As therapists, it is easy to fall into the trap of protocol-based treatment—treating a clinical diagnosis like a strict recipe book. But true, transformative patient care requires us to step back from the "cookbook" approach and lean heavily into intentional clinical reasoning and pattern recognition.

In this episode, Hallie Bulkin takes the mic for an essential masterclass on the critical distinctions between screening, assessment, and treatment in clinical practice. She unpacks how blurring these clinical boundaries leads to stalled progress and directly impacts overall patient safety.

Hallie explores the delicate balance between structural anatomy and true muscle function, provides practical strategies for sustainable habit formation, and highlights why patient-centered decision-making is the key to successful therapy. If you are ready to confidently look at the whole patient, break out of professional silos, and elevate your interdisciplinary collaboration, this episode will completely reframe your daily practice.

Key Topics & Takeaways

• Unblurring the Boundaries: Clear, non-negotiable definitions separating screening, comprehensive assessment, and actual functional treatment.
• The Clinical Reasoning Shift: Why relying strictly on protocol-based "cookbook" therapy limits your growth as a clinician and slows down patient outcomes.
• Anatomy vs. Function: Understanding that structural differences (like a tongue-tie) are only half the battle—how the muscles actually move and compensate dictates the treatment plan.
• The Referral Strength: Normalizing interdisciplinary care and seeing specialized cross-referrals as a position of clinical strength rather than a limitation.
• Integrated Care Systems: A high-level look at breaking down professional silos to build a truly holistic, collaborative network for your patients.

Soundbites

"Screening is simply deciding if more evaluation is needed. It’s a decision point, not a roadmap for immediate therapy."

"Assessment is about understanding exactly why the dysfunction exists, looking at the entire system from the bottom up."

"Treatment is about fundamentally changing muscle function and building sustainable new habits, not just checking exercises off a list."

• 00:00:36 – Welcome to the Untethered Podcast
• 00:01:12 – Defining the distinction between screening, assessment, and treatment
• 00:02:43 – The primary purpose of a screening
• 00:06:23 – Why assessment requires clinical detective work
• 00:11:02 – Treatment: Changing function rather than just exercises
• 00:15:25 – Normalizing the non-linear path of progress
• 00:21:49 – The problem with collecting interventions without clinical reasoning
• 00:25:01 – Anatomy versus function: Why function must drive clinical decisions
• 00:30:13 – Shifting from rigid silos to integrated care
• 00:39:07 – Conclusion and final thoughts on serving patients

Links & Resources

• Fast Myo Screening Tool: Stop guessing during your intakes and download the checklist at FastMyoScreening.com.
• FREE TRAINING: Ready to bridge the gap between screening and assessment? Join the free Screen The Peds to Feed The Peds Training.

RELATED EPISODES YOU MIGHT LOVE

• Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
• Episode 145: The Missing Link In Your SLP & OT Screenings with Hallie Bulkin, MA, CCC-SLP, COM

STAY CONNECTED

💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on

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⭐ Love the show? Leave a quick review — it means the world to me!

If this episode inspired you to take a closer look at the functional clinical reasoning behind your treatment plans, please take a quick moment to leave a review! Your support keeps us climbing the charts to reach the providers who need these exact answers. 

Hosted on Acast. See acast.com/privacy for more information.

When a child presents with complex speech or feeding challenges, it’s easy to focus solely on the surface-level behaviors. But true, long-lasting transformation happens when we dig deeper to look inside the mouth and assess the underlying muscle function.

In this episode, Hallie sits down with Galina Kislin, a pediatric speech-language pathologist and myofunctional therapist, to discuss her clinical journey and the shift that led her to prioritize root-cause assessments. Galina shares her experiences transitioning from Early Intervention into private practice, highlighting how a myofunctional approach became the "missing piece" for her stalled feeding and speech cases.

Together, Hallie and Galina dive into the critical importance of looking at a child from the bottom up, executing thorough oral-motor exams, and building local interdisciplinary care teams. Galina also shares actionable, naturalistic strategies to help families integrate therapy seamlessly into their daily routines without feeling overwhelmed.

