Bridging the Gap: Advancing Education in Pediatric Feeding Disorders

Join us for an insightful discussion with Jaclyn Pederson, CEO of Feeding Matters, as we discuss the critical gaps in education for pediatric feeding disorders. Jaclyn sheds light on the challenges faced by clinicians, who often lack the specialized training needed to manage complex feeding issues in children. Drawing on her background in nonprofit leadership and healthcare innovation, she shares a strategic approach to advocating for improved education and research in this area. This episode calls for meaningful action to enhance education and resources, ensuring better support for those affected by pediatric feeding disorders around the world.

Episode Resources:
https://pubmed.ncbi.nlm.nih.gov/38801459/

https://youtu.be/oVZWdpu71Wc?si=Tz4QK1xzDQErAH4V

Chapters

• 0:00 Pediatric Feeding Disorder Education Gap
• 12:11 Challenges in Pediatric Feeding Disorder Training
• 16:39 Gravity of the Matter
• 27:14 Making a Difference

Transcript

Tim Stockdale: 0:44

Welcome. Everybody Joining me today is Jaclyn Peterson. Jaclyn Peterson is a CEO of Feeding Matters and Feeding Matters works to advance the field of pediatric feeding, so I know that most well. I don't know, I suppose most of the listeners here are for adult dysphagia. You need to stick around.

Tim Stockdale: 1:02

There is a tremendous amount of cross-application in how we're trained for adult dysphagia with how Jaclyn what she's uncovered as far as pediatric feeding training and I suspect you know, maybe a number of us have gone into adult dysphagia by necessity, because of some of the reasons that she's going to mention, that there is not a whole lot of training. I mean, we think there's a paucity of training for adult dysphagia. Look at pediatric dysphagia. So stick around, Jaclyn. What else would you like people to know about yourself before we continue?

Jaclyn Pederson: 1:33

Thanks, tim, for having me. So my background is actually not clinical. I have a background of nonprofit leadership and management, and then my graduate work is in healthcare innovation and systems practice. So I always look at things from like a systems lens, and that, I think, really applies to the research we're going to be talking about today.

Tim Stockdale: 1:55

Well, it seems like that would give you a heads up in being able to affect change and not just being like you'd be a great collaborator for clinicians like all of us listening here, to be able to like hey, this is how you take some steps to get things done. Is that fair? That's true? Hey, this is how you take some steps to get things done.

Jaclyn Pederson: 2:08

Is that fair? That's true. I mean, I think that hopefully I'm kind of and that collaborator to bring a different perspective and get this work done together, because I do think that we can move mountains as long as we're doing it all together.

Tim Stockdale: 2:22

OK, good deal, Good deal. So this article we're looking at, looking at preparedness of speech, language pathologists and occupational therapists to treat pediatric feeding disorder a cross-sectional survey. This was published in received December 5th 2023, accepted May 10th 2024. So this is recent. This is good stuff. What is? What would you say, are the main primary, key takeaways from this?

Jaclyn Pederson: 2:48

The primary key takeaways from this article are that there really isn't a well-defined educational pathway that allows a professional to develop a specialty in pediatric feeding and pediatric feeding and swallowing. That is something that I think is assumed by a lot of families who are looking for providers to treat their children. And then I think, if you're a student and we by a lot of families who are looking for providers to treat their children, and then I think, if you're a student and we see a lot of students interested in feeding and swallowing and you end up not realizing that you kind of have to build this path along the way, and so I'd say that's the highlight is you think there's a pathway but there really isn't.

Tim Stockdale: 3:27

And this sounds like it's not just unique to speech pathology. Is that right?

Jaclyn Pederson: 3:31

It is not just unique to speech pathology, so in the field of pediatric feeding disorder. So the definition of pediatric feeding disorder is when a child really isn't eating appropriate for their age and they have dysfunction in the medical domain, the nutrition domain, the feeding skill domain and the psychology domain domain the nutrition domain, the feeding skill domain and the psychology domain. And so within that feeding skill domain it's a lot of crossover and collaborative work between speech language pathologists and occupational therapists and that collaborative work looks different based on what the background of that professional has and what is available within that community. But yeah, it's for both, and so that was a big highlight of this work too was it wasn't just one discipline that needed a little bit more support, it was both.

Tim Stockdale: 4:17

Okay.

Jaclyn Pederson: 4:17

Very interesting.

Tim Stockdale: 4:19

What was it that led to you investigating this?

