First Bite (Michelle Dawson & Erin Forward)

Guest: Dani Newcomb, MS CCC-SLP - In this episode Michelle is joined by Dani Newcombe, MS CCC-SLP, the delightfully candid Pediatric Feeding SLP blogger behind The Messy SLP, where she shares bits and pieces of what it's like to be a "messy perfectionist". Dani, who currently works as an SLP in an autism therapy center in South Bend, Indiana, has traveled the country in the pursuit of her passion… delivering EBP Feeding Services to those in need! Today she shares how we can work collaboratively with our ABA Colleagues in the somewhat contentious area of “Feeding”. Yes, you read that right, how to work collaboratively with ABA Colleagues in the world of Pediatric Feeding Disorders…and trust Dani and Michelle…it is possible! Enjoy the hour filled with real life trials and tribulations, lessons learned from past failures, and how to set your tiny human up for Feeding Success!

Guest: Angie Neal, MS, CCC-SLP - In this episode, Michelle is joined by the dynamic Angie Neal, MS CCC-SLP, for an hour to discuss the intersection of language and literacy. Angie, who keeps every audience on the edge of their seat with laughter and love, shares her extensive knowledge on how an SLP can become involved in a child’s journey in literacy. In addition, she explains how phonological awareness can impact literacy, who to refer to in an academic/medical setting and why their role is critical when a child presents with concerns for dyslexia.

Guest: Marina Shipilova, MS, CCC-SLP - In this course, the presenter discusses her successful strategies for connecting with families from different cultures, the most common empowering advice she gives to families, and how to hold crucial conversations to embolden caregivers when barriers exist to accessing the highest quality services available to them. Michelle and Marina share some of their more memorable moments from the field (the flops and successes) to inspire us all to embrace the joy and evidence of caregiver coaching.

Guest: Joleen Fernald, PhD, CCC-SLP, BCS-CL

Earn 0.1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/course?name=DIR-and-Selective-Mutism

In this episode, host Erin welcomes Jolene Fernald, an expert in selective mutism and DIR floor time, to discuss the complexities of selective mutism, neurodiversity, and how to support children who struggle with communication in anxiety-provoking situations. Jolene shares personal experiences, diagnostic criteria, and effective strategies based on a holistic DIR approach. Viewers will learn about the role of sensory processing, how to build a supportive classroom environment, and the importance of understanding the 'why' behind behaviors. This episode also covers the overlap between selective mutism and autism, providing insights into the situational challenges faced by neurodivergent individuals. Jolene introduces useful resources, including a new card deck to guide therapists and educators. This enriching conversation aims to equip you with knowledge and tools to better support children with selective mutism.

Episode Timeline:

00:00 Introduction and Excitement for the Episode

00:30 Upcoming Events and Conferences

01:09 Guest Introduction: Jolene Fernald

03:29 Jolene's Journey and Expertise in Selective Mutism

09:49 Understanding Selective Mutism and DIR Approach

13:29 Diagnosing and Addressing Selective Mutism

20:55 Building Communication Capacities in Children

28:15 The Role of Sensory Activities and AAC

31:24 Understanding Communication Challenges in Children

32:28 Addressing Classroom Anxiety and AAC Systems

35:12 Supporting Teachers and Creating Safe Environments

38:23 Effective Classroom Strategies for Anxious Students

47:09 Selective Mutism and Autism: Overlapping Conditions

57:32 Resources and Tools for Supporting Children with SM

01:01:48 Conclusion and Final Thoughts

About the Guest: Joleen R. Fernald, PhD, CCC-SLP was awarded Board Specialty Recognition in Child Language from the American Speech-Language Hearing Association. Dr. Fernald follows Greenspan and Wieder’s model, DIRFloortime® , when working with children and families.She has a special interest in the social-emotional development of young children and its impact on their speech and language skills. As a speech-language pathologist, Dr. Fernald works with children who have a variety of communication disorders. She specializes in the assessment and treatment of Selective Mutism and is the developer of the DIR-SM model.

In this episode Michelle is joined once by again by her dynamic First Bite partner the lovely Miss Erin Forward, MSP CF-SLP. Today they jump into the data behind the Language Assessments that we use to evaluate our little ones. Specificity, Sensitivity, Validity, and even ASHA Guidelines on what is “Best Practice for Assessments” and when we should draw our proverbial line in the sand and trash a test are all covered. Be warned, there are a couple of EBP Soapboxes floating around!

Guest: Dr. Kelly Farquharson - Scientists now know more than ever about dyslexia, but there are still a lot of misconceptions about this common learning difference. In this episode of the First Bite Podcast, we are debunking some popular myths surrounding dyslexia and language-based learning disabilities with today’s special guest, Dr. Kelly Farquharson! Kelly is a speech-language pathologist, associate professor, and director of the Children’s Literacy and Speech Sound (CLaSS) Lab at Florida State University. She studies the cognitive, linguistic, orthographic, and environmental factors that influence how children with speech and language disorders acquire literacy skills. Specifically, her research examines the intersection between speech sound production and literacy acquisition and, in this episode, she shares her unique insight with us about the very real intersection between speech sounds and dyslexia. Believe it or not, dyslexia is a phonological impairment disorder, not a visual one, which means that SLPs can and should play a very important role in its assessment and treatment! Listen in to learn more about why phonetics matter to clinicians, the importance of taking a code-based approach, and why strategies like eye tracking exercises aren’t necessarily helpful. We also touch on the value of both real word and non-word assessments, phonological input, and collaboration between SLPs and teachers, and Kelly emphasizes the need for patience, persistence, and advocacy when it comes to addressing dyslexia in your institution. This is a fascinating discussion that you won’t want to miss, so make sure to tune in today!

Guests: Charlene Fregosi, PT, C/PAA-Instructor, and Ilene Sperling, MA, CCC-SLP, C-PAA-Instructor - If you tuned into episode #193, “Pediatric Feeding Disorder and the NICU: Best Practice for Discharge,” then you heard Cuyler Romeo, MOT, OTR/L, SCFES, IBCLC, mention the “Institute for Perception-Action Approach,” (of which she is a founding member). Well, Folks, that’s what this episode is dedicated to, learning about the “Perception-Action Approach" from two of their certified instructors. So, suppose you are interested in learning how to engage in a whole-body assessment and treatment of a little one with a pediatric feeding disorder, how to engage in interprofessional education and practice across allied health members, or in what Isaac Newton has to do with teaching a little one to engage with their body in space. In that case, this is the hour for you! Join Ilene and Charlene as they teach you how to embrace the power of gentle touch for powerfully optimistic pediatric outcomes.

Guests: Fe Murray, EdD, CCC-SLP, Raquel Garcia, SLPD, CCC-SLP, CNT, BCS-S & Sofia Carias, MS, CCC-SLP - In this episode, Michelle and Erin are joined by industry leaders from across the nation to hold intimate conversations on how our faith and cultures influence our practice as pediatric speech-language pathologists. These two hours is an outgrowth of a lifetime of experiences shared by all the presenters, cultural missteps and corrections, religious misunderstandings, and deeply personal conversations for growth and respect. One of the beautiful aspects of our profession is the diversity of the patients we are called upon to serve. However, to fully engage our therapeutic presence, we must understand how different faiths and cultures influence our patients’ daily routines and how our religion and culture influence the services we deliver. With this expansion in our knowledge, we can improve our ability to coach caregivers through language acquisition within the framework of daily routines and make respective dietary recommendations for pediatric feeding and swallowing disorders.

Guest: Tessa Gonzalez, MD - Today’s episode centers around an intense and personal conversation with a very special guest who speaks candidly from the perspective of both a pediatrician and the passionate parent of a child who suffers from a rare genetic disorder that contributed to pediatric feeding disorder (PFD). Dr. Tessa Gonzalez is a close friend, a pediatrician with over 10 years of experience, and a mother to two beautiful girls, the eldest of which has been on a long journey with PFD. Tessa is also a volunteer with Feeding Matters, where she shares her invaluable experience with families navigating their way through the often confusing and difficult world of PFD. She is a fierce advocate for her daughter and is passionate about helping other families advocate for their loved ones too, which she explains in this episode. Tuning in, you’ll learn more about the importance of inter-professional education, collaboration, and communication, and Tessa shares her personal journey with PFD and why she believes that a feeding tube was the best possible solution for her family at the time. Make sure not to miss this episode!

In this episode Michelle is joined by the author of Management of Swallowing and Feeding in Schools Emily M. Homer, CCC-SLP, ASHA Fellow! If you have ever been concerned about transitioning your patient from the world of Early Intervention into the Local Education Agency, (LEA), then after this hour you should be armed with knowledge and peace of mind about options to support and ease your little one’s transition. Are you concerned about who will provide services for feeding and swallowing in the LEA? What about if the CCC-SLP at the LEA can make referrals to the medical community? OR…and this is a biggie for the EI CCC-SLP…what can you do to ease the transition from EI to LEA for your patient? Don’t worry Emily Homer, CCC-SLP, ASHA Fellow, will equip you today!

