Episode 96: Free Pediatric Feeding Screening Packet and Training

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, Hallie Balkan. I'm a certified orofacial myologist, feeding specialist 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, tethered oral tissue and airway space. I challenge you to keep an open mind and join my mission to get this information out to the masses. Let's get started. Hi and welcome to episode 96 of the Untethered Podcast. Today it is me, your host Hallie Balkan, and we're going to chat about Pediatric feeding screenings. Because if you don't know already, I have a pediatric feeding screening packet that I created for you all. It's actually been available for download for free for goodness over a year now, which is really cool. And we have over 35,000 people on our email list who have downloaded this already. So holy cow. I mean I haven't even looked lately. That was the number the last time I checked. I know there's been more. So you're definitely going to want to jump on this if you haven't already. And we will put the link in the show notes for getting that pediatric feeding screening packet. We will also put it on theuntetheredpodcast.com or you can go to my Instagram and it's just Allie Balkan and you will see a link in my bio that will take you to the free screening packet as well. If you're listening today on Monday, February 1, then you also have the opportunity to join us for a free five hour training this week where I'm actually going to teach you all how to screen your first pediatric feeding patient. Or hey, if you're already a pediatric feeding therapist and you want to join us and hone in your skills, you're totally welcome to join us too. The more the merrier. It's free, so join us. It'll be right in our Facebook group on Facebook under Feed the peds. I want to be a Pediatric feeding therapist. Although we're also looking into how we can broadcast this live across Instagram. So again, if you're following me either on that Facebook page or Allie Balkan, you'll be able to view this training now. If you would like a certificate at the end, then you're definitely going to want to be on our email list so that you get the notification when it goes out at the end of the week that you can get your certificate that says you have free five free hours that you can count toward your educational hourly requirement for continuing ed. You know, for asha, these will be CMHS continuing maintenance hours. However, for our feed the peds course and everything else we do, we do give actual ASHA CEUs. But these are ASHA CMHS. So I just wanted to make that very clear for these five free hours. All right, so let's jump in and let's talk about what the heck the pediatric feeding screening packet even is. How do we use that? First and foremost, I'm going to go through this all with you next week. So we're not next week this week. So I'm not going to spend a ton of time, you know, explaining how do we even know who needs it. I will tell you that there is such a high prevalence and we're going to talk more about this in the free training of kids already on your caseload. So if you're not even seeing them for pediatric feeding concerns, you're seeing them for other issues that chances are they may have some oral motor deficits and or pediatric feeding challenges that the parent may not even realize is something you can treat as an SLP or an ot. And so that is something that one we really need to educate our parents better on, our caregivers better on because they don't even know what's in our scope of practice. A lot of SLPs and OTs are not trained in feeding. So if you are somebody who is and you're interested in that or you dabble in the tethered oral tissue space, right in the airway space, these are things that we should be looking at from birth. And we've talked about this on here. Babies are born with tethered oral tissues. Orofacial myofunctional disorders. Oh yes, those are present at birth pediatric feeding disorders. Right. And again, chances are if a child has a speech delay, there's something going on oral motor wise and we should definitely be looking at that because that can also point to maybe a dysfunctional swallow. So you know, these are things that we need to screen for and we need to make sure that we are helping our patients function optimally, not just get by every day because oh well, they eat foods, they're fine. Okay, that's good and great. But if they're in therapy, we need to be looking at them holistically. And this really includes taking a deep dive into asking about things like what do they eat? Okay, let me observe them have a snack and watch them eat a few different consistencies and let's watch them drink. What do they typically drink out of? You know, what kind of a cup are they using? Or bottle if they're still an infant? What are they, you know, do they have oral habits? Are they constantly putting things in their mouth? Are they sensory seeking? There's all, there's just all different kinds of things we need to be asking parents about. We should also be asking about these kids sleep, especially if they're kiddos who are running all over the office or the house. If you're treating, you know, wherever you're treating them, if they have a really hard time focusing their attention. Yes, sometimes that can be related to age. However, we as therapists tend to know that fine line of what may be related to age and what might be an actual concern. And so when something kind of tips you off and you start to go, I have a little bit of a concern about how much this child kind of bops around from one toy to the next. That's when we need to start asking about airway questions and we need to get in the mouth and we need to look in the mouth. And so I hope that this is at least opening your mind to the kinds of things we're going to talk about this week and why using such a simple pediatric feeding screening packet is the answer to screening these