathologist. That allows me to assess, diagnose, treat. Right. Certain things that other people can't do without a license as a speech language pathologist. Like, are we letting this sink in? Let's let that sink in for a second. Okay, so now that we all understand that, who can do myotherapy? Well, currently, speech pathologists. Well, according to the. Let me back up. According to the International association of Orificial Myology, which I no longer belong to, they have always said that SLPs, registered dental hygienists and dentists can basically do mayo. They've allowed, I believe, one physical therapist in to do mayo who's, like, super highly specialized. And I kind of always looked at this and wondered, like, what am I. What am I missing here? Like, if somebody can do feeding therapy, why can't they do myo? There's such an overlap. Right? And technically, when you're working with kids who are under the age of four, cognitively, that's exactly what you're doing. You're doing feeding therapy. So only professionals who are licensed to do feeding therapy can work with a myo. Myo. Quote unquote, myo patient under the age of four, cognitive. Four. Okay. When I say Cognitive for those who may not be familiar. I mean, the way in which our brain is functioning. Right. So not chronological, not like, oh, I had my fourth birthday. That child that you may be working with, or an adult who may have, you know, delay disorder, disability, whatever may be going on, if they are not functioning at or above the level of a four year old cognitively, their ability to understand and then do. Right, to process, to take in information and volitionally perform whatever we're asking them to in the therapy. If they cannot do that. Right. If they're not functioning at least at the level of a four year old cognitively, they cannot appropriately engage in myofunctional therapy based on what a true MYO program looks like and what we're asking them to do. Okay, so there's that under the age of four, what we're asking them to do, since it's not really yet cognitively appropriate, we have to modify and those modifications actually make what we do in Mayo overlap greatly with pediatric feeding assessment and intervention. And that's actually what I teach in my Feed the peds course. So I'm not going to keep belaboring that. I know I've talked about that on the podcast in the past. The whole point of this was to talk about how MYO is regulated. It does require a license. Just because somebody's teaching other people who are not licensed to do it does not mean it's not regulated. And that. That's actually illegal. That's illegal. Point blank. We are people who are working out of scope and do it knowingly doing so. Open themselves up to losing a license that they have in another area opens them up to litigation. Opens themselves up to really like, all it takes is a patient. Like bringing a malpractice case against you as a, as a person, or basically suing you for, for not doing therapy correctly or whatever. Right? Because you are practicing without a license. That's the thing. Like, people should look into that. Again, I'm not a lawyer, but I just, I don't understand why. We've gotten to a point where, and this is not just in this field, but we've gotten to a point where people feel like, oh, I've did this training, I can go out and do this therapy now. No, no, I can't be a physical therapist. I can't be a registered dental hygienist. I may have an advanced degree, but it's not in dental hygiene. I would need to go back to school for that. Right? So if somebody wants to do Mayo and they Want to work with kids birth to four, you need to go back to school, and you need to become either an SLP or an OT or maybe even a pt, right? Or a dentist to technically do that work. I will argue dentists actually probably don't fall into that. So I, I'm going to retract that comment, really. Slp, OT and pt. Because for the under four group, right, we're talking pediatric feeding therapy. And then I always kind of scratched my head and wondered why, like, the IOM would not allow ots and pts to take courses and get the certification. Because, hi, again, if you can do pediatric feeding therapy, and arguably feeding is within your scope and working on the orofacial complexes within your scope, and you're doing those kinds of modalities, well, why, why, why can't you take a mile course? Like, why can't. So this whole exclusionary process of keeping certain professionals out who are licensed to do this work and then allowing others in who are, you know, not. That's. That's a, That's a problem. That's kind of scary, right? I don't want to go to a doctor who took a course and is now like, oh, yeah, I specialize in this. And then they're hanging their hat on the wall and basically saying, like, this is my specialty. I know we all got to start somewhere, but that's very different than actually having the license and working within scope while you hone a skill set, then basically jumping into something that you are technically not licensed to do. Like, we're talking about legalities here. I don't, I don't understand what's happening in the world. So for anybody who is super confused, and while our, our state license trumps Asha, you can go to asha.org and there is a practice portal and you can look up orofacial myofunctional disorders, and it has an overview. It talks about incidence and prevalence, signs and symptoms, causes, roles and responsibilities, assessment, treatment resources, references, et cetera, on the asha.org website, the American Speech Language Hearing Association's website. And it talks about, like, what SLPs, for example, can do. And there's even like an ORO patient myofunctional disorders evidence map or with summaries related to research and like, you know, all this fun stuff. Okay, but please know who you're working with. Please know mayo is regulated. Please know mayo is not its own profession. Now, as a business owner, putting my business hat on because of all the marketing and because of all the noise and because of a lot of people Working at a scope, we get a lot of phone calls in my private practice. I get a lot of DMS on social media that basically say, say we need mayo for my, my one month old. What? Your one month old needs mayo? What's going on? Right? It's not that they need mayo per se, it's that they need to work with somebody who is trained in pediatric feeding and my own airway, who maybe has also training in tethered oral tissues to do a comprehensive assessment and understand what's going on and how we get your child on track. Right? Because that's very different than a MYO assessment. And I'm not downplaying myo, but for a one month old, a three year old, a three and a half year old, and even arguably some four year olds, they are not going to receive what is traditionally taught in a MYO course, right? My assessment, MYO treatment, all the things very, very different. Very, very different. And after trying to educate and educate and educate and educate, I finally was like, you know what, it's now an accepted term, right? Myotherapist myotherapy. This is now an accepted term, a very widely used term. So instead of trying to change that, I'm just gonna join, I'm gonna join the conversation and I'm gonna change what it means. And so I know that there are some people who feel like a myofunctional therapist is not, it's not a standalone profession, it's not 100% agree with that. But we do have certifications, right? Like Certified orofacial Myologist, the calm. With the iom, I've created the Certified Myofunctional Therapist, the cmt. Through my business, I decided that if I can't beat them, let's join them and let's start to control the quality of the therapists and the scope of making sure people are doing what they're actually licensed to do. So I can do that through my own certification, right? In certifying people who can do mayo and not allowing those who can't do my own, like I don't allow them into my course, I don't allow them into my membership, I will not certify them. If you don't have the proper license, right? SLPs, OTs, PTs, RDHs and dentists can go through my, my course, my, my membership, my, my certification. When it comes to pediatric feeding, my pediatric feeding course, and our future certification, which does go through, like, how do you adapt, like these concepts of myo, like how does it fall into pediatric feeding and tethered oral tissues and all that fun stuff for that Birth of Four crowd. Right? It's currently a course for SLPs and OTs, and it's currently going to be a certification for SLPs and OTs as well. Okay. So we can start to control the narrative by only allowing what's right, what's licensed, what's, you know, legal through our own daily activities, our daily actions, and our daily education of for patients, ultimately, and even colleagues. So I'm going to wrap this up here, but I really wanted to kind of hone in on the fact that Mayo is not the wild wild West. It is regulated, it requires licensure. And just please know who you are working with. Okay. I do have two directories. One is pediatricfeedingtherapist.com for kids who may need help with this stuff under the age of four. And then we are working on the MYO Directory as well, which will be linked to the untethered podcast.com website. Soon we're just working through a few last kinks and then we will have individuals who've taken the course and those who are certified through my program, their names will be on that website as well. But for now, for now, let's just remember it is not the wild wild West. It is highly regulated. And that's that. Talk to you guys soon. 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 Apple and share this episode on.

Your social media platforms.

You can access free resources and all I offer@halliebalkin.com or pop over to alliebulcan on Instagram to get all the latest updates.