About the Guest: Galina Kislin, M.A., CCC-SLP, CMT®

Galina Kislin is a bilingual (Russian/English) speech-language pathologist and Certified Orofacial Myologist (CMT®) with 28 years of rich clinical experience. Her journey began in Early Intervention, where an early exposure to oral-motor therapy ignited her lifelong passion for pediatric feeding. Over nearly three decades, Galina has served children across preschools, elementary schools, and multidisciplinary outpatient clinics.

Key Topics & Takeaways

The Missing Piece:

The Root Cause Approach:

Interdisciplinary Collaboration:

Soundbites

"Why has nobody else looked in the mouth? We cannot treat what we don't thoroughly assess."

"We need to look at everything from the bottom up. Understanding the underlying root causes completely changes your clinical outcomes."

"Therapy shouldn't feel like an extra burden for parents. When we integrate functional, naturalistic strategies into daily life, families feel truly empowered."

Timestamps

01:01 – Galina's Journey: From Early Intervention into Myofunctional Therapy

03:10 – Facing Structural Hurdles and Stalled Feeding Challenges in EI

04:46 – The Missing Piece: Embracing a Myofunctional Lens & Finding the Root Cause

09:40 – Intentional Parent Education and Functional, Hour-Long Sessions

10:58 – Crafting Naturalistic Home Strategies That Blend Into Daily Routines

14:03 – Navigating the Real-World Limitations and Rules of Early Intervention

16:33 – The Vital Importance of Thorough Oral Motor Exams Over Assumptions

24:22 – Boutique Service: Guiding Families Through the Treatment Process with Empathy

27:42 – The Clinical Value of True Root Cause Tracking (The Middle School "R" Case)

30:11 – Unpacking a Case: Speech, Feeding, and Myo Evaluation Integration

33:22 – Unlocking Speech Clarity and Intelligibility Without Traditional Targeting

37:58 – Private Practice Growth Mindset, Autonomy, and Overcoming Limitations

40:37 – Final Thoughts, Where to Connect with Galina, and Closing Resource

Links & Resources

Connect with Galina: Explore her courses and resources at www.Love2communicate.com and follow her updates on Instagram.

Clinical Assessment Tool: Easily screen for muscle patterns and oral dysfunction at FastMyoScreening.com.

RELATED EPISODES YOU MIGHT LOVE

• EP 343: Inside a Mission-Driven Pediatric Feeding Practice
• Episode 145: The Missing Link In Your SLP & OT Screenings with Hallie Bulkin, MA, CCC-SLP, COM

STAY CONNECTED

💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on

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⭐ Love the show? Leave a quick review — it means the world to me!

If Galina's root-cause approach inspired you to collaborate with new providers in your area, please take a second to leave a review! Your support helps us reach the pediatric professionals and families searching for these exact answers. 

Hosted on Acast. See acast.com/privacy for more information.

When a child struggles with swallowing, chewing, or food transitions, our first instinct is often to look directly at traditional feeding strategies. But what if the missing piece of the puzzle isn't the food itself, but the foundational resting posture and function of the orofacial muscles?

In this solo episode, Hallie Bulkin demystifies myofunctional therapy (Myo) and explores its critical, undeniable overlap with pediatric feeding therapy. She breaks down how addressing underlying myofunctional dysfunction can drastically accelerate your clinical progress, protect airway safety, and create long-term, sustainable outcomes for the children on your caseload.

Hallie addresses common misconceptions surrounding Myo, discusses structural considerations like tongue-ties, and explains why a whole-system approach—looking at tongue posture, breathing, and body alignment—is non-negotiable. If you're ready to stop looking at oral motor function in a vacuum and want practical steps to seamlessly weave myofunctional thinking into your next feeding evaluation, this episode is exactly what you need.

• Defining the Scope of Myo: Understanding what myofunctional therapy actually is and how it targets the resting postures and functions of the oral and facial muscles.
• The Perfect Partners: Why feeding therapy and Myo should never be treated as entirely separate disciplines, but rather as deeply interconnected systems that support one another.
• The Trifecta of Function: Exploring how tongue resting posture, nasal breathing, and physical body posture directly dictate a child's success with chewing and safe swallowing mechanics.
• Debunking Common Misconceptions: Shedding light on the myths surrounding myofunctional therapy and highlighting the evidence-based research that supports its clinical efficacy.
• Integrating the Assessment: Practical, realistic steps to incorporate orofacial muscle function and structural considerations (like tongue-ties) into your standard feeding evaluations without blowing your timeline.

