November 13, 2024 • 33 mins
Join us for an insightful discussion with Jaclyn Pederson, CEO of Feeding Matters, as we discuss the critical gaps in education for pediatric feeding disorders. Jaclyn sheds light on the challenges faced by clinicians, who often lack the specialized training needed to manage complex feeding issues in children. Drawing on her background in nonprofit leadership and healthcare innovation, she shares a strategic approach to advocating for improved education and research in this area. This episode calls for meaningful action to enhance education and resources, ensuring better support for those affected by pediatric feeding disorders around the world.
Episode Resources:
https://pubmed.ncbi.nlm.nih.gov/38801459/
https://youtu.be/oVZWdpu71Wc?si=Tz4QK1xzDQErAH4V
Gap Education:
https://swallowthegap.com
Facebook:
https://www.facebook.com/GapEducationLLC
Instagram:
https://www.instagram.com/swallowpatho
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Tim Stockdale (00:00):
Welcome.
Everybody Joining me today isJaclyn Peterson.
Jaclyn Peterson is a CEO ofFeeding Matters and Feeding
Matters works to advance thefield of pediatric feeding, so I
know that most well.
I don't know, I suppose most ofthe listeners here are for
adult dysphagia.
You need to stick around.
There is a tremendous amount ofcross-application in how we're
(00:22):
trained for adult dysphagia withhow Jaclyn what she's uncovered
as far as pediatric feedingtraining and I suspect you know,
maybe a number of us have goneinto adult dysphagia by
necessity, because of some ofthe reasons that she's going to
mention, that there is not awhole lot of training.
I mean, we think there's apaucity of training for adult
dysphagia.
Look at pediatric dysphagia.
(00:43):
So stick around, Jaclyn.
What else would you like peopleto know about yourself before
we continue?
Jaclyn Pederson (00:49):
Thanks, tim, for having me.
So my background is actuallynot clinical.
I have a background ofnonprofit leadership and
management, and then my graduatework is in healthcare
innovation and systems practice.
So I always look at things fromlike a systems lens, and that,
I think, really applies to theresearch we're going to be
talking about today.
Tim Stockdale (01:10):
Well, it seems like that would give you a heads
up in being able to affectchange and not just being like
you'd be a great collaboratorfor clinicians like all of us
listening here, to be able tolike hey, this is how you take
some steps to get things done.
Is that fair?
That's true?
Hey, this is how you take somesteps to get things done.
Jaclyn Pederson (01:23):
Is that fair?
That's true.
I mean, I think that hopefullyI'm kind of and that
collaborator to bring adifferent perspective and get
this work done together, becauseI do think that we can move
mountains as long as we're doingit all together.
Tim Stockdale (01:38):
OK, good deal, Good deal.
So this article we're lookingat, looking at preparedness of
speech, language pathologistsand occupational therapists to
treat pediatric feeding disordera cross-sectional survey.
This was published in receivedDecember 5th 2023, accepted May
10th 2024.
So this is recent.
This is good stuff.
What is?
(01:59):
What would you say, are themain primary, key takeaways from
this?
Jaclyn Pederson (02:03):
The primary key takeaways from this article are
that there really isn't awell-defined educational pathway
that allows a professional todevelop a specialty in pediatric
feeding and pediatric feedingand swallowing.
That is something that I thinkis assumed by a lot of families
who are looking for providers totreat their children.
And then I think, if you're astudent and we by a lot of
families who are looking forproviders to treat their
(02:25):
children, and then I think, ifyou're a student and we see a
lot of students interested infeeding and swallowing and you
end up not realizing that youkind of have to build this path
along the way, and so I'd saythat's the highlight is you
think there's a pathway butthere really isn't.
Tim Stockdale (02:42):
And this sounds like it's not just unique to
speech pathology.
Is that right?
Jaclyn Pederson (02:46):
It is not just unique to speech pathology, so
in the field of pediatricfeeding disorder.
So the definition of pediatricfeeding disorder is when a child
really isn't eating appropriatefor their age and they have
dysfunction in the medicaldomain, the nutrition domain,
the feeding skill domain and thepsychology domain domain the
nutrition domain, the feedingskill domain and the psychology
(03:07):
domain.
And so within that feedingskill domain it's a lot of
crossover and collaborative workbetween speech language
pathologists and occupationaltherapists and that
collaborative work looksdifferent based on what the
background of that professionalhas and what is available within
that community.
But yeah, it's for both, and sothat was a big highlight of
this work too was it wasn't justone discipline that needed a
(03:29):
little bit more support, it wasboth.
Tim Stockdale (03:32):
Okay.
Jaclyn Pederson (03:33):
Very interesting.
Tim Stockdale (03:34):
What was it that led to you investigating this?
Jaclyn Pederson (03:38):
A lot of it is because at Feeding Matters we
support families, and so whenyou're trying to help families
find the care that they need, wehad to continuously build
supports around families to helpthem understand that you may be
trying to go find interventionfor your child who is having
trouble with feeding, but thatperson may not have had the
(04:01):
education that you think orexpect them to have had.
And so it started withsupporting families and then it
grew to kind of like theadvocacy and the awareness work
of like okay, well, if that's aproblem, how can we be a part of
the solution?
And so we were like okay, weneed to at least build an
evidence base to figure outwhat's happening.
(04:22):
And so that's what led to usdoing a survey of okay across
the United States.
You know how are people feelingabout their educational efforts
in this area.
And so there was a there's aprecursor to this publication.
Actually, that just is ageneral, like landscape
publication from the survey,which is you know who's treating
what?
How are they treating it?
What does that look like With815 individuals?
(04:45):
And then this got into thespecifics around the feeding
scale domain, and so the historyof this is really like if we
need to change and prepareprofessionals to better support
families, we need to even figureout where the baseline is.
What are individuals coming outof school learning, or what was
(05:06):
their pathway to developing aspecialty in this area?
And so a lot of it was just ourown curiosity.
Tim Stockdale (05:12):
Yeah, I mean, it almost sounds like you're being
strategic in trying to figureout how to fix this, which is
great.
Jaclyn Pederson (05:17):
A lot of advocacy.
Work is pretty strategic.
It's hard to you know.
When you go into advocacyconversations, a lot of it is
like well, show me the data,show me the data, and you're
like this is an emerging field.
There really isn't a lot ofresearch in this area.
Tim Stockdale (05:30):
Yeah, I mean, this is a pretty good start,
though, and you have aremarkable N.
You have 418 speechpathologists, 195 occupational
therapists, for a total of 613people that you surveyed, kudos.
That's awesome.
Jaclyn Pederson (05:47):
Thank you.
Thank you.
It was very helpful to havesuch an amazing community of
support to be able to fill outthis survey.
We did also get funding forthis research, so we were able
to offer an incentive, which Ialso think is like really
helpful in research and beingable to up your participation
numbers.
And then I think it helps thatfeeding matters is really
(06:10):
popular among pediatric feedingprofessionals, and so we were
able to leverage our communityto be able to fill out the
survey.
But that is described as alimitation too, because you know
that was one of the primaryrecruitment methods, so there
could be inherent bias in thatsense.
Tim Stockdale (06:27):
Yeah, for sure.
No, I was thinking, I wasthinking the same thing.
