Infant Feeding
Feeding is the process of eating or drinking. It includes what your baby’s mouth and tongue are doing before and when they swallow. Any difficulty with this process can be stressful in those first few months and affect not only feeding, but sleep patterns as well.
What are some possible red flags for Baby?
- Difficulty with latching onto the breast or the bottle
- Leaking milk while drinking from the breast or the bottle
- Preference for the bottle over the breast
- Excessive sleepiness
- Chronic open mouth breathing
- Fast or noisy breathing
- Poor weight gain
- Less than expected wet and/or soiled diapers
- Ongoing feeding difficulties even after support from a lactation consultant
- Signs of distress while feeding such as:
- Coughing
- Choking
- Spitting up
- Hiccuping
- Refusing
- Falling asleep
- Crying
- Back arching
What are some possible red flags for Mom?
- Pain while breastfeeding
- Creased, flattened, blanched (i.e., white in color), blistered, or bleeding nipples
- Still feeling full of milk in breasts after feedings
- Plugged milk ducts
- Infected nipples or breasts
- Mastitis (i.e., inflammation and/or infection of the breast tissue)
Why consider treatment?
Because it doesn’t have to be this hard! Ongoing feeding difficulties can be very stressful not only for mom and baby but for the entire family unit.
Treatment from a trained professional can impact all aspects of infant feeding. Successful feeding in infancy leads to typical development of the face and oral structures necessary to safely and easily transition to solid foods in the future. It also results in efficient breathing patterns, development of a typical swallowing pattern, and age-appropriate speech sound acquisition.
SOS (Sensory Oral Sequential) Approach to Feeding
The SOS Approach focuses on increasing a child’s comfort level by exploring and learning about the different properties of food.
The program allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her, then moving on to managing the smell of the foods, learning about how foods feel on the body and in their mouth, and then enjoying tasting and eating new foods following the Steps to Eating.
What are some possible red flags?
- Eats a restricted range/variety of foods
- less than 30 different foods (10 fruits/vegetables, 10 proteins, 10 grains)
- Cries or “falls apart” when presented with new or disliked foods
- Difficulty trying or touching new foods
- Ongoing problems with vomiting or more than one incident of nasal reflux
- Refuses entire categories of food textures or groups
- Eats the same foods for every meal/snack
- Prefers snacking/grazing vs sitting down for mealtimes
- Requires different foods at meals than the rest of the family
- No longer likes/eats favorite foods
- Frequently pushes food away on plate/table
- Refuses entire categories of food textures or groups
- Minimal chewing or swallowing
- Frequent gagging/choking/coughing
- Covers face with hands or turns entire body away from plate
- Inconsistent eating patterns
- (i.e. may like a food one day and then not eat it the next)
Why consider treatment?
The earlier you can begin working with a child who is struggling to eat, the faster you will see changes.
It is much easier to change a 2 year old’s relationship to food than a 12 year old’s; however, feeding therapy can help make mealtimes more enjoyable for people of all ages! Adults can even benefit from these strategies.
Tongue Thrust Therapy & Orofacial Myofunctional Therapy
An Orofacial Myofunctional Disorder can impact many aspects of daily life including posture, breathing, drinking, eating, and talking.
OMD includes behaviors and patterns created by inappropriate muscle function and incorrect habits involving the tongue, lips, jaw, and face (IAOM, 2014).
What are some possible red flags?
- Chronic mouth breathing and/or forward tongue position while breathing
- Abnormal dental alignment (e.g., anterior open bite ~ when molars make contact and incisors to not)
- Tongue thrust/inverted swallowing patterns
- Picky eating and/or food texture avoidance
- Difficulty forming a food bolus (i.e., messy eating)
- Persistent speech sound errors and/or recurring speech sound errors following speech therapy
- Prolonged use of pacifier, bottle, and/or sippy cup
- Prolonged oral habits (e.g., thumb sucking)
- Limited tongue range of motion
- (i.e., difficulty clearing food from cheeks/molars or sticking tongue out to lick an ice cream cone)
- Difficulty with feeding/swallowing at birth
- Sleeping problems or snoring
- Facial pain (i.e., jaw or neck pain)
- Clenching or grinding teeth
- Headaches
Why should I consider treatment?
If not addressed, Orofacial Myofunctional Disorders can have a lifelong impact on facial symmetry/appearance, dental alignment, speech articulation, sleep health, focus/attention, and overall quality of life.
