The Untethered Podcast™

If you’ve ever felt like you were "guessing" your way through a feeding session, you aren’t alone. In fact, many clinicians enter the field with a passion for OT or SLP, only to realize their foundational schooling barely scratched the surface of pediatric feeding.In this episode, Hallie is joined by Courtney Lewis, MOT, OTR/L, CPST, a pediatric feeding specialist and owner of NOSH Pediatric Feeding Therapy. Courtney opens up about her "long and winding road" to feeding—a journey that began with an 8th-grade project and evolved through home health, clinics, and hospitals.They discuss the pivotal moment when Courtney realized she needed more than just general experience to truly help her families. From the "regulation lightbulb" moment that changed how she views patient behavior to the deep empathy she brings as a former "picky eater" herself, this conversation is a masterclass in why specialized training and clinical reasoning are the keys to professional confidence.About the Guest: Courtney Lewis, MOT, OTR/L, CPSTCourtney Lewis is a pediatric occupational therapist, feeding specialist, and the founder of NOSH Pediatric Feeding Therapy. With over a decade of experience across various settings, she specializes in transforming mealtime struggles into joyful family experiences using a holistic, play-based approach. Courtney is a Feed The Peds® graduate and a dedicated mentor within The Pediatric Feeding Hub™.Key Topics & TakeawaysThe Accidental Specialist: How pediatric feeding "found" Courtney and why every previous setting—from home health to hospitals—was a necessary stepping stone.The Missing Link in Education: A candid look at why most therapists feel underprepared and how to fill the gaps that grad school leaves behind.The Sensory Lived Experience: Courtney shares how her own history as a picky eater allows her to advocate for her patients with a unique, firsthand perspective.44,000 CFA Points: The story behind Courtney's "Regulation Lightbulb" and how understanding the nervous system changes everything in the clinic.The Power of "The Hub": Why having a community of mentors and peers is essential for preventing burnout and ensuring clinical excellence.Soundbites"I didn't choose feeding therapy; it chose me. Every setting I worked in was leading me here.""You go from feeling like you're guessing to actually having a clinical 'why' behind what you're doing.""When you understand the nervous system, you stop looking at the behavior and start looking at the child."Timestamps000:00 – Overcoming imposter syndrome and the "stuck" feeling in feeding therapy.02:22 – Courtney’s Journey: How pediatric occupational therapy "found" her.05:47 – The Confidence Catalyst: Helping a breastfeeding infant transition to solids in 10 weeks.06:34 – The Foundational Gap: Why standard courses like SOS and Beckman sometimes leave therapists wanting more.23:40 – How Feed The Peds® provided the framework to finally "connect the dots."29:10 – Lived Experience: How being a former "picky eater" shapes Courtney’s empathy as a therapist.38:20 – Mentorship: Transitioning from student to leader within The Pediatric Feeding Hub™.42:15 – Closing thoughts and where to find NOSH Pediatric Feeding Therapy.Links & ResourcesVisit Courtney’s Website: noshfeeding.comFollow Courtney on Instagram: @NoshFeedingFeed The Peds®: Join the 3-Day Screen The Peds to Feed The Peds ChallengeTHE HUB: Become a part of The Pediatric Feeding Hub™WORTH A LISTEN: CONTINUE YOUR JOURNEYEpisode 369: The 4 Layers of Feeding: How to Finally Know Where to StartEpisode 361: Why Two Therapists Get Different Feeding Outcomes (And How to Fix It)STAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips onInstagram | Facebook | LinkedInIf this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

In this solo episode, Hallie Bulkin dives deep into a common pitfall in pediatric feeding therapy: treating red flags as a diagnosis rather than a starting point. Many clinicians feel the pressure to jump straight into treatment the moment a concern is raised, but skipping the foundational steps often leads to stalled progress and clinical uncertainty.Hallie clarifies the critical distinction between screening, assessment, and treatment. She explains why red flags should be viewed as "decision points" and how a structured screening process can transform your clinical decision-making. Whether you are navigating complex sensory issues or safety concerns, this episode provides a systematic framework to help you move forward with clarity and intention.About the Host: Hallie BulkinHallie