Episode 287: CDC Masking Milestones with Hallie Bulkin, MA CCC-SLP, CMT®, CPFT™

Hi and welcome to episode 287 of the Untethered Podcast. This is your host, Hallie Balkan, and we're going to talk about something that we talked about on the podcast a couple years ago, like back in 2022, and that is the topic of the CDC changing developmental milestones. Because I really feel like we are continuing to see the harm that has come from that. So bear with me. We're going to dive into that. Let's get started. 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.

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Tongue up, lips closed, teeth apart, breathe through your nose. Let's get started. Foreign. As a reminder, if you're on our email list, you've known about this, we've sent you emails, but I haven't talked about this. I don't think on the podcast tomorrow because this is launching September 30th this episode tomorrow. The Price of the CMT Certification Remember, you can only get the Certified Myofunctional Therapist CMT certification through me, through the myomethod.com or hallie balkin.com which will lead you there the price of the certification is going up. Why? Because the cost of everything is going up and it really is to cover our team's expenses. Because we do have when you get certified, we do have. The cost of the course is staying the same, but the cost of certification is going up. We have individuals who are blindly reviewing your submissions and then we have a third team member who then puts everything together and makes sense of it and make sure all the grading practices remain fair before sending it back to you. And sometimes we have several rounds of that for cases that are submitted. And those are cases actually that we give to you so we're very familiar with the cases. It really helps us with a lot of the mentorship on the. That that particular level of the certification. So basically, to cover own expenses, this is a necessary jump up in certification pricing. But wanted to let you know, if you want to lock in the current pricing, you're going to want to go do the myo membership, sorry, the myomethod.com and lock it in there. You'll also get free access to the BIO membership for three months if you buy the course. If you buy the certification, you get the three months. When you go through the course, you get ongoing access to the MYO membership as well when you are going through certification. Okay. That's part of what we give you when you're going through certification for mentorship and all that fun stuff. All right, so let's jump in. So what is this podcast episode being triggered by? Lately I feel like I've just been. I've been recording episodes, soul episodes, instead of having guests on. In some of our most recent episodes. Because I've wanted to talk about certain topics. And one of those topics that we're circling back on, like I said, is a topic from a couple of years ago, back in 2022, where we realized that instead of changing, like developmental milestones to actually match what is happening and the needs of our smallest, you know, our littlest clients, our patients, you know, our pediatrics, our children, they actually made it that the CDC basically is not acknowledge. They're not acknowledging. Listen, I'm making up acknowledging. And recognizing is now acknowledging. I made a new word. They're. They're not acknowledging the need. Why does that word sound so weird to me right now? They're not acknowledging the need, the true need. And in fact, they're actually creating larger gaps, in my opinion. And I want to share what was shared by the holistic ot. So I'm giving her a shout out. I love her account. If you don't follow her. The holistic. And it's the whole like H O L. I wrote it down. W, sorry, the T H E W H O L I S T I C O T. Right. The holistic ot. Follow her. She's incredible. She gives a great product recommendations. Very, you know, so if you're someone who is holistic or you're just a parent wanting to learn more and understand, like more about what I'm talking about. She's got some posts that she has created on this topic. But, you know, she said. Okay, I'm quoting her. Instead of changing the developmental Milestones checklist to mask the fact that 1 in 6 kids in the US have a developmental disability. Maybe the CDC should start acknowledging and spreading awareness of how toxins in our environment impact brain development in young children. And I thought, this is such an interesting but needed take on what's going on. And so she goes on to talk about, like, the different CDC milestone changes. And we had done that back on the podcast. I would have to, like, actually Google and I can do this, like, while I'm recording, but I'd have to look up and see what episode that was where I had a conversation and maybe a couple different conversations around some of these specific milestones that they just changed. And I want to highlight some of them. And again, she's got this on her account. I've talked about this in the past, but it was worth re highlighting because it hasn't gone away, it hasn't changed. And I think that as medical providers, you know, SLPs, OTS, PTS, you know, whoever is here that works with pediatric patients, we need to be aware of the old milestones, not the new ones. We need to be working from the old