I was like I got to reach outto my audience and I say my
audience that's, that's and Ialmost said something like.
I did say something like thatearlier and I corrected myself
this is, this is a, it's acommunity, it's a platform where
people talk.
I don't know, I don't likereferring it to my audience,
(06:47):
because I would say I'm one ofthe least important parts of
this show that it's the peoplewho come on and finding them,
and, of course, that stuffmatters in engaging in
conversation, but looking atpeople who come from all these
different perspectives, bringingthem together, having a
conversation, giving them aplatform to be able to talk
about things that are importantto them, and raising awareness
of clinicians about what'simportant and you know, I'm a
(07:10):
small part of that, so forgivemy the semantics of me saying
that I it's not a not I don'tthink it's an ego thing or
anything like that, but so well,this is.
This is really interesting andwhat is making me think about
there's some work for adultdysphagia done in 2013 or 2014,
giselle Carnaby and Herrenbergthat came out and they looked at
(07:33):
practice patterns of speechpathologists and saw that it was
kind of like everywhere,everywhere.
And then Vos et al in 2018 didsomething similar.
I mean, there was, of course,more to the publication, but
part of it was looking atpractice patterns and it was
just so broad, not you know, somuch standardization on.
Okay, if you see this, you dothis or whatever.
Not that everything's formulaichardly anything is but at the
(07:55):
same time it was a little bitalarming, like if there is
really strong evidence behind Xto treat Y, then why are we
doing it all so differently?
I don't know.
It raised a lot of goodquestions, so when I saw this
article I was like this would besomething great to talk about.
Like this one in particularjust caught my attention.
(08:15):
Gap education is predicated ongaps in education.
Imagine that.
Jaclyn Pederson (08:21):
And that's what I've heard.
So because my interest is in OK, how can we make sure there is
an educational specialty pathway?
And so I've started askingquestions of people you know,
like, how do we get to this?
Like, how do we work inpartnership with these national
associations to develop this out?
Is it more at the academicinstitution and university level
?
Is it more at the nationalassociation level?
(08:43):
Is it more at the employerlevel?
We've even asked that of thecommunity at feeding matters,
and what does that look like?
And I think it goes back to whatyou're saying of part of the
problem is there isn'tnecessarily like a best practice
for treatment, so how can youeven train on that?
And it just ends up being thiscycle of we don't have enough
(09:04):
research to show X supports Y,and so then it ends up being
this black hole of people havingto do the research on their own
, find a mentor on their own andreally try to do this work on
their own.
And I think that's also whereadult dysphagia comes into play,
because the dysphagia world ingeneral and research in
(09:27):
dysphagia world, it's come along way and I know it still
feels like an emerging fieldsometimes, but I think the
pediatrics of it is looking tothe adult dysphagia world and
seeing how that can be ourleaders.
Tim Stockdale (09:42):
Oh man, that's a little scary.
Jaclyn Pederson (09:45):
I know.
Tim Stockdale (09:48):
No, I don't mean that to Blind leading the blind
in some instances, in someinstances and that's not
something that speaks to theintegrity of clinicians or
anything- no, not at all.
It's a systemic thing thatlimits our training so much.
And people, I'm not gonna ranton this all episode, I promise
guys.
But it's like nine diagnosticcategories, five or six
semesters and there's so muchvariability in background and I
(10:10):
don't know.
It's alarming to me and like youhad mentioned earlier, this is
at least what I took away fromyour comment that you started
really supporting families, butthen to support families, you're
like, well, families arerelying on clinicians and are
like, oh well, I don't know.
You know that sort of thingbecause of the lack of training.
(10:31):
I mean, think, if you'rewhoever's listening right now,
think of your training in adultdysphagia, right.
So think of that, Think of whatit should have been or what it
could have been versus what itwas.
And now think about yourtraining in pediatric feeding or
pediatric dysphagia, thosetypes of things.
Jaclyn Pederson (10:47):
I mean, even like pediatric motor speech,
limited, limited, depending onwhere you are, yep, yep and your
exposure of it and what thepassion of the I mean it's
really predicated on whatuniversity or academic
institution am I attending andwhat passion or history is at
(11:08):
that institution and and that iswhat sets you on the trajectory
for your career.
And I don't think that this isthe like in pediatric feeding
disorder.
It's a new condition.
It was only published inOctober of 2021.
And so in that sense, it isstill very emerging.
But this issue is one that Ithink could be done, or a study
(11:32):
done for many different otherissues.
I think the challenge is it's alot of practice areas and so
it's hard to be a generalist anda specialist all at once.
Absolutely.
Tim Stockdale (11:43):
Absolutely, absolutely, especially without.
I mean, we have fellowship,sort of clinical fellowship for
speech photographers, but that'snot like a medical fellowship
or not like a residency, so Idon't know.
There could be a lot of thingsin place but you think of, like
well, who's going to pay for it?
Yeah, that component of it too.
Jaclyn Pederson (12:02):
That's a huge component too.
Tim Stockdale (12:03):
And if we transition to a doctorate like
it's also, who's going to payfor it?
Because it's not likereimbursement rates are going to
go sky high.
We're going to be in more debt.
From going to school.
We're going to be betterprepared, but we're also going
to be eating ramen noodles forthe next 20 years, you know.
Jaclyn Pederson (12:27):
Yeah is you know, both national associations
, aota and ASHA, had pathways todo some sort of like board
certification or specialty infeeding and swallowing, and
because it's within the scope,that pathway kind of existed,
but people weren't using thatpathway because the incentive to
use it wasn't there.
Having the board certificationdidn't necessarily mean you were
paid a higher salary oranything like that.
(12:48):
So kind of like back to thatsystem problem who is going to
pay for it?
And I think that's the hardestchallenge in a lot of these
system problems is like I wastalking to someone the other day
.
They were like who's to blamefor this issue?
And I was like I mean, thesystem is like always the person
I blame, because it's just likeit's not built.
And so then you see all thedomino effects that result
(13:10):
because of it, and families areleft in the lurch.
And then professionals arethere too.
You all as professionals arejust trying to support your
families and do the best thatyou can clinically, but it's
challenging for you too.
Tim Stockdale (13:25):
Oh yeah, yeah, there's a lot.
I kind of a one trick pony.
Jaclyn Pederson (13:31):
I want to be good at dysphagia.
I'm sure you feel that way.
Tim Stockdale (13:34):
Well, I mean, there's a lot of other stuff.
I find that when you go atdysphagia, I'm sure you feel
that way.
Well, I mean, there's a lot ofother stuff.
I find that when you go intodysphagia, you know you get
motor speech disorders, you getall these acquired neurogenic
disorders and whatnot.
So like I love all that too,but I am lost as far as
pediatric feeding goes.
I mean, I'm lost as far asphonology and a number of other
things too, but this is so farout of my comfort zone.
It's crazy, like it is just sofar Back to the article.
(14:00):
So we've kind of got an ideaand would you say the theme is
that training is limited, it'snot standardized, it's not
supporting clinicians.
Is that fair?
That is very fair.
Yes, so what are some of themost?
Jaclyn Pederson (14:19):
alarming takeaways for you.
I think the most is thattreating pediatric feeding
disorder is in both scopes ofpractice for both disciplines.
