EPISODE 238

[INTRODUCTION]

[00:00:00] MD: Okay. So this moment of gratitude goes to Kelsey Panera and this sweetest little baby bump that is on its way. Kelsey is a colleague, she's another SLP, who lives here in Virginia. She's new to my local area that I live in now too. She reached out and said, "Hey, I'm new. I love PFD, and AAC, and tiny humans, and sounds interesting, but do you want to meet for lunch?" I was like, "Oh my God, I'm going to have an SLP friend, because like I don't know anybody in Staunton. Kelsey, thank you for meeting me and being truly just a ray of sunshine, and a light, and you're going to be the best boy mom ever. Remember, tuck it down, then put the diaper on. Otherwise, the pee goes everywhere. But I am so grateful for your kindness because I was feeling very lonely, and isolated from SLPs because I hadn't basically talked to another SLP since we moved. Thank you for your kindness and for inviting me to Panera. That was so much fun, and I can't wait to do it again. There it is. Thanks.

Hi, folks, and welcome to First Bite: Fed, Fun, and Functional. A speech therapy podcast sponsored by SpeechTherapyPD.com. I am your host on this nerd venture, Michelle Dawson, MS, CCC-SLP, CLC, the All-Things PFDs SLP. I am a colleague in the trenches of home health, early intervention right there with you. I run my own private practice at Heartwood Speech Therapy here in Columbia Town, South Carolina, and I guest lecture nationwide on best practices for early intervention for the medically complex infant, toddler, and child. First Bite's mission is short and sweet, to bring light, hope, knowledge, and joy to the pediatric clinician, parent, or advocate.

[0:02:20] EF: By way of a nerdy conversation, so there's plenty of laughter too.

[0:02:23] MD: In this podcast, we cover everything from AAC to breastfeeding.

[0:02:27] EF: Ethics on how to run a private practice.

[0:02:31] MD: Pediatric dysphagia to clinical supervision.

[0:02:34] EF: And all other topics in the world of pediatric speech pathology. Our goal is to bring evidence-based practice straight to you by interviewing subject matter experts.

[0:02:43] MD: To break down the communication barriers so that we can access the knowledge of their fields.

[0:02:49] EF: Or as a close friend says, "To build the bridge." 

[0:02:52] MD: By bringing other professionals and experts in our field together, we hope to spark advocacy, joy, and passion for continuing to grow and advance care for our little ones.

[0:03:03] EF: Every fourth episode, I join them. I'm Erin Forward, MSP, CCC-SLP, the Yankee by way of Rochester New York transplant who actually inspired this journey. I bring a different perspective, that of a new-ish clinician with experience in early intervention, pediatric acute care, and non-profit pediatric outpatient settings.

[0:03:24] MD: Sit back, relax, and watch out for all heart growth and enjoy this geeky gig brought to you by SpeechTherapyPD.com.

[EPISODE]

[0:03:38] MD: Okay, y'all. I absolutely love today's guest. Her inner light just radiates, and she exudes kindness with her confidence. She's just naturally beautiful too, so there's that. But like, she's genuinely a wonderful human. I am so honored that we get to spend Dysphasia Awareness Month with the almost Dr. Rachel Arkenberg. She is like so close. When you're on the other side, and you get to come back, and I get to formally introduce you as the doctor.

We're talking about something that is vital to keep our profession moving forward. It's about getting PhDs, it's about getting your doctorate because the standard says, they are. We need that in academia, but also, we need this. We need souls that love asking questions and then deep diving into research to find the answers. But then, once they want to carry it back and listen to clinicians, and it's this beautiful circle, and we need that element. That is a huge part of our evidence base triangle.

I am so grateful that Rachel has come back on. Is this your third? I've lost tracks.

[0:05:07] RHA: Second, I think.

[0:05:08] MD: Oh my gosh. I feel like it should be your third. But like, she's coming back on and we just love her. Yay. Also, she did bring her sweet baby girl to ASHA, and I got like to smell her, which is Ð I love how baby smell. Yes. So all the things. Hi, how are you? Get us up to speed, honey.

[0:05:32] RHA: Oh, thank you so much for your super kind introduction. I am honored to be here again and so excited. I love getting to talk with you anytime, and so this is great. Yes. I am hopefully in my last year of my doctorate at Purdue University. I am a speech pathologist and worked in a medical setting, and then came back to school in 2019, and have been working on my PhD ever since. So I'm getting close.

[0:06:01] MD: Yes. I feel like they should add like an extra P to PhDs earned in the pandemic, like a pandemic, like pandemic PhD But okay, but also super amazing mom life. You said she's eating solids. Can we talk about that?

[0:06:16] RHA: Yes, it's been the best thing ever. My research, which is maybe jumping ahead, but I'm studying starting solids and I have a little, a little human starting solids in my house, which is great. She's just thrilled to be eating, and sitting at the table with us, and it's the cutest thing ever.

[0:06:35] MD: Oh my God. I told her before we started, I was like Ð we were talking about how quickly it flies by and I was like, and we've hit the stage where it's like Nerf gun battles. Or how we have a rule, no Nerf gun shooting in the house. We went running out the door, and because Rocky Ð you know Rocky Garcia, right? Rocky was like, "Michelle, you got to get a Nerf gun and shoot him back." So we got Mommy a Nerf gun, a little too good of a shot. I definitely took out Bear's carotid artery one time. So we were running out of the house earlier this week, and it was like close contact, and Bear got excited, trigger happy, and he shot me right in my tootie ta, and like I can't believe. He was like, "Mom, I hit you in your vagina." I wow like, "One, don't ever say that word again. Two, it hurts so bad. Like, time out."

[0:07:21] RHA: I can't imagine.

[0:07:23] MD: Yes. I was like Ð I mean, I think they need to make mom's armor sets like coats for close Nerf gun combat. Yes.

[0:07:35] RHA: Yes, totally. We're at the grabby phase, so breastfeeding is a whole new challenge now.

[0:07:41] MD: Oh, yes. Oh, I remember that. That hurts. 

[0:07:44] RHA: Yes, one day at a time.

[0:07:46] MD: Especially Ð yes, and then they get like a little hangnail.

[0:07:48] RHA: Oh, gosh, the little fingernails, yep.

[0:07:52] MD: Yes, nope, nope. I just had some core memories I wish we were just far, far away. That's amazing. Okay. All right. Well then, let's roll into it because we have covered a lot of ground. But can you kind of take us to Ð I know we talked about this a little bit when you were first on, but what made you want to be a speech pathologist? Then, how did you hit that shift into pursuing a PhD?

