Latest / The Driven Athlete / How Pediatric Speech And Myofunctional Therapy Boost Breathing, Sleep, And Sports w/ Dr Christina | Ep 113

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How Pediatric Speech And Myofunctional Therapy Boost Breathing, Sleep, And Sports w/ Dr Christina | Ep 113 · The Driven Athlete

• 0:00
  SPEAKER_00: If you're a driven, active person who wants to reach and pursue a higher quality life with some ambition, then guess what?
• 0:06
  SPEAKER_00: This podcast is for you.
• 0:08
  SPEAKER_00: This is the Driven Athlete Podcast.
• 0:12
  SPEAKER_00: What's up, y'all?
• 0:12
  SPEAKER_00: It's your man, Dr.
• 0:13
  SPEAKER_00: Kyle.
• 0:14
  SPEAKER_00: Welcome to the Driven Athlete Podcast again.
• 0:16
  SPEAKER_00: We got really cool special guests with us, Dr.
• 0:19
  SPEAKER_00: Christina Colonna.
• 0:20
  SPEAKER_00: She's a speech pathologist who um has been working with my son, which is really cool and I really appreciate the work you've been doing.
• 0:27
  SPEAKER_00: Um but I thought it'd be insightful to bring her on and um some of the relationship with youth, um, active young kids, and then some of the things you work with on with them.
• 0:38
  SPEAKER_00: So thanks for coming in.
• 0:39
  SPEAKER_02: Thank you for having me.
• 0:40
  SPEAKER_00: I know you're busy running your own practice and stuff, so yeah, thank you.
• 0:43
  SPEAKER_02: Thank you.
• 0:44
  SPEAKER_00: Um, so where are you from?
• 0:45
  SPEAKER_02: Originally I'm from Staten Island, New York.
• 0:48
  SPEAKER_00: Okay.
• 0:48
  SPEAKER_02: I moved to Florida about three, three and a half years ago.
• 0:52
  SPEAKER_00: Um, what brought you to like Palm Beach County, Palm Beach Gardens?
• 0:56
  SPEAKER_02: Honestly, it was just somewhere I used to vacation.
• 0:58
  SPEAKER_02: And when it was time to move, it felt like a familiar place.
• 1:02
  SPEAKER_00: Cool.
• 1:02
  SPEAKER_00: Well, good.
• 1:03
  SPEAKER_00: Well, welcome.
• 1:04
  SPEAKER_00: I'm glad you're here because then, you know, we're getting help.
• 1:07
  SPEAKER_00: Yeah.
• 1:08
  SPEAKER_00: Um, what yeah, why pursue speech pathology?
• 1:12
  SPEAKER_02: So my sister was diagnosed with autism when she was two years old.
• 1:16
  SPEAKER_02: So we had every therapist there was in the home: occupational therapy, physical therapy, ABA therapy, and speech therapy.
• 1:23
  SPEAKER_02: And the speech therapists just always stood out to me as the coolest because they helped the children communicate.
• 1:31
  SPEAKER_02: She gave my sister her first words.
• 1:34
  SPEAKER_02: And now I say I like to give other parents their I love you's too because it's such a cool thing to go from nothing to any sort, any form of communication.
• 1:44
  SPEAKER_00: Yeah.
• 1:44
  SPEAKER_00: I mean, that's extremely impactful.
• 1:46
  SPEAKER_00: Yeah.
• 1:46
  SPEAKER_00: Her first words, you know?
• 1:48
  SPEAKER_02: Yeah.
• 1:48
  SPEAKER_00: Um, well, that's cool.
• 1:50
  SPEAKER_00: That's great.
• 1:50
  SPEAKER_00: Um, where'd you go to school?
• 1:52
  SPEAKER_02: Um, I went to school at Toro University and then Columbia University in New York City.
• 1:58
  SPEAKER_00: Cool.
• 1:59
  SPEAKER_00: So Columbia for speech pathology?
• 2:01
  SPEAKER_02: For speech pathology, we need our masters to practice.
• 2:04
  SPEAKER_02: And then in New York City, you need your bilingual extension if you're gonna practice in another language.
• 2:09
  SPEAKER_02: Um, my other language is Spanish.
• 2:10
  SPEAKER_00: Oh, cool.
• 2:11
  SPEAKER_02: And then I received my doctorate.
• 2:13
  SPEAKER_00: Awesome.
• 2:13
  SPEAKER_00: Wow, that's really cool.
• 2:14
  SPEAKER_00: I didn't know that.
• 2:15
  SPEAKER_00: That's awesome.
• 2:15
  SPEAKER_00: Um that's really cool.
• 2:17
  SPEAKER_00: Um, so you what's the the main type of demographic you work with now?
• 2:22
  SPEAKER_00: What do you think?
• 2:23
  SPEAKER_02: I'm a pediatric practice.
• 2:25
  SPEAKER_02: So I see birth through 18, but I would say the primary clientele that I see is birth through five, a lot of late talkers, expressive language delays, um, children who just don't have enough vocabulary yet.
• 2:40
  SPEAKER_00: So what would make a parent like reach out?
• 2:43
  SPEAKER_00: Do you feel like they're just delayed in speech, swallowing, drooling, like what kind of stuff are they?
• 2:49
  SPEAKER_02: Yes, a lot of if they're not hitting their speech milestones.
• 2:53
  SPEAKER_02: So typically by around 18 or 20 months, a child should have 10 to 50 words.
• 2:59
  SPEAKER_02: And if a parent is seeing that their child is not using any words by that time, they usually give us a call.
• 3:05
  SPEAKER_02: And I'm also a myofunctional therapist.
• 3:08
  SPEAKER_02: Myo means muscle and um functional is working.
• 3:11
  SPEAKER_02: So we look at how the muscles are working in the face and the mouth.
• 3:16
  SPEAKER_02: And a lot of parents call if their child is mouth breathing, drooling.
• 3:22
  SPEAKER_02: Maybe they went to an ENT, an ears-nose, throat doctor, and they're they said they have enlarged tonsils and that they should check out a myofunctional therapist.
• 3:30
  SPEAKER_02: So parents just call me inquiring about that.
• 3:32
  SPEAKER_00: Interesting.
• 3:33
  SPEAKER_00: And that's exactly what we did, you know.
• 3:35
  SPEAKER_00: Um, because my son, he's three, but he uh yeah, we just like you know, excessive drooling.
• 3:40
  SPEAKER_00: Um, he just, you know, he's a cute kid, he talks funny.
• 3:44
  SPEAKER_00: You know, he's he just so like I don't didn't think that was really an issue.
• 3:47
  SPEAKER_00: Like the way he's saying words funny, you know?
• 3:49
  SPEAKER_00: Yeah, just cute.
• 3:51
  SPEAKER_00: This it's it's a good video recording opportunity when you're like, I want to record that.
• 3:55
  SPEAKER_00: Yeah, um, but that's the way we reached out.
• 3:57
  SPEAKER_00: We're like, I wonder if there's I don't know, some adenoid or tonsil inflammation, and then um if there's any speech uh like strength um stuff that we can intervene with, you know.
• 4:08
  SPEAKER_00: Yes.
• 4:09
  SPEAKER_00: And I thought what's cool is like because you just don't know this stuff, like like I don't I just didn't know, but um, all the cool little interventions of to like little exercises to do at home that are engaging for the kids, for my kid at least.
• 4:22
  SPEAKER_00: Um, because what kids gonna do like you know, repetitions of an exercise?
• 4:26
  SPEAKER_00: You gotta make it a game, you know?
• 4:27
  SPEAKER_01: Yeah.
• 4:28
  SPEAKER_00: Um, but yeah, like insightful little exercises that are purposefully driven to improve some kind of dysfunction, you know.
• 4:36
  SPEAKER_00: Yeah.
• 4:36
  SPEAKER_02: And well, like we talked about, structure does impact function.
• 4:40
  SPEAKER_02: So checking out the structure to see what's going on in his mouth before doing the exercises and while we're doing the exercises, it's a really collaborative approach.
• 4:49
  SPEAKER_00: Yeah, that's good.
• 4:50
  SPEAKER_00: Um, explain tonsils or adenos and tonsils.
• 4:55
  SPEAKER_00: Okay, those are the same thing.
• 4:56
  SPEAKER_02: You're not.
• 4:57
  SPEAKER_00: Okay, yeah, tell it explain.
• 4:58
  SPEAKER_02: But you can see them in the mouth.
• 5:01
  SPEAKER_02: Um, tonsils if you just have your child go, ah, if they are enlarged, you will see that they are enlarged.
• 5:07
  SPEAKER_02: So we use sort of a grading system to see how enlarged they are.
• 5:12
  SPEAKER_02: Um, and that is considered an airway obstruction, which would cause mouth breathing because they are enlarged in the mouth.
• 5:19
  SPEAKER_02: And it children typically sit with their mouth open to get that air.
• 5:24
  SPEAKER_00: Interesting.
• 5:25
  SPEAKER_00: So this is going to exacerbate their need to mouth breathe, which then would probably cause more drooling because their mouth's open all the time.
• 5:32
  SPEAKER_02: Yes.
• 5:33
  SPEAKER_02: And that low tongue resting posture.
• 5:35
  SPEAKER_02: So whenever we say mouth breathing, we're assuming that the tongue is resting at the bottom of the mouth.
• 5:40
  SPEAKER_02: When really normal resting posture is our tongue suctioned to the top of the mouth.
• 5:45
  SPEAKER_02: Like you're sitting right now with your mouth closed and your tongue is suctioned to the top of your mouth.
• 5:48
  SPEAKER_00: Weird.
• 5:49
  SPEAKER_00: I feel it.
• 5:49
  SPEAKER_02: That's how it should be.
• 5:51
  SPEAKER_02: Yeah.
• 5:52
  SPEAKER_00: Interesting.
• 5:52
  SPEAKER_02: So we teach children where to put their tongue in their mouth.
• 5:56
  SPEAKER_02: But of course, we can't change the structure.
• 5:59
  SPEAKER_02: We refer out for that.
• 6:00
  SPEAKER_00: So that's why adeno inflammation is what you're saying.
• 6:03
  SPEAKER_02: Yes, or tonsil, a tonsilectomy.
• 6:05
  SPEAKER_00: Yeah.
• 6:05
  SPEAKER_02: Or children who sit with their tongue low in their mouth typically develop a high and narrow palate.