Yet the standardization for howa clinician may be coming out
of school is not there.
Overwhelmingly, the respondentsshared that they felt
(14:41):
underprepared to be able totreat this coming out.
And again, who to blame?
The system is to blame.
There's not great mentorsavailable for these students
because there's not a lot ofresearch out there, and so it's
this.
It kind of piles on.
But you know what we detailedin what we heard from the survey
(15:05):
and the respondents sharingtheir kind of their, their
self-directed educationalpathway was really dependent on
if they were able to find afellowship that made sense in
the feeding world, if they wereable to find a mentor.
There was a lot of like takingcourses and different classes
and that kind of produces itsown challenge as it relates to
(15:30):
where evidence is at right nowand then I think a lot of times
people are also doing thingslike listening to podcasts to
get exposure to other thingsit's mentioned in and having
article review clubs and kind ofsome of those like more case,
like peer reviewed, sort ofself-directed activities.
Tim Stockdale (15:51):
Yeah, that's very interesting.
You know, I I'm thinking aboutthis and I'm thinking if someone
was going to have like openheart surgery and they're like
oh where'd you go to medicalschool?
Oh, harvard Medical School, orlike you know whatever.
Or where did you learn to docardiac surgery?
Well, I took some CEUs.
(16:12):
I, you know.
I got my general medical degreeand then I took some CEUs.
I, you know, I got my generalmedical degree and then I took
some CEUs.
I even did a little bit ofhands-on practice under a mentor
who was also self-taught, andit was alarming.
Jaclyn Pederson (16:26):
You know you'd be like oh my gosh, jim, that's
such an interesting metaphor.
Tim Stockdale (16:30):
You'd be like get away, like I'm going to go to
some other place, some othercountry, other side of the world
, where they actually like teachthis based upon an evidence
base, and so, like I think thething with that, though, is we
know like, oh yeah, yeah, youneed the heart to live, right,
you know, someone gets in there.
They can kill you really fastif they nick the aortic artery
and you bleed out, that type ofthing.
Jaclyn Pederson (17:21):
And that's a big deal because it's like with
this, it's important for peopleto understand what are the
implications of it right now.
So the pediatric feedingdisorder, if it's not identified
or not treated well, or even insome cases, if it is, it can
turn into ARFID avoidant,restrictive food intake disorder
which is a mental healthdiagnosis later on in life as an
older child and intoadolescence and into adulthood.
And so I think that's one of theimpacts is the true
psychosocial damage of notgetting identified early but
(17:44):
also not getting to a providerthat can support your feeding
skill development, includingyour swallowing, as well as your
psychosocial relationship withmealtimes.
You know, we're finding becausethe research is now progressing
a little bit, we're findingthat it takes us seven years and
(18:04):
longer to learn to eat, torefine those skills, and if
there's any disruption in that,it can have devastating effects
for the individual but then forthe entire family, because this
condition brings families totheir knees, because it is just
so stressful, so expensive andthen to be told I don't know if
(18:27):
you're seeing the right provider, like you've got to evaluate
whether you have the rightprovider or you're doing further
damage is really challenging.
And the problem is that even ifa provider thinks that they are
qualified or thinks it's withintheir scope, I sometimes worry
that they don't even necessarilyhave the foundation to know
(18:48):
that, and so it's just a realbig crisis because it's a very
prevalent issue.
Tim Stockdale (18:57):
And the whole thing with self-assessment, like
you're saying, like someonefeels like they're pretty good
at something.
Like when I was in the thirdgrade, I thought I was pretty
good at basketball.
Like I thought I was prettygood.
Jaclyn Pederson (19:07):
Going to the NBA.
Tim Stockdale (19:08):
Exactly, exactly.
I would get so ticked off if mymom was like you know what
happens if you don't go to theNBA.
I'm like mom, come on, don't bea hater.
Like.
I thought I knew this andobviously I'm third grade, very
cognitively underdeveloped andwhatnot.
But this is hyperbole, right,using hyperbole.
But then you get and you go tolike a bigger town where a lot
(19:29):
of other kids play and you getschooled and you're like, oh
okay, this is what it looks likewhen you're doing the right
thing or whatever.
And then they go to anotherplace, you get to a bigger pond,
a bigger pond and you see, oh,I'm not as good or as smart or
as whatever as I thought I was.
And so there are limitations inself-assessment.
If you don't have a way tocalibrate and I'm going to take
(19:51):
that back and say, well, I'm notgoing to take it back, but I
know there are standards thatare out there to look through
this checklist.
But how many providers can saythat when they started
practicing they met all thosestandards?
Like I would be baffled.
I think that would be somereally interesting
self-assessment to calibratewith.
Jaclyn Pederson (20:10):
I would agree with you.
Tim Stockdale (20:12):
There are also known biases too.
I'm not going to say thesciences is perfect, but, like
Dunning and Kruger's work, whenyou know a little bit about
something, sometimes you thinkyou know a lot more than you do.
And then, as you learn more,you're like oh man, I didn't
really know what I was talkingabout.
I didn't know what I was doing.
And then as you continue, your,your competence and your
(20:33):
competent, these competence andyour confidence become more
proportional.
But initially, like it's realeasy for confidence to be
through the roof, we don't knowas much just like little third
grade NBA Timmy with his bowlcut out on the playground.
You know it's man.
Yeah, that's how it goes.
Jaclyn Pederson (20:50):
Well, and I completely agree with that, and
I can't remember if it's in thisarticle or the one prior or
maybe it's in a future one, butwe we were trying to get a sense
of like, okay, because I thinkone of the questions asked was
what is your confidence level intreating pediatric feeding?
(21:12):
And we saw a kind of scoredpositively.
So the lack of educationalpathway, the having to do
self-directed work and stuff,and I think it speaks to that
piece of it's hard to do someself-assessment work in this
(21:34):
area and so the confidence isreally high.
I do hope that we can get alittle bit more depth to some of
those standards and work onwhat are we really want to see
from a competence standpoint, sothat way everybody can kind of
be on the same playing field,because it's so individualized
depending on what course youwent to or whatever.
But all the competence doesseem to be high, which I think
(21:56):
is kind of concerning from asending families out into the
world standpoint and there areamazing providers out there and
I don't want anything that I sayto detract from that.
I am just trying to sound thealarm that we need to better
support our professionals sothat they can feel supported and
feel confident in going outinto the world to treat children
(22:18):
.
Tim Stockdale (22:18):
Yeah, and that's really been a huge razor's edge
of this podcast and some otherstuff that I try to put out, is
that it's not meant to becritical of the clinician
because, if you're listening tothis or earlier, and not say
like you might be listening tosomething else wherever.
If you're actively trying tolearn, that says you know so
(22:42):
much totally does in a positiveway.
But I think we just areidentifying that there is a
problem there and we're tryingto find out what the cause of
that problem is so that we canwe can help to be a part of the
solution.
And, like you were talkingabout the magnitude of this, the
psychosocial implications, Imean just from an adult
dysphagia perspective, lookingat the functional outcomes like
(23:02):
nutrition, hydration, pulmonarysequelae and quality of life.
So the psychosocial stuffreally hits on quality of life
If it turns into potentially amental health diagnosis like,
yeah, that's pretty huge.