[0:08:23] RHA: Yes, I think it's always so interesting to hear everyone's journeys to where they are in their careers. Originally, when I was much younger, I wanted to be either a teacher or a doctor, and kind of as I explained last time I was on, I found speech pathology and just fell in love with it. I was planning to be a clinician, I wanted to work in the schools, and then I went to Purdue and just fell in love with pediatric dysphasia. I went to a couple of great seminars. I took Dr. Malandraki's dysphasia course. So I was like, "Okay, I'm going to be a medical SLP. I'm going to work with kids.Ó That's what I did. 

I was really blessed to be able to start in that area right after I graduated with my master's and I was working in inpatient and outpatient medical settings, the NICU in outpatient peds, and I really loved it. But I was getting frustrated, as many of us do, about the lack of evidence. I felt, especially in the NICU setting, I was trying to do the best that I could by these babies, and I just didn't have all the information I wanted. When I looked at the literature, I couldn't find it there either.

I had maintained contact with Dr. Malandraki and kind of had the door open to talk about a PhD back at Purdue. I started talking with her, and she had some projects that we're working with, kids that were really interesting to me. I thought about it, prayed about it, talked with my family, and decided that was going to be the next step, going back to kind of try to add to the evidence of what was there from a clinician's perspective.

[0:10:04] MD: Folks, when we're talking about evidence for what it is that we do, we need to put this in reference where the evidence for pediatric feeding and swallowing disorders is Ð to borrow Dr. Malandraki's phrase, it's still in its infancy. We're still, I mean, it's so fresh. A lot of what people are doing, if they may not have that firm of a foundation for their individual treatment methodologies, and treatment approaches, which is why we need people that have a question that want to pursue this to do this. Also, on that note, I have totally frozen the video feed to accentuate two double chins, and I am staring into the distance. And I'm like, "Oh my God, that's great." Rachel, you're just literally going to have to look at my face like that for the remainder of this because it's Ð I donÕt know, itÕs going to crash. 

Okay. We're going to eventually have to take my old laptop here for a tune-up, but I don't know when that will happen. They will add it to the to-do list. Okay. When you say you were frustrated by the evidence, what specifically, what question did you have that sent you there? Because my first Ð we've got to do more, and we need to do better was the vibrating of the faces, and everybody was telling me that we had to wake faces up. I'm like, they're awake. How much more awake can they be? That's what started me Ð honestly, that kind of eventually gave birth to First Bite. Not a PhD, but it led us down this rabbit hole. What was it for you?

[0:11:47] RHA: Yeah, that's such a great question. There were so many things. It was every day there was something new. I think, definitely like vibrating faces was something for me as well. Yes, there were a lot of people doing things that just didn't make sense to me. I couldn't find the evidence to say, yes or no, it made sense. But based on physiology, it didn't make sense. I mean, that's one asset. But the thing that really like Ð the question that I had was actually a little bit different. It was related to the relationship between feeding disorders and communication disorders. Because I would see these kiddos in the NICU, and then I would see them follow up in outpatient months later, and years later, and would see all this cooccurrence, and these weren't kids like with syndromes, or we would expect them to have disorders in both domains.

That was actually the question that led me back for my PhD, was trying to look at the relationship between swallowing and speech and language. That was kind of like I said, I had many, many questions, but that was the one that I really couldn't find anything on, and that I knew I would be able to work on here at Purdue.

[0:12:58] MD: The question that I have, that if we're going to speak it into the universe, I want to know the role of AAC in PFD treatment.

[0:13:07] RHA: Yes.

[0:13:10] MD: Because I use them intimately in treatments, because the children that I see have both, but how, how do I do a better job with that, and I can't find it. That question brought Ð that question is, you have a question, but then when you go to do a research project, don't you have to super narrow it down to like a nano bite in comparison?

[0:13:34] RHA: It's been so interesting. I think so many of us clinicians have so many questions. And then, the PhD process is really teaching you how to be a scientist. That's so different. I think your point is something I'm still learning all the time is like, we have these really super interesting questions. Then, how do we actually get reliable information to help us answer them? Often, that is like taking 15 steps back and making it very small and measurable. That was initially very frustrating to me, because I was like, "No, I have these big questions." Thankfully, in your PhD, you have a group of mentors, and they all over and over again tell me, "Okay, scale it back, scale it back. You have to start somewhere, and then you can build." But yes, you're right. You have to make it a much smaller chunk to start with.

[0:14:26] MD: Yes. Michelle Therrien, Dr. Michelle Therrien and she's out of Florida State University. She talks about AAC, but she talks about making friends with AAC and play. How do you play? Then she was like, "But you can't just research, like play is too big." So she had to like whittle it down to these tiny little Ð and I was like Ð but the way she described that because it was just like the combo of those two. No, this is one day. That's why when you pitch this idea to me, I was like, this is perfect because my soul needs to hear this again. But I only know academia from the perspective of undergrad and grad school. I don't know what does it actually look like to get a PhD in dysphasia. How different is that? What a mind shift is it?

[0:15:21] RHA: Yes, I think that's a great question, and one that I like definitely didn't know how different it would be going into my PhD I've since learned that, because I think like so many of us SLPs are so motivated to learn more, and we're very oriented toward excellence and achievement. So a PhD can kind of feel like the next step. Sometimes, when I hear people talking, but I think I've come to think of it as kind of just a different path. They work together beautifully, but it's a very different kind of training. Like I said a little earlier, it really is a scientific degree. 

So you're using all this clinical information you have, but you are, at the end of the day, learning how to be a good scientist. It's kind of crazy, because Ð thankfully, I still do get to spend time at the clinic and work PRN, but my day-to-day work looks much more similar to my biomedical engineering husband's work than it did to my mom who worked in a school, and what I thought I would do as an SLP. So yes, it's a totally different focus. I think I didn't quite realize how different it would be, but it's all in service of our learning in the profession. It's just that like I was saying before, you have to learn all these scientific skills to be able to answer our clinical questions. It's a lot of background work before you can get to the really good stuff.

[0:16:48] MD: In the world of our fields, I know that there are clinical science doctorates, there are SLPDs, then we have some that pursue educational doctorates, and then some are PhDs. The way it was explained to me was that in academia, in order to like Ð you have to have so many terminal degrees in academia, according to accreditation standards for faculty, right? That's the PhD and a certain amount of educational doctorates, but I like smaller teaching schools. But at the same time, we have a lot of SLPDs in clinical research degrees, and I've had that explained to me because I've asked these questions, like, "Where am I going?"