Guest: Stephanie Michelle Sweigart, MS CCC-SLP - In this episode, Michelle is joined by none other than the “Golden State SLP,” aka Stephanie Michelle Sweigart, MS CCC-SLP, to cover all things of Therapeutic Presence. If you’ve met Stephanie, then you know that a conversation with her feels like a warm hug. Why? Because she has spent years cultivating her emotional intelligence, regulation, and therapeutic presence to be fully engaged and present in those moments. Stephanie provides her new take on the three “C’s”: “Center,” “Connection,” and “Communication." The outcome is improved therapeutic presence with those that we serve.

Guest: Alyson Ware, MS, CCC-SLP - In this episode, Alyson discusses the process as a community-based clinician to improve continuity of care for medically complex patients discharged from the NICU. If you’ve ever wondered what occurs in early intervention, the SLP’s role on the team, the common barriers to NICU discharges, and want strategies to smooth the transition for your patients, this episode is for you.

Cari inspires colleagues with her P.I.E. analogy and offers functional strategies on what an appropriate parent-driven outcome really looks like with respect to goal writing. If you’ve ever worried about best practice for the dreaded data collection, breathe a sigh of relief, and brace yourself for side splitting laughter, while Cari and Michelle speak the truth on data for Early Intervention.

Guest: Memorie Gosa, Ph.D., CCC-SLP, BCS-S - Seven weeks after we obtained access to the new PFD ICD-10 codes, the annual ASHA Convention will host its very first PFDs Feeding and Swallowing track. To honor this monumental event, today we are joined by Memorie Gosa who served as the chair of the inaugural 2021 Pediatric Normal and Disordered Feeding and Swallowing Topic Committee. Memorie Gosa is a world-renowned Pediatric Speech-Language Pathologist, Board Certified Specialist in Swallowing and Swallowing Disorders, and Associate Professor and Chair of the Communicative Disorders Department at the University of Alabama. In this episode, she joins us to walk us through the history of PFDs and dysphagia. She explains how the PFD world came to be, the progress of clinical training programs on dysphagia at a university level in recent years, and the evolving trends in evidence-based treatment. Tuning in you’ll hear why treating pediatric dysphagia has to be multidisciplinary, expert advice for anyone wanting to engage in IPP, and insight into where you can find helpful resources for evidence-based treatments. With the ASHA 2021 Convention upon us, find out what you can expect and what master classes you should not miss. Tune in for all this and more!

In this episode, Michelle and Erin are back to discuss pediatric feeding disorder clinical case studies for “Dysphagia Awareness Month." With the addition of the new ICD-10 codes for Pediatric Feeding Disorder, there have been questions on the role and responsibilities of the SLP in diagnosing a PFD and how pediatric dysphagia fits into the diagnostic criteria. Michelle and Erin share resources to answer this question and how to guide allied health and medical health partners in their roles for PFD and pediatric dysphagia diagnoses too. The ladies of “First Bite” then transition to case studies that discuss strategies for intervention and how to engage in the interprofessional practice for optimal patient outcomes for little ones with pediatric dysphagia and PFD.

Co-Host: Erin Forward, MSP, CCC-SLP - In this episode, Michelle and Erin take a fresh look at Leadership opportunities available in our field. One aspect about the ASHA Convention that both Michelle and Erin miss the most, aside from hugging colleagues from across the nation, is the missed opportunities for learning how to engage in leadership activities to drive a positive change both a local and national level for our profession and our patients. Since the convention is cancelled this year, they decided to bring some ideas to you. So, regardless of what stage of your career you are in, #slp2be, #earlycareerslp, or #seasonedslp, this episode is designed to bring the tools and opportunities to you to help be the source of a positive change.

Guest: Heidi Liefer Moreland, MS, CCC-SLP, BCS-S, CLC

In this episode, Michelle is joined by the one and only Heidi Liefer Moreland, MS, CCC-SLP, BCS-S, CLC, Clinical Coordinator with Thrive Tube-Weaning Program, cohost of the podcast “Tube to Table,” published author and researcher, and internationally sought after speaker! For this hour-long conversation, Heidi shares her evidence-based approach to supporting little ones and their caregivers in their natural environment as they learn to eat by mouth! So, suppose you are ready to learn about intrinsic motivation and responsive feeding and pick up successful strategies to engage in interprofessional practice as a home-based, private practice, or school-based clinician. In that case, this is the episode for you.

Guest: Alyson Smith, MS, CCC-SLP - This episode combines the great minds of Alyson Smith, MS CCC-SLP from @ei.teletherapy on Instagram, Erin Forward, MSP CCC_SLP, and Michelle L.W. Dawson, MS CCC-SLP, CLC, where they deep dive into evidence based intervention for Pediatric Feeding and Swallowing Disorders. Join this electrifying trio as they tackle what the true definition of evidenced-based practice is for PFDs, move into explaining exercise principles, and discuss how to implement EBP strategies in your Early Intervention Clinic or Home-Based Services. These three women are on a mission to bring fabulously functional tips to your practice via an hour packed with laughter and #SLPNerdCrushes.

Guest: Jackie Rodriguez, MS CCC-SLP - Jackie discusses health literacy and how it impacts our assessment and treatment of feeding and swallowing disorders, especially for individuals from different cultures. Diving further, Jackie transitions to dispelling myths about cultural diets and health in minority communities. Finally, to close the hour, Jackie suggests incorporating culture into feeding and swallowing therapy for colleagues.

Guest: April Helper, LPC - Michelle is joined for this truly powerful episode by April Helper, LPC, Founder and Executive Director of Adagio House. The Adagio House “exists to provide high-quality, trauma-informed, attachment-based services to all types of caregivers and their loved ones, regardless of their ability to pay.” They engage in comprehensive care through psychotherapy, holistic wellness, mentoring, sustainable gardening, medical and psychiatric services, and psychological testing for neurodiverse individuals from toddlers to adults and their caregivers. April spends this hour talking about the various interprofessional practice partners that make this dream a reality and how to support their clients and caregivers ethically, and she offers strategies to make this a possibility.

In this episode Michelle is joined once again by the talented Carol A. Page, PhD, CCC-SLP, ATP, CBIS is the Director of the South Carolina Assistive Technology Program (SCATP) at the USC School of Medicine, from Episode 24, “AAC is more than Pictures and Velcro?!? What?!?”. Have you worked with a child who needed an AAC device, but had limited vision? Maybe they were diagnosed with a CVI and you were scratching your head as to what that diagnosis is…then afraid to move forward with functional treatment? Well… fear no more! Dr. Carol Page is here to educate us all on what a Cortical Vision Impairment is, early warning signs for a CVI if the little one you’re working with doesn’t have a diagnosis yet, and then how to go about considering an AAC device…including considering eye gaze equipment… when completing evaluations and treatments! This is an episode that has been in the works for a few years folks…you won’t want to miss it!

Guest: Meg Simione, Ph.D., CCC-SLP - In this episode, Michelle is joined by Meg Simione, Ph.D., CCC-SLP, a clinician-scientist focusing on infant and child feeding and growth and implementing innovations to improve care delivery. One of the hardest aspects of the “Pediatric Feeding Disorder” diagnosis to grasp can be the “psychosocial" domain. Why? As clinicians, we were trained to focus on the “feeding skill” domain, typically addressing the caregiver’s psychosocial impact falls by the wayside. But, it is critical that we understand this core component of PFD. Dr. Meg shares some of the most common psychosocial consequences, what clinicians can do to overcome these impacts, and why it is critical for clinicians to collaborate with researchers to expedite current research into daily practice for the little ones we have been called to serve.

Guest: Megan Branham, LMSW - In the past thirty years, our knowledge of trauma and its effects have progressed significantly, but there is still plenty of research that needs to be done to further deepen our understanding. In today’s episode of First Bite, we get together with Megan Branham to discuss adverse childhood experiences, known as ACEs. We unpack how our knowledge of trauma is integrated into the field of SLPs, pediatrics, specialists, and social workers and the many challenges inherent to that mission. Megan holds a Master's in Social Work and is a graduate of the Annie E. Casey Foundation's Leadership for State-Based Advocates. She currently serves as VP Strategy for North, a media company based out of South Carolina. In our conversation with Megan, we discuss how ACEs first gained attention in the 1990s after new research found that these experiences led to a myriad of adverse health outcomes from learning disabilities to mental health problems, to chronic health conditions. We also discuss new insights into intergenerational trauma and how its biological impact alters human physiology on a cellular level, increasing the likelihood of adverse health outcomes and other issues. We cover a variety of topics that practitioners are confronted with regularly when it comes to dealing with trauma, like how to protect yourself when your personal trauma is triggered, and engaging in advocacy when you recognize policy failures. Join us for this fascinating and in-depth discussion on ACEs and how to be trauma-informed!

