37 The Cycle of Nutrition and Oral Motor in “Picky Eating” with Shandy Laskey

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Disclaimer: The information in this Podcast is for educational purposes only. Vaishnavi Sarathy, Ph.D. is an educator, not a doctor, specifically not your child’s doctor. Please consult your physician before implementing any supplement or diet recommendations.

Audio Transcription: 

Vaish:

Hey everyone, three days late but here it is. Welcome back to functional nutrition and learning for kids. I’m your host vaish and that is spelled Vaish I’m here is hosting this podcast because I believe that sound nutrition and equal education and the birthright of each. I also believe that finding these buttons is not trivial or accidental. If you have a child with Down syndrome or autism.

Today, I’m interviewing a fellow nutrition practitioner who also has some very interesting extra qualifications. But before we move on, I want to ask you if you love the podcast, please drop in a review on iTunes. If you have a recommendation or a comment, write to me advice at functional nutrition for kids.com. My day is absolutely made when I hear from my guest today shandy Lansky and shandy have this amazing interplay of, you know, skills that I haven’t actually seen before.

She’s an integrative speech-language pathologist, a pediatric feeding specialist. She’s also a functional nutrition therapy practitioner and a health coach. So Shandy, can you tell us a little bit? Can you start off by telling us a little bit about the work you do? Yeah,

Shandy Laskey:

absolutely. So um, what do I do now? So my work is kind of twofold I am set up to be to see kids locally and to see families online, most of my work organically has grown online. And I didn’t expect it to go that way, it just is the way that it happens.

I do a lot of parent coaching work around looking at where their child is developmentally, and how to optimize everything that parents can do at home, through nutrition and lifestyle and developmental strategies to optimize their kid’s health and development. So you know, oftentimes, parents, especially parents, who are navigating new diagnoses, it’s overwhelming to go through this new diagnosis. And then you get this team of therapists and you, you know, you’re going through all these therapies, and you’re doing all these things. And I really want to be that person that is empowering families and parents on what they can do themselves at home. Rather than, you know, relying on like the whole team, I think that’s awesome.

You need a team approach. But I think it’s empowering to let parents know what they can do

Vaish:

A lot better. Maybe we can end with a few action items before we end for parents that they can do just after listening to this podcast. But I also wanted to ask you a little bit about integrative speech therapy. So can you tell us a little bit more about what that term is? And if parents what is the difference between seeing a conventional speech therapist and an integrative one?

Shandy Laskey:

Yeah, that’s a good question. So I’m a conventional speech-language pathologist who has not been trained in nutrition, conventional speech-language pathologists, we are trained to be holistically minded professionals, and we’re looking at how the challenge communication challenge and speech challenge whatever is going on how impacts their quality of life as a whole. So in that sense, SLPs are holistic providers.

Where I feel the gap is, or the difference between, you know, a conventional SLP and an integrative SLP is that we’re integrating these health and wellness aspects, right? We’re integrating nutritional components, we’re integrating lifestyle components, and these things are going to help lay that foundation down so that that child is in a better space for learning those nutritional interventions. So in terms of like my actual practice, work, I’m, never doing traditional speech and language therapy anymore.

Like in local settings, I might give a parent a communication strategy or a speech strategy, that I’m modeling for the parents to be able to do it. But for the most part, I am letting traditional speech therapists do the traditional speech therapy so that I can relate target the nutritional aspects with the family, and that developmental coaching role.

Vaish:

I know that you work with a lot of children with disabilities and we were just before we started recording, we were talking about your passion statement, which I liked a lot. So can you tell us what is it that you know, brought you here.

Shandy Laskey:

I’m really Passionate about working with kids who are on a healing journey. So kids who are kids might have had a developmental regression, maybe they were development developmentally typical and they had some sort of regression as a toddler, or something happened, where development changed.