They talk about, like, how those degrees are more for clinicians that want to engage in research, but it's far different from a PhD, which is a researcher that wants to maybe engage in clinical. Is that like a fair Ð am I butchering that, Rachel? Where are we?

[0:17:59] RHA: I think that's consistent with what I've heard. To be honest, I didn't go down a lot of routes exploring options. I had done research before, I knew I liked it. So, I didn't really explore the SLPD, I just went for the PhD I may not be the best person to explain the difference. I will say that, in the PhD process, it definitely is Ð the scientific training is the primary portion. Then you can use that scientific training toward clinical questions, toward other Ð I know people with PhDs who are in clinical positions, and it doesn't completely limit you to academia, but it is geared toward scientific research.

I'm at an R1 research institution, which there are different kinds of universities. That one is, is very research focused. My PhD experience is always through that lens of, I'm at a research institution, and I'm being trained in research. So there is definitely variation in different programs, but that's my experience.

[0:18:57] MD: Okay. R1, I had not heard of the difference between a teaching institute versus like an R1 or an R2 until I went into faculty. I was like, I was playing along, and nodding, and then finally, I was like, "Dr. Burns, I don't know, the words that you're using in this moment, you're going to have to translate for me.Ó She graciously agreed to explain. R1 is the highest level of a research facility like program, right?

[0:19:26] RHA: Yes, it's interesting. Like you said, there's a whole different world in academia, and I didn't know anything about that going into my PhD I'm still just kind of beginning to learn about all that. But yes, R1 is Ð there's this thing called the Carnegie classifications, basically how they classify universities. R1 universities are like you said, the most research-intensive, and there are like, different specifications for that. I think they have to have a certain number of research base degrees. They have to spend a certain million dollars on research every year, et cetera, et cetera. 

Different institutions meet different qualifications. But often, those R1s are going to be really big schools, like places that have the budget for that. Yes.

[0:20:10] MD: Yes. I went to smaller schools, we were a little more intimate. We were not there, but we made it.

[0:20:17] RHA: I did my undergrad at a teaching institution. I think every type of university has an important place. I absolutely loved my education at the teaching university. They're just different purposes, I think.

[0:20:31] MD: Yes, but that's just it. To be fair, I'm the oldest of five. I actually got my associate's degree first because there was no money for college. I didn't want to go away to a big school for those final two years, because that was overwhelming, and it inked like overwhelming for me. A small teaching school was perfect for it.

Folks, if you're listening to this, and you're thinking about your doctorate, those are heartfelt conversations that you need to have. One of the other thoughts that I had was an eye toward. A couple of years ago in between babies Ð no, I was pregnant with Bear. I had this wild idea to go back to school and get a PhD here in South Carolina, at the University of South Carolina, but I was like pregnant with Bear. What made me think I could do that with a two-year-old or an almost two-year-old and pregnant? That's insane. God knew what he was doing when he said, "This is not the time." But I had a lot of questions about what do the different years look like? Because in my mind, I thought a PhD on paper would be like a master's. Like you take these classes, and then you have this rotation each semester. I'm sure that varies wildly, according to PhDs. But could you talk about what your experience looks like? Because honestly, I really do want to go back, Rachel, but I'm scared to death I'm going to be up until midnight every night and I am too freaking old for that. So, help.

[0:22:02] RHA: Yes. I'm very happy to share kind of my experience. I think your insight is absolutely correct, that I certainly thought it would be more like the master's program, and then was kind of surprised by how different it was. So yeah, I'll kind of walk through my experience, and like I've said, I'm at a big research institution with a fairly large PhD program. There's a pretty established kind of path that we take, and this will vary wildly by institution. But if you're interested in your PhD, and you're listening, these are questions to ask and things to look for in their PhD handbook. From my experience, when you start your PhD, you are going to be taking some classes, doing some research, and maybe doing some teaching. 

The interesting thing is, instead of having, in at least my master's, you have a list of classes, and you take these classes, your first semester, and these classes your second semester. For the most part in my PhD program, it's been basically, there are a few required classes that you can take over the course of several years. But most of the classes are anything. It's like, what classes do you want to take to serve your research?

[0:23:10] MD: Wait. I'm sorry. Like you get to design the program kind of, because it sounds like an ala carte buffet. I'm like, literally hanging on the edge of my seat.

[0:23:23] RHA: Yes. I mean, there are some requirements, like I had to take a stat sequence. You have to take statistics, and I had to take a minimum of three statistics classes. That's a mandatory one and a tricky one. That was definitely the hardest piece even though I like math. I had to take grant writing and scientific writing, so there are some like basic classes that you have to take. There's no necessarily Ð it's not like you have to take this in the fall semester of your first year. But there are those kinds of standards. 

Then after that, yes, it was pretty much a la carte. I could look at classes in our department, and actually, I had to take a lot of classes in other departments just because they want us to be well-rounded. I took a class on human motor development in kinesiology that was all about infant gross motor learning.

[0:24:07] MD: Oh my god. Amazing. Oh my God, that so jives now. Oh, because that was what we talked about the last time. Rachel, ugh.

[0:24:18] RHA: Yes. It's really cool. I mean, I took a class on human nutrition across the lifespan in Nutrition Sciences, and I took a class on family structure and how family structure influences health outcomes. Yes, it's really neat that you can take Ð some of my peers are taking classes on neurophysiology of aging, and gerontology. We can take classes across the university, even in the med school, really whatever is important to our learning, those can be those elective classes, which most of my requirements were electives.

[0:24:51] MD: So are those requirements at like a 600-700 or like a 700-800? How does that work?

[0:25:01] RHA: At our university, I believe 600 and above is what most of those requirements are. So you take a lot of seminar classes, it's a lot of, you know, for me at least, a lot of classes with five, 10, 15 people in it and you're doing lots of discussions. I really loved taking classes as part of my PhD I was really excited to finish that because it was another checkmark. But then once I did, I finished my coursework in the first, I think, two years. Then I was like, "Wait, I can't take any more classes." It was kind of sad.

[0:25:34] MD: I would have been saddened too, because I love Ð yes, okay.