Guest: Erin Forward, MSP CCC-SLP, CLC and Karen McWaters, MOT, OTR/L - In today’s show, Erin and Michelle are joined by Karen McWaters to discuss the very important topic of interprofessional collaboration. Healthcare professionals generally tend to silo themselves in their own disciplines, and according to the Autism Research Journal, there are four main barriers to communication which exist. This disconnect is very unfortunate because, as you will hear in this episode, collaboration across professions has the potential to be a very powerful force. Erin, who is an SLP, and Karen, who is an OT, worked concurrently with a child who, when he first started therapy, was communicating using signs. A year into his sessions, he was asking to be dressed up like the Pixar lamp and trying to find a dark room he could “light up!” With palpable joy, Karen and Erin share the story of this boy’s progress, which highlights the benefits that arose from their commitment to working together and learning from each other, and they offer valuable advice for anyone interested in doing the same.

In this episode Michelle is once again joined by the passionate Erin Forward, MSP CCC-SLP. Together they spend an hour dedicated to dissecting common airway, cardiac, and GI issues prevalent with Infants, Toddlers, and Children who have Down syndrome, and how these can result in a Pediatric Feeding and Swallowing Disorders. Special attention is placed on how airway, cardiac, and GI issues can occur in isolation, but often for our patients with Down syndrome, they occur concomitantly. Appropriate Interprofessional Practice referrals, Functional Feeding strategies, and shout outs for the amazing work that the National Down syndrome Society is doing… are all on the menu too!

Guest: Rachel Hahn Arkenberg, M.S. CCC-SLP, CLC - In this episode, Michelle is joined by Rachel, who is a medical speech-language pathologist and lactation counselor pursuing her Ph.D. with Dr. Georgia Malandraki in the Imaging, Evaluation, and Treatment of Swallowing Lab at Purdue University. Michelle and Rachel felt like the middle of “Dysphagia Awareness Month” was the perfect time to discuss the amazing opportunity that is pursuing a Ph.D. in Dysphagia. Are you a practicing clinician that has more questions than answers with regard to the evidence for evaluations and interventions for pediatric dysphagia and PFD, then this is the episode for you! Tune in as Rachel shares her inspirations for pursuing a Ph.D., the vital role a mentor plays in your pursuit of a Ph.D., the typical day of a Ph.D. candidate, as well as how the curriculum between a master's degree differs from that of a Ph.D.

Guest: Tiffany Elliott, MS CCC-SLP, CNT, IBCLC

Earn 0.1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/course?name=Bridging-NICU-to-Home

In this special birthday episode of First Byte, Michelle Dawson, a devoted therapist and mother, explores the intricate journey from NICU to home with expert Tiffany Elliott. They discuss practical strategies for caregivers in maintaining emotional wellbeing, the importance of neuroprotective care, and the Hospital to Home Systems Change project aimed at improving continuity of care for infants and their families. Elliott shares her insights from working in various NICUs, setting up essential support systems, and the critical role that emotional support plays in successful infant feeding. This episode is packed with valuable information for anyone interested in pediatric feeding, NICU professionals, and caregivers navigating early intervention services.

Episode Timeline:

00:00 Welcome to First Bite

00:29 A Day in the Life of a Pediatric Feeding Specialist

01:31 University of Tennessee Lecture Experience

04:11 Encouragement for Clinical Supervisors

05:59 Introducing Tiffany Elliott

06:41 Tiffany's Journey and NICU Experience

19:09 Hospital to Home Systems Change

23:39 Challenges in Early Intervention

26:53 Barriers and Solutions in Washington State

36:21 Personal and Professional Reflections

40:12 Navigating Academia and Authenticity

41:39 Balancing Productivity and Care in the NICU

44:21 Challenges in Early Intervention Systems

45:29 Continuity of Care and Billing Codes

49:21 Training and Support for Caregivers

51:59 Emotional Wellbeing and Feeding

01:00:16 Practical Strategies for Caregiver Support

01:11:38 Final Thoughts and Resources

About the Guest(s): Tiffany Elliott, MS CCC-SLP, CNT, IBCLC, is a Speech-Language Pathologist (SLP) who specializes in pediatric feeding and swallowing disorders with a strong focus on preterm and medically complex infants and strengthening the caregiver-infant dyad. She is also an International Board Certified Lactation Consultant (IBCLC) and holds certifications in neonatal therapy (CNT) as well as neonatal touch and massage (NTMTC). She is currently a LEND trainee at the University of Washington. Tiffany is passionate about improving systems of care. She is a hospital-to-home systems change specialist with Northwest Center, where she partners with professionals across Washington state to enhance the hospital-to-home transition for infants and build community therapists' capacity. She also works on the infant feeding team at Seattle Children’s Hospital, providing direct care for infants and their families. Before these positions, she co-founded the UW Medical Center’s NICU SLP program and worked at Mary Bridge Children’s Hospital.

Watch this episode on YouTube: https://youtu.be/n7hXTJG_FJM

Michelle is joined by the effervescent Kayla Duncan, MS in Applied Psychology, Francis Marion University’s Assistant Director of Counseling and Testing, adjunct professor, and advocate for student and clinician’s mental health. The presenters spend an hour getting into the details on signs and symptoms of caregiver fatigue and burnout, quick functional strategies that you can implement lying in bed in the morning or in the afternoon school carline pickup. But what about when those functional strategies are just not covering it? Kayla shares her resources on how to obtain professional resources for yourself and Michelle shares resources on support teams and groups for our patient’s caregivers.

Guest: Andrea Storie, M, ClSc, CCC-SLP - In this episode Michelle is joined by Andrea Storie, MCLSC CCC-SLP, a professional whose focus is on evaluation and treatment of pediatric chronic cough and voice disorders. Whenever a pediatric feeding disorder SLP hears a child cough, instantly our ears perk up and we start wondering, “What is going on in there?” But did you know that some children develop a habit cough that is not triggered by penetration/aspiration? Andrea will educate and inspire us as to the signs and symptoms of pediatric habit cough, the interprofessional team that is needed to diagnose it, and the current evidenced based practice strategies to help treat a pediatric cough.

*** This episode is not available for ASHA CEUs.****

In this episode, Michelle is joined by the accomplished lecturer Jill Eversmann, MS CCC-SLP, Academic and Clinical Faculty of Columbia College, and X instructor w/ ASDF. In this hour they challenge all the preconceived notions about incorporating American Sign Language into Early Intervention….in short, they will teach you how “talking with your hands” is an excellent strategy to increase acquisition of functional communication, the differences between Baby Sign and American Sign Language, and the best resources and references behind the beautiful intersection that is ASL and EI. Be sure to stretch before this hour because it will have you moving!

In this episode Michelle and Erin have fully recovered from the intensity that is the annual ASHA Convention from November 2019. Why is that great news? Easy! They are going to share their “Top 10 Takeaways” for adding functional evidence to your practice! They will take you on an EBP hunt in the exhibit hall, hit up Erin’s Top 3 Lectures, and wrap with Michelle’s Top 3 Lectures, and spread some joy that can be found by being surrounded by almost 14,000 colleagues. If you weren’t able to make to Orlando this past year, no worries, they are all set to bring the magic to you!

*** This episode is not available for ASHA CEUs.****

In this episode, Michelle is joined by Elizabeth (Beth) Halpin, MHS, OTR/L, SCFES, from episode #60, “Ots and Feeding? Who knew!?!” and Rob Dempster, PhD, Pediatric Psychologist, from episode #7,1 Psyched about Psychology and Feeding!”. In this hour of “First Bite,” the dynamic duo opens up about their collaboration for a combined treatment approach for pediatric feeding and swallowing disorders. They share the good, the bad, the ugly: lessons learned about best practices for a team approach, etiologies that benefit the most from a team approach, as well as their favorite “do-overs”…as in, “welp if we had known this, then we would have done this”…and let’s be honest, the do-overs tend to be the best life lessons! Let this cheery episode warm you up this chilly winter day!

Guest: Rachel Archambault, MA CCC-SLP (@PTSD.SLP)

Earn 0.1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/course?name=Taking-a-Bite-out-of-TraumaInformed-Care

In this episode, Michelle and Erin are joined by Rachel Archambault, an SLP Program Specialist for Broward County Public Schools and passionate colleague behind the @PTSD.SLP social media advocacy account. “Trauma-informed care” (TIC) has gained traction within our field in the last few years; however, most of us who practice this approach have never received explicit instruction. Where do we begin? Well, that’s what Rachel and Erin break down in this episode. Tune in as they go through the key principles, discuss preferred resources, and then teach us how to clinically apply it to the little ones we serve in all settings: early intervention, private practice, and even public schools!

