EPISODE 265

[INTRODUCTION]

[0:00:14] MD: 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 Peds SLP. I am a colleague in the trenches of home health, early intervention right there with you. I run my own private practice, Heartwood Speech Therapy here in Cola Town, South Carolina. And I guest lecture nationwide on best practices for early intervention for the medically complex and fragile children. First BiteÕs mission is short and sweet, to bring light, hope, knowledge, and joy to the pediatric clinician, parent, or advocate.

[0:01:01] EF: By way of a nerdy conversation, so there's plenty of laughter, too.

[0:01:05] MD: In this podcast, we cover everything from AAC to breastfeeding.

[0:01:10] EF: Ethics on how to run a private practice.

[0:01:12] MD: Pediatric dysphagia to clinical supervision.

[0:01:15] 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.

[0:01:25] MD: To break down the communication barriers, so that we can access the knowledge of their fields.

[0:01:30] EF: Or, as a close friend says, ÒTo build the bridge.Ó

[0:01:34] 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.

[0:01:45] 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.

[0:02:06] MD: Sit back, relax, and watch out for all hearthÕs growth, and enjoy this geeky gig brought to you by speechtherapypd.com.

[DISCLOSURE]

[0:02:22] MD: Hey, this is Michelle Dawson, and I need to update my disclosure statements. My non-financial disclosures. I actively volunteer with Feeding Matters, the National Foundation of Swallowing Disorders, NFOSD, the Dysphagia 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, and a current Board of Trustees member with the Communication Disorders Foundation of Virginia. I am a current member of ASHA, ASHA SIG13, SCSHA, the Speech-Language-Hearing Association of Virginia, SHAV, a member of the National Black Speech Language Hearing Association, NBASLH, and Dysphagia Research Society, DRS.

Additionally, I volunteer with ASHA as the topic chair for the Pediatric Feeding Disorder Planning Committee for the ASHA 2023 Convention in Boston, and I hope you make it out there.

My financial disclosures include receiving compensation for the First Bite Podcast from speechtherapypd.com, as well as from additional webinars and for webinars associated with Understanding Dysphagia, which is also a podcast with speechtherapypd.com. I currently receive a salary from the University of South Carolina for my work as an adjunct professor and student services coordinator, and 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.

[0:02:23] EF: Hi, this is Erin Forward, and these are my disclosure statements. I receive a salary from Cincinnati Children's Hospital Medical Center. I receive royalties from SpeechTherapyPD for my work with First Bite Podcast and other presentations. I also receive payment for sales from the First Bite boutique, which I have with Michelle Dawson.

For non-financial disclosures, I am a member of ASHA and a member of Special Interest Group 13. I also am a volunteer for Feeding Matters. I am a contributor for the book, Chasing the Swallow with Michelle Dawson, which I receive no financial gain. I also am a member of the South Carolina Coalition Committee with ICLDIF full-time.

[0:05:01] EF: The views and opinions expressed in today's podcast do not reflect the organizations associated with the speakers and are their views and opinions solely.

[INTERVIEW]

[0:05:10] EF: Okay. Hello, and welcome to First Bite. Today, we don't have Michelle. You just have me, Erin. And I am excited, about the title, which I always forget what I title these episodes. We're talking about mentorship and pediatric feeding therapy, what we have to learn as mentors and mentees. I'm really excited because I get to have one of my favorite people on the podcast today, Taylor Anderson, who Ñ we have like a funny, how we Ð I guess it's not funny. It's funny Òhow we metÓ story that, which involves Michelle just being Michelle, and I can let Ð I don't know. Do you want to tell the story? We'll tell the story afterwards.

But Taylor was my first, and I don't like to call you a mentee, because I feel like we mentored each other, but you were one of the first people that I really was able to learn about how I like to mentor, but also, somebody who really got the way that I think, which I hadn't really experienced since Michelle, but that was just a very different relationship. I think I very much needed Taylor in my life at the time, especially with therapy and to be able to watch her grow and build her confidence and just hone into the very grounded, kind, and intuitive therapist that she is was just a very Ð I felt very honored to be a part of that, because Taylor just has really great instincts in herself. I think it's always helpful to have somebody who can see that in you and can just almost tell you you're right when you're right, I think is what we all need.

It made for a very easy mentorship experience, but I think we both learned a lot. I wanted to have Taylor on to talk about our experience of building that relationship. Granted, she is now one of my very best friends, which is not what happens with every mentor-mentee relationship, but we're lucky enough that that's what happened for us. And so, I wanted to pick her brain and she's taking on a role in her position now, where she's going to start mentoring people. In pediatric feeding therapy, it's such a niche part of what we do as a speech pathologist. That's the question, Michelle, and I get the most, I think is how do I get mentorship? How do I find a mentor? How do I mentor people in this section of what we do that there's not as much information that we get in grad school? I will let Taylor, I'll let you introduce yourself. Michelle and I love a little background knowledge of how you started as a speech path Ð or going into speech, up into what you're doing now.

[0:08:07] TA: First of all, thank you for that warm welcome, all those kind words. I don't even know what to do without that. Likewise, back at you. We've been talking about doing it for a while and I think it was a little hesitant about it. But then, you brought up talking about mentorship and this is like, I've had such a positive experience with you.

[0:08:26] EF: This is really just to warm her up y'all. She'll be back. I tried to pick the topics, too, and she's like, ÒI don't think I'm ready for that.Ó We're still building the relationship.

[0:08:38] TA: Yes. You know that I have significant imposter syndrome, like many of us, unfortunately. I was like, ÒWhen do you want me on this for? What am I going to share with the people that listen to First Bite? What do I have to offer?Ó Mentorship is, I think it's such a big deal and we had such a great experience that I'm so happy to talk about that and encourage others to seek out mentorship like we have.