And look at the role, though,of nutrition in fighting illness
.
I mean, I know more about thatin the elderly than I do in kids
, but you have, I mean, that'syour immune system's developing,
(23:25):
you have so much going on andso that if you're undernourished
and you're not getting themacronutrients and you may
probably even the micronutrientsthat you need to to fight
infection or fight illness, thatcan lead to early death.
And in other places like we'rewe're thinking the United States
you know we're very privilegedor or or Canada, the number of
different places in the world Idon't want to assume anything
(23:47):
about anybody who's listening tothis, but I can imagine in
other places where there is lessprivilege and less robust
medical care, how this can leadto so many more deaths and how
it can just set people back.
So far, I am very fortunate tohave a friend in Cameroon and
(24:08):
there's like this ongoing civilwar there and he's a remarkable
individual.
He takes people into his housewho have been displaced and he
has kids of his own and you see,like all of this stuff that
he's going through just in adifferent world than we're
living in.
And so I don't know like it'senough of a problem here that
(24:30):
when we're not considering whatpeople in other places of less
privilege are going through,it's just, it's remarkable to me
, it really is.
Jaclyn Pederson (24:41):
Yeah, that's very true and this particular
article was based on the UnitedStates respondents, but when we
did do the survey we did getsome international respondents.
We haven't gone back and lookedat that, but I just know in
Feeding Matters work as we tryto talk to other countries and
what's happening there.
(25:01):
It is definitely a worldwideproblem that no one has great
solutions for not only on theidentifying the kid's side and
figuring out their treatmentpathway, but also on the
education side and getting morespecialists available to treat
children with PFD.
Tim Stockdale (25:19):
Yeah, so kind of along the lines of what you're
saying, that most individualswho answered this were from the
United States.
What other limitations do yousee in?
You know the potential togeneralize this article.
Jaclyn Pederson (25:36):
Yeah, I think I mentioned earlier too that one
of the challenges is werecruited through Feeding
Matters and then the differentlistservs through the national
associations.
So you know, in that sense Ifeel like we tried to get as
many individuals as possible toparticipate.
But I think there's always alimitation in bias, in
(25:56):
participation based on yourrecruitment methods, and so I
think that's one of the biggestlimitations.
That's one of the biggestlimitations and just it's
important to kind of get abetter understanding of what
(26:17):
exists within the NationalAssociation standards but then
what also exists in theuniversity standards.
So as much as we are reportingon what people shared with us
and then we try to also thenresearch kind of what's
happening in the field, to tryto share both of those stories,
that may be a limitation too,okay.
Tim Stockdale (26:30):
So, as we, as we get close to the end of this
episode, there are two thingsthat I want to make sure to
cover.
One, I want to see if there'sanything else that you believe
we haven't covered that isimportant for people to know.
And other than that, I want toknow, like what do you think are
some actionable steps that wecan take to make this better?
And maybe we're not there yet,maybe we don't know, maybe we as
(26:51):
a profession don't know.
Are there any other things thatyou think this article has
brought to the light that aresuper out there, important, that
we haven't discussed?
Jaclyn Pederson (27:00):
I think it's the start of the work.
So I think for us it was aboutyou know, this is an emerging
field of research.
We know that, likeprofessionals aren't supported.
Well, let's get a betterunderstanding of it.
But for me it felt very muchthe start of the work and we
need to continue the work.
But I think, and I guess maybeit's kind of a future direction
(27:25):
or limitation of futuredirection in terms of what do we
do with it.
But you kind of get into thiscycle of okay, we know there's
no educational specialty pathway, how do we fix it?
We talk to the nationalassociations, try to work in
collaboration with them.
They are open to partnership,but they often don't know what
to do on their end, because it'sdifficult from their
perspective.
And then we've talked touniversities and it's difficult
(27:47):
from their perspective becausethey don't have standards of
best practices to be able tothen train individuals and so to
not use like meme culture, butit feels almost like the
Spider-Man meme whereeverybody's pointing at
everybody else.
And it's hard because it's likethis work needs to happen and
so you know we have a vestedinterest in making it happen.
(28:08):
We're a nonprofit, it's part ofour mission.
So we need to support families,we need to support
professionals, but that's thefuture direction is like we're
going to have to figure out thistogether and collaborate and
really get curious about how wedo that.
Tim Stockdale (28:23):
Yeah, and you know, from an educator
perspective it is extremelydifficult, like if you look at
all the things you're supposedto be teaching versus like what
people are walking away with.
If you cover so much breadth,especially like if these are
students in their first, second,third semester who don't have a
bunch of clinical experience toanchor this on, like they,
(28:47):
sometimes you end up you're atrisk for teaching to the test
and long-term retention isn'tnecessarily there.
I mean, teaching methodologyhas changed.
The knowledge of how learningscience, how we learn and can
apply things, has changed somuch.
And so I believe and I thinkeverybody knows that I believe
this that our scope is well,speech, I speak to speech
(29:08):
pathology in particular scope isjust so broad and if it's going
to be that broad on things, Imean everything matters.
But especially on areas whereyou can kill people or cause
like I mean I can think any,just about any category can
cause like permanentpsychological harm, which is
huge.
There's got to be a clear,supported pathway for that depth
(29:31):
.
It can't be all student-ledlearning, right and kudos.
I commend everybody who istrying so hard to do their best,
but we need so much moresupport.
That is my belief and I knowthat educators can't do it alone
.
I don't know the answer.
I mean, hopefully someone out.
I know that educators can't doit alone.
I don't know the answer.
I mean, hopefully someone outthere.
Maybe you haven't figured itout.
If you do, please send me anemail.
Come on the podcast.
I would love to hear that.
(29:52):
There's just so much so withwhat we have.
What would be some actionablesteps that listeners can take or
that you know as a whole, ashealthcare providers, that we
can take?
Jaclyn Pederson (30:07):
As healthcare providers.
I think there's two facets tothis.
So if you're interested in thisas a field, you know definitely
if it's not anything that youhave education in, you will have
to go and try to find thateducation, unfortunately, the
good news is I think you've gota plethora of different options
(30:29):
out there for courses to take ordifferent people or mentors to
follow, whether they're personalmentors in your local area or
more kind of internetpersonality mentors.
There's also many differentcommunities of practice.
There is a growing presence ofpediatric feeding specialists in
the SIG 13 group at ASHA and acommunity of practice at AOTA.
(30:52):
So even if you're a dysphagiaprovider like that may be an
easy area to kind of find someothers that are part of you.
And then Feeding Matters is acommunity that supports families
and supports professionals andcan help you find other
providers out there, find accessto information and more.
Tim Stockdale (31:10):
Well, thank you.
Thank you for your investmentin this, as, not being a
clinician, I think it takes avillage, and it takes a village
with different skill sets anddifferent perspectives.
So I am very grateful for thework that you're doing and
grateful for the work that somany others are doing as well.
Thanks for coming on here.
The name of the article againis preparedness of speech,
language pathologist andoccupational therapist to treat
(31:32):
pediatric feeding disorder colona cross-sectional survey.
This is in dysphagia.
I can post a link to it in thewebsite.
Um the podcast description, andit's with Kelsey Thompson.