• 6:13
  SPEAKER_02: And when your palate is too narrow, your palate is the top of your mouth.
• 6:18
  SPEAKER_02: And when that's too narrow, your tongue actually doesn't have a place to rest.
• 6:22
  SPEAKER_02: It's too small.
• 6:23
  SPEAKER_02: So that it's kind of like a catch catchball because then they have to rest with their tongue low because there's no room at the roof of their mouth.
• 6:30
  SPEAKER_00: Yeah.
• 6:31
  SPEAKER_00: So it just feeds itself.
• 6:32
  SPEAKER_02: Yeah.
• 6:32
  SPEAKER_02: That's early intervention matters.
• 6:34
  SPEAKER_00: I I've actually, yeah, I have heard that um with in relation to like thumb sucking.
• 6:39
  SPEAKER_02: Yeah.
• 6:39
  SPEAKER_00: Where the suction in the thumb that replaces your thumb, your tongue posture, but then it forms your palate and teeth form around your thumb.
• 6:47
  SPEAKER_02: Exactly.
• 6:47
  SPEAKER_00: And you can see like the is this all accurate?
• 6:50
  SPEAKER_00: And like the the top teeth like to do a curve?
• 6:53
  SPEAKER_02: This is accurate.
• 6:54
  SPEAKER_02: That's the same with pacifier use.
• 6:56
  SPEAKER_02: So usually when a child comes in and they smile, I can tell exactly if they've been on the pacifier a little too long or are thumb sucking because of how their dentition is.
• 7:05
  SPEAKER_00: It's interesting.
• 7:06
  SPEAKER_00: Um if you saw my daughter, you would know that she sucks her thumb.
• 7:10
  SPEAKER_00: We're actually, she's five and a half.
• 7:12
  SPEAKER_00: We're weaning her out of it now, which is tricky.
• 7:14
  SPEAKER_00: You know?
• 7:15
  SPEAKER_02: Gotta do it.
• 7:16
  SPEAKER_00: I know, I know.
• 7:17
  SPEAKER_02: Um, she's make a lot of tools for them now for your hand.
• 7:20
  SPEAKER_00: What we've tried to do is um we have like an Elsa glove, you know, like the princess Elsa.
• 7:26
  SPEAKER_00: We're like, you're gonna wear your glove tonight.
• 7:28
  SPEAKER_00: She's like, but I don't want to do a taste bad.
• 7:30
  SPEAKER_00: I'm like, Yeah, I know.
• 7:31
  SPEAKER_00: That's the reason why we're doing it.
• 7:32
  SPEAKER_00: So you know fucking thumb.
• 7:33
  SPEAKER_00: She's like, I promise I won't.
• 7:36
  SPEAKER_00: I'm like, I know you.
• 7:38
  SPEAKER_00: You know you.
• 7:39
  SPEAKER_00: You know that I know you.
• 7:40
  SPEAKER_00: You ever see that movie, Dodgeball?
• 7:42
  SPEAKER_00: No, yes.
• 7:44
  SPEAKER_00: Um, but uh, yeah, so she has like you can tell like her teeth, her upper teeth, you know, they're more curved to the upwards in the middle than the front.
• 7:53
  SPEAKER_02: I was also a thumb sucker, so it it can be fixed.
• 7:56
  SPEAKER_00: Yeah, I was as well.
• 7:58
  SPEAKER_00: Um, yeah, I remember I used to like wrap like a fruit roll-up on my thumb and then eat that, suck that.
• 8:04
  SPEAKER_00: Did you do that?
• 8:05
  SPEAKER_02: I've never heard of that.
• 8:05
  SPEAKER_00: No, yeah, I was just a weird kid, maybe.
• 8:08
  SPEAKER_02: No.
• 8:08
  SPEAKER_00: Um, but uh so then what's the with tonsils?
• 8:12
  SPEAKER_00: Okay, where are those located?
• 8:13
  SPEAKER_00: Like versus the adenoids.
• 8:15
  SPEAKER_02: Tonsils are right in the back of your mouth.
• 8:17
  SPEAKER_02: Your adenoids are in your nose.
• 8:19
  SPEAKER_00: Oh, okay.
• 8:20
  SPEAKER_00: All right.
• 8:21
  SPEAKER_02: So that's another thing that impacts people, are like deviated septums.
• 8:25
  SPEAKER_02: That would be considered another um airway obstruction where people are going to mouth breathe because their airway, like one side is deviated, so they are only getting air through one of their nostrils.
• 8:39
  SPEAKER_00: Interesting.
• 8:40
  SPEAKER_00: Um oh my god.
• 8:42
  SPEAKER_00: I think I told you this, but um, at our first appointment, Colt way, one of the first things we were noticing, Colt was like not breathing well through his nose.
• 8:49
  SPEAKER_00: So I would like it was tricky, he's three, right?
• 8:52
  SPEAKER_00: But I'm like, I would pinch his mouth closed and then put one off, close a nostril and tell him to breathe in, and he could do it, but it was a little struggle.
• 8:59
  SPEAKER_00: And I switched sides, couldn't breathe through that nostril.
• 9:02
  SPEAKER_00: So we went to the we went to the ENT.
• 9:04
  SPEAKER_00: Yes, and uh right before the appointment, he was like laying back on the table, just kind of like messing around.
• 9:10
  SPEAKER_00: And my wife was looking at him and saw something in his nose.
• 9:14
  SPEAKER_00: Literally a couple seconds before the doc walked in.
• 9:16
  SPEAKER_00: She's like, Oh my gosh, there's something in there.
• 9:19
  SPEAKER_02: And what was it?
• 9:20
  SPEAKER_00: It was a sponge.
• 9:21
  SPEAKER_02: Oh yeah, yeah.
• 9:24
  SPEAKER_00: There was a sponge lodged in one of his nostrils, and my wife was like, Okay, doc, so like we we were here because of speech issue.
• 9:32
  SPEAKER_00: We're not really sure, but we don't get in, you know, an insight with you, adenoids, tonsils, ENT doc investigation, whatever.
• 9:39
  SPEAKER_00: Well, we just saw someone in his nose.
• 9:40
  SPEAKER_00: Can you check?
• 9:42
  SPEAKER_00: Took some took some um um tweezers and pulled out a sponge.
• 9:46
  SPEAKER_00: Nice.
• 9:47
  SPEAKER_00: Yeah, it was nasty.
• 9:48
  SPEAKER_02: Talk about an obstruction, yeah.
• 9:50
  SPEAKER_02: That'll do it.
• 9:50
  SPEAKER_00: I was like, no wonder this has been facilitating an issue.
• 9:54
  SPEAKER_02: Or like how long it was in there.
• 9:56
  SPEAKER_00: Exactly.
• 9:56
  SPEAKER_00: But there was he was on antibiotics because it was they're not a good sight, you know.
• 10:00
  SPEAKER_00: And he was like, Yeah, it's inflamed in there, and like it's red.
• 10:03
  SPEAKER_00: The sponge looks really nasty.
• 10:04
  SPEAKER_00: Like, you're gonna be on antibiotics.
• 10:06
  SPEAKER_00: Um, but I was like, man, it's definitely you know, how the dude'd you get in there, dude?
• 10:12
  SPEAKER_00: You know, like what are you doing, man?
• 10:13
  SPEAKER_00: Yeah, funny kid, man.
• 10:15
  SPEAKER_00: Um, but the uh but anyway, so it reached out to you, right?
• 10:20
  SPEAKER_00: Because we were like, we want to improve all this stuff.
• 10:23
  SPEAKER_00: Um how do you pick and choose specific like exercises or interventions?
• 10:28
  SPEAKER_02: Like all of our exercises are coded by your lips, your tongue, and your jaw, your face muscles, basically.
• 10:39
  SPEAKER_02: And we see where the weakness truly lies.
• 10:43
  SPEAKER_02: So all of our exercises, if I have him do the evaluation and there's five tongue exercises and he flies through them, I know that the tongue is not really the weakness.
• 10:54
  SPEAKER_02: But what children tend to do is compensate because they have had this inefficiency for a while.
• 11:02
  SPEAKER_02: So some children can move their tongue, but they have to move their jaw with their tongue.
• 11:08
  SPEAKER_02: So their jaw and their tongue move as one.
• 11:10
  SPEAKER_02: That's considered a compensatory strategy, which we want to break them out of.
• 11:14
  SPEAKER_02: Your tongue should be able to move independently, your lips moving independently.
• 11:18
  SPEAKER_02: So, really, the evaluation is the most important piece where they're doing all the exercises and you can kind of see where the weakness lies.
• 11:24
  SPEAKER_02: And of course, you're looking at the structure and seeing if you see a tongue tie, a lip tie, a buckle tie, anything that might be impacting that again, we have to refer out for those.
• 11:37
  SPEAKER_00: Yeah, yeah.
• 11:38
  SPEAKER_00: So tonsils, adenoids, lip tie, tongue tie, buckle tie.
• 11:42
  SPEAKER_00: Oh, yeah.
• 11:42
  SPEAKER_00: Those are structural deviated septum.
• 11:45
  SPEAKER_00: Those are structural things that would need to be intervened with that would be in good conjunction with speech therapy exercise to comprehensively like improve the issue.
• 11:56
  SPEAKER_02: Yes.
• 11:56
  SPEAKER_02: Typically, especially with a tongue tie, that means the bottom part of your tongue is being restricted down.
• 12:02
  SPEAKER_02: We recommend myofunctional therapy before getting it released so that your tongue gets used to where it should be once it's released.
• 12:09
  SPEAKER_02: Because once you have all that freedom with your tongue, um, it's important to have that consistency of where it should go.
• 12:16
  SPEAKER_01: Yeah.
• 12:16
  SPEAKER_02: Um, but same with the narrow palate that we talked about before.
• 12:20
  SPEAKER_02: A lot of children in Florida, I'm noticing, have palate expanders.
• 12:24
  SPEAKER_02: They go for expansion to again widen the jaw so that there's room for the tongue.
• 12:30
  SPEAKER_02: And we do myofunctional therapy in conjunction with the expansion.
• 12:33
  SPEAKER_00: Would that be like orthodontist?
• 12:35
  SPEAKER_02: Yes.
• 12:36
  SPEAKER_00: Interesting.
• 12:36
  SPEAKER_00: So is that like a like part of just the braces uh whole approach?
• 12:41
  SPEAKER_00: Like in in addition to straightening the teeth, also widening the palate?
• 12:45
  SPEAKER_02: Yes.