Okay, so a little bit about me. I'm an SLP currently working in Tampa. From California originally and made my way across the states via a grad school in Boulder and then a couple of years in South Carolina and ended up here. I've worked in mostly outpatient settings, early intervention, private practice, some health, and my special interest areas are feeding, grant coaching, AAC, all the things that you guys talk about so often on the pod are the things that fill my cup and guide my practice, too.

[0:09:32] EF: What made you want to go into speech?

[0:09:34] TA: Yeah, how I found it. I worked with kids for a while. I was a nanny and just knew I wanted to do something with kids. I thought maybe a teacher. I bounced around different ideas as a child development major for a minute. Then one of my kids that I nanny for was getting early intervention services. He had OT, an SLP in the hole. Once I saw those sessions, I was like, ÒYeah, this is what I need to be doing.Ó Funny enough, I thought OT first. That's what I was leaning towards and then I was a bit overwhelmed by OT and speech seems more Ð I was like, ÒThis is just about talking. This will be more simple.Ó Turns out, I could not have been further from the truth, and actually, what I love most about speech is how complex it is and how broader scope is, and I think I ended up in the right space.

[0:10:26] EF: I feel like OT is very Ð they work on activities of daily living, which can involve pretty much anything but communication and feeding are so all encompassing in our day, so it's different level of that. I think what was really cool, too, with our journeys is that we were going through similar trainings, too. We took the TBRI, Trust-Based Relational Intervention training together and then I was taking some floor time courses and then you started taking Ð well, actually, we took our one-on-one together.

[0:11:00] TA: We did. Yeah.

[0:11:01] EF: We took our one-on-one together. And so, it is really cool to be growing your knowledge and understanding with somebody, because it's almost like, somebody that gets you and knows you, you're then able to take what you're learning and processing and filter it through them a little bit, which I think we did for each other. Taylor ended up at the private practice that I was working at, because Ð

[0:11:31] TA: Well, should we tell the whole story?

[0:11:33] EF: Yeah, we'll tell the whole story. Yeah. People like the story.

[0:11:36] EF: Okay. It's just such a classic Michelle thing that I feel like it needs to be shared. I was in my clinical fellowship working at a clinic on the coast of South Carolina. That's not where Erin went. I knew right from the jump that I wanted to go into feeding. As a lot of us know, it's hard to find a mentor or a position at an entry-level going into feeding. I just took this job and went about it on my own and was seeking out my own resources and listening to podcasts and reading books and taking courses and just trying to figure it out.

One of the podcasts I was listening to was First Bite. I remember on one of the episodes, you guys mentioned South Carolina and I was like, ÒOh, my gosh. They're here. They're in the state.Ó I reached out to Michelle. I think it was about billing. I just cold messaged the First Bite Instagram handle and was like, ÒI'm an SLP here in South Carolina.Ó Just a lot when it comes to the CPT codes and diagnosis codes and I don't know how to ethically and appropriately bill for my services.

She was like, ÒHere's my number. Give me a call. Let's talk about it.Ó She was just so kind and supportive and helpful and guided me in the right direction. I told her that I was living alone there. She just was like, ÒHere's my number. Here's what I'm doing next weekend. Come up to my place. Meet my boys.Ó It was during the holidays. ÒWe're going to make cookies and look at Christmas lights.Ó I did, and I spent a day with Michelle's family and it was lovely and we connected right away. She was just exactly what I needed and I'm so excited to just have someone in my corner that I could go to, and because I was desperately seeking that. I was just so hungry for any guidance related to feeding.

Then, I think, it was a month later, she called me and was like, ÒOkay, so Erin's at this practice. They're hiring. This is where you need to be. Erin can mentor you. This is where you need to be. This is where I see you. This is what needs to happen.Ó I applied and got the job and I'm like, ÒOkay. I guess, I'm doing this and I'm moving. Michelle says this is where I need to be. This is what I'm going to do.Ó It ended up being the best decision. I'm so grateful for Michelle for just taking me and then I'm pointing me in the right direction.

[0:14:00] EF: Mm-hmm. I remember she called me and she goes, ÒSo, I invited this girl and she's going to come up. We're going to do all these Christmas things.Ó I was going the next weekend, I think. She's like, ÒYouÕll love her. She's so great.Ó Christian, Michelle's husband, he just Ð Michelle just is so welcoming and lets all these ladies in her house. Christian just sits there and he's quiet and he observes and he takes it all in. Then he's the protector of like, ÒOkay. I observed this.Ó After everything goes away, he's like, ÒOkay, Michelle,Ó and has his thoughts on it, but you got the Christian stamp of approval, which is not everybody gets it. It's a good balance.

No, I remember. I think, I definitely was in your interview. I just remember you having just a very calming presence. I have had conversations with the woman that Taylor works for now. I remember one day, she's like, ÒTaylor. Listening to Taylor is like going to a spa.Ó It's just like, ÒI wish I could listen to Taylor all day, because it's just ÐÓ But it's true. You have just a very, I think it's so subtle, which is why kids gravitate towards you, because it's like, you're not trying. You're not trying too hard. You're just being who you are.

I remember I sat in your interview and I was like, okay. You just have a good energy, your vibration. I was talking to our boss at the time, I was like, ÒI just like her.Ó It's like, ÒI just like her. We just need to hire her.Ó Thankfully, they listened.

[0:15:36] TA: It was a very smooth process. The feelings were all mutual.

[0:15:41] EF: Which is something I would like to start with in regards to the mentor-mentee relationship, or seeking a mentor. Because I will say, especially in the world of pediatric feeding, like you said, people are so desperate for information and knowledge that I think, oftentimes, people will, if they get any opportunity at a mentor, they're going to grab it, which I think is valid. But I think there are certain things that are really important in a mentor that may be missed initially.

