The Untethered Podcast™

When a child exhibits behavioral challenges, facial recession, or struggles with sleep, the root cause is frequently hiding in plain sight: their breathing habits. Unfortunately, these vital signs of compromised airway health are often overlooked by traditional medical models.

In this episode, Hallie sits down with Dr. Leslie Pasco, an expert in airway health, pediatric development, and the author of The Great Contraction. Dr. Pasco breaks down the profound impact that mouth breathing, poor jaw development, and tongue-ties have on a child’s long-term physical and neurological growth.

About the Guest: Dr. Leslie Pasco, DMD, OFM, CBBI

Dr. Leslie Pasco is the visionary founder and President of MyoWay Centers for Kids. With almost three decades of experience in dentistry, Dr. Pasco has dedicated her career to understanding how airway health and muscle function deeply influence growth, sleep, learning, and overall health in children.

Rather than simply addressing surface symptoms, she emphasizes early screening, thorough functional assessments, and close collaboration with other healthcare professionals to ensure her young patients receive truly comprehensive care. Her clear, driving mission is to help children grow right, breathe right, and live better.

Key Topics & Takeaways

Mouth Breathing as a Danger Signal: Why mouth breathing should never be dismissed as a "phase," and how it actively derails midface growth, jaw position, and dental alignment.
The ADHD & Sleep Link: How sleep-disordered breathing frequently mimics or exacerbates symptoms of ADHD, leading to misdiagnoses that could be resolved with airway support.
A Call for Holistic Care: Understanding the environmental stressors driving facial recession and contraction, and why true patient healing requires organic, multidisciplinary collaboration.

Soundbites

"Mouth breathing is a danger signal. It is your body’s emergency backup system, not a functional way for a growing child to live and develop."
"Breathing therapy can change lives. When you restore nasal breathing and correct sleep architecture, you aren't just changing a habit—you're shifting a child's entire behavioral and developmental trajectory."
"Holistic care requires collaboration. No single provider can fix a contracted airway or a system-wide dysfunction completely on their own."

Timestamps

00:00 - The Impact of Airway Health on Families
01:12 - Introducing Dr. Leslie Pasco
02:20 - Shifting from General Dentistry to Airway Care
07:23 - The Dangers of Chronic Mouth Breathing
12:04 - ADHD Misdiagnosis vs. Sleep Disordered Breathing
19:02 - The Connection Between Palatal Expansion and Myofunctional Therapy
28:44 - Functional Assessments for Tethered Oral Tissues (Tongue & Lip Ties)
30:53 - The Critical Role of Pre-Op and Post-Op Preparation for Releases
44:00 - What is the Buteyko Breathing Method? (Form, Function, Fuel)
52:39 - Breaking Down Medical Silos: A Holistic Approach
54:16 - The Great Contraction Book Overview
58:52 - Medical Disclaimer & Outro

Links & Resources

Connect with Dr. Leslie Pasco: Learn more about her clinical work at https://buteykoclinic.com/pages/instructors/dr-leslie-pasco?srsltid=AfmBOoqEmYjR8y3SzFHFpgr-JpFWFgfyViaOItLvpazcPnDMqwDwd7w0.
Facebook : https://www.facebook.com/DrLesliePasco/
Linkedin:https://www.linkedin.com/in/dr-leslie-pasco-03a096a1/?isSelfProfile=false

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Dr. Richard Baxter on How to Know If a Tongue Tie Is Really the Problem
Don’t Ignore the Snore: The Hidden Link Between Airway, Sleep, and ADHD

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If Dr. Pasco's insights on pediatric breathing reframed how you analyze your complex developmental cases, please take a brief moment to leave a review! Your support helps us share these crucial airway answers with the clinicians and families who need them most.
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As therapists, it is easy to fall into the trap of protocol-based treatment—treating a clinical diagnosis like a strict recipe book. But true, transformative patient care requires us to step back from the "cookbook" approach and lean heavily into intentional clinical reasoning and pattern recognition.

In this episode, Hallie Bulkin takes the mic for an essential masterclass on the critical distinctions between screening, assessment, and treatment in clinical practice. She unpacks how blurring these clinical boundaries leads to stalled progress and directly impacts overall patient safety.

Hallie explores the delicate balance between structural anatomy and true muscle function, provides practical strategies for sustainable habit formation, and highlights why patient-centered decision-making is the key to successful therapy. If you are ready to confidently look at the whole patient, break out of professional silos, and elevate your interdisciplinary collaboration, this episode will completely reframe your daily practice.