Jaclyn Pederson: 4:22

A lot of it is because at Feeding Matters we support families, and so when you're trying to help families find the care that they need, we had to continuously build supports around families to help them understand that you may be trying to go find intervention for your child who is having trouble with feeding, but that person may not have had the education that you think or expect them to have had. And so it started with supporting families and then it grew to kind of like the advocacy and the awareness work of like okay, well, if that's a problem, how can we be a part of the solution? And so we were like okay, we need to at least build an evidence base to figure out what's happening. And so that's what led to us doing a survey of okay across the United States. You know how are people feeling about their educational efforts in this area.

Jaclyn Pederson: 5:16

And so there was a there's a precursor to this publication. Actually, that just is a general, like landscape publication from the survey, which is you know who's treating what? How are they treating it? What does that look like With 815 individuals? And then this got into the specifics around the feeding scale domain, and so the history of this is really like if we need to change and prepare professionals to better support families, we need to even figure out where the baseline is. What are individuals coming out of school learning, or what was their pathway to developing a specialty in this area? And so a lot of it was just our own curiosity.

Tim Stockdale: 5:57

Yeah, I mean, it almost sounds like you're being strategic in trying to figure out how to fix this, which is great.

Jaclyn Pederson: 6:02

A lot of advocacy. Work is pretty strategic. It's hard to you know. When you go into advocacy conversations, a lot of it is like well, show me the data, show me the data, and you're like this is an emerging field. There really isn't a lot of research in this area.

Tim Stockdale: 6:14

Yeah, I mean, this is a pretty good start, though, and you have a remarkable N. You have 418 speech pathologists, 195 occupational therapists, for a total of 613 people that you surveyed, kudos. That's awesome.

Jaclyn Pederson: 6:32

Thank you. Thank you. It was very helpful to have such an amazing community of support to be able to fill out this survey. We did also get funding for this research, so we were able to offer an incentive, which I also think is like really helpful in research and being able to up your participation numbers. And then I think it helps that feeding matters is really popular among pediatric feeding professionals, and so we were able to leverage our community to be able to fill out the survey. But that is described as a limitation too, because you know that was one of the primary recruitment methods, so there could be inherent bias in that sense.

Tim Stockdale: 7:12

Yeah, for sure. No, I was thinking, I was thinking the same thing. I was like I got to reach out to my audience and I say my audience that's, that's and I almost said something like.

Tim Stockdale: 7:21

I did say something like that earlier and I corrected myself this is, this is a, it's a community, it's a platform where people talk. I don't know, I don't like referring it to my audience, because I would say I'm one of the least important parts of this show that it's the people who come on and finding them, and, of course, that stuff matters in engaging in conversation, but looking at people who come from all these different perspectives, bringing them together, having a conversation, giving them a platform to be able to talk about things that are important to them, and raising awareness of clinicians about what's important and you know, I'm a small part of that, so forgive my the semantics of me saying that I it's not a not I don't think it's an ego thing or anything like that, but so well, this is. This is really interesting and what is making me think about there's some work for adult dysphagia done in 2013 or 2014, giselle Carnaby and Herrenberg that came out and they looked at practice patterns of speech pathologists and saw that it was kind of like everywhere, everywhere. And then Vos et al in 2018 did something similar. I mean, there was, of course, more to the publication, but part of it was looking at practice patterns and it was just so broad, not you know, so much standardization on. Okay, if you see this, you do this or whatever.

Tim Stockdale: 8:36

Not that everything's formulaic hardly anything is but at the same time it was a little bit alarming, like if there is really strong evidence behind X to treat Y, then why are we doing it all so differently? I don't know. It raised a lot of good questions, so when I saw this article I was like this would be something great to talk about. Like this one in particular just caught my attention. Gap education is predicated on gaps in education. Imagine that.

Jaclyn Pederson: 9:06

And that's what I've heard. So because my interest is in OK, how can we make sure there is an educational specialty pathway? And so I've started asking questions of people you know, like, how do we get to this? Like, how do we work in partnership with these national associations to develop this out? Is it more at the academic institution and university level? Is it more at the national association level? Is it more at the employer level? We've even asked that of the community at feeding matters, and what does that look like?