I equate it to, as I was looking for jobs, I think when I was first looking for jobs, there were certain criteria I had. As I went through and went through different interviews and went through different jobs, my criteria has changed and it's changed more to what my core values are, as opposed to what's the setting, what's the persona of the setting and what patient population am I going to see specifically into more, does this organization have the same core values as me?

I think when you're looking for a mentor, yes, you want to find someone that is doing pediatric feeding, but you also want to find someone that you relate to and connect with, because if you're really going to dive into being the best therapist you can be, you want someone that also understands you and relates to you. There's value. I've had mentees that I've had to learn a lot from in the way of we didn't communicate the same way, or they wanted feedback in a different way, and there's so much value to learning that, because not everybody is wanting the same type of mentorship. But that core value piece, I think is so critical, because it can really affect your experience.

[0:17:33] TA: I think initially when I was looking for a mentor, yeah, it was just seeking. You just want anybody, because there's just not a lot out there. I think you're right and that it's so important to be mindful of who you align yourself with, because there's a lot of shenanigans going on out there in the feeding family world. That was something that was very important to me initially was to find someone who was engaging in the therapy that really resonated with my values and my own approach.

I was, at the time, very much in the space of educating myself about neurodiversity of forming practices. I was learning so much about why compliance-based approaches and approaches based on behaviors and why all this was harmful, and I didn't know what else to do when I wasn't seeing a lot of people doing the therapy that I wanted to engage in. I was just like, ÒIs this what I'm supposed to be doing? I know what I'm not supposed to do, but I don't know what this is supposed to look like.Ó When I met you and saw the therapy you were doing, I was like, ÒOkay, yeah. This is it. This feels good.Ó

I think that's just also a gut thing, too, when you meet someone and start having those conversations and you can just connect on that level and know that it's a good match in the lines, because otherwise, yeah, you won't be as productive of a relationship.

[0:18:50] EF: Mm-hmm. Do you feel like there are any Ð and I was trying to think as I was writing this episode, too, of any misconceptions of what that relationship has to look like. Because I will say, and to everybody out there, I realized I'm incredibly lucky with my experiences, both as a mentee and a mentor. I had Michelle who was placed in my lap. I had a placement with her. We connected. She's mentored me in different ways. Then my experience with you, where we do just really connect and relate to each other. It was a pretty smooth experience because of that, but I understand that that's not the norm.

[0:19:32] TA: Right. You might not become the best friends with every mentor you have.

[0:19:36] EF: You might not become best friends. Yeah. That's true. Yeah. You might not start a pod Ð I'm not the norm. But I have watched other relationships. I have had other relationships with mentors and mentees that maybe didn't go as well. I guess, one of the misconceptions that I really find is that you have to have this strict mentor-mentee relationship, because I think if you have a good mentor, they will also view you as a mentor.

If you are in a relationship, or an experience where you feel like it's just constant instruction and there's not as much of that back and forth and trying to see where you're coming from, that would be a red flag to me, because you want a mentor who is also trying to learn as well.

[0:20:27] TA: Right. Yeah. I think when I came into working with you, I did have that idea that I was going to come in and listen and watch and learn and you were just going to dump this knowledge on me. That's not what happened at all. You didn't come on strong with this all-knowing presence. It was right from the get-go, it felt very collaborative and we both were on this. I think it also helped, like you said earlier, that we both were on this path of diving into trauma-informed care and taking floor time courses. I think that lent itself to being in that space of we're learning together, we're on a team and we had so many great discussions because of that.

I think the way that you were able to be vulnerable right back to me because as a mentee, you're in a more vulnerable position and you have so much to learn and you're looking up to this person. But you would say like, ÒI don't have all the answers either. We're learning together.Ó And you modeled that by taking courses, and seeking information, and having your own mentorships, and reading books and articles. It was very much a two-way street and a partnership. I always felt like I was supposed to be there, like my opinions were also valued and I think it's something that is super important in a mentor is the ability to help your mentee find, come across an answer on their own by guiding them there, instead of telling them directly what to do.

I think it was very rare that you would say, ÒTry this, or do this, or I think this is what's happening here.Ó More often than not, you would just ask me questions like, ÒWhat do you think would happen at this, and I wonder why this is going on? Do you think it's this or this?Ó That gentle guiding to support my own critical thinking, as opposed to you just telling me what to do. That was really huge and something I wasn't expecting, because it hadn't been my experience in the past with mentors. But yeah, you seemed to always know when I was truly stumped and when I maybe knew the answer and I just needed you to walk me there a little bit.

[0:22:24] EF: Which I also, before I decided we would do this podcast, I was like, ÒOh, I guess, we are going to talk about Ð now I'm nervous as what I was doing as a mentor.

[0:22:34] TA: Oh, gosh. No.

[0:22:35] EF: I have gotten reverse feedback though. I've worked with people who have said, ÒWell, I just want explicit information on what to do.Ó What I say to that though and I don't mean for this to come across as negative at all, I think if you're going to work with pediatric feeding, you also have to be willing to use those critical thinking skills. Michelle and I have had the conversation a lot about how Ð I mean, she's teaching her pediatric feeding class and the university, or when she taught at South Carolina, where she was before. She's like, ÒMy biggest goal is to teach critical thinking skills.Ó

It's similar to how I do therapy, how I know you do therapy and that my goal isn't to get a child to do a specific thing. My goal is to help them learn to be able to work through that process when the next opportunity comes, or when the next challenge presents itself. As a mentor, I really want to help the people I'm working with come to their own realizations, because also, that's how you learn and then are able to do that on your own.

My goal as a mentor is to continue to grow the relationship, so that it becomes this partnership. So that it becomes this, we're working together and we can bounce ideas off of each other and you feel honest and authentic in the decisions that you're making, because also, we're all different therapists. I don't want to make a bunch of mini-mes. What I want is people who use evidence-based practice in an ethical way, in a neurodiversity affirming way, but interact with children in a way that feels genuine to them.

