Speech Pathologist

[Anonymous]

Does any one have a recommendation in the NOVA or DC area for a speech pathologist? My child is almost three months old and she has sever reflux problem according to our pediatrician and we were told to see a gastroenterologist. We did see a gastroenterologist and we were told to see a speech pathologist. The doctor thinks my child has swallowing problem. Thanks.

[Anonymous]

Did they say what kind of swallowing problem? Does her tongue go forward when she swallows (this is a tongue thrust, the tongue is supposed to go back) & that kind of thing is treated by a speech pathologist, but if there is a medical swallowing issue then that should be followed by a dr. Does she have voice issues (hoarse voice) due to the reflux? A speech pathologist would just say to give her lots of water, make sure she doesn't shout & to have her use her voice softly. I am a speech pathologist by the way, but do not work with swallowing patients.

[Anonymous]

Thank you so much for your response. I do not know if her tongue goes forward or backward. What I need to do so that I can find that out. My daughter spits up a lot and after taking half a ounce of formula she started screaming. It is very difficult to feed her. She started having the problem three weeks after she was born. Initially she did not have this problem. Now on average she is taking 15 ounces. Our pediatrician told us it seems like she has reflux problem.If you know a speech pathologist who work with swallowing patients and you like the doctor, would you mind sharing some names?

[Anonymous]

I had great difficulty finding speech therapists who were competent with eating issues. I used The Language Experience (offices all around the greater DC area, I used Rockville). They were wonderful. I would also suggest an OT evaluation at Children's Hospital with Cathy Fox. She initially evaluated my son and was able to identify my son's specific problem and direct me to the right type of treatment (which was not OT).

[Anonymous]

Thank you so much for sharing your experience. What does OT evaluation mean? I tried to look up Dr. Cathy Fox at Children Hospital but did not find her. I tried her under Hearing and Speech and Pathology Dept but could not find her. Did you see her long time ago?

[Anonymous]

I'm sorry, OT is occupational therapy. She can be very hard to get ahold of, but it was worth the effort. I hope all works out well for your baby.

[Anonymous]

PP speech therapist here. I'm sorry I didn't realize your DD is 3 mo. old. All children have a tongue thrust at that age (it is part of the sucking reflex) & doesn't go away til about 6mo+. So I'm not sure what a speech path would do. I'm sorry I can't help more. Can your pediatrician give you a referral? A hospital based speech path would probably be based since they work with more medically based disorders. Good luck.

[Anonymous]

To the 8:17 poster- I got an appoinment with Dr. Cathy Fox. Do you think I should take my daughter? Our gastroenterologist told us to see a speech pathologist now is Dr. Cathy Fox is a speech pathologist? Our gastroenterologist is not that helpful and we are going to see another gastroenterologist but mean as while I want to get done as much possible so that we can get to the bottom of the problem(we are hopping). It is really hard to watch the little one suffering that much. Thank you.

[Anonymous]

OP here sorry I meant to say 17:07 poster but feel free to comment on it.

[Anonymous]

Both of my babies had severe reflux, one lasting 11 months and the other 22 months. Both children required medication (zantac for the first and prevacid for the second). My first child was able to eat and became a calm baby once her medication kicked in, but the second child really struggled with feeding and wasn't able to advance to finger foods or anything other than pureed #2 foods without the help of a feeding therapist. We did three years of feeding therapy with him, and he now (at 4.5 yrs old) eats like a picky toddler, so we have stopped the therapy. He now can chew and move food around his mouth with his tongue (he also has apraxia), and his esophagus has healed completely.

In our case, we were told that therapeutic intervention was going to be a huge challenge to enact without much result until an older age, so it was 9 months when he was evaluated by an SLP/OT/MD team and 12 months before he started any intervention. As the speech path who is a PP on this thread posted, it is hard at this young age your daughter is to see what is a "normal" tongue thrust and what is specific to her disorder. Also, at least in our case, with United Healthcare, insurance paid for NOTHING in terms of feeding therapy, even though it was a documented medical illness, so it was hugely expensive and you want to make sure when you take on bills like that, that it's a time/developmental age when your child can really benefit.

Since you're under the care of specialists, if you haven't already, you should try medication for the reflux and don't stop with the first one you try. If zantac doesn't work, try prevacid. If prevacid doesn't work, try prilosec, and so on down the line of approved-for-baby reflux meds. I was adamantly opposed to medicating my first baby, and I let her suffer far longer than she should have just because of my own anti-medication stance. Thank God I saw the light because once I medicated her, she was much better and now is the best and easiest 7 yr old you can imagine (and became this way by 3 months, when I medicated her). For my second child, we medicated him at 2 weeks old but had to switch around and try lots of different meds before settling on the highest dosage of prevacid for his age/weight, and he needed that medication until he was 22 months old when his reflux finally calmed down enough that he stopped spitting up so much.

Do go to another gastro and find someone who will work with you. Reflux is a challenging condition but it shouldn't be untreatable and your baby shouldn't be left suffering as you describe.

Good luck.

[Anonymous]

Sorry I forgot to mention that DD is on prevacid. First she was on Zantac. None of the medicine made a difference so far and she is getting worse everyday. She does not sleep more than an hour at a time. I do not understand one thing if she has acid reflux, why the doctor says she has swallowing problem. I thought they are were two different thing. I am just asking since I do not know anything about the relationship between them.

[Anonymous]

11:11 here. Make sure she is on a high enough dose of prevacid. We needed the MAX dosage for our son's weight, twice a day. We also found that getting the prevacid mixed in a pharmacy worked much better than the kind that gets dissolved at home with the tablets in water or juice.

In our daughter's case, there was reflux with no swallowing issue. In our son's case, there was reflux plus swallowing issue. I think it's probably too early to tell in your daughter's case, but I am no expert. This is why IMHO you need a second GI opinion from one of the well-respected pediatric gastros around.

Good luck.

[Anonymous]

Reflux and swallowing issues together caused my DS to fail to thrive at a couple weeks old and we were admitted to Children's Hospital and seen by many specialists over the course of a couple of weeks. Turned out to be a very rare neurological condition seen in people of eastern European Jewish descent. DS was given a feeding tube and seen by both gastroenterology and speech pathology (along with many other specialists through the years). I think Children's Hospital is a good place to seek help so I encourage you to continue to see specialists there. They can refer you within the hospital to other specialists if they observe something you and your pediatrician might be missing. Medicine is great if it works, but you also want to rule out underlying conditions that might be better treated in other ways -- medicine can also mask conditions. And reflux and swallowing problems can result in liquids getting into the lungs, so it's important to find ways to remedy those problems.

[Anonymous]

17:07 here. Cathy Fox is an Occupational Therapist. Feeding issues cross disciplines between speech and OT and I honestly don't know if there is a bright line or if there is some blurring around the middle. I found Dr. Fox extremely knowledgable about feeding issues. She diagnosed my son and then recommended speech therapy rather than OT because my son's problems were more appropriately treated by a speech therapist.

If you have insurance and/or the means to pay for an evaluation, I would do it. You are lucky that your doctor's directed you toward treatment so early. Mine did not and we had a couple of years of very difficult eating issues and very little weight gain.