Episode 251: You’re Worth The Time and Investment with Melanie Peacock Shell, MEd, CCC-SLP

Hi and welcome to episode 251 of the Untethered Podcast. Today we have Melanie Peacock Shell joining us. Melanie is a speech language pathologist with 40 plus years of experience working in virtually every setting from schools to private practice to early intervention and hospitals and she specializes in pediatrics, beating and swallowing, sensory communication and neurodiversity affirming practices with autism and other diagnoses. She works in a hospital outpatient facility and RDA based practice, private practice and as a parent coach for the Inside Out Sensory Communication program. Quick Disclaimer all information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified healthcare provider. Welcome to the Untethered Podcast. I am your host, Holly Balkan. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, airway, tethered oral tissue and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide. If you've been around since June 2019, thanks for being a loyal listener. As we jump into today's episode, remember to listen with correct oral rest posture, tongue up, lips closed, teeth apart, breathe through your nose. Let's get started.

Foreign.

Welcome to the podcast.

Hey, it's so great to be here.

I'm excited for you to join me because we talk all the time online and I feel like I, you know, I just recorded another episode with a colleague and want to call her a friend, somebody who also was, I think in your Feed the Peace cohort actually. And I was telling her, I'm like, I just love the community that it's created for so many of us because, you know, I feel like you all are colleagues and friends and so I'm excited. Chat.

Exactly. That's great.

So let's dive in and tell me a bit about your history. Feed the Peas was not your entry point into being a pediatric feeding therapist. So will you share with us your journey into pediatric feeding?

Sure. So I graduated from graduate school from University of Georgia in 1980, long time ago. And at that point we had all the anatomy courses, physiology, all of that, but no feeding, even though we knew the parts. So after graduation I had to really piece that together. Started reading online when I online then. Back then it was more, you know, books and whatever because we didn't have online back then. So then I would go to courses, try to piece it together, did some things like ndt intro and Run Alexander, all of those things and just had to do a on my own. In fact, when I was in Albany in private practice, Georgia, I was trying to get modified started there. There were no modified barium swallow studies at all. So I was working on that and a radiologist came to me and said, let's do it. So we did no protocols, no nothing. We did it on our own. And the first two were a baby, an infant, and then an adult with a stroke. So that's kind of where I really started and got into it. And then I worked in lots of different places with child development centers. And then I'm back now in Macon, Georgia and working in a hospital setting, outpatient pediatrics. So I kind of honed it down to peds at that point and probably 2020, when I was really searching online, I found you. Yay. And I read it first, you know, immediately downloaded the screener, the feed, the peed screener, and started using that like day one. Even though I've done lots of feeding therapy, had lots of courses, you know, the whole gamut, I thought, this is so concise and great and I love that developmental sheet that you can just give to a parent, explain, here's what we're looking at here, here's where we're going. And it was awesome. So then started delving in and delving in and found out about feed the pace and thought, man, I want to do that. Even with 40 years of experience, I thought, this is it. So I kind of muddled in my mind, went to my manager and said, you know, I know we only have $250 for continuing ed. What can I do? So they pointed me to the Navicet foundation here at the hospital and I wrote an application to come to the course. And you look at things like no travel, they're not having to pay for lodging, they're not having to pay you to go to a course and not be at work for however long. I mean, Yours is a 12 week course, so, you know, that would be a lot. It'd be like MDT or something like that. So I put all those points in there. You're not, I won't miss any work. And then I'll be able to take this and bring it into the workplace. So that's how I kind of got into the feed, the peds course and loved it. And it's part of my journey. And even though with all this experience, when I got in there, I was like, whoa, this is so cool. Because you started development, you know, normal development. That's so important. I think some people don't always think about that first. It's like, oh, what are the disorders? How do I treat those? Well, you got to know what's normal first, right? Or typical. And so you started at the very beginning, or y' all did. And great mentors in the course, Ramya and Caitlin, and you are just fabulous. So can't say enough about that. And so with that first part, and then starts with that sensory level, which is key for me because my area is feeding, swallowing, and really autism, which is kind of different, and sensory differences. But you validated so much of what I was feeling but was not getting from the outside world.

I love that. I think that, you know, we really set out to create something that, like you said, was more comprehensive and kind of holistic in the sense that, like, we have to know what typical looks like in order to know what we're going to be treating. And how are we even off trajectory here. Right. And even going back to. You mentioned the. The free screening, you know, fe. The free feeding screening packet that we launched, like, before the course ever came out. You know, I kind of just. I was looking at. I think I was staring at, like, a checklist that I had just made one day, and I was like, huh? I feel like we need to make this into something else. Like, I feel like this needs to be more comprehensive. I also feel like if I could just visually see those, like, steps of development on a chart, like, that would be so helpful to me, and I would love to see it up against, like, some gross motor skills and some fine motor skills, because, again, just like, looking at the body holistically is so critical. And I just.