At all, there are 1, 2, 3, 4, 5, 6, 7, 8 authors on this, so
some pretty tremendouscollaboration.
It sounds like.
Jaclyn Pederson (31:52):
Thank you for having me.
Tim Stockdale (31:53):
Thanks so much.
It was a pleasure, I learned alot and, to be honest, I had a
blast.
This was great, so thank you.
Jaclyn Pederson (31:58):
Yeah, it was so fun.
Thank you, tim, reallyappreciate it.
Welcome.
Everybody Joining me today isJaclyn Peterson.
Jaclyn Peterson is a CEO ofFeeding Matters and Feeding
Matters works to advance thefield of pediatric feeding, so I
know that most well.
I don't know, I suppose most ofthe listeners here are for
adult dysphagia.
You need to stick around.
There is a tremendous amount ofcross-application in how we're
(00:22):
trained for adult dysphagia withhow Jaclyn what she's uncovered
as far as pediatric feedingtraining and I suspect you know,
maybe a number of us have goneinto adult dysphagia by
necessity, because of some ofthe reasons that she's going to
mention, that there is not awhole lot of training.
I mean, we think there's apaucity of training for adult
dysphagia.
Look at pediatric dysphagia.
(00:43):
So stick around, Jaclyn.
What else would you like peopleto know about yourself before
we continue?
Jaclyn Pederson (00:49):
Thanks, tim, for having me.
So my background is actuallynot clinical.
I have a background ofnonprofit leadership and
management, and then my graduatework is in healthcare
innovation and systems practice.
So I always look at things fromlike a systems lens, and that,
I think, really applies to theresearch we're going to be
talking about today.
Tim Stockdale (01:10):
Well, it seems like that would give you a heads
up in being able to affectchange and not just being like
you'd be a great collaboratorfor clinicians like all of us
listening here, to be able tolike hey, this is how you take
some steps to get things done.
Is that fair?
That's true?
Hey, this is how you take somesteps to get things done.
Jaclyn Pederson (01:23):
Is that fair?
That's true.
I mean, I think that hopefullyI'm kind of and that
collaborator to bring adifferent perspective and get
this work done together, becauseI do think that we can move
mountains as long as we're doingit all together.
Tim Stockdale (01:38):
OK, good deal, Good deal.
So this article we're lookingat, looking at preparedness of
speech, language pathologistsand occupational therapists to
treat pediatric feeding disordera cross-sectional survey.
This was published in receivedDecember 5th 2023, accepted May
10th 2024.
So this is recent.
This is good stuff.
What is?
(01:59):
What would you say, are themain primary, key takeaways from
this?
Jaclyn Pederson (02:03):
The primary key takeaways from this article are
that there really isn't awell-defined educational pathway
that allows a professional todevelop a specialty in pediatric
feeding and pediatric feedingand swallowing.
That is something that I thinkis assumed by a lot of families
who are looking for providers totreat their children.
And then I think, if you're astudent and we by a lot of
families who are looking forproviders to treat their
(02:25):
children, and then I think, ifyou're a student and we see a
lot of students interested infeeding and swallowing and you
end up not realizing that youkind of have to build this path
along the way, and so I'd saythat's the highlight is you
think there's a pathway butthere really isn't.
Tim Stockdale (02:42):
And this sounds like it's not just unique to
speech pathology.
Is that right?
Jaclyn Pederson (02:46):
It is not just unique to speech pathology, so
in the field of pediatricfeeding disorder.
So the definition of pediatricfeeding disorder is when a child
really isn't eating appropriatefor their age and they have
dysfunction in the medicaldomain, the nutrition domain,
the feeding skill domain and thepsychology domain domain the
nutrition domain, the feedingskill domain and the psychology
(03:07):
domain.
And so within that feedingskill domain it's a lot of
crossover and collaborative workbetween speech language
pathologists and occupationaltherapists and that
collaborative work looksdifferent based on what the
background of that professionalhas and what is available within
that community.
But yeah, it's for both, and sothat was a big highlight of
this work too was it wasn't justone discipline that needed a
(03:29):
little bit more support, it wasboth.
Tim Stockdale (03:32):
Okay.
Jaclyn Pederson (03:33):
Very interesting.
Tim Stockdale (03:34):
What was it that led to you investigating this?
Jaclyn Pederson (03:38):
A lot of it is because at Feeding Matters we
support families, and so whenyou're trying to help families
find the care that they need, wehad to continuously build
supports around families to helpthem understand that you may be
trying to go find interventionfor your child who is having
trouble with feeding, but thatperson may not have had the
(04:01):
education that you think orexpect them to have had.
And so it started withsupporting families and then it
grew to kind of like theadvocacy and the awareness work
of like okay, well, if that's aproblem, how can we be a part of
the solution?
And so we were like okay, weneed to at least build an
evidence base to figure outwhat's happening.
(04:22):
And so that's what led to usdoing a survey of okay across
the United States.
You know how are people feelingabout their educational efforts
in this area.
And so there was a there's aprecursor to this publication.
Actually, that just is ageneral, like landscape
publication from the survey,which is you know who's treating
what?
How are they treating it?
What does that look like With815 individuals?
(04:45):
And then this got into thespecifics around the feeding
scale domain, and so the historyof this is really like if we
need to change and prepareprofessionals to better support
families, we need to even figureout where the baseline is.
What are individuals coming outof school learning, or what was
(05:06):
their pathway to developing aspecialty in this area?
And so a lot of it was just ourown curiosity.
Tim Stockdale (05:12):
Yeah, I mean, it almost sounds like you're being
strategic in trying to figureout how to fix this, which is
great.
Jaclyn Pederson (05:17):
A lot of advocacy.
Work is pretty strategic.
It's hard to you know.
When you go into advocacyconversations, a lot of it is
like well, show me the data,show me the data, and you're
like this is an emerging field.
There really isn't a lot ofresearch in this area.
Tim Stockdale (05:30):
Yeah, I mean, this is a pretty good start,
though, and you have aremarkable N.
You have 418 speechpathologists, 195 occupational
therapists, for a total of 613people that you surveyed, kudos.
That's awesome.
Jaclyn Pederson (05:47):
Thank you.
Thank you.
It was very helpful to havesuch an amazing community of
support to be able to fill outthis survey.
We did also get funding forthis research, so we were able
to offer an incentive, which Ialso think is like really
helpful in research and beingable to up your participation
numbers.
And then I think it helps thatfeeding matters is really
(06:10):
popular among pediatric feedingprofessionals, and so we were
able to leverage our communityto be able to fill out the
survey.
But that is described as alimitation too, because you know
that was one of the primaryrecruitment methods, so there
could be inherent bias in thatsense.
Tim Stockdale (06:27):
Yeah, for sure.
No, I was thinking, I wasthinking the same thing.
I was like I got to reach outto my audience and I say my
audience that's, that's and Ialmost said something like.
I did say something like thatearlier and I corrected myself
this is, this is a, it's acommunity, it's a platform where
people talk.
