New Beginnings | NB1-Office

Patient Name: Matthew

Patient Information:

Patient ID: 9768

Patient First Name: Matthew

Patient Date of Birth: 09-15-2012

Gender: male

Assigned Office: NB1 east side

Primary Care Physician: Annette, Griego

Patient Status: Active

Primary Attendance / Assigned Therapists:

ST - Speech Therapy:

FD - Feeding Therapy: Serna, Teresa

OT - Occupational Therapy:

PT - Physical Therapy:

Patient Primary Authorizations:

Auth. ID	Status	Start Date	End Date	Insurance	ST-Units	FD-Units	OT-Units	PT-Units
23003	Active	01-12-2026	07-10-2026	El Paso First Health Plans	0	26	0	0

Speech and Language Evaluation:

ID	Date	Type	Evaluation Diagnosis
26096	01-19-2026	Speech Initial Evaluation	Q90.9, F80.2
Speech Background History: Matthew is a 13 year, 4 month old male with a history of an uncomplicated birth. Mother reported that genetic testing was not completed during pregnancy due to potential risks; therefore, a diagnosis was not known prenatally. Matthew carries a primary medical diagnosis of Down syndrome. Mother reported that Matthew underwent heart surgery at approximately 5 months of age due to a heart murmur. She reported that his cardiac health has remained stable, and Matthew continues to receive annual follow-up care with a cardiologist. Mother reported that Matthew currently takes thyroid medication, allergy medication, omega-3 supplements, and atenolol as prescribed by his cardiologist. Matthew is currently enrolled in 6th grade. Mother reported no concerns in the area of hearing at this time. Matthew wears corrective lenses and underwent vision-related surgeries in 2017 and 2021 to address visual needs. Matthew currently receives feeding services at the same facility. Mother reported that Matthew gets along well with peers and demonstrates positive social interactions. The primary concerns at this time are related to speech sound production and conversational skills, specifically difficulty with pronunciation and maintaining appropriate conversational topics, which impact Matthew’s ability to effectively communicate during social and academic interactions.
Speech Medical History:
Speech Medications:
Speech Behavioral Observations: Attending Skills: Inconsistent, Response Rate: Moderate delays, Level of Activity: Active, Cooperation: Active, Communicative Intent: With some prompts, Awareness of Others: Present, Reliability of Scores: Adequate, Awarencess of Environmental Events: Good, Social Interactions: Usually, Prognosis for Improved Communicative Functioning: Friendly,
Speech Communication Strengths: Easily separated from Parents, Follows verbal command with cues, Interactive,
Speech Communication Weaknesses: Difficult to understand, Diminished vocabulary, Unable to answer questions,
Speech Background Summary:
Speech Diagnosis/Impressions: Matthew is a 13 year, 4 month old male with a primary diagnosis of Down syndrome who presents with significant receptive and expressive language deficits, as evidenced by standardized testing, language sampling, clinical observation, and caregiver report. Results from the PPVT-5 indicate severely reduced receptive vocabulary skills, particularly impacting his understanding of verbs, attributes, and higher-level academic vocabulary. Informal assessment further revealed limited expressive language output, reduced sentence length, difficulty following directions, challenges organizing and sequencing information, and impaired conversational skills, including difficulty maintaining appropriate conversational topics. Functionally, Matthew primarily communicates using one- to two-word utterances and relies heavily on familiar routines and contexts to be understood. While his mother is generally able to interpret his messages, communication breakdowns frequently occur with unfamiliar listeners and in less predictable situations. When Matthew is not understood, he demonstrates frustration, may shut down, and requires compensatory strategies such as spelling words aloud to attempt to repair communication. Matthew also demonstrates difficulty independently requesting help and following multi-step directions, which significantly impacts his participation in academic tasks, social interactions, and daily activities. Based on the severity and persistence of Matthew’s language deficits and their functional impact, skilled speech-language therapy is medically necessary to improve functional communication, reduce frustration, and support Matthew’s ability to participate meaningfully and independently across environments. Prognosis for improvement is fair. Matthew demonstrates emerging communication skills, motivation to communicate, and strong caregiver support, which are positive indicators for progress. Given the nature of Down syndrome and the severity of Matthew’s receptive and expressive language deficits, progress is expected to be gradual and will require consistent, skilled speech-language therapy. With ongoing intervention and carryover across environments, Matthew is expected to make meaningful gains in functional communication, conversational skills, and independence; however, continued services will be necessary to support long-term communication needs.
Speech Diagnosis/Impressions: Matthew is a 13 year, 4 month old male with a primary diagnosis of Down syndrome who presents with significant receptive and expressive language deficits, as evidenced by standardized testing, language sampling, clinical observation, and caregiver report. Results from the PPVT-5 indicate severely reduced receptive vocabulary skills, particularly impacting his understanding of verbs, attributes, and higher-level academic vocabulary. Informal assessment further revealed limited expressive language output, reduced sentence length, difficulty following directions, challenges organizing and sequencing information, and impaired conversational skills, including difficulty maintaining appropriate conversational topics. Functionally, Matthew primarily communicates using one- to two-word utterances and relies heavily on familiar routines and contexts to be understood. While his mother is generally able to interpret his messages, communication breakdowns frequently occur with unfamiliar listeners and in less predictable situations. When Matthew is not understood, he demonstrates frustration, may shut down, and requires compensatory strategies such as spelling words aloud to attempt to repair communication. Matthew also demonstrates difficulty independently requesting help and following multi-step directions, which significantly impacts his participation in academic tasks, social interactions, and daily activities. Based on the severity and persistence of Matthew’s language deficits and their functional impact, skilled speech-language therapy is medically necessary to improve functional communication, reduce frustration, and support Matthew’s ability to participate meaningfully and independently across environments. Prognosis for improvement is fair. Matthew demonstrates emerging communication skills, motivation to communicate, and strong caregiver support, which are positive indicators for progress. Given the nature of Down syndrome and the severity of Matthew’s receptive and expressive language deficits, progress is expected to be gradual and will require consistent, skilled speech-language therapy. With ongoing intervention and carryover across environments, Matthew is expected to make meaningful gains in functional communication, conversational skills, and independence; however, continued services will be necessary to support long-term communication needs.
Speech Recommendations: Speech Therapy: 2 time(s) a Week for 45 to 60 minute sessions

Speech and Language Plan of Care:

Plan of Care

58095

Plan Date: 01-19-2026

Speech Assessment Summary: Matthew is a 13 year, 4 month old male with a primary diagnosis of Down syndrome who presents with significant receptive and expressive language deficits, as evidenced by standardized testing, language sampling, clinical observation, and caregiver report. Results from the PPVT-5 indicate severely reduced receptive vocabulary skills, particularly impacting his understanding of verbs, attributes, and higher-level academic vocabulary. Informal assessment further revealed limited expressive language output, reduced sentence length, difficulty following directions, challenges organizing and sequencing information, and impaired conversational skills, including difficulty maintaining appropriate conversational topics. Functionally, Matthew primarily communicates using one- to two-word utterances and relies heavily on familiar routines and contexts to be understood. While his mother is generally able to interpret his messages, communication breakdowns frequently occur with unfamiliar listeners and in less predictable situations. When Matthew is not understood, he demonstrates frustration, may shut down, and requires compensatory strategies such as spelling words aloud to attempt to repair communication. Matthew also demonstrates difficulty independently requesting help and following multi-step directions, which significantly impacts his participation in academic tasks, social interactions, and daily activities. Based on the severity and persistence of Matthew’s language deficits and their functional impact, skilled speech-language therapy is medically necessary to improve functional communication, reduce frustration, and support Matthew’s ability to participate meaningfully and independently across environments.

Speech Rehabilitation Potential: Good. with consistent Speech Therapy and parental support. Prognosis for improvement is fair. Matthew demonstrates emerging communication skills, motivation to communicate, and strong caregiver support, which are positive indicators for progress. Given the nature of Down syndrome and the severity of Matthew’s receptive and expressive language deficits, progress is expected to be gradual and will require consistent, skilled speech-language therapy. With ongoing intervention and carryover across environments, Matthew is expected to make meaningful gains in functional communication, conversational skills, and independence; however, continued services will be necessary to support long-term communication needs.