ones still. And that is my plea to you, because these new milestones are. Are not helping children, if anything. Okay, Like I said before, they're making the gap larger, which makes therapy interventions take longer. They're more expensive if we get started later because we're now pushing these milestones back. So just something, you know, a little. A little food for thought. But episode 151 of the Untethered podcast, if you wanted to go back, I. It's titled CDC Milestone Updates Beneficial or Bogus. And that was an episode that I. I think I focused more mostly on, like, speech and language feeding related types of milestones. I think I might have mentioned crawling as well. That's a big one we'll talk about shortly. I did have a really great episode, episode 204, progressing through play with tethered oral tissues with Dr. Britta Distefano. That's another good one. But then one of the other milestone conversations was episode 156 with Dr. Mitchell, and we talked about crawling and other milestones from, like, an OT perspective because she's an ot, so definitely episodes you want to go back and listen to. So again, that was episode 151 and 156 are, like the top two you'd want to listen to on prior conversations surrounding, like, milestones and all that fun stuff, but just to highlight some. And this is more from the OT standpoint, right? The motor Motor skills, all skills were basically pushed back three months or more. And crawling was completely removed from the developmental milestone checklist, which is mind blowing to me. And that's why you're going to want to go back and listen to episode 1:56, because Mary Ellie Mitchell talks about like specifically about why crawling is so important and why we need it. Right. There's a lot of integration that happens. And I'll tell you a story, you've probably heard me say it here before if you've listened to my episodes. But I'll tell you a story about my own child really quick so you can understand like how important crawling is, right. So my second born was both my kids had tethered oral tissues. But she was released at five days old. She fed really well after release, did not feed well before breastfeeding in particular. We weren't bottle feeding yet at that point, so I don't really have that comparison. But she then went on when, when she was very tight. And so we did start physical therapy. When she got to the point of crawling, she would crawl and drag one her. And so she was doing more of a scoot than a crawl. She hated like certain weight bearing exercises that we would, we would do at physical therapy. We took her to a pediatric physical therapist and I later took her to craniosacral therapy and osteopathy within like a week and a half of each other. And that was after her first birthday, I think closer to maybe 13 months or so. I'd have to go back and let the look at the exact dates, but just to kind of give you perspective because she wasn't walking yet, she wasn't crawling yet. And, and I know, I know walking, you know, now they say 18 months, right? But even back then, cause she was born in 2018, so this was like 2019. It was still 12 to 15 months. And I'm like, we're not crawling. Which used to be an 8 to 10 month old milestone, which is no longer listed. And she's not walking yet. And she's like, you know, 12 to 13 months. Like we were in that range. And I was like, I don't want to wait till she's 15 months and not walking. Like let's go see what's going on because she's not crawling. She did roll from her stomach to her back. And that I feel like both my kids did really early because they were so tense. So they were maybe doing that by like a couple months of age, if not earlier, which is a little scary because they don't know how to go back to their back and don't want them to get stuck on their face. But both my kids also really seem to really like, laying on their bellies to sleep. And so, like, with rolling from tummy to back, that used to be between three to five months of age, and they moved that to six months months sitting without support. We used to say six months. And that's really key for feeding, right? Because at six months, we'd say we want you sitting independently so that you have the proper core support. If we have the proper core support, we know we can support digestion. But that got pushed to nine months sitting without support. Okay, so are we supposed to delay introducing solids to nine months to, like, make this make sense? None of this makes sense. No, it should be six months. This. That's what we still. That's what I still teach. That's where we should be working from. Just FYI, like I said, crawling was totally removed. That's supposed to happen next with between 8 to 10 months, with pulling to stand around 9 months and walking between 12 to 15 months. Right. That was the previous, like, previous milestones. They changed it so that crawling is no longer there. Pulling the stand is supposed to happen around 12 months, which MIA was pulling to stand. My youngest one was pulling to stand maybe around 12 months of age. So she was falling in the new updates, but she was delayed. That's not typical. Right. And she wasn't walking out, which is, you know, used to be 12 to 15 months. Now they're saying 18 months. So this is problematic. This is problematic. And the thing that, you know, we