The Untethered Podcast™

When a baby suffers from persistent crying, gas, or feeding struggles, parents are routinely told that "colic" is just something infants outgrow. But true clinical care recognizes that colic is not a final diagnosis—it is a clear physiological cry for help pointing to underlying mechanical tension, airway compromise, or feeding dysfunction.

In this episode, Hallie Bulkin sits down with Kate Kurzhal, M.A., CCC-SLP, owner of Ripple Effect Pediatric Therapy and mom of four. Kate shares her personal journey through the emotional toll and exhaustion of early motherhood, which sparked her transition into specialized feeding, myofunctional therapy, and pediatric airway care.

Kate Kurzhal, M.A., CCC-SLP, is a speech-language pathologist with eight years of pediatric experience and the owner/operator of Ripple Effect Pediatric Therapy in South Bend, Indiana. A double graduate of Indiana University-Bloomington with proficiency in American Sign Language (ASL), Kate specializes in pediatric feeding therapy (supporting picky eaters and ARFID), myofunctional therapy, and airway-centric care.

• Deconstructing "Colic": Why framing colic as a symptom rather than a diagnosis unlocks true root-cause solutions for infant distress.
• The Impact of Micro-Detail Video Analysis: Using high-level feeding evaluations to spot subtle body tension, oral motor fatigue, and structural limits.
• The Value of Private Pay & Out-of-Network Care

"Colic is a symptom, not a diagnosis—it's a physiological sign that something in the child's system needs attention."

"Early physical and physiological intervention can completely change the developmental trajectory of a child."

• 02:21 — Kate’s story: colic, feeding struggles, and finding support
• 11:02 — From motherhood to myofunctional training and airway advocacy
• 21:57 — Oral releases, pre- and post-care, and body tension
• 32:51 — Why “wait and see” can delay access to care
• 55:24 — Where to connect with Kate and closing reflections
• 57:46 — Disclaimer and outro

• Connect with Kate Kurzhal: Learn more about her practice, services, and team at Ripple Effect Pediatric Therapy.
• Follow Kate on Social Media: Connect on Instagram @rippleeffectpediatrictherapy and Facebook.
• Fast Myo Screening Tool: Identify functional, structural, and airway red flags during intake at FastMyoScreening.com.
• FREE TRAINING: Learn how structural airway limits directly affect feeding in our free Screen The Peds to Feed The Peds Training.
• THE HUB: Connect with pediatric SLPs, OTs, ENTs, and airway specialists inside The Pediatric Feeding Hub™.
• Black Friday is coming! Starting November 9th, we’re dropping a new exclusive deal every day on Instagram! Follow @halliebulkin so you don’t miss your chance to save BIG on our feeding and myofunctional therapy courses and trainings!

Seeing It vs. Understanding It: The Gap in Myo Training

Mouth Breathing vs. Nasal Breathing: Changing Lives Through Early Airway Intervention

STAY CONNECTED

💬 Join the Conversation: Connect with Kate on Instagram @rippleeffectpediatrictherapy or visit Ripple Effect Pediatric Therapy, and follow Hallie for weekly clinical takeaways, case breakdowns, and mentorship updates on Instagram | Facebook | LinkedIn.

If Kate's journey with root-cause analysis, retiring "wait and see," and private pay advocacy resonated with you, please take a quick moment to leave a review! Your support helps us share these vital clinical conversations with parents and providers everywhere.

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

It’s easy to fall into the trap of collecting CEUs just to renew a license or chasing course discounts, but taking a class doesn't automatically equal gaining clinical competence. With countless courses available in pediatric feeding and myofunctional therapy, how do you ensure your investment in education translates directly into better patient outcomes?

In this solo masterclass, Hallie Bulkin shares a strategic 5-part framework for evaluating continuing education before spending your time and money. She breaks down the difference between accumulating introductory certificates and developing deep clinical reasoning, guiding clinicians away from courses that simply teach a "menu of exercises" without explaining the diagnostic "why."

• CEU Completion vs. Clinical Competence: Recognizing that collecting course credits is fundamentally different from building actionable clinical reasoning and diagnostic depth.
• Clinical Reasoning over Menus of Strategies: Choosing programs that teach thorough assessment, data interpretation, and treatment planning rather than isolated lists of exercises.
• Evaluating Case Studies & Instructor Thinking: Looking for instructors who demonstrate real-world clinical decision-making, including complex presentations, unexpected responses, and course corrections.
• Evaluating Fit & Value Over Price: Assessing education by its alignment with client needs rather than price tags or discounts, including strategies for securing employer funding.