Speech and Language Long Term Goals:

Category	Goal Description
Home Management Intervention Program	When counseled by the clinician, parents will incorporate the home management intervention program as a daily and weekly activity to transfer skills learned in therapy into the home environment. Home management training will optimize patients functional communication tasks in the home.
Receptive Language	Matthew will improve receptive and expressive language skills to support functional communication, academic participation, and social interaction across environments, as evidenced by increased accuracy and independence in targeted short-term goals.
Expressive Language	Matthew will increase his ability to effectively communicate wants, needs, and ideas using developmentally appropriate verbal and supportive communication strategies to reduce communication breakdowns and frustration.

Speech and Language Short Term Goals:

Category	Goal Description
Expressive Language	Within 6 months, Matthew will increase expressive language by producing functional phrases of 3 or more words to communicate wants, needs, or comments with 60% accuracy and minimal to moderate cues to improve message clarity.
Expressive Language	Within 6 months, Matthew will answer simple WH-questions related to daily activities or short narratives with 60% accuracy across three consecutive therapy sessions with minimal to moderate cues to improve comprehension and conversational participation.
Expressive Language	Within 6 months, Matthew will independently request help or clarification using verbal language or an appropriate compensatory strategy with 60% accuracy across three consecutive therapy sessions with minimal cues to improve self-advocacy and reduce frustration.
Oral Motor/Articulation	Within 6 months, Matthew will accurately produce multisyllabic words during structured and functional activities with 60% accuracy across three consecutive therapy sessions with minimal to moderate cues to improve overall speech intelligibilit
Receptive Language	Within 6 months, Matthew will use targeted functional vocabulary words during structured activities with 70% accuracy across three consecutive therapy sessions with moderate cues.
Receptive Language	Within 6 months, Matthew will demonstrate understanding of simple sequences (first/next/last) by correctly ordering 2–3 steps during structured activities with 60% accuracy across three consecutive therapy sessions with minimal to moderate cues.

Speech and Language Soap Note/Visit:

ID	Soap Note

Feeding Therapy Evaluation:

ID	Date	Type	Evaluation Diagnosis
25742	10-21-2025	Feeding Initial Evaluation	R13.11, R63.32, Q90.9
Feeding Background History: Matthew is a 13-year, 3-month-old male referred for a feeding evaluation by his pediatrician due to concerns regarding swallowing (dysphagia). At this time, the pediatrician reports no concerns regarding Matthew’s growth or nutritional status. His mother, Mrs. Hernandez, served as the primary informant for this evaluation and provided detailed medical and developmental history. Matthew was diagnosed with Down syndrome at birth and is currently followed by multiple specialists, including a cardiologist and ophthalmologist, as part of his multidisciplinary care team. Mrs. Hernandez reported that there were no difficulties during bottle or breastfeeding in infancy. However, transition to purees and solid foods was challenging, reportedly due to low oral-motor tone and episodes of gagging with textured foods. Matthew has no known food allergies, gastrointestinal, or respiratory issues. At present, he is described as a “very picky eater”, with a limited food repertoire and dependence on puree consistencies, demonstrating minimal acceptance of varied textures. He is able to consume liquids appropriately from both a straw and an open cup. There is no reported history of respiratory complications associated with feeding. English was identified as the appropriate language for intervention, based on caregiver report and direct clinical observation. Matthew’s feeding and swallowing abilities were assessed through a bedside swallow evaluation and structured mealtime observation.
Feeding Medical History: According to caregiver report, Matthew’s prenatal history and labor were unremarkable, and he was born full term. He has a significant medical history of atrioventricular (AV) canal repair completed in February 2013 and strabismus affecting both eyes. No other major illnesses, hospitalizations, or significant accidents have been reported to date.
Feeding Medications: Matthew is currently prescribed Ermeza (1.5 mL once daily in the morning) for thyroid management and Enalapril (2.5 mL twice daily) as part of his cardiac care regimen. No other major illnesses, hospitalizations, or significant accidents have been reported to date.
Feeding Behavioral Observations: Attending Skills: Adequate, Response Rate: Moderate delays, Level of Activity: Active, Cooperation: Active, Communicative Intent: With numerous prompts, Awareness of Others: Present, Reliability of Scores: Fair, Awarencess of Environmental Events: Good, Social Interactions: Moderately, Prognosis for Improved Communicative Functioning: Friendly,
Feeding Communication Strengths:
Feeding Communication Weaknesses:
Feeding Background Summary: Pragmatics was not formally assessed as this was not the purpose of today's evaluation.
Feeding Diagnosis/Impressions: Matthew is a 13-year, 3-month-old male referred for a feeding evaluation by his pediatrician due to concerns regarding swallowing (dysphagia). At this time, the pediatrician reports no concerns regarding Matthew’s growth or nutritional status. His mother, Mrs. Hernandez, served as the primary informant for this evaluation and provided detailed medical and developmental history. Matthew was diagnosed with Down syndrome at birth and is currently followed by multiple specialists, including a cardiologist and ophthalmologist, as part of his multidisciplinary care team. At present, he is described as a “very picky eater”, with a limited food repertoire and dependence on puree consistencies, demonstrating minimal acceptance of varied textures. There is no reported history of respiratory complications associated with feeding. An oral mechanism and cranial nerve examination were conducted to evaluate the structural and functional integrity of Matthew’s orofacial mechanism. Overall, findings indicate that while Matthew’s oral anatomy is structurally adequate to support basic feeding and swallowing, low muscle tone, limited oral space, and reduced oral-motor coordination may impact his efficiency, bolus control, and endurance when managing advanced textures. Based on the bedside swallow evaluation and skilled mealtime observation, Matthew presents with a CHRONIC PEDIATRIC FEEDING DISORDER and ORAL PHASE DYSPHAGIA, characterized by impaired oral intake that is not developmentally appropriate for his age. His feeding challenges appear to be multifactorial, influenced by medical factors (Down syndrome and associated low muscle tone impacting oral-motor coordination and endurance), nutritional factors (limited food repertoire, food jags, and inconsistent intake), sensory-based feeding skill deficits (sensitivities to textures and decreased oral-motor coordination), and psychosocial components (learned mealtime behaviors and feeding-related avoidance). No overt clinical signs or symptoms of aspiration or penetration were observed with the textures presented (puree and thin liquid), and according to caregiver report, Matthew has no history of aspiration pneumonia or unexplained fevers. To supplement clinical findings, Matthew’s mother completed the Pediatric Eating Assessment Tool (PediEAT), a caregiver-reported measure of feeding behaviors. Results indicated scores approaching the “No Concern” range