picky eating help blog twins
Megan Cawlfield Megan Cawlfield

Don’t forget to PLAY with SOUNDS!

When I make this recommendation to parents, I expect 80% of children to find this easy and fun and 20% to avoid this task. Helping a child reach a SUCCESSFUL goal when avoidance is a concern is a BIG DEAL and for this 20%, helping them never feel reluctance for reading is THE goal.

It has taken me an embarrassingly long time to understand the value of ‘sound’-alogical awareness. I make this hard distinction between sounds in words (phonemes) and everything else we think of when we refer to reading readiness (letters) because this fundamental predisposition to be sensitive enough to play with the sounds in a given language is not equal for everyone. About one fifth of the population is not sensitive to the sounds in a language. When left untreated these people usually struggle to read, write, and spell and some seek out a diagnosis of dyslexia. I would not advocate that families work to try to have a child reading before school age, but simple sound based (not print based) phonological awareness through SOUND PLAY is ALWAYS a recommendation in my book. When I make this recommendation to parents, I expect 80% of children to find this easy and fun and 20% to avoid this task. Helping a child reach a SUCCESSFUL goal when avoidance is a concern is a BIG DEAL and for this 20%, helping them never feel reluctance for reading is THE goal.  

8 Quick Sound Games to play anywhere! anytime!

Sound-alogical Handout FREE

-          Sound Detective: EX) find word with the sound of the day…. OU/OW

-          Starting Twins: EX) Chant: “can and kit both start with K!”  

-          Help Me End: EX) “Ready set G_!” “Time to go to BE_!”

-          Chant it out: EX) Chant the word of the day ‘movie’.. “give me an ‘m* (sound) oo* v* EE* yay, movie day!

-          Can you guess? EX) “I have a new p*.e*.t*” *-sounds, not letters. “it is a c.a.t”

-          Help me Fix it: EX) “I want to ride my hike.. oops, I meant ____, not hike!” “I want a chocolate birthday cape.. oops, I meant ___, not cape!”

-          Find the Beat: EX) tap it out, cat -hat -mat… jungle-muddy-fire … eleven- December - volcano --- keeping syllable numbers together

-          The name game: EX) banana fanana song You Tube: Shirley Ellis The Name Game Song

Read More
directory Megan Cawlfield directory Megan Cawlfield

In case you missed it…

VMA is proud to be hosted on Gezoont! An inclusive online directory ! Check out the link to the blog post over at Gezoont!

https://www.gezoont.com/blog/vma-helps-you-help-your-child

Virtual Milestones Academy (VMA) is new, innovative, and much needed.  VMA guides parents and professionals to help children with communication, developmental, and learning goals. 

Sending our kids to therapists can be incredibly useful, but transferring that to everyday life can feel close to impossible. Megan Cawlfield, MS CCC-SLP, and Emily Roberts, OTR/L, a speech therapist and occupational therapist duo, have created a model that fills this gap. They advise adults so those adults can help the children they care for.  Read on for more insights. 

Their depth of speciality experience is now paired with relaying that experience to parents. 

They answer the question on parents’ minds:  How can I help my child at home? 

Amy at Gezoont: 

1. I’d love to hear more about what you do and what led to starting VMA. Why did you start VMA and what did you see that needed to be addressed?

Megan at VMA:  VMA’s vision was developed through a conversation about what the barriers are when helping children and what we strive to see more of, not just in our community but how we could accomplish more virtually. The barriers range from learning differences, organization skills, executive function, eating and feeding concerns, frustration, and self regulation.

As we put our thoughts to words, we realized we were part of an innovative form of consultation and advocacy for childhood development. We see the value in conversations with the adults who are working with a child, and we see a future where experienced educators and therapists can lead and teach individuals by providing considerations through individual conversations. 

Amy at Gezoont:  This is really fascinating. This ability to help oneself is both advocacy and empowerment for the adults and the children.

Amy at Gezoont: 

2. How is VMA different and similar to other services for children?

Megan at VMA: I love how you frame this question. VMA is aimed at helping children when they are struggling by speaking with their family, caregivers, and educators. VMA consultants see the value in the conversations and help families to make specific goals and individualized strategies for accomplishing goals. Consultants are able to strategize with parents and model to them as they work towards addressing individual concerns togethers. Consultants focus on building relationships and rapport with families and caregivers whereas therapists, tutors, and teachers focus mainly  rapport on the child.

Amy at Gezoont: 

3. What are a few examples of the help that parents request and how you might address their concerns in your consultations?

Megan at VMA: A VMA consultant can be very helpful for parents who are struggling with homeschooling and beyond. As more and more families are learning how to homeschool, helping more with homework, addressing their special needs, and assisting struggling students, it has been amazing helping these families make progress together. More and more parents are learning how their children learn best and are becoming professionals at teaching their own children by recognizing how to help them best developmentally and academically. 

We are also finding that the more families are learning together, the more preschool skills and readiness skills are being taught at home. In this way, many families are beginning to reach out to help their children “get ready to learn” when they notice some possible concerns. Parents are seeking out information and prevention more and we are excited to be a part of these conversations!

