Summary
In this engaging podcast episode, Franchesca Cox and Megan Williams share their personal journeys into the therapy world, discussing their experiences with various therapy techniques, the importance of family education, and the challenges faced in the field. They emphasize the significance of understanding reflexes in therapy, the impact of insurance on treatment options, and the need for continuous learning and adaptation in therapy practices. The episode aims to create a supportive community for parents and therapists alike, encouraging listener engagement and future topic suggestions.
Takeaways
Megan Williams specializes in feeding therapy and community support.
Franchesca Cox emphasizes the need for more education in therapy.
Creating a supportive space for families is essential.
Reflexes play a crucial role in therapy and child development.
Combining different therapy approaches can lead to better outcomes.
Parental involvement is key to a child’s progress.
Insurance limitations can hinder access to necessary therapy.
Building neural pathways requires consistent practice and opportunities.
Therapists should aim to empower families with tools for home practice.
The podcast aims to share knowledge and resources for better therapy.
Resources Mentioned:
All Things Sensory by Harkla (podcast)
Show Transcript
Franchesca Cox (00:01)
Hi there, I’m Francesca Cox, an occupational therapist based in Houston, Texas. Over the years, I’ve had the incredible honor of working with children who have neuromuscular conditions, rare genetic disorders, and developmental delays. Using approaches like DMI therapy and TheraSuit, I’ve seen firsthand the resilience and strength of these amazing kids and their families. Each day brings new lessons, and my passion is to empower families with the tools and knowledge to support their child’s journey.
Megan Williams (00:26)
And I’m Megan Williams, a speech language pathologist also based in Houston, Texas. I specialize in feeding therapy and I’m an MNRI core specialist. I’ve worked with children facing feeding challenges and sensory processing issues using reflex integration techniques to support the brain body connection and help children thrive.
My mission is to guide families through the often complex world of feeding and communication, empowering them to support their child’s growth with confidence.
Franchesca Cox (00:58)
are here to share insights, practical strategies, and heartfelt stories that can help you navigate the unique challenges and joys of raising a child with special needs.
Megan Williams (01:07)
We know every family’s journey is different, but our goal is to create a supportive space where you feel seen, heard, and equipped with the knowledge to help your child reach their fullest potential.
Franchesca Cox (01:19)
whether you’re looking for therapy techniques, expert advice, or just a sense of community, you’re in the right place.
Megan Williams (01:25)
Let’s explore this journey together filled with hope, growth, and endless possibilities.
Megan Williams (01:31)
Hey there, welcome to Little Brain’s Big Steps. We are so excited to have you. My name is Megan.
Franchesca Cox (01:38)
And I’m Francesca.
Megan Williams (01:39)
And we are here with our very first podcast episode. We are here to talk about therapy and just have conversations with each other and to really help families, therapists, and anybody that is in the therapy world to kind of just feel like you have a community that is here for you to learn from, to laugh.
with and feel included as a member of this complex and loving space. We know that there are so many unique challenges no matter your background and we just want you to feel welcome. We’re totally here for you and we’re gonna now talk a little bit about kind of our backgrounds, why we…
entered the therapy world and just kind of let you get to know us.
Franchesca Cox (02:33)
Yeah, I am super excited about starting this journey with you, Megan. My introduction to the therapy world started with ABA therapy of all things. And I quickly knew that was not the route that I did not want to take, but it definitely got my foot in the door after being in the education field into the therapy world. And so once I became an OT, was, it was, it was a little hard because I knew that when you work for
a big company, there’s limits to what you can do and sometimes you just don’t see the results for a variety of reasons. Sometimes it’s just insurance putting a restraint on how many visits you can see or how many. Sometimes there’s restraints with…
So sometimes when you work with a big company, it’s hard to be able to see the results that you want to see with the child. A lot of times it’s because there’s just not the availability that you want. Sometimes insurance puts limits on how many times you can see the child per week. And the follow through is often not what you hope it would be. And so I kept looking for something else. I wanted more education in the therapy world.
how to take my understanding of child development, my ability to work with the children to where I could see changes that would last. And I came into a podcast, actually I stumbled into a podcast by the Sensory Podcast 208, I think is the name of it. I will link it in the show notes.