[0:25:40] RHA: Your kind of first few years, you do, at least for me, I did most of my coursework in the first two years. That was Ð I mean, I did have the pandemic in the middle of my PhD I definitely did more classes earlier, because I couldn't do human research. I was just like, I'm just going to load up on all my classes, get them all done in those times when we were not able to have subjects in the lab. Then throughout that whole time, you're still doing research. I have in our lab, we always as PhD students work at least 20 hours a week on research in our lab.

[0:26:10] MD: Okay. So the 20 hours a week, what you say you do research, but like in my head, I'm imagining. I mean, this is terrible. But you know, the Muppets that didn't really talk, but they just beat and pretended they were scientists. Whenever anybody says they're doing research, that's where my inner brain goes. Is the Muppets going with the beakers going, ÒBeep, beep, beep, beep.Ó So I'm like, yes, help.

[0:26:32] RHA: Yes. I can give you kind of a like day in the life in the lab. This is going to really depend on what type of research someone's doing or what their lab is like. But for me, I am in a lab with a good amount of undergraduates, and a wonderful PI, Dr. Malandraki who's very involved. So we kind of go through this Ð

[0:26:50] MD: What is PI? Is she a private like Ð I know Dr. Malandraki is, but it sounds like a private investigator, and that takes another spin on Dr. Malandraki. 

[0:26:59] RHA: I forget sometimes and use all this jargon, which I apologize. I try very hard not to. But when I start talking about my day, it comes out. PI is the primary investigator, so the lead investigator.

[0:27:13] MD: Yes, I don't know. Now, I kind of see her in a Carmen San Diego outfit, and now, that's amazing. Please, please tell her that she's officially Carmen San Diego on dysphagia.

[0:27:22] RHA: Perfect. Dysphasia Carmen San Diego.

[0:27:26] MD: That's amazing. Yes. Okay. So she's the primary PI. Okay.

[0:27:32] RHA: Yes. We have a lab space, so if we're in a season like right now, for example, I'm preparing to start data collection. So I'm trying to get everything ready to start collecting data on this project. I am writing protocols, I'm uploading things to a file sharing sites to make sure that all our collaborators can access them. I'm trying out different software to see if they'll work. I'm ordering equipment. Lots of kinds of random things. Then, once people start participating in the study, I'll be doing Zoom calls with families, or having people in the lab, collecting data. 

Along the whole way with all of this stuff, we also have a bunch of undergraduates who I'm training and teaching. So right now, we haven't started the project, but I want them to know how to analyze the data before the data is coming in. So they have a bunch of practice data that they're working on. I'll set them up on a computer and be like, okay, teach them how to do the analysis, and then they'll practice for a while, and I'll come back and check. It's just kind of a lot of little things that add up to big things.

Then we'll go through seasons, where it's a lot of, I just finished up a bunch of projects. So for a while, I was doing a lot of writing. It was like, I've already collected all my data. So when I say I'm doing "research," what I'm really doing is sitting down at a computer, looking at my data, graphing my data, writing about my data, reading, a lot of reading to try and put it all in context. It's a pretty varied day, but it all is kind of in pursuit of those projects.
[0:29:12] MD: All right. You were talking about sitting there, and then you're reading, and you're absorbing a ridiculous amount of how to write. Are there journals or resources for how to write these data samples? That's a very novice question. I'm slightly embarrassed. I don't know that.

[0:29:30] RHA: No, that's a great question. I think it's actually a really complicated question. I Ð yeah, improving my scientific writing has been one of the things that have been the hardest of my PhD Because there isn't a whole lot of like Ð this is how you do it. I'm blessed and that I am at a university where they have a scientific writing course in our department. Legendary researcher in DLD, Dr. Larry Leonard teaches that class and he's been Ð I don't know, NIH funded and a professor for years, and years, and years, and years.

We're lucky enough that we have that class, but even with a whole class, there's still so much too that goes into writing a scientific article. I am a great clinical writer, I am very descriptive, and I can write a narrative quite well. But communicating scientifically is a whole different skill set. That has been a challenge, and this is where, in the PhD, the mentor-mentee relationship is super important, because they're the person who's going to be really helping you with that. 

Dr. Malandraki is the one who looks at all my writing and gives me all my edits and advice. Over the years, I've gotten better incrementally, but she still has lots of feedback. That's what really helps you grow is that mentor. That's why you want a really great mentor who will help you with that because you definitely need a guide. Because it's not a straightforward process to learn how to write scientifically, for example.

[0:31:02] MD: I've gotten feedback that my writing is too emotional. I'm like, "Well, I'm not writing scientifically. My purpose was to be emotional in my writing too.Ó We just took on a project, which I don't know if there'll be approved, but we submitted a couple of journals to the Journal of Speech-Language and Hearing Science for Pediatric Dysphasia in the public schools, PFD, and dysphasia. Hasn't been updated in 14 years, and Dr. Goza was like, "Let's do it." I'm like, ÒAaaahÓ, so we did it. 

The feedback at every turn has just been so overwhelming, but I have never been trained, so that's huge. But it also Ð having a mentor Ð folks, if you're listening, don't just seek out mentorship for one aspect of your career. Find mentors for different aspects. Dr. O'Donoghue, at James Madison, who was retired chair there. I reached out to her back early earlier this year and was like, I need help learning how to engage with my distance education students better because that's hard. Like to create buy-in when they're just talking into a computer, but like there's a mentor for this.

[0:32:24] RHA: Yes. Kind of aspect that makes a PhD really different in a clinical master's program. So in your clinical programs, you have a cohort of people, and you're doing similar things, and you have lots of maybe clinical supervisors. But in your PhD, at least in my experience, you aren't relying as much on the other PhD students. It's really you and your mentor. They're the ones who are kind of guiding you through every step of the way. That can be really wonderful, and really challenging. I think every single PhD student I know has Ð their mentor becomes a super important person in their life. It can be tricky, because they're busy, and you're busy. They're kind of in charge of your progression the whole entire way. 

You want to have a mentor who you can work well with. I think when we think about applying to a master's program, you're applying to a program. But when you're applying for a research doctorate, you're really applying to a lab or a mentor. The university may matter less than the individual person that you're going to work with, because they're the ones who are going to Ð who are going to be teaching you about research, helping your writing, showing teaching you how to mentor, giving you access to things. I think that's something that is one of the most fundamental differences is that, yes, you do apply to your PhD to a certain program. But whether or not you get into that program is really just going to depend on your mentor.

If you find a mentor, you want to talk to the mentor. They may Ð you may like them, they may like you, but they may not have space in their lab. That's nothing you could have done to make yourself a better candidate. It's just a matter of resources. That's a really different piece of the application process, it's really all down to what that mentor has resources for and whether or not you guys are a good fit together.