"Feeding and Myo are partners, not separate disciplines. When you treat them as a connected system, your outcomes transform."

"Addressing myofunctional dysfunction speeds up feeding progress. We cannot build functional feeding skills on top of poor oral resting postures."

"Myo literacy makes you a better clinician in any specialty. It completely shifts the lens through which you analyze a child's struggles."

• 00:02:29 | Defining Myofunctional Therapy
• 00:03:32 | The Root Cause vs. Symptom Lens
• 00:07:09 | Breaking Through Feeding Plateaus
• 00:11:56 | Where Feeding and Myo Overlap
• 00:14:41 | Airway Management & Nasal Breathing
• 00:18:12 | Debunking the "Just Exercises" Myth
• 00:23:54 | How to Run a Myo Assessment
• 00:30:12 | The 5-Step Integration Framework
• 00:33:33 | The Connected Child System

• Clinical Tool: Streamline your assessments and screen for muscle dysfunction 

F.A.S.T. MYO SCREENING PACKET: Need a simple & science-backed way to screen your patients for potential orofacial myofunctional disorders?

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• The 4 Layers of Feeding: How to Finally Know Where to Start
• When You Screen a Child and Think 'Now What?

💬 Join the Conversation: Connect with our community, catch weekly clinical breakdowns, and get daily practice tips on Instagram | Facebook | LinkedIn.

If this episode helped you see the connection between muscle posture and feeding progress, please leave a quick review! Your support helps us reach the pediatric professionals and families looking for these vital puzzle pieces.

Hosted on Acast. See acast.com/privacy for more information.

As pediatric therapists, we know that our time with a child is only one small piece of the puzzle. Real, lasting progress happens when parents and caregivers feel confident carrying strategies into everyday family life. Yet, navigating parent communication can sometimes feel like its own clinical challenge.

In this episode, Hallie sits down with Johanna Stadtmauer, MS, CCC-SLP, a pediatric speech-language pathologist, feeding therapist, and owner of Ready Stadt Speech. Johanna shares her passion for family-centered care, breaking down how clinicians can intentionally weave counseling skills and active listening into their daily practice to meet parents exactly where they are.

They explore how Johanna uses innovative practice models like caregiver classes to build a supportive local community, and dive into how private practice owners can leverage social media and AI tools responsibly without losing the human connection that defines excellent therapy. Whether you’re looking to deepen your rapport with families or want actionable insights on clinical entrepreneurship, this interview offers a refreshing, holistic roadmap.

Johanna Stadtmauer is a pediatric speech-language pathologist, feeding therapist, and the owner of Ready Stadt Speech, serving families in Northern Bergen County, New Jersey. Specializing in the early stages of speech, language, feeding, and literacy development, Johanna is also an SLP consultant and advisor. 

As both a clinician and a mother to three young children, she brings a uniquely relatable perspective to child development, helping parents feel genuinely empowered rather than overwhelmed.

• Counseling Skills in Action: Moving past rigid clinical updates and incorporating active listening to facilitate goal-focused, empathetic conversations with caregivers.
• Building Community Beyond the Table: How designing and promoting local caregiver classes transforms isolated parenting struggles into shared community experiences.
• Responsible Tech Integration: Navigating the role of AI in modern practice—using tools like Glint to support administrative tasks or visual creation while fully preserving human judgment and clinical intuition.
• Grounding in Your "Why": Why keeping your core mission at the forefront is the ultimate guide for sustainable private practice growth and marketing alignment.
• The Multidisciplinary Approach: Empowering families by fostering a holistic care team that treats the whole child.

"Be transparent with families about what to expect. True collaboration starts with setting clear, honest expectations."

"AI can support but it can never replace human connection. Our empathy and clinical intuition are irreplaceable."