About the Guest:

Rachel Archambault, MA CCC-SLP is an SLP Program Specialist for Broward County Public Schools. After a traumatic event happened at her workplace on 2/14/18, she looked for ways to help work with students (and herself) after trauma. She found trauma-informed care and has been presenting nationally to SLPs and other providers on how TIC can be used in their setting. She runs the Instagram account, @PTSD.SLP which discusses TIC from a speech lens.

Hosted by: Michelle Dawson MS, CCC-SLP, CLC, BCS-S and Erin Forward, MSP, CCC-SLP, CLC, Advanced DIR/Floortime® Provider, TBRI® Trained Practitioner

Watch the full video interview on YouTube: https://www.youtube.com/@speechtherapypd

Guest: Kerrie Mansfield Rigberg, MS, CCC-SLP - In this episode, Michelle is joined by Kerrie, a highly trained pediatric speech-language pathologist, with experience in the NICU, PICU, Inpatient Pediatric Rehabilitation, Private Practice, and teletherapy. She is here today to talk about the empowering role of yoga for both our pediatric patients, as well as for the treating clinician. Kerrie, who presented, “United on the Mat: Yoga, Meditation & Mindfulness for the SLP, Audiologist & Related Healthcare Provider” at the American Speech-Language and Hearing Association (ASHA) National Convention in Washington, D.C. in November 2021, delights the listener with her favorite research to support the use of yoga for our pediatric patients, the benefits to engaging in interprofessional practice with OTR/Ls via yoga for our patients, as well as the benefits of yoga for improving the therapeutic presence for the treating clinician. Bonus points… near the end she walks the clinician through a series of stretches and quick postures that we can do while sitting at our desks between SOAP note writing! So, get comfy cozy, pull up your notepad and your yoga mat, and let Kerrie inspire you to breathe deep and keep moving forward.

Guest: Joan C. Arvedson, Ph.D., CCC/SLP, BCS-S, ASHA-Fellow - Dr. Arvedson, an expert in pediatric dysphagia and pediatric feeding disorder (PFD), is known worldwide for her extensive lifelong work on behalf of the littlest patients we serve. She has published three textbooks for pediatric dysphagia, countless articles in peer-reviewed journals, served as a Clinical Professor in the Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, and is currently the Program Coordinator of Feeding and Swallowing Services at Children’s Hospital of Wisconsin-Milwaukee. In her first-ever podcast appearance, Dr. Arvedson shares from her heart and lifetime of experiences: basic skills that PFD clinicians need to know to get started, guidelines from the World Health Organization that should shape our practice, as well as functional strategies for intervention that you can put into practice tomorrow. Her cup overflows with joy and knowledge… so bring your proverbial cup and join Michelle and Erin and soak it all in!

Guest: Renee Garrett, MSEd, CCC-SLP, CBIS - As clinicians in speech-language pathology and audiology, we are tasked with providing services to all ages, ethnicities, gender expressions/identifications, races, national origins, and disabilities. During the last decade, more awareness and emphasis has been placed on identifying and understanding health disparities. Renee is here to inspire us to better understand how we as clinicians can support and foster change, by first defining health disparities and then identifying what our active role looks like. By providing resources for further education and policy impacts, we can move towards eliminating modifiable disparities: the things we can change.

Michelle and Erin discuss how a little one’s diagnosis of cerebral palsy (CP) can impact functional communication and potentially result in a pediatric feeding disorder (PFD). It is important for a clinician to understand how the four major groups of CP differentiate from one another because each presentation comes with its own treatment considerations given unique comorbidities. Join Michelle and Erin as they deep dive into how the four classifications of CP can impact access to functional communication and feeding.

Guest: Marsha Dunn Klein, OTR/L, MEd, FAOTA - Having a child with feeding challenges can be anxiety-inducing for parents and children alike. Feeding strategies and interventions are synonymous with pressure, which only perpetuates the discomfort around eating. Marsha Dunn Klein OTR/L, Med, FAOTA, joins us to share her Get Permission Approach, and to talk about the newly-founded Get Permission Institute. In this episode, Marsha talks about Get Permission Approach's principles and shares the impetus for creating it. She saw from her work in feeding that the relational aspects of food and eating were often neglected despite how important they are to healthy feeding habits. We hear about responsive feeding and how she fosters children's autonomy while building confidence, connection, trust, and consistency. An incredibly important part of helping children with these challenges is providing opportunities, and Marsha walks us through two case studies of children she has worked with. Rather than leading with a heavy therapeutic approach, she helped parents provide organic opportunities to pique children's interests and let them explore for themselves. As the conversation wraps up, Marsha also highlights the value of letting children mouth, and she also shares some of the exciting events Get Permission is hosting in the months to come.

In this episode Michelle is joined by the esteemed Crystal Murphree-Holden, MA CCC-SLP, who is the Director of Distance Education/Clinical Instructor at the University of South Carolina, as well as VP of Higher Education with SCSHA. She was also a recent recipient of the Honors of the Association for SCSHA. In this episode Crystal and Michelle attempt to clarify the muddied waters of SLPA vs. SLP Scope of Practice! Haven’t heard of an SLPA? Well you’re not alone! Enjoy as Crystal enlightens, educates, and inspires us to consider our scopes in a new light!

In this episode, Michelle and Erin discuss functional strategies for getting a pediatric patient started. If you are in the world of pediatric private practice (home health and/or a clinic), this is the hour for you. Michelle and Erin share easy-to-implement strategies for how to ethically triage a waitlist, the process of completing comprehensive dynamic assessments, as well as share some of their favorite goals they include in their initial evaluations and plan of care. The best part is that Michelle and Erin share the resources and sources of guidance they have received over the years so that you have those forever on your side too.

Guest: Amy Delaney, PhD, CCC-SLP - In this episode, to kick off Dysphagia Awareness Month, Michelle and Erin are joined by Amy Delaney, PhD, CCC-SLP, who is an Assistant Professor in Speech-Pathology & Audiology at Marquette University and Director of the Neurodevelopmental Feeding and Swallowing Lab. Dr. Delaney, who co-authored the Infant and Child Feeding Questionnaire© and PFD consensus paper by Goday et al. in 2019, is here to ignite our souls on fire with her passion for PFD. So, if you have questions on if an SLP can diagnose PFD, why our field needs to study typical feeding skills, or the trajectory that Amy’s PFD research is taking our field, then tune in for this delightful conversation with Dr. Delaney.

Guest: Breanne Dalton - Complications that arise from issues in the gut are plentiful and complex, something that we in the world of feeding disorders are all too familiar with. Here on the show today to share about her work and own journey with digestive problems is Breanne Dalton from the University of Southern Mississippi! The life-altering first-hand experiences that Breanne has had have enabled her to connect with little ones on a very deep level, and serve them with a real understanding and empathy. We celebrate Breanne and her heroic work, how she has turned her own needs around feeding tubes into a way to help others! In our conversation, we get to hear from Breanne about J-Tubes and G-Tubes, the important steps on her path to where she is today, her attitude towards normalizing feeding issues, and why food and eating are so central to the human experience and building relationships. So, to hear it all from our great guest, be sure to listen in with us today!

Guest: Dr. Richard Noel, MD

Earn 0.1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/course?name=The-Medical-Domain-of-Pediatric-Feeding-Disorder

In this episode, Dr. Richard Noel joins the discussion to shed light on Pediatric Feeding Disorder (PFD) and its medical domain. Dr. Noel shares his journey to becoming a pediatric GI specialist and explores the critical components of managing PFD. Key topics include the importance of growth and nutrition, management of upper GI tract issues, and the significance of airway and lung concerns. Dr. Noel also addresses common misconceptions about reflux in infants and the use of various appetite stimulants such as ciproheptadine and mirtazapine. Viewers will gain valuable insights into constipation management, the role of scheduled toileting, and the importance of multidisciplinary care in treating PFD. The conversation underscores the need for better medical understanding and care strategies for children with PFD.