Improvements from treatment can be seen in a matter of weeks and can reduce the potential for relapse following orthodontic intervention. Consider the following before and after pictures. This patient was referred by her orthodontist and presented with the following symptoms: forward tongue position while breathing, difficulty forming a food bolus, tongue thrust/inverted swallowing pattern, mouth breathing, and speech sound errors. Upon completion of our program, all of her symptoms were resolved.
Dyslexia & Reading Services
Red Door offers the Barton Reading and Spelling Program for children and teens who struggle in the area of reading, spelling, and writing.
The Barton System is a structured literacy program that utilizes a multi-sensory approach that is direct, explicit, structured and sequentially intense. This program is implemented at Red Door by certified teachers trained in this approach. The Barton system is researched, evidence-based, and has been proven to drastically improve the areas of reading listed above.
What are some possible red flags?
- Confuses letters that look similar (e.g., b/d, u/m, m/n)
- Confuses letters that sound the same (e.g., v/f/th)
- Reverses or transposes words when reading or writing (e.g., was/saw)
- Confuses small words (e.g., a, an, of, the, on, for, from)
- Difficulty learning sight words
- Decreased fluency when reading
- Difficulty tracking with finger or keeping correct place, frequently loses his/her place
- Difficulty with reading comprehension
- Difficulty with spelling
- Illegible and/or grammatically incorrect writing
- Difficulty following directional phrases such as: (e.g., left/right, over/under, up/down, east/west)
- Difficulty telling time
- Difficulty with sequencing daily tasks (e.g., shoe tying, getting dressed)
- Confuses mathematical symbols
- Discrepancy between verbal and written proficiency
- Difficulty organizing time or materials
- Inconsistency with classwork and subjects
- Family history of dyslexia or similar difficulties/learning problems
- Currently receiving reading support in school
Why consider treatment?
Treatment is crucial to facilitate life-long skills related to reading, writing, spelling, and math.
Intervention is necessary to provide the appropriate kind of tutoring, at the necessary frequency, at the right time in development (i.e., early elementary years). A diagnosis followed by one-on-one tutoring will also likely reduce the risk of future negative impacts on self-concept and emotional health.
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Social Communication Therapy
A Social Communication Disorder refers to a child’s difficulty with interpreting and using language (both verbal and nonverbal) in functional and expected ways.
It impacts the ability to participate successfully in groups, build/maintain relationships, and adapt to others effectively across contexts. It encompasses problems with social interaction, social understanding, and pragmatics (i.e., using language in the proper context). While all individuals with autism spectrum disorder have pragmatic problems, children without autism can also have a Social Communication Disorder.
What are some possible red flags?
Difficulty initiating language (i.e., self advocacy);
tendency to withdraw or avoid instead of using language skills to seek assistance and/or information; these children may have difficulty asking for help, asking questions to gain information, seeking clarification, and initiating appropriate social entrance and exit with people
Difficulty conceptualizing to a larger whole (i.e., getting the “big picture,”);
tendency to think in parts instead of fully relate pieces of information back to a larger pattern of behavior or thought; difficulty with reading comprehension, determining main idea, and following subplots; these children may have difficulty with reading comprehension, summarizing, understanding social and academic information, and organization
Difficulty understanding perspective (i.e., theory of mind);
tendency to think about their own thoughts and feelings even when in a group setting; difficulty understanding the needs, emotions, thoughts, beliefs, experiences, motives, intentions, expectations, and personality of others in order to respond appropriately; difficulty participating groups; difficulty with obligatory tasks not of their choosing; limited knowledge of what it means to participate in a relationship
Difficulty solving problems (i.e., executive function);
difficulty creating organizational structures that allow for flexibility and prioritization.; these individuals crave structure but have difficulty creating it; difficulty managing homework and predicting time to complete tasks
Difficulty interpreting abstract and inferential language (i.e., reading between the lines);
tendency to be black and white/rigid/literal in thinking; tendency to miss information communicated nonverbally (e.g., eye gaze, gesture, facial expression, and posture) resulting in difficulty understanding the total communicative messages and making sense of one’s surroundings (especially when in a group); difficulty understanding humor; difficulty knowing if they are being laughed at versus being laughed with and/or may produce inappropriate humor (Winner, 2007)
Why seek treatment?
Treatment is valuable as children with pure social communication needs are unlikely to qualify for services at school.
They generally have good grades, good test scores, average to above average IQs, and are not seen as having “educational problems.” At Red Door Pediatric Therapy, we understand that education not only includes academic knowledge but also includes preparing children to be effective communicators, critical thinkers, and problem solvers (i.e., social communication).