across domains of oral processing and physiological symptoms, suggesting adequate chewing and swallowing coordination and no significant caregiver concern regarding physiological responses during feeding. However, despite these caregiver-reported scores, clinical observations during the evaluation revealed ongoing selective and restrictive eating patterns, including a limited food repertoire, reliance on puree consistencies, and resistance toward textured foods. This discrepancy suggests that Matthew’s feeding difficulties may be under-recognized at home or that caregiver perceptions differ from observed clinical presentation. CURRENT FEEDING: Matthew currently eats under adult supervision and typically shares meals with his family. A structured feeding schedule is in place, consisting of three meals and one evening snack, with meals generally lasting around 40 minutes. His mother expressed ongoing concern regarding limited food intake and picky eating behaviors. Matthew’s diet primarily consists of puréed foods, including protein and vegetables, occasionally mixed with small pasta pieces. He prefers smooth or slightly lumpy textures and tends to favor foods that are sweet or warmly flavored. Meals are generally served at a warm temperature, and his appetite is reported to be good. Matthew’s accepted food inventory currently includes approximately 21 solid foods and 5 liquids. His accepted liquids include juice (orange, cherry, berry, grape, fruit punch, strawberry), lemonade, tea, and water. His preferred solids consist of carbohydrates, including oatmeal and small pasta pieces. Protein sources are notably limited, with consistent acceptance of chicken and yogurt only. He demonstrates a broader acceptance of fruits, including blueberries, raspberries, strawberry, black berries, peaches/nectarines, banana, mango. Vegetables are incorporated more consistently into his diet, with green beans, cauliflower, squash, zucchini, carrots, celery, asparagus, peas, broccoli, corn, and spinach reported as accepted. According to the U.S. Department of Agriculture (USDA) Dietary Guidelines and the American Academy of Pediatrics (AAP), children around thirteen years of age typically require a balanced and varied diet across all food groups, including adequate protein, carbohydrates, and healthy fats to support ongoing growth, energy needs, and muscle development. While Matthew’s exact caloric intake is unknown, caregiver report of restricted food variety and limited protein intake suggests that his current diet may not consistently meet age-appropriate nutritional requirements, particularly for protein and overall nutrient diversity. FEEDING OBSERVATIONS: During the feeding observation, Matthew was seated in a stable 90-90-90 position (hips, knees, and ankles supported) at the table for the duration of the assessment. A variety of preferred foods (oatmeal with yogurt; puréed vegetables and chicken with small pasta pieces) were presented. Despite maximum verbal and visual prompting, Matthew did not accept the food offered during the session. Given the importance of comfort and rapport building in feeding therapy, food intake was not forced, and the session instead focused on establishing trust and assessing baseline tolerance. To supplement direct observation, Matthew’s mother shared a video demonstrating his typical mealtime routine at home, in which he consumed approximately 100% of his meal consisting of puréed vegetables and chicken with pasta. Due to his limited engagement with preferred foods during the evaluation, non-preferred foods were not introduced, as the immediate goal was to support regulation and promote a sense of safety in the therapeutic setting. Parent education was provided regarding the Steps to Eating Hierarchy to help the family understand Matthew’s current stage of feeding tolerance and how to gradually expand participation without increasing stress. At home, when presented with non-preferred foods, Matthew may look at them, smell them, briefly touch them with his fingertips, or push them away, demonstrating strong texture-based aversions. These behaviors are consistent with functioning at the “touch with finger pads” stage of the hierarchy, indicating emerging sensory exploration with minimal engagement beyond tactile contact. Per caregiver report, Matthew exhibits heightened sensory aversions during mealtimes, and his behaviors during the session were consistent with these patterns. These challenges appear to be influenced by sensory processing differences that affect his ability to tolerate a variety of food textures and expand his diet. An occupational therapy (OT) referral is recommended to further evaluate and address sensory integration needs in collaboration with ongoing feeding therapy. ORAL MOTOR SKILLS: During observation of oral intake, Matthew demonstrated significant oral-motor deficits impacting his ability to safely and efficiently manage even puréed textures. When presented with preferred foods, he exhibited minimal active oral-motor engagement, characterized by stripping food from the spoon using his lips, absent jaw grading or rotary movement, and a phasic bite pattern rather than sustained chewing. No tongue lateralization was observed to assist with bolus manipulation, and there was limited lip closure or rounding, resulting in an overall open-mouth posture throughout feeding. His swallowing appeared primarily reflexive, with reduced coordination between oral movements and swallow initiation. By approximately 13 years of age, children are typically expected to demonstrate consistent rotary chewing patterns, effective tongue lateralization, and mature bolus formation and transfer across a variety of textures. Matthew’s current oral-motor presentation reflects a delay in the development of these age-expected feeding skills. Given that only puréed textures were offered during the session, ongoing monitoring is recommended as he is gradually introduced to more complex textures under controlled therapeutic conditions. Overall, findings indicate decreased oral-motor strength, coordination, and endurance, which likely contribute to reduced feeding efficiency and limited progression to age-appropriate textures. These deficits should continue to be addressed through targeted oral-motor and feeding interventions to promote improved chewing, bolus control, and safe swallowing function. RECOMMENDATIONS: Feeding therapy is strongly recommended to address Matthew’s current feeding challenges. His oral-motor inefficiencies, texture-based aversions, and restricted food repertoire place him at risk for nutritional compromise if not addressed. Intervention should focus on gradual texture advancement through a structured approach incorporating the Steps to Eating Hierarchy, desensitization strategies, sensory-based feeding activities, and food chaining techniques to increase tolerance and acceptance of non-preferred foods. Therapy will also target oral-motor coordination—including chewing, bolus formation, and tongue lateralization—to promote safe and efficient intake. Parent education and structured mealtime routines will be emphasized to support carryover at home and reduce stress during feeding. A Home Management Intervention Program (HMIP) will be provided to reinforce therapy strategies and promote generalization into daily routines. Given Matthew’s sensory sensitivities and difficulty tolerating varied textures, an occupational therapy referral is recommended to address underlying sensory processing needs in collaboration with ongoing feeding therapy. Without appropriate intervention, Matthew remains at risk for inadequate nutrition secondary to food selectivity, limited dietary variety, and restricted texture tolerance.
Feeding Recommendations: Feeding Therapy: 1 time(s) a Week for 30 to 45 minute sessions