but they were interviewing the founders of DMI therapy. And so at the time I had heard about intensive therapy, I don’t remember how I first heard about it, but everything that I saw on the internet before this podcast was very clear that it was gross motor, a mobility, definitely the PT realm of things. And I thought, wow, I just so wish that maybe I would have become a PT because that is just such an exciting world to be in. Well, long story short,
The podcast was an interview with Joanne Weltman and Jake, cannot remember his last name, Jake Kringler. And they were talking about…
And so the podcast was an interview with one of the co-founders of DMITherapy and she was talking about how passionate she was to train other therapists. And she made it so clear that she was wanting to train PTs, OTs, and even speech therapists and with DMITherapy because she believed that every discipline could benefit from exposing the children to these exercises that could help with
posture, could help with transitions, could help with of course mobility, breathing and so many things. And so I looked for the first course and I was hooked. And so I’ve taken a few courses now and that has revolutionized not only my practice as a no-tee but my private practice as well. When I opened my own practice, I was not…
only doing DMI, was doing OT and I was also doing some DMI. But I had a child that came in and I knew that he would benefit more from an intensive than these weekly sessions that we were doing. And so that kind of pushed me, that pushed me past my comfort zone and I thought I really need to go get a little bit more training. So I had DMI training, but I saw a therisuit training coming up and I knew that
based on what I had read and based on what I had seen, the TheraSuit program could really help him get more mobility. It could also help me help him because the spider cage has the ability to almost act like eight therapists with these bungees helping you move the child in and out of position. And so I got the training and so it was so fun to watch some of the things that he could do in the cage and with a TheraSuit.
that maybe he couldn’t even do a DMI therapy. it was, that was like my turning point in my practice to set, and I really started to focus more on intensive therapy and even DMI sessions versus traditional LT. And so that’s kind of been my story with how I got into therapy and of course, and into the intensive therapy world.
Megan Williams (06:43)
Yeah, so I am a pediatric speech language pathologist. I’ve been out of school for…
I’ve lost track the number of years. I think I’ve been practicing for about 15 years. I love working with kiddos. And at one point early on, even in grad school, I kind of felt like I wanted to do feeding and swallowing. A friend of mine was in the early stages of having one of her kids had
birth injury and so she watching her navigate
you know, as a parent, what this looks like feeding and swallowing for her baby and kind of trying to see both sides, caring about my friend and then also having an interest in feeding and swallowing. I was very just drawn to it. And so that kind of became a passion of mine. And as I worked in the area of feeding and swallowing, I was able to learn from the amazing occupation
therapists
that I was working with about this idea of how the body and the brain are really connected through reflexes. And honestly, you know, if it wasn’t for them, those therapists who were willing to kind of teach me the things that, you know, we didn’t learn in school. We learned a few reflexes that pertain to feeding and swallowing, but
you know, it wasn’t as in-depth as what I learned from my coworkers. And so it really opened up this passion for me to just want to consume all the information about reflexes that I can find. And so, you know, about five or six years into learning all the things to do for feeding, I was starting to find that
I was working with a lot of older kids who really didn’t care so much about playing with their food. Of course, we had our kind of our picky eater toddlers and who rightly had sensory issues or oral motor development issues that kind of got in the way. But then trying to work with a preteen to
to be more interested in their food was really tough. And so the more I was able to learn about reflexes, I was able to learn about fear paralysis and more reflex and kind of how they really tie into your personality, your willing to take chances, your even just your desire to try new things.
And so I found MNRI, which is Moskitova Neuro Sensory Motor Reflex Integration. And I was able to take my very first class with Dr. Moskitova. She taught the oral facial one class, and it was somewhat local to Houston. And…
I showed up not really sure what I would be learning or how I would fit it into my toolbox, but a lot of the things she explained just really clicked with me and really stuck with me. And after I finished the two or three day class, I came home and I was just like, okay, this is going to be…
I just have to keep going down this path and figuring out how this all fits together. Kind of like, I guess, a detective who becomes really stuck on a case and wanting to know more. so, yeah, that first class I think was in 2016, and then at some point a few classes in.