• 12:45
  SPEAKER_00: Or is that a completely separate thing?
• 12:47
  SPEAKER_02: If they have a small lower jaw, we usually see crooked teeth in children.
• 12:52
  SPEAKER_02: Or when children are growing in their teeth, you actually want to see spacing in between each teeth, um, each tooth.
• 12:59
  SPEAKER_02: And when we don't see the spacing, that is an indicator that they're probably developing a smaller palate.
• 13:05
  SPEAKER_02: Um, but not all children that get expansion need braces.
• 13:10
  SPEAKER_02: Those are separate from each other.
• 13:11
  SPEAKER_02: Interesting.
• 13:12
  SPEAKER_00: Okay, cool.
• 13:12
  SPEAKER_02: Yeah.
• 13:13
  SPEAKER_00: Awesome.
• 13:14
  SPEAKER_00: Um what would make like if someone's listening right now, just like looking at their bottom of their tongue and looking to see if there's a tongue tie, like what would or their lip tie in the top of their top lip?
• 13:25
  SPEAKER_02: So not everyone can identify it.
• 13:28
  SPEAKER_02: And even myself as a myofunctional therapy, I can assess and observe, but I refer out to a pediatric dentist that has experience with myofunctional therapy.
• 13:39
  SPEAKER_02: That's very important because sometimes I've sent clients out for referrals, especially for tonsils.
• 13:46
  SPEAKER_02: That's the worst one.
• 13:46
  SPEAKER_02: There are some ENTs here, the biggest tonsils.
• 13:50
  SPEAKER_02: If you can see the tonsils hanging in your kid's mouth, they are enlarged.
• 13:54
  SPEAKER_02: And I've had ENTs be like, it's fine.
• 13:56
  SPEAKER_02: Here's an antibiotic.
• 13:58
  SPEAKER_02: And sometimes, again, I can't work on therapy until there's no obstruction, or you know, I'm not going to continue therapy until there's a structural intervention.
• 14:08
  SPEAKER_00: Yeah.
• 14:09
  SPEAKER_00: Interesting.
• 14:10
  SPEAKER_00: Um I always we we went and see an ENT and while my wife took them.
• 14:15
  SPEAKER_00: And his his thought was like, you know, his adenoids seem to be me, they're fine.
• 14:21
  SPEAKER_00: Um, they are they're they're fine, but if we were to, if you I could definitely tell that if you went to another ENT, plenty of ENTs would be like, oh, surgery, you know, like right away.
• 14:31
  SPEAKER_00: But I don't think he needs it.
• 14:33
  SPEAKER_01: Yeah.
• 14:33
  SPEAKER_00: Is that a common thing too?
• 14:35
  SPEAKER_00: Like I don't want to say over surgery, you know, over recommending surgery.
• 14:39
  SPEAKER_02: I would say for the tongue tie, definitely.
• 14:42
  SPEAKER_02: Um, and sometimes also for the tonsils, definitely.
• 14:46
  SPEAKER_02: And the thing is, if your child gets myofunctional therapy early enough, you can actually prevent some of that.
• 14:52
  SPEAKER_00: Oh, cool.
• 14:53
  SPEAKER_00: Yeah.
• 14:53
  SPEAKER_00: All right.
• 14:54
  SPEAKER_00: So, like lip tie, tongue tie, are those um like born congenital?
• 15:00
  SPEAKER_00: Like are you born?
• 15:01
  SPEAKER_00: Okay.
• 15:02
  SPEAKER_02: I you can get a surgery.
• 15:03
  SPEAKER_02: My nephew actually got his tongue tie lasered at two months because he was having difficulty breastfeeding, latching.
• 15:13
  SPEAKER_02: Those are the signs for our infants that there's um an issue.
• 15:17
  SPEAKER_02: Yeah maybe colic reflux.
• 15:19
  SPEAKER_01: Yeah.
• 15:20
  SPEAKER_02: That's why our intake is so informed because we want to see how they're sleeping, how they're breathing during the day, how they're eating.
• 15:27
  SPEAKER_00: Yeah.
• 15:27
  SPEAKER_00: So not latching.
• 15:28
  SPEAKER_00: That's interesting.
• 15:29
  SPEAKER_00: Because I know that's a pro that's a difficult thing, especially for the first baby, like our first, you know, it was this challenge.
• 15:34
  SPEAKER_00: It's challenging.
• 15:35
  SPEAKER_00: Yeah.
• 15:35
  SPEAKER_00: Um, but I didn't consider that, you know, it could be like a tongue tie, lip tie issue.
• 15:38
  SPEAKER_00: Yes.
• 15:39
  SPEAKER_00: Or a buckle tie.
• 15:40
  SPEAKER_02: Yes.
• 15:40
  SPEAKER_00: Interesting.
• 15:42
  SPEAKER_00: Um did you and so at school, you mentioned your doctorate research was mainly on autism.
• 15:49
  SPEAKER_02: Yes, I did autism and parent coaching because I feel that parents are sometimes left out of the therapy, but we have to take into consideration that my clients are coming to me for a half an hour, sometimes once a week.
• 16:02
  SPEAKER_02: They are with their parents the rest of the week.
• 16:05
  SPEAKER_01: Yeah.
• 16:05
  SPEAKER_02: So it's so important to me that parents know what's happening in the therapy room so that they feel comfortable to carry it over at home.
• 16:12
  SPEAKER_00: Yeah.
• 16:12
  SPEAKER_00: I mean, I would agree.
• 16:13
  SPEAKER_00: Like the biggest coach is gonna be their mom or dad, you know, both.
• 16:16
  SPEAKER_02: Um, so then what led you to shift more into the myofunctional that shift actually happened in Florida with the influx of what I was seeing again with the palate expanders, the tongue ties.
• 16:31
  SPEAKER_02: And I had a lot of clients with persistent articulation errors, which is any speech sound is um sorry, lost my train of thought.
• 16:44
  SPEAKER_02: Speech sound disorders that last for a long period of time.
• 16:48
  SPEAKER_02: So clients were coming to me that had been in speech therapy for three or four years, seeing very little progress.
• 16:54
  SPEAKER_02: And that was a red flag to me because with speech therapy, we expect to get them off our caseloads pretty quickly, especially if they're cognitively able to do the exercises.
• 17:04
  SPEAKER_02: So I started looking into myofunctional therapy because I saw how the different parts of the mouth that aren't functioning correctly, structure-wise, are impacting now the speech sounds because children are unable to move their mouth in a certain way, move their tongue in a certain way.
• 17:22
  SPEAKER_02: A lot of sounds our tongue actually goes up for, like L and T, D.
• 17:27
  SPEAKER_02: Um, so if a child is unable to elevate their tongue, they're gonna have trouble with these sounds forever.
• 17:32
  SPEAKER_00: Yeah.
• 17:33
  SPEAKER_02: For a long time until they compensate.
• 17:35
  SPEAKER_00: Interesting.
• 17:36
  SPEAKER_00: Um, I'm not sure if it's related, but my like when my son says like animal or like the L words, like he his his tongue goes out of his mouth.
• 17:45
  SPEAKER_00: It's like animal.
• 17:47
  SPEAKER_02: And that makes sense because he is not yet able to find the spot that his tongue should rest.
• 17:52
  SPEAKER_02: That upper palate.
• 17:53
  SPEAKER_02: Yeah, he's having trouble with that.
• 17:55
  SPEAKER_00: We put honey in the back of his teeth.
• 17:56
  SPEAKER_00: Like, yeah, he did it last night and he wanted to say hi.
• 18:00
  SPEAKER_02: Oh, thanks.
• 18:01
  SPEAKER_00: And he he said that uh I was like, I get to, you know, show me your exercises so I can tell Dr.
• 18:06
  SPEAKER_00: Christina that you did them and what to do and stuff.
• 18:08
  SPEAKER_00: So he was like doing them good last night.
• 18:09
  SPEAKER_01: Awesome.
• 18:10
  SPEAKER_00: And he had that little green bite thing.
• 18:12
  SPEAKER_01: Yes.
• 18:12
  SPEAKER_00: And then he was able to put his tongue behind his teeth.
• 18:14
  SPEAKER_00: Yeah.
• 18:15
  SPEAKER_00: I think that's the first time I ever saw him do it, actually.
• 18:17
  SPEAKER_02: I had told mom that that bite block really helped him because it kind of was pushing back the tongue too, and he kind of understood, like, I can't really stick it out with the bite block in my mouth.
• 18:26
  SPEAKER_00: But it's just funny, it was like we have a mirror in front of him, and we're like, I'm gonna put some honey, or I'll rug, I'll like rub uh the back of his teeth and he still go in the front of his teeth, you know.
• 18:35
  SPEAKER_00: Just under front of his teeth.
• 18:37
  SPEAKER_00: I'm like, no, no, no, behind your teeth.
• 18:38
  SPEAKER_02: Yeah.
• 18:39
  SPEAKER_00: And he'll go in front of his teeth, under his top lip, put honey behind his teeth, still can't find it.
• 18:43
  SPEAKER_00: He has to close his mouth and then he'll you know find it.
• 18:46
  SPEAKER_02: He's doing exceptional for his age, though.
• 18:48
  SPEAKER_02: We have to take that into context.
• 18:50
  SPEAKER_00: Yeah, I mean, I don't disagree.
• 18:51
  SPEAKER_00: I don't I mean, he's doing he's practicing, he's doing good.
• 18:53
  SPEAKER_00: Yes, but it's just I'm like, man, I still didn't I didn't know this stuff, you know.
• 18:57
  SPEAKER_00: This is interesting, it's super interesting.
• 19:00
  SPEAKER_00: Um, so for him, all right, would you say it's uh lip weakness or tongue weakness or both?
• 19:07
  SPEAKER_02: Both.
• 19:08
  SPEAKER_00: Okay.
• 19:08
  SPEAKER_02: I think he has a lip insufficiency with his lip just being pulled up and not being able to make that labial seal.
• 19:16
  SPEAKER_02: Um, but he does struggle with finding his tongue in his mouth as well.
• 19:19
  SPEAKER_02: So that's just more awareness.
• 19:21
  SPEAKER_02: We're retraining him where to put his tongue.
• 19:23
  SPEAKER_00: Yeah, like proprioception, I would imagine, right?
• 19:27
  SPEAKER_00: Like, okay.
• 19:28
  SPEAKER_00: Um interesting.
