Who can benefit from the Interactive Metranome?
Children with motor and sensory disorders, learning deficits, speech and language delays and various cognitive and physical difficulties can benefit from Interactive Metranome.
- SPD/SI (Sensory Processing Disorder/Sensory Integration)
- CAPD (Central Auditory Processing Disorder)
- NVLD (Non-Verbal Learning Disorder)
- Cerebral Palsy
- SWALLOWING/FEEDING/VITALSTIM THERAPY
- ORoFACIAL MYOFUNCTIONAL THERAPY
- OTHER pediatric SERVICES
Dysphagia is difficulty or discomfort swallowing. It is estimated in the U.S. that 15 million people have dysphagia, and that dysphagia is underdiagnosed. Many people who are affected by the disorder include 75% of stroke survivors, 90% of patients with progressive neurological disorders such as Parkinson's disease, ALS, and MS. Also, patients with head and neck cancer, brain injury, and the elderly can be affected.
VitalStim therapy SAVED MY LIFE. I had a stroke in October 2002 and was having a very difficult time recovering my ability to swallow. I had gone through several doctors, therapists and types of therapy; it was very evident that I was not improving. This medical condition of mine landed me in 9 different hospitals in the last three years. One day while watching WTAE news, I saw a clip on VitalStim being done by Denise Dougherty and the rest is history. After living with a feeding tube for 18 months, VitalStim therapy had me swallowing within 2 months. I was able to shed myself of the feeding tube and today I swallow any type of food. Denise has a very special quality in dealing with the differences in ages and also the variety of swallowing problems. VitalStim was the tool she used but it took Denise to make sure that it was used properly." --Ed F., Former Patient
My son, Sean, was referred by his Oral Motor therapist to Denise Dougherty for VitalStim therapy. Sean is a beautiful three year old boy who has cerebral palsy and associated challenges with his eating and swallowing. Although the office is a six hour drive from our home, we decided to make the trip after corresponding with Denise on the phone and e-mail. We were encouraged by the results VitalStim has produced with other children, and we were also reassured by Denise's professionalism and helpfulness with our many questions."
My son is 13 and Autistic. We are fortunate he can talk but his speech development was delayed and he has always struggled with conversation. We have been to numerous speech therapists over the years with little results. We have heard about Denise on the radio. In the few months my son has been working with Miss Denise, we have noticed improvements already. My son also has an amazing connection with Miss Denise that he has never had with his other therapists and cannot wait to go to his next appointment. Denise is very patient with my son and always lets me know what they are working on and how he is progressing after every appointment."
We are thrilled that we made the decision to work with Denise - our hopes for Sean's progress were greatly exceeded! Sean's swallowing became more coordinated, allowing him to eat more easily and also handle his saliva more efficiently. In addition, we noticed that his tongue thrust was diminished. Lastly, Sean's use of his lips and tongue while eating improved noticeably."
Addison was born in 2013 with a diagnosis of down syndrome. While he was remarkably healthy in every other way his dysphagia was evident in the delivery room. He struggled to nurse and was unable to take a bottle. In his first months he nursed eight hours a day in order to maintain a healthy weight gain. One feeding specialist commented with the complexity of Addison's oral issues she could not believe he did not have a feeding tube. It would take several years before we fully understood the depth or impact dysphagia would have on our little guy and just how very true that statement was.
In the first fifteen months we sought help for Addison's dysphagia through our local early intervention program as well as multiple pediatricians and ENT's. I consulted with every speech and language pathologist and feeding specialist in our tri-state area. No one offered any explanation or help aside from saying it was related to his down syndrome and to decline his case. When Addison was fifteen months old and developed, infantile spasms, a catastrophic seizure disorder, we realized the full impact of his dysphagia. The medication for Addison's seizures could only be taken orally and he was unable to swallow it. The seizures were killing off parts of his brain so there was no other option but to get the medication in him. We spent four hours a day giving him the four 10 ML doses drop by drop, often while he screamed and gagged. We sought help in multiple places but each told us the same thing, "There is nothing we can do to help you."
Three months later Addison was seizure free. In the aftermath, as we were reeling trying to understand what had happened, what it meant long term and what we needed to do to help him recover, we learned the seizures and the treatment had made Addison's dysphagia worse by killing off the nerves endings in his body, including his taste buds, and making his hypotonia so severe he could no longer smile or sit up.
Along the way to a diagnosis and cure we have traveled to Washington DC, Baltimore and Connecticut where he was treated by the heads of ENT at two top teaching hospitals and a genetic researcher considered one of the world leading experts in down syndrome. Over three and a half years Addison's feeding team, in addition to Denise has included ten speech and language pathologists and occupational therapists who specialize in feeding issues for children with down syndrome. He has had multiple surgeries and received oral placement and feeding therapy three to four times a day almost every day of his life. Despite all of that we have often found ourselves at a complete loss as to what to do or where to go. While we truly believed there was a way no one had any answers and nothing we did seemed to help long term.