Timeline:

00:00 Introduction and Guest Welcome

01:41 Journey to Becoming a Pediatric Gastroenterologist

05:32 Understanding Pediatric Feeding Disorders

06:51 Medical Domain of PFD: Key Considerations

08:24 Addressing Nutritional Concerns

14:17 Managing Constipation in PFD

21:39 Behavioral Strategies for Feeding

23:36 Family Involvement in Feeding Therapy

26:04 Family Routines and Feeding Therapy

26:47 Medications for Appetite Stimulation

27:03 Ciproheptadine: Uses and Effects

31:18 Mirtazapine: An Appetite Stimulant

34:49 Megastrol: A Powerful Appetite Stimulant

37:07 Managing GI Issues in Children

38:03 Reflux and Vomiting in Infants

43:09 Cyclical GI Disorders: Abdominal Migraines and More

47:20 The Role of Multidisciplinary Teams in Pediatric Care

48:56 Challenges in Pediatric Feeding Disorder Education

53:46 Advocacy and Access to Multidisciplinary Care

About the Guest: Dr. Richard Noel was born in Mexico City and grew up in San Antonio, TX. He has MD/PhD degrees from the University of Texas Southwestern Medical Center in Dallas and did a residency in Pediatrics at Wake Forest University in NC. He trained in Pediatric Gastroenterology at Cincinnati Children’s Hospital Medical Center, where he developed an interest in working with children with pediatric feeding disorders. He worked for 10 years at the Children’s Hospital of Wisconsin with Dr. Colin Rudolph and then transitioned to Duke University, where is currently Division Chief for Pediatric Gastroenterology, Hepatology, and Nutrition.

Watch this Interview on YouTube: https://youtu.be/NVGPdIzfobs

Guests: Caroline Brindo, MA, CCC-SLP, BCS-S & Steven Sireci, MD - Not all of us will have the professional opportunity to conduct video fluoroscopic instrumental swallow evaluations; however, most of us will encounter pediatric patients, clients, or students who are in need of one. When that happens, it is common for the caregiver to ask, “What’s going to happen?”, “Will the barium hurt?”, “Will they be radioactive?”. These questions can feel overwhelming for those of us in home health, early intervention, and schools because we may not have the answers readily available. But never fear, Caroline and Dr. Steven are here! They will answer these questions and more, such as, “What is barium?”, “Do different recipes for barium impact the swallow study?”, “What can my patient expect?”. So, if you want to know more about the nitty-gritty of barium, then tune in for this hour.

Guest: Missy Schraeder, PhD, CCC-SLP, CALT-QI, C-SLDS - If you're an SLP who works with preschoolers and elementary-age children that have a severe and profound communication disorder and/or dyslexia, then this is for you. In this course, Dr. Missy Schraeder and Michelle spend time sharing functional strategies that can be implemented with your patients tomorrow.

Guest: Jerrold Jackson, MA, CCC-SLP - In this episode, Michelle is joined by Jerrold Jackson, who embodies the meaning of servant-led leadership. His compassion for colleagues and students is abundant. This heartfelt conversation, which definitely exceeds our hour-long average, gets to the core of what it means to serve one another and our field as advocates, mentors, and sponsors and how to do so with joy and hope. Jerrold shares his personal walk as a black male speech-language pathologist, how mentors shaped his life, how, through their representation in the field and now his, conversations have been held, advocacy has occurred, and desperately needed policy changes have resulted.

Guest: Jennifer Casteix, MS, CCC-SLP - In this episode, discuss how to mentor the next generation of pediatric feeding disorder clinicians. Do you have a waitlist a mile-long for your services? Do you have a calling to do “more” for our profession, but are unsure of where to begin? Do you have a bit of wit along with your PFD wisdom and a desire to share it? Then join Jennifer as she inspires us to take up the mantle of Clinical Supervision and Mentorship! Learn an update on the current state of affairs of pediatric feeding disorder coursework in graduate school to understand the knowledge base students are coming to us with, and then embrace the conversation regarding different adult learning styles as strategies to effortlessly train our profession’s future.

Guest: Ed Bice, MEd., CCC-SLP - Have you ever taken a course and thought, “Wow! Yes! This is what my patients need!” and then felt a little embarrassed at how you were previously treating their dysphagia deficits? Why do we have those dysphagia competency concerns, to begin with? If you have ever asked the “why,” then join Michelle and Ed as they explore the limitations in professional preparedness. Ed walks us through how limitations in academic coursework (even down to textbook selection) impact professional preparedness for clinical competency but then offers functional solutions to remedy the situation.

Guests: Vicki R. Deal-Williams, MA, CCC-SLP, FASAE, CAE and Andrea M. Falzarano, CAE. For Better Speech and Hearing Month, the First Bite podcast could think of no better way to celebrate this, than by holding crucial conversations around leadership within our profession. Why? Because we have all witnessed and experienced firsthand deficits within our profession. These can include unreasonable expectations for productivity and caseloads, limited access to speech-generating augmentative and alternative communication devices, the scope of practice encroachment from non-licensed individuals, and the list could go on, but we will stop it there. Why? it is what you do with that next breath that makes the difference. It’s that next breath that drives change in our field. It’s what you do with that next breath that makes a lasting impact on future colleagues and their patients. Why not learn about ASHA’s unique leadership training opportunities from THE Leaders themselves? In this hour, we hope to inspire you with wisdom from the council of elders, from the greats in our fields, to move the needle of our profession forward, one conversation at a time.

Guest: Sari Risen, M.A., CCC-SLP, Reg. CASLPO, BCBA - In this episode Michelle is joined by Sari Risen, M.A., CCC-SLP, Reg. CASLPO, BCBA, from Toronto, Canada, and they tackle the complicated topic of ABA Therapy and Speech Therapy…within the framework of the fields working collaboratively! Join the ladies as Sari takes First Bite Listeners on an Interprofessional Education tour of the process it takes to earn a BCBA certification, explains the differences and similarities between the terminology of the ABA and SLP worlds, and shares the theory of language acquisition that is the framework for the BCBA approach. Extra tidbit… there’s a mini crash course on the differences between licenses in the States and Canada! Here’s hoping that this crossroads conversations can lead to collaboration at a local level.

Guest: Memorie M. Gosa, PhD., CCC-SLP, BCS-S - If you love pediatric feeding disorders and deep diving into research to practice on this topic, then this is the hour for you. Michelle and Dr. Gosa tackle pediatric feeding disorders and the public schools, baby-led weaning, favorite dysphagia resources, as well as a sneak peek for the pediatric feeding disorder track at this year’s ASHA 2022.

Guest: Morgan Oates, MA CCC-SLP - In this episode, Michelle is joined by Morgan, a Ph.D. student in the Speech and Hearing Science Department at The Ohio State University with a Graduate Interdisciplinary Specialization in Disability Studies. Morgan’s research interests include the implications of double empathy theory in terms of the effects of neurotype on language and communication, neurodiversity-affirming supports for adolescent and adult autistic individuals, and the intersections of gender and autism. In this episode, Morgan provides clinicians and caregivers with insight into what neurodiversity and double empathy are and how they relate to communication. She then takes us on a joyful journey of how we can provide neurodiversity-affirming communication support for adolescent autistic individuals.

Guest: Sarah Breshears, MA CCC-SLP - In this course, Michelle is joined by Sarah Breshears, MA CCC-SLP, of @ShortandSweetSpeech from Instagram. This oral care champion is here to hold the crucial conversation about “Baby Burnout." Sometimes the world of Early Intervention and pediatrics is overwhelming and you hit your professional “done level”. But, you then run into the almost insurmountable challenge of, “But babies are all I know! How do I make the change into adults?”. Sarah is here to educate about the signs and symptoms of burnout, functional strategies to overcome it, and offer suggestions to help you make a transition from babies to adults, from home health to acute, from stress to relief.

Have you ever noticed a trend on your pediatric feeding disorder caseload in which you see a couple of patients with similar GI complaints, or similar cardiopulmonary complaints, but there is an unknown etiology? Michelle and Erin spend this hour reviewing the technical details of what a pediatric feeding disorder is, various types of neurogenic conditions that you may commonly encounter, and how all those bits and pieces connect together, and your role in all of it.

Guest: Melissa Davis, MS CCC-SLP - Melissa is the owner of Speech Therapy for Kids and co-owner of Kids Therapy Spot with clinics in Starkville and Columbus, MS. Melissa, who is known for her pediatric feeding disorder advocacy work, especially with Feeding Matters, joins to discuss the unique challenges of serving patients in a Prescribed Pediatric Extended Care (PPEC). Never heard of a PPEC? Don’t worry; Michelle hadn’t either when she first met Melissa. So please tune in to learn what a PPEC is, the unique challenges of serving patients in a PPEC, and how Melissa and her colleagues have overcome those challenges to engage in joyful interprofessional practice for optimal patient outcomes.

Co-Host: Erin Forward, MSP, CCC-SLP - In this episode Michelle is joined once again by her dynamite First Bite partner, Erin Forward, MSP CCC-SLP, where they take on the topic of Clinical Supervision…for a newbie! The lovely Erin, like so many other SLP’s out there, is coming down the home stretch for when she can serve the next round of Clinicians as their Clinical Practicum Supervisor! There’s no better time than now to cover all the amazing supports, supervision requirement changes, research, and practical application strategies for being successful Supervisor! Have you thought about venturing into the world of Clinical Supervision, but not sure where to start? Michelle and Erin will share the fabulous resources to set you and your future students for success!

