picky eating - Creative Speech Therapy NYC

10 Things I’ve Learned Listening to Speech Therapists in the Room Next to Me the Past Two Years

Rachael Rose — Tue, 27 Feb 2024 21:24:20 +0000

From the Mouths of Babes: 10 Things I've Learned From Our Clients and Speech Therapists

I’ve had the unique opportunity of working as the office manager and marketing director for Creative Speech Therapy NYC for almost two years. Creative Speech Therapy NYC is a private speech and feeding therapy clinic on the upper east side of Manhattan. There, the highly trained therapists strive to collaborate with parents and children’s teams to ensure the most holistic approach to therapy possible.

A job I fell into through nannying, I’ve basically been given a crash course on speech therapy, feeding therapy, and the dynamics of families whose children need those services. I feel so lucky to have absorbed so much incredible knowledge hearing therapy sessions in the room next to me and speaking with parents and families of clients. Here are 10 things I’ve learned and want to pass on:

1. A therapist trained in orofacial myology can work wonders
“Neuromuscular re-education” or “re-patterning” of the oral and facial muscles may include mouth, face and tongue exercises, and strategies to facilitate proper feeding, swallowing and oral rest tongue posture (Source). Meaning, they can help a child stop drooling, prevent dental problems, improve picky eating, and stop chronic mouth breathing. I highly recommend googling this topic because it is INCREDIBLE what speech therapists can prevent and fix when they’re specially trained in this area.

(See the below pictures for what can be done to correct issues like mouth breathing by a speech therapist trained in orofacial myology and what happens when its left untreated. Click on the pictures to learn more about the individual.)

2. Snoring is never normal
Snoring can happen to anyone now and then, but no one should snore chronically – this includes your kids. It’s often indicative of a serious health condition. It can also lead to poor sleep habits, behavioral issues, and poor diet. Speech therapists are a great resource in finding the cause and helping treat whatever may be going on. They also usually have relationships with ENTs, dentists, and other providers who can help and be referred to.

3. Picky eating is rarely a child trying to be difficult or stubborn
Most picky eating habits result from structural issues in the mouth like a child not being able to manipulate certain textures or a sensory aversion to a certain texture or taste. These poor chewing and swallowing skills or aversions often result in a child’s distrust of food. Feeling unsafe chewing/swallowing, gagging, being force fed, or feeling intense pressure to eat a certain thing or amount create picky eaters/problem feeders. Even if a child matures and develops the skills to manipulate a food later on, the picky eating can persevere as a result of past experiences. A feeding therapist (speech language pathologist) can help them both overcome their structural issues with physical exercises or overcome the psychology behind eating those “scary foods.” Therapists also coach the family on how to properly feed their child and what kind of environment to create. Kids don’t want to disappoint their parents, sometimes food is genuinely terrifying! Learn more about feeding therapy, here.

4. Stuttering is one small part of what speech therapists do
TV and movies had me believing that stuttering was 90% of what speech therapy covers. I’ve learned that stuttering/fluency is more of a specialty and not all therapists are focused on cases of stuttering. Articulation, language delays, social/pragmatic language, receptive and expressive language disorders, gestalt language learning, feeding therapy, oral motor re-education, and so much more take up a large amount of a speech therapist’s case load.

5. A diagnosis is meant to be helpful not a limitation
Pursuing a diagnosis is a personal decision and every family should do it in their own time. On that note, it has been a beautiful thing for me to see a diagnosis provide clarity and direction to helping children live fully and proudly. I’m not a parent and I can only assume that getting a diagnosis like autism or a learning disability for your child can be scary and overwhelming. Remember that a licensed provider’s assessment can simply help them understand why they act or communicate a certain way, it won’t change anything about who they are. It can be an empowering step to mark the beginning of them (and you) learning how to advocate for their needs, which will become increasingly more important in school and in their future career.

6. Kids in NYC are the busiest people on the planet
I’m in constant disbelief of how these tiny humans have such packed calendars. Incredible that they get it all done.