A lot of those families go down a path of looking for some answers of why did their kid changed and even some kids who are not experiencing a regression, their parents go down this holistic search. Right. And it’s not that the trouble is that nutrition is not always like the first thing that’s recommended. So, and that’s I guess like where my passion is. And that’s where I want to hone in more with my work is the nutritional piece is the missing piece for many of these kids.

So I would love to get to a place where we’re talking about nutrition and lifestyle for kids with complex picky eating, and neurodevelopmental disorders across the board. But like we were talking about, it’s, hard to focus so much on the nutrition and recovery aspects when you have this major hurdle of these complex, picky eating challenges.

A lot of these children have that. And so um, so that’s a big aspect of my work, too, is not only looking at the biochemical pieces of what’s going on at like the cellular level with your child, but also looking at these other pieces, and how can we integrate all of that?

Vaish:

One thing that I often find is that that’s a vicious cycle, isn’t it? So like your nutritional deficiencies can drive your pig eating and your pig eating can drive the nutritional deficiencies? And then where do you start?

Shandy Laskey:

So it depends on where the kids at, right? So it depends on where they’re at a lot of families that come to me, um, their children are, like, biochemically addicted to gluten and dairy, that casein protein in dairy. And you may have covered this on your podcast before but just so people listen maybe this is their first one. Oh, boy,

Vaish:

I haven’t actually like yet gotten into a podcast about just gluten and dairy. And I’ve been meaning to talk about opioids and everything. But this is a great time. Go ahead.

Shandy Laskey:

Yeah, yeah, so it’s so big, and the work that I do, and it’s why I incorporate kids with complex picky eating into my work, even though they don’t have a neurodevelopmental diagnosis. But the approach is so similar. And it’s remarkably like powerful.

I feel like, it’s so overlooked by a lot of conventional feeding specialists. So, not all feeding specialists are SLPs. Some of them are OTs, maybe PTS or psychologists, nutrition professionals, it just kind of depends. But most often it’s gonna be an SLP, or an OT. But nutrition, again, is not like, not where we’re trained. So I learned about the opioid theory, just through my own learning.

You know, I went through my own health journey, which led me to like my integrative work with children. And so a lot of the kids that I work with, they come to me and they only have just like a handful of foods, and it’s almost always pizza, mac, and cheese, chicken nuggets, you know, or they’re drinking obscene amounts of milk.

Yeah, like, a lot of milk. Um, you know, and sometimes there’s other like components in there are two and there are and I should note, there are most certainly other foods outside of gluten and casein and dairy, that can cause that, like biochemical addiction drive. But those are the two that I see most commonly. So first and foremost, like, that’s my approach is how can we do gluten and casein-free trial for your child to see if that’s actually a problem for your child? Almost always it is right? Like if even if parents are in denial at first, like, oh, I don’t think it’s an issue. How about we just remove it totally for three weeks, and then you just see, and almost always, they’re like, they’re a different child.

They’re a completely different person. They’re calmer, they’re less irritable. They’re, they’re having a bowel movement every day. They’re sleeping through the night. Oh, my gosh, he’s babbling now. You know, and this is all like, no therapy. This is all nutrition intervention. That’s all like parent coaching. You know, so that’s pretty remarkable to me. So I often look there, and that’s more of like that biochemical addiction piece of it. The other aspect of picky eating that’s very biochemical that I see is zinc deficiency. And I find that that is super common. And there are, like liquid zinc assay drinks.

You know, like we learned at a nutritional therapy practitioner school. And so I’ll have families either get started, like testing with that, but if they’re too little, or the kid is not, um, some of the kids that I work with aren’t able, whether it’s, you know, metaphorically or like their understanding perception, they’re not able to just hold the liquid in their mouth to test for the zinc deficiency. And so what I’ll say is like, why don’t we just ask your doctor about trying a zinc supplement for a couple of months or so just to see if that helps? And we can, you know, we can even test with the pediatrician to see what the levels are and stuff. But that’s not always totally necessary, because sometimes it’s so obvious that it’s needed. Right. Right.