Feeding Therapy Plan of Care:

Plan of Care

57194

Plan Date: 10-21-2025

Feeding Assessment Summary: Matthew is a 13-year, 1-month-old male referred for a feeding evaluation by his pediatrician due to concerns regarding swallowing (dysphagia). At this time, the pediatrician reports no concerns regarding Matthew’s growth or nutritional status. His mother, Mrs. Hernandez, served as the primary informant for this evaluation and provided detailed medical and developmental history. Matthew was diagnosed with Down syndrome at birth and is currently followed by multiple specialists, including a cardiologist and ophthalmologist, as part of his multidisciplinary care team. At present, he is described as a “very picky eater”, with a limited food repertoire and dependence on puree consistencies, demonstrating minimal acceptance of varied textures. There is no reported history of respiratory complications associated with feeding. ORAL MECHANISM/CRANIAL NERVE EXAMINATION: An oral mechanism and cranial nerve examination were conducted to evaluate the structural and functional integrity of Matthew’s orofacial mechanism. Overall, findings indicate that while Matthew’s oral anatomy is structurally adequate to support basic feeding and swallowing, low muscle tone, limited oral space, and reduced oral-motor coordination may impact his efficiency, bolus control, and endurance when managing advanced textures. FEEDING EVALUATION: Based on the bedside swallow evaluation and skilled mealtime observation, Matthew presents with a CHRONIC PEDIATRIC FEEDING DISORDER and ORAL PHASE DYSPHAGIA, characterized by impaired oral intake that is not developmentally appropriate for his age. His feeding challenges appear to be multifactorial, influenced by medical factors (Down syndrome and associated low muscle tone impacting oral-motor coordination and endurance), nutritional factors (limited food repertoire, food jags, and inconsistent intake), sensory-based feeding skill deficits (sensitivities to textures and decreased oral-motor coordination), and psychosocial components (learned mealtime behaviors and feeding related avoidance). No overt clinical signs or symptoms of aspiration or penetration were observed with the textures presented (puree and thin liquid), and according to caregiver report, Matthew has no history of aspiration pneumonia or unexplained fevers. To supplement clinical findings, Matthew’s mother completed the Pediatric Eating Assessment Tool (PediEAT), a caregiver reported measure of feeding behaviors. Results indicated scores approaching the “No Concern” range across domains of oral processing and physiological symptoms, suggesting adequate chewing and swallowing coordination and no significant caregiver concern regarding physiological responses during feeding. However, despite these caregiver-reported scores, clinical observations during the evaluation revealed ongoing selective and restrictive eating patterns, including a limited food repertoire, reliance on puree consistencies, and resistance toward textured foods. This discrepancy suggests that Matthew’s feeding difficulties may be under-recognized at home or that caregiver perceptions differ from observed clinical presentation. CURRENT FEEDING: Matthew currently eats under adult supervision and typically shares meals with his family. A structured feeding schedule is in place, consisting of three meals and one evening snack, with meals generally lasting around 40 minutes. His mother expressed ongoing concern regarding limited food intake and picky eating behaviors. Matthew’s diet primarily consists of puréed foods, including protein and vegetables, occasionally mixed with small pasta pieces. He prefers smooth or slightly lumpy textures and tends to favor foods that are sweet or warmly flavored. Meals are generally served at a warm temperature, and his appetite is reported to be good. Matthew’s accepted food inventory currently includes approximately 21 solid foods and 5 liquids. His accepted liquids include juice (orange, cherry, berry, grape, fruit punch, strawberry), lemonade, tea, and water. His preferred solids consist of carbohydrates, including oatmeal and small pasta pieces. Protein sources are notably limited, with consistent acceptance of chicken and yogurt only. He demonstrates a broader acceptance of fruits, including blueberries, raspberries, strawberry, black berries, peaches/nectarines, banana, mango. Vegetables are incorporated more consistently into his diet, with green beans, cauliflower, squash, zucchini, carrots, celery, asparagus, peas, broccoli, corn, and spinach reported as accepted. According to the U.S. Department of Agriculture (USDA) Dietary Guidelines and the American Academy of Pediatrics (AAP), children around thirteen years of age typically require a balanced and varied diet across all food groups, including adequate protein, carbohydrates, and healthy fats to support ongoing growth, energy needs, and muscle development. While Matthew’s exact caloric intake is unknown, caregiver report of restricted food variety and limited protein intake suggests that his current diet may not consistently meet ageappropriate nutritional requirements, particularly for protein and overall nutrient diversity. FEEDING OBSERVATIONS: During the feeding observation, Matthew was seated in a stable 90-90-90 position (hips, knees, and ankles supported) at the table for the duration of the assessment. A variety of preferred foods (oatmeal with yogurt; puréed vegetables and chicken with small pasta pieces) were presented. Despite maximum verbal and visual prompting, Matthew did not accept the food offered during the session. Given the importance of comfort and rapport building in feeding therapy, food intake was not forced, and the session instead focused on establishing trust and assessing baseline tolerance. To supplement direct observation, Matthew’s mother shared a video demonstrating his typical mealtime routine at home, in which he consumed approximately 100% of his meal consisting of puréed vegetables and chicken with pasta. Due to his limited engagement with preferred foods during the evaluation, non-preferred foods were not introduced, as the immediate goal was to support regulation and promote a sense of safety in the therapeutic setting. Parent education was provided regarding the Steps to Eating Hierarchy to help the family understand Matthew’s current stage of feeding tolerance and how to gradually expand participation without increasing stress. At home, when presented with non-preferred foods, Matthew may look at them, smell them, briefly touch them with his fingertips, or push them away, demonstrating strong texture-based aversions. These behaviors are consistent with functioning at the “touch with finger pads” stage of the hierarchy, indicating emerging sensory exploration with minimal engagement beyond tactile contact. Per caregiver report, Matthew exhibits heightened sensory aversions during mealtimes, and his behaviors during the session were consistent with these patterns. These challenges appear to be influenced by sensory processing differences that affect his ability to tolerate a variety of food textures and expand his diet. An occupational therapy (OT) referral is recommended to further evaluate and address sensory integration needs in collaboration with ongoing feeding therapy. ORAL MOTOR SKILLS: During observation of oral intake, Matthew demonstrated significant oral-motor deficits impacting his ability to safely and efficiently manage even puréed textures. When presented with preferred foods, he exhibited minimal active oral-motor engagement, characterized by stripping food from the spoon using his lips, absent jaw grading or rotary movement, and a phasic bite pattern rather than sustained chewing. No tongue lateralization was observed to assist with bolus manipulation, and there was limited lip closure or rounding, resulting in an overall open-mouth posture throughout feeding. His swallowing appeared primarily reflexive, with reduced coordination between oral movements and swallow initiation. By approximately 13 years of age, children are typically expected to demonstrate consistent rotary chewing patterns, effective tongue lateralization, and mature bolus formation and transfer across a variety of textures. Matthew’s current oral-motor presentation reflects a delay in the development of these age-expected feeding skills. Given that only puréed textures were offered during the session, ongoing monitoring is recommended as he is gradually introduced to more complex textures under controlled therapeutic conditions. Overall, findings indicate decreased oral-motor strength, coordination, and endurance, which likely contribute to reduced feeding efficiency and limited progression to ageappropriate textures. These deficits should continue to be addressed through targeted oral-motor and feeding interventions to promote improved chewing, bolus control, and safe swallowing function. RECOMMENDATIONS: Feeding therapy is strongly recommended to address Matthew’s current feeding challenges. His oral-motor inefficiencies, texture-based aversions, and restricted food repertoire place him at risk for nutritional compromise if not addressed. Intervention should focus on gradual texture advancement through a structured approach incorporating the Steps to Eating Hierarchy, desensitization strategies, sensory-based feeding activities, and food chaining techniques to increase tolerance and acceptance of non-preferred foods. Therapy will also target oral-motor coordination, including chewing, bolus formation, and tongue lateralization, to promote safe and efficient intake. Parent education and structured mealtime routines will be emphasized to support carryover at home and reduce stress during feeding. A Home Management Intervention Program (HMIP) will be provided to reinforce therapy strategies and promote generalization into daily routines. Given Matthew’s sensory sensitivities and difficulty tolerating varied textures, an occupational therapy referral is recommended to address underlying sensory processing needs in collaboration with ongoing feeding therapy. Without appropriate intervention, Matthew remains at risk for inadequate nutrition secondary to food selectivity, limited dietary variety, and restricted texture tolerance.

Feeding Rehabilitation Potential: Matthew demonstrates good rehabilitation potential for improvement in feeding skills given his young age, supportive and involved family, and emerging oral-motor abilities. His progress may be influenced by the complexity of his medical history (Down syndrome with associated low muscle tone) and sensory processing differences that contribute to feeding-related aversions and limited texture tolerance. Consistent participation in structured feeding therapy and active caregiver involvement will be critical to his success. With appropriate intervention and caregiver follow-through, Matthew is expected to make meaningful gains in oral-motor coordination, tolerance for varied textures, and overall expansion of his food repertoire.

Feeding Long Term Goals:

Category	Goal Description
Feeding/Swallowing	In 12 months, Matthew will improve his feeding/swallowing skills in order to optimize safe and effective nutrition with 50% accuracy across 5 consecutive sessions.

Feeding Short Term Goals:

Category	Goal Description
Feeding/Swallowing	In 6 months, Matthew will demonstrate emerging tongue lateralization to assist with bolus manipulation in 4 out of 10 opportunities across 3 consecutive sessions, to promote transition toward more advanced chewing patterns.
Feeding/Swallowing	In 6 months, Matthew will initiate a diagonal chewing movement with soft, dissolvable solids or oral-motor tools in 4 out of 10 opportunities across 3 consecutive sessions, to support development of a rotary chew.
Feeding/Swallowing	In 6 months, Matthew will accept and safely swallow minced & moist (IDDSI Level 5) textures in 3 out of 10 opportunities across 3 consecutive sessions, without signs of distress or aversion, demonstrating improved oral-motor coordination and texture tolerance.
Feeding/Swallowing	In 6 months, Matthew will increase acceptance of new foods through systematic food chaining, expanding his food repertoire by at least 3 new items (e.g., variations of preferred puréed proteins, fruits, or vegetables) with minimal aversive behaviors, in order to increase food inventory.
Feeding/Swallowing	In 6 months, Matthew will tolerate direct interaction with non-preferred foods via upper distal extremities in 4 out of 10 opportunities across 3 consecutive sessions, demonstrating progress through the “touches” stages of the Steps to Eating Hierarchy.
Home Management Intervention Program	When counseled by the clinician, parents will incorporate the home management intervention program as a daily and weekly activity to transfer skills learned in therapy into the home environment. Home management training will optimize patients functional communication tasks in the home.