[0:34:20] MD: Dr. Norman gave me advice when I was starting to look and she goes, "Yes, you want to apply. But first, Hold the conversations with the labs." You don't want to go through the in-depth application process if they don't have, or if they know the funding is going to run out or Ð I was like Ð where is this information? Is there a secret handbook on how to get a PhD? She was like, "No, we just pass it along." I'm like Ð

[0:34:51] RHA: Yes. That's why I'm glad we're talking about this, because I think it is really hard to know where to start if someone's thinking about it, and doesn't have a connection, which is where you think about access, and equity, and stuff. I have the extreme privilege of Ð my dad has a PhD He's the one who told me, to find a mentor, and I would have had no idea. That's why I wanted to talk with you so that we can kind of pass this type of stuff on to other people because it is a confusing world, and there's a lot of politics and a lot of like do's and don'ts. I think this is one example of something that I never would have known if it hadn't been for having an in kind of having a dad who knew this. 

[0:35:31] MD: Yes. I mean, this is Ð I mean, my parents have their college degrees, but they were the first in their families to actually attain that, but this is a privilege. But you have to then forge your way and then Ð

[0:35:47] RHA: Pass it on.

[0:35:48] MD: Pass it along. Okay. Then how, and this is like Ð please don't feel obligated. Wait, I just lost my mouse. To answer the personal details on this. But like one of the things that I got feedback on was, and for us, it's been okay, but we have a mortgage payment, and we had two children in daycare. To be fair, daycare in Columbia, South Carolina literally cost more than our mortgage payment, which is a whole other conversation on equity that I don't have time to go down. But I think, humbly, daycare should be free, and it should be well-educated, and well-funded. That's a way to keep women out of the workforce. I will go there and then digress. 

But how about budgeting? Are there funds? How is it paid for? Because that's a fear, that's a huge unknown for a lot of people. 

[0:36:49] RHA: Yes, I'm so open about this, and happy to talk about it. I know a lot of people are not, but I think if we don't talk about it, how can we ever pass on? How can people do this? Because it matters. 

[0:37:00] MD: Okay. Also, aren't you Ð this came Ð now, you got me fired up. This came up in class the other night where the students were like Ð one of them called me Miss Dawson. I was like, "Please, just call me Michelle, because you're going to be a colleague in three months." But they're not given advice on a competitive salary for a CF. Why? Why do we not talk about that? Because men talk about it. So why, because I have a tootie ta? Are we not allowed to talk about competitive starting salaries? Just going, okay.

[0:37:31] RHA: I think we do need to talk about money and our field is not great at it. I'm happy, I'm happy to start here. Something that Ð coming from Ð knowing people with PhDs, and a piece of advice I was given was, "You should never pay for your PhD. You should only go to your PhD if it is paid for." That's kind of the expectation. Often, I mean, you are working for that. For example, I had a fellowship for the first part of my PhD That was when I applied, they submitted all my stuff to the whole university, and I happened to get selected. That was a wonderful gift that I had my first couple of years paid for with a stipend. It was just a fellowship.

Most, I would say people become research assistants or teaching assistants. In that way, you are working in order to have a stipend and pay for the PhD But I don't know anyone who's paying out of pocket for their PhD That really is not the model. That's something that if a place doesn't have funding for you, I was given the advice of, if they don't have funding for you, that's not the place for you. I think there's a bigger conversation to be had here that a lot of universities are having right now about what is fair funding. Because I'll be completely honest, I think I took a $30,000 or $40,000 pay cut to come get my PhD 

It's not like I was making a crazy amount of money as an SLP, it's a pretty Ð I feel very blessed that my PhD has been paid for, and that I am being paid. But it is a very low salary compared to a clinical SLP. I think that's a big barrier of why we don't have many SLPs in our field, is when you're able to make a good salary to say, "Okay, I'm going to take a huge pay cut and go back to school full time." That's a really Ð just many of us don't have that option. My husband and I were both working on our PhDs at the same time. So because we had dual income, and we had already bought a house, we'd already bought a car, and we live in the Midwest, which is really reasonable. All those things made it feasible for us financially. But I think that's a conversation that universities are starting to have and our profession needs to have. If we need people with PhDs, we need to be able to afford to get our PhDs
[0:39:59] MD: That was ultimately Ð it was like, "Okay, you could do this." But one, it wasn't in a field of research I was passionate about. It wasn't in dysphasia, which is Ð nor anything close to AAC. So if it has nothing to do with that, that was a barrier. Then two, with Bear on the way, knowing that our daycare expenses were going to jump like $600, $700 a month. The south is not Ð I mean, it's less expensive to live than like for say, parts of Virginia but. But at the same time, this is Ð also folks and editors, please don't edit this out. In the course of Rachel's nice conversation, the lenders just called about the pre-approval on the mortgage. I was like, "Rachel, I love you. We have to take this call for two seconds."

The first half of this lecture had a whole lot of edits in it to celebrate life. She's given me grace, so thank you.

[0:41:02] RHA: Of course.

[0:41:03] MD: But those would have been impossible.

[0:41:05] RHA: Absolutely. 

[0:41:06] MD: Yes.

[0:41:08] RHA: I mean, we had our first child while I was doing my PhD, I am doing my PhD She's six months old now, and we live near family intentionally because we are not paying for childcare. There are new things where like, for example now, I'm funded by the NIH, and they do have a childcare grant that automatically comes through my fellowship, which is wonderful. It's a new thing in the last couple of years, and I think there's increasing awareness. Now, the childcare grant is not anywhere near enough to cover what daycare would cost here. But it is a start. I mean, Purdue also has, every semester, there are childcare grants for grad students that you can apply for.

People are starting to talk about this more, and it is on people's minds. But these practical reasons are not kind of extraneous to the PhD process. I think they're really central, because if you can't afford to go for PhD, if you can't afford to live, you're not going to do it. I think, yes, we need to really be thinking about it and talking about it. It's not wrong for all of you listeners who are thinking about your PhD to be asking those questions and looking for that information, because those are really important as you're weighing your decisions.

[0:42:29] MD: Then, what about the ones that have families, because I know I've talked to colleagues that already Ð whether they have their own biological children, or they're raising someone else's, or they are taking care of aging parents. Because that, I mean, you might have gotten your humans out of your tiny nuts or tiny humans up and gone. Now, you're, I don't know, just turning 40 and contemplating the next step in your life. But when there are those variables, I worry about, on my end, the time, and the age in my career. That's a very candid, honest, raw, like, "I want to work another 25 to 30 years. That's my goal. I'd like to retire by 70." I don't know what I'm going to do. I can't imagine not being a speech pathologist. God help us all.