"There is a massive difference between completing continuing education just to renew a certification and developing true clinical competence."

"If all you learned was a collection of activities, what happens when that strategy doesn't work? Understanding how an instructor thinks is where deeper learning happens."

"The cheapest course isn't automatically the best value, and the most expensive program isn't automatically the best education. The most valuable CEU is the one that addresses the child who has you stuck today."

• 00:00 – Introduction: Continuing Education & Black Friday Season
• 00:36 – Host Welcome & Oral Rest Posture Reminder
• 01:13 – CEUs vs. Clinical Competency
• 02:32 – Tip 1: Know What Type of Education You’re Purchasing
• 05:39 – Tip 2: Learning Strategies vs. Developing Critical Thinking & Root Cause Assessment
• 08:43 – Tip 3: High-Quality Case Studies & Real Clinical Application
• 11:46 – Tip 4: Access to True Mentorship and Feedback (The Elevation Movement Framework)
• 14:03 – Clinical Application & Episode 384 Reference
• 14:20 – Tip 5: Learning Contraindications & When Not to Use an Approach
• 17:59 – Evaluating the Educator: Research vs. Clinical Judgment & Collaboration
• 21:16 – Case Example: Toddler Transitioning Beyond Purees & Postural Support
• 22:54 – Is the Course Worth the Investment? Employer Funding & CEU Budgets
• 25:44 – Practical Checklist: 5-Minute Assessment Before Purchasing a Course
• 27:01 – Holly's Course Offerings (Feed the Peeps, The Myo Method) & Black Friday Announcement
• 28:30 – Final Thoughts & Disclaimer

• Black Friday is coming! Starting November 9th, we’re dropping a new exclusive deal every day on Instagram! Follow @halliebulkin so you don’t miss your chance to save BIG on our feeding and myofunctional therapy courses and trainings!

Seeing It vs. Understanding It: The Gap in Myo Training

Scope of Practice vs. Clinical Competence: Are You Prepared to Treat?

STAY CONNECTED

💬 Join the Conversation: Join the Conversation: Connect with Hallie for weekly clinical takeaways, case study breakdowns, and mentorship opportunities on s on Instagram | Facebook | LinkedIn.

If Hallie's framework for evaluating continuing education helped clarify your professional development plans, please take a quick moment to leave a review! Your support helps us share these vital educational frameworks with clinicians everywhere.

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

Just because a clinical intervention falls within your legal scope of practice does not automatically mean you possess the clinical competence to execute it safely and effectively. In a field as fast-evolving as pediatric feeding, airway health, and myofunctional therapy, confusing scope with competence can lead to stalled patient progress, burnout, and compromised care.

In this solo masterclass, Hallie Bulkin dives into the critical distinction between legal scope of practice and true clinical competence. She addresses the harsh reality many clinicians face out of graduate school: managing increasingly complex caseloads without the specialized clinical reasoning or structured mentorship needed to drive outcomes.

Hallie breaks down how to identify personal clinical gaps, why confidence must be backed by deep foundational knowledge, and how practice owners can foster an environment centered on quality care rather than raw volume. She offers a clear, reflective framework for knowing when to seek advanced continuing education, when to collaborate interdisciplinary teams, and when a referral is the most responsible clinical choice.

• Scope vs. Competence: Understanding why legal licensure allows a wide range of practice, but true competence requires targeted post-graduate education and supervised experience.
• The Graduate Education Reality: Acknowledging the inherent limitations of university programs in preparing clinicians for complex pediatric feeding and airway cases.
• Confidence vs. Competence: Why feeling confident in a session is dangerous without the underlying clinical reasoning and evidence-based knowledge to support your choices.

"Having something within your scope of practice and being truly competent to treat it are two completely different things."

"True clinical expertise develops through targeted education, supported clinical experience, and ongoing learning - not just years on the job."

"Confidence and competence are not the same; confidence without deep foundational knowledge can lead to stalled patient care."