Feeding Therapy Soap Note/Visit:

Soap Note

491424

Note Date: 03-25-2026

Subjective: Patient completed all required tasks,Patient was alert and cooperative,

Assessment of Goals/Response to Treatment: Matthew demonstrated emerging tongue lateralization to assist with bolus manipulation in 5 out of 10 opportunities given 10 verbal and 10 visual models. Matthew initiated a diagonal chewing movement with soft, dissolvable solids or oral-motor tools in 1 out of 10 opportunities given 10 verbal and 10 visual models. Matthew accepted and safely swallowed minced & moist (IDDSI Level 5) textures in 6 out of 10 opportunities given 10 verbal and 10 visual models. Matthew increased acceptance of new foods through systematic food chaining, expanding his food repertoire by at least 3 new items (e.g., variations of preferred puréed proteins, fruits, or vegetables) given 10 verbal and 10 visual models. Matthew tolerated direct interaction with non-preferred foods via upper distal extremities in 10 out of 10 opportunities given 10 verbal and 10 visual models. When counseled by the clinician, parents incorporated the home management intervention program as a daily and weekly activity to transfer skills learned in therapy into the home environment. Home management training will optimize patients functional communication tasks in the home. **Food attempted: boiled sweet potato, strawberry, dino nugget

Plans: Continue with current Plan of Care,

Additional Notes:

Completed Appointments:

ID	Plan of Care

Appt-ID	Service	Start-Date	End-Date	Therapist	Location	Status
826573	92610: Feeding Evaluation	10-21-2025 09:30 AM	10-21-2025 10:30 AM	Teresa Serna	NB1 east side	Completed
870565	92526: Feeding Visit	01-13-2026 01:30 PM	01-13-2026 02:00 PM	Teresa Serna	NB1 east side	Completed
868205	92523: Artic & Language Eval	01-19-2026 02:30 PM	01-19-2026 03:30 PM	Stephanie Escobar	NB1 east side	Completed
872392	92526: Feeding Visit	01-21-2026 02:00 PM	01-21-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
872393	92526: Feeding Visit	01-28-2026 02:00 PM	01-28-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
872394	92526: Feeding Visit	02-04-2026 02:00 PM	02-04-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
872395	92526: Feeding Visit	02-11-2026 02:00 PM	02-11-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
872396	92526: Feeding Visit	02-18-2026 02:00 PM	02-18-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
872397	92526: Feeding Visit	02-25-2026 02:00 PM	02-25-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
902784	92526: Feeding Visit	03-10-2026 11:30 AM	03-10-2026 12:00 PM	Teresa Serna	NB1 east side	Completed
872399	92526: Feeding Visit	03-11-2026 02:00 PM	03-11-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
872402	92526: Feeding Visit	03-17-2026 04:30 PM	03-17-2026 05:00 PM	Teresa Serna	NB1 east side	Completed
872400	92526: Feeding Visit	03-18-2026 02:00 PM	03-18-2026 02:30 PM	Teresa Serna	NB1 east side	Completed
872401	92526: Feeding Visit	03-25-2026 02:00 PM	03-25-2026 02:30 PM	Teresa Serna	NB1 east side	Completed

Canceled Appointments:

Appt-ID	Service	Start-Date	End-Date	Therapist	Location	Status
872398	92526: Feeding Visit	03-04-2026 02:00 PM	03-04-2026 02:30 PM	Teresa Serna	NB1 east side	Canceled

Scheduled Appointments:

Appt-ID	Service	Start-Date	End-Date	Therapist	Location	Status
872403	92526: Feeding Visit	04-01-2026 02:00 PM	04-01-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872404	92526: Feeding Visit	04-15-2026 02:00 PM	04-15-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872405	92526: Feeding Visit	04-22-2026 02:00 PM	04-22-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872406	92526: Feeding Visit	04-29-2026 02:00 PM	04-29-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872407	92526: Feeding Visit	05-06-2026 02:00 PM	05-06-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872408	92526: Feeding Visit	05-13-2026 02:00 PM	05-13-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872409	92526: Feeding Visit	05-20-2026 02:00 PM	05-20-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872410	92526: Feeding Visit	05-27-2026 02:00 PM	05-27-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872411	92526: Feeding Visit	06-03-2026 02:00 PM	06-03-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872412	92526: Feeding Visit	06-10-2026 02:00 PM	06-10-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872413	92526: Feeding Visit	06-17-2026 02:00 PM	06-17-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872414	92526: Feeding Visit	06-24-2026 02:00 PM	06-24-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872415	92526: Feeding Visit	07-01-2026 02:00 PM	07-01-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled
872416	92526: Feeding Visit	07-08-2026 02:00 PM	07-08-2026 02:30 PM	Teresa Serna	NB1 east side	Scheduled

Paient Notes:

Date	Posted By	Description
02-13-2026	Shekinah Velasquez	Received 2/3 signatures and THsteps. Refaxed last signature request. Pending response.
02-11-2026	Avery Fontenot	Called office regarding missing paperwork and they stated that they will fax it over to us.
01-28-2026	Avery Fontenot	faxed ST paperwork to PCP. Pending.
01-09-2026	Avery Fontenot	FD Auth starting 01/12/2026 to 07/10/2026 for 1x/wk = 26 visits. Therapist notified.
01-06-2026	Shekinah Velasquez	FD auth request submitted to EPH, pending approval
12-18-2025	Avery Fontenot	Called office and they said they will fax over the THSTEPS. Pending.
12-18-2025	Avery Fontenot	Called office twice and got no response, left a message for anahi for THSTEPS.
12-17-2025	Shekinah Velasquez	Faxed THsteps request faxed to Dr.
12-15-2025	Shekinah Velasquez	Called the office for THsteps. They will be sending paperwork soon.
12-09-2025	Avery Fontenot	Received signatures missing THSTEPS. Office said they aren't completed yet and will fax them over once they're finished.
12-08-2025	Avery Fontenot	Called office. They will email us the signatures.
11-25-2025	Julie Mora	Called PCP office, spoke to front desk. They will be faxing a new speech referral with speech DX codes.
11-19-2025	Shekinah Velasquez	Called Dr. office to request ST referral. Was transferred and sent to voicemail. Left voicemail.
11-18-2025	Avery Fontenot	Called office, they cant find the paperwork that we faxed over. Emailed paperwork to elpasofamilyclinic@gmail.com. Pending.
11-05-2025	Shekinah Velasquez	FD paperwork sent to PCP via fax. pending signatures.

Paient Missed Visit Notes:

Date	Service	Therapist	Description
03-04-2026	92526	Serna, Teresa

Paient Messages Admin:

Date	Posted By	Message
09-30-2025 04:58 PM	Julie Mora	Please fillout the form https://patient.newbeginnings-elp.com/Registration/default.aspx?sid=2255
10-01-2025 08:47 AM	Shekinah Velasquez	Griselda has been added to our Speech & Language Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/Schedule/waitlist_status.aspx?pid=9768&type=1&wid=314
10-01-2025 12:26 PM	Avery Fontenot	Hi, it looks like we need to reschedule your Feeding Evaluation. We will get back to you soon with an update or to schedule a new appointment. If you have any questions, please let us know. Thanks! 😊
10-04-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-05-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-06-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-06-2025 11:22 AM	Julie Mora	Matthew has been added to our Speech & Language Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9768&type=1&wid=320
10-07-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-08-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-09-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-10-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-11-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-12-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-13-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-14-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-15-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-16-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-16-2025 11:17 AM	Julie Mora	Good morning, One of our therapist will be contacting you soon to set up an appointment for Matthew's initial evaluation.
10-17-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-18-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-19-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Feeding Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-19-2025 11:07 AM	Shekinah Velasquez	Schedule Evaluation: When you are ready to schedule your evaluation, click this link https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-20-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-21-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-21-2025 12:40 PM	Stephen Tullius	Matthew has been added to our Speech & Language Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9768&type=1&wid=337
10-28-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-29-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-30-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
10-31-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
11-01-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
11-02-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
11-03-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
11-04-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
11-05-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
11-06-2025 08:36 AM	Shekinah Velasquez	Schedule Evaluation: Are you having problems scheduling your Speech Evaluation? Reply here if you need help. Or, schedule your evaluation now https://patient.newbeginnings-elp.com/Schedule/default.aspx?pid=9768
11-06-2025 04:14 PM	Stephen Tullius	Matthew has been added to our Speech & Language Therapy wait list. To send us a message at any time, just respond here. To check the status of the wait list, click this link https://patient.newbeginnings-elp.com/register/waitlist_status.aspx?pid=9768&type=1&wid=356
11-13-2025 12:46 PM	Monica Tullius	Hello, this is a general broadcast message. Please do not respond to this message. Holiday Turkey Giveaway! We’re happy to share that Hope Across the Border is giving away free turkeys for the holiday season. If you or someone you know could use a little extra support this year, you’re invited to pick one up: Sunday, November 16th 8:00 a.m. 5411 N. Mesa St, Suite 27, El Paso, TX 79912 If you or someone you know would like a turkey, please email: hopeacrossstheborder@gmail.com. Wishing you and your family a warm and joyful holiday season! Team New Beginnings
11-19-2025 02:28 PM	Shekinah Velasquez	Hello, this is Shekinah from the front office. I recently contacted you regarding your child's speech referral. I followed up with the doctor and requested to speak with the staff member we discussed, but my call was transferred to voicemail. I attempted again to obtain the referral from another member of the front office, but was still unable to reach anyone. We would greatly appreciate your assistance in securing this referral. I am also providing my email address in case the office would prefer to contact us directly with any questions. svelasquez@newbeginnings-elp.com. If we do not receive the referral by the end of this week, I plan to visit the office in person to speak with someone. Thank you for your time, patience, and support!
11-25-2025 02:52 PM	Celeste Collette	Dear Parents, We are deeply grateful for the love, trust, and partnership of our amazing families. Thank you for allowing us to be part of your child’s journey! From all of us at New Beginnings, we wish you a very Happy Thanksgiving filled with comfort, joy, and meaningful moments with the ones you cherish.
12-23-2025 02:05 PM	Stephen Tullius	Dear Families, As the holiday season approaches, we want to take a moment to express our heartfelt gratitude to you. It has been a true privilege to be part of your child’s journey this year. Every milestone reached, every effort made, and every smile shared, reminds us why we do what we do. We hope this season brings your family moments of joy, rest, and togetherness. May the coming year be filled with continued progress and many reasons to celebrate. We’d like to remind you at this time that our offices will be closed from December 24th thru January 4th. We will reopen Monday, January 5th, regular hours. From all of us, we wish you a joyful holiday season and a bright, healthy New Year! With warmest regards, Stephen Tullius New Beginnings Pediatric Therapy Services
01-07-2026 10:34 AM	Julie Mora	Good morning, I hope this message finds you well in the New Year. We are currently preparing to release some patients from our Speech Therapy waiting list, and before doing so, we would like to inform you of our available treatment times. At this time, we do not have any after-school appointments available. However, we do have daytime availability between 9:00 a.m. and 1:00 p.m. Please note that we are unable to guarantee a specific treatment time at this moment, as scheduling will be finalized once insurance approvals are received. If these times work for you, please message us to confirm your interest, and we will send you a scheduling link to arrange an initial evaluation. Thank you, and we look forward to hearing from you. Kind regards, New Beginnings Front Office
01-07-2026 10:48 AM	Matthew Gutierrez	Hello 9:00am will great.
01-07-2026 11:37 AM	Julie Mora	Hi, it's time to schedule your Speech Evaluation. Thank you for your patience! NOTE: This link will expire in 3 days...Please select an appointment time now by clicking here https://patient.newbeginnings-elp.com/ReSchedule/stevaluation.aspx?pid=9768
01-09-2026 10:15 AM	Shekinah Velasquez	Hi, Matthew as been assigned a therapist for Feeding therapy. Here's a link to learn more about Teresa https://st-pros.com/newbeginnings/reports/welcomefromtherapist.aspx?id=9768&tid=113
01-20-2026 12:10 PM	Caleb Tullius	🌟 You’re Invited! 🌟 Join us for our Kids Sensory Series — a fun, movement-based sensory play event for kids! 📅 Feb 2nd, 2026 ⏰ 10:00 AM 📍 Esperanza Acosta Moreno Public Library We’d love to see you there! 💙 _________________________________ 🌟 ¡Están invitados! 🌟 Acompáñenos a nuestra Serie Sensorial para Niños, un evento divertido con actividades sensoriales y de movimiento. 📅 2 de febrero de 2026 ⏰ 10:00 a.m. 📍 Biblioteca Pública Esperanza Acosta Moreno ¡Esperamos verlos! 💙
02-03-2026 03:52 PM	Caleb Tullius	🌟 You’re Invited! 🌟 Join us as we celebrate the unveiling of the Sensory Nook we proudly donated to the library! Come see the space, explore, and enjoy this special moment with us. 📅 February 7th, 2026 ⏰ 4:30 PM 📍 Esperanza Acosta Moreno Public Library We’d love to see you there! 💙 🌟 ¡Están invitados! 🌟 Acompáñenos a celebrar la inauguración del Rincón Sensorial que con orgullo donamos a la biblioteca. Vengan a conocer el espacio y compartir este momento especial con nosotros. 📅 7 de febrero de 2026 ⏰ 4:30 p.m. 📍 Biblioteca Pública Esperanza Acosta Moreno ¡Esperamos verlos! 💙
02-16-2026 05:27 PM	Caleb Tullius	Join us this Wednesday!
02-16-2026 05:48 PM	Stephen Tullius	Please join us for the next New Beginnings free Parent Training: Introduction to AAC (Augmentative and Alternative Communication). This session introduces AAC in a simple, supportive way on why it's used and how it helps children communicate. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=19&pid=9768
02-18-2026 04:15 PM	Stephen Tullius	For those of you that would like to attend our parent training: Introduction to AAC, but are not able to attend in person, we are setting up a webinar. This will be our first attempt at a webinar so I hope it goes well :) Here is the link: https://webinar.getresponse.com/JvvC9/introduction-to-aac/
03-09-2026 07:22 PM	Stephen Tullius	Please join us for the next New Beginnings free Parent Training: Sensory Play. In this session learn how to create safe, engaging sensory experiences that help hypersensitive children regulate their responses to touch, sound, and movement. Register here: https://patient.newbeginnings-elp.com/trainings/default.aspx?id=20&pid=9768
03-11-2026 05:40 PM	Stephen Tullius	Hello, for anybody who would like to attend our Sensory Play parent training today but can't, we will be attempting a webinar version. You can register to see it online at https://webinar.getresponse.com/JvvC9/sensory-play/

Paient Messages Therapist:

Date	Posted By	Message
10-01-2025 08:59 AM	Victoria Chacon	Hi, my name is Victoria, with New Beginnings, and I will be performing your child's Feeding Evaluation. If you have any questions before the evaluation, you can message me here. See you soon!😊 Oh, and here's a link to learn more about me https://st-pros.com/newbeginnings/reports/welcomefromtherapist.aspx?id=9768&tid=99
10-01-2025 08:59 AM	Griselda Hernandez	Griselda SCHEDULED: 11:00AM-10/9/2025 92610: Feeding Evaluation
10-13-2025 09:19 AM	Daniella Anchondo	Dear Parents, As the weather gets colder, I want to remind everyone to please keep children who are feeling unwell at home. This helps protect all our patients and staff from spreading illness during the cold season. Thank you for your understanding and for helping keep our community healthy! Warm regards, Daniella Anchondo, MS, CCC-SLP Estimados padres: A causa que el clima se vuelve mas frio, quiero recordarles que por favor mantengan en casa a los niños que no se sientan bien. Esto ayuda a proteger a todos nuestros pacientes y al personal, evitando la transmision de enfermedades durante la temporada de frio. ¡Gracias por su comprension y por ayudar a mantener saludable a nuestra comunidad! Con cariño, Daniella Anchondo, MS, CCC-SLP
10-16-2025 03:23 PM	Teresa Serna	Good afternoon, my name is Teresa Serna, and I will be the Speech Language Pathologist evaluating Matthew for feeding. I would like to go ahead and get him scheduled in. I currently only have the following available: 9:30 on 10/21, 9:30 on 10/28, 11:00 on 10/29. Please let me know which of these times work best for you. Thank you and I look forward to meeting you both!
10-16-2025 04:42 PM	Matthew Gutierrez	Matthew (Prim) Replied: Hello 10/21 at 930am will be great
10-19-2025 01:10 PM	Teresa Serna	Hello(: there was an error in the system would 10am on the 21st work for you?
10-19-2025 01:10 PM	Teresa Serna	Disregard message! The 9:30 is still open sorry for the confusion
10-19-2025 01:14 PM	Teresa Serna	The evaluation typically lasts about an hour. I recommend arriving 15 minutes early to allow time for paperwork. Alternatively, I can email you the documents in advance so you can complete them ahead of time and bring them with you on the day of the evaluation. I will go ahead and schedule him for Thursday and send you the forms. Here is the address for the appointment: 1512 N Zaragoza Rd, Ste C-1, El Paso, TX 79936 When you have a chance, please answer the following questions so I can prepare for the evaluation: (1.) Name and Date of Birth (2.)Any complications during pregnancy or birth? (3.)Any major illnesses or accidents since the last check-up? Any medical diagnoses (e.g., Down syndrome, etc.)? (4.)Any hospitalizations or surgeries? (5.)Were developmental milestones met within normal limits or delayed? (6.)Known allergies? (7.)Any sleeping or breathing issues? (Does your child get 8–10 hours of sleep? Wake up several times at night? Snore? Sleep with mouth open or closed? Enlarged tonsils?) (8.)Current medications? (9.)Has the pediatrician expressed concerns about nutritional growth? (10.)Any gastrointestinal issues? (11.)In a few words, please describe your concerns regarding your child’s feeding.
10-19-2025 01:24 PM	Matthew Gutierrez	Matthew (Prim) Replied: That's sounds good. Can I pickup paperwork myself, my printer broke on me last week.
10-19-2025 01:24 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
10-19-2025 01:27 PM	Teresa Serna	Yes of course! I can also have them ready for you for the day of the evaluation and you would just have to arrive 15 minutes earlier to have it all filled out. Let me know what you prefer(: If you have the opportunity, would you be able to take a video of him eating in the home environment just incase she doesn′t eat during the evaluation. This will help me get an idea of how feeding is at home. For the evaluation, please bring in 3 preferred foods and 2 non preferred foods along with a plate, utensils, and preferred drink. Let me know if you have any questions.(:
10-19-2025 01:38 PM	Matthew Gutierrez	Matthew (Prim) Replied: Thank you. I will stop by Monday morning after I drop him off at school.
10-19-2025 01:38 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
10-19-2025 01:43 PM	Teresa Serna	Perfect the front office will have the documentation ready for you(:
10-20-2025 12:25 PM	Matthew Gutierrez	Matthew (Prim) Replied: (1.) Name and Date of Birth - Matthew Gutierrez 9/15/12(2.)Any complications during pregnancy or birth? None (3.)Any major illnesses or accidents since the last check-up? None. Any medical diagnoses (e.g., Down syndrome, etc.)? Down Syndrome (4.)Any hospitalizations or surgeries? AV canal repair in February 2013, Strambismis-both eyes October 2017 & August 2023(5.)Were developmental milestones met within normal limits or delayed? Delayed (6.)Known allergies? None (7.)Any sleeping or breathing issues? None (Does your child get 8–10 hours of sleep? Yes Wake up several times at night? No Snore? No Sleep with mouth open or closed? Both Enlarged tonsils?) No (8.)Current medications? Ermeza & Enalapril (9.)Has the pediatrician expressed concerns about nutritional growth? None (10.)Any gastrointestinal issues? No (11.)In a few words, please describe your concerns regarding your child’s feeding. Would like for him chew more when eating & try new things.
10-20-2025 12:25 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
10-20-2025 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Evaluation appointment scheduled tomorrow at 09:30 AM. See you soon! - New Beginnings 🙂
10-21-2025 07:58 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Evaluation appointment scheduled today at 09:30 AM. See you soon! - New Beginnings 🙂
10-21-2025 09:15 AM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=826573
10-21-2025 09:27 AM	Matthew Gutierrez	Matthew is CHECKED IN for: 9:30AM-10/21/2025 92610: Feeding Evaluation
12-15-2025 01:15 PM	Daniella Anchondo	Dear Parents, This is just a reminder that there will be no speech therapy services in the clinic due to the holidays from 12/22/2025 - 1/4/2026. I hope you enjoy the holiday season with your families. Merry Christmas and Happy New Year :) Estimados padres, Esto es un recordatorio de que no habran terapias del 12/22/2025 - 1/4/2026 en la clinica. Esperamos pasen una muy bonita Feliz Navidad y Año Nuevo con sus seres queridos! Gracias.
01-07-2026 01:49 PM	Stephanie Escobar	Hi, my name is Stephanie, with New Beginnings, and I will be performing your child's Speech Evaluation. If you have any questions before the evaluation, you can message me here. See you soon!😊 Oh, and here's a link to learn more about me https://st-pros.com/newbeginnings/reports/welcomefromtherapist.aspx?id=9768&tid=125
01-07-2026 01:49 PM	Matthew Gutierrez	Matthew SCHEDULED: 2:30PM-1/19/2026 92523: Speech Evaluation
01-11-2026 09:16 AM	Teresa Serna	Hello, this is Teresa the feeding therapist (: Matthew has received authorization to begin feeding treatment this upcoming week. For this week I have the current days/times open: Tuesday at 10am, 12:30pm, 1:30pm - please let me know what works best (:
01-11-2026 09:23 AM	Matthew Gutierrez	Matthew (Prim) Replied: Good morning the 1:30pm works for us. Thank you.
01-11-2026 09:23 AM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
01-11-2026 09:30 AM	Teresa Serna	I like to start with five non-preferred foods (2 protein, 1 starch, 1 fruit, 1 veggie) along with his preferred choice of liquid and a preferred food to work on his oral motor skills. These foods will be the same foods for a one-month span. To help Matthew's sensory system, we will stick to a color scheme (any foods that are light in color so white or yellow). Here are some ideas: protein: yogurt, ham, chicken nuggets, turkey deli, cheese sticks, cheese, eggs. starch: rice crackers, rice cakes, veggie strips, pasta, noodles, bread, english muffin, veggies: yellow squash, corn, cucumber. fruits: yellow apples, pears, pineapple, dried mango/apple/pear. Let me know if you have any questions (: However, I have noticed that during the first sessions kiddos do take some time to adjust to the new environment so if you think that will be the case with Matthew feel free to pick 2 non-preferred foods and 2 preferred foods (:
01-11-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 01-13-2026 at 1:30 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
01-11-2026 04:22 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
01-11-2026 04:22 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
01-12-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 01:30 PM. See you soon! - New Beginnings 🙂
01-13-2026 08:09 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 01:30 PM. See you soon! - New Beginnings 🙂
01-13-2026 01:15 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=870565
01-13-2026 01:23 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 1:30PM-1/13/2026 92526: Feeding Visit
01-18-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 01-21-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
01-18-2026 04:22 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
01-18-2026 04:22 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
01-18-2026 06:30 PM	Stephanie Escobar	Hi, this is a just a reminder that Matthew has a Speech Evaluation appointment scheduled tomorrow at 02:30 PM. See you soon! - New Beginnings 🙂
01-19-2026 07:53 AM	Stephanie Escobar	Hi, this is a just a reminder that Matthew has a Speech Evaluation appointment scheduled today at 02:30 PM. See you soon! - New Beginnings 🙂
01-19-2026 02:15 PM	Stephanie Escobar	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=868205
01-19-2026 02:21 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 2:30PM-1/19/2026 92523: Artic & Language Eval
01-20-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
01-21-2026 07:58 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
01-21-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872392
01-21-2026 01:52 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 2:00PM-1/21/2026 92526: Feeding Visit