They're like, "She cannot." We attempted for me being a stay-at-home mom for the pandemic, and I think I repainted every room in the house at least twice. So it's not good. It's not good. But how much time does it take like, truly to get a PhD?

[0:43:39] RHA: That's a good question, and unfortunately, I don't have a great answer.

[0:43:44] MD: That sucks.

[0:43:46] RHA: It really depends on your program and your mentor. For example, I'm at a research institution, and I'm going full-time. It is absolutely a full-time job, maybe more than full-time. With the pandemic, and maternity leave, I'm probably going to Ð it'll be about five years total, but I've been working full-time in it for most of that time. Now, I know other people who have had programs and mentors that have been willing to do part-time work, and that is what really comes down to talking with that mentor of, "Is this realistic?" For a program like I'm in, it just wouldn't have been realistic. It really is a full-time load for multiple years to get done. 

I mean, the good news is, I am not going into debt, I am being paid to do it, so it is my job. I'm just making less money than I would be in the hospital. It's things to consider, but it is a large undertaking. I think talking with your mentor about what's reasonable, I know I talked to Dr. Malandraki at the beginning of, "Okay. What timeframe do you think is reasonable? What kind of flexibility do we have?Ó All these things.
We set that out at the beginning, and I think it's been really helpful and accurate for my situation at my university. That's the conversation to have with those potential mentors is, could I do this part-time? Could I do this over while I'm working? I think a PhD in particular, is hard to do part-time because it's designed to be full-time in a lot of places. For example, at my university, it's absolutely Ð I think every single one of us are doing it full-time. But that's not the case for everyone. I know other people who have different schedules, and so it can be done.

[0:45:34] MD: I mean, I enjoy working full-time. I worked multiple part-time jobs that somehow add up to several full-time jobs. I'm not quite sure. It's so funny when people are like, "What do you do?" I'm like, "Which day of the week are you asking?" Because like that's a different Ð like, this day I do this, this day I do this. That to me has been a concern. Also, the trickle over after hours, like with families, there's a hard stop where you have to be able to walk away and be present. When I was a grad student, there was no trickle-over. It was late-night hours studying on the weekends for hours. Is that still a thing or is there a better boundary there?

[0:46:23] RHA: I would say that's super personal. The PhD, one of the really nice things about it, and not nice things is that it's like ultimately flexible. There's no, like I said, you're choosing your classes, you're making your own schedule. You are Ð it's kind of up to you. If you want to power through and finish faster, you can. If you want to go slower, you can. For me, because I worked between my master's and PhD, I was like, I do not Ð I need my evenings and weekends for family.

I set a pretty hard boundary for myself that like, I'm going to work working hours, then I'm going to stop. I think the tricky part about the PhD as opposed to the master's is, in the master's, you have a to-do list of doing this SOAP note and studying for this test. In the PhD, my to-do list never ends. I mean, it is years long to-do list. So you have Ð

[0:47:20] MD: It's terrifying.

[0:47:22] RHA: I know. Like literally, some of my things are like, "Okay, work an hour on this thing that is due in 18 months." The timeline is very different. You are the one who's determining what you're working on. I kind of made myself a boundary that was like, "Okay, these are my working hours." Of course, there are times in the PhD when we're in a really heavy data collection season where there might be weeks where it's like, "Okay, this child is flying in from Texas who has CPE, and they can only come on a weekend. I'm going to work that weekend.Ó That's a decision that I've made. 

But on a week-to-week basis, I really try to keep it in working hours. I think some people do not. They work 80 hours a week, and that's what they want to do, because they want to finish faster. I've just decided I want a life, and so I'm going to try and keep those boundaries as much as I can. Of course, there are seasons where I can't, but for most of the past few years, I really have only worked during working hours.

[0:48:24] MD: Send that vibe my way, as I'm presenting tonight. Honestly, I think two to four nights for the last three or four weeks, I've been like scheduling meetings after hours at like eight o'clock at night. But like eight o'clock, I can tuck the kids into bed, we can do family prayers, and then I can like hop on a call. I'm like, "We're so close, just a little bit more." Then we're on the other side of this volunteer project.

[0:48:53] RHA: Yes. That is the beauty of the PhD, is it's very personal. But that's also Ð it matters who your PI is and what they expect of you. That's a conversation to have with them as well.

[0:49:04] MD: That's good advice. Yes. But also, your person cares about people being as a human. That's huge. The amount of love that she emanates is just Ð

[0:49:16] RHA: Oh, yes.

[0:49:17] MD: Yes. Most excellent. Okay, all right. Because Rachel is this phenomenal person, she gave me the most detailed outline for today and it's like goals. I wish I was this organized as I'm sitting over here looking at all of Ð all right, your current research, what can we Ð I know you haven't totally published, and we're there, but what are you doing? It is Dysphasia Awareness Month and this yumminess.

[0:49:52] RHA: The exciting part about getting further in the PhD process is you get to do more of what you're interested in. At the start of the PhD process, oftentimes you're working on things that are already ongoing in your lab so that you can learn things. So like coming onto a project, and learning the methods, and observing, and taking on portions of it. Then when you get to your dissertation, that gets to be more, what do you want to do? So, yes, I am starting to work on a project on kind of the question that I said brought me to my PhD 

I'm looking at the relationship between feeding development and communication development in infants. Right as they're starting solids, and starting babbling, and so I Ð I'm just starting that, so I don't have any data to share with you, but it is exciting. In my previous projects, we're on older kids, kind of learning the methods. We found that in seven- to 12-year-olds, there are some links between language skills, and feeding, and swallowing skills, in typically developing children and in kids with CP. 

Now, I'm kind of taken that back to a younger age range. But the data that we have, like I said, I've just finished a whole season of lots of writing, and so that hopefully should all be being published relatively soon. What we found was that, even though kids use different amounts of muscle activity for speaking and swallowing, they do some of the same patterns. As they do more complex tasks, like for instance, chewing a giant pretzel rod, something a little more challenging, or repeating the whole sentence, that's a more challenging task. They use more muscular effort in the same way for speech and swallowing. 

They may use different amounts, but they're showing the same patterns as the tasks get harder. That was kind of my last project, and really interesting. 

[0:51:55] MD: How did you measure the muscles? 