probably seven or eight classes in, I told my husband, I think I want to become a course specialist, which means a lot of taking classes, traveling to conferences, observing, and then ultimately testing with the instructors to kind of get that certification piece of them saying, you have, you’re proficient in the skills and…
you know, we think your technique is good and, you know, getting that certificate was huge. I got it in 2022. Even trying to do this through the pandemic was tough, but it was worth it. I think the thing that stands out a lot for me is when I was working with a preteen girl, this was when I was in a clinic setting, and she had a lot of sensory stuff going on that
really just had started wearing on her confidence and her mom was really open to trying anything because they had tried everything and she just knew that her daughter was not the happiest, the most joyful version of herself and she just wanted to be able to see her daughter feel comfortable at family meals when she
was having, you know, sensory issues with her siblings, the smell of their food or the sound of them crunching their food as they ate. And so I took some of the MNRI that I knew at the time and we did MNRI. We did active pieces from different protocols and later after I’d worked with her for…
A few weeks the mom said, know, I really don’t know what y’all are doing. The preteen was of age to go back by herself and mom felt comfortable with that. she said, but you’ve given me a different daughter. And to hear her just tell me about how she feels like her daughter, her self-esteem has improved and her joy and her enjoyment of life.
had improved and that was just, that was huge for me because it transcended just wanting to add a new vegetable to her preferred foods. was seeing along with her amazing occupational therapy assistant, her COTA that she was seeing to work on sensory issues just to see how, you know.
The reflex work really turned things around for her. And I will never forget that young lady and her mom and just the confidence that they had in me and seeing the improvements that MNRI was able to give her that will last for a lifetime.
Franchesca Cox (13:31)
What a gift to be able to give that to the family and that independence to her. It really is those little things that
are maybe not so little, right? They might be little to us, to the families, that’s huge.
We have learned so much from working with the kids and their families and we just can’t wait to share those moments and those lessons with you with future episodes.
Megan Williams (13:55)
We are hoping to have some educational episodes that we can delve more into the therapy tools that we come to use in every session. So MNRI, the DMI, reflex integration, and feeding techniques that are kind of go-tos for us. We want to make sure that we are able to cover those topics with y’all.
Franchesca Cox (14:19)
Yes, and we are excited about also including some quote unquote real talk episodes, just candid conversations about therapy wins struggles behind the scenes work. We’re just excited. We have so many ideas and we just can’t wait to get this vision in this dream out there. So whether you’re a parent, a therapist, or just someone curious about brain development and children, this is a space for learning, growing and also celebrating progress.
Megan Williams (14:48)
So one thing that a lot of people will ask us is why does this matter, this work matter to us? Let me try that again. So one thing people will ask us is why are we so passionate? Why does this work matter to us so much that we have set out and kind of started our own practices and really made this the focus? And I think…
one of the main things that coming from two different therapy backgrounds, we come together to really try to create these changes for children and their families. Collaboration between different professionals is something that is so huge. Like I said earlier in the podcast, if the occupational therapists that I worked with,
If they wouldn’t have been willing to share their knowledge, I honestly would not be able to look at a child from this holistic standpoint of the brain and the body are connected. What you see happening in the mouth is not just happening in the mouth. Like you need to be a true sensory detective and kind of…
seeing how these things weave together for feeding, communication, and things like that. I think that’s something that should be really a foundation of teaching in schools, but I know that time is short in the two or three years that therapists are working on getting their advanced degrees. And so we like to really, we want to come together.
on this podcast and show how we can come from our two different backgrounds and have a common goal to educate and just share this information with maybe even therapists who are still in school and who are trying to figure out what their future looks like.
Franchesca Cox (16:44)
Yes, I could not agree more. And I think once I got out of graduate school, that was one of my biggest, I felt the biggest gap in, okay, I know how to evaluate. I know what the problem is, but I just don’t know, like specific tools. What do I do? Like they give you a toolbox, you know, they call it an OT toolbox. But to me, that just wasn’t enough because every child and every patient is so different.
And when you’re with children, and even with adults, but especially with children, you’re not just working with the child, you’re working on and with the family. And so I just am very passionate about continuing to learn and just.
