The Untethered Podcast™

In a digital age where social media posts and quick photos often drive clinical discussions, it is easy to mistake an anatomic tether for a definitive diagnosis. However, looking at a static picture of a lingual frenulum tells you almost nothing about how that tongue functions in real time during feeding, speech, or sleep. In this solo masterclass, Hallie Bulkin revisits the nuanced and evolving l...

When pediatric therapists treat feeding and speech in isolation, critical underlying root causes are easily overlooked. From jaw instability and retained primitive reflexes to phonological processes that are actually unaddressed motor speech deficits, true clinical progress requires an integrated, whole-system framework. In this episode, Hallie Bulkin welcomes back returning guest Samy Hernandez,...

Navigating healthcare billing is about to undergo a massive structural shift. For speech-language pathologists, feeding therapists, and private practice owners, the sunsetting of long-standing core CPT codes requires proactive preparation, documentation adjustments, and clear system updates. In this episode, Hallie Bulkin unpacks the upcoming 2027 CPT code overhaul for speech and feeding therapy s...

When a baby struggles with infant feeding, weight gain, or subtle airway restrictions, parents are frequently told to "wait and see." Yet, waiting often turns minor early red flags into complex speech, feeding, and oral-motor challenges down the road. In this episode, Hallie Bulkin sits down with Mackenzie Shiba, M.S., CCC-SLP, CMT®, pediatric speech-language pathologist, certified myofunctional t...

One of the biggest hurdles clinicians face when transitioning into pediatric feeding therapy is realizing that traditional graduate coursework and isolated weekend seminars often leave massive gaps in clinical application. Too many training programs treat pediatric feeding as if it were simply adult dysphagia scaled down—focusing strictly on oral-motor mechanics while ignoring the child's entire d...

In this episode, Hallie Bulkin sits down with Shayla Bollman, MA, CCC-SLP, CPFT, CLC, to discuss her journey as a pediatric speech-language pathologist and how earning her Certified Pediatric Feeding Therapist (CPFT) credential transformed her clinical evaluation process, treatment approach, and referral network. Shay shares practical strategies for responsive feeding, differentiating gagging from...

When feeding therapy stalls, it is rarely because a clinician lacks exercises - it is usually because intervention began before the child’s foundational systems were fully understood. Trying to fix oral-motor mechanics without addressing postural stability, airway integrity, or sensory overload is like building a house on sand. In this episode, Hallie Bulkin shares a structured, child-centered fra...

When a child presents with sleep-disordered breathing, chronic mouth breathing, or persistent feeding challenges, evaluating the upper airway becomes a top priority. However, determining when conservative management is sufficient versus when surgical intervention - like a tonsillectomy or adenoidectomy - is required can be complex for both parents and providers. In this episode, Hallie Bulkin sits...

For many speech-language pathologists, occupational therapists, and myofunctional providers, billing and documentation feel like navigating an ever-shifting maze. Between selecting appropriate CPT codes, justifying medical necessity, and adhering to strict scope-of-practice guidelines, clinicians often struggle to ensure proper reimbursement while remaining compliant. In this episode, Hallie Bulki...

Maxillary expansion isn't just an orthodontic intervention - for adults navigating narrow palates, compromised airways, and chronic TMJ dysfunction, it can be a total health transformation. In this episode, Hallie Bulkin sits down with Jeannie Nelson, MS, CCC-SLP, to share an unfiltered, first-hand account of their personal experiences undergoing MARPE (Minimally Invasive Micro-Implant Assisted Ra...

Taking a weekend course can make you see tongue posture, restricted movement, and mouth breathing everywhere you look. But recognizing a pattern is vastly different from truly understanding it. In this solo episode, Hallie Bulkin addresses "The Myo Gap" - the space between noticing an isolated anatomical finding and developing the clinical depth to understand how it fits into a child's connected,...

When we think about core stability, digestive efficiency, or functional breathing patterns, we rarely consider the foundational muscle group resting at the base of our pelvis. Yet, pelvic floor health directly dictates everything from diaphragmatic excursion to bowel regularity, posture, and systemic stress management. In this episode, Hallie sits down with Dr. Svetlana Mehlman, a physical therapi...

When a child walks into your clinic presenting with a tongue thrust, a high-arched palate, or a complex feeding delay, what is your immediate clinical instinct? Is it to reach for a specific exercise in your toolkit, or is it to zoom out and analyze how the entire system is functioning together? In this solo episode, Hallie Bulkin dives into the powerful paradigm shift of becoming an integrated th...

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...

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 distinc...

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 clinic...

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, unde...

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-...

When a child struggles with feeding, it’s easy to get laser-focused on oral-motor exercises or sensory strategies. But what if the root cause isn't a lack of coordination, but a struggle to breathe? In this solo episode, Hallie Bulkin dives deep into a critical, yet frequently missed, component of pediatric feeding therapy: airway screening . Airway issues often hide in plain sight, quietly underm...

When looking into tethered oral tissues, it is easy to focus entirely on visual structural appearance. However, judging a restriction by looks alone frequently misses the true clinical picture. Real progress happens when healthcare providers shift the diagnostic paradigm away from what a tie looks like and focus entirely on how it affects dynamic function over a patient's lifespan. In this episode...

Making the leap from a school-based setting into a specialized pediatric feeding niche is an incredible professional transformation. But what happens when that career pivot collides with your own deeply personal parenting journey? In this episode, Hallie sits down with Aerica Walsh, M.S., CCC-SLP, CPFT™, an ASHA-certified speech-language pathologist, pediatric feeding therapist, and the founder of...

Navigating the world of tethered oral tissues (TOTs) can often feel like wading through murky waters. With so much conflicting information out there, it’s incredibly easy for clinicians to fall into the trap of letting a visual anatomical structure dictate their entire treatment plan. But looking at a tongue or lip tie doesn’t tell you the whole story. In this solo episode, Hallie Bulkin dives dee...

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 Feed...

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 bet...

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...