"Know your 'why' to guide your practice and growth. When things get complex, your core mission is your compass."

• 02:18 The Importance of Communication in Therapy 
• 05:25 Navigating Challenges in Therapy 
• 11:11 Building Community Through Caregiver Classes 
• 14:38 Marketing and Positioning in Private Practice 
• 19:09 The Absolute Importance of Human Connection 
• 22:42 Navigating AI in Therapy Responsibly 
• 27:44 Understanding Your Why 
• 31:32 Building a Holistic Care Team 
• 33:58 Empowering Families in Therapy 
• 37:48 The Journey of an SLP Entrepreneur

• Visit Johanna’s Website: readystatsspeech.com
• Follow Johanna on Instagram: @ReadyStadtSpeech

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 371: When You Screen a Child and Think 'Now What?'
• Episode 372: From Guessing to Growth: How a Clear Framework Transformed My Practice

STAY CONNECTED & GROW YOUR PRACTICE

Join the conversation: Get behind-the-scenes insights, clinical pearls, and real conversations over on Substack.

Hosted on Acast. See acast.com/privacy for more information.

When a child struggles with feeding, it’s easy to get laser-focused on oral-motor exercises or sensory strategies. But what if the root cause isn't a lack of coordination, but a struggle to breathe?

In this solo episode, Hallie Bulkin dives deep into a critical, yet frequently missed, component of pediatric feeding therapy: airway screening. Airway issues often hide in plain sight, quietly undermining feeding progress and leaving clinicians wondering why their traditional treatment plans have stalled.

Hallie breaks down the undeniable connection between airway health, posture, and feeding mechanics. She highlights the specific signs of airway obstruction every therapist should look out for, outlines clear referral pathways, and explains why screening the airway is fully within your scope of practice. If you want to elevate your clinical outcomes and treat the whole child with true clarity and intention, this episode is a must-listen.

• Airway in Scope: Why airway screening is not a luxury or a sub-specialty—it is a foundational part of your clinical scope as a feeding therapist.
• Signs of Airway Obstruction: Recognizing the red flags of compromised breathing, from subtle mouth breathing and poor daytime posture to severe nighttime sleep disturbances.
• Feeding Mechanics & Tongue Position: How an unsupported airway forces compensatory tongue resting positions, instantly disrupting the mechanics required for safe and efficient chewing and swallowing.
• The Posture Connection: Why children with airway issues alter their head and neck alignment just to breathe, and how this compromised posture stalls feeding progress.
• Navigating the Referral Pathway: Knowing exactly when to step back and coordinate care with an ENT or airway-focused specialist before proceeding with direct feeding intervention.

"Airway screening is not outside your lane - it is a vital part of your scope as a feeding therapist."

"If a child is struggling to breathe, their nervous system will always prioritize oxygen over eating. Tongue position impacts feeding mechanics, but airway dictates tongue position."

"We cannot out-therapy an airway obstruction. Sleep disturbances and daytime breathing struggles will always affect feeding outcomes."

• 01:15 Why Airway Screening Matters
• 03:00 The Biggest Mistake Feeding Therapists Make
• 06:01 Why Airway Is Often Missed in Training
• 09:00 What Airway Dysfunction Looks Like
• 12:00 The Medical System's Blind Spot
• 15:02 Airway Screening: What to Look For
• 18:00 Real-World Case Results & Outcomes
• 21:00 How to Start Screening for Airway Issues
• 24:00 Final Thoughts & Resources 

Download the Packet here: https://www.feedthepeds.com/f-a-s-t-myo-screening-packet-3

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 371: When You Screen a Child and Think 'Now What?'
• Episode 369: The 4 Layers of Feeding: How to Finally Know Where to Start

STAY CONNECTED & GROW YOUR PRACTICE

Join the conversation: Get behind-the-scenes insights, clinical pearls, and real conversations over on Substack.

Hosted on Acast. See acast.com/privacy for more information.

When looking into tethered oral tissues, it is easy to focus entirely on visual structural appearance. However, judging a restriction by looks alone frequently misses the true clinical picture. Real progress happens when healthcare providers shift the diagnostic paradigm away from what a tie looks like and focus entirely on how it affects dynamic function over a patient's lifespan.