[0:51:57] RHA:  We use surface electromyography, which are these little sensors that go on muscles, and they measure electrical activity. When your muscle fires, there's an electrical burst.

[0:52:06] MD: How could they not eat them? I'm so sorry, my mom mode, I'm like, "How did they not get the Ð like, how did you Ð how?Ó

[0:52:14] RHA: This is, we were working with older kids, so they were seven. So yes. They were like, we put sensors right around their lips, and then on their segmental muscle region. We did lots of coaching, and they got to touch them and see them on a little stuffed monkey. These are the things in research that you learned. How do I get children to not mess with thousand-dollar sensors?

[0:52:39] MD: I want to take that class. Okay.

[0:52:42] RHA: So you asked what I do on a daily basis. Some days, we're okay. How could we put these sensors on? Yes, lots of problem-solving. But yes, we found some really interesting results from that. That's going to be published here soon. Then, as I said, I'm going to be doing a different type of study, but also looking at communication, and swallowing in those little kids. So I'm excited to see what we find.

[0:53:08] MD: I want to learn more about the evolution of mastication and how that ties in with cognition. Because there was some research, and I think it was published in dysphasia a while ago from Dr. Reva Barewal, she's the woman that created savories, those transition crackers. She partnered with a woman, I think it was at the University of Washington or University of Oregon. I'm butchering this, but they specifically looked at mastication, and food preferences for children with Down syndrome. It was really, really fascinating how the preferred food group was like a smoosher, like Ð right? Yeah, y'all can't see I'm like making the face while Ð the different eating style. That was what they found, but it made sense, like on my hand as the clinician that have worked with a lot of patients that have Down syndrome, and they prefer that, IDDSI level five consistency. 

What they found, but then, they were talking about the evolution of mastication and cognition, and they broached on it, but like it didn't deep dive there. But that makes sense that you gain mature mastication patterns when you're like school age, not in our infancy that it makes sense that you're going to have a cognitive growth there because you're starting Ð that's a whole another stage of cognitive Ð you see what I'm saying?

[0:54:39] RHA: Yes. I think that's a super interesting question. I think what you said just kind of highlighted kind of the nature of research of like, they looked at that specifically in one population in Down Syndrome. I think that's kind of like what we talked about earlier, of like dialing your questions back. It's like, we may be interested in like, "Okay. I want to know everything about the development of mastication, but where are we starting." Oftentimes, looking at one population or in just typically developing kids is a place to start because it gives you a mechanism of physiology you can look at. Okay. We know these things about Down Syndrome. We can easily identify these kids because they have genetic markers.

So then, you can make a study, and that's kind of the first step. Then the next study, maybe it's a different population, or is typical development, and research is a very Ð you have to be very patient because the rewards come much longer. For your idea of looking at cognition and mastication, it might be like multiple studies over many years to try and answer that one question. But it's worth it, and that's why we do what we do.

[0:55:39] MD: Okay. So then, what about the first one about feeding in AAC? What if we were to look specifically at a neuro-diverse population, and their access to a robust communication system on a speech-generating device, and how that positively or negatively influences their multidisciplinary caregiver-led, caregiver-driven, child-led feeding session?

[0:56:07] RHA: Yes. It'd be super interesting. I mean, I can Ð because I'm being trained in this, and I have a million questions of what outcomes are you measuring and what Ð

[0:56:15] MD: I know.

[0:56:16] RHA: But I think that's a wonderful place to start, and that's why we're Ð we're talking about mentors. That's where you need that research mentor who can look at that question and be like, "Okay, here's the nugget of what you want to learn." Now, how are we actually going to reliably measure that, in which kids? The years of experience really do help. I come up with so many questions in my committee because in your PhD, you have a committee of multiple people looking at your stuff. 

I have a kinesiologist, and a nutritionist, and obviously, Dr. Malandraki is a speech pathologist, and I have a statistician. They each come at the question from different ways, and are like, "Have you thought about this? Have you thought about this?" That's really how I'm learning to ask the right question. That's why you do go to school to get a PhD Because it's like, there's so much to learn and think about, and it's exciting, but overwhelming.

[0:57:04] MD: I'm taking this all in and like, okay, but we could do this. Another idea I have is, what about the language that happens at the busy juncture points on a playground? I mean, we talked about like communication boards, that's part, that's a step. But like, having communication in the moment, and like, what if all playgrounds were universally accessible? But when we say that, universally, like taking to account also like our friends that have vision and hearing deficits. I'm gesturing towards my ear, a little bit of a [inaudible 0:57:34] today. But like, yes.

You just get me so excited. I'm all ignited. Yes. Okay. I feel like there's more on here than what Ð walk away. When somebody walks away at the end of today, what do you want them, and they're like, "I am frustrated about this act at work." I heard Louisa Ferrara, she's on the committee. She was doing a presentation on sleep. Sorry, Rachel and I are on the PFD committee together. But Louisa is on and she was doing a presentation at ASHA on CPAP. Like, why her body of research and what she has garnered says, "We don't feed infants, and toddlers, and children that are on CPAP." Her counterpart was someone who felt differently. But, yes, so not touching that with a 10-foot pole, we will have I'm going to ask Louisa when I build up the confidence to come on to talk about that. 

But she also was somebody at some point in time was like, "No, I got to go back and get my doctorate." What is your pearls of wisdom if somebody's on the fence right now? 

[0:58:49] RHA: Yes, I would say, my big takeaway is like, I wouldn't think of a PhD as a next step for a speech pathologist. I would think of it as a different path. It's super interesting, and important, and we need people doing this research. But I think learning as much as you can about the process, and about the reality of it is important as you're considering. So talking with a mentor, looking at financials, thinking about all these different elements of your life is my biggest pearl of wisdom. Is that, this isn't just like a master's 2.0, it's a very different animal. It's a different way of thinking, and it really is scientific training. 

If that's something that you're interested in, talk to a mentor, talk to several mentors, visit their labs, and read PhD handbooks on people's websites. Those really tell you the architecture of each program. Just try and get in conversation with people who have done their PhD, are doing their PhD, and trying to help you determine if that's really the right fit. Because there are lots of ways to be involved in research, and the PhD is, I would say, like is a very scientific way of getting your own scientific training. But if you want to be involved in research, I know in our lab, we often need clinicians for portions of our projects. That can be a way to get your foot in the door and kind of see, "Okay. Do I really like this? Am I really interested in this?" So yes, just talking to those mentors and people in the field in academia before you jump all in and dive in, I think is a great place to start.