kiddos to figure out what are the next steps. Now look, if you don't want to be a pediatric feeding therapist, that's okay. This training is still very helpful to you because maybe you need to screen them and refer them to somebody else who is a feeding therapist. We should not just let these kids slip through the cracks because it actually ends up becoming much harder down the road for the families. It takes a much bigger toll on the family and the child. And I know that so many of us are heart centered practitioners who really want to do best buy our family. So I beg you, look at the child holistically, look at what's going on as you look at their behavior. Look at how they eat a snack, listen to how they're speaking, watch their tongue. What does it do? You know, these are just a couple ways that we can jump in and you're going to get a full on checklist of things when you download this free packet. But I just wanted to give you that little tidbit. Now I will say that we've had thousands of SLPs and OTs go through this training. When I say thousands, we had, like I mentioned, we have over 35,000 people and I could be even undershooting it. I'm going to look this up right now while I'm chatting with you guys. I'm actually really curious. I haven't checked as of late, but we have a lot of people that have gone through this and who have downloaded the feeding screener and given us a lot of really good feedback. Ooh, we actually have 38,000 people on our list. So there you go. It's increased. You know, Brenda told us that she learned a lot just from one screening. And Claire said, you know, oh, wow, this training is actually groundbreaking for me. I'm watching all the videos all over again now. I'm taking even more notes this time around. I love the way we can watch and rewatch the videos on our own time. And yes, this free training will be up until the 12th of February. And. And at that point it does come down. The reason it comes down then is because that is when we close the doors to our Feed the peds program and more information on that later. So don't worry so much about that right now. But we close it there and it gets moved in as a bonus for our members who join the next round of our Feed the Peeds feeding course. So let's jump back to talking about the free training this week. Julie says, the forms make it so easy. I want to get started with this asap. Margaret said, I'm so glad I found you and Feed the peds. I listened to your podc. I'm really enjoying this week's training. You know, Kaylee said, it was so helpful. Can't wait till tomorrow's training. And Katie said, thank you again for today's presentation. So informative and easy to assess with this reading tool. Love. She loved my decor behind me and my shirt, my little mouth pillow and my lip shirt. Anyways, you know, there's definitely more so you guys can go and look through what everybody has to say about it. But the bottom line is thousands of SLPs and OTs have gone through it. We've had amazing feedback and that's why we keep doing it, because you guys are asking for it. If you guys are in the Facebook group. You see, I asked if you guys want another one. Like, I think it was a week ago while we were deciding, hey, are we going to do this again? And you guys were like, yes, please, yes, please, yes, please. We're like, ok. All right, we got it. We'll do it. So if you want to join us, you're going to need to download that free pediatric feeding screening packet. And what you get in the packet is a checklist, first and foremost, and then you get a pediatric development chart. And so what's really cool about the pediatric development chart, and I will show you guys if you're watching on YouTube. And by the way, you can see these on YouTube as well. I know that you're most likely listening on the podcast. The feeding development chart is a beautifully organized chart that goes over basically all the skills you really need to know about between birth and 36 months of age as they relate to, you know, gross motor, sensory motor. Oh, no, there's not so much sensory motor on there. I take that back. It's more gross motor, oral motor. And then we have, you know, oral motor as it relates to feeding, all that fun stuff, right? Everything from pre crawling to crawling to ambulatory. And you can see how that, that overlaps with skills like flexion to rolling to sitting, all the way up to jumping, you know, and how that interacts with, you know, whether they're feeding on breast or bottle, when we introduce spoon and cup, when we introduce straws and forks into their, into their repertoire. And then how that all overlaps with the skills that are needed through use of the jaw, the lips, the tongue. Right, because, hello, jaw, lips and tongue. We need those babies functioning in order to feed properly. But we also need our gross motor skills and arguably fine motor skills, you know, and core skills we need. We need a lot of these things in place to be successful feeders. So this little chart, from what we've been told, has been a really beautiful tool that therapists like to share with families simply because it simplifies the conversation. And you can visually see, hey, at this age, my child should have these skills. And you can even draw a line across it and realize, oh, okay, well, the child is at this age. So they should have all these skills above this line and we only have about half of them. And so it just is a very beautiful representation to a family. As to why we might be recommending an evaluation to explore this further because, hey, we're not seeing these skills today. So let's explore this further and see, like, are they really not there? Let's do a feeding eval and see if we, if we do need to work on these things. So, really fabulous chart. The next thing I'm going to discuss is our feeding screening form. And so this actually has 50 of the most common concerns that or symptoms that may come up on a pediatric feeding screening