I'm not a therapist for every family, but I am going to be a genuine and authentic therapist when I work with a family. Every family needs something a little bit different and granted, do I think I've learned how to adjust and shift and read families to the point where I can mold myself, but there are some families where I'm just not going to be their fit. If we're looking at actual adult learning styles, sure I can give you an answer, but if you didn't work through it on your own, then what's going to happen when I'm not there?

When I meet with a mentee that really wants a direct answer, I then want to dive a little bit deeper to see where their confidence level is, why they feel that need for that answer, and is there still a way I can help you work through it to come to a conclusion that might not necessarily be exactly what I would have done, but also, there's more than one right answer. I think that's another thing to consider.

[0:25:24] TA: Yeah. Yeah. I was just thinking, how many parallels are between how we navigate these relationships with each other and with our clients. I was just thinking about how I'm on this kick lately about declarative language and with our patients, like using more declarative language, as opposed to directing them on what to do. It's that same idea. I could tell you, go get your shoes on, or I could say, ÒOh, all of the kids in the class are getting their shoe in. Let me just point this out to you,Ó and you make the decision. You get yourself there, because that's where the learning comes, versus just telling someone what to do.

It's the same thing in our practice. You can tell me what to do, but am I going to be able to arrive at that same idea on my own at a later time, or am I going to be able to use my own critical thinking skills to know when to do that again, and why I'm doing it?

[0:26:10] EF: We also know that in pediatric feeding and adult dysphagia is the one place of our field where you can Ð I mean, you can cause emotional harm and trauma and stress and anxiety in any part of what we do, which is why you and I are trained in trauma-informed care. But physical harm, you can cause in the context of pediatric feeding based on the decisions that you make. I need to trust as a mentor that you are working through things in a critical way, so that when a new diagnosis Ð I mean, I work with kids, especially in the hospital that IÕm in, that have diagnoses that I've never seen on top of diagnoses I've seen with comorbidities that the combinations I haven't seen.

What mentees need to understand, too, is that you're never going to have all the answers. I think you need a mentor that also helps you feel comfortable in that, that there's never going to be a point where I'm like, ÒOkay. You're good. You know everything you need to know. Have at it.Ó I need to know that you can think critically and find the resources and have people. I mean, I reach out to people all the time that I know know things about craniofacial that maybe I don't have experiences on, or have more experience with neuro. Having your people and helping you build that network is important. I would say, I have people that have Ð mentors and mentees that I had a broader experience with, but I have so many mentors and mentees and continue to grow that relationship.

[0:27:50] TA: Yeah. I was thinking about that trust piece of it and that's something that I found to be really helpful in building my confidence right away, is that you gave me these patients and I was like, ÒOkay, here we go.Ó I have these patients and you're like, ÒYou got this. I'm here. I'm going to be here to support you, but you can do this.Ó That was a huge thing for me also, because I've had mentors who will have you sit back and watch and observe and just discuss it afterwards and not really get in there. The fact that you just trusted me to just get going, but you were there with me. I wasn't on my own. We were doing it together. But I felt like that piece of it gave me so much confidence and made me become independent faster.

[0:28:40] EF: I remember my favorite thing is when I would be, because I had the front room and there was an area that had books and a table and a little kitchen, a place an some Ð and Taylor and I are also very like, I would sit on the swing and write notes, or something. I sit on the floor. I have my own neurodiversity and my own sensory differences. The clinic we worked out was very accommodating for how you want to use your space and how you want to be productive. I would have a patient and I'd see Taylor, who didn't have a patient sit and write her notes near. I'd leave the door a little bit open and I knew she was taking it in, which I loved so much, and I was like, this girl really wants to.

You were craving that knowledge and experience and just absorbing it and taking it all in, which I think as a mentor, there are very little things that you are watching in someone. Again, part of that is that like, if you're going to do this part of what we do, you're going to spend time outside researching diagnoses and reaching out to doctors and calling nurses. It's a lot of extra work outside of the session. What I look for in somebody, too, that I'm mentoring is like, are they taking that extra initiative? Are they wanting to learn outside of what I'm teaching them? I've had people I've worked with who I will Ð

Michelle taught me this. I remember sitting in Michelle's car before sessions and she'd be like, ÒOkay. This is their diagnosis.Ó I'd be like, ÒOkay.Ó And she goes, ÒLet's look up their diagnosis.Ó Because she, again, was showing me, I hadn't seen a child with Wolf-Hirschhorn before. ÒLet's look up their diagnosis. Okay. Let's problem-solve. How do we think this diagnosis might impact their feeding?Ó We go through it. I have some of my mentees look at diagnoses of a patient we're going to see, write down how it might affect them, and write down what patients are seeing.

I've had mentees I've worked with where it's like, they just won't do it. To me that might say like, okay, do you not feel that this is valuable? Do you not care? There are just very subtle things that I think mentors pick up on. I also think, Taylor, you're on to something with the way Ð I do really feel the relationships I try to foster and I think you're the same with other clinicians is similar to how I foster relationships with my patients. That point of building relationship and trust. You also have to do that before you're really going to get to the vulnerability and being able to have some of those conversations and anybody deserves that. It's like, I think we were able to build a trust very quickly, just because intuitively, I think we understood each other and that doesn't always happen, but I want to learn about a person and I think there's this misconception, too, of don't get emotional, be very professional.

It's like, we're working with humans and it's a very emotional thing. It's okay to have feelings and show them and the people that I've gotten closest with, whether it is Ð I think most of the people I work with that I really connect with, I view as mentors. I view Taylor as a mentor, also. Those are the people I've been able to go and cry to after a hard session, or just vent about some caregiver that it's not their fault and my fault, but I'm just not connecting and I don't know how. I think those are also the moments that make you a better clinician. Yes, information, medical ideologies, diagnoses could refer to is so important, but I think that's more valuable.