• 19:29
  SPEAKER_00: Well, that's this is cool.
• 19:31
  SPEAKER_00: I'm glad we're working on it.
• 19:32
  SPEAKER_00: You know.
• 19:33
  SPEAKER_00: Um what did you have your own practice before you came down?
• 19:38
  SPEAKER_00: Like in when you were in New York, did you have your own practice?
• 19:40
  SPEAKER_02: I did.
• 19:41
  SPEAKER_02: I worked in early intervention and the schools for a little when I first graduated, and then I had a private practice in Staten Island for five years.
• 19:49
  SPEAKER_02: Oh, cool.
• 19:49
  SPEAKER_02: Before moving down here.
• 19:51
  SPEAKER_00: Awesome.
• 19:51
  SPEAKER_02: Yeah.
• 19:52
  SPEAKER_00: What uh what made you want to do your own practice?
• 19:55
  SPEAKER_00: Or they're not like is that is that normal?
• 19:58
  SPEAKER_02: Yeah, I I don't.
• 20:00
  SPEAKER_02: That it's normal.
• 20:01
  SPEAKER_02: I ventured off because the schools have a lot of restrictions on what you're able to work on, especially because everything needs to have an educational impact in the schools, which is great.
• 20:12
  SPEAKER_02: But there are a lot of children who don't fall under that criteria.
• 20:17
  SPEAKER_02: And same with insurance.
• 20:19
  SPEAKER_02: Insurance really heavily dictates what you're able to work on and how.
• 20:23
  SPEAKER_02: And having your own practice, you kind of have free range to do whatever you want and see a little bit of everything because the schools sometimes you're seeing like the same thing all day.
• 20:33
  SPEAKER_02: And for me, my mind wants to work a little more.
• 20:36
  SPEAKER_02: So I like to I like the variety of private practice.
• 20:40
  SPEAKER_00: Yeah, yeah.
• 20:41
  SPEAKER_00: We're super similar.
• 20:42
  SPEAKER_00: I mean, it's you're basically speaking the same thing.
• 20:44
  SPEAKER_00: I have said about a thousand times.
• 20:46
  SPEAKER_00: Yeah.
• 20:46
  SPEAKER_00: Um, so what the link between so we see a lot of active people, youth at we see a lot of youth athletes, you know.
• 20:54
  SPEAKER_00: Um, I coached football at King's Academy for a couple of years.
• 20:57
  SPEAKER_00: We have a lot of a lot of connections in the area with um youth athletic and and coaches and stuff.
• 21:02
  SPEAKER_00: So we we've seen athletes as young as eight.
• 21:06
  SPEAKER_00: Um and uh from eight till until the college athletes, high school athletes, and some pro athletes, and then active adults too.
• 21:14
  SPEAKER_00: But anyway, we do see a lot of youth athletes too.
• 21:17
  SPEAKER_00: Um breathing patterns, of course, I would imagine, with issues like this, would affect their athletic performance and ability, right?
• 21:25
  SPEAKER_02: Definitely.
• 21:26
  SPEAKER_00: Um, is that yeah, what's the tell could you describe the link of speech issue and breathing as it relates to like sports performance or activity?
• 21:35
  SPEAKER_02: Yeah, well, when a child is breathing through their mouth, they're not getting the same oxygen delivery that they should be.
• 21:43
  SPEAKER_02: And a lot of what I see in my little athletes that come in for speech and myofunctional therapy is actually over-breathing, where they're taking in too much air and they're actually working harder than they need to.
• 21:55
  SPEAKER_02: So that decreases their endurance because they're actually overworking themselves.
• 21:59
  SPEAKER_02: So teaching them good diaphragmatic breathing.
• 22:03
  SPEAKER_02: A lot of our children, we talk about thoracic chest breathing where we're breathing through our shoulders.
• 22:08
  SPEAKER_02: And once children really understand it, it makes a huge difference.
• 22:12
  SPEAKER_02: We do so many exercises like bear crawls and um lunges and high knees in my sessions because children can breathe just sitting like this.
• 22:24
  SPEAKER_02: But as soon as you put them in movement, which kids are always moving, that's when they lose it and you realize they can't generalize it yet.
• 22:31
  SPEAKER_02: So the movement piece in our sessions is very important because it just teaches them how to move during their breathing.
• 22:39
  SPEAKER_00: So when they and you described like they run out of, well, what about like running out of air?
• 22:42
  SPEAKER_00: Is that also a common, like when they feel strained, rust, or like hyperventilating?
• 22:47
  SPEAKER_02: Yes.
• 22:47
  SPEAKER_00: And then they run out of air when they're trying to talk, exercise?
• 22:50
  SPEAKER_02: Yes.
• 22:51
  SPEAKER_02: So that has to do with the subglottic pressure, which is the air pressure in our vocal folds.
• 22:56
  SPEAKER_02: And when there's too much, uh, some kids talk really fast because they have to get everything out on one breath.
• 23:03
  SPEAKER_02: Or some kids are really quiet because they're not taking a full breath to be able to articulate.
• 23:09
  SPEAKER_02: So um it can go both ways.
• 23:11
  SPEAKER_00: Interesting.
• 23:11
  SPEAKER_00: Subglottal.
• 23:12
  SPEAKER_00: I'm like, okay.
• 23:14
  SPEAKER_00: And that's where your vocal cords are located.
• 23:16
  unknown: Yes.
• 23:17
  SPEAKER_00: Interesting.
• 23:17
  SPEAKER_00: Okay, I never really did that stuff.
• 23:18
  SPEAKER_00: Yeah, that's cool.
• 23:20
  SPEAKER_00: That's that's interesting.
• 23:22
  SPEAKER_00: Um yeah, so the with diaphragmatic breathing, chest breathing, um, the tongue position, like how does that play a role?
• 23:32
  SPEAKER_02: Well, if you are breathing through your mouth with your mouth open and your tongue rested low, then we can almost always assume that you're not breathing with your diaphragm because for that diaphragmatic breath, you're breathing through your nose, your your belly is expanding.
• 23:48
  SPEAKER_02: And then a lot of kids learn.
• 23:51
  SPEAKER_02: I don't know if this is like a gym class thing or who teaches this, but breathing in through your nose and then out through your mouth.
• 23:58
  SPEAKER_02: I've heard it a bunch of times where people say, in through your nose, out through your mouth.
• 24:02
  SPEAKER_02: And I'm like, in through your nose, out through your nose.
• 24:04
  SPEAKER_00: I love them.
• 24:05
  SPEAKER_02: That's what we're teaching.
• 24:06
  SPEAKER_00: That's a good question.
• 24:07
  SPEAKER_00: I don't know where I've heard.
• 24:08
  SPEAKER_00: I mean, I've heard that a thousand times too.
• 24:09
  SPEAKER_00: I don't know like where that came up.
• 24:10
  SPEAKER_00: I I would imagine it has to be just a mental um, like just uh um like a mental game uh exercise just for yeah, mental and there's nothing, I'm sure there's nothing wrong with it for maybe regulation and relaxing.
• 24:25
  SPEAKER_02: And there are times where we need that breath through our mouth, but for everyday breathing, it's important to let children know it's in through your nose, out through your nose.
• 24:34
  SPEAKER_02: So that um, because again, everything is about where your tongue is resting.
• 24:39
  SPEAKER_02: You're not able to get that diaphragm breath if your tongue is resting low and your mouth is open.
• 24:44
  SPEAKER_00: Interesting.
• 24:45
  SPEAKER_00: I'm trying to write now, it's weird.
• 24:49
  SPEAKER_00: Um, the uh I was gonna ask something.
• 24:52
  SPEAKER_00: Um children run out of air.
• 24:55
  SPEAKER_00: Oh, oh, uh stuttering.
• 24:57
  SPEAKER_00: So, like my son stutters a lot too.
• 24:58
  SPEAKER_00: I was like, I did the same exact thing.
• 25:00
  SPEAKER_00: He'll like say this, it's like and and then and I'm like, okay, let's go.
• 25:04
  SPEAKER_00: You know, we get we need to get in the car.
• 25:05
  SPEAKER_00: Yeah.
• 25:06
  SPEAKER_00: Or like go wherever we're going.
• 25:07
  SPEAKER_00: Um, does that I would imagine that also affects them running out of air or because their ability to like just not articulate what they're trying to say and it feeds in a poor breathing pattern.
• 25:18
  SPEAKER_02: Well, what I'm gonna tell you is don't rush Colt anymore.
• 25:21
  SPEAKER_02: Okay.
• 25:21
  SPEAKER_02: Because that's we want low pressure, okay, to be able to take our time when speaking, um, and to get into our speech slowly.
• 25:30
  SPEAKER_02: So for stutterers, we say a slower speech, maybe a little rhythmic.
• 25:34
  SPEAKER_00: Okay.
• 25:34
  SPEAKER_02: Yeah.
• 25:35
  SPEAKER_00: Good to know.
• 25:36
  SPEAKER_00: I'll do that today, you know?
• 25:38
  SPEAKER_00: Problem like totally changed trajectory.
• 25:41
  SPEAKER_00: Um so it's some kind of pressure, um, too little pressure, too much pressure, and then unstable pressure.
• 25:49
  SPEAKER_00: What's that lead to?
• 25:52
  SPEAKER_02: Um great question.
• 25:53
  SPEAKER_00: Well, like wait, what I mean is like you wrote down like um like weak and imprecise consonants, okay.
• 25:59
  SPEAKER_00: Too much pressure, excessive tension and distortion, and then inconsistent articulation just with unstable pressure.
• 26:06
  SPEAKER_02: So like So too little pressure means not enough breath to get out the full sentence.
• 26:11
  SPEAKER_02: So those consonants, maybe they're dropping the ends of words.
• 26:14
  SPEAKER_02: You know, if you've ever heard a kid who uh isn't finishing his words completely, that's too little pressure.
• 26:20
  SPEAKER_00: Okay.
• 26:21
  SPEAKER_00: Um too much pressure.
• 26:24
  SPEAKER_02: Too much pressure.
• 26:26
  SPEAKER_00: Excessive tension and distortion.
• 26:28
  SPEAKER_00: Yes.
• 26:28
  SPEAKER_02: That's what's that's what I was talking about with people who are maybe over-articulating and they're rushing out their words.
• 26:34
  SPEAKER_02: So then it's imprecise because they're talking so fast.