7. Insurance will almost always deny you, but don’t give up
When it comes to private pay/out of network services, parents are willing to pay a bit more to get a higher quality of service. However, these high quality services should not only be for a small select crowd of people who can afford it. As I’ve worked with families trying to get these services reimbursed by their insurance, I’ve seen that with patience and determination, it is very possible to get something worked out with your insurance company. Sometimes it only takes speaking to the right helpful representative. Nothing is definite when it comes to insurance, but don’t lose hope and always remember to be your own greatest advocate.

8. A good therapist will be transparent and collaborative
It takes a village to raise a child and so it goes with therapy. The best providers will want to refer you to other specialists to treat your child holistically (like an ENT or occupational therapist). They will want to communicate with you about your child’s progress and use transparent language to help you get accurate help.

9. The key to progress is consistency
Daily practice and commitment, even for a short amount of time, cannot be understated.

10. Autism really is a spectrum
Autism spectrum disorder is a fascinating and beautiful way that some people move through the world. It has been eye opening for me to see children come in with such different levels and techniques of communicating. Check out this cool article about one way people with autism acquire language.

Speech therapy is a vast field. It is unique in that it’s providers need to be skilled in both creative and data driven work. It’s science and its also personal intuition. I’m so grateful there are people who dedicate their lives to this vital skill and that I’ve been able to be a fly on the wall absorbing all their knowledge.

Written by: Jane Wright, Office Manager/Marketing

The post 10 Things I’ve Learned Listening to Speech Therapists in the Room Next to Me the Past Two Years first appeared on Creative Speech Therapy NYC.

Stress Free Meals in 2024

Rachael Rose — Fri, 05 Jan 2024 17:41:30 +0000

Stress Free Meals in 2024

Making new year’s resolutions this year? Improving stressful mealtimes at home are a great addition to the list of things you want to improve. And guess what? Its absolutely possible. Here are my top four tips to make this year run more smoothly for your family and especially your picky eaters.

1. Encourage mealtime and snacks at a scheduled time each day

We typically encourage children to eat three meals and two snacks a day. We also like for these times to be spaced out by two hours. When we keep mealtimes consistent everyday, it helps our children’s bodies to regulate around food. They can feel hunger cues and then satiation cues. These are lifelong skills that will help them develop a healthy relationship with food.

2. Introduce a transition activity before mealtime

We have busy lives and our days are full; however, when we eat a meal we should try to shed that stress and sit down to a calm table. Using transitions is a very helpful way to alert your children that they are going to do a new activity and also a great way to separate the stress of the day from mealtimes. I often suggest to parents to give a five minute warning to kids before the meal, have children help set the table, and wash their hands before sitting down to the table. Rituals like this are important because we can do them with little thinking – they allow our minds to rest. In feeding therapy, we use songs during transitions as well. You could make a family mealtime song or simply turn on calming and soft music to signal it’s mealtime.

3. All members of the family should sit at the table together

This is a hard one due to our busy schedules, but it’s an important aspect of feeding for your children. There is significant research to show that children eat more and eat better when they are eating with their family members. Kids want to please their parents and they want approval. Eating together builds trust between parent and child as well. This is another way to prevent picky eating. Think about what changes you can make in your home to make it more pleasurable for everyone. This is where thinking about nourishment and nutrition come in to play. You don’t want to get into a battle with your children at mealtimes. It makes you both feel frustrated and can cause feelings of anxiety in your children. They don’t want to feel that they are disappointing you – help set them up for success!

4. Family meals should be served to all members of the family sitting at the table

It is the adult’s job to set the menu and decide what the family will eat at the meal. That said, you should always provide at least one food that your child willingly eats. Imagine you sat down at a restaurant and you start to peruse the menu. You see nothing that you like on the menu. Are you going to stay at the table and order non-preferred foods? Probably not. Imagine if you look at the menu and see a dish that contains one thing you like and one thing you don’t like. You are more likely to order the dish and you may even pick at and try that food you “don’t like”. That’s what it’s like for your child when they sit down at the table and are served some preferred foods and non-preferred foods.