[0:32:50] TA: I think everybody in that clinic had cried in your office at some point because you just always had that. But you had the best office space and it was just such a warm environment to the end. I just all knew that it was a safe space to go and get your feelings out. It was sometimes messy. Always messy.

[0:33:07] EF: Always messy.

[0:33:11] TA: Yeah. Also, I love sitting outside your door and observing, just to circle back to that, because I love observing sessions. I learned so much from just sitting back and removing myself from the interaction and just watching the dynamics or the dance that we think what I'm Ð like, watching that all happen, I learned so much from it. Yeah, back to that like, how this is very similar to how we engage with our patients. You have to learn your patient. You got to connect and figure out who they are, and it was the same thing with us.

I think knowing your mentee, knowing their communication style, and knowing what support they need, what they're going to respond to, and what's going to excite them or inspire them. I thought of how we are different in the way that I'm a very much an internal processor. I need a lot of time and space and quiet to think about things and let everything digest before I'm ready to discuss and ask questions. Whereas, I feel like, you're more of a verbal processor. I think you like to talk things through. But you knew this about me, so we would do things like, your evals.

I remember observing your emails. I remember asking to write them. ItÕs like, ÒCan I watch this eval, and then can I write it?Ó Because it's going to help me. That's another piece of it, knowing yourself and knowing what's going to support your learning and growth. I knew that if I sit down and I think about something and I write it and I put it in this email, that's going to help me. Then I'll be ready to go to you and talk and ask questions and discuss the case.

I'm not that person that like, right after a session, I want to go talk about it and talk it through. I need some time. I felt like you were very aware of that and were like, ÒWhen you're ready, let me know when you want to talk about that one, or if you have questions about it, you come to me.Ó That was super helpful. Yeah, that just comes back to knowing the people you're interacting with. Oh, my gosh. I remember just going into your office sometimes and being like, ÒOh, my God. Erin, what do I do? What do I do with this one case?Ó

We had some complex cases and some emotional ones and it's like, the stuff that you're not taught in grad school. Like, how do I navigate these family dynamics, or there's all this trauma here and I don't know what to do with this. I always felt very safe and comfortable and going there with you and having those conversations. It always felt like a very open and honest environment to really dig into that stuff. If we had had more of the professional cold, hard lines, that discussion might not have happened.

[0:35:41] EF: Yeah. I think, like we have said, this came very naturally for us, which is why we're still best friends. If it doesn't, there are opportunities to have those conversations about how you like feedback, how you like to learn, how you process things. Because I knew these things about Taylor. I knew that when she did finally come to me and want to process something out loud, she had already really gone through it in her head. Those are things I knew about her.

Me on the other hand, when I go to somebody, I'm processing it as I'm saying it. Sometimes I just need someone to hear and maybe even say back to me what I'm saying, just so I can process it in a different way. The people that have mentored me, like Taylor, know that. In starting a mentor-mentee relationship, I think it is important to write down what your expectations are and talk about how you like to learn so that there is that groundwork almost for the relationship. Any relationship can change. You have a right to Ð this is the same with any patient I work with, or a caregiver.

We can go down a path of working on this specific thing. Then you could say, ÒYou know what? Actually, this happened, or I want to shift the focus.Ó That's okay, and you have the right both as the mentee and the mentor. Don't ever feel any groundwork that you set in this relationship is set in stone.

[0:37:20] TA: Goals might change, too, and interest areas and having that ongoing conversation of like, ÒOkay, I'm feeling comfortable in this. I want to lean into this a little bit more.Ó And being, yeah, super communicative about what path you want to go down and making sure you're both aware of it.

[0:37:37] EF: I think you are also a very self-aware person. When you grow in these relationships, too, you're going to learn more about yourself. There's emotional intelligence quizzes that you can take that help you learn more about how you process information and what you benefit from. Those are all things to think about as you go through these experiences. I've had mentors that I think when you go into jobs, oftentimes you will be assigned a mentor, or a supervisor, I guess. In that role, they sometimes become mentors. I've been given mentors that was not a great experience, that involved what I felt like Ð I wasn't met with as much kindness towards my ideas. I wasn't met with a lot of openness in regards to change, which that I'm learning is a core value of mine.

After that experience with a job, I went to the next job and they asked me what was important and I said, it's important that someone's open to change. I have had experiences where I've been what I would qualify as bullied, where I would qualify, where I had to sit down with my manager and eventually HR and say, ÒI did not deserve to be treated this way.Ó Where I had to list things that I felt were unethical. That was a really, really hard experience. While I'm sitting here saying I've had these great experiences, I've also had not great experiences and those not great experiences taught me a lot about myself.

If you're sitting here feeling like, okay, well this is a lot harder than you're making it sound, it is, and I've been there. That's why this core value piece is also really important, I think. I would suggest maybe when you start that relationship, what are your mentorsÕ core values? What are really important to them when it comes to therapy and how they like to do therapy and how they like to mentor. If there's a huge disconnect, that can cause some problems sometimes. That is not something that I think is the usual to talk about when you first build our relationship.

[0:39:53] TA: Yeah. Yeah. I think it's very rare to find these great matches in within your workplace, and sometimes you have to look outside of where you're at and seek your mentors, find them. They don't have to be in your direct environment. That's something Michelle said during our first home poll, because I was venting about not having support where I was and she was like, ÒTaylor, you can find support. You just have to ask for it. You have to look. There's so many amazing therapists out there that are more than willing to give their time and knowledge and share it with newer clinicians. Yeah, don't be intimidated. Don't be afraid to ask.Ó

I think Michelle said, ÒGo find your mentors and make them your friends.Ó I did exactly that. I'm just going to find people to support me. Because, yeah, you don't always get lucky with your immediate environment, but there are people out there who are passionate about bettering our field and lifting each other up, where I feel the helpers and most of the time, people are genuinely want to support and mentor others. They're out there.