Guests: Juliet Ochura, MS CCC-SLP, CLC, Kerry Pearl, MS CCC-SLP, CLC, & Jennifer Perez, MS CCC-SLP, CLC - In this episode, Michelle is joined by Juliet, Kerry, and Jennifer, a fabulous trio of colleagues from Boston Medical Center, to discuss all things “Breaking Down Barriers to PFD Care." These brilliant leaders have witnessed first-hand the health equity barriers that numerous patients have encountered in their attempts for evaluation and treatment of pediatric feeding disorders. They share the successful strategies that they have implemented at their facility.

Guest: Dr. Georgia Malandraki, Ph.D., CCC-SLP, BCS-S - As we continue this amazing journey through our tricky yet important field, we are joined today by a real leader from the field! Dr. Georgia Malandraki, Ph.D., CCC-SLP, BCS-S, is an associate professor of Speech Language and Hearing Sciences at Purdue University and a Board-Certified Specialist in Swallowing and Swallowing Disorders. In her research, she focuses on investigating developmental swallowing neuroplasticity and developing rehabilitative and telehealth interventions for dysphagia. In addition to this, she is the research director of the Purdue I-EaT Swallowing Research Laboratory and Clinic and has served on editorial boards for ASHA journals, as an editor for the American Journal of Speech Language Pathology, and is the current president-elect of the Dysphagia Research Society. In this awesome conversation, we get to really go deep with Dr. Malandraki, talking about her most recent work on the developmental stages of the nervous system, some very helpful papers and resources that she recommends, muscle tone issues in infants, and the gaps that she has noticed in the pediatric care systems, that still persist today. For all this, and a whole lot more great insight, where it is so badly needed, listen in with us to hear what Dr. Malandraki has to say!

Guest: Jenn Rubenstein, MS CCC-SLP - Have you ever stood in AWE watching an eye-gaze user navigate their communication device to express joy but were left scratching your head and wondering, “But how does it work?” In this episode, the ladies of “First Bite” are joined by Jenn Rubenstein, MS CCC-SLP, speech-language pathologist and Clinical Account Executive for Eyegaze, to unlock the mysteries behind the machine. Jenn starts with explanations of the anatomy and physiology, transitions into how the device works to “read” the eye, and then offers an explanation of some diagnoses that could prohibit access for a potential user. Jenn concludes the first of her two-part episode by guiding colleagues through a screening tool to determine if they could potentially benefit from an eye gaze communication device.

Guest: Lillian Thompson Brown, MS CCC-SLP - Lillian's current research undertakings have been driven by passion from her personal experiences as a younger sibling to an autistic brother. If you, too, have been despairing over the extensive wait times that little ones and their caregivers have to endure in the process of obtaining an ASD diagnosis, then despair no more. If you have been frustrated that children of color tend not to receive an ASD diagnosis until years after their white male counterparts, again, we say, despair no more. There is hope. “The Reduce the Wait” project in Illinois is currently training over 1,000 early intervention SLPs on how to conduct virtual ASD assessments. Lillian is conducting qualitative research with the caregivers on their experiences to grow our cultural understandings and improve our caregiver coaching with families from different backgrounds.

Guest: John Holahan, President of SimplyThick, LLC

Earn .1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/course?name=Simply-Thick-IDDSI-and-Compassionate-Clinical-Implications

Join Michelle as she welcomes John Holahan, President of SimplyThick, LLC and co-author of Modern Dysphagia Cookbook, for the final episode of 2024. John shares the story behind SimplyThick, its IDDSI connections, and why these insights matter in pediatric care. With his grace, joy, and dedication to supporting others, this episode is a perfect way to end the year on an inspiring note!

Guest: Karen McWaters, MOT, OTR/L - As SLPs, we have, in the past, passed all of our questions regarding sensory systems and regulation off to our OT counterparts due to their expansive education on the subject. However, it is time that we sit at the same table and have a conversation about sensory and its role in communication. A child needs to be regulated to grow their communication skills, and as such, we as SLPs need to learn from those around us how to support a child’s sensory system for optimal language development. Today, Erin and Karen discussed sensory systems and regulation and how it is imperative for us to join in.

Guests: Tamala Close, MS, CCC-SLP & Britney Desir, MS, CCC-SLP - In this episode, Tamala and Britney bring their years of expertise to inspire us to take that leap of faith and start our own private practices. Unsure of where to begin, never heard of an “NPI Number”, afraid of writing a business plan, overwhelmed by potential overhead costs? Breathe deep, grab your favorite pen and notebook, and let Tamala and Britney instill practical guidance to build your private practice confidence.

Guest: Madilyn "Madi" Metcalf, MS, CCC-SLP - In this episode, Michelle is joined by Madi, the delightful host of “Making Sense of Selective Eating,” a podcast miniseries with Speech Therapy PD. Over this hour, Madi speaks from her heart, sharing insight on the journey that she took to be able to competently serve the pediatric feeding disorder (PFD) patients in her hometown. So, if you, too, have looked around your community and recognized that PFD services are in need but are unsure where to begin, this is the conversation for you! Madi shares how she overcame imposter syndrome by bravely taking numerous courses, volunteering with her state association, and entering the field of early intervention and private practice to cast a wide net, all to meet caregivers and patients right where they are (both figuratively and literally!). Let her illuminate the path forward through functional recommendations for growing your PFD evidence-based practice!

Michelle and Erin discuss the purpose of play in treating pediatric feeding disorder (PFD). Erin, who holds a Basic DIR® Floortime Provider Certification and a TBRI® Trained Practitioner, highlights the importance of play. Did you know that play has a therapeutic purpose and role in treatment, especially for pediatric feeding disorder? Join in to learn more about play and its therapeutic role.

Guest: Karen McWater, MOT, OTR/L - As SLPs, we can often look at speech and language development in isolation, as our formal assessments encourage us to do; however, it is imperative that we learn from our occupational and physical therapy colleagues regarding motor learning principles and how they parallel those of language development. When we get out of our box, we can further understand the children we work with and their capacities. Erin and Karen will discuss their journey of collaborating within this context and how they learned from each other to help the children they worked with reach further potential.

Co-Host: Erin Forward, MSP, CCC-SLP - In this episode Michelle is joined once again by co-host extraordinaire Erin Forward, MSP CCC-SLP…and they are taking on those tricky tethered tissue issues. Have you too been confused about the HIPAA compliant pictures that you see popping up on social media that ask advice about that presumed “tongue tie”? Or has a colleague sent you a HIPAA friendly pic of a supposed “lip tie” and asked your advice about a static image? Welp, us too! In this episode Michelle and Erin address normal anatomical variations, the history of tethered tissue treatments, and what the evidence currently tells us. Enjoy the untanglement!

Guests: Jaclyn Pederson, MHI, Athena Flicek, and Jen Lambert, M.ED. - Michelle is joined by Jaclyn Pederson, MHI, Chief Executive Officer of Feeding Matters, Athena Flicek, Programs and Events Manager with Feeding Matters, and Jen Lambert, M.ED., Director of Programs and Events with Feeding Matters, to celebrate “Pediatric Feeding Disorders Awareness Month." It’s been a while since Feeding Matters was on “First Bite,” and there has there been tremendous growth and change. Over the course of this hour, absorb the advocacy updates, learn new ways to volunteer your professional skills to advance the knowledge of pediatric feeding disorder, and share how Feeding Matters has impacted one phenomenal caregiver who is now paying it forward.

Guest: Gregory Black, MD - In this episode Michelle is joined by Dr. Gregory Black, the current President of the SC Allergy, Asthma, and Immunology Society, and guest for Episode 13 “So You’re Telling Me Allergy Testing is Important?”, and Episode 18 “Dairy vs Soy vs What? The Correct Formula for Your Allergy and Why!” and they are taking a closer examination of that elusive Eosinophilic Esophagitis diagnosis. Okay, so let’s admit, most of us had never heard of “EOE”, as it is more commonly known, in grad school, but it appears to be popping up left and right these days when we go to obtain a past medical history for our patients. This is a hard diagnosis to come by, and unfortunately, it is a hard diagnosis to effectively treat, and for the “Feeding Therapist”, well y’all it’s hard to try new foods when we are worried about which ones our patient’s could be allergic too. That’s where the lovely Dr. Gregg Black comes in! He is back y’all to explain all about EOE! Through his helpful tips, all of us in the trenches will find better footing in the evaluation and treatment process for our patients! Three Cheers for Dr. Gregg!

In this episode, Michelle and Erin discuss a topic dear to their hearts: busting common myths surrounding the utilization of speech-generating AAC devices in early intervention. The ladies of First Bite spend this hour empowering listeners on the steps to initiate a speech-generating device (SGD) trial within the world of EI, how to overcome common barriers such as the myth “but the device will prevent them from talking,” how to engage and encourage caregivers to use an SGD AAC device during their daily routines, as well as troubleshooting the simple steps to submit for insurance approval.