I don't know, I don't likereferring it to my audience,
(06:47):
because I would say I'm one ofthe least important parts of
this show that it's the peoplewho come on and finding them,
and, of course, that stuffmatters in engaging in
conversation, but looking atpeople who come from all these
different perspectives, bringingthem together, having a
conversation, giving them aplatform to be able to talk
about things that are importantto them, and raising awareness
of clinicians about what'simportant and you know, I'm a
(07:10):
small part of that, so forgivemy the semantics of me saying
that I it's not a not I don'tthink it's an ego thing or
anything like that, but so well,this is.
This is really interesting andwhat is making me think about
there's some work for adultdysphagia done in 2013 or 2014,
giselle Carnaby and Herrenbergthat came out and they looked at
(07:33):
practice patterns of speechpathologists and saw that it was
kind of like everywhere,everywhere.
And then Vos et al in 2018 didsomething similar.
I mean, there was, of course,more to the publication, but
part of it was looking atpractice patterns and it was
just so broad, not you know, somuch standardization on.
Okay, if you see this, you dothis or whatever.
Not that everything's formulaichardly anything is but at the
(07:55):
same time it was a little bitalarming, like if there is
really strong evidence behind Xto treat Y, then why are we
doing it all so differently?
I don't know.
It raised a lot of goodquestions, so when I saw this
article I was like this would besomething great to talk about.
Like this one in particularjust caught my attention.
(08:15):
Gap education is predicated ongaps in education.
Imagine that.
Jaclyn Pederson (08:21):
And that's what I've heard.
So because my interest is in OK, how can we make sure there is
an educational specialty pathway?
And so I've started askingquestions of people you know,
like, how do we get to this?
Like, how do we work inpartnership with these national
associations to develop this out?
Is it more at the academicinstitution and university level
?
Is it more at the nationalassociation level?
(08:43):
Is it more at the employerlevel?
We've even asked that of thecommunity at feeding matters,
and what does that look like?
And I think it goes back to whatyou're saying of part of the
problem is there isn'tnecessarily like a best practice
for treatment, so how can youeven train on that?
And it just ends up being thiscycle of we don't have enough
(09:04):
research to show X supports Y,and so then it ends up being
this black hole of people havingto do the research on their own
, find a mentor on their own andreally try to do this work on
their own.
And I think that's also whereadult dysphagia comes into play,
because the dysphagia world ingeneral and research in
(09:27):
dysphagia world, it's come along way and I know it still
feels like an emerging fieldsometimes, but I think the
pediatrics of it is looking tothe adult dysphagia world and
seeing how that can be ourleaders.
Tim Stockdale (09:42):
Oh man, that's a little scary.
Jaclyn Pederson (09:45):
I know.
Tim Stockdale (09:48):
No, I don't mean that to Blind leading the blind
in some instances, in someinstances and that's not
something that speaks to theintegrity of clinicians or
anything- no, not at all.
It's a systemic thing thatlimits our training so much.
And people, I'm not gonna ranton this all episode, I promise
guys.
But it's like nine diagnosticcategories, five or six
semesters and there's so muchvariability in background and I
(10:10):
don't know.
It's alarming to me and like youhad mentioned earlier, this is
at least what I took away fromyour comment that you started
really supporting families, butthen to support families, you're
like, well, families arerelying on clinicians and are
like, oh well, I don't know.
You know that sort of thingbecause of the lack of training.
(10:31):
I mean, think, if you'rewhoever's listening right now,
think of your training in adultdysphagia, right.
So think of that, Think of whatit should have been or what it
could have been versus what itwas.
And now think about yourtraining in pediatric feeding or
pediatric dysphagia, thosetypes of things.
Jaclyn Pederson (10:47):
I mean, even like pediatric motor speech,
limited, limited, depending onwhere you are, yep, yep and your
exposure of it and what thepassion of the I mean it's
really predicated on whatuniversity or academic
institution am I attending andwhat passion or history is at
(11:08):
that institution and and that iswhat sets you on the trajectory
for your career.
And I don't think that this isthe like in pediatric feeding
disorder.
It's a new condition.
It was only published inOctober of 2021.
And so in that sense, it isstill very emerging.
But this issue is one that Ithink could be done, or a study
(11:32):
done for many different otherissues.
I think the challenge is it's alot of practice areas and so
it's hard to be a generalist anda specialist all at once.
Absolutely.
Tim Stockdale (11:43):
Absolutely, absolutely, especially without.
I mean, we have fellowship,sort of clinical fellowship for
speech photographers, but that'snot like a medical fellowship
or not like a residency, so Idon't know.
There could be a lot of thingsin place but you think of, like
well, who's going to pay for it?
Yeah, that component of it too.
Jaclyn Pederson (12:02):
That's a huge component too.
Tim Stockdale (12:03):
And if we transition to a doctorate like
it's also, who's going to payfor it?
Because it's not likereimbursement rates are going to
go sky high.
We're going to be in more debt.
From going to school.
We're going to be betterprepared, but we're also going
to be eating ramen noodles forthe next 20 years, you know.
Jaclyn Pederson (12:27):
Yeah is you know, both national associations
, aota and ASHA, had pathways todo some sort of like board
certification or specialty infeeding and swallowing, and
because it's within the scope,that pathway kind of existed,
but people weren't using thatpathway because the incentive to
use it wasn't there.
Having the board certificationdidn't necessarily mean you were
paid a higher salary oranything like that.
(12:48):
So kind of like back to thatsystem problem who is going to
pay for it?
And I think that's the hardestchallenge in a lot of these
system problems is like I wastalking to someone the other day
.
They were like who's to blamefor this issue?
And I was like I mean, thesystem is like always the person
I blame, because it's just likeit's not built.
And so then you see all thedomino effects that result
(13:10):
because of it, and families areleft in the lurch.
And then professionals arethere too.
You all as professionals arejust trying to support your
families and do the best thatyou can clinically, but it's
challenging for you too.
Tim Stockdale (13:25):
Oh yeah, yeah, there's a lot.
I kind of a one trick pony.
Jaclyn Pederson (13:31):
I want to be good at dysphagia.
I'm sure you feel that way.
Tim Stockdale (13:34):
Well, I mean, there's a lot of other stuff.
I find that when you go atdysphagia, I'm sure you feel
that way.
Well, I mean, there's a lot ofother stuff.
I find that when you go intodysphagia, you know you get
motor speech disorders, you getall these acquired neurogenic
disorders and whatnot.
So like I love all that too,but I am lost as far as
pediatric feeding goes.
I mean, I'm lost as far asphonology and a number of other
things too, but this is so farout of my comfort zone.
It's crazy, like it is just sofar Back to the article.
(14:00):
So we've kind of got an ideaand would you say the theme is
that training is limited, it'snot standardized, it's not
supporting clinicians.
Is that fair?
That is very fair.
Yes, so what are some of themost?
Jaclyn Pederson (14:19):
alarming takeaways for you.
I think the most is thattreating pediatric feeding
disorder is in both scopes ofpractice for both disciplines.
Yet the standardization for howa clinician may be coming out
of school is not there.
Overwhelmingly, the respondentsshared that they felt
(14:41):
underprepared to be able totreat this coming out.
And again, who to blame?
The system is to blame.
There's not great mentorsavailable for these students
because there's not a lot ofresearch out there, and so it's
this.
It kind of piles on.