Every time we thought we made a little ground we seemed to get another blow. In the fall of 2015, at two and a half we were rejoicing because Addison was taking eight ounces of formula a day. We would pour his formula into his mouth from a therapeutic cup. He would swallow a little and twice as much would run back out. It took him four to six hours a day and at the end of each feeding Addison, the person feeding him and the surrounding area were soaking wet. We used a roll of paper towels at each feeding to clean up the mess. The work of eating was so exhausting Addison would nap for hours after each feeding. We couldn't leave the house because he wore out so easily and he needed all his strength to make it through the next feeding. However, it was a huge step over a year before when he could not swallow even one milliliter. At that time Addison came down with gastroenteritis which triggered ketonic hypoglycemia, a life threatening situation in which low blood sugar causes toxicity in the blood and eventually causes kidney failure. The simple treatment is to consume juice to quickly raise the blood sugar. Addison spent days in the hospital but doctors could not bring his blood sugar above 40 intravenously and we could not get enough sugar in him orally to help him.
Denise Doughtery and Vital Stim had come on our radar in January 2015 but everyone agreed Addison was too fragile to handle the intensive treatment or the trip at that time. Over the next few months we continued building his weight and strength with adaptive feeding methods. By February 2016, in consultation with Denise, his SLP and OT we entered into an intensive vital stim therapy program where we planned for Addison to receive therapy every day for 24 weeks and then move to a tapering program. We saw instant improvement through less anterior loss, improved swallowing and increased sensation. Within weeks on vital stim Addison ate four ounces of applesauce in a 45 minute session. We cried and took photographs. By the end of twelve weeks Addison was eating pudding and avocado puree as well. At that time we had seen enough to know vital stim was the answer we had been searching for. Unfortunately, his therapist moved. Without vital stim, Addison quickly spiraled downhill until he again could barely manage a puree. We began traveling three to four hours a day to the nearest therapist who could offer vital stim therapy and continued working to get him strong enough to see Denise. By July of 2016 we felt Addison had reached the maximum benefits with this therapist and believed he was finally ready for the three hour trip and a week long stay of intensive therapy.
Going into this we were anxious about how Addison would respond to a strange environment, a strange therapist and four hours a day of even more intensive therapy. We also were unsure how Addison would get the rest he needed to withstand therapy and maintain his carbohydrate intake to maintain his blood sugar. And we couldn't figure out how we were going to prepare the special foods his therapist was recommending for our sessions without a kitchen. Denise worked with us so much before we even arrived to help us feel comfortable with all these issues. She also helped us find a place to stay and offered us the use of her kitchen to meet Addison's dietary needs. She was patient with Addison's moods and sensitive to meet all his special needs and put us at ease while telling it to us honestly. Within a few hours of meeting her, all of us in the sessions (myself, my husband and Addison's two adult sisters) were convinced Denise had not only the skills but also the WANT to help us teach Addison how to eat. We left that first week exhausted, encouraged and challenged. Over the last eight months, we have averaged about a week each month working on vital stim with Denise. She has been as flexible as possible to work out a travel and therapy schedule conducive to our busy lifestyle and Addison's therapeutic needs. Each time we see Addison make more and more gains. In between sessions she consults with us to deal with set backs, answer questions and encourage us.
Today this little boy who could not swallow even a puree exactly one year ago, the boy who doctors and previous therapists said could only be helped with a feeding tube, is eating a burger, french fries and a milk shake for dinner. He is healthy and strong. He struggled to maintain 18 pounds one year ago and now at 32.5 pounds is in the 50th percentile for a typically developing child. This is almost unheard of for a child with down syndrome, never mind a child with dysphagia. Our family is able to live again. We don't need to plan life around his eating or nap schedule. Addison is able to explore life as a three year old should. Among other things, he enjoys animals, the outdoors, learning through his teaching therapies, playing with his older siblings and riding horses. Addison still has a long way to go before he will chew a steak dinner, but with Denise as an indispensable part of his team I have no doubt that day will come."
Mama and Advocate for Addison
"Denise is an instructor for VitalStim certification, and she is one of the leading providers of VitalStim in the country. Because of her extensive training and expertise in many areas of Speech Therapy, Denise was also able to employ other techniques that helped Sean make progress. In addition to being a consummate professional, Denise was caring and compassionate towards our whole family. She was not just treating a patient when she worked with Sean's Denise was helping a little boy make valuable gains in a gentle, caring way. " --Mother of Patient
Orofacial Myology is the study of normal and abnormal use of the muscles of the tongue, lips and the face. Muscles can affect the tooth alignment, speech production, chewing and swallowing. Orofacial myologists use myofunctional therapy; which are specialized exercises to establish correct functional activities of the tongue, lips, facial muscles and jaw. These exercises eliminate or greatly reduce:
- Lip Biting
- Food chewing problems
- Facial muscular imbalance
- Open lips resting posture
- Abnormal tongue resting posture
- Articulation problems
- Tongue thrust
Children as young as four years old can benefit from a diagnostic session to determine if they can be helped with giving up thumb-sucking, prolonged use of a baby bottle or pacifier. Children of 7 or 8 are often mature enough to receive complete training. Children, teenagers and adults of all ages are capable of success in treatment. Many recent scientific studies have shown that treatment for orofacial myofunctional disorders can be 80-90% effective.
Research found an 81% prevalence of orofacial myofunctional disorders in children with speech and articulation problems.
To learn more about Orofacial Myology, visit www.iaom.com
Expressive Language Disorders
Receptive Language Disorders
Independent Education Evaluations