for everything from behaviors to diet. Sensory. This is where the sensory component comes them jaw, palate, face, you know, tongue, cheeks, lips, tone utensils, support, posture, all these different things that we really need to be screening for. And yes, this is not an eval, this is just in a screening. However, you can do the screening in about five minutes. It is meant to be super quick, super easy. Watch a kiddo have a snack and or watch a baby feed if they're being seen in your clinic. Likely if you're seeing them in your clinic, they may already be coming to you for feeding if they're an infant, unless you are an OT who's treating them for, for Torticollis or something. But if you're treating a baby for Torticollis, chances are they actually have tethered oral tissues and tight muscles as a result of that because it's very holistic and we've talked about this plenty on the podcast, so we're not going to go too deep into that right now. But you need to be looking in their mouth if they're coming to you for a concern like Torticollis or their head is flattened on one side or they're not rolling over. Right. So all these gross motor type skills are heavily related and connected to tevidural tissues and pediatric feeding disorders. What do you know? You really can't separate that out. And you know, I know there's people out there who don't believe in tongue tie. I know, it's crazy, right? What's really crazy is how many babies I have seen end up on a feeding tube because somebody didn't believe in releasing a tongue tie as compared to how many babies we've been able to treat and prevent from getting a feeding tube placed. Because we advocated for that baby and we had that tongue tie, we prepped them for it, we made sure that it was an optimal time to release them like one of my colleagues, Michelle Emanuel talks about. And we really jumped into prepping that baby, getting that release done and supporting them in their pediatric feeding therapy following the Reese. Right. It wasn't just a one off procedure and that I always have to plug this and say this because so many people think that oh well, baby's a tongue tied, we're just going to go release it. If they're a newborn, that might work in the first couple weeks of life. Beyond that, it doesn't work like that anymore. We actually really need to prep the Baby. And that could just be a couple sessions. It's not necessarily an intensive long term period of prepping. In some cases it might be longer because it's really individualized based on how that child responds and what that child needs, not on some cookie cutter program. But this is why tongue ties get a bad rap. So if you're going to somebody who will just release a tongue because you're asking them to run far away, that's not what we want. We want somebody who understands that we need to support this child with preoperative and post operative pediatric feeding support to make sure they're ready for the release and to make sure that they are, you know, getting what they need afterwards. Now, along with that, these children often also need bodywork. And there's many, there's many types of body workers, if you will, anywhere from PTs to OTs to chiropractors to cranial sacral therapists or osteopaths. You know, the list goes on. There's different. But those are more traditionally who I'm talking to, talking about when I say bodyworker in this space who has studied and understands tongue ties, tether oral tissues, buccal ties, lip ties. You know, they really get this topic and they understand the full body connection. That's who you need to be seeing. And yes, babies do respond, and adults also do respond, and older children and younger children, everybody responds better when their body is prepared for a procedure like this. We should not just be going in blind and releasing it with hopes that everything's gonna magically get better. Because again, that is why it gets a bad rap out in certain communities. But it is an absolutely necessary procedure at times. And in the cases where the patient is prepped, the results are also beautiful. So, you know, that's where we really need to be having more of that conversation, which is, again, we've talked about it in the past, we can talk about it again in the future. Let me know what you guys want to hear more of. But let's jump back to this pediatric feeding screening, because I went off on my little tongue tied tangent there, which happens often because you know about my passion for tots. All right, so the screening results and referral form will be your next two pages in the packet. So we give you a page that says finding. There's three columns. One says findings. And you can put your findings in, separated out by the jaw, the lips, the tongue, the cheeks, and any sensory concerns. And then there's a box to check if you want further assessment. You can even Write what further assessment you want in there and then there's a referral box. So do we need to make referrals based on any of these areas? Do we have concerns? Right. And if you do want to make a referral, we even made it super easy for you and gave you a referral form that you can use or copy. Make it your own, do whatever you want with it. Bottom line is this is a tool that is free to you. And the reason why we've had over 38,000 people download it is because it's simple, it works. And as I mentioned before, people who have never done feeding a day in their life, we've trained them on it and they've been able to start helping families get the care they need for their child. So that their child who may have a pediatric feeding disorder or tethered oral tissues or orofacial myofunctional disorder even. Right, because that's going to show up in certain ways and most likely impact the swallow and definitely impacts where the tongue is resting in the mouth. So these are the things that we need to be looking for. These are the things that. This is why we've had such a good response. Because