In this episode, Hallie sits down with Dr. Richard Baxter, DMD, MS, FAAPD, a board-certified pediatric dentist, founder of the Alabama Tongue-Tie Center, and lead author of the bestselling book Tongue-Tied. Dr. Baxter shares his personal and professional insights into the complexities of identifying oral restrictions, moving past basic anatomical definitions to explore how a tiny string under the tongue can alter systemic, long-term health.

Dr. Richard Baxter is a board-certified pediatric dentist, a Fellow of the American Academy of Pediatric Dentistry (AAPD), a Diplomate of the American Board of Laser Surgery, and the founder of the Alabama Tongue-Tie Center. As an internationally recognized speaker and creator of the Tongue-Tied Academy, he has dedicated his career to educating healthcare providers and parents on the structural and functional impacts of oral restrictions. Having experienced a tongue-tie himself and treated his three daughters as infants, his dedication to the field is deeply personal. He resides in Birmingham, Alabama, with his family.

• Symptoms Over Appearance: Why a visual exam never tells the full story and why diagnostic protocols must prioritize symptom functional profiles over pure aesthetics.
• Groundbreaking Research in Complex Profiles: Dr. Baxter shares fascinating insights from recent research surrounding oral restrictions and their structural correlations to cerebral palsy.
• Buccal and Lip Ties Exploded: Clarifying the distinct functional impacts of cheek and lip restrictions, and how they play a role in infant feeding dynamics.
• The Interdisciplinary Standard: Best practices for post-operative care, follow-up timelines, and maintaining clear, collaborative communication lines across the therapy team.

"Common does not mean normal.

" "Digestion starts in the mouth."

"Untie the shoelaces for proper function."

• 00:00:00 – Intro Hook: The Shoelace Analogy breakdown.
• 00:01:03 – Guest Welcome: Dr. Richard Baxter joins the show.
• 00:02:43 – Clinical Debate: Treating oral restrictions based on symptoms vs. appearance.
• 00:06:51 – Collaborative Care: How a therapist should present a concise, one-page case review to a doctor.
• 00:09:13 – The Post-Op Rule: Why myofunctional therapy is essential (The knee surgery comparison).
• 00:11:51 – Clinical Truths: Why "common" does not mean "normal" when tracking snoring or mouth-breathing.
• 00:13:08 – Complex Case Study: Dr. Baxter's landmark research on tongue-tie releases in children with Cerebral Palsy.
• 00:20:27 – Digestion & The Nervous System: How poor swallowing mechanics trigger chronic fight-or-flight states.
• 00:26:49 – Emerging Research: Survey insights on identifying and treating Buccal (cheek) ties globally.
• 00:32:24 – The Bed-Wetting Link: The surprising connection between airway stress, heart peptides, and nocturnal polyuria.
• 00:48:28 – Reclaiming "No-Man's Land": Why releasing ties between 6 months and 4 years old is critical for core brain development.

• Read the Best Selling Book: Tongue-Tied by Dr. Richard Baxter
• Explore Clinical Resources: Visit TongueTie.com
• Watch and Learn: Tune into Dr. Baxter's YouTube Channel

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 200: Functional Impact: When A Tongue Tie Is ACTUALLY A Tongue Tie
• EP 348: Tongue Ties, Sleep Apnea & More: The Patient-Centered Approach to Airway Dentistry

STAY CONNECTED & GROW YOUR PRACTICE

Join the conversation: Get behind-the-scenes insights, clinical pearls, and real conversations over on Substack.

Hosted on Acast. See acast.com/privacy for more information.

Making the leap from a school-based setting into a specialized pediatric feeding niche is an incredible professional transformation. But what happens when that career pivot collides with your own deeply personal parenting journey?

In this episode, Hallie sits down with Aerica Walsh, M.S., CCC-SLP, CPFT™, an ASHA-certified speech-language pathologist, pediatric feeding therapist, and the founder of Thrive Therapy Solutions. Aerica opens up about her unique path into the world of pediatric feeding—a journey that took a profoundly meaningful turn when her daughter was born with tongue and lip ties that impacted their early breastfeeding dynamic, followed by her son being born with Down syndrome and diagnostic feeding challenges.