Vaish:

Yeah, yeah. So those are good things. I was going to ask you if, what are the hurdles that you experienced. So would you let me back up a little bit? Would you say that starting with a gluten-free and dairy-free diet? Would that be a non-negotiable in your eyes?

Shandy Laskey:

For the kids? I see? Yeah, yeah. Yeah. That’s all like I and I know parents, like really don’t want to hear that. Because if you’re coming from, like, standard American diet to hear that, casein dairy-free, all that, I mean, some people don’t even like exactly know what casein and gluten are like, they don’t like I’ve had some families, you know, at no fault to them, that don’t understand like, no, he cannot have milk, but he also cannot have cheese, or like, in the flavorings of their favorite foods.

There’s cheese in that flavoring

Vaish:

or yogurt. And that’s a big one. Because a lot of people think I mean, I think there’s the confusion with lactose where you think you can have yogurt. But

Shandy Laskey:

yeah, yeah, you’re absolutely right. And so I think that there’s the first phase of like, understanding that they need to be removed. And then the second phase of like, actually doing it, going through it. But when you have a kiddo who has four foods, and those four foods are all gluten and dairy foods, what do you do? Do you starve your child? No, of course not. Right? You can’t just cold turkey. And the thing with kids with autism is, you know, a lot of people will say, Oh, that kid will eat when they’re hungry, though, only when they’re hungry.

No, that is dangerous for kids that I work with as they will. Some of them like we start here. Yes, they will start like, I’ve never had it happen or kid ends up in the hospital. But I’ve heard stories, you know, so I’ve heard enough stories to say, I will never recommend it because I don’t feel comfortable. And so that’s where my work of families really focuses is okay.

How do we look at where your child is, and transition them to gluten-free casein-free? Eventually soy-free corn-free. And um, and then from there also looking at okay, food additives? Are they taking in artificial dyes, artificial flavors, food, preservatives, MSG, which we know is neuron site is how it Tori? Um, so, you know, even before I go gluten and casein-free with families, I say, are you mostly organic, like as much as humanly possible for you and your budget? Like following the Dirty Dozen? Yes, absolutely.

To say that a family is already organic, gluten-free, casein, free, soy-free, corn-free, and they just want to take those next steps. I’m also there for those next steps. So looking at, okay, what are the other foods that your child drives towards? Like, for example, I’ve had kiddos that weren’t gluten and casein-free.

They’ve been gluten and casein-free and organic for quite some time. But they’re still very limited in their food options, right? So I look at a food journal. And this kid’s eating like five red apples a day. And I’m going, that’s interesting. And they’re also struggling with aggression. Hmm, that’s interesting.

I wonder if it’s possible that they have a salicylates sensitivity or something like that, that could be creating those addictive-like drives to those foods and also creating that like aggression or hyperactivity So through my training and my lens, I’m able to look at a kid’s food and mood journal and tease out, okay, they’re great happened here? Well, I wonder if this food or that food causes that let’s do a trial, let’s take it out, let’s put it in. And sometimes with certain cases, I might say, we need some food sensitivity testing, or we need some sort of like testing.

I’m not ordering those tests myself, I would be, you know, working with that family to get them to their pediatrician or to a functional medicine doctor or to someone who can order those labs and, you know, work as a team to collaborate on that. Right. But at the same time, like there’s so much of my work that’s done with elimination and reintroduction trials of foods because I mean, really, that’s the best way that you’re going to see the reactions, because a lot of those food sensitivity tests, they’ll test the protein reactivity, but they’re not testing for soulless reactivity or, you know, absolutes or whatever else that could be impacting a kid and some sort of thing.

Vaish:

Yeah. And, you know, it takes, it takes a lot of commitment from this from the side of the parent, and do you get some pushback from parents? Is it like their parents decided they don’t want to go down this road? And I’m sure when they start doing it, it’s a lot initially almost go through? What do you call them? The five stages of grief, right? You can actually feel the emotional response, removing gluten, it’s not as a child just that goes through the grief. It’s like, you I remember when I took out gluten from my son’s death, this fear of them never being able to eat within quotes normally again, so I don’t have that anymore. I mean, I, even in myself, I find that ridiculous, but I did go through it.