Jaclyn Pederson: 9:36

And I think it goes back to what you're saying of part of the problem is there isn't necessarily like a best practice for treatment, so how can you even train on that? And it just ends up being this cycle of we don't have enough research to show X supports Y, and so then it ends up being this black hole of people having to do the research on their own, find a mentor on their own and really try to do this work on their own. And I think that's also where adult dysphagia comes into play, because the dysphagia world in general and research in dysphagia world, it's come a long way and I know it still feels like an emerging field sometimes, but I think the pediatrics of it is looking to the adult dysphagia world and seeing how that can be our leaders.

Tim Stockdale: 10:27

Oh man, that's a little scary.

Jaclyn Pederson: 10:30

I know.

Tim Stockdale: 10:32

No, I don't mean that to Blind leading the blind in some instances, in some instances and that's not something that speaks to the integrity of clinicians or anything- no, not at all. It's a systemic thing that limits our training so much. And people, I'm not gonna rant on this all episode, I promise guys. But it's like nine diagnostic categories, five or six semesters and there's so much variability in background and I don't know.

Tim Stockdale: 10:56

It's alarming to me and like you had mentioned earlier, this is at least what I took away from your comment that you started really supporting families, but then to support families, you're like, well, families are relying on clinicians and are like, oh well, I don't know. You know that sort of thing because of the lack of training. I mean, think, if you're whoever's listening right now, think of your training in adult dysphagia, right. So think of that, Think of what it should have been or what it could have been versus what it was. And now think about your training in pediatric feeding or pediatric dysphagia, those types of things.

Jaclyn Pederson: 11:31

I mean, even like pediatric motor speech, limited, limited, depending on where you are, yep, yep and your exposure of it and what the passion of the I mean it's really predicated on what university or academic institution am I attending and what passion or history is at that institution and and that is what sets you on the trajectory for your career. And I don't think that this is the like in pediatric feeding disorder. It's a new condition. It was only published in October of 2021. And so in that sense, it is still very emerging. But this issue is one that I think could be done, or a study done for many different other issues. I think the challenge is it's a lot of practice areas and so it's hard to be a generalist and a specialist all at once. Absolutely.

Tim Stockdale: 12:28

Absolutely, absolutely, especially without. I mean, we have fellowship, sort of clinical fellowship for speech photographers, but that's not like a medical fellowship or not like a residency, so I don't know. There could be a lot of things in place but you think of, like well, who's going to pay for it? Yeah, that component of it too.

Jaclyn Pederson: 12:46

That's a huge component too.

Tim Stockdale: 12:48

And if we transition to a doctorate like it's also, who's going to pay for it? Because it's not like reimbursement rates are going to go sky high. We're going to be in more debt. From going to school. We're going to be better prepared, but we're also going to be eating ramen noodles for the next 20 years, you know.

Jaclyn Pederson: 13:12

Yeah is you know, both national associations, aota and ASHA, had pathways to do some sort of like board certification or specialty in feeding and swallowing, and because it's within the scope, that pathway kind of existed, but people weren't using that pathway because the incentive to use it wasn't there. Having the board certification didn't necessarily mean you were paid a higher salary or anything like that. So kind of like back to that system problem who is going to pay for it? And I think that's the hardest challenge in a lot of these system problems is like I was talking to someone the other day. They were like who's to blame for this issue? And I was like I mean, the system is like always the person I blame, because it's just like it's not built. And so then you see all the domino effects that result because of it, and families are left in the lurch. And then professionals are there too. You all as professionals are just trying to support your families and do the best that you can clinically, but it's challenging for you too.

Tim Stockdale: 14:09

Oh yeah, yeah, there's a lot. I kind of a one trick pony.

Jaclyn Pederson: 14:16

I want to be good at dysphagia. I'm sure you feel that way.

Tim Stockdale: 14:19

Well, I mean, there's a lot of other stuff. I find that when you go at dysphagia, I'm sure you feel that way. Well, I mean, there's a lot of other stuff. I find that when you go into dysphagia, you know you get motor speech disorders, you get all these acquired neurogenic disorders and whatnot. So like I love all that too, but I am lost as far as pediatric feeding goes. I mean, I'm lost as far as phonology and a number of other things too, but this is so far out of my comfort zone. It's crazy, like it is just so far Back to the article. So we've kind of got an idea and would you say the theme is that training is limited, it's not standardized, it's not supporting clinicians. Is that fair? That is very fair. Yes, so what are some of the most?

Jaclyn Pederson: 15:03

alarming takeaways for you. I think the most is that treating pediatric feeding disorder is in both scopes of practice for both disciplines. Yet the standardization for how a clinician may be coming out of school is not there. Overwhelmingly, the respondents shared that they felt underprepared to be able to treat this coming out. And again, who to blame? The system is to blame.