They dive into the common medical misconceptions surrounding low tone and special needs, the reality of balancing deep grief with profound gratitude as a parent, and the heavy advocacy needed in hospital and NICU settings. This conversation is an invaluable mix of raw personal storytelling, actionable clinical advice, and a beautiful reminder of why compassionate, holistic, family-centered care always trumps generic medical protocols.

Key Topics & Takeaways

• The Leap From Schools to Feeding: How Aerica navigated the transition from a traditional school-based SLP caseload into the highly specialized world of feeding therapy.
• A Diagnosis in the Middle of Training: Aerica shares the emotional and clinical impact of receiving her child's Down syndrome diagnosis while completing her specialized CPFT™ program.
• The "Low Tone" Misconception: A close look at why low muscle tone is so frequently misunderstood in children with Down syndrome, and how to look past a label to find functional solutions.
• The Power of Pre-Feeding Skills: Practical strategies for supporting vital pre-feeding motor skills long before a child with special needs ever takes their first bite of solids.
• Advocacy & "The Mama Gut": Why clinical reasoning and motherly intuition should always come before generic medical timelines in hospital and NICU environments.
• Building Thrive Therapy Solutions: The challenges, rewards, and exact mindset shifts required to successfully launch your own specialized private practice while parenting children with additional needs.

Soundbites

"Low tone is often misunderstood in Down syndrome" 

"Trust your mama gut over medical protocols" 

"Find your niche and dive deep into it"

Timestamps

00:00 – Intro Clip

00:20 – Welcome to the Untethered Podcast

00:57 – Meet Aerica Walsh, M.S., CCC-SLP, CPFT™

02:10 – How Motherhood Led Aerica Into Feeding Therapy

04:35 – Pregnancy Expectations vs Reality

07:15 – Parenting a Child With Additional Needs

10:25 – NICU Experience & Early Feeding Challenges

13:40 – The Overwhelming Amount of Parenting Advice

15:00 – Identifying Feeding & Development Concerns

18:20 – Tongue Ties, Breastfeeding & Early Intervention

21:45 – Navigating Medical Professionals & Parent Advocacy

25:00 – Hospital Experiences & Emotional Impact

28:15 – Why Standardized Feeding Support Matters

30:00 – Gaps in Pediatric & Feeding Education

34:10 – Supporting Families Beyond Clinical Care

37:50 – The Emotional Side of Motherhood & Therapy

40:00 – Learning to Trust Your Parent Instincts

43:25 – Helping Parents Feel Seen & Supported

46:40 – Balancing Family Life & Professional Growth

50:00 – Building a Career in Feeding Therapy

52:30 – Advice for Clinicians Entering Feeding Therapy

55:00 – Investing in Education & Mentorship

57:00 – Final Thoughts & Outro

Links & Resources

• Connect with Aerica: Follow her on Instagram https://www.instagram.com/thrivewithaerica/

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• EP 343: Inside a Mission-Driven Pediatric Feeding Practice
• Episode 361: Why Two Therapists Get Different Feeding Outcomes (And How to Fix It

STAY CONNECTED & GROW YOUR PRACTICE

Hosted on Acast. See acast.com/privacy for more information.

Navigating the world of tethered oral tissues (TOTs) can often feel like wading through murky waters. With so much conflicting information out there, it’s incredibly easy for clinicians to fall into the trap of letting a visual anatomical structure dictate their entire treatment plan. But looking at a tongue or lip tie doesn’t tell you the whole story.

In this solo episode, Hallie Bulkin dives deep into the complexities of diagnosing and treating tethered oral tissues during feeding evaluations. She pulls back the curtain on why presence does not automatically equal cause, and why a systematic, function-first approach is the only way to truly help your pediatric patients.

Whether you are feeling the pressure from families to provide quick answers or trying to differentiate between a primary and secondary driver of a feeding challenge, this episode is a crucial masterclass in clinical decision-making. Tune in to learn how to move past the anatomy trap and build ultimate confidence in your functional assessments.