talked about with Dr. Marieli Mitchell, and the thing that, you know, on the holistic OTS page that she talks about as well, is that crawling has an impact on brain development. It's one of the most critical brain milestones from a developmental perspective. Okay. It impacts our whole body. And I can tell you that from seeing, excuse me, seeing my own child not crawl and not yet, you know, around close to 13 months, not walking, I was like, huh? These things are all interconnected, aren't they? Yes. Yes, they are. Like, I kind of knew that, but I'm seeing it firsthand in my own child. So. So. And we had gone to physical therapy, like, we were trying. It was sort of like we were pushing her to do something her body and her brain just weren't ready for. And really fascinating. I. I myself was going to a provider, Manny Kim, who's a physical therapist who does what he calls modern counter strain technique, and Other amazing interventions. And so, you know, he has this. This business, this company, unlocking your body. And I just learned so much from him about, like, the brain, you know, body, nervous system, all the systems interconnected. Like, it's just how everything is so connected, fascia and everything. Right. But what was fascinating that, you know, I noticed too, was that if he didn't work, like, on my head first, like, things weren't changing in the body, and sometimes he would actually go to my head and kind of read what was going on with my. Within my body and go straight to a point, like on my leg, and he would, like, touch that area and he'd be like, how does that feel? I'm like, that hurts. And he would kind of like, unlock it, right? Very gentle, like intervention, but totally went, like, through brain mapping, like, through, like, reading what was happening on the top of my head. He knew exactly where to go in my body. And I think that this really speaks to the brain and full body, like, whole body connection. That is not talked about enough. Because as I mentioned at the beginning of this episode, the thing that I learned was the integration that happens between our brain hemispheres, the left brain and the right brain, when crawling happens. Right? And so basically this teaches the body to, like, both sides of the body to work together, you know, holistic ot. On her website or on her Instagram post, she talks about how basically it helps everything work together in a smooth and coordinated way. And, you know, yeah, here I have this child who was dragging one leg behind her. She wasn't crawling yet. Things were not integrating. She was not integrating across hemisphere is like, from one side to the other. She was, like, pretty on par with her speech and language milestones, her feeding milestones, you know, but her gross motor and her fine motor was actually doing okay as well. She wasn't. I don't. I'd have to go back and watch videos to see if she was crossing midline during meals or anything or, like, when she was, like, doing art. Because my kids have always loved to, like, color, even at a. You know, an infant. You know, an infant, young infant age or, like, not young infant, but, like, you know, as soon as we could sit at the table, we give her things to play with and she would color with those big egg crayons, you know. But I have to go back. I'm so curious to see if I have any videos that demonstrate her crossing midline even. And so basically, it also impacts, like, how they process visual information, right? It impacts how they interact with their environment. I mentioned like crossing midline. I want to see what else holistic OT mentioned, because I'm totally. She's the OT here, not me. But developmentally, you know, development, developing central core control. We talked about that. We talked. You know, motor plans. Motor plans are a big thing. So motor planning impacts everything we do, whether it's speech or feeding or writing or running or like, literally, there are motor plans involved in all of these things. And our brain and our muscles need to talk with each other. They need to speak together in order to carry out a task. And so, you know, like, I can talk about another example. We just had a case come through my private practice where the parent called for mayo and the therapist basically had to have a conversation with the parent, say, hey, you know, the child may not be ready for MYO yet because they are not necessarily able to control their muscles. Like, we're thinking there may be some apraxia at play. And so can we do MYO at some point? Can we modify and integrate my goals? Absolutely. Like, we will work towards that or on that. But at the same time, taking a traditional MYO approach is not what's going to be best for that child. Because the muscles in the. The muscles in the mouth, the muscles on the face, like, this child doesn't just necessarily appear to have, like, speech apraxia, like, oral apraxia. It actually appears that it might be global. Like, it might be hands, arms, feet, like, moving the body. Like, if the brain wants to do something, it's kind of firing off a signal, but the signal is not reaching that muscle and telling it to go and do what it needs to do. So, you know, we're saying, can you move the tongue left and right? We're showing them, and they can't do it. Well, this is a motor planning