Key Topics & Takeaways

Unblurring the Boundaries: Clear, non-negotiable definitions separating screening, comprehensive assessment, and actual functional treatment.
The Clinical Reasoning Shift: Why relying strictly on protocol-based "cookbook" therapy limits your growth as a clinician and slows down patient outcomes.
Anatomy vs. Function: Understanding that structural differences (like a tongue-tie) are only half the battle—how the muscles actually move and compensate dictates the treatment plan.
The Referral Strength: Normalizing interdisciplinary care and seeing specialized cross-referrals as a position of clinical strength rather than a limitation.
Integrated Care Systems: A high-level look at breaking down professional silos to build a truly holistic, collaborative network for your patients.

Soundbites

"Screening is simply deciding if more evaluation is needed. It’s a decision point, not a roadmap for immediate therapy."
"Assessment is about understanding exactly why the dysfunction exists, looking at the entire system from the bottom up."
"Treatment is about fundamentally changing muscle function and building sustainable new habits, not just checking exercises off a list."

00:00:36 – Welcome to the Untethered Podcast
00:01:12 – Defining the distinction between screening, assessment, and treatment
00:02:43 – The primary purpose of a screening
00:06:23 – Why assessment requires clinical detective work
00:11:02 – Treatment: Changing function rather than just exercises
00:15:25 – Normalizing the non-linear path of progress
00:21:49 – The problem with collecting interventions without clinical reasoning
00:25:01 – Anatomy versus function: Why function must drive clinical decisions
00:30:13 – Shifting from rigid silos to integrated care
00:39:07 – Conclusion and final thoughts on serving patients

Links & Resources

Fast Myo Screening Tool: Stop guessing during your intakes and download the checklist at FastMyoScreening.com.
FREE TRAINING: Ready to bridge the gap between screening and assessment? Join the free Screen The Peds to Feed The Peds Training.

RELATED EPISODES YOU MIGHT LOVE

Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)
Episode 145: The Missing Link In Your SLP & OT Screenings with Hallie Bulkin, MA, CCC-SLP, COM

STAY CONNECTED
💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on
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⭐ Love the show? Leave a quick review — it means the world to me!

If this episode inspired you to take a closer look at the functional clinical reasoning behind your treatment plans, please take a quick moment to leave a review! Your support keeps us climbing the charts to reach the providers who need these exact answers.
Hosted on Acast. See acast.com/privacy for more information.

When a child presents with complex speech or feeding challenges, it’s easy to focus solely on the surface-level behaviors. But true, long-lasting transformation happens when we dig deeper to look inside the mouth and assess the underlying muscle function.

In this episode, Hallie sits down with Galina Kislin, a pediatric speech-language pathologist and myofunctional therapist, to discuss her clinical journey and the shift that led her to prioritize root-cause assessments. Galina shares her experiences transitioning from Early Intervention into private practice, highlighting how a myofunctional approach became the "missing piece" for her stalled feeding and speech cases.

Together, Hallie and Galina dive into the critical importance of looking at a child from the bottom up, executing thorough oral-motor exams, and building local interdisciplinary care teams. Galina also shares actionable, naturalistic strategies to help families integrate therapy seamlessly into their daily routines without feeling overwhelmed.

About the Guest: Galina Kislin, M.A., CCC-SLP, CMT®

Galina Kislin is a bilingual (Russian/English) speech-language pathologist and Certified Orofacial Myologist (CMT®) with 28 years of rich clinical experience. Her journey began in Early Intervention, where an early exposure to oral-motor therapy ignited her lifelong passion for pediatric feeding. Over nearly three decades, Galina has served children across preschools, elementary schools, and multidisciplinary outpatient clinics.

Key Topics & Takeaways

The Missing Piece:
The Root Cause Approach:
Interdisciplinary Collaboration:

Soundbites

"Why has nobody else looked in the mouth? We cannot treat what we don't thoroughly assess."
"We need to look at everything from the bottom up. Understanding the underlying root causes completely changes your clinical outcomes."
"Therapy shouldn't feel like an extra burden for parents. When we integrate functional, naturalistic strategies into daily life, families feel truly empowered."