01-21-2026 02:34 PM	Teresa Serna	For next session: boiled apples, banana, boiled carrots, boiled green beans
01-25-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 01-28-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
01-25-2026 04:16 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
01-25-2026 04:16 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
01-27-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
01-28-2026 07:55 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
01-28-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872393
01-28-2026 01:55 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 2:00PM-1/28/2026 92526: Feeding Visit
02-01-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 02-04-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
02-01-2026 06:58 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
02-01-2026 06:58 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
02-03-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
02-04-2026 07:53 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
02-04-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872394
02-04-2026 01:54 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 2:00PM-2/4/2026 92526: Feeding Visit
02-08-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 02-11-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
02-10-2026 09:27 AM	Matthew Gutierrez	Matthew (Prim) Replied: YES
02-10-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
02-11-2026 07:49 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
02-11-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872395
02-11-2026 01:52 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 2:00PM-2/11/2026 92526: Feeding Visit
02-11-2026 02:05 PM	Matthew Gutierrez	Matthew (Prim) Replied: Just witnessed our 1st accident at therapy.
02-11-2026 02:34 PM	Teresa Serna	Oh no! What happened?
02-15-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 02-18-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
02-15-2026 04:02 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
02-15-2026 04:02 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
02-17-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
02-18-2026 07:46 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
02-18-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872396
02-18-2026 01:52 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 2:00PM-2/18/2026 92526: Feeding Visit
02-18-2026 04:09 PM	Teresa Serna	Patient School Note Report https://st-pros.com/newbeginnings/patients/Intakereports/School_Note_Report_print.aspx?pid=9768&Appt=872396
02-22-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 02-25-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
02-22-2026 04:32 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
02-22-2026 04:32 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
02-24-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
02-25-2026 07:46 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
02-25-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872397
02-25-2026 01:55 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 2:00PM-2/25/2026 92526: Feeding Visit
02-25-2026 02:29 PM	Teresa Serna	Patient School Note Report https://st-pros.com/newbeginnings/patients/Intakereports/School_Note_Report_print.aspx?pid=9768&Appt=872397
02-25-2026 02:33 PM	Teresa Serna	Hello, chicken nuggets, 2 veggies, 2 fruits
03-01-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 03-04-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-02-2026 05:57 PM	Matthew Gutierrez	Matthew (Prim) Replied: No
03-02-2026 05:57 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-02-2026 07:07 PM	Teresa Serna	Hello, I just saw you answered "no" is everything okay?
03-02-2026 08:27 PM	Matthew Gutierrez	Matthew (Prim) Replied: All is well, Matthew unfortunately is unable to attend his feeding therapy on Wednesday at 2pm. Do you have another day he can makeup?
03-02-2026 08:27 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-03-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
03-04-2026 07:43 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
03-04-2026 09:30 AM	Teresa Serna	Hello, I just saw this message on him not being able to attend. We can do twice next week. I currently do not open this week
03-04-2026 09:30 AM	Teresa Serna	Here is the new address 1510 N Zaragoza Rd Suite B1, El Paso, TX 79936
03-04-2026 09:30 AM	Teresa Serna	Teresa Serna CANCELLED: 2:00PM-3/4/2026 92526: Feeding Visit
03-04-2026 09:32 AM	Matthew Gutierrez	Matthew (Prim) Replied: Sounds great. Wednesday will still be the same? Just let us know the makeup time/date. Thank you
03-05-2026 11:26 AM	Teresa Serna	Yes Wednesday will stay the same. Would i be able to see him earlier Tuesday since he is out of school?
03-05-2026 12:32 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes, let me know time.
03-07-2026 08:19 AM	Teresa Serna	Hello can I see Matthew at 11:30 on Tuesday to make up the session?
03-07-2026 01:46 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes that would be great. See you then.
03-07-2026 01:46 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-08-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 03-10-2026 at 11:30 AM, and on 03-11-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-08-2026 04:04 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
03-08-2026 04:04 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-09-2026 03:20 PM	Teresa Serna	Hello(: here is the address for the new building I am in 1510 N Zaragoza Rd Suite B1, El Paso, TX 79936
03-09-2026 04:05 PM	Matthew Gutierrez	Matthew (Prim) Replied: Okay thank you, see you tomorrow.
03-09-2026 04:05 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-09-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 11:30 AM. See you soon! - New Beginnings 🙂
03-10-2026 08:01 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 11:30 AM. See you soon! - New Beginnings 🙂
03-10-2026 11:15 AM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=902784
03-10-2026 11:27 AM	Matthew Gutierrez	Matthew is RUNNING LATE for: 11:30AM-3/10/2026 92526: Feeding Visit
03-10-2026 11:31 AM	Teresa Serna	Let me know when you are here (:
03-10-2026 11:37 AM	Matthew Gutierrez	Matthew (Prim) Replied: Here
03-10-2026 12:10 PM	Teresa Serna	Patient School Note Report https://st-pros.com/newbeginnings/patients/Intakereports/School_Note_Report_print.aspx?pid=9768&Appt=902784
03-10-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
03-11-2026 07:43 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
03-11-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872399
03-11-2026 02:38 PM	Teresa Serna	Patient School Note Report https://st-pros.com/newbeginnings/patients/Intakereports/School_Note_Report_print.aspx?pid=9768&Appt=872399
03-13-2026 10:38 AM	Teresa Serna	Hello (: I will also be out of town in April and wanted to take this time with him being on break to make up the session. I have Tuesday at 3pm open - let me know if that works for you!
03-13-2026 10:46 AM	Matthew Gutierrez	Matthew (Prim) Replied: Matthew is back in school on Tuesday. We have appointments for that day. Do you have other availability?
03-13-2026 10:49 AM	Teresa Serna	Let me get back to you (:
03-15-2026 02:26 PM	Teresa Serna	Hello(: I have Tuesday at 4:30 open - would that work?
03-15-2026 02:32 PM	Matthew Gutierrez	Matthew (Prim) Replied: Hello Tuesday the 17th?
03-15-2026 02:32 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-15-2026 02:33 PM	Teresa Serna	Yes, but I just remembered you have appointments that day
03-15-2026 02:35 PM	Matthew Gutierrez	Matthew (Prim) Replied: That works for us, we are free at that time.
03-15-2026 02:35 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-15-2026 02:36 PM	Teresa Serna	Perfect (:
03-15-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 03-17-2026 at 4:30 PM, and on 03-18-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-15-2026 05:15 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
03-15-2026 05:15 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-16-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 04:30 PM. See you soon! - New Beginnings 🙂
03-17-2026 07:45 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 04:30 PM. See you soon! - New Beginnings 🙂
03-17-2026 04:15 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872402
03-17-2026 04:19 PM	Matthew Gutierrez	Matthew is CHECKED IN for: 4:30PM-3/17/2026 92526: Feeding Visit
03-17-2026 05:05 PM	Teresa Serna	Patient School Note Report https://st-pros.com/newbeginnings/patients/Intakereports/School_Note_Report_print.aspx?pid=9768&Appt=872402
03-17-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
03-18-2026 07:42 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
03-18-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872400
03-18-2026 02:32 PM	Teresa Serna	Patient School Note Report https://st-pros.com/newbeginnings/patients/Intakereports/School_Note_Report_print.aspx?pid=9768&Appt=872400
03-22-2026 04:01 PM	Teresa Serna	Hi, this is a just a reminder that Gutierrez, Matthew has a Feeding Therapy appointment on 03-25-2026 at 2:00 PM. Reply YES to Confirm or NO to reschedule - New Beginnings 🙂
03-22-2026 04:40 PM	Matthew Gutierrez	Matthew (Prim) Replied: Yes
03-22-2026 04:40 PM	Teresa Serna	Hi, I received your message but am not at work at the moment. Please be patient and I will respond just as soon as I can. Thank you for understanding! 😊 -- This is an automated message.
03-24-2026 06:30 PM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled tomorrow at 02:00 PM. See you soon! - New Beginnings 🙂
03-25-2026 07:43 AM	Teresa Serna	Hi, this is a just a reminder that Matthew has a Feeding Therapy appointment scheduled today at 02:00 PM. See you soon! - New Beginnings 🙂
03-25-2026 01:45 PM	Teresa Serna	Matthew Gutierrez : Time to check in at New Beginnings 🙂 Click here https://patient.newbeginnings-elp.com/checkin/default.aspx?AppId=872401
03-25-2026 02:34 PM	Teresa Serna	Patient School Note Report https://st-pros.com/newbeginnings/patients/Intakereports/School_Note_Report_print.aspx?pid=9768&Appt=872401