[0:40:55] EF: What would be some suggestions you would give to somebody who is looking for a mentor, who wants to get more into pediatric feeding, who feels a little lost? What would be some of your go-to tips? Find an Erin. Just kidding.

[0:41:14] TA: Find yourself an Erin. No, but truly, find your people because that's everything, when you're a new clinician and you're just on your own and just trying to figure things out and not knowing where to go, there are so many resources out there. I'm a big, a big podcast gal. there are so many podcasts you can listen to and yeah, just reach out to other people and stay hungry. You got to keep looking. Don't give up.

I think if you're in a space right now where you are feeling lost and like, it's not the best environment for you. I know I went through a little phase where I was like, do I stay in this space and be the change here? If I abandon this environment, am I just giving up where I could be making a difference here because they do have something to offer that they don't have right now? Which may be, but if you're depleted and uninspired and you're alone without guidance, you're not going to be able to make those changes. Make moves. If you're unhappy, make a move, make a change. It can be scary, but it's worth it to find that environment where you are supportive, supported, and fulfilled and have those people that do share your core values and are aligned with what you're trying to do.

It's so hard to be in an environment where you're going against the grain and I feel like, that can be a lot of us and a lot of different ways, especially if you're a very play-based therapist, or a neurodiversity farming therapist. There are so many environments where we're just swimming upstream sometimes and that can be so exhausting. It can really just suck all the fun out of this job. Finding people who are on that journey with you is everything.

[0:42:59] EF: Yeah. I would say, too, and this is coming from I had this mentality before, like be open to different settings and environments than maybe you thought you wanted. I think there is a little bit of a misconception that being in the NICU, or Ð yes, I work at a children's hospital right now, IÕm not Ð this is not knocking children's hospitals, but I think especially in feeding, there's this idea that being in a children's hospital is the most hardcore and the best place to be. I will say, there are value and hurdles to every setting that you're in.

I mean, when I did home health with medically complex children, there were no doctors there. There are no nurses standing right there. There's a whole other world of problem-solving and decision-making and it's different, but it can be just as valuable and just as much opportunity to learn. You're just learning different things. I would say to think about who you want to be as a therapist. I know Taylor and I can get very vibrations. But I think there's value to that. Who do you want to be and what is important to you as a therapist? I've learned that having a space to build relationships with my families, having a space to really work on play, and being able to be authentic and vulnerable are all things that are really important to me. That's something that I look for in people that I choose to build those relationships with.

Taylor, what were things that you were looking for in a mentor, or what are things that specifically for you and for clinicians in general that you would think about as what you wanted to see?

[0:45:00] TA: Yeah. I just want to add one more thing to what we were talking about before. Don't be afraid to look outside of your discipline, too, for mentors. There's so much to learn from OTs, PTs, anybody else that you're working with.

[0:45:14] EF: Parents. Caregivers have mentored me.

[0:45:16] TA: Yeah. Yeah. Yeah, if you don't have any SLPs in your immediate environment, you can Ð there are all kinds of opportunities for mentorships. What was I looking for? I don't know if I really knew what I was looking for until I had it and I'll just try not to just talk about how wonderful our working relationship was. I think I figured it out as I went. Like I said, I was just super hungry for guidance and information and I thought I wanted someone to tell me what to do. I realized very quickly that that was not how I learned and I needed to just dive right in.

Yeah, someone with a similar therapy approach that I had, I think, was top of my list. I think that partnership piece of it was huge for me. Being able to have those reciprocal conversations where what I said was also valued and the way that you always lifted me up and made sure that I like Ð you still do this all the time. You feel like, you thought that you know what you're doing. I still do that.

Again, it just comes back to, again, knowing what you need from your mentor. The communication piece is huge, being really open and honest about what you need and what you're looking for and being honest with yourself. These are some areas I want to grow and these areas I feel pretty competent in, and then seeking out that information and communicating that with your mentor. I said that when you touched on that fostering independence piece, I needed someone to come and let me spread my wings and do anything.

[0:46:49] EF: Okay. Well, I was going to say, now that you are looking to mentor, what are things that you either are planning to do, or focus on, or what have you learned to then foster those relationships?

[0:47:10] TA: Yeah. I'm currently working at an amazing clinic, that speak outside the box in Tampa. I'm the only thing in therapist right now that others are starting to express their interest in it. I'm actually getting really excited about this prospect of paying it forward and building a program where I have others on my team and we get to grow and learn together in the ways that you and I did. I think I was putting that off for a bit, because I was like, ÒI'm not ready. I don't know enough.Ó But like you taught me and like we've been discussing, we're always learning, we're always growing. You're never going to have all the information. You're actually doing a service to others that you're training if you're showing them that we can learn together.

I think that's a big piece of what I want to pay forward. I think this idea of being flexible and knowing the therapists that I'm working with and knowing that they might need different support. I mean, I hope to create some kind of Ð working on some plan like we did with our scheduled meetings, with different topics to cover and different Ð a trajectory of observing, or working up towards independence. But also knowing that that's going to look different for a different therapists and being flexible and trusting that process.

I think snapping into the other side of this now, I'm realizing that it is hard to trust others and hand over your patients. But it's so exciting, because we get to share this really cool thing that we do and share that light and know that it's going to reach so many more families because of that. It does feel like an honor and privilege and something I want to be careful with and spend some time thinking about, but I also know I just need to do it and get started when it comes. Yeah.

[0:48:47] EF: Well, it's like with anything. You just learn and you just are a person who is going to be very intentional with what you do. I think that's another thing to consider. I think it is hard when people Ð especially new grads coming out. You're used to grad school where everything is you have to check these boxes and you're constantly getting graded on things. I do understand that there needs to be some level of like am I meeting these requirements? That's why I kind of, when we were doing mentorship, created a little bit of like, okay, what do you feel comfortable with? We're going to start with observing and build up to being independent and create an expectation of what are these skills?