Shandy Laskey:

Totally well, and you know, I agree. Like even with my own health journey. I live in Colorado. Now my family lives in Michigan. But when I go home to Michigan for holidays and stuff, I mean, there’s still some grieving that comes up for me, even I can’t eat my grandmother’s cookies. I can’t, you know, just different things where it’s like, you don’t realize that there’s a grieving process to removing these foods until it happens. So I love that you brought that up because I feel like no one really talks about that.

Vaish:

Yeah, yeah, I don’t even talk about that as much as I can. Because we forget, we go through these, like, you know, if you’ve been in that journey for a very long time, it’s very easy to forget, I wanted to ask you. So you talked earlier about how like conventional therapy sometimes. Or maybe this was when we were talking with ourselves, but we’ve had this discussion about how conventional therapy can sometimes have a gap when the foundational nutritional needs are not met. So I want to flip that question over. And I know because you work with kids that are self-restricted in their eating, you know, the so-called picky eaters and so on.

Can traditional therapy work without oral motor support? Can you just work through picky eating? Nutritionally?

Shandy Laskey:

It depends. It depends on that kiddo, right? Because you can do all the nutrition work in the world, but that’s not going to fix your child’s hierarchy palette due to their tongue-tie, right? Um, or you can do all the nutrition work in the world, but it’s not going to fix, you know, your child’s motor planning.

I think that it really depends on that child. And I will say like, I’ve had a lot of kiddos where the nutrition work really improves the picky eating even though the oral motor stuff still needs to be worked on that biochemical component really, like gives that boosts like I’ve got a little guy that I just wrapped up a package with that is just right there in my mind as we talk about this because I actually referred them to be seen by someone in their local area to have an evaluation for a tethered oral tissue, like a posterior tongue tie. Um, but sometimes, and it’s kind of like the chicken or the egg question.

Sometimes that oral motor structural-functional issue is like the starting point that then creates a biochemical issue. But it can also be vice versa to like if you’re only eating these really soft foods, or you’re only drinking milk for forever, and you don’t you know like developmentally move through that continuum of getting to harder, crunchier textures and things like that, then yeah, your oral motor development could be delayed, and similarily. If your oral motor challenges are bad enough that you feel unsafe to eat, well, then that kid will just default to those softer foods that they know they’re safe with and Oftentimes, those are gluten and dairy foods. Or, you know, okay, here’s one. That’s the perfect example of that.

The kiddos that come to me that are toddlers that only eat pouches, and that is all they will eat is pouches or pureed smoothie type of texture. You have to ask yourself, is that nutritional? Or is that oral motor? What’s in that puree? Okay, so I guess what I’m saying is, it can be both. And I’m having good luck. And then you can combine Yes, exactly. Because like if you’re only eating soft things, or you’re only eating certain foods because those are the only foods that you feel safe with.

Well, over time, your microbiome is not getting a diversified enough intake. And so you start to drive towards those foods. And if those foods are just gluten and dairy-containing then each time each meal that is causing that intestinal permeability, that leaky gut, and then we spiral into like, then we’re developing the food sensitivity to it. And maybe it all started from, I didn’t feel safe eating it because of my oral motor structure, but it spirals into something more.

Vaish:

So we’re in this vortex of these multiple vicious cycles, oral motor feeding, picky eating, you know, nutritional deficiencies, leaky gut, and each of these feeding each other, and inflammation, intestinal inflammation, all of them, it’s like, everything feeds another and where do you start? And definitely, I feel like nutrition is a great place to start, because it’s an easier place to start, even though it seems harder, it’s actually an easier place to start in some ways.