• 26:37
  SPEAKER_02: It happens a lot when kids are reading and they're reading so fast that you, if you're reading the same thing, you notice that they're dropping off words or mixing things up, and you think maybe it's a reading problem, but sometimes it's a breath, a breath problem because they're not taking a big enough inhale um to be able to finish the entire sentence and to continue on reading for a full paragraph.
• 27:01
  SPEAKER_00: Yeah.
• 27:02
  SPEAKER_00: Okay, cool.
• 27:03
  SPEAKER_00: And then unstable pressure, but just inconsistency.
• 27:05
  SPEAKER_02: Yes.
• 27:06
  SPEAKER_00: Same thing.
• 27:07
  SPEAKER_02: Yeah.
• 27:07
  SPEAKER_00: Yeah.
• 27:08
  SPEAKER_02: Neither or.
• 27:09
  SPEAKER_00: So how do you teach kids like imagine like a four-year-old or five-year-old or something, like teaching diaphragmatic breathing?
• 27:15
  SPEAKER_00: Like, what how do you how do you go about that?
• 27:17
  SPEAKER_02: We have a couple of exercises.
• 27:19
  SPEAKER_02: We try to keep them playful.
• 27:22
  SPEAKER_02: I like to tell, I like to lay kids on their back and say we're taking something for a ride.
• 27:28
  SPEAKER_02: Um, because if you put something on their stomach, they can see the little object raise when they're taking that belly breath.
• 27:34
  SPEAKER_02: If they're not taking a belly breath, that little object, whatever it is, is not going to move.
• 27:39
  SPEAKER_02: Um, that's a really fun one.
• 27:41
  SPEAKER_02: And then for kids that are maybe using their shoulders to breathe a lot, I lay them on their stomach and um their head is in their hands, and they take a big breath, and we should be able to see it on the floor, like they're pushing away from the floor, and we see that belly moving, and we take the shoulders out of it because they're laid on their stomach.
• 27:59
  SPEAKER_00: Oh, cool.
• 27:59
  SPEAKER_00: Yeah, yeah, good.
• 28:01
  SPEAKER_00: Yeah.
• 28:01
  SPEAKER_00: Um, so with parents not monitoring their parents' breathing or their kids' breathing, um, yeah, what what do you recommend for parents to like keep an eye on this?
• 28:16
  SPEAKER_00: So, like, watch them when they breathe.
• 28:19
  SPEAKER_00: Just breathing at rest should be quiet nose, nasal breathing.
• 28:24
  SPEAKER_02: Quiet breathing.
• 28:25
  SPEAKER_02: Your child should hear your child's breathing.
• 28:27
  SPEAKER_02: Their lips should definitely be closed.
• 28:29
  SPEAKER_02: If you see any drooling or during the day, if you see them sitting with their mouth open, that would definitely be a red flag.
• 28:37
  SPEAKER_02: When they're sleeping, if you are hearing snoring um or their mouth open, that would be a red flag.
• 28:44
  SPEAKER_02: Or if they have restless sleep, they're waking up a lot in the middle of the night.
• 28:47
  SPEAKER_02: Um, because sleep is heavily impacted by the way we breathe.
• 28:51
  SPEAKER_00: Yeah, totally.
• 28:51
  SPEAKER_00: I mean, whenever I'm sick and my nose is stuffy, it's the worst.
• 28:54
  SPEAKER_02: Exactly.
• 28:56
  SPEAKER_02: We've all been there.
• 28:57
  SPEAKER_00: Yeah.
• 28:57
  SPEAKER_00: What do you recommend for that?
• 28:59
  SPEAKER_02: Um, well, something for airway.
• 29:02
  SPEAKER_02: Um, it's called a boom boom stick.
• 29:04
  SPEAKER_02: Have you ever seen it or heard of it?
• 29:07
  SPEAKER_02: It's like this little stick that clears your airway, or they also make nasal sprays.
• 29:11
  SPEAKER_02: Yeah.
• 29:12
  SPEAKER_02: Those are the best.
• 29:13
  SPEAKER_02: Nasal spray or the boom boom stick for sure.
• 29:16
  SPEAKER_02: And then if you're a mouth breather as an adult and you have no airway obstruction, you can also try mouth taping.
• 29:23
  SPEAKER_02: It's very popular now.
• 29:25
  SPEAKER_02: I only recommend it if I know that there's no airway obstruction because you don't want two obstructions.
• 29:31
  SPEAKER_00: Yeah, totally.
• 29:32
  SPEAKER_02: But um, mouth taping works.
• 29:34
  SPEAKER_00: I was gonna ask.
• 29:34
  SPEAKER_00: Oh, so mouth taping is it's a good one as long as your nose is good.
• 29:37
  SPEAKER_00: Yes.
• 29:37
  SPEAKER_00: What about the nasal strips to like open up your nostrils?
• 29:40
  SPEAKER_02: I've seen those.
• 29:41
  SPEAKER_02: Um, it's not something I've recommended because I don't know much about it.
• 29:45
  SPEAKER_02: We're more into the mouth tape.
• 29:47
  SPEAKER_00: Okay.
• 29:47
  SPEAKER_02: But I'm sure anything that opens up your airway is a good thing for sleeping at least.
• 29:52
  SPEAKER_00: I've had people, uh a good number of people, like um, they said they've done mouth tape.
• 29:58
  SPEAKER_00: Because we talk about sleep posture a lot with everybody, just with neck pain, shoulder pain, back pain, whatever.
• 30:04
  SPEAKER_00: Um, and they, yeah, people are like, well, it's hard for me to lay my back or whatever because I, you know, a mouth breather.
• 30:09
  SPEAKER_00: I'm like, okay, incline your pillows, put try mouth tape as long as your nose is good, you know.
• 30:15
  SPEAKER_00: I could try to like make somebody suffocating moves.
• 30:16
  SPEAKER_02: I was getting the one with that has the slit in the middle.
• 30:18
  SPEAKER_02: There's only one that I recommend.
• 30:20
  SPEAKER_02: It's called Myotape.
• 30:21
  SPEAKER_00: Okay.
• 30:22
  SPEAKER_02: And it's a really good brand.
• 30:23
  SPEAKER_00: All right, good to know.
• 30:24
  SPEAKER_00: I'll keep that, I'll keep that in my back pocket.
• 30:27
  SPEAKER_00: Um, but yeah, the uh I actually had another patient that they were getting palate therapy.
• 30:33
  SPEAKER_00: They're like an adult, right?
• 30:34
  SPEAKER_00: They're the grown guy.
• 30:35
  SPEAKER_00: He was in his 40s, and he was going to a um like a manual therapist, a cranial sacral type of therapist and getting palate therapy where he's spreading his palate.
• 30:45
  SPEAKER_02: Yeah.
• 30:46
  SPEAKER_00: Have you have you heard that before?
• 30:47
  SPEAKER_02: Yeah, palate expansion.
• 30:48
  SPEAKER_00: That what means like manual versus like orthodontic.
• 30:51
  SPEAKER_02: Oh, oh no.
• 30:52
  SPEAKER_02: What did they do for that?
• 30:54
  SPEAKER_02: How is it?
• 30:54
  SPEAKER_02: They manually expand it.
• 30:56
  SPEAKER_00: Well, they put their thumbs in their mouth and then they will like open up their palate.
• 31:00
  SPEAKER_00: Yeah.
• 31:01
  SPEAKER_02: Is that real?
• 31:02
  SPEAKER_00: Yeah, yeah.
• 31:03
  SPEAKER_02: So your palate fuses together at a certain age.
• 31:06
  SPEAKER_02: So, no, I have not heard of that.
• 31:07
  SPEAKER_00: I spoke to this therapist on the phone because they were like, she wants to talk to you and meet you.
• 31:11
  SPEAKER_00: And I was like, Cool.
• 31:12
  SPEAKER_00: Uh, you know, she was a unique individual, you know.
• 31:17
  SPEAKER_02: That seems very holistic.
• 31:18
  SPEAKER_00: Yes, very good, you know, very granola.
• 31:20
  SPEAKER_02: Yeah.
• 31:21
  SPEAKER_00: But um, everybody, you know, everybody has their own personality and flavor with that they bring to the table, and then patients, each each individual patient has their own flavor they like.
• 31:32
  SPEAKER_00: You know?
• 31:33
  SPEAKER_02: Yeah.
• 31:33
  SPEAKER_00: Um, there's very spiritual individuals, and then there's your granola, and then there's also very like just pathoanatomical in black and white, you know, orthopedic surgeons would be in that boat, probably.
• 31:44
  SPEAKER_00: And then cranial sycal therapists and yogis, and you know, they'd be on that other end.
• 31:49
  SPEAKER_02: Yes.
• 31:49
  SPEAKER_00: She was on that end, which is cool.
• 31:51
  SPEAKER_00: You know, it has this like it.
• 31:53
  SPEAKER_02: Is he okay?
• 31:54
  SPEAKER_02: He says you heard from him since he's a unique individual.
• 31:57
  SPEAKER_00: Okay.
• 31:58
  SPEAKER_00: Uh, a lot of interesting stories I can tell you off the mic, but uh he was probably a mouth breather as a kid.
• 32:04
  SPEAKER_00: Probably.
• 32:04
  SPEAKER_02: That's why it all goes into adulthood.
• 32:06
  SPEAKER_02: You don't know how hard dating is once you look at someone's mouth and everything gives you the ick.
• 32:11
  SPEAKER_00: Interesting.
• 32:12
  SPEAKER_02: A lot of adults with deviated septums that need that fixed.
• 32:16
  SPEAKER_00: Huh.
• 32:16
  SPEAKER_00: That's good to I it's also it's mouth breathers.
• 32:19
  SPEAKER_00: Yeah.
• 32:20
  SPEAKER_00: It's funny as like as a PT, like we'll do the same thing with just like walking patterns or posture and like the way they move, whatever.
• 32:26
  SPEAKER_00: Yeah.
• 32:27
  SPEAKER_02: But you do that with you can't unsee it.
• 32:29
  SPEAKER_00: It's so funny.
• 32:31
  SPEAKER_00: Um yeah.
• 32:32
  SPEAKER_00: So what do you look at?
• 32:33
  SPEAKER_00: What do you look at for that?
• 32:35
  SPEAKER_02: I'm just always looking at the face.
• 32:37
  SPEAKER_02: But I I did, I don't know if I should say this on here.
• 32:39
  SPEAKER_02: You're gonna cut this, right?
• 32:40
  SPEAKER_00: We'll see.