simple, it's straightforward, it's a great tool to use in explaining things to parents and it just makes that screening go so quickly. So what are we going to do this week? Real quick in a nutshell, we are going to use both of my kiddos, my little models. One of them was released at 24 months and she has a pediatric feeding disorder and you guys are going to use her as your main patient this week. So if you're thinking I don't have patience to use this on while I learned that this week, that's okay, that's not the goal this week. This week the goal is we are all going to be studying the same little patient, same four year old Lily. And on the flip side we also have my 2 year old. So I am actually going to do the screener with my 2 year old first, watching her feed. She has typical feeding skills but you can see how there is also a variation sometimes in what typical looks like. So I really want you to take a good look at her her and we're going to go through that first and I'm going to actually upload that because you know getting your children like a two year old and a four year old to do exactly what you need in a timely manner is like herding cats. So I pre recorded that for you guys just for time purposes that will be uploaded on Monday at 1pm and with that there the rest of the week, Tuesday through Friday, the trainings will all be live at 1pm EST. I am definitely broadcasting it in our pediatric feeding Facebook group. Feed the peas. I want to be a pediatric feeding therapist, so definitely request it. When you request, please answer the question gems. We are checking. You will not get in if you don't answer the questions. You will not get in if you don't give us, you know, a response to the questions. That basically shows that you should be in this group. This is not a free for all. This is really for SLPs and OTs. That said, you can also watch it here on Instagram. So for the first time we are going, we are working on, I'm telling you, get into the Facebook group if you're on Facebook in case there's a technical difficulty and it doesn't work. But we're working on trying to use a platform and if it doesn't work, I might just use my cell phone for Instagram and use my computer, my desktop for Facebook just to stay in integrity with what I'm promising you all. But we're trying to use a platform that might allow us it's supposed to allow us to broadc across both platforms, although apparently Instagram is a little bit tricky with that stuff. So if that doesn't work, we will be, we'll do our best to get it out on both platforms. The trainings will be left up so it'll be on IGTV and it'll be on the Facebook group again until February 12th. And they will come down promptly on February 12th at midnight because they are downloaded, they're deleted from the platforms and downloaded into the feed, the PEDS program. For those who joined, they can watch it over and over again. It's a bonus to them, as I mentioned before. So the other thing I should mention is there will be scholarships this week that will be given out and basically that means you should watch the training this week so you can learn how to earn one of three scholarships that we're giving away. And these are full scholarships to a 40.5 hour continuing ed course or 4.05 asha ceus. 4.05 iota ceus. So yes, we are an ASHA approved provider. We are also an AOTA approved provider. So the course itself is that. And we can talk more about this next week. Don't worry about it today. But I'll just leave you with this. It is a 12 week comprehensive course. There is absolutely nothing like it on the market. This is the grad school course that you did not get in grad school. This is the one I wish I had and that many of our participants, even people who have been in the field for 15 and 20 years have said to me, oh my gosh, I wish I had this in grad school. And like this just really pulls everything together. Everything I've spent trying to do my whole life and piecemeal together from this one course to the next and my experience and just thousands and thousands and thousands of dollars, you know, tens of thousands of dollars spent on courses and trying to just make sense of it all. And here you put it into one 12 week program and in 40.5 hours, like, holy cow, I wish I had this at the beginning of my career. So one thing I will add is we also do a partial scholarship for all students in cf. So more information coming on that as well. But join us for the free training this week. We will talk more about the details of the actual program towards the end of the week and the doors to Feed the Peds. The actual paid program will open on, oh, February 8th, Monday, February 8th. So exactly one week from today. So we'll talk more about Feed the Peds as I mentioned. But get into that free training. Go to feedthepedes.com training or just go straight to my Instagram at Hallie Balkan and go to the link in the bio and you will get access to that has the links to the free training, that has links to the Feed the Peds wait list that has the link to the pediatric feeding screening packet. All the things you need are right there. Makes it super, super simple. Can't wait to see you on the free training. Thank you guys so much for hanging with me today. And let's do this. Let's go screen some pediatric feeding patients. All right guys, we'll chat soon. Thanks for listening to this podcast. If you want to hear more of these Myo Tots, Airway and Feeding related episodes, be sure to leave us review on Apple Podcasts or pledge a small amount on patreon.com the Untethered podcast. If you found value, others you know in this space will too. So be sure to share this episode on your social media platforms and join us over on Facebook on my Facebook page @hallebulcan biz, on Instagram at Halibalkin and you can head over to theuntetheredpodcast.com to grab a copy of the Show Notes where you can also see subscribe to be kept up to date on the latest podcast episodes.