Specialties/Areas of Expertise
- Head injury
- Cleft lip or palate
- Vocal disturbance
- Articulation difficulties
- Language difficulties
- Failure to thrive
- Picky eating
- Neurological, genetic, or chromosomal diagnosis
- Myofunctional disorder
- Feeding disorders (including ARFID, picky eating, and failure to thrive)
- Speech sound disorders: articulation and phonology
- Apraxia of speech
- Social language disorders
- Voice disorders
- Fluency disorders
- Augmentative and alternative communication devices
- Myofunctional treatment
- Pre and post frenectomy treatment
The Milestones feeding team is skilled in the diagnosis and treatment of difficulties related to breastfeeding, bottle feeding, transitions to solid foods or texture variety, and expanding the diets of picky eaters.
Toddlers - School Aged Children
- Weight gain
- Maternal pain/nipple damage
- Signs of distress
- Increased breathing rate
- Frustration (crying, turning head, pulling legs up, pushing away)
- Wet sounding cry
- Wet sounding breathing
- Frequent post feed vomiting
- White residue on tongue
- Restricted oral tissues (tongue/lip tie)
- Changes in bowel movement appearance/frequency
- Signs of pain/discomfort post feeding
We treat children with all types of complex feeding problems, such as those who:
- Eat or drink very little and do not gain weight or grow.
- Eat only certain food types or textures.
- Get some or all of their nutrition through a tube in their stomach, bowel or vein (G tube, J tube or NG tube).
- Struggle with the oral motor skills they need to chew, swallow, and eat or drink safely.
- Have sensitivities that make it hard for them to eat a wide range of food types and textures. For example, they might struggle with the way eating or drinking feels or with the taste, smell, texture, bite size or sight of food. They might seem afraid of food coming near their face or mouth.
- Learned that eating is unpleasant or difficult.
- Felt pain with eating due to a health problem, like gastroesophageal reflux or irritable bowel disease.
- Have severe anxiety about mealtimes linked with challenging behaviors. These may include refusing to come to the table for meals, not following directions during meals, having tantrums and being aggressive.
- Have a condition called “avoidant restrictive food intake disorder" (ARFID).
Orofacial Myology is the treatment of orofacial complex dysfunction and includes differential diagnosis to determine specific structural and functional impacts followed by an individualized treatment plan for each patient. Atypical oral rest posture (lips apart, tongue low or forward in the oral cavity), mouth breathing, forward movement of the tongue during swallowing, sucking habits (thumb, finger, tongue, etc), clenching, and grinding are all examples of orofacial myofunctional disorders and when untreated these can lead to changes in dental alignment (malocclusion), maxillary and mandibular jaw growth patterns, breathing, chewing and swallowing, speech sound production, and sleep patterns.
Our skilled therapists are focused on providing individualized intervention for speech sound production, language, and play based difficulties that ensure a child can engage and interact in their environment. We incorporate evidence based treatment strategies to address unintelligible speech, late talking toddlers, social language difficulties, and underdeveloped play and interaction skills.
We pride ourselves on being able to remediate articulation errors, support motor planning for sound sequencing for children with apraxia of speech, and enhancing the communication skills of those who are late to babble and say words. We know that building language skills through literacy based tasks supports academic skills and use books to promote early literacy skills and language development.