Another thing that we are both passionate about is making our families and our online listeners feel supported because a lot of times we hear almost every intensive that I get, the family’s going to tell me some kind of burden that they’ve been working through, whether it’s trying to get approved for a specific device, trying to work with insurance, trying to get…
their regular therapies to coordinate and get that child to the next level. There’s always just specific challenges and it comes with emotional challenges too and just I feel like that’s another way that we can support families is just making them feel heard, handing them the resources that we know exist and then always looking for new resources. And that’s one of my favorite parts of social media.
There’s so many downfalls to it, but there’s so many good things about it too, because it shares resources. And so anytime I see something new, I’m like, go check out this person, because this person knows where the grants are, or this person is talking about a new seating device, or how to get approved for this, or whatnot. there’s just, those are the different ways that we support families.
So Megan, I wondered if you could talk a little bit about what are some of the outcomes and what are some of the observations that you see from when we work together, you and I. So we both have our own private practices. They’re right next door to each other. don’t always, we almost never treat at the same time. But oftentimes we’re seeing children the same week or very close together, even sometimes the same day. So what are some of the things that you’re seeing the benefits from?
that combined approach.
Megan Williams (19:11)
So a lot of times when we’re able to collaborate, Francesca and I have a few kiddos that we are able to kind of work with in the same space, maybe not the same day, but in some type of collaborative approach. I find that because of
Francesca’s understanding of reflex integration, she sees behaviors, she sees certain preferences for…
how a kiddo moves and can say, it’s this reflex. And so I can look at it and say, you know what, is a movement that’s impacted by a specific reflex that’s kind of interfering. And so let’s focus on how we can address that reflex or the pieces, the sensory and motor pieces of the reflex. I’ve also noticed that proprioception. So a kiddo’s
awareness of where their body is in space. After they have spent some time with Francesca, I can tell that just their brain has a better understanding of their body and their motor planning has improved. And from a speech standpoint, if I’m working with a kiddo who we’re really trying to get breathing and articulation, articulator placement in a better place,
It’s so hard to tell a child with poor proprioception, you know, open your jaw but put your tongue tip on the roof of your mouth. Like, you can do that all day. But if they don’t even know where their, you know, their limbs are attached to their trunk, then it’s gonna be really hard to teach them, you know, how to specifically move their mouth. And so it’s really cool seeing how
our work can kind of come together. What have you seen Francesca?
Franchesca Cox (21:04)
I think my biggest observation is that when we’re able to treat because you treat from the neurological standpoint, almost 100%, you’re working from what I understand with directly with their brains as am I, but I’m also giving them that sensory input to bring mobility to provoke a movement. And so I find that it’s such a strong
foundation for the child when they go to your clinic, they work with those reflexes completely just focused on those reflexes. It also gives the parents a broader understanding and a better understanding of how these reflexes work. A lot of times by the time the child is working in my clinic, they are working on some really hard things. They’re working on against more gravity than they’re used to. Most of the time they’re upset. It may not always be crying, but there is some crying.
And so sometimes there’s just not a lot of time to explain to parents why we’re seeing what we’re seeing. Now, the parents are gonna walk away from the intensive, fully understanding why we’re doing what we’re doing. But I feel like in your clinic, you have the quiet, you have the time while you’re working with that child with those reflexes to explain to them why those reflexes are doing what they’re doing and why that child’s moving the way they’re moving or presenting the way they’re presenting.
And so when they get to the clinic on my side, they are working with mobility and we may not have the time that y’all have because of the nature of the therapy that I do. And so it’s definitely a lot more physically challenging for the child on the DMI side especially. But that’s my biggest observation and I love that. I am very big proponent of.
educating families because if they understand why something is important, they are more likely to go home and do something with that or explain to them, explain to the family member who or the caregiver or the nurse who is working with a child why we need to do XYZ that we saw or did in the clinic.
Alright, so I have a question for you Megan. I want to do a little fun get to know you and I have a couple of questions and then if you want to ask me some questions you’re free to. What’s a fun fact about your therapy style?