Members in your family may have different favorites and that’s okay. What is important is that everyone be offered all the foods on the table. When we limit the foods we serve to only preferred foods, the child doesn’t even have the opportunity to try a new food. Exposure to new foods gives your children the “opportunity” rather than a “demand.” Even better, if you serve food family style on platters, kids have to pass a non-preferred food from one family member to another, and they will smell it. That’s exposure!

Written by: Rachael Rose, Owner/Founder

The post Stress Free Meals in 2024 first appeared on Creative Speech Therapy NYC.

What Does Pediatric Feeding Therapy Look Like?

Rachael Rose — Mon, 23 Oct 2023 20:52:34 +0000

What Does Pediatric Feeding Therapy Look Like?

Pediatric feeding therapy is a personalized and holistic approach to support children in developing healthy eating habits and fostering a positive relationship with food. Feeding therapy is a specialized area of therapy that focuses on addressing a child’s difficulties related to eating, feeding, and mealtime behaviors. The treatment approach will depend on the root cause. For example, a child may have difficulty with the motor movements necessary to masticate food or sensory deficits such as overstuffing, gagging or aversion to the sight, smell or taste of food. Feeding is a complex task that involves all of our eight senses. Imagine how overwhelming this may be for your child if they are averse to a strong smell or frightened of the way a food item looks on their plate.

The good news is, feeding therapy can be creative and fun! A session often includes controlled exposure to different foods, textures, colors, and smells. This gradual approach allows children to acclimate to unfamiliar foods at their preferred speed, alleviates anxiety, improves nutritional intake, and rebuilds enjoyment to mealtimes.

The main approach I use with my picky/problem eaters during sessions is The SOS Approach to Feeding. The SOS Approach stands for “Sequential Oral Sensory,” and is a holistic and systematic approach to pediatric feeding therapy. It was developed by Dr. Kay Toomey, a pediatric psychologist, and Dr. Erin Ross, an occupational therapist. This approach is designed to address the multifaceted issues that many children with feeding difficulties face, including sensory aversions, oral motor challenges, and behavioral concerns. In SOS, we use children’s intrinsic motivation, allow children to move up and down the feeding hierarchy at their own pace, teach that learning to eat can be enjoyable and empower families to take part in the feeding journey.

We get messy during feeding sessions! From an early age, I advise parents to embrace messiness. This allows the full sensory experience – to touch and feel the diverse food textures. Children absorb knowledge most efficiently through play, so what better way to approach mealtime than through playful exploration. If a child’s goal is to progress toward eating crunchy snacks we may use veggie sticks as drums or pretend we are an alien with antennas. This motivates a child to progress through the feeding hierarchy, starting with food touching their hands and moving closer to eventually consuming the food.

I also love incorporating fun tools into feeding therapy. One effective tool is a silicone ice cube tray, which not only serves to separate foods but also presents them in a creative and novel fashion. This encourages individuals to sample a wide range of foods in a new and exciting way. Other tools include decorating laminated pictures, making food kebabs, using vegetable/fruit cutter shapes to cut out the food using them as stamps or decoration. Exploring food during a time that is not mealtime sets up a calm and pressure free environment. These are great tips to carryover in the home environment!

You can also involve your child in meal preparation and the preparations leading up to the meal. Sometimes taking your child food shopping will take the unknown out of what will be prepared for the week. This allows your child to build control and confidence surrounding food. Also, including your child in meal preparation may encourage exploration of novel foods. Have your child cut vegetables with child- safe knives, wear a chef’s hat or set the table. Keep in mind each individual’s feeding journey is different and one strategy may be helpful for one child and intimidating for another.

Feeding therapy is more than just getting a child to eat. In reality we do not “get” a child to eat but help them to learn that exploring food is fun and playful! Feeding therapy is about helping the individual gain confidence surrounding food and improve the relationship with food. We want to create a pressure-free zone where children are safe to experiment with different food textures. Keep in mind that every path is unique, and feeding therapy may employ a range of strategies and approaches!