• 32:41
  SPEAKER_02: We'll um the last person I dated had a deviated septum, but I noticed it on the first date.
• 32:46
  SPEAKER_02: It didn't really bother me.
• 32:47
  SPEAKER_02: I guess he masked his mouth breathing.
• 32:49
  SPEAKER_02: And then after that, all I saw was mouth breathing and it drove me crazy.
• 32:54
  SPEAKER_02: I took him to a doctor myself and he got the surgery for it.
• 32:57
  SPEAKER_02: But then we broke up.
• 32:58
  SPEAKER_00: Oh my gosh.
• 32:59
  SPEAKER_02: I did get him the surgery.
• 33:01
  SPEAKER_02: Well, at least he was miserable.
• 33:02
  SPEAKER_02: He had um a deviated septum with turbinates, which is like big balloons in your nose of pressure.
• 33:09
  SPEAKER_02: Um and yeah.
• 33:10
  SPEAKER_00: Wow.
• 33:12
  SPEAKER_02: But you can't unsee it.
• 33:13
  SPEAKER_02: That's it's not, it's a deal breaker.
• 33:15
  SPEAKER_00: I mean, yeah, like you know, if you're hanging out with somebody that long.
• 33:18
  SPEAKER_02: Yeah.
• 33:19
  SPEAKER_00: I feel like something for me that is I don't know, is this similar kind of thing, but like the way that they chew and they eat.
• 33:25
  SPEAKER_00: If they're like loud chewers, I'm like, yo, we can't do that.
• 33:28
  SPEAKER_02: That's probably a myofunctional thing too.
• 33:31
  SPEAKER_00: Interesting.
• 33:31
  SPEAKER_02: It is at all, it's all connected.
• 33:34
  SPEAKER_02: Anything that has to do with the face and mouth.
• 33:37
  SPEAKER_00: Interesting.
• 33:37
  SPEAKER_00: Yeah.
• 33:38
  SPEAKER_00: That's that anyway, that's a big pet peeve.
• 33:40
  SPEAKER_00: Chewing loud, too.
• 33:41
  SPEAKER_00: Like, have some consideration.
• 33:43
  SPEAKER_00: But it could have been that they were a mouth breather the whole time when they were a kid.
• 33:45
  SPEAKER_00: Some kind of a tie, maybe.
• 33:47
  SPEAKER_00: It's not their fault.
• 33:48
  SPEAKER_02: It's not their fault.
• 33:49
  SPEAKER_00: Like, why are you being so inconsiderate?
• 33:51
  SPEAKER_00: This is absolutely atrocious, you know, atrocious to listen to.
• 33:54
  SPEAKER_00: Um, that's funny.
• 33:55
  SPEAKER_00: What what about snoring?
• 33:56
  SPEAKER_00: What about snoring?
• 33:57
  SPEAKER_00: Is that something related to palate?
• 34:00
  SPEAKER_02: Airway obstruction.
• 34:00
  SPEAKER_00: Is it airway obstruction?
• 34:02
  SPEAKER_02: And and could be palate, because if you're snoring, your mouth is open.
• 34:07
  SPEAKER_02: And if you're open mouth breathing while you're sleeping, you might be open mouth breathing during the day too.
• 34:13
  SPEAKER_02: So that's how it's all connected.
• 34:14
  SPEAKER_00: It just facilitates it more.
• 34:15
  SPEAKER_00: Yeah.
• 34:16
  SPEAKER_00: So let's say a grown man.
• 34:17
  SPEAKER_00: Fortunately, I really don't sleep.
• 34:19
  SPEAKER_00: It's not me.
• 34:19
  SPEAKER_00: Okay.
• 34:19
  SPEAKER_00: I really don't snore in my sleep.
• 34:21
  SPEAKER_00: But um, what would you yeah, would you recommend speech pathology, some kind of evaluation on that for them?
• 34:27
  SPEAKER_02: It really depends on what's causing the snoring.
• 34:30
  SPEAKER_02: In some cases, it's it could be allergies that need to be looked at.
• 34:36
  SPEAKER_02: It could be the deviated septum.
• 34:38
  SPEAKER_02: It could be habit because prolonged mouth breathing it it creates this habit of mouth breathing.
• 34:46
  SPEAKER_02: That's all you know.
• 34:46
  SPEAKER_02: Your mouth is open and you don't even realize it's open, just like our mouth is closed, but we don't realize it's closed.
• 34:52
  SPEAKER_02: So finding out why the snoring is happening is really important.
• 34:56
  SPEAKER_00: So let's say it was mouth breathing habit.
• 34:59
  SPEAKER_00: Would the interventions of speech pathology-related interventions be helpful?
• 35:02
  SPEAKER_02: This would be fall more under myofunctional therapy.
• 35:05
  SPEAKER_02: And I would say that is where maybe mouth tape would come in handy because maybe they're only snoring because they're only opening their mouth at night, and the mouth tape would help with that.
• 35:15
  SPEAKER_00: Interesting.
• 35:16
  SPEAKER_00: Yeah.
• 35:17
  SPEAKER_00: Um, oh, I was also gonna ask about TMJ dysfunction, like TMJ issues.
• 35:22
  SPEAKER_00: Um, because we've done some TMJ therapy re interventions for people, rehab.
• 35:28
  SPEAKER_00: Um, and we have to go get sometimes you got to go in their mouth and like mobilize their their mandible and stuff.
• 35:33
  SPEAKER_00: Um, and that's this one patient I was talking about, similar kind of he was having similar things like that, and um, some TMJ interventions with the same therapist that he was saying.
• 35:43
  SPEAKER_00: And then any one of the things too was palate widening.
• 35:45
  SPEAKER_00: And she was like, Yeah, you really need to widen your palate.
• 35:47
  SPEAKER_00: So get gloves on, get in there, and then doing some TMJ mobilizations and interventions, some soft tissue work of like the pterygoids and the masseter, stuff like that.
• 35:57
  SPEAKER_00: But then yeah, then widening the palette.
• 35:59
  SPEAKER_02: Yeah, that does sound like craniosacral therapy.
• 36:01
  SPEAKER_02: Is that what that therapist was?
• 36:02
  SPEAKER_00: Yeah, I think so.
• 36:04
  SPEAKER_00: Yeah.
• 36:04
  SPEAKER_00: Um, and they she actually came in and met me.
• 36:08
  SPEAKER_00: Um, I forgot, and she brought me the notebook of her interventions that she was doing her own photos in plastic sheets and a notebook in a notebook.
• 36:19
  SPEAKER_00: Um, I was I was like, wow, thank you for this.
• 36:22
  SPEAKER_00: You know, this is awesome.
• 36:23
  unknown: Yeah.
• 36:25
  SPEAKER_02: I did use more tools for your toolbox.
• 36:27
  SPEAKER_00: Yeah, more tools for my toolbox, man.
• 36:28
  SPEAKER_00: I've like, I and I love that you're passionate about what you do, you know.
• 36:32
  SPEAKER_00: It's just not what I do.
• 36:33
  SPEAKER_00: You know, I'm sorry.
• 36:34
  SPEAKER_00: But uh, and that's I'm when we need you, you know, people need you too.
• 36:37
  SPEAKER_00: But yeah, she was cranial sacral therapy.
• 36:39
  SPEAKER_00: And it was, yeah, it's just interesting.
• 36:42
  SPEAKER_00: Um, do you see a lot of TMJ stuff?
• 36:44
  SPEAKER_02: Actually, no, I think that would fall more into the adult category as the children.
• 36:49
  SPEAKER_02: I'm not seeing that as much.
• 36:51
  SPEAKER_00: Okay.
• 36:51
  SPEAKER_00: I know some like um older teenagers, you know, um can develop some some necks, stuff like that.
• 36:59
  SPEAKER_00: But it's interesting is like um the relationship between neck issues like cervical dysfunction and then TMJ, they're super you know closely related.
• 37:09
  SPEAKER_00: Um so you haven't really seen any of that.
• 37:12
  SPEAKER_01: No, not so much.
• 37:13
  SPEAKER_00: Any of your do some piece of speech pathology pathologists in school, they do do they go that direction for adult treatments?
• 37:20
  SPEAKER_02: I would assume at at clinics, definitely not in schools.
• 37:24
  SPEAKER_02: Um, schools actually were not allowed to touch the mouth at all.
• 37:27
  SPEAKER_02: There's no, for the most part, feeding therapy or myofunctional therapy that takes place in schools, which is why, like I said before, it's so contradictory because if a child is on for a speech sound disorder, but I feel like they need that intervention in their mouth, you really can't treat it.
• 37:45
  SPEAKER_00: So when do you do that?
• 37:46
  SPEAKER_00: Like post like inner um as soon as you graduate doing on-site training.
• 37:52
  SPEAKER_02: When I graduated 10-ish years ago, we didn't get any training on myofunctional therapy.
• 37:59
  SPEAKER_02: It was not really even a thing yet.
• 38:03
  SPEAKER_02: It wasn't as popular as it is now.
• 38:05
  SPEAKER_02: Of course, there was research on it dating way back, but our grad schools and postgrad did not prepare us for this.
• 38:12
  SPEAKER_02: So this was all outside training.
• 38:15
  SPEAKER_00: Interesting.
• 38:15
  SPEAKER_02: And usually myofunctional therapists can actually be dental hygienists as well.
• 38:19
  SPEAKER_02: Some people go can become myofunctional therapists without the speech therapy component.
• 38:24
  SPEAKER_02: I like both because most of my kids have a swallowing um issue as well, or a speech issue as well.
• 38:33
  SPEAKER_02: And we can treat all of that.
• 38:34
  SPEAKER_02: Yeah.
• 38:35
  SPEAKER_02: It falls in our scope.
• 38:36
  SPEAKER_00: Yeah, yeah.
• 38:36
  SPEAKER_00: It makes total sense.
• 38:38
  SPEAKER_00: Uh yeah, for swallowing interventions, what do you do?
• 38:41
  SPEAKER_00: Like, how do you teach that?
• 38:45
  SPEAKER_02: There is a swallow and sip um little program in our myofunctional program, and it all falls back to, again, tongue posture and tongue placement.
• 38:54
  SPEAKER_02: Okay.
• 38:55
  SPEAKER_02: So we swallow without food first, with our tongue up and just our saliva, and then we introduce food.
• 39:03
  SPEAKER_02: But we have to um take into consideration the tongue because we don't realize that our tongue is what's pushing the food back, right?