Timestamps

01:01 – Galina's Journey: From Early Intervention into Myofunctional Therapy
03:10 – Facing Structural Hurdles and Stalled Feeding Challenges in EI
04:46 – The Missing Piece: Embracing a Myofunctional Lens & Finding the Root Cause
09:40 – Intentional Parent Education and Functional, Hour-Long Sessions
10:58 – Crafting Naturalistic Home Strategies That Blend Into Daily Routines
14:03 – Navigating the Real-World Limitations and Rules of Early Intervention
16:33 – The Vital Importance of Thorough Oral Motor Exams Over Assumptions
24:22 – Boutique Service: Guiding Families Through the Treatment Process with Empathy
27:42 – The Clinical Value of True Root Cause Tracking (The Middle School "R" Case)
30:11 – Unpacking a Case: Speech, Feeding, and Myo Evaluation Integration
33:22 – Unlocking Speech Clarity and Intelligibility Without Traditional Targeting
37:58 – Private Practice Growth Mindset, Autonomy, and Overcoming Limitations
40:37 – Final Thoughts, Where to Connect with Galina, and Closing Resource

Links & Resources

Connect with Galina: Explore her courses and resources at www.Love2communicate.com and follow her updates on Instagram.
Clinical Assessment Tool: Easily screen for muscle patterns and oral dysfunction at FastMyoScreening.com.

RELATED EPISODES YOU MIGHT LOVE

EP 343: Inside a Mission-Driven Pediatric Feeding Practice
Episode 145: The Missing Link In Your SLP & OT Screenings with Hallie Bulkin, MA, CCC-SLP, COM

STAY CONNECTED

💬 Join the Conversation: Catch behind-the-scenes insights, collaboration tips, and daily clinical pearls on
Instagram | Facebook | LinkedIn

⭐ Love the show? Leave a quick review — it means the world to me!

If Galina's root-cause approach inspired you to collaborate with new providers in your area, please take a second to leave a review! Your support helps us reach the pediatric professionals and families searching for these exact answers.
Hosted on Acast. See acast.com/privacy for more information.

When a child struggles with swallowing, chewing, or food transitions, our first instinct is often to look directly at traditional feeding strategies. But what if the missing piece of the puzzle isn't the food itself, but the foundational resting posture and function of the orofacial muscles?

In this solo episode, Hallie Bulkin demystifies myofunctional therapy (Myo) and explores its critical, undeniable overlap with pediatric feeding therapy. She breaks down how addressing underlying myofunctional dysfunction can drastically accelerate your clinical progress, protect airway safety, and create long-term, sustainable outcomes for the children on your caseload.

Hallie addresses common misconceptions surrounding Myo, discusses structural considerations like tongue-ties, and explains why a whole-system approach—looking at tongue posture, breathing, and body alignment—is non-negotiable. If you're ready to stop looking at oral motor function in a vacuum and want practical steps to seamlessly weave myofunctional thinking into your next feeding evaluation, this episode is exactly what you need.

Key Topics & Takeaways
Defining the Scope of Myo: Understanding what myofunctional therapy actually is and how it targets the resting postures and functions of the oral and facial muscles.
The Perfect Partners: Why feeding therapy and Myo should never be treated as entirely separate disciplines, but rather as deeply interconnected systems that support one another.
The Trifecta of Function: Exploring how tongue resting posture, nasal breathing, and physical body posture directly dictate a child's success with chewing and safe swallowing mechanics.
Debunking Common Misconceptions: Shedding light on the myths surrounding myofunctional therapy and highlighting the evidence-based research that supports its clinical efficacy.
Integrating the Assessment: Practical, realistic steps to incorporate orofacial muscle function and structural considerations (like tongue-ties) into your standard feeding evaluations without blowing your timeline.

Soundbites
"Feeding and Myo are partners, not separate disciplines. When you treat them as a connected system, your outcomes transform."
"Addressing myofunctional dysfunction speeds up feeding progress. We cannot build functional feeding skills on top of poor oral resting postures."
"Myo literacy makes you a better clinician in any specialty. It completely shifts the lens through which you analyze a child's struggles."