Jaclyn Pederson: 15:35

There's not great mentors available for these students because there's not a lot of research out there, and so it's this. It kind of piles on. But you know what we detailed in what we heard from the survey and the respondents sharing their kind of their, their self-directed educational pathway was really dependent on if they were able to find a fellowship that made sense in the feeding world, if they were able to find a mentor. There was a lot of like taking courses and different classes and that kind of produces its own challenge as it relates to where evidence is at right now and then I think a lot of times people are also doing things like listening to podcasts to get exposure to other things it's mentioned in and having article review clubs and kind of some of those like more case, like peer reviewed, sort of self-directed activities.

Tim Stockdale: 16:36

Yeah, that's very interesting. You know, I I'm thinking about this and I'm thinking if someone was going to have like open heart surgery and they're like oh where'd you go to medical school?

Tim Stockdale: 16:50

Oh, harvard Medical School, or like you know whatever. Or where did you learn to do cardiac surgery? Well, I took some CEUs. I, you know. I got my general medical degree and then I took some CEUs. I, you know, I got my general medical degree and then I took some CEUs. I even did a little bit of hands-on practice under a mentor who was also self-taught, and it was alarming.

Jaclyn Pederson: 17:11

You know you'd be like oh my gosh, jim, that's such an interesting metaphor.

Tim Stockdale: 17:14

You'd be like get away, like I'm going to go to some other place, some other country, other side of the world, where they actually like teach this based upon an evidence base, and so, like I think the thing with that, though, is we know like, oh yeah, yeah, you need the heart to live, right, you know, someone gets in there. They can kill you really fast if they nick the aortic artery and you bleed out, that type of thing.

Jaclyn Pederson: 18:05

And that's a big deal because it's like with this, it's important for people to understand what are the implications of it right now.

Jaclyn Pederson: 18:08

So the pediatric feeding disorder, if it's not identified or not treated well, or even in some cases, if it is, it can turn into ARFID avoidant, restrictive food intake disorder which is a mental health diagnosis later on in life as an older child and into adolescence and into adulthood.

Jaclyn Pederson: 18:21

And so I think that's one of the impacts is the true psychosocial damage of not getting identified early but also not getting to a provider that can support your feeding skill development, including your swallowing, as well as your psychosocial relationship with mealtimes. You know, we're finding because the research is now progressing a little bit, we're finding that it takes us seven years and longer to learn to eat, to refine those skills, and if there's any disruption in that, it can have devastating effects for the individual but then for the entire family, because this condition brings families to their knees, because it is just so stressful, so expensive and then to be told I don't know if you're seeing the right provider, like you've got to evaluate whether you have the right provider or you're doing further damage is really challenging. And the problem is that even if a provider thinks that they are qualified or thinks it's within their scope, I sometimes worry that they don't even necessarily have the foundation to know that, and so it's just a real big crisis because it's a very prevalent issue.

Tim Stockdale: 19:42

And the whole thing with self-assessment, like you're saying, like someone feels like they're pretty good at something. Like when I was in the third grade, I thought I was pretty good at basketball. Like I thought I was pretty good.

Jaclyn Pederson: 19:51

Going to the NBA.

Tim Stockdale: 19:53

Exactly, exactly. I would get so ticked off if my mom was like you know what happens if you don't go to the NBA. I'm like mom, come on, don't be a hater. Like.

Tim Stockdale: 20:01

I thought I knew this and obviously I'm third grade, very cognitively underdeveloped and whatnot. But this is hyperbole, right, using hyperbole. But then you get and you go to like a bigger town where a lot of other kids play and you get schooled and you're like, oh okay, this is what it looks like when you're doing the right thing or whatever. And then they go to another place, you get to a bigger pond, a bigger pond and you see, oh, I'm not as good or as smart or as whatever as I thought I was. And so there are limitations in self-assessment. If you don't have a way to calibrate and I'm going to take that back and say, well, I'm not going to take it back, but I know there are standards that are out there to look through this checklist. But how many providers can say that when they started practicing they met all those standards? Like I would be baffled. I think that would be some really interesting self-assessment to calibrate with.

Jaclyn Pederson: 20:54

I would agree with you.