[1:00:27] MD: Excellent. What are you going to do when you graduate?

[1:00:30] RHA: That is a great question. When I came into the program, I was convinced I was going to go back to the hospital, back to the clinic, and maybe do clinical research. Then, throughout the process, my favorite part has been teaching. I really love teaching and mentoring students. I don't know exactly what that's going to look like, but I could see myself being a professor at a teaching institution, supervising, and doing a variety of things. I think, I'm not sure what that is going to look like, but I definitely want teachers to be a part of it.

[1:01:05] MD: Beautiful. In a lab. Head to your own lab, whether Ð I mean, maybe not like Ðbut you have so much there, and it'd be so awesome to watch you teaching, and then having them in the lab, and like guiding that.

[1:01:21] RHA: I feel like God has opened the door each step of the way of, I never planned to get my PhD I never planned to do any of this. It's like, each step, God has shut doors, and open doors. I really believe that each step of the way, I'm going to know what comes next. I don't know what five years from now looks like. But hopefully, I'll know what the next step makes sense to be.

[1:01:40] MD: How I get that in my soul? Yes. Oh, my friend. Okay. Well, thank you. Thank you. Thank you. Okay, wait. Love money. At the end of every episode, we talked about a little bit of love money. That's what my grandma called it, love money or mad money. If somebody is listening, and they have a little bit of love money, or mad money laying over at the end of the month, where do you recommend that they could donate to or share?

[1:02:07] RHA: I mean, I think Feeding Matters is the first one that comes to mind. I work with pediatric feeding disorders. They have done such great work with advocacy, with support for families. I think that's a wonderful place to start another one. As a scientist, very near and dear to my heart is the Dysphagia Research Society. That's really the premier scientific group studying swallowing. Donating to that group enables scientists like me and my mentor to keep doing the projects because we can't do these projects without funding, or places to publish your conferences to go learn it. Those are two organizations that I think come to mind first.

[1:02:49] MD: Excellent. Okay. You heard it. If you've got extra mad money, or love money, Feeding Matters and Dysphasia Research Society, and I love them both, so has offered this. Rachel, if somebody has a question and wants to reach you afterward, how can they contact you?

[1:03:06] RHA: My email is always open. I think people don't realize that about people in research, we really like to hear from you. If you need a copy of a paper, if you have an idea, if you have a question, reach out to me. My email is hahnr@purdue.edu. I will be happy to get back to you. I will be happy to get back to you. I never hear for as many people as I'd love to. Please send me an email and I really will respond.

[1:03:30] MD: Yay. If you email me or Instagram me, I will get there, but it might be two months.

[1:03:37] RHA: [Inaudible 1:03:37] your audience than I do. Not that many people are reading my publications.

[1:03:42] MD: Normally, it's honest to God, it's all SCSHA. I'm sorry, South Carolina Speech and Hearing Association. We've been working on baby net initiatives. So people like the message and it's like, it's all SCSHA stuff. But like we are going to make it better. I couldn't see that, but I was like fist bumping in my hand because like Ð

[1:04:02] RHA: Watch it. 
[1:04:02] MD: Yes. I'm sorry. They have non-licensed individuals acting as early interventionists, who feel that it is their job to teach people, and caregivers how their child should eat. Oh, you know, they might have a bachelor's degree in anthropology. 

[1:04:16] RHA: Yes. Our skills matter, people.

[1:04:21] MD: Yes. Okay. On that note, hit us up on First Bite Podcast on Instagram, on First Bite Podcast on the Facebook page. Then, you know we love it when you hop on over to First Bite podcast on the Apple podcast and hit five stars, and leave a kind and gentle review. Rachel, thank you. Thank you. Thank you.

[1:04:46] RHA: Thank you. It is great to be here as always.

[OUTRO]

[1:04:51] MD: Feeding Matters guide system-wide changes by uniting caregivers, professionals, and community partners under the Pediatric Feeding Disorder Alliance. What is this alliance? The alliance is an open-access collaborative community focused on achieving strategic goals within three focus areas; education, advocacy, and research. Who is the alliance? It's you. The alliance is open to any person passionate about improving care for children with a pediatric feeding disorder. Today, 187 professionals, caregivers, and partners have joined the alliance. You can join today by visiting the Feeding Matters website at www.feedingmatters.org. Click on the PFD Alliance tab and sign up today. Change is possible when we work together.

That's a wrap folks. Once again, thank you for listening to First Bite: Fed, Fun, and Functional. I'm your humble but yet sassy host, Michelle Dawson, the All-Things PEDs SLP. This podcast is part of a course offered for continuing education through SpeechTherapyPD.com. Please, check out the website if you'd like to learn more about CEU opportunities for this episode, as well as the ones that are archived. As always, remember, feed your mind, feed your soul, be kind and feed those babies.

[DISCLAIMER]
[1:06:31] MD: Hey. It's Michelle Dawson. I need to update my disclosure statements. My non-financial disclosures, I actively volunteer with Feeding Matters, National Foundation of Swallowing Disorders (NFOSD), Dysphasia Outreach Project (DOP). I am a former treasurer with the Council of State Association Presidents (CSAP), a past president of the South Carolina Speech Language and Hearing Association (SCSHA). A current board of trustees member with the Communication Disorders Foundation of Virginia. I am a current member of ASHA, ASHA SIG 13, SCSHA, The Speech Language Hearing Association of Virginia (SHAV), a member of the National Black Speech Language Hearing Association (NBSHA), and Dysphagia Research Society (DRS). Additionally, I volunteer with ASHA as the topic chair for the Pediatric Feeding Disorder Planning Committee for the ASHA 2021 convention in Boston. I hope you make it out there. 

My financial disclosures include receiving compensation for First Bite Podcast from SpeechTherapyPD.com, as well as from additional webinars, and for webinars associated with Understanding Dysphasia, which is also a podcast with SpeechTherapyPD.com. I currently receive a salary from the University of South Carolina in my work as an adjunct professor and Student Services Coordinator. I receive royalties from the sale of my book, Chasing the Swallow: Truth, Science, and Hope for Pediatric Feeding and Swallowing Disorders, as well as compensation for the CEUs associated with it from SpeechTherapyPD.com. Those are my current disclosure statements. Thanks, guys. 

[1:08:28] EF: The views and opinions expressed in today's podcasts do not reflect the organizations associated with the speakers and are their views and opinions solely.

[END]
FBP 238		Transcript

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