In this episode, Michelle and Erin tackle the joy of episodic care for the treatment of Pediatric Feeding Disorder. For those who are used to productivity requirements, understand that those percentages are probably substandard during the summer months. But what if those weekly sessions for a year-long plan of care that adhere to tight productivity regimens may not be optimal for your patient or client? Let Michelle and Erin share the power of episodic care with you. The who, what, where, when, and why will all be covered in this hour-long conversation on an alternate form of service delivery.

Guest: Stephen Kneece, MA, CCC-SLP - In this episode, Stephen Kneece, who is a highly skilled augmentative and alternative communication specialist, inspires us all with his practical insight into how to select the ideal access approach for the little ones that we serve. If you work with medically complex pediatric patients and need insight into direct versus indirect access, troubleshooting common barriers to utilization and implementation of speech-generating devices, or if you just need inspiration from a skilled “been there and done that” school-based SLP, then tune in and let Stephen inspire you.

In this episode Michelle interviews licensed dietitian nutritionist Jeremy Ponds and he explains what types of feeding formulas are available, how each of the different types of formulas processed/utilized in the body, and what are the usual reasons why a child may be placed on one formula rather than another. 

In this course, Michelle has a frank conversation with Stephanie Schank regarding student clinician fears and anxiety disorders that are more than a “Millenial thang”. Discover how real life heartbreak can lead to a powerful place of healing and serve as an inspiration to clinical supervisors to educate our students with compassion and patience.

Michelle is joined by the lovely Erin Forward of Rochester, NY, where they tackle hard questions facing the world of pediatric speech therapy. In this episode, the roles are reversed and Erin asks Michelle about special considerations when completing a pediatric dysphagia/feeding eval in the home health/natural environment setting.

Ms. Karina McCollam, ECSE teacher, joins Michelle for this interview, where we have that crucial conversation about IFSP to IEP transitions. Do you despise that “ohhh-to-common” breakdown in communication during this critical period too? Sit back and enjoy as functional strategies are discussed to address this concern.

Michelle is joined again by Jeremy Ponds, RD with Path of Life Nutrition, as he tackles the nitty gritty about who is a candidate for a feeding tube, how flow rates are configured…get your calculator ready!... and the implications of TPN for the little ones we treat.

In this podcast, Michelle is joined by the lovely Miss Erin Forward of Rochester, NY. On the menu: common terminology for our pediatric populations with feeding tubes, emphasis on quality not quantity feeds, and addressing long-term planning…stressing the motto of “fed is fed is fed” and that some of these little ones do need a feeding tube for nourishment and PO for quality of life.

In this podcast, Michelle is joined by the dynamic Mrs. Diane Postman of Yorktown, VA to demystify how AAC and emergent literacy can work in an ECSE classroom with a “push-in” approach. We are not talking swapping out pictures for objects here folks, but data drive core-vocab with real-life examples! Hilarity, albeit in a geeky fashion, does occur in this most functional of discussions!

In this course Michelle is joined by the charming Mrs. Juliana Miller, from Columbia, SC…and together they address problematic practicum placements and the “do’s” vs. the “do not’s” of clinical supervision, as well as to highlight the upcoming 2020 ASHA changes to supervision…all from the perspective of a Director of External Clinical Practicums. 

In this episode Michelle is joined by business savy Mrs. Jennifer Tardy, with “PT the OT Therapy and Wellness, originally from Millinocket, Maine, however currently residing in Lexington, SC. In this lecture we tackle the largest fear of small business owners, “how do we ethically obtain referrals?”. Jennifer, a successful Director who currently manages referrals for three different businesses, offers her functional/practical insight into how you too can make it in the world of habilitation/re-hab…and still maintain your glass-half-full disposition!

In this episode Michelle is joined by the charismatic Gregg Black, MD, of Carolina Allergy and Asthma Consultants, PA. Dr. Black, from Columbia, SC, (by way of Clemson, SC, Birmingham, AL, Whangaeri, NZ, and New Orleans, LA), shares the process by which infants, as young as 30 days, can begin safely assessing for food allergies and the best way to go about the diagnostic process.  This lecture is the perfect starting point for clinicians as they learn to recognize early s/s of potential food allergies and its affect on feeding and how to offer guidance on helping our patients reach out to an allergist.

In this episode, Michelle is joined by the gifted Mrs. Melissa Monteil, MS CCC-SLP, from the Medical University of South Carolina and the Evelyn Tramell Institute for Voice and Swallowing.  In this lecture, we discuss the process of prenatal diagnosis of cleft and dispel misconceptions regarding feeding a little one with a cleft, especially in that first critical year.  Not only does this amazing woman specialize in the subject matter for her career, but also she also freely gives of her spare time and treats patients through Global Smile Foundation around the world. Be sure to have your questions ready for this dynamic guest interview! 

In this episode Michelle is joined by holistically fierce “Momma-Bear” Mrs. Jennifer Tardy, with Eating for Healing, from Millinocket, Maine, however currently residing in Lexington, SC. In this lecture we tackle EOE, Eosinophillic Esophagitis, from the unique perspective of a mother…who happens to be a nutrition coach…to learn key insights into how a devastating diagnosis was tackled with compassion, understanding, and education!  Just new to the world of EOE, then this lecture is a great starting point as we are learning from a member of the front line! 

In this episode, Michelle is joined by the gifted Mrs. Melissa Monteil, MS CCC-SLP, from the Medical University of South Carolina and the Evelyn Tramell Institute for Voice and Swallowing.  In this lecture, we discuss the process of prenatal diagnosis of cleft and dispel misconceptions regarding feeding a little one with a cleft, especially in that first critical year.  Not only does this amazing woman specialize in the subject matter for her career, but also she also freely gives of her spare time and treats patients through Global Smile Foundation around the world. Be sure to have your questions ready for this dynamic guest interview! 

In this episode Michelle is joined by social media guru, Kiki L’Italien, CEO and founder of Amplified Growth, a digital marketing consultancy specializing in social media, SEO, and influencer marketing.
Kiki, who regularly lectures to Speech-Language Pathologists and other medical colleagues, will focus this lecture in maintaining professionalism and navigating potential ethical pitfalls of social media…all the while teaching how to put social media to work for you, making your practice thrive! 

Guest: Dr. Kristen West, M.A., CCC-SLP - In today’s episode of First Bite, we are delighted to welcome back Dr. Kristen West, M.A., CCC-SLP, to discuss her work as an SLP in public schools. Kristen is an assistant professor in the Department of Communication Sciences and Disorders at Edinboro University in Pennsylvania and is currently also pursuing her educational doctorate at Slippery Rock University. In our conversation with Kristen, we delve into the challenges of setting up a program in public schools and how her journey led her to work in that space. We spend some time appreciating the role that advocacy plays when it comes to special education services in schools and how our host Michelle Dawson, in collaboration with Angie Neal, was able to pass a proposal that countless children in South Carolina will benefit from for years to come. Listening in, you'll hear Michelle break down the many aspects of working as an SLP in public schools and what she has learned throughout her career. She expands on the inextricable relationship between nutrition and learning, why cafeterias pose a unique challenge to children with PFDs, and why teamwork between nurses, teachers, and parents is essential. We loved having Kristen back on the show and we know you’ll find the conversation as informative and inspiring as we did! For all this and much more, join us today!

The Dysphagia Outreach Project is a nonprofit organization whose mission is to provide meaningful assistance to individuals affected by dysphagia. Today on the show we invite Allie Mataras, Amanda Weissberg, Allison Boyer, Jessica Lasky, Hillary Cooper, and Michelle Coffaro from the Dysphagia Outreach Project’s Board of Directors to talk about how they have come together to work on this project as volunteers and the great things they are doing for the community. The original idea came from Hillary and she kicks things off by talking about how she was disturbed by a general lack of access to supplies experienced by patients and how she wanted to take the initiative to fix this. Hillary teamed up with Michelle and Jessica and our next two guests weigh in on the contributions they made to get the idea off the ground. Jessica speaks about the role she plays in the organization in the fields of education and advocacy and the Michelle shares her responsibilities as VP of operations. Michelle runs the food bank in Cincinnati and we hear about the incredible wealth of supplies they distribute. From there, we hear from Allie and her work as Director of Fundraising before getting to know Amanda and the contributions she has made on the social media front as Captain of Instagram for the public relations team. Wrapping up, we meet our final guest, Allison Boyer, who manages the DOP Facebook page where she helps assemble literature reviews of the most current research in the field to be distributed freely to all who are interested. So for all this and more about an amazing project that stands testimony to the power of purpose-driven teamwork, tune in today!