• 00:00 – Scope of Practice vs. Clinical Readiness
• 00:12 – Welcome to Untethered Podcast with Host Hallie Bulkin
• 00:48 – The Hidden Challenge: Feeling Unprepared for Complex Referrals
• 01:51 – Scope of Practice vs. Clinical Competency
• 02:42 – The Limits of Graduate School Training
• 05:01 – Workload vs. Caseload Volume: Why Complex Cases Burn Clinicians Out
• 07:39 – Moving Beyond Protocols: Understanding "What" vs. "Why" in Therapy
• 10:49 – Specialty Care vs. Integrated Clinical Care
• 14:01 – Stop Confusing Confidence with Competence
• 15:58 – The Role of Mentorship and Clinical Reasoning
• 16:54 – Practical Guidance for Employers & Practice Owners
• 19:03 – How Employees Can Advocate for Strategic Mentorship & Training
• 19:47 – Actionable Steps to Address Gaps in Your Clinical Practice
• 22:00 – How Mentorship Programs Support Expanding Access to Quality Care
• 24:02 – Closing Thoughts & Outro

• Go beyond traditional continuing education with clinical mentorship, expert-led trainings, collaborative case discussions, and a community of SLPs, OTs, and PTs committed to treating the whole child. Explore https://theintegratedtherapist.com/

Seeing It vs. Understanding It: The Gap in Myo Training

Screening vs. Assessment vs. Treatment: Why Every Clinician Needs to Know the Difference

STAY CONNECTED

💬 Join the Conversation: Join the Conversation: Connect with Hallie for weekly clinical takeaways, case study breakdowns, and mentorship opportunities on s on Instagram | Facebook | LinkedIn.

If Hallie's insights on clinical competence, professional boundaries, and targeted growth helped clarify your path forward, please take a quick moment to leave a review! Your support helps us share these vital professional conversations with clinicians everywhere.

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

Healthcare is undergoing a radical paradigm shift. For orthodontists, pediatric therapists, and airway specialists, delivering transformative patient care requires moving far beyond basic mechanical interventions to treat the whole patient - and their family’s underlying nervous system regulation.

In this episode, Hallie Bulkin sits down with Dr. Catherine "Cathy" Murphy, DDS, MSD, a pioneer in holistic, patient-centered orthodontic consulting and collaborative care. Dr. Murphy reflects on her transition from traditional orthodontic practice to a holistic model rooted in connection, clinical intuition, and interdisciplinary partnership.

Dr. Catherine (Cathy) Murphy, DDS, MSD, is an orthodontist, practice consultant, and advocate for holistic, patient-centered healthcare. She partners with orthodontic facilities across the country to establish and enhance collaborative care models and specialized patient-focused programs. Dr. Murphy is passionate about interdisciplinary collaboration, nervous system regulation, preventing clinician burnout, and empowering families through education.

• Transitioning to Holistic Care: Shifting from standard mechanics to a whole-body, patient-centered model that prioritizes root-cause health.
• Combating Clinician Burnout: Implementing practical self-care strategies, self-awareness, and clear clinical boundaries to sustain high-level practice.
• Harnessing Clinical Intuition: Understanding how subconscious pattern recognition allows experienced providers to process complex clinical data rapidly.
• Nervous System & Family Dynamics: Recognizing how parental stress and emotional regulation directly influence a child’s progress and appliance compliance.

• 01:51 - Dr. Catherine Murphy’s Evolution from Traditional Orthodontics to Patient-Centered Care
• 05:36 - The Reality of Clinician and Parent Burnout
• 11:00 - Integrated Care vs. Simple Interdisciplinary Collaboration
• 14:10 - Managing Patient Anxiety and Family Nervous System Dynamics
• 17:48 - Why Dr. Catherine Murphy Reframes Standard "Airway" Terminology
• 20:54 - The Role of Appliances in a Holistic Treatment Model
• 28:26 - Setting Healthy Professional and Personal Boundaries to Prevent Compassion Fatigue
• 39:22 - Patient-Centered Communication: Addressing the Child Directly in Care
• 43:40 - Daily Self-Care Practices for Long-Term Practice Sustainability

• Connect with Dr. Cathy Murphy: Explore practice consulting, books, and resources at CatherineMurphy.com.
• Follow Dr. Cathy on Social Media: Connect on Instagram @drcatherinemurphy.
• Fast Myo Screening Tool: Identify functional, structural, and airway red flags during intake at FastMyoScreening.com.
• Go beyond traditional continuing education with clinical mentorship, expert-led trainings, collaborative case discussions, and a community of SLPs, OTs, and PTs committed to treating the whole child. Explore https://theintegratedtherapist.com/

The Evidence Based Research Behind Tethered Oral Tissues with Richard Baxter, DMD, MS (Ep 137)

Episode 137: The Evidence Based Research Behind Tethered Oral Tissues with Richard Baxter, DMD, MS

Why Some Cases Stay Stuck: The Clinical Thinking That Changes Outcomes (Jul 20, 2026)

Why Some Cases Stay Stuck: The Clinical Thinking That Changes Outcomes

STAY CONNECTED

💬 Join the Conversation: Connect with Dr. Cathy on https://www.instagram.com/drcatherinemurphy/ or visit https://drcatherinemurphy.com/ and Follow with Hallie for weekly clinical takeaways, case study breakdowns, and program updates on Instagram | Facebook | LinkedIn.