challenge. Right. And so not the whole point of this episode today, but being able to effectively do that is super, super critical. There's other things she talks about, too, that I'm not going to dive into, but there's just. There's so much that integrates and so much that happens when we crawl. And so to remove crawling from the milestone chart is actually a huge issue, which is, again, why I talked about it a couple years ago when it happened and why I'm talking about it now. But the other thing that she talks about, and maybe I'll have her come on here and do a whole episode on this, because I think this is definitely her expertise and not mine, is she talks about, like, the metals out there in our environment and neurodevelopment and she like screenshots some different studies with like talking about aluminum and brain tissue and autism and, you know, just aluminum and brain development in general. I'm seeing a lot of that here. She's got different things that are screenshotted. And I think that we need to look at what's happening in our environment. Right. It's a combination of nature and nurture. Like we've got things going on in our bodies. She talks about endocrine disruptors like glyphosate. Glyphosate. Mike, why can't I say words today? And its impact on neurodevelopment. Right. She's again, she's got articles. Another one that came up this week that I've actually received a, an email about based on some research that was done. Not in the US I'd have to go find it. But fluoride. We know fluoride exposure and neural development are a big topic. There's different toothpaste companies that are, that have come out with alternatives that are fluoride free. My kids do not get fluoride applied to their teeth when they go to the dentist. It is toxic. It is toxic. And we're actually seeing. She has something screenshotted that she shares. So you can, you can see those articles. But the one that I just received this week, I want to see if I can pull it up quickly. It was just kind of fascinating because it's not coming up like I know I sent it to the team. I think it's fascinating because it's been so heavily debated. Right. But again, it's another one of these topics that I think we need to be discussing. It's super important because it definitely has an impact on neurodevelopment. And guess what? That impacts all of these milestones. Right? Because we just talked about her, how our brain is connected to the rest the of of our body. So, you know, she's got this whole list of things that I often preach. I also live my life accordingly. We are very holistic in my family. But some of the reasons that children in the US are developmentally delayed, like why. Why are they struggling with certain developmental milestones? Why are we having to push back these milestones? Cdc, could it be the, the ultra processed foods and maybe the, the standard American diet, which when we look at sad, sad. It is sad. It is really sad. What has been taught is healthy in the United States of America because it's very different than the rest of the world. We have kids with nutritional deficiencies, mineral imbalances we know that there's a lot of issues, as she points out, with like breastfeeding disruptions and GI issues. You know, my child that I was just talking about is working with functional medicine. She is 6, and she is working with functional medicine because nobody else could. You know, I didn't trust anybody else to help her, so I went straight to functional medicine. And she has a very unhealthy gut that we've been working to heal. And she's kind of like, following in my footsteps, like. And I was like, I don't want her to deal with the gut stuff that I'm dealing with, you know, that I've. I've dealt with, I feel like my whole life, but has progressively gotten worse over time because there was no traditional doctor who said, hey, let's address that stuff. No, they just want to put me on meds. And guess what? That just ruins the linings of your digestive system further anyways. But, you know, looking at, like, overgrowth of organisms in the gut, like toxic, you know, or as she calls them, pathogenic bacteria, yeast organisms, you know, these things that are overgrowing, that are unhealthy and that cause all kinds of symptoms. Exposure to medications that overstimulate the immune system. Right. She's a kiddo who had croup nine times in one year. And a lot of times leading up to that. And that was in her. She was three when that happens many times leading up to that. She also has had it since. It's decreased a lot since expanding her. Normally. If she gets sick, it doesn't turn into croup. I think we've had croup a couple of times now since she was expanded. And she's been out of her expander since she turned five or maybe five and a half or it's been over. It's been over a year for sure, I believe, at this point. So, you know, for her to only have had croup a couple times, when she had it nine times in one. One year. And they constantly were putting her on steroids and, you know, antibiotics and things that are disrupting her gut lining and her digestion. And just her. Her immune system was kind of like, in not a healthy state for a very long time. And we've worked really hard to get her back there. I do everything in my power to, like, minimize exposure to heavy, you know, toxic