Co-Host: Erin Forward, MSP, CCC-SLP - To kick off their first episode of 2021, Michelle and Erin, tackle one of their favorite topics, clinical case studies for evaluation and treatment of Pediatric Feeding Disorders. In this hour the ladies address some current clinical needs for individuals that have signs and symptoms of neurogenic based PFD, congenital heart defect (CHD) induced PFD, and esophageal dysphagia. Tune in as Michelle and Erin consult on the steps they have taken to engage interprofessional practice for the care of the little ones and how uncovering the new etiologies is shaping their plan of cares.

At least once in our careers, we have all struggled with the question, “But does this little one need an instrumental swallow evaluation?” Sometimes, we feel that we are over referring for instrumentals, other times, we may feel that we are not sending the patients out frequently enough. In this course, our presenters help answer this question with functional guidelines to help lead us in our evidence based decision making process.

Guest: Sucheta Kamath - As SLP’s, we tend to focus on our specific area of expertise; language or speech production or cognition, for example. However, our guest on the show today, the wonderful Sucheta Kamath, believes that this lack of a big picture perspective is problematic and that there is a better way to do things. Sucheta has focused her career on the functioning of the brain as a whole, and the intersection between brain functioning, psychology, sociology, and education. After listening to this episode, you’ll have a better understanding of executive functioning, metacognition, and the variety of factors that impact these. Sucheta shares the strategies that she utilizes to help children master executive functioning, how to determine whether a child has executive dysfunctions, as well as a few stories which highlight what can go wrong when our executive function isn’t operating at its full capacity.

Guests: Rebekah Wada, ABD, CCC-SLP and Megan Israelsen-Augenstein, PhD, CCC-SLP - In the last few years, the field of speech-language pathology has increased its attention on the understanding and use of implementation science. But what is implementation science? And how is it useful for practicing speech-language pathologists? In this hour, Michelle hosts Dr. Rebekah Wada and Dr. Megan IIsraelsen-Augenstein to discuss all of the above and how an implementation science framework can be applied to AAC assessment and intervention. P.S. Catch Rebekah and Megan at ASHA sharing more on the beautiful scientific marriage between AAC and Implementation Science.

Guests: Nasha Fitter and Nicole Johnson - In this course, Michelle is joined by Natasha Fitter, CEO and Head of Research, as well as Nicole Johnson, President of Communications, for FOXG1 Research Foundation. These two co-founders are here to share how their very personal parenting walks of children with FOXG1 Syndrome, led to the birth of this amazing Research Foundation that is changing the lives of countless children around the world. FOXG1 is know for causing varied and severe Pediatric Feeding Disorders. Not only will Natasha and Nicole share the history of the Foundation, but they will also discuss their latest research, and recommendations for best practice for evaluation and treatment of individuals with PFDs secondary to FOXG1.

In this episode Michelle is joined by Lisa Bjelland MSW and Psy D, who works as a trauma therapist and Monte Torkelsen, M Div, President of Abba's Child Grief Camps for an hour dedicated to finding grace in grief. The caregivers of our little ones that we work with can struggle through the various stages of grief. We, the licensed SLP on the interprofessional practice team, can also struggle with grief, especially when the little ones that we work with pass on. What are we to do? How can we help our caregivers? How can we help ourselves? Maintaining our emotional, psychological, physical, and spiritual health is critical. But simply finding the time to engage in the acts of self-care can in itself be a challenge for the busy SLP. Today, Michelle, Lisa, and Monte hold the crucial conversation to help you bring healing, comfort, and joy into your being, so you are better equipped to help others.

Co-Host: Erin Forward, MSP, CCC-SLP - In this episode Michelle is joined by the powerhouse that is Erin Forward, MSP CCC-SLP, when they break down some of their favorite tips for conducting a successful Feeding Therapy Session. If you are struggling with creating optimal position for PO intake, Erin and Michelle will help provide strategies that are low cost to no cost. Have you consider how “busy” the therapy room may appear to the patient that you’re working with…and how that will impact their ability to attend to the activity? Erin and Michelle offer guidance on how to declutter that clinic space and why! Are you feeling frustrated by challenging behaviors during your session…and not sure which steps you need to take to help ease the storm? Erin and Michelle have ideas to bring the calm! Tune in for an hour of evidenced based feeding strategies that work!

Guest: Betsy Pilon - In this episode, Michelle is joined by Betsy, the Executive Director of “Hope for Acquired Hypoxic Ischemic Encephalopathy (HIE).” This hour is a deeply profound conversation as one mom shares her journey of advocacy and empowerment, inspiring and educating us along the way. Join in as the topics of causes and current treatment for HIE. are presented. Potential long-term impacts and barriers to continued treatment after NICU discharge will be discussed.

Guest: Ashley Muñoz López MBA, MS, CCC-SLP, BCS-S

Earn 0.1 ASHA CEU for this episode with Speech Therapy PD: https://www.speechtherapypd.com/course?name=Discovering-the-Leader-in-You

In this episode, Michelle Dawson introduces the theme of leadership within the field of speech pathology. Michelle shares insights from her recent experience at the Feeding Matters conference, highlighting the importance of advocacy, especially regarding the protection of 504 plans under threat in several states. The week's guest, Ashley Lopez, delves into her journey as a speech pathologist transitioning from adult care to pediatric care, her pursuit of leadership roles, and the challenges of balancing professional and personal life during these transitions. Ashley also opens up about the impact of postpartum depression, the necessity of finding one's tribe for support, and her educational path that includes obtaining an MBA to enhance her leadership skills. This episode is a heartfelt discussion about personal growth, professional transitions, and the essential role of advocacy in the field.

Link to ASHA Advocacy - Texas v. Beccera: https://www.asha.org/news/2025/texas-v-becerra-a-lawsuit-that-threatens-disability-rights/

Episode Timeline:

00:00 Welcome to First Bite

00:18 Reflections on Feeding Matters Conference

02:52 The Fight for 504 Plans

07:39 Introducing Ashley Lopez

09:14 Ashley's Journey into Speech Pathology

17:33 Career Pivots and Challenges

20:45 Transitioning to Pediatrics

22:52 Navigating Postpartum Depression

32:35 Mentorship and Adult Learning

34:19 Pursuing an MBA During the Pandemic

37:38 Discovering a Passion for Medicine

38:01 Pursuing an MBA

38:41 Balancing Education and Career

39:59 Understanding the Bigger Picture in Healthcare

40:50 The Importance of Leadership in Healthcare

41:38 Graduating and Future Aspirations

43:06 Challenges in Clinical Training

45:09 The Role of Business in Healthcare

46:10 Personal Life and Professional Balance

49:14 Finding Support and Building a Tribe

51:43 Adapting to New Normals

01:03:04 Leadership and Continuous Learning

01:09:09 Concluding Thoughts and Gratitude

About the Guest: Ashley is a board-certified clinician with experience in direct patient care, project management, service line development, and leadership. She has worked as a speech-language pathologist for over a decade and has experience working with children and adults in various practice pathways. She has substantial experience working with patients with acquired brain injury, respiratory compromise, and dysphagia.

Ashley has been published in the ASHA Leader and Aerodigestive Health as well as the Perspectives of the ASHA Special Interest Groups. She received the Distinguished Early Career Professional (ECP) Certificate in 2018 and graduated from ASHA's Leadership Development Program (LDP) in 2019. She is a current member of the Hispanic Caucus for ASHA and a previous board member. She has been a guest speaker for several universities and has presented at the local, state, and national levels, including multidisciplinary presentations with nursing organizations. Most recently, she was invited to be a speaker at ASHA's upper airway online conference. In 2020, Ashley began her term as a site visitor for the Council on Academic Accreditation (CAA). ​​​

Ashley provided dedicated service to ASHA's Special Interest Group 13 as a professional development member from 2021 - to 2023 and the CE content manager. Currently, she is serving on the adult swallowing committee for the ASHA 2024 convention. Outside of her duties in the clinical realm, Ashley empowers diverse members of the healthcare workforce and was the 2022 co-chair and 2023

Guest: Lane Rials MS, CCC-SLP - The presenters discuss how our own implicit biases in AAC can hinder our patient’s progress, how accessing AAC for individuals with complex mobility needs can be achieved, and how Neural Nod utilizes EMG to give a voice to those in need. If you are on the hunt for the latest evolution in functional AAC SGD to give your little ones the ability to make their wants known, then make sure you tune in for this hour!

Guest: Cuyler Romeo, M.O.T., OTR/L, SCFES, IBCLC - In this course, our guest Cuyler, who is a PFD advocate extraordinaire, discusses the recent changes to best practices for NICU discharge for infants with a pediatric feeding disorder. She highlights updates from the National Perinatal Association, discusses common barriers to successful discharge, and best yet how we can engage in improved continuity of care for these little ones to set them up for long-term success.