If Dr. Cathy's perspective on holistic orthodontics, clinician burnout, and nervous system regulation resonated with you, please take a quick moment to leave a review! Your support helps us share these vital clinical conversations with therapists and providers everywhere.

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

In a digital age where social media posts and quick photos often drive clinical discussions, it is easy to mistake an anatomic tether for a definitive diagnosis. However, looking at a static picture of a lingual frenulum tells you almost nothing about how that tongue functions in real time during feeding, speech, or sleep.

In this solo masterclass, Hallie Bulkin revisits the nuanced and evolving landscape of pediatric tethered oral tissues (TOTS). She breaks down why clinical decision-making must always prioritize functional limitations over visual appearances.

Hallie explores how children build compensation strategies, when those compensations become exhausting or harmful, and how restricted tongue mobility interacts with underlying airway and sleep architecture. She also outlines a child-centered framework for pre- and post-release therapy, informed consent, and knowing when a surgical referral is truly warranted.

• Anatomy vs. Function: Why a photograph or visual inspection alone can never determine whether a tongue tie requires surgical release.
• Evaluating Compensations: Identifying when a child's compensatory movements are masking deeper motor fatigue, inefficient feeding, or speech breakdown.
• Airway & Sleep Interplay: Understanding how restricted lingual mobility coexists with mouth breathing, high-arched palates, and compromised sleep quality.
• The Clinical Reasoning Checklist: Asking what isn't functioning, what evidence exists, and whether targeted therapy alone can achieve functional goals.

"You haven't seen how the tongue moves if you're only looking at a picture - function always trumps anatomy."

"True clinical confidence isn't knowing how to spot a tie; it's understanding what the patient actually needs to function efficiently."

"Ask yourself: what isn't functioning, what evidence do you have, and how does this affect the child's whole system?"

• 00:00 – Reflection on Episode 184 and Evolving Clinical Reasoning
• 00:37 – Introduction to The Untethered Podcast
• 01:14 – Shifting the Focus: Assessing Function over Anatomy
• 01:46 – Moving Beyond the "Tongue Tie Debates" and Binary Mindsets
• 02:23 – Defining Ankyloglossia (Tongue Tie) vs. Tissue Appearance
• 03:41 – The "Function, Form, Impact, Decision" Framework
• 04:00 – Evaluating Tongue Mobility and Function
• 04:50 – Analyzing Compensatory Strategies in Patients
• 05:33 – Assessing Functional Impact on Feeding and Speech
• 07:18 – Airway Considerations and Coexisting Factors
• 08:38 – The Connection Between Speech Sound Disorders and Tongue Ties
• 09:30 – Recognizing When Therapy Progress Hits an Anatomical Ceiling
• 10:35 – Effective Interprofessional Collaboration and Referral Workflows
• 11:53 – Pre- and Post-Release Rehabilitation Care
• 12:33 – Individualized Care vs. Standardized Protocols (Infant & Pediatric Considerations)
• 14:34 – Putting the Patient (Not the Tissue) at the Center of Care
• 14:51 – Practical Key Questions to Ask in Your Clinical Practice
• 16:44 – The Ultimate Goal of Integrated Clinical Reasoning
• 17:16 – Tongue Tie Boot Camp & Ep. 184 Listener Challenge
• 18:12 – Outro & Legal Disclaimer

• Become the Pediatric Feeding Therapist Who Knows Exactly What to Do With Every Child https://www.feedthepeds.com/.

• Episode 184: Not All Ties Need to be Released.
• Why Some Cases Stay Stuck: The Clinical Thinking That Changes Outcomes.

💬 Join the Conversation: Connect with Hallie for weekly clinical takeaways, case study breakdowns, and program updates on Instagram | Facebook | LinkedIn.

If Hallie's insights on functional assessment and clinical reasoning gave you a fresh perspective on tethered oral tissues, please take a quick moment to leave a review! Your support helps us share these vital clinical frameworks with therapists everywhere.