Tim Stockdale: 20:57

There are also known biases too. I'm not going to say the sciences is perfect, but, like Dunning and Kruger's work, when you know a little bit about something, sometimes you think you know a lot more than you do. And then, as you learn more, you're like oh man, I didn't really know what I was talking about. I didn't know what I was doing. And then as you continue, your, your competence and your competent, these competence and your confidence become more proportional. But initially, like it's real easy for confidence to be through the roof, we don't know as much just like little third grade NBA Timmy with his bowl cut out on the playground. You know it's man. Yeah, that's how it goes.

Jaclyn Pederson: 21:34

Well, and I completely agree with that, and I can't remember if it's in this article or the one prior or maybe it's in a future one, but we we were trying to get a sense of like, okay, because I think one of the questions asked was what is your confidence level in treating pediatric feeding?

Jaclyn Pederson: 21:57

And we saw a kind of scored positively. So the lack of educational pathway, the having to do self-directed work and stuff, and I think it speaks to that piece of it's hard to do some self-assessment work in this area and so the confidence is really high. I do hope that we can get a little bit more depth to some of those standards and work on what are we really want to see from a competence standpoint, so that way everybody can kind of be on the same playing field, because it's so individualized depending on what course you went to or whatever. But all the competence does seem to be high, which I think is kind of concerning from a sending families out into the world standpoint and there are amazing providers out there and I don't want anything that I say to detract from that. I am just trying to sound the alarm that we need to better support our professionals so that they can feel supported and feel confident in going out into the world to treat children.

Tim Stockdale: 23:03

Yeah, and that's really been a huge razor's edge of this podcast and some other stuff that I try to put out, is that it's not meant to be critical of the clinician because, if you're listening to this or earlier, and not say like you might be listening to something else wherever. If you're actively trying to learn, that says you know so much totally does in a positive way.

Tim Stockdale: 23:29

But I think we just are identifying that there is a problem there and we're trying to find out what the cause of that problem is so that we can we can help to be a part of the solution. And, like you were talking about the magnitude of this, the psychosocial implications, I mean just from an adult dysphagia perspective, looking at the functional outcomes like nutrition, hydration, pulmonary sequelae and quality of life. So the psychosocial stuff really hits on quality of life If it turns into potentially a mental health diagnosis like, yeah, that's pretty huge. And look at the role, though, of nutrition in fighting illness. I mean, I know more about that in the elderly than I do in kids, but you have, I mean, that's your immune system's developing, you have so much going on and so that if you're undernourished and you're not getting the macronutrients and you may probably even the micronutrients that you need to to fight infection or fight illness, that can lead to early death.

Tim Stockdale: 24:22

And in other places like we're we're thinking the United States you know we're very privileged or or or Canada, the number of different places in the world I don't want to assume anything about anybody who's listening to this, but I can imagine in other places where there is less privilege and less robust medical care, how this can lead to so many more deaths and how it can just set people back. So far, I am very fortunate to have a friend in Cameroon and there's like this ongoing civil war there and he's a remarkable individual. He takes people into his house who have been displaced and he has kids of his own and you see, like all of this stuff that he's going through just in a different world than we're living in. And so I don't know like it's enough of a problem here that when we're not considering what people in other places of less privilege are going through, it's just, it's remarkable to me, it really is.

Jaclyn Pederson: 25:25

Yeah, that's very true and this particular article was based on the United States respondents, but when we did do the survey we did get some international respondents. We haven't gone back and looked at that, but I just know in Feeding Matters work as we try to talk to other countries and what's happening there. It is definitely a worldwide problem that no one has great solutions for not only on the identifying the kid's side and figuring out their treatment pathway, but also on the education side and getting more specialists available to treat children with PFD.

Tim Stockdale: 26:03

Yeah, so kind of along the lines of what you're saying, that most individuals who answered this were from the United States. What other limitations do you see in? You know the potential to generalize this article.

Jaclyn Pederson: 26:20

Yeah, I think I mentioned earlier too that one of the challenges is we recruited through Feeding Matters and then the different listservs through the national associations. So you know, in that sense I feel like we tried to get as many individuals as possible to participate. But I think there's always a limitation in bias, in participation based on your recruitment methods, and so I think that's one of the biggest limitations. That's one of the biggest limitations and just it's important to kind of get a better understanding of what exists within the National Association standards but then what also exists in the university standards. So as much as we are reporting on what people shared with us and then we try to also then research kind of what's happening in the field, to try to share both of those stories, that may be a limitation too, okay.