We help with organization skills, frustration management, sensory integration, literacy, and other skills ranging from life skills to educational goals.

Amy at Gezoont: 

4. Do you help train parents how to help their children directly?  

Megan at VMA: Basically, yes. Virtually directly :) We model with them on screen when possible. We also watch them in their natural environment and provide feedback during and after. We send lots of resources and guides and through conversations, many questions are answered and a lot of natural learning moments occur for parent training. 

We send lots of resources and we also provide short and simple guidelines which is especially important to the busy caregiver. 

Amy at Gezoont: 

5.  Do you work only with parents and caregivers or also schools or even with children directly?


Megan at VMA: We are most interested in working with parents, caregivers, and schools. However we do model techniques with children. This may be with the children we are speaking about or we may model with another child if that is helpful. We love working with children and are happy to do this when it is helpful.

Amy at Gezoont: 

6.  Where do you find inspiration? 

Megan at VMA: Everyday life and how curious children and adults naturally are. What comes into our life that week, who is reaching out and what moments helped them most, and the most exciting moments! I am quickly inspired by whatever gave the adult the “aha” moment and covet every question. 

That gives me perspective into their challenges with a child. When an adult discovers why their child performs differently in different contexts or how to create short to long term memories for their child, then they inspire me by what they can do for their child. 

We also grab lots of inspiration from trying to learn something new everyday. We read a lot of literature, articles, forums ,and listen to podcasts. We covet our resource library and are eager to understand anything new. We also love attending workshops, continuing education, and conferences. We find inspiration from the children and families we’ve worked with over the years and the progress they have made.

Amy at Gezoont: 

7.  What are some interesting things you've learned during COVID especially with parents and other caregivers being at home with their children more? 

Megan at VMA: We have seen that parents are becoming more integral resources to the education system and when a child is struggling to learn, education and parenting have more grey areas of overlap than they do a divide.Many teachers and parents have had greater dependencies on each other to learn virtually and at home during COVID and with this, parents and teachers have seen more clearly into the challenges of each other’s worlds. Though the environmental goals and challenges differ, the grey challenge areas that are students’ foundational challenges often remain the same. For example, a child who is struggling to complete an assignment is often having difficulty completing other tasks at home as well.  We have seen that parents want to be part, they want to understand how to help their children, and they want to be part of conversations that lead to bigger and easier outcomes.

Amy at Gezoont: 

8. Vision and growth. Where or how would you like to see VMA grow? 

Megan at VMA: VMA is a vision and it’s growth is alongside us, much as we are our working alongside our clients and families. It’s growth is one small step at a time and  steady growth.  We understand that our services are one of a kind and we see ourselves growing into our community and pairing with traditional services and therapies.  We understand that consultation services are accessible to some and not all. With this in mind, we have long term goals of partnering with non-profit organizations for opportunities that would allow more creative ways to consult and advocate for a more diverse population.  We see ourselves as being a team of many different professionals with diverse backgrounds and expert level knowledge in multiple areas, so that each client is able to receive dynamic, efficient consultations.

Read More
Megan Cawlfield Megan Cawlfield

GEAR UP Your Picky Eater: Consider Breath and Mealtime Stress

Check our the video companion for this blog post:

Quick Discussion on Breath and Mealtime Stress

Advanced Discussion - Breath and Mealtime Stress

Check out the FREE PDFs

Reminder to BREATHE

Teach APPROPRIATE spitting

I you are like me, some days I really do feel like I live to eat! When someone starts talking about my favorite food, my mouth starts watering and I begin to get a bit excited! My neurotransmitters begin releasing juicy appetite enhancing chemicals to my brain that ready my body for an enjoyable, comforting meal.

For many of the kiddos I meet, mealtimes don’t trigger that it is time to relax, it triggers the opposite of relax. Instead of the parasympathetic nervous system readying the body to rest and digest, the sympathetic nervous system takes over, heart rate and breathing rate increase, and our body prepares for fight or flight. Let’s face it, because of this; mealtimes often become stressful for everyone when feeding challenges arise. It is understandable how these feelings develop into huge concerns overtime. Food is often thought to be the primary resource we need for survival, but the truth is that the number one resource we need is breath! Considering the connection between breathing and mealtimes will empower you to make simple, meaningful changes when you need them most.

Consider Breathing and Functional Readiness:

Our ability to attain and maintain a level of arousal state appropriate for functional activities, such as eating, is referred to as readiness. Because our readiness state impacts our breathing patterns so considerably, it truly can be unsafe to ignore readiness before meals. Considering breathing prior to the onset of mealtime routines initiates foundational changes that ready the body for mealtime success. 

When mealtime problems exist and it is caused by an inability to self-regulate arousal state, it is more common the person is “too high” rather than “too low”.  If a person is described as “too high” (appear “on the go”, unable to focus, and sit still), then they struggle to attain the attention necessary for mealtime. When this happens, heart rate and breathing rate increases; breathing becomes arrhythmical and shallow. If a person is described as “too low” (lethargic/tired/sleepy, non-expressive, propping etc), then breath may be rhythmical, but slow and shallow with some intermittent deeper breaths.

