4 Surprising Ways to Help Your Kids LOVE Vegetables (That Have Nothing to Do With Eating or Cooking)

Helping your child love vegetables can start outside of the kitchen. 

Problem is, those strategies might make a kid eat, but he’ll likely still hate vegetables. The key is to help kids learn to love vegetables while taking the tension out of family mealtimes. Here are four surprising ways, backed by research, that you can help your kids learn to accept (and even love!) vegetables…

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Tongue Tie: Why I Can’t Wait for the Research

By Melanie Potock, MA, CCC-SLP

I’m in the trenches. I’m the one holding a mom’s hands while she tears up and asks me why her baby can’t eat solid foods after the GI test results can’t pinpoint a problem. I’m having delicate, respectful discussions with physicians, but who insist that “If the baby can bottle feed with that tongue, then they can learn to eat solids with that tongue” or worse, “Don’t worry if he can’t breast feed, he’ll be eating solids soon and won’t need the breast.”  I’ve had preschoolers finally end up on my caseload after seeing several different medical professionals (including geneticists), but never a feeding professional. It’s what spurred me on to write three articles for the American Speech Language Hearing Association – Just Flip the Lip and Tip Back the Tongue. Later, I shared my clinical observations in the article Three Structures in A Child’s Mouth that Can Cause Picky Eating.

From my perspective, I can’t wait for the research on ankyloglossia (tongue-tie) in order to further determine how tethered oral tissues might be impacting an individual child’s functional skills for feeding. As a professional, I have the utmost respect for evidence based practice.  If I child can’t move his tongue adequately for safe chewing and swallowing, it’s my job to determine why, with or without a study. Problem is, that child can’t wait for multiple studies to support what I see in plain sight as an experienced clinician. I’m going to consider all the possibilities impacting a child’s ability to eat in an age-appropriate manner using my differential diagnosis skills. I don’t see tethered oral tissues in all my clients, but the ones that are clearly tied can’t manipulate food safely.  It may not be the only culprit, but I’m not going to ignore what’s right in front of me.

Would we question an occupational therapist’s clinical observations if they reported that a child’s fine motor skills were delayed due to syndactyly (webbing of the fingers)?  Would we expect that OT to provide months of therapy to rule out other causes for the child’s motor challenges before discussing their clinical observations with the pediatrician, hand surgeon or other members of that child’s team? Would we question a physical therapist’s clinical observations if they reported that a child’s gross motor delay was related to progressive heel-cord contractures?  At some point, it comes down to clinical experience and knowledgeable assessment skills, an understanding of typical development, a respect for the family’s concerns and frankly, decent eyesight.

On one hand, I can’t wait for the research!  I want to learn more! We need it, but for now, I’m in the trenches.

In short, I can’t wait for the research because it’s not fair to these families.  My job is to assess function for feeding.  It’s pretty clear to me when I’m evaluating a child’s oral motor skills and her tongue has limited range of movement because of a tie.  As a feeding specialist, I know the range of movement necessary for safe and comfortable eating.  I can’t wait for the research and I think that’s enough of a reason to speak up and help these kids.


To learn what research we do have, and what we know so far, check out this post on the Talk Tools website, as well as their new book being released soon!

Functional Assessment of Feeding Challenges in Children with Ankyloglossia by Robyn Merkel-Walsh, MA, CCC-SLP & Lori Overland, MS, CCC-SLP, C/NDT, CLC.  In this excellent article highlighting Walsh and Overland’s presentation at the 2017 American Speech Language Hearing Association, the following references were provided:

References:

American Academy of Breastfeeding Medicine (AABM). (2016). Protocol # 11: Guidelines for the evaluation and management of neonatal ankyloglossia and its complications in the breastfeeding dyad. Retrieved from: http://www.bfmed.org/Media/Files/Protocols/ankyloglossia.pdf

Amir, L.H., James, J.P. & Donath, S.M. (2006). Reliability of the Hazelbaker assessment tool for lingual frenulum function. International Breastfeeding Journal, 1(3).

American Speech-Language-Hearing Association (2015). ICD-10-CM Diagnosis Codes for Audiology and Speech-Language Pathology Preparing for Implementation. Retrieved from: http://www.asha.org/Practice/reimbursement/coding/ICD-10/

Boyd, K. (2014). Impact of tongue-tie over a lifetime: an anthropological perspective. Presentation at the IATP 2nd World Summit. Montreal, Quebec.

de Castro Martinelli, R.L., Marchesan, I.Q., Gusmao, R.J., de Castro Rodrigues, A. & Berretin-Felix, G. (2014). Histological characteristics of altered human lingual frenulum. International Journal of Pediatrics and Child Health, 2, 5-9.

Ferres-Amat, E., Pastor-Vera, T., Ferres-Amat, E., Mareque-Bueno, J., Prats-Armengol, J. & Ferres-Padro, E. (2016). Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol. Journal of Oral Medicine and Pathology, 1:21 (1):39-47

Francis, D.O., Chinnadurai, S., Morad, A., Epstein, R.A., Kohanim, S., Krishnaswami, S., Sathe, N.A. & McPheeters, M.L. (2015). Treatments for ankyloglossia and ankyloglossia with concomitant lip-tie. Comparative Effectiveness Reviews, No. 149. Agency for Healthcare Research and Quality. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK299120/.