• 39:11
  SPEAKER_02: So a child who has a tongue tie, whose tongue is restricted down to the bottom of their mouth, they're not able to chew their food on both sides of their mouth, which is also very important.
• 39:22
  SPEAKER_02: So we need to make sure that their tongue is has had enough exercise and is able to move lateralize.
• 39:30
  SPEAKER_02: Um, a good check for that is seeing if your child can touch their molars with their tongue.
• 39:36
  SPEAKER_02: That's how you know that their tongue can go in all directions.
• 39:40
  SPEAKER_02: They're able to move their food from side to side with their tongue.
• 39:43
  SPEAKER_02: And then the elevation piece, like being able to put your tongue to the roof of your mouth, is how you push the food back.
• 39:49
  SPEAKER_02: So kids who chew with their mouth open are probably restricted in some area and they're they're compensating, they're chewing with their mouth open.
• 39:58
  SPEAKER_02: They might only be chewing on one side of Their mouth or just in the front of their mouth.
• 40:02
  SPEAKER_02: Um, they might usually in swallowing therapy.
• 40:05
  SPEAKER_02: After I think I did this with Colt, he ate something.
• 40:09
  SPEAKER_02: And afterwards, I had him open his mouth because I wanted to see if there was any residue on his tongue so that I would be able to determine if he was propelling his food back.
• 40:17
  SPEAKER_00: Yeah.
• 40:18
  SPEAKER_02: And there was no residue.
• 40:20
  SPEAKER_00: He when he when he wants to be, he's a good eater.
• 40:23
  SPEAKER_01: Yeah.
• 40:24
  SPEAKER_00: He was, yeah, he was the not the best eater of all three of my kids.
• 40:29
  SPEAKER_00: My baby right now.
• 40:30
  SPEAKER_00: Oh my gosh.
• 40:30
  SPEAKER_00: You've seen Mavs, right?
• 40:31
  SPEAKER_00: Maverick?
• 40:32
  SPEAKER_00: Oh my gosh.
• 40:32
  SPEAKER_00: He's a tank.
• 40:33
  SPEAKER_02: All your kids are so tall, too.
• 40:35
  SPEAKER_02: Pretty tall.
• 40:36
  SPEAKER_02: I'm like, you're only three.
• 40:38
  SPEAKER_00: Yeah.
• 40:39
  SPEAKER_02: He's as big as some of my like six, seven.
• 40:41
  SPEAKER_00: Really?
• 40:42
  unknown: Yeah.
• 40:42
  SPEAKER_00: Wow.
• 40:43
  SPEAKER_00: Okay.
• 40:44
  SPEAKER_02: He's tall.
• 40:45
  SPEAKER_00: Yeah.
• 40:45
  SPEAKER_00: He's, I mean, you know, we'll we'll see.
• 40:49
  SPEAKER_00: But uh, yeah, he he didn't he ate the he didn't eat the mo the best of all of our kids.
• 40:55
  SPEAKER_00: Um, but he eats good now.
• 40:56
  SPEAKER_00: Like when he wants to, he can eat when he's incentivized, you know.
• 40:59
  SPEAKER_02: Yeah.
• 41:00
  SPEAKER_00: Um, and it's interesting as though they he did not suck his thumb and my baby did not suck his thumb.
• 41:05
  SPEAKER_02: But you're older.
• 41:06
  SPEAKER_00: My daughter did.
• 41:06
  SPEAKER_02: Interesting.
• 41:07
  SPEAKER_00: Colt would suck his um his hand like this.
• 41:10
  SPEAKER_00: He would suck right here, and he'll he would have a blister.
• 41:13
  SPEAKER_01: Yeah.
• 41:13
  SPEAKER_00: So we couldn't find his thumb.
• 41:14
  SPEAKER_00: And my wife, Nicole, was like, just find your thumb, you'll fall back asleep.
• 41:18
  SPEAKER_00: And I was like, Well, we don't want him to suck his thumb, right?
• 41:20
  SPEAKER_01: Yeah.
• 41:21
  SPEAKER_00: I'm talking to you.
• 41:21
  SPEAKER_00: We're like, I'm definitely glad we didn't, you know.
• 41:23
  SPEAKER_01: Yeah.
• 41:24
  SPEAKER_00: I'm gonna be more, I'm gonna be a little more like rigid, I think, tonight, starting the night with my daughter, be like, we're done.
• 41:29
  SPEAKER_00: Yeah.
• 41:30
  SPEAKER_00: You can be, you can wear the princess glove.
• 41:32
  SPEAKER_02: You can wear both of them pictures of of funky smiles and be like, this is what you're gonna look like.
• 41:37
  SPEAKER_00: Do you want to look like this?
• 41:38
  SPEAKER_00: Yeah.
• 41:38
  SPEAKER_00: Yeah.
• 41:38
  SPEAKER_00: For prom when you're 16, 17?
• 41:40
  SPEAKER_00: Exactly.
• 41:40
  SPEAKER_00: She's not ready for that.
• 41:41
  SPEAKER_00: She doesn't know what that is yet.
• 41:43
  SPEAKER_00: No, I'm not ready.
• 41:44
  SPEAKER_00: I'm not ready for that.
• 41:46
  SPEAKER_00: Um, but yeah, so it's so yeah, they didn't, they both didn't suck their thumb, which is a good thing.
• 41:51
  SPEAKER_00: Um, Mav hasn't done any of that at all, you know.
• 41:55
  SPEAKER_00: Um like any hand sucking or anything.
• 41:57
  SPEAKER_02: Does he have a pacifier?
• 41:58
  SPEAKER_02: No, perfect.
• 42:00
  SPEAKER_00: None of them really took my daughter took a pacifier a little bit, um, and then trusted to her thumb.
• 42:05
  SPEAKER_02: We say to get the pacifier out by 12 months.
• 42:08
  SPEAKER_02: Oh 11 to 12 months.
• 42:10
  SPEAKER_02: Okay, yeah.
• 42:11
  SPEAKER_02: We see I I've seen four-year-olds on a baby bottle still.
• 42:16
  SPEAKER_02: No, a baby bottle.
• 42:19
  SPEAKER_00: What's that conversation look like?
• 42:23
  SPEAKER_02: I mean, at the end of the day, a parent is going to do what they want to do and what they feel is best.
• 42:28
  SPEAKER_01: Yeah.
• 42:28
  SPEAKER_02: And they're gonna comfort their child the way they want to comfort their child.
• 42:31
  SPEAKER_02: And I'm just here to say what might happen in the future with your dentitian and your speech and all the other effects that it might have.
• 42:41
  SPEAKER_02: But at the end of the day, it's your choice if you need to give your child the pacifier at three years old.
• 42:46
  SPEAKER_02: They're they're just gonna have a different smile.
• 42:50
  SPEAKER_00: What what's the reception like?
• 42:51
  SPEAKER_00: Is that how you is that how you present that conversation?
• 42:54
  SPEAKER_02: I do.
• 42:54
  SPEAKER_02: I I make sure that parents realize all of the effects of it because even again with bottle feeding, um, you really want to see children off the bottle and eating regular food by 12 months because they need their jaw developed.
• 43:11
  SPEAKER_02: And what develops our jaw is chewing, chewing meats, chewing things that are tough.
• 43:16
  SPEAKER_02: Otherwise, you see the buckle fat pads for longer where kids would have chunky cheeks for a long time because their jaw is not developing.
• 43:25
  SPEAKER_00: Um interesting.
• 43:27
  SPEAKER_02: So most parents take it well though, when I say, you know, there's also something called bottle rot, where the your two front teeth, or you know, a lot of your front teeth kind of decay because milk has so much sugar.
• 43:40
  SPEAKER_02: Um and yeah, and formula and all those things.
• 43:44
  SPEAKER_02: So parents are usually pretty receptive, but some parents are like, I just can't.
• 43:48
  SPEAKER_02: He just won't give it up, or he cries.
• 43:50
  SPEAKER_02: And we try to do, you know, a pacifier fairy and all the things, but you know, sometimes parents decided it is what it is and they're not ready, and that's your family's decision.
• 44:02
  SPEAKER_00: Okay.
• 44:03
  SPEAKER_00: That's uh, I don't know.
• 44:04
  SPEAKER_02: I'm only here to educate.
• 44:06
  SPEAKER_00: Yeah, I'm sure you see a lot more moms and dads.
• 44:08
  SPEAKER_02: Yes.
• 44:09
  SPEAKER_00: Yeah.
• 44:09
  SPEAKER_00: Are do any dads besides myself come in?
• 44:11
  SPEAKER_02: Well, you don't come in anymore.
• 44:13
  SPEAKER_00: I know.
• 44:13
  SPEAKER_00: It was the first time.
• 44:14
  SPEAKER_02: Maybe for an evaluation.
• 44:16
  SPEAKER_02: For an evaluation, I usually see both parents, and then after that, it's mostly moms.
• 44:20
  SPEAKER_02: There's about two dads that come in currently.
• 44:22
  SPEAKER_00: Okay.
• 44:23
  SPEAKER_02: Two of 30.
• 44:24
  SPEAKER_00: Yeah, I I bet.
• 44:26
  SPEAKER_02: Yeah.
• 44:26
  SPEAKER_00: I uh I mean, at moms and dads, I mean, I totally have a different, I have a different lens, you know, and like well, so does my wife, you know, which we need that.
• 44:35
  SPEAKER_00: It's super important.
• 44:36
  SPEAKER_01: Yes.
• 44:37
  SPEAKER_00: Um, yeah, I've, you know, I've I'm like, I'm not as affected by crying, you know.
• 44:43
  SPEAKER_00: Yeah, I am affected by dad.
• 44:47
  SPEAKER_02: There's one little girl.
• 44:48
  SPEAKER_02: I tell the mom, I'm like, she's playing you because dad brings her in, there's not one tear, she's in and out.
• 44:55
  SPEAKER_02: Happy smiles.
• 44:57
  SPEAKER_00: Have I had my own opinion on that?
• 45:01
  SPEAKER_00: I I totally agree, in my opinion.
• 45:04
  SPEAKER_00: It's because they know they can manipulate mom.
• 45:05
  SPEAKER_00: Yeah.
• 45:06
  SPEAKER_01: Yeah.
• 45:06
  SPEAKER_00: I'm just like, no, the answer is no, you know, sorry.
• 45:08
  SPEAKER_00: They're like, we're doing this, this is the option, you know.