The good news is there are many techniques we can use to do this once we assess the underlying cause of the difficulty attaining/maintaining a functional readiness state. When a person that is “too low” it is easier to determine the cause and thus can remedy it more easily.  For example mealtime may be too late and the child is tired, consider earlier mealtimes. When a child is “too high”, simple changes such as: a heavy book or backpack, carpet to sit/ visual, or changes in speech and language can greatly impact functional readiness.  

Consider the breath and sensory input: 

Meals begin as soon as the food passes our lips, right? (Shaking head “No!”)

Parents KNOW this is not true; if mealtimes could just be this easy! Mealtimes begin with a thought, a routine, and an action. This sequence of events sets into play important foundations that ready our body for a successful meal. Mealtimes are announced in a variety of ways at various stages in life. Infants may perceive mealtimes beginning by their mother sitting down to nurse with a familiar pillow or they may see a bottle being prepared nearby. These routines are often initiated by smells and noises that fill the room. For those of us who do not struggle with eating, these preparation cues release signals to our body that it is a time to relax; appetite is enhanced at these times and breathing is steady, so that the body may ready itself for an enjoyable mealtime experience. Consider the variety of sensory input available at mealtimes such as appearance, smell, sound, touch, and taste, and how that impacts proprioception (how/where joints are moving in the body), vestibular (where your head and eyes are in space), and Interoception (what internal organs are doing: breathing, hunger, thirst, etc.).

To understand how this may feel, we have to think about our own experiences. Smell, images, and even sounds have the ability to trigger stress responses.  Faster, shorter, shallower breathing patterns are usually accompanied by decreased appetitive and/ or upset stomach (GI issues).  Personally, an emergency room or dentist waiting room can easily make me feel this way, but what if everyday food triggered a similar response?

When these cues trigger the opposite response (adrenal response) as mealtime routines begin, our body begins to adapt to protect itself from the perceived threat. As our body adjusts, breathing patterns often become shorter, quicker, shallower, and more irregular. The list of possible causes may be a combination of sensory deficits that contribute to mealtime aversion, but one of the first, observable responses to the noxious stimuli at mealtime is breathing patterns. Observations at the onset of mealtime routines can provide essential information about underlying causes.  For example, If breathing changes are noted ‘as soon as the food hits the plate’, then it may be helpful to address visual sensory; if breathing changes are noted ‘at the first bite’, then it may be helpful to address textures or even auditory sensory tolerances. 

Consider breathing and seating.

During mealtime, adults sit down to eat and automatically adjust to optimize breathing capacity. We understand how to prop our bodies, where we can put our feet, and how we can adjust as we experience fatigue. We understand how to adjust our weight as our stomachs fill up and push against our diaphragm. Children not only lack this same instinct, but they are also oftentimes at a disadvantage. Most chairs, high chairs, and tables simply are not designed to adjust with our ever growing child. Because of this, breathing rate can increase due to either the inherent challenge in the seating provided or decreased overall postural stability. It is also important to note that sitting posture impacts proprioceptive (how/where joints are moving in the body), vestibular (where your head and eyes are in space), and interoceptive (what internal organs are doing: breathing, hunger, thirst, etc.) systems that rely heavily on optimal functioning for healthy breathing patterns. 

Consider seating and posture before beginning a meal; the goal is to sit at a 90 degree angle with feet on a flat surface, hips square on the seat, and sitting up right.  Explore using a footstool/books/box under feet or consider using a Boppy, towels, or swimming inner tube around the waist/pelvic area. A grip mat may be helpful under the plate or on the seat to prevent sliding. Consider a seat with a back that is placed at an appropriate distance from the table.  Lastly, consider if your child is left handed or right handed.  Hand dominance impacts sitting posture and so placement at table can be significant.

Consider breath and oral motor:

As we observe newborns rooting and suckling during the first moments of life, it is easy to understand the assumption that we are born ready to eat. The assumption is often that eating is easy and instinctive and that it is not a skill that has to be taught or even learned. For many of the little ones that I meet, this couldn’t be farther from the truth. When oral motor is a concern, consider the magnitude of vulnerability when food or liquid is presented at such close proximity to one’s airway.

Fortunately, feeding is not our body’s number one priority and we can assume that our bodies will adjust to keep us safe. Exploring how our little one adjusts and compensates in these instances will allow us to make meaningful changes when we need them most. Simple changes in presentation can allow your little one to gain skill, without the need for unwanted compensation and mealtime stress. Be mindful of rate and positioning during bottle feeding by exploring a slower flow nipple or a side lying position to allow for unmanageable liquid to utilize gravity to pull unmanaged liquids out of the mouth. Observe your little one swallow and breathe during spoon feeding as they signal readiness for the next bite. Use stick shaped to allow for oral motor exploration and skill enhancement without the risk of airway penetration. Try a Nosey cup to decease flow rate by decreasing the angle needed for cup drinking.  Lastly, teaching appropriate spitting early on can provide your little one with the confidence and freedom to embrace mealtime experiences! 

Send Me REMINDER PDF

Read More