I didn't look at it as much as specific like, do you know exactly what to do with this specific diagnosis or this specific treatment technique? It's more of, do you have these larger skills? But then, also providing opportunities. Like, we would have journal club, or we'd have read Michelle's book and talk about it. But I also want to know how, and I think it's important to know how your mentee is absorbing that information. What are you getting from this, too? I remember when we would talk about Michelle's book, it would be like, okay, you'd read something and then a patient would come in and be like, ÒOh, I remember something in the book. Let's go back to this.Ó Because the way our wires connect things are different.

Yes, our job as a mentor is to provide information and to make sure we're Ð especially with feeding, helping them understand the medical ideologies and who to refer to and what signs and symptoms to look for. I do think that really, where that mentorship piece grows is in that relationship and understanding how that person learns. That's what I think everything comes back to, honestly.

I am a little tired of the idea that especially in feeding, it has to be this like, you have to earn it and we're going to haze you a little bit. That's not how this should work. There are enough patients for everybody and then some. If you really want to make the field better, then share knowledge and be open to people that really want to do this and want to learn and take every opportunity to learn something. Like I said, from people you come across, I've learned a lot from caregivers I've worked with, who have helped me understand their perspective, who have made me a better clinician, because I've been able to hear their stories and it's given me more empathy for what they're going through.

I've had patients that have mentored me and plenty of other clinicians. It's like, take every opportunity to learn from the people around you and take pieces of them with you, because who I am as a clinician today, there are pieces from all these people that I've had experiences with that have helped me grow. Yes, we're talking about a specific mentor-mentee relationship, but I'm also a better clinician because of Taylor, and the way that she saw things that I was able to see things differently and the kindness that she showed her patients and just the, like I said, I think your intuition was all Ð which I trusted you so quickly. You had this great intuition that you just needed a little bit of a push to trust it and just not even always, I think sometimes you work with mentees who do something and they don't always know why they're doing it, but they feel it. And so, part of your job as a mentor is then to be like, helping them understand the why, which I think was a lot of what we did.

[0:52:44] TA: Yeah. That's something that I think as a mentor, I can Ð this will be helpful to me as a mentor, because I don't always know why I'm doing something. But if I have someone there then explaining it to Ð like, I don't think I know and then I start explaining myself to a student, if I have a student with me, or whatever the situation is. It's like, ÒOh. Okay. Yeah. I understand this.Ó Then it's you're hearing me process it out loud and I'm realizing it more for myself. It's just that reciprocal learning that's just happening all the time, the more you discuss things.

I learned a lot from just listening to you do that troubleshooting out loud, just talking through cases and patients and figuring out like, ÒOkay, that's interesting she did that. That was with her patient and I can apply this here, or this makes sense here.Ó Or just grasping bits and pieces of things you were discussing and applying it to my own situation. I think, yeah, it is that balance with feeding, because like you said, we can do harm and especially if you're working with these medically complex patients, you have to be Ð there has to be some level of competence. You have to know what you're doing. 

The biggest thing there is knowing when to ask for help and knowing when you don't know. Some people struggle with that piece and that to me would be a red flag and a mentor, like not being able to recognize or call out like, ÒOkay, I actually don't know what's going on here. Let me step back and figure this out.Ó There's no harm, or shame in asking questions and not knowing the answer. You've got to be vulnerable in this job. You've got to be able to put your ego aside and recognize when you don't know.

[0:54:22] EF: Yeah. That's when I've had a hard time trusting people that I've meant, like that's Ðwhen people will not ask questions, I have, A, I don't understand. I'm having a hard time grasping what you're thinking. B, I don't trust that when you have a patient that maybe you don't know what to do with it, you're going to come to me and ask. That's a big factor, I think, is asking those questions. That's why I love students, too, because you're like, ÒOkay, wait. You have this question. Either I can explain it, or I need to dive deeper into why I'm doing that.Ó The same way that I think model for your mentee, because we are in a field where we're constantly learning. I'm always being mentored. I'm always learning new things.

If I model that for the people that I'm mentoring, that shows them that I'm also Ð it makes it more accessible, too, because feeding feels like this thing that we can't touch, I think when you leave grad school, ÒThis is so scary. I'm not going to be able to do this. These people that are doing it have so much more experience.Ó It's like, they may have more experience, but they're always going to have something new to learn, too. Don't be afraid to start that and then have people to support you while you're doing it.

[0:55:47] TA: There's so much Ð so much of this job is just on the job learning and training barely scratched the surface in grad school. You're supposed to have questions. That's part of the gig is it's lifelong learning. There's always going to be something new. There's always going to be new research, new approaches. It's constantly evolving. You have to get really comfortable with the idea that you're not going to do everything right and you don't have all the answers and it's okay.

[0:56:12] EF: Yeah. Like we said confidently on Ð there's a lot of stuff that yes, you need to be competent on and yes, we're going to check those boxes. I think we just really wanted to focus, too, on building that relationship and standing up for yourself as a mentee, too. If you feel like, I have had friends who have had experiences where they've been given a CF mentor, that the relationship was just not mutually beneficial, it was not healthy and they went to their supervisor, manager and talks about that and advocated for that.

There are people that have experiences, I mean, my experience I mentioned earlier, I was sick to my stomach every day going into work. I was crying every day leaving work and that's not okay. This is not the something that we need to keep allowing in our field. We need to support each other. We need to lift each other up. We need to lift our field up, because if we're doing this to each other, it's helping nobody. Don't be afraid to have those conversations to write things down, to stand up for your value.

Yes, if someone is mentoring you not in the workplace and out of their own time, they're doing that for the love of the field, or helping you learn and grow. You want to respect that. At the same time, you're also providing your time and giving something to that as well.