• 45:10
  SPEAKER_00: Um, yeah.
• 45:12
  SPEAKER_00: They're as soon as mom gets home, it's like a lot of whining and crying, and I'm like, they were not like this five minutes ago.
• 45:18
  SPEAKER_02: Yeah.
• 45:19
  SPEAKER_02: I see it all the time.
• 45:20
  SPEAKER_00: It's so funny.
• 45:22
  SPEAKER_00: But uh, but you know, that's just they're more comfortable with mom, you know.
• 45:25
  SPEAKER_00: That's what I've heard.
• 45:26
  SPEAKER_00: The best explanation, a more comforting explanation was that the kids feel more comfortable with mom to express their true feelings.
• 45:34
  SPEAKER_00: I was like, it's a very nice, soft, sugar-coated way to bring it up.
• 45:39
  SPEAKER_01: Yes.
• 45:40
  SPEAKER_00: But uh, it's really funny because my kids do the same thing, man.
• 45:43
  SPEAKER_00: As soon as my mom, my wife gets home in, it's like, man, they we were chill.
• 45:47
  SPEAKER_00: We were having fun.
• 45:48
  SPEAKER_02: Well, I see all three of them when they come in.
• 45:50
  SPEAKER_02: Yeah, oh yeah.
• 45:51
  SPEAKER_00: Oh, yeah, Blake comes.
• 45:52
  SPEAKER_00: How is she in there?
• 45:53
  SPEAKER_02: Loves to play.
• 45:54
  SPEAKER_02: Oh, she wants to be right back there.
• 45:56
  SPEAKER_02: She's like, Do you want me to walk you back?
• 45:57
  SPEAKER_00: Yeah, she'll come back with us.
• 45:59
  SPEAKER_00: She's awesome.
• 45:59
  SPEAKER_00: She's adorable.
• 46:00
  SPEAKER_00: Have you seen her teeth?
• 46:01
  SPEAKER_00: I'm sure you've seen.
• 46:02
  SPEAKER_02: I have.
• 46:02
  SPEAKER_00: Yeah.
• 46:03
  SPEAKER_00: You're like, You suck your thumb.
• 46:04
  SPEAKER_00: Yeah.
• 46:05
  SPEAKER_00: Okay.
• 46:05
  SPEAKER_00: So you knew I forgot that she went to come see you because they go after she pushed up from school.
• 46:09
  SPEAKER_00: That's really funny.
• 46:10
  SPEAKER_02: She was pushing someone on the swing the other day.
• 46:12
  SPEAKER_02: She gets right up in there.
• 46:14
  SPEAKER_00: Yeah, she she's very friendly.
• 46:16
  SPEAKER_00: She tells all the stories.
• 46:19
  SPEAKER_00: She gets all up in there.
• 46:20
  SPEAKER_02: Yeah.
• 46:21
  SPEAKER_00: Yeah.
• 46:21
  SPEAKER_00: They're uh they're energetic for sure.
• 46:24
  SPEAKER_00: Uh, but hopefully not too distracting.
• 46:25
  SPEAKER_02: Like, not at all.
• 46:27
  SPEAKER_02: You wait in the waiting room.
• 46:28
  SPEAKER_02: They just like to come back initially and maybe at the end.
• 46:30
  SPEAKER_00: Okay.
• 46:31
  SPEAKER_02: It's fun.
• 46:32
  SPEAKER_00: Good.
• 46:32
  SPEAKER_02: I allow it.
• 46:33
  SPEAKER_02: You know, we're very easy there.
• 46:34
  SPEAKER_00: Friendly.
• 46:35
  SPEAKER_02: Yeah.
• 46:36
  SPEAKER_00: Um, but so oh, so I was gonna ask.
• 46:38
  SPEAKER_00: Okay.
• 46:39
  SPEAKER_00: So the the conversation with um, you know, parents are gonna do what they want to do.
• 46:43
  SPEAKER_00: They um if they're not ready, they're not ready.
• 46:47
  SPEAKER_00: Um has anybody uh given a really bad response been like, I can't believe you bring that up, we're not doing that at all?
• 46:54
  SPEAKER_00: Or if people are usually understandable?
• 46:56
  SPEAKER_02: Most parents say, I know.
• 46:59
  SPEAKER_02: Okay.
• 46:59
  SPEAKER_02: They they already know that they're facilitating this behavior, maybe, and they usually say, I know, we're just not ready.
• 47:08
  SPEAKER_00: Okay.
• 47:08
  SPEAKER_00: So anybody ever blow up on you?
• 47:12
  SPEAKER_00: Okay, good.
• 47:13
  SPEAKER_02: I think my delivery is kind enough that and again, they they trust the um professional advice.
• 47:20
  SPEAKER_02: And again, it's just my opinion.
• 47:22
  SPEAKER_01: Yeah, right, exactly.
• 47:24
  SPEAKER_02: Whatever they want and go anywhere they want.
• 47:26
  SPEAKER_02: And that's the again, the great thing about private practice is that you kind of choose your clients and they choose you.
• 47:32
  SPEAKER_01: Yeah.
• 47:33
  SPEAKER_02: So if I run across a parent who really isn't going to implement anything I'm saying, after a couple of months, if we see no progress, I might say, I might not be the right therapist for you because I'm asking you to do this and this, and um, there's no follow through, and your child's not gonna see any progress with me.
• 47:54
  SPEAKER_01: Okay.
• 47:55
  SPEAKER_01: What's that?
• 47:56
  SPEAKER_01: What's that conversation?
• 47:57
  SPEAKER_02: I've I've said that probably only twice um in the past three years.
• 48:03
  SPEAKER_02: And it's just because some families are against a surgical approach, which again is totally their um decision.
• 48:12
  SPEAKER_02: I think it should be a team-based decision, a family decision.
• 48:15
  SPEAKER_00: Yeah, totally.
• 48:15
  SPEAKER_02: But but parents are understanding after that.
• 48:19
  SPEAKER_00: Yeah, interesting.
• 48:20
  SPEAKER_00: I've actually thinking back, like I've had, and then we'll we'll land the plane, but um, I had uh one situation in particular, this guy like he didn't blow up on me, but I I swear I was being very I thought I was being super tactful and just like inquisitive, you know, I'm just like sharing thoughts, you know.
• 48:39
  SPEAKER_00: But um, he was like in his 50s or 60s, but he had like this shoulder and elbow issue and playing a lot of sport golf or whatever.
• 48:46
  SPEAKER_00: This was a couple years ago.
• 48:47
  SPEAKER_00: So not even not my own practice, it was somewhere else.
• 48:50
  SPEAKER_00: But um, I was like, hey, so like you know, sleeping position, and you say it hurts in the morning, it doesn't hurt when you go to bed.
• 48:55
  SPEAKER_00: Uh how do you sleep?
• 48:57
  SPEAKER_00: He's like, Well, I sleep on my right side.
• 48:58
  SPEAKER_00: I'm like, Well, that's the arm that hurts.
• 48:59
  SPEAKER_00: It might be important, it could be influential to not sleep on your right side to give the thing a break.
• 49:04
  SPEAKER_00: It's contributing maybe to the sensitivity.
• 49:05
  SPEAKER_00: He's like, Hold on a second.
• 49:07
  SPEAKER_00: He's like, What where'd you go to school?
• 49:08
  SPEAKER_00: How old are you?
• 49:09
  SPEAKER_00: He's like, You're gonna tell me I've been sleeping like this for 35 years.
• 49:12
  SPEAKER_00: Like, I'm like, bro, the 35 years conversation, like, dude, relax.
• 49:15
  SPEAKER_00: You know, I'm just sharing information that might be helpful and applicable for your arm issue that you're sleeping on that might be contributing to some issues and not allowing it to be better.
• 49:24
  SPEAKER_00: Anyway, he was not happy with that.
• 49:26
  SPEAKER_00: And I was like, Whoa, man, like, I feel really defensive right now.
• 49:29
  SPEAKER_00: Like, I'm sorry, you feel like I'm attacking you.
• 49:31
  SPEAKER_02: Uh, it's because you see adults.
• 49:33
  SPEAKER_02: I think people are a little more kinder about their kids.
• 49:36
  SPEAKER_00: Yeah, you yeah.
• 49:37
  SPEAKER_00: A little softer and like, yeah, yeah.
• 49:39
  SPEAKER_02: Um, and for a lot of people, it might be their first time having kids and their first kids, so they don't really know, so they're just appreciative of any and all input.
• 49:47
  SPEAKER_00: Insights and help, yeah, totally, for sure.
• 49:49
  SPEAKER_00: But that was uh, and I was like, like Ashman, relax, you know.
• 49:54
  SPEAKER_00: Um, but anyway, but thanks for coming in.
• 49:57
  SPEAKER_01: Thank you.
• 49:57
  SPEAKER_00: Um, if people want to reach out to you, how's the best way to get in contact with you?
• 50:02
  SPEAKER_02: Probably on Instagram, special kids speech.
• 50:05
  SPEAKER_02: You can find my website on there, message me on my website.
• 50:08
  SPEAKER_02: Okay, my phone number is on there too.
• 50:10
  SPEAKER_00: So special kids speech on Instagram or website, and they can DM you there or inquire on your website.
• 50:16
  SPEAKER_02: Yeah.
• 50:16
  SPEAKER_00: Is that how Nicole reached out to you or she called?
• 50:19
  SPEAKER_02: She called.
• 50:20
  SPEAKER_00: She called.
• 50:20
  SPEAKER_00: Okay.
• 50:21
  SPEAKER_02: Might have found me on Google.
• 50:22
  SPEAKER_00: Yeah, or Google.
• 50:23
  SPEAKER_00: All right, cool.
• 50:23
  SPEAKER_00: Awesome.
• 50:24
  SPEAKER_00: Well, thanks again for coming in.
• 50:25
  SPEAKER_00: And um don't hesitate to reach out to Dr.
• 50:27
  SPEAKER_00: Christina if you have any kids that are battling any uh speech issues or swallowing and things you might need, she might need to help you out with.
• 50:36
  SPEAKER_00: And if you have any questions or comments, concerns with me, like please don't hesitate to reach out.
• 50:39
  SPEAKER_00: Any orthopedic sports related pain issues.
• 50:42
  SPEAKER_00: We'd love to at least talk on the phone and and give you some insights and some direction.
• 50:46
  SPEAKER_00: And uh catch y'all next time.