But you know what we detailedin what we heard from the survey
(15:05):
and the respondents sharingtheir kind of their, their
self-directed educationalpathway was really dependent on
if they were able to find afellowship that made sense in
the feeding world, if they wereable to find a mentor.
There was a lot of like takingcourses and different classes
and that kind of produces itsown challenge as it relates to
(15:30):
where evidence is at right nowand then I think a lot of times
people are also doing thingslike listening to podcasts to
get exposure to other thingsit's mentioned in and having
article review clubs and kind ofsome of those like more case,
like peer reviewed, sort ofself-directed activities.
Tim Stockdale (15:51):
Yeah, that's very interesting.
You know, I I'm thinking aboutthis and I'm thinking if someone
was going to have like openheart surgery and they're like
oh where'd you go to medicalschool?
Oh, harvard Medical School, orlike you know whatever.
Or where did you learn to docardiac surgery?
Well, I took some CEUs.
(16:12):
I, you know.
I got my general medical degreeand then I took some CEUs.
I, you know, I got my generalmedical degree and then I took
some CEUs.
I even did a little bit ofhands-on practice under a mentor
who was also self-taught, andit was alarming.
Jaclyn Pederson (16:26):
You know you'd be like oh my gosh, jim, that's
such an interesting metaphor.
Tim Stockdale (16:30):
You'd be like get away, like I'm going to go to
some other place, some othercountry, other side of the world
, where they actually like teachthis based upon an evidence
base, and so, like I think thething with that, though, is we
know like, oh yeah, yeah, youneed the heart to live, right,
you know, someone gets in there.
They can kill you really fastif they nick the aortic artery
and you bleed out, that type ofthing.
Jaclyn Pederson (17:21):
And that's a big deal because it's like with
this, it's important for peopleto understand what are the
implications of it right now.
So the pediatric feedingdisorder, if it's not identified
or not treated well, or even insome cases, if it is, it can
turn into ARFID avoidant,restrictive food intake disorder
which is a mental healthdiagnosis later on in life as an
older child and intoadolescence and into adulthood.
And so I think that's one of theimpacts is the true
psychosocial damage of notgetting identified early but
(17:44):
also not getting to a providerthat can support your feeding
skill development, includingyour swallowing, as well as your
psychosocial relationship withmealtimes.
You know, we're finding becausethe research is now progressing
a little bit, we're findingthat it takes us seven years and
(18:04):
longer to learn to eat, torefine those skills, and if
there's any disruption in that,it can have devastating effects
for the individual but then forthe entire family, because this
condition brings families totheir knees, because it is just
so stressful, so expensive andthen to be told I don't know if
(18:27):
you're seeing the right provider, like you've got to evaluate
whether you have the rightprovider or you're doing further
damage is really challenging.
And the problem is that even ifa provider thinks that they are
qualified or thinks it's withintheir scope, I sometimes worry
that they don't even necessarilyhave the foundation to know
(18:48):
that, and so it's just a realbig crisis because it's a very
prevalent issue.
Tim Stockdale (18:57):
And the whole thing with self-assessment, like
you're saying, like someonefeels like they're pretty good
at something.
Like when I was in the thirdgrade, I thought I was pretty
good at basketball.
Like I thought I was prettygood.
Jaclyn Pederson (19:07):
Going to the NBA.
Tim Stockdale (19:08):
Exactly, exactly.
I would get so ticked off if mymom was like you know what
happens if you don't go to theNBA.
I'm like mom, come on, don't bea hater.
Like.
I thought I knew this andobviously I'm third grade, very
cognitively underdeveloped andwhatnot.
But this is hyperbole, right,using hyperbole.
But then you get and you go tolike a bigger town where a lot
(19:29):
of other kids play and you getschooled and you're like, oh
okay, this is what it looks likewhen you're doing the right
thing or whatever.
And then they go to anotherplace, you get to a bigger pond,
a bigger pond and you see, oh,I'm not as good or as smart or
as whatever as I thought I was.
And so there are limitations inself-assessment.
If you don't have a way tocalibrate and I'm going to take
(19:51):
that back and say, well, I'm notgoing to take it back, but I
know there are standards thatare out there to look through
this checklist.
But how many providers can saythat when they started
practicing they met all thosestandards?
Like I would be baffled.
I think that would be somereally interesting
self-assessment to calibratewith.
Jaclyn Pederson (20:10):
I would agree with you.
Tim Stockdale (20:12):
There are also known biases too.
I'm not going to say thesciences is perfect, but, like
Dunning and Kruger's work, whenyou know a little bit about
something, sometimes you thinkyou know a lot more than you do.
And then, as you learn more,you're like oh man, I didn't
really know what I was talkingabout.
I didn't know what I was doing.
And then as you continue, your,your competence and your
(20:33):
competent, these competence andyour confidence become more
proportional.
But initially, like it's realeasy for confidence to be
through the roof, we don't knowas much just like little third
grade NBA Timmy with his bowlcut out on the playground.
You know it's man.
Yeah, that's how it goes.
Jaclyn Pederson (20:50):
Well, and I completely agree with that, and
I can't remember if it's in thisarticle or the one prior or
maybe it's in a future one, butwe we were trying to get a sense
of like, okay, because I thinkone of the questions asked was
what is your confidence level intreating pediatric feeding?
(21:12):
And we saw a kind of scoredpositively.
So the lack of educationalpathway, the having to do
self-directed work and stuff,and I think it speaks to that
piece of it's hard to do someself-assessment work in this
(21:34):
area and so the confidence isreally high.
I do hope that we can get alittle bit more depth to some of
those standards and work onwhat are we really want to see
from a competence standpoint, sothat way everybody can kind of
be on the same playing field,because it's so individualized
depending on what course youwent to or whatever.
But all the competence doesseem to be high, which I think
(21:56):
is kind of concerning from asending families out into the
world standpoint and there areamazing providers out there and
I don't want anything that I sayto detract from that.
I am just trying to sound thealarm that we need to better
support our professionals sothat they can feel supported and
feel confident in going outinto the world to treat children
(22:18):
.
Tim Stockdale (22:18):
Yeah, and that's really been a huge razor's edge
of this podcast and some otherstuff that I try to put out, is
that it's not meant to becritical of the clinician
because, if you're listening tothis or earlier, and not say
like you might be listening tosomething else wherever.
If you're actively trying tolearn, that says you know so
(22:42):
much totally does in a positiveway.
But I think we just areidentifying that there is a
problem there and we're tryingto find out what the cause of
that problem is so that we canwe can help to be a part of the
solution.
And, like you were talkingabout the magnitude of this, the
psychosocial implications, Imean just from an adult
dysphagia perspective, lookingat the functional outcomes like
(23:02):
nutrition, hydration, pulmonarysequelae and quality of life.
So the psychosocial stuffreally hits on quality of life
If it turns into potentially amental health diagnosis like,
yeah, that's pretty huge.
And look at the role, though,of nutrition in fighting illness
.
I mean, I know more about thatin the elderly than I do in kids
, but you have, I mean, that'syour immune system's developing,
(23:25):
you have so much going on andso that if you're undernourished
and you're not getting themacronutrients and you may
probably even the micronutrientsthat you need to to fight
infection or fight illness, thatcan lead to early death.