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

When pediatric therapists treat feeding and speech in isolation, critical underlying root causes are easily overlooked. From jaw instability and retained primitive reflexes to phonological processes that are actually unaddressed motor speech deficits, true clinical progress requires an integrated, whole-system framework.

In this episode, Hallie Bulkin welcomes back returning guest Samy Hernandez, M.S., CCC-SLP, TSSLD, ASDCS, CPFT™, a pediatric speech-language pathologist at B Well Tots. Samy reflects on her clinical evolution since becoming one of the very first Certified Pediatric Feeding Therapists™ and making the pivotal decision to integrate Orofacial Myofunctional Therapy (OMT) and Oral Placement Therapy (OPT) directly into her practice.

Samy Hernandez is a licensed and certified Speech-Language Pathologist, Certified Autism Spectrum Disorder Clinical Specialist (ASDCS), and Certified Pediatric Feeding Therapist™ (CPFT™) at B Well Tots, where she provides neurodiversity-affirming, child-led therapy built through trust, play, and curiosity.

• Two Sides of the Same Coin: Why pediatric feeding therapy and myofunctional therapy (OMT) cannot be separated when treating complex oral-motor and airway challenges.
• How OPT & OMT Enhance Practice: Integrating Oral Placement Therapy (OPT) and myofunctional tools to strengthen diagnostic precision and treatment outcomes.
• Rethinking Speech Sound Hierarchies: Questioning traditional phonological processes and exploring how motor speech hierarchies provide a clearer roadmap for children with PFD and OMD.
• Interdisciplinary Team Care: Structuring seamless collaboration between SLPs, OTs, ENTs, and bodyworkers working toward shared goals for the same child.

"Pediatric feeding therapy and myofunctional therapy were never two separate things - they are two sides of the same coin."

"When you evaluate speech through a motor speech hierarchy, you realize how many 'phonological processes' are actually unaddressed jaw instability."

01:25 – Guest Introduction: Hallie Bulkin introduces speech-language pathologist Samy Hernandez.

02:14 – Clinical Practice Updates: Samy Hernandez shares updates on moving to Philadelphia and incorporating myo therapy into her daily practice.

05:00 – Airway & ARFID: Samy Hernandez and Hallie Bulkin discuss addressing root airway issues before treating feeding disorders.

16:50 – Motor vs. Phonology: Hallie Bulkin and Samy Hernandez explore how speech errors often stem from motor constraints rather than phonological processes.

26:03 – Jaw Stability & Speech: Samy Hernandez and Hallie Bulkin detail how jaw grading directly impacts speech sounds like /r/.

34:47 – Neurodiversity-Affirming Myo: Samy Hernandez explains adapting myofunctional therapy for autistic children using sensory movement and play.

• Connect with Samy Hernandez on Instagram @happyhandsSLP : Book an appointment, explore clinical services, and view practice resources at B Well Tots.
• Become the Pediatric Feeding Therapist Who Knows Exactly What to Do With Every Child https://www.feedthepeds.com/.

• Seeing It vs. Understanding It: The Gap in Myo Training.
• Why Some Cases Stay Stuck: The Clinical Thinking That Changes Outcomes.

💬 Join the Conversation: Connect with Samy on Instagram @happyhandsSLP or at B Well Tots and follow Hallie for weekly clinical takeaways, case study breakdowns, and program updates on s on Instagram | Facebook | LinkedIn.

If Samy's insights on jaw grading, motor speech hierarchies, primitive reflexes, and neurodiversity-affirming care broadened your clinical perspective, please take a quick moment to leave a review! Your support helps us share these vital clinical conversations with therapists everywhere.

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

Navigating healthcare billing is about to undergo a massive structural shift. For speech-language pathologists, feeding therapists, and private practice owners, the sunsetting of long-standing core CPT codes requires proactive preparation, documentation adjustments, and clear system updates.

In this episode, Hallie Bulkin unpacks the upcoming 2027 CPT code overhaul for speech and feeding therapy services. Most notably, standard CPT code 92507 will be replaced by five distinct, specialized codes covering fluency, speech sounds, language, combined speech and language, and voice upper airway dysfunction.

Hallie breaks down how to report multiple services provided on the same day, navigate payer-specific policies, apply modifier 59 correctly, and utilize time-based add-on codes using midpoint timing rules. She also discusses the business and clinical importance of building internal feeding therapy expertise to optimize patient care and ensure long-term practice sustainability.