[0:57:51] TA: Yeah. I think that goes beyond just mentor-mentee relationships to just this job in general and that's on that note of self-advocacy, that's something that you really modeled for me when we were working together, especially when it comes to feeding versus language therapy and advocating for her time and resources and compensation and support for the work that you're putting in in these niche areas.

I took that forward and have been in situations where I've advocated to be compensated appropriately for this skill and experience I have, or for more resources or whatever it is. I feel comfortable doing that, because I watched you do it. I think that's something that is hugely valuable in a mentor to model that for your mentees and show them like, sometimes you have to stand up and ask for what you need. It's a tough thing to do to have those conversations, but showing a mentee that you can do that is huge. I'm, yeah, grateful that I got to see you put in that work, because I now feel comfortable doing it for myself.

[0:58:54] EF: Yeah. I think it comes down to pick people that you value more than just what patients they're seeing and where they work. Pick people that you value how they talk about what we do and that you value who they are as a person, too. I think that's really important. Don't ever hesitate to reach out. If the people that really want to help in our field really want to help and they will answer an email, or be like Michelle and tell you to call them at 7.00 in the morning on your way to work, or just provide guidance. Those are the people you want as your mentors.

If you do reach out to somebody and they don't answer, or you have a gut feeling about them, then they're probably not the right person. Even as a clinician coming out of grad school, place value on yourself and who you are and what you bring, because if you go into the relationship feeling like you're not providing anything, then that can set you up for a negative experience.

Yeah. I think that there's lots of resources out there in regards to mentorship. I really love that I was in the ASHA Leadership Development Program, which did talk a lot about mentorship and growing that. ASHA does have a program that sets you up with a mentor. Again, I think they try and do the best they can for interest area and also, just how you want to be mentored. That doesn't guarantee that it's going to be a perfect relationship, but setting those ground rules and groundwork, I think, is really helpful.

I love the Crucial Conversations book, which was really helpful for me when I had to have difficult conversations and certain experiences. I think, gaining understanding of yourself and your emotional intelligence is also going to set you up better for any relationship, because you're going to better understand why you do something and what you need to be able to advocate for that. Do you have any resources, anything that you just have been dying to say that Ð

[1:01:13] TA: No. I think, just find a mentor that Ð find yourself an Erin. Find someone who lifts you up, builds you up, shares your life, trusts you. I'm so incredibly grateful that I had you as a Ð I mean, I still have you now. But working alongside you was such a gift. I think having a good, solid mentor is Ð and has the capability of changing the trajectory of your career. It's something that I think is there's so much value in seeking it and finding the right person for you and holding on to that relationship. The SLP world is small, so stay connected to people and, yeah, value those relationships.

[1:01:52] EF: Okay. You never know who is going to know who, who knows who.

[1:01:55] TA: Yeah.

[1:01:56] EF: You never know. That's why, I think, never underestimate what one conversation, or one experience could turn into. I think most of the people that have had such an impact in my life, I've just like, it's been a gut thing. You just Ð

[1:02:16] TA: Trust yourself. It's always coming back to trust. Trust your gut.

[1:02:21] EF: How do you feel around people? Do people make you feel good? I don't know. I think there's so much value to that. Even subtle things. I always talk about how Michelle introduces somebody. She'll stand behind them at an angle and try Ð literally, her light is Ð like, she's trying to shine their light. Her light is very bright, but you can Ð she's literally just Ð there's very subtle things that I think you learn as you get older, too, to pick up on people.

It's tough. It's hard, especially in the pediatric feeding world. What we really want to put, get across is that it's a lot more than just learning how to do this and what this diagnosis is and those experiences and that you can get those experiences in a lot of different settings, too. Don't just assume the home health SLP doesn't see complex kids or doesn't know what they're doing, because we are seeing more and more complex patients than we ever have before and they're everywhere, and they need help everywhere. Well, thank you for coming. I am grateful to have you on and I'll make you come back, because Ð

[1:03:34] TA: Thank you for having me. This is just such a surreal. Erin knows I'm a very introverted person, and I think I'm an SLP anomaly and that I actually don't like to talk, or listen to myself talk. The fact that you got me to do this, to talk for an hour and have it be recorded is quite a feat. But you make it easy. This was so nice.

[1:03:57] EF: I love you and I appreciate you.

[1:03:59] TA: I love you.

[1:04:00] EF: And all that you do. Yeah. If you haven't picked up, we have very, very similar philosophies. I have been trying to recruit Taylor to join me.

[1:04:13] TA: We did it. I'm here. It happened.

[1:04:16] EF: I know. I'm making her do a floor-time lecture live with me. That's going to be a whole other step.

[1:04:24] TA: Yeah. Last note, it's find mentors who push you and keep moving you forward and yeah, appreciate you.

[1:04:32] EF: Mm-hmm. I don't think we have any announcements that are coming up. Just if you haven't seen on our Instagram, Michelle and I have the First Bite Boutique with some fun T-shirts and sweatshirts, so feel free to check that out. It's on bonfire still.

[1:04:55] TA: So cute.

[1:04:56] EF: We will have more coming out sooner than later if Michelle has anything to say about it. She's already got everything planned. Yeah, thank you all for listening and we'll see you soon.

[END OF INTERVIEW]

[1:05:10] ANNOUNCER: Thank you for joining us for today's course. To complete the course, you must log into your account and complete the quiz and the survey. If you have indicated that you are part of the ASHA registry and entered both your ASHA number and a complete mailing address in your account profile prior to course completion, we will submit earned CEUs to ASHA. Please allow one to two months from the completion date for your CEUs to reflect on your ASHA transcript. Please note that if this information is missing, we cannot submit to ASHA on your behalf. Thanks again for joining us. We hope to see you next time.

[OUTRO]

[1:05:51] MD: Feeding Matters guides 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. To date, a 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 PFD Alliance tab and sign up today. Change is possible when we work together.

[1:06:43] MD: 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 PFDs 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.

[END]
FBP 265		Transcript

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