International Affiliation of Tongue-Tie Professionals (2016). Classification. Retrieved from: http://tonguetieprofessionals.org/about/assessment/classification/

Kummer, A. (2016). To clip or not to clip? That’s the question. Presented at the annual convention of The American Speech-Language-Hearing Association. Philadelphia, PA.

Martinelli, R.L., Marchesan, I.Q., & Berretin-Felix, G. (2012). Lingual Frenulum Protocol with Scores for Infants. International Journal of Orofacial Myology, 38, 104-113.

Merdad, H. & Mascarenhas, A.K. (2010). Ankyloglossia may cause breastfeeding, tongue mobility, and speech difficulties, with inconclusive results on treatment choices. Journal of Evidence-Based Dental Practice, 10(3):152-3.

Messner, A.H. & Lalakea, M.L. (2000). Ankyloglossia: controversies in management. International Journal of Pediatric Otorhinolaryngology, 54(2):123-31.

Overland, L. & Merkel-Walsh, R. (2013). A sensory-motor approach to feeding. Charleston, SC: TalkTools.

Sethi N., Smith D., Kortequee S., Ward V.M. & Clarke S. (2013). Benefits of frenulotomy in infants with ankyloglossia. International Journal of Pediatric Otorhinolaryngology, 77(5): 762-5.

Head’s UP! I just pre-ordered the new book by Walsh and Overland: Functional Assessment and Remediation of TOTs.  You can order it here for the pre-sale price, as of today, for 50% off, on the Talk Tools website.

 

 

 

Remembering Sandy Hook: How to Live Like a First Grader

By Melanie Potock

As a speech-language pathologist who works with young children in their homes and schools, it’s impossible for me not think of the heartbreak at Sandy Hook Elementary School this time of year. Shortly after the tragedy in 2012, I made a list of some simple things I can do to honor those precious lives taken on December 14th. Every year, I plan to add to the list. This new year, I promise to embrace life more like a first grader in memory of the children and the young-at-heart adults who will always be missed by their families and communities. I plan to…

Read more on the ASHA LEADER BLOG >>

You Want My Kid to Play in Food? Seriously?

By Melanie Potock

Yep, seriously. For many kids, food exploration begins with just learning to tolerate messy hands and faces. Many parents who bring their kids to feeding therapy have one goal in mind: Eating. In fact, as a pediatric feeding therapist, a common phrase I hear when observing families at their dinner tables is, “Quit playing with your food and just eat it!”

Read more on the ASHA Leader Blog >>

Make a Choice: Food Police or Food Education

By Melanie Potock, MA, CCC-SLP

In Aurora, CO, a preschool teacher in a public school setting would not allow 4 year-old Natalee Pearson to eat the Oreo cookies in her home-packed lunch. Instead, a note reprimanding the mother’s choice to include cookies was sent home to Natalee’s mother, who had also packed a sandwich and fruit. The note read:

“Dear Parents, It is very important that all students have a nutritious lunch. This is a public school setting and all children are required to have a fruit, a vegetable, and a healthy snack from home, along with milk. If they have potatoes, the child will also need bread to go along with it. Lunchables, chips, fruit snacks, and peanut butter are not considered to be a healthy snack. This is a very important part of our program and we need everyone’s participation.”

Read more on The Laboratory >>

How to Track Food Exposures and Expand Food Variety for Selective Eaters

By Melanie Potock

Research shows a child takes eight to 15 exposures to a new food just to enhance acceptance of that food. Yet, most parents offer a new food to a child just three to five times before giving up on presenting it. As a speech-language pathologist who specializes in pediatric feeding, I have created a guideline for parents to give them research-based,  practical strategies for expanding their picky eater’s palette.

The Three E’s: Expose, Explore, Expand, is a systematic method of helping families create consistent exposures to a variety of foods, even when the child is a hesitant eater. Exposure and exploration might include sensory play, gardening, visiting farmers’ markets or food pantries, and cooking.

DOWNLOAD THE CHART

Read more on ASHA Leader Blog >>

What Is Hippotherapy?

By Barbara Smith

Horses are essential in hippotherapy, a form of neuromuscular therapy that can improve the posture and coordination of a child with disabilities.

Horses are special animals and their healing powers have been recognized for thousands of years. Hippos is the Greek word for horse and hippotherapy means the therapeutic use of horses. But hippotherapy shouldn’t be confused with therapeutic riding — hippotherapy is a medically based treatment tool, whereas therapeutic riding involves teaching people with disabilities equestrian skills. Although Hippocrates first mentioned using horses therapeutically in his ancient Greek writings around 400 B.C., it wasn’t until the 1960s that physical therapists (PTs) in Europe began using horses to help patients with neuromuscular disorders such as cerebral palsy or brain injury. Physical therapists believed that the horse’s movement created neurological changes that helped improve a person’s postural control, strength, and coordination.

Read more on Parents.com >>

Iron Chef, Dysphagia Style

By Melanie Potock

Picadillo ground beef from the Dining With Dysphagia cookbook.

What do a coconut-milk-infused shake, spicy risotto, and macaroni and cheese have in common? They are just a few examples of the winning recipes from a cooking competition created for people who have difficulty swallowing. Sampled by professional and celebrity chefs in New York City, these culinary creations were developed by students taking Interdisciplinary Care-Based Management of Dysphagia.

Read more on the ASHA LEADER BLOG >>