Bulkin, MA, CCC-SLP, CMT®, CPFT™, is a pediatric feeding and orofacial myofunctional therapist and the founder of Elevation Movement. With years of experience in pediatric feeding, myo, airway, and tethered oral tissues, Hallie is dedicated to empowering clinicians with the tools they need to provide life-changing therapy for children and their families. Key Topics & TakeawaysRed Flags as Decision Points: Understanding why a red flag is a signal for more data, not a roadmap for immediate therapy.The Power of Structured Screening: How a checklist removes the guesswork and identifies specific risks.The Clinical Sequence: Why the order of Screening → Assessment → Treatment is non-negotiable for successful outcomes.Avoiding Common Pitfalls: Why relying solely on parent reports or mislabeling limited variety as "just sensory" can hinder progress.Building Confidence: How a systematic approach reduces "imposter syndrome" and helps you know exactly what to do next.Soundbites"Red flags are decision points, not treatment plans.""Screening answers the vital question: Is further assessment even needed?""Jumping straight to treatment skips the assessment phase entirely."Timestamps00:00 – Red Flags: The Doorway to the Next Step00:36 – Introduction: Meet Your Host, Hallie Bulkin01:52 – The "Now What?" Moment in Feeding Therapy02:54 – Why Structured Screening is Not Optional03:48 – Screening vs. Assessment: Solving the Sequencing Issue04:22 – Mistake #1: Treating Parent Concern as the Only Data Point05:27 – Mistake #2: Equating Limited Variety with Sensory Issues06:17 – Mistake #3: Skipping the Safety & Airway Layer07:22 – What a Strong Feeding Screening Checklist Actually Does08:24 – The 3-Step Sequence: Screening, Assessment, and Treatment09:34 – Case Example: Moving from Red Flags to Clarity10:30 – Building Confidence & The "Screen The Peds" Free Training👉 Join the free 3-day Screen The Peds to Feed The Peds trainingWORTH A LISTEN: CONTINUE YOUR JOURNEYWhy Two Therapists Get Different Feeding Outcomes (And How to Fix It)The 4 Layers of Feeding: How to Finally Know Where to StartSTAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips onInstagram | Facebook | LinkedInIf this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

In this interview episode, Abigail Kemp shares her honest journey through her Clinical Fellowship Year (CFY) and into the world of pediatric feeding therapy. Like many new clinicians, Abigail quickly realized that academic knowledge alone wasn’t enough—especially when faced with the complexity of real-life feeding cases.She opens up about the challenges of navigating unclear expectations, limited mentorship, and the pressure to perform early in her career. Through these experiences, Abigail discovered the power of self-advocacy, continuous learning, and finding the right support system to grow as a clinician.This episode offers a grounded and relatable perspective for therapists who feel overwhelmed or unsure—reminding you that confidence isn’t about knowing everything, but about learning how to think, adapt, and take action.About the Guest: Abigail KempAbigail Kemp, M.S., CCC-SLP, is a speech-language pathologist who began her clinical career in 2024, gaining experience across pediatric clinics, preschool and daycare settings, elementary schools, as well as adult outpatient and acute care.While she had strong academic exposure—particularly in dysphagia—her early clinical experience in pediatric feeding therapy presented unexpected challenges. During her CFY, Abigail was faced with feeding cases that pushed her beyond her comfort zone, often without the level of mentorship and guidance she needed.Abigail continues to expand her expertise in feeding therapy and hopes to further specialize in the field. She encourages new clinicians to advocate for themselves, ask questions, and trust that growth takes time—but is always worth the journey.Key Topics & TakeawaysThe Reality of CFY Challenges:Why many new clinicians feel unprepared—and how real growth happens after graduation.The Power of Mentorship & Community:How the right environment can accelerate your confidence and clinical development.Building Confidence in Feeding Therapy:Why confidence comes from action, not perfection.Self-Advocacy in Clinical Practice:How speaking up and seeking support can transform your career trajectory.Individualized Feeding Therapy:Why no two clients are the same—and treatment must reflect that.Soundbites“I realized how little I knew about feeding.”“Treatment strategies must be individualized.”