Timestamps
00:02:29 | Defining Myofunctional Therapy
00:03:32 | The Root Cause vs. Symptom Lens
00:07:09 | Breaking Through Feeding Plateaus
00:11:56 | Where Feeding and Myo Overlap
00:14:41 | Airway Management & Nasal Breathing
00:18:12 | Debunking the "Just Exercises" Myth
00:23:54 | How to Run a Myo Assessment
00:30:12 | The 5-Step Integration Framework
00:33:33 | The Connected Child System

Links & Resources
Clinical Tool: Streamline your assessments and screen for muscle dysfunction

F.A.S.T. MYO SCREENING PACKET: Need a simple & science-backed way to screen your patients for potential orofacial myofunctional disorders?
WORTH A LISTEN: CONTINUE YOUR JOURNEY

The 4 Layers of Feeding: How to Finally Know Where to Start
When You Screen a Child and Think 'Now What?

STAY CONNECTED
💬 Join the Conversation: Connect with our community, catch weekly clinical breakdowns, and get daily practice tips on Instagram | Facebook | LinkedIn.

If this episode helped you see the connection between muscle posture and feeding progress, please leave a quick review! Your support helps us reach the pediatric professionals and families looking for these vital puzzle pieces.
Hosted on Acast. See acast.com/privacy for more information.

As pediatric therapists, we know that our time with a child is only one small piece of the puzzle. Real, lasting progress happens when parents and caregivers feel confident carrying strategies into everyday family life. Yet, navigating parent communication can sometimes feel like its own clinical challenge.

In this episode, Hallie sits down with Johanna Stadtmauer, MS, CCC-SLP, a pediatric speech-language pathologist, feeding therapist, and owner of Ready Stadt Speech. Johanna shares her passion for family-centered care, breaking down how clinicians can intentionally weave counseling skills and active listening into their daily practice to meet parents exactly where they are.

They explore how Johanna uses innovative practice models like caregiver classes to build a supportive local community, and dive into how private practice owners can leverage social media and AI tools responsibly without losing the human connection that defines excellent therapy. Whether you’re looking to deepen your rapport with families or want actionable insights on clinical entrepreneurship, this interview offers a refreshing, holistic roadmap.

About the Guest: Johanna Stadtmauer, MS, CCC-SLP

Johanna Stadtmauer is a pediatric speech-language pathologist, feeding therapist, and the owner of Ready Stadt Speech, serving families in Northern Bergen County, New Jersey. Specializing in the early stages of speech, language, feeding, and literacy development, Johanna is also an SLP consultant and advisor.

As both a clinician and a mother to three young children, she brings a uniquely relatable perspective to child development, helping parents feel genuinely empowered rather than overwhelmed.

Key Topics & Takeaways

Counseling Skills in Action: Moving past rigid clinical updates and incorporating active listening to facilitate goal-focused, empathetic conversations with caregivers.
Building Community Beyond the Table: How designing and promoting local caregiver classes transforms isolated parenting struggles into shared community experiences.
Responsible Tech Integration: Navigating the role of AI in modern practice—using tools like Glint to support administrative tasks or visual creation while fully preserving human judgment and clinical intuition.
Grounding in Your "Why": Why keeping your core mission at the forefront is the ultimate guide for sustainable private practice growth and marketing alignment.
The Multidisciplinary Approach: Empowering families by fostering a holistic care team that treats the whole child.

Soundbites

"Be transparent with families about what to expect. True collaboration starts with setting clear, honest expectations."
"AI can support but it can never replace human connection. Our empathy and clinical intuition are irreplaceable."
"Know your 'why' to guide your practice and growth. When things get complex, your core mission is your compass."

Timestamps

02:18 The Importance of Communication in Therapy
05:25 Navigating Challenges in Therapy
11:11 Building Community Through Caregiver Classes
14:38 Marketing and Positioning in Private Practice
19:09 The Absolute Importance of Human Connection
22:42 Navigating AI in Therapy Responsibly
27:44 Understanding Your Why
31:32 Building a Holistic Care Team
33:58 Empowering Families in Therapy
37:48 The Journey of an SLP Entrepreneur

Links & Resources

Visit Johanna’s Website: readystatsspeech.com
Follow Johanna on Instagram: @ReadyStadtSpeech

WORTH A LISTEN: CONTINUE YOUR JOURNEY

Episode 371: When You Screen a Child and Think 'Now What?'
Episode 372: From Guessing to Growth: How a Clear Framework Transformed My Practice

STAY CONNECTED & GROW YOUR PRACTICE

Join the conversation: Get behind-the-scenes insights, clinical pearls, and real conversations over on Substack.
Hosted on Acast. See acast.com/privacy for more information.