Megan Williams (23:20)
So I don’t know if I would say it’s my therapy style, but I consider myself neurodivergent. I have ADHD. It makes therapy really fun sometimes. And I know some families will watch me and they’re just like, who is this person? is maybe, she may be missing a few screws, but that’s okay. So a lot of times.
Whenever I’m working with a child who is kind of afraid to really move their body to explore things, I become just kind of very silly. And if a child is not really following my lead with playing with new toys or, you know, like kind of being a typical toddler where they push the boundaries, you know, maybe they’re not.
really engaging a whole lot, then I kind of throw the book out the window, so to speak, where I’ll start making silly sounds, maybe I’ll throw toys, or I just kind of, like I said, I look like families are probably questioning my mental status, but it’s really how I can help kids feel.
feel like they are in a safe environment. A lot of times when kids come, they have been to other therapists and they’re not sure what I’m going to expect them to do. So like what am I gonna make them do? I want them to feel comfortable and sometimes if that makes me look like a grown up toddler, then I’m totally okay with that.
Franchesca Cox (24:57)
I love that, just getting right on their level. All right, so one more question. What’s a book resource or tool that you swear by?
Megan Williams (25:05)
So that’s a very good question. I am looking over at my bookshelf and I have tons of books and things that I’m always wanting to learn from, but I swear mostly by my hands. So a part of MNRI is that it’s a very tactily guided therapy. And I always tell families like, you know.
if you are feeling like you don’t have a lot of time to invest in a home program, you always have your hands. Like they’re always going to be a part of you. And if you can just do some grounding, embracing squeeze to just help your child, whether you’re in the car riding somewhere or, you know, like taking a break while you’re waiting on an older sibling to get out of soccer practice.
Like you have your hands and you can always use your hands as a therapeutic tool to really make changes in a child’s body.
Franchesca Cox (26:03)
that is a good one. When my daughter was three, she had a really hard time sitting still for any amount of time. And so one of the things I learned is to just squeeze her arms gently but firmly and she would get to the point where she would ask for it. She’d be like, mom, please squeeze my arm.
It was so cute, but it was so effective. It would just calm her nervous system.
Megan Williams (26:23)
Yeah. Okay, I have some questions for you, Francesca.
What’s a piece of advice that you give families all the time?
Franchesca Cox (26:34)
For me, I think I would have to say I try to encourage families consistently to be consistent. So across the board, and it doesn’t mean that they go home and do every single thing or even half of what we’re doing in the clinic. I, a lot of times tell them, if you just pick one thing that we have worked on, and I’m very specific on which exercise, you know, the child needs the most.
If you go home and do this thing every day five times or whatever the child can tolerate, it will make more progress than trying to squeeze, you know, or trying to find an extra hour in the day that may not exist. Another thing, another way I sometimes word it is building that exercise or movement or activity into the routine. So almost like habit stacking. And so let’s say like the child’s trying to work on
transitions to sitting from the floor, instead of grabbing the child once the diaper changes over or once you dress the child in the morning, transitioning them from lying down to sitting. And you do that, I don’t know, depends on the child’s age, but like three to 10 times a day. And if you do that, every time you’ve transitioned or every time you’ve changed child, their diaper or their clothing, you have done that exercise. And if you didn’t,
get to the home program, you know, the 20 minutes that we recommend or 30 minutes we recommend per day, you’ve done something and that’s gonna count more than it’s going to count.
it’s going to and accumulate over time.
Megan Williams (28:10)
That’s really good advice, because yeah, I feel like these days and times, it is really hard to find spare time, and we’re all given 24 hours in a day. I don’t know anyone that’s able to make more time happen for their family. So that’s a really good one.
Okay, your next question. What’s something that you wish everyone understood about therapy?
Franchesca Cox (28:34)
I would say, at least as it pertains to…
what we do with children, pediatric therapy, that most of the time when you go to a clinic, that therapist is, they have the best intentions, they got into the therapy world for the right reasons most of the time, but they have restraints on the time in the clinic and of course they have an outside life. And so they are not gonna always be thinking,
I need to send something home with the parents and family so that the child makes progress when they’re not with me.
Megan Williams (29:05)
Hmm, that’s so true. That’s so true. So much of grad school for me was just trying to figure out how to think like a clinician and maybe not so much about the treatment side, but more of the assessment piece and learning how to treat has been, you know, since I graduated, the day I graduated from then on, it’s been what I’ve been constantly trying to pursue.