• The Murky Waters of TOTs: Why diagnosing and treating tethered oral tissues has become a clinical minefield, and how to navigate it safely.
• Presence vs. Cause: A critical reminder that just because an anatomical tie exists does not mean it is the primary driver of the family's feeding struggles.
• Common Clinical Traps: How relying solely on visual anatomy can lead to incomplete treatment plans and poor patient outcomes.
• The Function-First Framework: Why evaluating dynamic feeding function is the only way to give structural anatomy its true meaning.
• Primary vs. Secondary Drivers: Learn how to decipher when a tie is the root cause of a feeding issue versus when it is simply an incidental finding.

"Don't let anatomy lead your feeding plan."

"Presence does not equal cause."

"Feeding function gives anatomy its true meaning."

• 00:00 – Introduction to Tethered Oral Tissues and clinical challenges.
• 01:24 – The murky waters of diagnosis and the role of anatomy.
• 02:32 – Understanding feeding challenges as multifactorial.
• 03:02 – Limitations of relying solely on anatomy.
• 04:22 – Common clinical traps in tethered oral tissue cases (Traps 1 & 2).
• 05:11 – Trap No. 3: Treating the restriction instead of the feeding pattern.
• 07:13 – Trap No. 4: Skipping a full feeding assessment because the tie feels explanatory.
• 07:50 – Pressure to provide quick answers and the importance of function.
• 08:15 – Shifting focus to feeding function over anatomy.
• 09:21 – Feeding function as the key to meaningful anatomy interpretation.
• 10:00 – Primary vs. secondary drivers of feeding difficulties.
• 11:50 – When ties are incidental and not the main issue.
• 12:10 – Assessing functional impact and developing confidence.
• 13:30 – The value of structured feeding assessment training.
• 14:37 – Empowering clinicians with feeding function knowledge & final wrap-up.

Links & Resources

Dive deeper with Tongue Tie Bootcamp

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 348: Tongue Ties, Sleep Apnea & More: The Patient-Centered Approach to Airway Dentistry
• Episode 363: Tongue Ties, Oral Habits & the Future of Airway Health

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

If you’ve ever felt like you were "guessing" your way through a feeding session, you aren’t alone. In fact, many clinicians enter the field with a passion for OT or SLP, only to realize their foundational schooling barely scratched the surface of pediatric feeding.

In this episode, Hallie is joined by Courtney Lewis, MOT, OTR/L, CPST, a pediatric feeding specialist and owner of NOSH Pediatric Feeding Therapy. Courtney opens up about her "long and winding road" to feeding—a journey that began with an 8th-grade project and evolved through home health, clinics, and hospitals.

They discuss the pivotal moment when Courtney realized she needed more than just general experience to truly help her families. From the "regulation lightbulb" moment that changed how she views patient behavior to the deep empathy she brings as a former "picky eater" herself, this conversation is a masterclass in why specialized training and clinical reasoning are the keys to professional confidence.

About the Guest: Courtney Lewis, MOT, OTR/L, CPST

Courtney Lewis is a pediatric occupational therapist, feeding specialist, and the founder of NOSH Pediatric Feeding Therapy. With over a decade of experience across various settings, she specializes in transforming mealtime struggles into joyful family experiences using a holistic, play-based approach. Courtney is a Feed The Peds® graduate and a dedicated mentor within The Pediatric Feeding Hub™.

Key Topics & Takeaways

• The Accidental Specialist: How pediatric feeding "found" Courtney and why every previous setting—from home health to hospitals—was a necessary stepping stone.
• The Missing Link in Education: A candid look at why most therapists feel underprepared and how to fill the gaps that grad school leaves behind.
• The Sensory Lived Experience: Courtney shares how her own history as a picky eater allows her to advocate for her patients with a unique, firsthand perspective.
• 44,000 CFA Points: The story behind Courtney's "Regulation Lightbulb" and how understanding the nervous system changes everything in the clinic.
• The Power of "The Hub": Why having a community of mentors and peers is essential for preventing burnout and ensuring clinical excellence.

Soundbites

• "I didn't choose feeding therapy; it chose me. Every setting I worked in was leading me here."
• "You go from feeling like you're guessing to actually having a clinical 'why' behind what you're doing."
• "When you understand the nervous system, you stop looking at the behavior and start looking at the child."