• The Replacement of CPT 92507: Preparing for 2027, where 92507 will split into five targeted codes for fluency, speech sound disorders, language, combined speech-language, and voice/upper airway dysfunction.
• Same-Day Multiple Service Reporting: Understanding how to accurately report distinct clinical services on the same date of service without triggering claim denials or unbundling errors.
• Applying Modifiers & Timing Rules: Utilizing modifier 59 effectively and calculating session midpoints for time-based add-on codes to secure appropriate reimbursement.
• Navigating Payer Reductions: Managing payment adjustments, commercial insurance policies, and Medicare guidelines when billing multiple codes per session.
• Building Internal Feeding Skills: Expanding internal clinical skill sets to keep pediatric feeding care in-house, reducing unnecessary external referrals while growing practice offerings.

"CPT code 92507 will be replaced by five distinct, specialized codes in 2027—preparing your documentation systems now is essential for practice compliance."

"Timing rules and session midpoints dictate when add-on codes can be reported to support accurate, defensible reimbursement."

"Understanding payer-specific policies and modifier applications allows you to protect your practice against underbilling or accidental unbundling."

• 00:00 — Introduction: Reporting Speech and Feeding Together
• 00:26 — Welcome to The Untethered Podcast & Oral Rest Posture Reminder
• 01:02 — Upcoming CPT Code Changes: Goodbye 92507, Hello 10 New Codes for 2027
• 02:21 — Code Bundling vs. Reporting Distinct Services on the Same Day
• 03:06 — Current Billing Landscape: Speech (92507) and Swallowing/Feeding (92526)
• 04:28 — 2027 Session Examples: Midpoint Timing Rules with Speech and Feeding
• 07:06 — Comparing Combined Speech-Language Codes vs. Separate Treatment (Speech Sounds & Voice)
• 11:56 — Expanding Pediatric Feeding Services in Your Practice & Team Mentorship
• 14:27 — Free 3-Day Training Announcement: "Screen the Peds to Feed the Peds"
• 15:43 — Episode Disclaimer, Review Call to Action, and Outro

• FREE TRAINING: Screen The Peds to Feed The Peds Training.

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• What Myofunctional and Feeding Therapists Need to Know About Scope, Coding, and Documentation (Ep 386).
• Screening vs. Assessment vs. Treatment: Why Every Clinician Needs to Know the Difference (Ep 380).

💬 Join the Conversation: Connect with Hallie for weekly clinical takeaways, case study breakdowns, and program updates on s on Instagram | Facebook | LinkedIn.

If this episode helped clarify the upcoming CPT code changes and billing rules for your practice, please take a quick moment to leave a review! Your support helps us share these vital business and clinical insights with therapists everywhere.

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

When a baby struggles with infant feeding, weight gain, or subtle airway restrictions, parents are frequently told to "wait and see." Yet, waiting often turns minor early red flags into complex speech, feeding, and oral-motor challenges down the road.

In this episode, Hallie Bulkin sits down with Mackenzie Shiba, M.S., CCC-SLP, CMT®, pediatric speech-language pathologist, certified myofunctional therapist, and founder of Communication Blooms Speech Therapy. Mackenzie shares her personal transition from clinician to a late-night searching parent when her own son faced unexpected feeding and growth struggles. That journey revealed a critical gap in early pediatric guidance and inspired her to build The Blooms Blueprint - a comprehensive roadmap for parents spanning six age windows from birth to age two.

Together, Hallie and Mackenzie discuss why "the mouth that eats is the mouth that talks", how to differentiate between common infant behaviors and true structural airway red flags, and why a parent's gut instinct is valid clinical data. They unpack actionable strategies for empowering caregivers, facilitating early interdisciplinary care, and shifting from reactive diagnoses to proactive developmental support.

Key Topics & Takeaways

• The 2 AM Googler Reality: How personal experience with infant feeding and growth struggles drives the need for clear, proactive parental guidance.
• Retiring "Wait and See": Shifting the clinical and pediatric culture from passive waiting to active, supportive observation and early action.
• The Interconnected Mouth: Understanding why feeding, oral-motor function, airway patency, and early speech are fundamentally linked ("the mouth that eats is the mouth that talks").
• The Blooms Blueprint Framework: Breaking down six key developmental windows from birth to age two to help families spot small red flags early.

Soundbites

"We need to retire 'wait and see' because it leaves worried parents sitting at home carrying that heavy burden alone."

"The mouth that eats is the mouth that talks—feeding, airway, oral motor, and early speech development are completely interconnected."

"Airway is the conversation nobody is having with new parents, but common isn't the same as fine."