And in other places like we'rewe're thinking the United States
you know we're very privilegedor or or Canada, the number of
different places in the world Idon't want to assume anything
(23:47):
about anybody who's listening tothis, but I can imagine in
other places where there is lessprivilege and less robust
medical care, how this can leadto so many more deaths and how
it can just set people back.
So far, I am very fortunate tohave a friend in Cameroon and
(24:08):
there's like this ongoing civilwar there and he's a remarkable
individual.
He takes people into his housewho have been displaced and he
has kids of his own and you see,like all of this stuff that
he's going through just in adifferent world than we're
living in.
And so I don't know like it'senough of a problem here that
(24:30):
when we're not considering whatpeople in other places of less
privilege are going through,it's just, it's remarkable to me
, it really is.
Jaclyn Pederson (24:41):
Yeah, that's very true and this particular
article was based on the UnitedStates respondents, but when we
did do the survey we did getsome international respondents.
We haven't gone back and lookedat that, but I just know in
Feeding Matters work as we tryto talk to other countries and
what's happening there.
(25:01):
It is definitely a worldwideproblem that no one has great
solutions for not only on theidentifying the kid's side and
figuring out their treatmentpathway, but also on the
education side and getting morespecialists available to treat
children with PFD.
Tim Stockdale (25:19):
Yeah, so kind of along the lines of what you're
saying, that most individualswho answered this were from the
United States.
What other limitations do yousee in?
You know the potential togeneralize this article.
Jaclyn Pederson (25:36):
Yeah, I think I mentioned earlier too that one
of the challenges is werecruited through Feeding
Matters and then the differentlistservs through the national
associations.
So you know, in that sense Ifeel like we tried to get as
many individuals as possible toparticipate.
But I think there's always alimitation in bias, in
(25:56):
participation based on yourrecruitment methods, and so I
think that's one of the biggestlimitations.
That's one of the biggestlimitations and just it's
important to kind of get abetter understanding of what
(26:17):
exists within the NationalAssociation standards but then
what also exists in theuniversity standards.
So as much as we are reportingon what people shared with us
and then we try to also thenresearch kind of what's
happening in the field, to tryto share both of those stories,
that may be a limitation too,okay.
Tim Stockdale (26:30):
So, as we, as we get close to the end of this
episode, there are two thingsthat I want to make sure to
cover.
One, I want to see if there'sanything else that you believe
we haven't covered that isimportant for people to know.
And other than that, I want toknow, like what do you think are
some actionable steps that wecan take to make this better?
And maybe we're not there yet,maybe we don't know, maybe we as
(26:51):
a profession don't know.
Are there any other things thatyou think this article has
brought to the light that aresuper out there, important, that
we haven't discussed?
Jaclyn Pederson (27:00):
I think it's the start of the work.
So I think for us it was aboutyou know, this is an emerging
field of research.
We know that, likeprofessionals aren't supported.
Well, let's get a betterunderstanding of it.
But for me it felt very muchthe start of the work and we
need to continue the work.
But I think, and I guess maybeit's kind of a future direction
(27:25):
or limitation of futuredirection in terms of what do we
do with it.
But you kind of get into thiscycle of okay, we know there's
no educational specialty pathway, how do we fix it?
We talk to the nationalassociations, try to work in
collaboration with them.
They are open to partnership,but they often don't know what
to do on their end, because it'sdifficult from their
perspective.
And then we've talked touniversities and it's difficult
(27:47):
from their perspective becausethey don't have standards of
best practices to be able tothen train individuals and so to
not use like meme culture, butit feels almost like the
Spider-Man meme whereeverybody's pointing at
everybody else.
And it's hard because it's likethis work needs to happen and
so you know we have a vestedinterest in making it happen.
(28:08):
We're a nonprofit, it's part ofour mission.
So we need to support families,we need to support
professionals, but that's thefuture direction is like we're
going to have to figure out thistogether and collaborate and
really get curious about how wedo that.
Tim Stockdale (28:23):
Yeah, and you know, from an educator
perspective it is extremelydifficult, like if you look at
all the things you're supposedto be teaching versus like what
people are walking away with.
If you cover so much breadth,especially like if these are
students in their first, second,third semester who don't have a
bunch of clinical experience toanchor this on, like they,
(28:47):
sometimes you end up you're atrisk for teaching to the test
and long-term retention isn'tnecessarily there.
I mean, teaching methodologyhas changed.
The knowledge of how learningscience, how we learn and can
apply things, has changed somuch.
And so I believe and I thinkeverybody knows that I believe
this that our scope is well,speech, I speak to speech
(29:08):
pathology in particular scope isjust so broad and if it's going
to be that broad on things, Imean everything matters.
But especially on areas whereyou can kill people or cause
like I mean I can think any,just about any category can
cause like permanentpsychological harm, which is
huge.
There's got to be a clear,supported pathway for that depth
(29:31):
.
It can't be all student-ledlearning, right and kudos.
I commend everybody who istrying so hard to do their best,
but we need so much moresupport.
That is my belief and I knowthat educators can't do it alone
.
I don't know the answer.
I mean, hopefully someone out.
I know that educators can't doit alone.
I don't know the answer.
I mean, hopefully someone outthere.
Maybe you haven't figured itout.
If you do, please send me anemail.
Come on the podcast.
I would love to hear that.
(29:52):
There's just so much so withwhat we have.
What would be some actionablesteps that listeners can take or
that you know as a whole, ashealthcare providers, that we
can take?
Jaclyn Pederson (30:07):
As healthcare providers.
I think there's two facets tothis.
So if you're interested in thisas a field, you know definitely
if it's not anything that youhave education in, you will have
to go and try to find thateducation, unfortunately, the
good news is I think you've gota plethora of different options
(30:29):
out there for courses to take ordifferent people or mentors to
follow, whether they're personalmentors in your local area or
more kind of internetpersonality mentors.
There's also many differentcommunities of practice.
There is a growing presence ofpediatric feeding specialists in
the SIG 13 group at ASHA and acommunity of practice at AOTA.
(30:52):
So even if you're a dysphagiaprovider like that may be an
easy area to kind of find someothers that are part of you.
And then Feeding Matters is acommunity that supports families
and supports professionals andcan help you find other
providers out there, find accessto information and more.
Tim Stockdale (31:10):
Well, thank you.
Thank you for your investmentin this, as, not being a
clinician, I think it takes avillage, and it takes a village
with different skill sets anddifferent perspectives.
So I am very grateful for thework that you're doing and
grateful for the work that somany others are doing as well.
Thanks for coming on here.
The name of the article againis preparedness of speech,
language pathologist andoccupational therapist to treat
(31:32):
pediatric feeding disorder colona cross-sectional survey.
This is in dysphagia.
I can post a link to it in thewebsite.
Um the podcast description, andit's with Kelsey Thompson.
At all, there are 1, 2, 3, 4, 5, 6, 7, 8 authors on this, so
some pretty tremendouscollaboration.
It sounds like.
Jaclyn Pederson (31:52):
Thank you for having me.
Tim Stockdale (31:53):
Thanks so much.
It was a pleasure, I learned alot and, to be honest, I had a
blast.
This was great, so thank you.
Jaclyn Pederson (31:58):
Yeah, it was so fun.
Thank you, tim, reallyappreciate it.
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