Timestamps

• 000:00 – Overcoming imposter syndrome and the "stuck" feeling in feeding therapy.
• 02:22 – Courtney’s Journey: How pediatric occupational therapy "found" her.
• 05:47 – The Confidence Catalyst: Helping a breastfeeding infant transition to solids in 10 weeks.
• 06:34 – The Foundational Gap: Why standard courses like SOS and Beckman sometimes leave therapists wanting more.
• 23:40 – How Feed The Peds® provided the framework to finally "connect the dots."
• 29:10 – Lived Experience: How being a former "picky eater" shapes Courtney’s empathy as a therapist.
• 38:20 – Mentorship: Transitioning from student to leader within The Pediatric Feeding Hub™.
• 42:15 – Closing thoughts and where to find NOSH Pediatric Feeding Therapy.

Links & Resources

• Visit Courtney’s Website: noshfeeding.com
• Follow Courtney on Instagram: @NoshFeeding
• Feed The Peds®: Join the 3-Day Screen The Peds to Feed The Peds Challenge
• THE HUB: Become a part of The Pediatric Feeding Hub™

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Episode 369: The 4 Layers of Feeding: How to Finally Know Where to Start
• Episode 361: Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)

STAY CONNECTED & GROW YOUR PRACTICE

💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on

Instagram | Facebook | LinkedIn

If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Hosted on Acast. See acast.com/privacy for more information.

In this solo episode, Hallie Bulkin dives deep into a common pitfall in pediatric feeding therapy: treating red flags as a diagnosis rather than a starting point. Many clinicians feel the pressure to jump straight into treatment the moment a concern is raised, but skipping the foundational steps often leads to stalled progress and clinical uncertainty.

Hallie clarifies the critical distinction between screening, assessment, and treatment. She explains why red flags should be viewed as "decision points" and how a structured screening process can transform your clinical decision-making. Whether you are navigating complex sensory issues or safety concerns, this episode provides a systematic framework to help you move forward with clarity and intention.

Hallie Bulkin, MA, CCC-SLP, CMT®, CPFT™, is a pediatric feeding and orofacial myofunctional therapist and the founder of Elevation Movement. With years of experience in pediatric feeding, myo, airway, and tethered oral tissues, Hallie is dedicated to empowering clinicians with the tools they need to provide life-changing therapy for children and their families. 

• Red Flags as Decision Points: Understanding why a red flag is a signal for more data, not a roadmap for immediate therapy.
• The Power of Structured Screening: How a checklist removes the guesswork and identifies specific risks.
• The Clinical Sequence: Why the order of Screening → Assessment → Treatment is non-negotiable for successful outcomes.
• Avoiding Common Pitfalls: Why relying solely on parent reports or mislabeling limited variety as "just sensory" can hinder progress.
• Building Confidence: How a systematic approach reduces "imposter syndrome" and helps you know exactly what to do next.

• "Red flags are decision points, not treatment plans."
• "Screening answers the vital question: Is further assessment even needed?"
• "Jumping straight to treatment skips the assessment phase entirely."

00:00 – Red Flags: The Doorway to the Next Step

00:36 – Introduction: Meet Your Host, Hallie Bulkin

01:52 – The "Now What?" Moment in Feeding Therapy

02:54 – Why Structured Screening is Not Optional

03:48 – Screening vs. Assessment: Solving the Sequencing Issue

04:22 – Mistake #1: Treating Parent Concern as the Only Data Point

05:27 – Mistake #2: Equating Limited Variety with Sensory Issues

06:17 – Mistake #3: Skipping the Safety & Airway Layer

07:22 – What a Strong Feeding Screening Checklist Actually Does

08:24 – The 3-Step Sequence: Screening, Assessment, and Treatment

09:34 – Case Example: Moving from Red Flags to Clarity

10:30 – Building Confidence & The "Screen The Peds" Free Training

👉 Join the free 3-day Screen The Peds to Feed The Peds training

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
• The 4 Layers of Feeding: How to Finally Know Where to Start
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