Book Resources

Stories of Extreme Picky Eating by Jennifer Friedman

Helping Your Child With Extreme Picky Eating by Katja Rowel M.D, Jenny Mcglothin

Tool Resources

Silicone Ice Cube Tray

Kid Safe Knives

Vegetable/Fruit Cutters for Kids

Written by: Siena Cardamone Viviano M.S. CCC-SLP, TSSLD
Speech-Language Pathologist/Feeding Therapist

The post What Does Pediatric Feeding Therapy Look Like? first appeared on Creative Speech Therapy NYC.

Picky Eaters & Meal Prep

Rachael Rose — Thu, 21 Sep 2023 17:17:55 +0000

Picky Eaters & Meal Prep

In May we partnered with Elia of, Feed Your Sister, to chat all things picky eating and meal prep. Elia is a meal prep GENIUS! She has piles of knowledge and resources for you and your family. She offers in-home services, online courses, and downloads to promote self-care through meal prep, kitchen organization, and healthy stress free meals. We loved chatting with her and adding in our theraputic knowledge of picky eaters to her experience with meal preparation. We are so excited to share that conversation, summed up below (in blog form!)

Preparing meals in advance is a wonderful way to help your picky eater. When food is ready to serve at mealtime, the stress of cooking evaporates and leaves you time to connect with your child and have a family meal. The importance of family meals cannot be overstated. Picky eaters benefit from eating together as a family in several ways:

Developing mealtime conversational skills will carry over into schooltime lunches and help your little one learn more social skills. It will also get them ready to eat at restaurants and in new environments.
Learning self-feeding and utensil use, especially when your child is transitioning to solids, is foundational to their comfortability in eating as they grow. Just watching you eat is a great example for them to imitate.
Mindful eating will become their go-to. Mindless eating, with an iPad or TV to distract them, can lead to worse picky eating and obesity.

So, you have your prepared meal ready to go, family assembled, table set…how can you make the family meal as productive as possible for your picky little one?

Expose them to new foods by serving items on platters and showing them what you’re eating. Even if they don’t eat the same thing as you during the meal, exposure to new food is a great step in expanding their diet. Platters can be a great tool when they are passed around the table. The exposure of seeing, smelling, and touching new foods in a safe environment will help them build up their resolve to try something new! The more exposure the better.
Have an “all done” bowl on the table. This will not only help with mess, but it will eliminate their chance to escape the meal if they don’t want to eat something. They can simply place something in the bowl and move on to something else. You can use the bowl too!
Use dips! If your child likes a dip such as ketchup, BBQ sauce, or ranch, it can help them try a new food by masking it with a flavor they know and like already.
Remember that not all foods may be safe for little ones with structural issues. If your child is struggling to transition to solids, they may need to see a feeding therapist to uncover why. When kids lack the skills needed to eat a specific texture, they quickly learn that food is “unsafe.” Kids spit out unsafe foods and will most likely refuse that food in the future. Parents often confuse spitting out foods as picky eating, but it is actually an anti-choking protective mechanism. Once your baby gains the necessary skills to safely chew and swallow a texture of food, you can safely re-introduce that food into your child’s/baby’s diet.

Our values go hand in hand with the values of Feed Your Sister. We want mealtimes to be less stressful, which Elia does via meal prep and we do it with feeding therapy. But the goal is having a healthy and joyful relationship with food no matter what! Family meals are one of the most important foundations you can build for a positive lifelong relationship with food and eating. It’s never too early to eat as a family.

For kid-friendly recipes and meal ideas, check out Elia’s Prep & Party: Baby & Toddler Edition replay. And definitely add her naked turkey pesto meatballs and miso maple chicken to your next meal plan. Both recipes are always a hit for the entire family!

If you struggle with meal planning for your picky eaters, drop in to the next Prep & Party with Elia. And be sure to follow her on social media to catch all the newest updates to Feed Your Sister

Written by: Rachael Rose, Owner/Found of Creative Speech Therapy NYC and Elia Wolberger of Feed Your Sister

The post Picky Eaters & Meal Prep first appeared on Creative Speech Therapy NYC.