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Today, I am so excited to have Quiara Smith, MOT OTR/L, join me on the podcast . As a pediatric pelvic health occupational therapist, Quiara specializes in treating pelvic floor dysfunction, toileting/elimination disorders, and bowel and bladder dysfunction in children between the ages of 4-18 years old both through her Aloha Integrative Therapy Clinic and telehealth services. I met Quiara on Instagram when she chimed in on a few posts referring to gross and fine motor skills and their relation to potty training, and the more contact we had, the more I realized that I needed her to be on this podcast, and so here we are. She has a lot to share and clears up a few mysteries along the way, so prepare to have your mind blown!   Quiara begins by sharing just what exactly the pelvic floor is, the many potential causes for dysfunction in this area, and what the symptoms of these dysfunctions show up as. She also describes the reasons why she would become involved in working with a child, the impact of the sensory system in children, and the holistic and non-invasive approach she employs in her work. We then discuss the role that core muscles, and the need to develop them in children, play in potty training, and explore some recommendations for building these muscles, some strategies for parents to implement, and the ways in which Quiara helps children and parents through her telehealth services. As you’ll discover, we could have talked on and on about these important topics which make such a huge difference in the life of the child and the parent, and you’ll certainly see why I want to have Quiara join us again to share even more wisdom and solve even more mysteries to help our kids.   The Finer Details of This Episode:     The pelvic floor is basically the muscles that span the bottom of the pelvis and provides support for our internal organs and assists in urinary and fecal continence (helps us pee and poop)   There are many potential causes for pelvic floor dysfunction and they should be addressed as early as possible   Symptoms can present in a number of ways including, abdominal pain, picky eating, reflux, wetting the bed, fecal leaking, but mainly in toileting troubles   If the child is 4 years old and has been successful with potty training to a typical extent for a year, and if they are dribbling or having issues past a year that would be a red flag   Issues can arise if a child is under-responsive or over-responsive to their sensory system   You have to take a holistic approach to dealing with these issues   Pediatric pelvic floor therapists use non-invasive evidence-based approaches to helping children   Core muscle challenges will affect a child’s ability to coordinate their pelvic floor to void pee or poo   A lack of variety in movement, especially in play, is impacting children’s development of gross motor skills and strength   As a pediatric pelvic health therapist, Quiara typically sees kids to identify a pelvic floor dysfunction, or a sensory component, or to provide proactive sensory consultation   Some recommendations for building gross motor skills are wheelbarrow, crabwalk, big body play, and yoga   Some strategies that parents can implement immediately to help support pelvic health are having the child sit properly on the toilet, sit after a meal (for those who’ve had trouble for years), push to begin and then relax by breathing in   Quiara can help children and parents across the country through ‘telehealth’   Quotes:   “Releasing poop is a really huge deal.”   “When I am at a loss, I can say ‘Hey, go see Quiara’.”   “It’s almost like the child is fighting their own urge.”   “If you can’t get, like, enough water or enough, like, fibrous foods because you’re a picky eater, you’re going to be more prone to constipation.”   “Oh my God, this is mind blowing!”   “There’s a rich dialogue happening in your kid’s body.”   “Your kid holds their tension in their butt.”   “I’m seeing withholding getting worse and worse and worse.”   “I’ve been doing this wrong my whole life!”   “You can see the anus isn’t opening because your child’s producing, like, ribbon-shaped poop.”   “I kind of want you to live with me.”   “I found that this has strengthened the bond between the child and the caregiver because you’re doing therapeutic touch – that’s what I like to call it.”   “I’m an idiot savant with a bag of tricks, don’t give me too much power over here.”   “I’m here to help you through this challenging moment, but it also could be very beautiful and very kind of sacred in a way.”   “Continence is a huge thing that they have to deal with, and once that starts resolving, you see this transformation of not only the child but the parents and the caregivers. It’s phenomenal and that’s why I do what I do.”   Links:   Jamie’s homepage -   http://www.jamieglowacki.com/     Oh Crap! Potty Training – https://www.amazon.com/Crap-Potty-Training-Everything-Parenting-ebook/dp/B00V3L8YSU   Oh Crap! I Have A Toddler -  https://www.simonandschuster.com/books/Oh-Crap!-I-Have-a-Toddler/Jamie-Glowacki/Oh-Crap-Parenting/9781982109738   Jamie’s Patreon Page:   https://www.patreon.com/join/jamieglowacki?     Aloha Integrative Therapy:   Homepage:   https://alohaintegrativetherapy.com/   Facebook:   https://www.facebook.com/alohaintegrativetherapy/   Instagram:   https://www.instagram.com/alohaintegrativetherapy/