“Support and mentorship are crucial in our field.”Timestamps00:00 – Introduction to Abigail Kemp01:43 – Early Career and the Clinical Fellowship Year (CFY)03:39 – Navigating Expectations in a New Pediatric Clinic05:39 – Challenges of Remote Mentorship and the First 4 Months06:56 – Finding a New Setting & The Power of Self-Advocacy08:21 – Facing the First Pediatric Feeding Client (approximate transition based on the flow of setting change)10:58 – Discovering "Feed The Peds" and Pediatric Feeding Courses17:16 – Balancing Practice in School and Clinic Settings21:38 – Navigating Ethical Dilemmas and Professional Integrity25:20 – Practical Application: Using Clinical Knowledge at Home47:24 – Final Advice for New Clinicians & Closing RemarksIf you’re feeling unsure where to start in pediatric feeding, Screen The Peds to Feed The Peds is the perfect next step.Join me for this free 3-day training, where I’ll show you how to screen feeding cases clearly, confidently, and with intention — so you know what to do next.👉 Join the free 3-day Screen The Peds to Feed The Peds trainingWORTH A LISTEN: CONTINUE YOUR JOURNEYWhy Two Therapists Get Different Feeding Outcomes (And How to Fix It)When Imposter Syndrome Shows Up in Pediatric Feeding Therapy (and What to Do Next)STAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips onInstagram | Facebook | LinkedInIf this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

In this solo episode, Hallie Bulkin dives deep into the "noise" of complex feeding therapy. When a child presents with multiple overlapping issues, it’s easy for clinicians to feel stuck. Hallie explains why the secret to better outcomes isn't working harder or using more strategies - it’s prioritization.By breaking feeding down into four essential layers, Hallie provides a framework for identifying the "primary limiter" and building a treatment plan that actually moves the needle. Whether you’re a seasoned therapist or new to the field, this episode will help you trade confusion for clinical confidence.Key Topics & TakeawaysThe Four Layers of Feeding: Understanding the hierarchy of physiological stability, oral motor skills, sensory processing, and behavior.Cutting Through the Noise: Why treating every issue at once often leads to plateaued progress and clinician burnout.Identifying the Primary Limiter: How to determine which factor is actually holding the child back from reaching their next milestone.The Foundation First Approach: Why skipping foundational stability for high-level skills is a recipe for failure.Clinical Confidence: How mastering decision-making skills changes the way you show up in the therapy room.Soundbites"The problem isn't effort, it's prioritization.""Not everything is equally urgent. If we treat everything like a priority, nothing is a priority.""Clarity in your plan builds confidence—not just for you, but for the families you serve."Timestamps02:09 – The Real Problem: Effort vs. Prioritization03:19 – The Confusion Loop: Why Feeding Cases Feel Complex04:22 – Identifying the Primary Limiter in Feeding05:05 – Layer 1: Physiological Stability05:54 – Layer 2: Oral Motor Skills06:25 – Layer 3: Sensory Processing07:01 – Layer 4: Behavior and Learned PatternsIf you’re feeling unsure where to start in pediatric feeding, Screen The Peds to Feed The Peds is the perfect next step.Join me for this free 3-day training, where I’ll show you how to screen feeding cases clearly, confidently, and with intention — so you know what to do next.👉 Join the free 3-day Screen The Peds to Feed The Peds trainingWORTH A LISTEN: CONTINUE YOUR JOURNEYWhy Two Therapists Get Different Feeding Outcomes (And How to Fix It)Why Pediatric Feeding Therapy Feels So Hard and What’s Been MissingSTAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips onInstagram | Facebook | LinkedInIf this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

In the ever-evolving world of motherhood, the journey through breastfeeding can often be fraught with challenges. In this episode, Hallie Bulkin and Tamari Jacob (CLC, founder of One With The Pump) share their personal experiences with exclusive pumping—a path less traveled but deeply impactful for many moms.Moving beyond traditional nursing expectations, Tamari opens up about the reality of the "hot mess express," from the initial confusion of latch struggles in 2017 to the emotional weight of grieving the nursing journey she thought she’d have. Whether you are a parent feeling isolated in your feeding choices or a professional seeking to provide more compassionate care, this episode sheds light on the emotional and practical pivots required to navigate infant feeding when the "natural" path doesn't