Timestamps

• 01:16 Guest Introduction: Mackenzie Shiba, M.S., CCC-SLP, CMT® 
• 02:16 From Clinician to 2 AM Googler: Mackenzie's Personal Journey 
• 05:44 Shared Experiences: Navigating Low Percentiles, Triple Feeding & System Gaps 
• 12:44 Having Non-Alarmist Airway Conversations with Parents 
• 25:00 Root Causes of Speech Patterns: Motor Patterns vs. Phonological Processes 
• 27:00 Hidden Red Flags: Maternal Oversupply & Missed Airway Signals 
• 38:08 Practical Action Steps: 1-Minute Daily Hacks for Caregivers 
•  43:03 How Myofunctional Therapy Shifts Clinical Practice 
• 47:40 Clinicians as Community Leaders: Disrupting the Status Quo 
• 55:24 Where to Connect with Mackenzie Shiba & Access The Blooms Blueprint 

Links & Resources

• Connect with Mackenzie Shiba: Explore resources and follow Mackenzie on Instagram @thebloomsblueprint and @communicationblooms.
• Access The Blooms Blueprint: Get the guide for infant and toddler developmental milestones at The Blooms Blueprint Guide.
• FREE TRAINING: Learn how structural airway limits directly affect feeding in our free Screen The Peds to Feed The Peds Training.

WORTH A LISTEN: CONTINUE YOUR JOURNEY

• Why Some Cases Stay Stuck: The Clinical Thinking That Changes Outcomes.
• Mouth Breathing vs. Nasal Breathing: Changing Lives Through Early Airway Intervention.

STAY CONNECTED

💬 Join the Conversation: Connect with Mackenzie on Instagram @thebloomsblueprint and follow Hallie for weekly clinical takeaways, case study breakdowns, and program updates on s on  Instagram | Facebook | LinkedIn.

If Mackenzie's proactive approach to infant feeding and airway health empowered your clinical practice or parenting journey, please take a moment to leave a review! Your support helps us share these vital early intervention frameworks with families and providers everywhere. 

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

One of the biggest hurdles clinicians face when transitioning into pediatric feeding therapy is realizing that traditional graduate coursework and isolated weekend seminars often leave massive gaps in clinical application. Too many training programs treat pediatric feeding as if it were simply adult dysphagia scaled down—focusing strictly on oral-motor mechanics while ignoring the child's entire developing system.

In this episode, Hallie Bulkin dives into the structural gaps of traditional feeding education and explains why treating a child requires an integrated, whole-system lens. She breaks down real-world case examples to demonstrate how behaviors like extreme texture selectivity or mealtime refusal are frequently symptoms of underlying postural instability, airway restriction, or sensory overload.

Hallie offers practical strategies to help clinicians move away from single-lens troubleshooting and develop the deep clinical reasoning required to connect isolated observations, uncover root causes, and create transformative intervention plans.

• Pediatric vs. Adult Dysphagia: Why pediatric feeding cannot be treated as scaled-down adult management and requires a developmental, whole-body framework.
• The Training Gap: Unpacking why standard feeding courses teach disconnected techniques rather than showing clinicians how to synthesize complex data.
• Systemic Interconnectedness: Understanding how posture, airway, sensory processing, and nervous system regulation directly dictate oral-motor performance.
• Redefining Clinical Reasoning: Shifting from "What exercise fixes this behavior?" to "What is this behavior telling me about the child's underlying system?"
• Root-Cause Assessment: Transitioning away from symptom chasing to evaluate foundational barriers and build defensible, effective treatment plans.

"Pediatric feeding isn't adult dysphagia scaled down—it is a complex, dynamic, developmental system."

"Traditional training teaches isolated pieces of the puzzle, but rarely shows clinicians how to connect them at the evaluation table."

"Effective feeding therapy requires us to look at the child's whole system. Symptoms are just clues pointing us toward the underlying root cause."