Shandy Laskey:

Absolutely. And it’s what you can control as the parent, right? Like, you know, your child has to eat at least three times a day. So you get to control that you get to control what they eat. And I think that parents, so often, you know, it’s very daunting, but like, they have to know that it’s not easy. If it was easy, my job wouldn’t exist. Even I mean like sometimes my, whole job is just getting them to that gluten and dairy-free point. And then we can move on with, you know, more work. But sometimes like that whole first initial package, if you’re working with a client might be just getting them on a gluten-free diet, or just getting them on gluten-free, casein-free. Um, I have some parents where it takes a few months to get to that point.

I also have some parents that I work with where, you know, I’ll talk to them during the discovery call. And then I get on the phone for the initial consultation, and they’re like, Yeah, we’re already dairy-free we’re working on, you know, they’re such go-getters, they’re just ready, and they just need that support from me to say, yes, you’re doing a good job, maybe tweak this or do it this way, or, you know, this time add and that, um, anything parents also, you know, going down the nutrition journey, when they’ve got a kiddo who is a complex picky eater, they want to do those nutritional changes in a way that’s not going to create like a negative relationship with food.

Vaish:

I think that’s important,

Shandy Laskey:

so important, you don’t want to ruin that relationship and that trust with food and mealtimes. And so what

Vaish:

we do isn’t radical by any means. But the changes we’re making are radical, right? So and the changes we’re seeing are also radical. But so there is definitely a chance for that trust factor to kind of, get twisted. So I think that that’s a really important thing that you brought up. So thank you. That was That was amazing. And because we’re so close to our time, I wanted to ask you a couple of things.

I feel like I was going to ask you for three action items. But did you have anything else you already brought those in terms of the first top three things that you were going you would do with a child in terms of your non-negotiables of removing, you know, gluten dairy? And we’re talking about going organic as either the first or the second? And then did you have anything else that you want to add as an action item?

Shandy Laskey:

Okay, yeah. So I would say with eating something that I like the first strategy that I always give to families is to take that like pressure and expectation that they’re going to just eat the food off. Just focus on exposures, positive exposures, versus actual food consumption. We know that for typically developing children without a diagnosis, it can take up to 15 exposures to a food for them to try that new food. Now, if you’ve got a kiddo who has a complex picky eating challenge, or a neurodevelopmental disorder, or delay, or something else involved, you can pretty much double that number or more.

It’s a long process. It’s not easy. You have to give yourself and your child grace with it. And focus on underwhelming, not overwhelming. Like, if it’s a new food, and they’re, they’re learning to try that new food again, don’t focus on the consumption of that food focus on, is it okay on their plate? Is it? Will they touch it? Will they smell it? Will they like it? Will they taste it? Will they bite it, you know, like really working up that hierarchy and that, that process to eating rather than putting like so much pressure on the child and yourself?

The other thing I would say is, you know, just be like celebrating those small victories along the trajectory of development, and only comparing your child to your child not comparing your child to everyone else’s child. Because I think that that’s just, that’s just really important to me to

Vaish:

wise words. working parents find you, Sandy.

Shandy Laskey:

Thank you for asking, you can find me at speakingofhealthandwellness.com. And you can also find me on Instagram at speaking of health and wellness. And I’m on Facebook at speaking of health and wellness, LLC is my handle on Facebook, and we’ve got a free community group for parents and professionals on Facebook as well so people can come to join me in there.

Vaish:

It was great talking to you. Shandy thank you so much.

Shandy Laskey:

Absolutely. Thank you so much for having me. Super.

Vaish:

We really need to get into the gluten and the dairy part won’t be so shiny brought in some very important points that as functional nutrition folks, we consider non-negotiables, why that is the case as many of you have asked, will be covered in a few weeks. My guess is probably another two or three weeks. I’m going to have a podcast about that. Until then, this is me Vaishnavi Sarathy signing off. Music is made by my daughter might record and see you in a week. Actually, it’s gonna be less than a week to see you this Friday. Bye.