Okay, so what’s something you wish everyone understood about the therapy that we provide specifically?
Franchesca Cox (29:36)
I definitely wish more people knew that it existed, but thanks to social media and word of mouth lately, more and more people are finding out. And in fact, in the past year or so, I’ve had more people referred to my clinic by therapists who work in the big hospital in our city.
And also in the past year or so, and maybe thanks to these therapists that are willing to refer to clinics like ours, we are getting them younger. And so that is really important. We know that the younger the child is, the more plastic their brain is. Of course, we know that neuroplasticity has no cap, but it is so nice to be able to get those children younger and younger to be able to establish good mobility patterns, good movement patterns, and also good rhythms and…
practices for the parents because sometimes they are reinforcing accidentally things that we know are not beneficial for the child.
Megan Williams (30:26)
gosh, I echo everything you just said. I wish that, I’m gonna try not to get on my insurance soapbox. That might be a different episode, but I do. I wish that insurance could see the benefit of intensive models of therapy. I wish that families were not so,
stuck in where they are able to find the best help for their child based on whether or not their insurance is taken or covered or provided or whatever you want to call it. That shouldn’t be the factor of the care that they are able to find for their child. That’s probably the main thing that I always…
try to help people understand because they say, you know, we have insurance or families, friends that I have who have children who don’t require any form of developmental assistance. They say, well, you know, if you take insurance, then I’ll have to tell them, no, not all insurances are the same. And it can vary from family to family, policy to policy.
another question that I get from friends of mine who don’t really know a lot about what it’s like to be in this kind of space. They always ask about like, is your job, is it easy? Is it hard? Is it, you know, they want to try to find common ground. And I always think about
I’m not, because of HIPAA, always able to share stories, but listening to stories from the family perspective of what they’re going through. Going from if it’s a birth injury or if it’s an anoxic brain injury that happens later in life, just being there and a part of their story and hearing what it’s like for them is something that
We want to really also be able to connect with people in the community through this podcast because No, man is an island. We should never feel alone. And so we want to Help families through the information that we share on this podcast and also You know therapy techniques anything that we can we can give and and help families feel like we’re walking along beside them
whether we see them in clinic or not. think the beauty of technology is that we can kind of all be in the space together.
There’s definitely a fear of doing something new that, you know, starting a podcast is kind of scary, but I think our goal is what keeps us really focused on trying to help families.
Franchesca Cox (32:59)
It looks like our time is almost up, but I wanted to thank everyone for joining in on our first episode. And I want to encourage all the listeners to subscribe and also share this episode if you think someone could benefit from this information.
Megan Williams (33:14)
Yeah, and we totally want our listeners to be a part of our episodes. So if you have any ideas about future episodes or a guess that you really want us to maybe try to reach out to, find us on Instagram at Little Brains Big Steps and just send us a DM and let us know what you would be interested in.
a topic or a speaker or just anything like that.
Yeah, so you can find us on, like I said, Facebook. I’m working on a Facebook page. I don’t know if that’s actually a very reliable resource, so that might be, you might need to cut that. But,
Yeah, so we definitely thank you for listening. I hope we have been able to share some information about ourselves to help you feel good and knowledgeable about why we’re passionate about this topic. And we hope that you’ll come back for more information, for good stories and laughs and…
Maybe even some tears along the way,
Franchesca Cox (34:31)
And we want to hear from you. So let us know what topics you would like us to talk about, explore conversations that you would like us to have.
Franchesca Cox (34:39)
We’re so glad you joined us for Little Brain’s Big Steps podcast. Please remember information provided on this podcast, whether from the hosts, sponsors, or guests is for informational purposes only, and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your child’s physician and therapist before making any changes to their medical care.
Franchesca Cox (34:59)
Thanks for joining us on the Little Brains Big Steps podcast. We hope this episode provided valuable insights and support for your journey. If you know a parent who could benefit from this episode, share it with them today. Be sure to visit our podcast website for show notes and additional resources. Until next time, take care and keep making those big steps forward.