metal, endocrine disruptors, you know, things in our food and our environment. But we, you know, we have to live. We can only do so much so you know, I call myself Scrunchy, semi crunchy, where I will do what I can do at home. But we also go out into the world and we enjoy it. And if they go to friends houses, they can eat what they want. Because it's my belief that if we have a healthy digestive system, if we have a healthy immune system, if we have a healthy nervous system, if all of our systems are basically healthy and working, we can handle a certain level of the. Of exposure to these things. Things. It's when we're not healthy that we go out and then enjoy those or try to enjoy those things that it comes back to really bite us in the butt. But you know, there's exposures to other things as well that are not healthy, that are considered toxic. And she's got a whole list. I'm not going to go through all of those things. But you know, I do think one thing that she points out that I love seeing on her list is facial tension and restricted airway. Because high. That's what we talk about normally on the, on these podcast episodes. So definitely worth taking a list. A list. A look at her list at her post she posted a couple days ago now. So maybe that was like September 18th. If you're going back and looking for it again, major shout out to the Holistic ot. Love her account. I think she's phenomenal. Her name is Ashley, but you'll find her under the Holistic ot, which is why I keep referring back to like her Instagram account name. So it's easy for you to find her and you can go under her. She's got a milestone tab. So go check out her milestone tab because there's a lot of great information there. But this really the whole point of this again is to encourage you to follow the old milestones. Like do you have an old milestone chart to follow? Because I really do think that what the CDC did was, was criminal. And just from a perspective, just to review, let's just review like these OT based milestones. Again, I'm an slp. I'm sharing what she shared. Um, but again we've got this in those past episodes, episode 156 and episode 157 or 151 here on the podcast. We should be rolling from our tummy to our back between three to five months. If you have a child who is roll who's holding their neck up at birth. If you have a child who is rolling over before then and maybe they're tight, maybe they arch their back when they eat or you just. They feel very tense, they squeeze their fists a lot. This is tension. Right. And so my recommendation is if there's any feeding issues, you're going to want to link up with an SLP or an OT to help with. Um, but you're also most likely going to want to find some type of a body worker in your area that works with infants with maybe tethered oral tissues, because they're going to know how to address these tension patterns, whether tethered oral tissues are present or not. Um, they're going to be working with a lot of babies who have tension, so they'll have the experience whether your child has those ties or they don't. And that's why I recommend, you know, to look for someone with those, with those skills. Um, but that might be a craniosacral therapist, an osteopath, a craniofascial therapists. You know, there's cst, cft, csft, cf, yeah, csf, cfs. There you can go to, like the Upledger Institute and look for people who are trained. You can also like the osteopathic doctors, as I mentioned, if you want to go the doctor route. There's also chiropractors, some physical therapists. So it's really whoever is in your area that is working with these patients, you can usually figure that out through like a Facebook mom group to help address tension patterns. Really, really, really important. We also kind of preach that. Not kind of preach. We do preach that it's really helpful to see somebody following birth anyways because that's a traumatic event for mom and baby. And mom and baby should really be treated to address any tension patterns, maybe from when baby was in the womb or from, you know, leaving the birth canal. There's a lot of goodness that can happen if you adjust the body and get the body into like a level of homeostasis where the body is able to function as it's supp. As early as possible. If, you know, you're listening to this later and you're like, I didn't do that. You can do it at any age. Like, I am going to be taking one of my older, one of my older kids. I have two kids, my older child, you know, for some body work soon. So it, you know, I've gone forward as an adult. There is no, like, wrong age to do it. It can be really super, super beneficial. But again, sitting without support 6 months of age, crawling between 8 to 10 months of age. It should not be missing from that chart, pulling to stand around nine months and walking 12 to 15 months. So let's go back to using those milestones, especially if you are a SLP or OT or BT who might be working with Pediatrics. Please, please go back to the pre2022 milestone charts. Let's use those and not rely on the 2022 version that the CDC came out with because it, in my opinion, is criminal. So there we have it. That is your episode for today. This is Hallie signing off. I'll talk with you guys next week. Thanks for listening to this podcast.

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