go as planned.Key Topics & TakeawaysThe Unforeseen Challenges of Nursing: Why we must normalize the shift from nursing to exclusive pumping when reality doesn't match our expectations or a baby struggles to latch.A Community of Support: How connecting with others—through online groups and social media—provides the validation and specific pumping education that is often missing from traditional healthcare.The Shift to Creating Change: How a personal project during the 2020 pandemic turned into a global platform to fill the gap in pumping-specific resources.The Emotional Toll of Feeding Struggles: Addressing the grief, guilt, and "triple feeding" trauma that occurs when feeding becomes a source of stress rather than bonding.The Professional Gap: A look at why many training programs fail to provide adequate lactation education, leaving parents to "drive the boat" in their own advocacy.Soundbites"I assumed that I would nurse because why wouldn't I? But when it didn't work, I found myself on the 'hot mess express,' grieving the journey I didn't have.""Exclusive pumping is essentially a second full-time job. We didn't just need the equipment; we needed to know we weren't alone in the middle of the night.""We have to stop chasing a 'perfect' ideal and start aligning our feeding choices with our values—bonding, flexibility, and mental health."Timestamps00:00 – Introduction: The Ever-Evolving Journey of Motherhood03:15 – The "Hot Mess Express": Navigating Latch Struggles and Confusion08:42 – Grieving the Goal: Processing the Emotional Toll of Feeding Challenges14:10 – Finding Your Village: The Rise of the Exclusive Pumping Community21:30 – COVID-19 & The Content Gap: Creating the Resources You Needed29:45 – Advocacy & Education: Why Compassionate Support is Non-Negotiable38:20 – Aligning Values: From "Perfect" Feeding to Mental Health SanityWORTH A LISTEN: CONTINUE YOUR JOURNEYEpisode 164: Lactation Consultants Journey Into Tethered Oral TissuesEpisode 82: Bottle Refusal Is Not Always A Feeding Disorder With Jill Rabin M.S. CCC-SLP/L IBCLCSTAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips onInstagram | Facebook | LinkedInConnect with our guest, Tamari Jacob: Follow One With The Pump on Instagram | TikTok | YouTube Visit onewiththepump.com If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

Is a thumb-sucking habit just a "phase," or is it a survival mechanism? In this episode, Hallie Bulkin breaks down the often-misunderstood world of oral habits in infants and toddlers. Moving beyond the traditional "just make them stop" approach, Hallie explores how frequency, duration, and intensity act as a roadmap to a child’s underlying airway and developmental health. Whether you’re a therapist or a parent, this episode will change how you look at pacifiers, fingers, and oral fixations forever.Key Topics & TakeawaysDecoding the "Why": Why we must stop viewing habits as behaviors to be eliminated and start seeing them as symptoms to be investigated.The Compensatory Connection: How thumb sucking often masks underlying airway issues or tongue-tie restrictions.The Triple Threat: Understanding the "Frequency, Duration, and Intensity" framework for assessing when a habit becomes a developmental red flag.Sleep & Behavior: The hidden link between poor sleep quality and the "behavioral" concerns that often land children in therapy.The Professional Path: Why specialized credentials in pediatric feeding and myofunctional therapy are non-negotiable for lasting results.Soundbites"We have to stop asking how to stop the habit and start asking: What is this habit trying to tell us about this child's system?""If a child is biting through a pacifier or sucking their thumb aggressively, they aren't just seeking comfort—they might be seeking an airway.""Frequency, duration, and intensity. If you don't look at all three, you're missing the full picture of a child’s development."Timestamped Chapters00:00 – Introduction to Oral Habits: More Than Just a "Phase"02:29 – Defining Oral Habits: From Pacifiers to Fingernails04:30 – The Red Flags: Identifying When a Habit Becomes Problematic07:50 – Why Credentials Matter: Finding the Right SLP or OT10:25 – The Airway Connection: Is the Habit a Compensation?12:19 – Root Cause Resolution: Moving Beyond Habit EliminationWORTH A LISTEN: CONTINUE YOUR JOURNEYEp 363: Tongue Ties, Oral Habits & the Future of Airway Health (with Dr. Casey Jones)Mouth Breathing in Toddlers: Why It Matters STAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips onInstagram | Facebook | LinkedInIf this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!