• 00:00 - Is What You See the Actual Problem?
• 00:44 - Welcome to The Untethered Podcast
• 01:20 - Why Grad School Didn't Prepare Us for Pediatric Feeding
• 02:26 - When 12 Complex Feeding Cases Land on Your Case Load
• 03:50 - Pediatric Feeding vs. Adult Dysphagia: A Different Operating System
• 05:00 - The Gap in Training & Connecting the Dots
• 06:41 - Case Example: Is It Sensory Refusal or Motor Difficulty?
• 08:24 - Looking Beyond Behavior to Find the Underlying Cause
• 09:03 - Avoiding "Hammer Lenses" (Airway, Sensory, & Motor Silos)
• 10:13 - Being Licensed Doesn't Magically Create Competency
• 11:27 - Why Continuing Education Alone Isn't Enough
• 13:13 - Developing True Clinical Reasoning
• 13:41 - Screen the Peds to Feed the Peds (Free 3-Day Training)
• 15:10 - Actionable Challenge for Your Hardest Case
• 16:16 - Episode Disclaimer & Outro

• FREE TRAINING: Learn how structural airway limits directly affect feeding in our free Screen The Peds to Feed The Peds Training.

• Why Some Cases Stay Stuck: The Clinical Thinking That Changes Outcomes.
• Screening vs. Assessment vs. Treatment: Why Every Clinician Needs to Know the Difference.

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

In this episode, Hallie Bulkin sits down with Shayla Bollman, MA, CCC-SLP, CPFT, CLC, to discuss her journey as a pediatric speech-language pathologist and how earning her Certified Pediatric Feeding Therapist (CPFT) credential transformed her clinical evaluation process, treatment approach, and referral network.

Shay shares practical strategies for responsive feeding, differentiating gagging from choking to ease caregiver anxiety, and managing pre- and post-operative care for tongue-tie releases. She also breaks down how blending lactation counseling with feeding therapy strengthens family advocacy, builds caregiver confidence, and creates sustainable, in-home support for complex infant feeding cases.

Shayla (Shay) Bollman is a licensed Speech-Language Pathologist with seven years of clinical experience in outpatient pediatric settings. She is a Certified Pediatric Feeding Therapist™️ (CPFT™️), Certified Lactation Counselor (CLC), and holds an interdisciplinary autism certification. Shay specializes in pediatric and infant feeding, tethered oral tissues (TOTS), bottle refusal, and supporting families through complex feeding transitions. Her clinical approach is responsive, family-centered, and focused on the whole child.

• The CPFT Certification Impact: How advanced clinical training shifts diagnostic reasoning, evaluation depth, and interdisciplinary referral strategies.
• Pre- & Post-Op TOTS Care: Why comprehensive pre-surgical preparation and targeted post-operative wound management are vital for successful release outcomes.
• In-Home Care & Parent Advocacy: Empowering families with practical, sustainable mealtime strategies and bridging communication between pediatricians, specialists, and caregivers.

"Holistic assessment is crucial for effective feeding therapy—we have to evaluate the entire developmental picture, not just the mouth."

"Building a collaborative team and offering in-home family support makes a profound difference in a child's feeding progress."

"Helping parents understand the clinical difference between a gag and a choke is essential for mealtime safety and peace of mind."

01:04 - Guest Introduction: Shayla Bollman, MA, CCC-SLP, CPFT, CLC

02:00 - Impact of CPFT Certification on Diagnostic Reasoning & Practice Growth

07:06 - Empathy in Infant Feeding: Transitioning to Infant Clinical Care

12:16 - Understanding Feeding Refusal in Infants

15:15 - Blending Lactation Counseling (CLC) with Pediatric Feeding Therapy

19:08 - Assessing Tethered Oral Tissues (TOTS): Bodywork & Functional Milestones

22:08 - Pre- and Post-Op Care for Tongue-Tie Releases

46:20 - Raising Intuitive Eaters: Long-Term Impacts of Mealtime Support

49:38 - Interdisciplinary Advocacy: Partnering with Pediatricians & Specialists

53:42 - In-Home Care, Caregiver Classes & Launching Private Practice

58:02 - Connecting with Shayla Bollman

• Connect with Shayla Bollman: Follow Shay’s clinical tips, private practice updates, and caregiver resources on Instagram @shaybollman.
• FREE TRAINING: Learn how structural airway limits directly affect feeding in our free Screen The Peds to Feed The Peds Training.

• Episode 137: The Evidence Based Research Behind Tethered Oral Tissues with Richard Baxter, DMD, MS.
• Screening vs. Assessment vs. Treatment: Why Every Clinician Needs to Know the Difference.

💬 Join the Conversation: Connect with Shay on Instagram @shaybollman and follow Hallie for weekly clinical takeaways, case study breakdowns, and program updates on  Instagram | Facebook | LinkedIn.

If Shay’s insights on responsive infant feeding and parent advocacy helped clarify your approach to complex cases, please take a moment to leave a review! Your support helps us share these vital clinical frameworks with therapists and families everywhere.

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