Tim Stockdale: 27:15

So, as we, as we get close to the end of this episode, there are two things that I want to make sure to cover. One, I want to see if there's anything else that you believe we haven't covered that is important for people to know. And other than that, I want to know, like what do you think are some actionable steps that we can take to make this better? And maybe we're not there yet, maybe we don't know, maybe we as a profession don't know. Are there any other things that you think this article has brought to the light that are super out there, important, that we haven't discussed?

Jaclyn Pederson: 27:44

I think it's the start of the work. So I think for us it was about you know, this is an emerging field of research. We know that, like professionals aren't supported. Well, let's get a better understanding of it. But for me it felt very much the start of the work and we need to continue the work. But I think, and I guess maybe it's kind of a future direction or limitation of future direction in terms of what do we do with it.

Jaclyn Pederson: 28:13

But you kind of get into this cycle of okay, we know there's no educational specialty pathway, how do we fix it? We talk to the national associations, try to work in collaboration with them. They are open to partnership, but they often don't know what to do on their end, because it's difficult from their perspective. And then we've talked to universities and it's difficult from their perspective because they don't have standards of best practices to be able to then train individuals and so to not use like meme culture, but it feels almost like the Spider-Man meme where everybody's pointing at everybody else. And it's hard because it's like this work needs to happen and so you know we have a vested interest in making it happen. We're a nonprofit, it's part of our mission. So we need to support families, we need to support professionals, but that's the future direction is like we're going to have to figure out this together and collaborate and really get curious about how we do that.

Tim Stockdale: 29:07

Yeah, and you know, from an educator perspective it is extremely difficult, like if you look at all the things you're supposed to be teaching versus like what people are walking away with. If you cover so much breadth, especially like if these are students in their first, second, third semester who don't have a bunch of clinical experience to anchor this on, like they, sometimes you end up you're at risk for teaching to the test and long-term retention isn't necessarily there. I mean, teaching methodology has changed. The knowledge of how learning science, how we learn and can apply things, has changed so much. And so I believe and I think everybody knows that I believe this that our scope is well, speech, I speak to speech pathology in particular scope is just so broad and if it's going to be that broad on things, I mean everything matters.

Tim Stockdale: 30:01

But especially on areas where you can kill people or cause like I mean I can think any, just about any category can cause like permanent psychological harm, which is huge. There's got to be a clear, supported pathway for that depth. It can't be all student-led learning, right and kudos. I commend everybody who is trying so hard to do their best, but we need so much more support. That is my belief and I know that educators can't do it alone. I don't know the answer. I mean, hopefully someone out. I know that educators can't do it alone. I don't know the answer.

Tim Stockdale: 30:31

I mean, hopefully someone out there. Maybe you haven't figured it out. If you do, please send me an email. Come on the podcast. I would love to hear that. There's just so much so with what we have. What would be some actionable steps that listeners can take or that you know as a whole, as healthcare providers, that we can take?

Jaclyn Pederson: 30:52

As healthcare providers. I think there's two facets to this. So if you're interested in this as a field, you know definitely if it's not anything that you have education in, you will have to go and try to find that education, unfortunately, the good news is I think you've got a plethora of different options out there for courses to take or different people or mentors to follow, whether they're personal mentors in your local area or more kind of internet personality mentors. There's also many different communities of practice. There is a growing presence of pediatric feeding specialists in the SIG 13 group at ASHA and a community of practice at AOTA. So even if you're a dysphagia provider like that may be an easy area to kind of find some others that are part of you. And then Feeding Matters is a community that supports families and supports professionals and can help you find other providers out there, find access to information and more.

Tim Stockdale: 31:54

Well, thank you. Thank you for your investment in this, as, not being a clinician, I think it takes a village, and it takes a village with different skill sets and different perspectives. So I am very grateful for the work that you're doing and grateful for the work that so many others are doing as well. Thanks for coming on here. The name of the article again is preparedness of speech, language pathologist and occupational therapist to treat pediatric feeding disorder colon a cross-sectional survey. This is in dysphagia. I can post a link to it in the website. Um the podcast description, and it's with Kelsey Thompson. At all, there are 1, 2, 3, 4, 5, 6, 7, 8 authors on this, so some pretty tremendous collaboration. It sounds like.

Jaclyn Pederson: 32:37

Thank you for having me.

Tim Stockdale: 32:38

Thanks so much. It was a pleasure, I learned a lot and, to be honest, I had a blast. This was great, so thank you.

Jaclyn Pederson: 32:43

Yeah, it was so fun. Thank you, tim, really appreciate it.