The foundation of health isn't just how we move or eat—it’s how we breathe.In this milestone episode, Hallie Bulkin is joined by certified practitioner Kaitlyn Shrum to pull back the curtain on the Buteyko Method. While many view breathing as a passive act, this deep dive reveals how functional breathing is the literal bedrock of speech, feeding, and cognitive development.From addressing the root causes of sleep apnea to navigating the "Physiological Pyramid," Hallie and Kaitlyn discuss why speech pathologists and myofunctional therapists must look beyond the mouth and into the airway to achieve lasting clinical results.Key TakeawaysThe Buteyko Blueprint: Understanding the science behind Dr. Konstantin Buteyko’s method and how it recalibrates the body’s breathing patterns.The Physiological Pyramid: Why airway and breathing form the base of the pyramid, supporting sleep, feeding, and—finally—speech at the very top.Beyond the Mask: How breathwork addresses physiological triggers like pharyngeal critical closing and arousal thresholds that CPAPs or surgery alone might miss.The "Stalled" Patient: Why children often plateau in traditional speech therapy when an underlying airway or tongue-tie issue remains unaddressed.A Holistic Shift: Moving from treating symptoms to managing the "Root Cause" of speech and developmental disorders.Key Soundbites"Breathing is the foundation. If the base of the pyramid is crumbling, everything above it—sleep, feeding, speech—is at risk.""We have to stop treating the mouth in isolation and start treating the human being as a respiratory system.""Proper airway management is the difference between a child struggling for years and a child finally finding their voice."WORTH A LISTEN: CONTINUE YOUR JOURNEYWhy We Can’t Ignore the Airway in Pediatric Feeding TherapyAirway First: The Pediatric Dentist's Essential Role in Treating Tongue Ties and Growth IssuesSTAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips onInstagram | Facebook | LinkedIn⭐ Help us celebrate 365 episodes!!! If this show has impacted your clinical practice, please leave a review. Your support helps us reach the therapists and families who need these answers most!Want to learn more about the Myo Method? Check it out here

Hallie Bulkin dives deep into one of the most misunderstood areas of airway health: the intricate relationship between sleep, airway dysfunction, and ADHD-like behaviors.Hallie shares her personal journey with ADHD, revealing how unrecognized sleep disorders can severely impact neurocognitive function in both children and adults. This episode highlights why "quiet breathing" is the gold standard for health, why we must stop normalizing snoring, and how proper evaluation of breathing patterns can lead to life-changing results that move beyond simply treating behavioral symptoms.Key TakeawaysThe Silent Standard: Breathing should be quiet; if you can hear it, there is likely an underlying dysfunction.Mouth Breathing vs. Airway Health: Recognizing mouth breathing as a primary red flag for systemic airway issues.The ADHD Mimic: How sleep deprivation and disordered breathing can produce symptoms that are nearly identical to ADHD.The Research Link: A look at how sleep disorders are scientifically linked to lower executive function and memory in developing minds.A Holistic Path Forward: The importance of comprehensive evaluations and interdisciplinary treatment options for patients of all ages.Key Soundbites"Breathing should be quiet.""Don't ignore the snore!""Snoring is not normal—it is a cry for help from the airway."WORTH A LISTEN: CONTINUE YOUR JOURNEYEP 348: Tongue Ties, Sleep Apnea & More: The Patient-Centered Approach to Airway DentistryEp 363: Tongue Ties, Oral Habits & the Future of Airway Health (with Dr. Casey Jones)STAY CONNECTED & GROW YOUR PRACTICE💬 Join the Conversation: Catch behind-the-scenes insights and daily clinical tips on  Instagram | Facebook | LinkedIn⭐ If this episode shifted your perspective, please Leave a quick review — it means the world to me!Your feedback helps us reach more therapists and families who need these answers!Want to learn more about the Myo Method? Check it out here