I don't.

You don't see enough of that. And so I honestly, I did not actually create the final checklist or really that chart. I just kind of was the brains, you know, the idea behind it. I brought in one of the speech pathologists who helped to put the course together with me, like, early on, and I was like, hey, you're really good at these things. I was like, this is what I have. This is what I'm envisioning. I was like, can we, like, you know, pull some sources together and basically create this comprehensive checklist? So even though it's a screening, honestly, times, like, I use those that I would Use that screening. And then I carry it through into the actual assessment too, because it's got so much on it. And yeah, I would just was. I've always been so, like, happy that we have that screener out there because I think that it really has opened up a lot of eyes to like, oh, hey, okay, feeding is complex, but even if I don't want to do feeding, I can still scream and I can still identify kids who may be struggling with something and help them get to the right person. And so, you know, then in came the course and it was like, how do we create this comprehensive thing that really does take somebody, whether they're in the field or they're new, through a journey of, hey, this is what we should be doing, this is what we're not doing. And here's like all the other bazillion things that could possibly happen. And, you know, we can't possibly cover that in one course and we don't. But I really wanted to dive into a lot of the trends that we were seeing and, you know, look at medically complex kids, which was not my scope. I was working with like the tongue tied babies and the infants and toddlers who weren't feeding, but they were not typically. I occasionally had a medically complex case, but typically they were not our medical, you know, complex kiddos who I wasn't working with a lot of, you know, G tubes. I wasn't working with kids with, you know, significant health issues who were hospitalized, who were, you know, inpatient, outpatient. It was more like, oh, they can travel to my home office or I can travel to their house, but they're not homebound for health issues kind of a situation. Right. And so I was like, I need people to help me because I haven't had those experiences. I've never worked. I worked in a hospital as a grad school clinician with adults, both inpatient, outpatient.

Right.

I only worked with children in other avenues and never. Yeah. So anyways, all that to say, you know, I love that you have such a vast, you know, background and so much experience and even coming into the course and still finding it beneficial for you in certain ways. Because I get asked all the time, well, you know, if I'm an experienced feeding therapist, like, would this be beneficial to me? And I always tell people, I'm like, I've been told by a few individuals who've taken the course that, yes, the answer is yes. I was like, but I will tell you straight out that this was created with, you know, newer feeding therapists in mind. However, there's a lot of information. This is a 40 hour course. So like you're going to, you're going to dive deep regardless if you're, you know, new or experienced. So I just, I love hearing, hearing your perspective because I know you're one of those individuals I like to reference that felt it beneficial, you know.

And when you were saying about the medically complex, that is a lot of my case. So I began with pediatrics, working in the NICU back in Albany, Georgia, in the old days, inpatient and outpatient. And then now at this point we get all the NICU referrals and those are like top of the list. So you got to be up on that game, you know. But the thing about that is, is with that trauma, that insult that they get over over there, I'm pointing to where the NICU is. Huh? Hello. When they get that have that kind of trauma and they all have it, you know, and we get the various cases, they're either tubes, some of them already have a G tube, they're very involved. This was so helpful to me to get other perspectives and what are the newest things coming out, you know, and what can we add to our program here that has also propelled two of our other speech pathologists who have completed the course here as well. So we have now three of us, which is great because we can use that information and bring it forward. And the other thing I thought was just like icing on the cake was after I completed the course, you know, my 12 weeks, I'm like, woohoo, this is great. All of a sudden in my course materials, bonuses popped up. I was like, whoa, whoa, whoa, whoa. And I was like, you have got to be kidding me. And even though, you know, some of the things were in the course, you had the PDF fillers for the intake forms, so important, the evaluation forms, the TOTS forms, all of that information, which was in fact a lot of that was new for me, that specific. And it has really taken me and propelled me forward. But also in those bonuses, you had videos and different, you know, what happened to some of the case studies that we did during the course. That was awesome. And recently I got really excited about this one. You've started doing the, you threw in what videos of the assessment and treatment library assessments for the library. And that's so helpful because it's really good to see someone else and then think about, okay, how can I utilize their technique? Maybe might give me some new ideas. Right?

Yeah, well, and I, you know, as a business Owner. I'm always kind of looking to go, like, how can I sweeten this? Right? You all have trust in me and you all have, you know, jumped into this course. And I know that you got everything out of it that we promised. However, like, you know, it was still an investment in money and time and energy. You know, what else can we do, just as a thank you, if nothing else? And so we do review the forms that everybody fills out at the end. They're not just there because Asha or Aota tells us we have to have them, they're actually there. Yes, they do have to have them, but we ask way more questions than is required of us. And it's really so that we can get feedback and understand is this still beneficial to all the students? We know what past students have said at this point, but how about current students? And then when we start to see trends or themes or things that people say they wish they had or they're asking for, well, okay, I mean, business person might say, okay, great, go create that course and sell it to them. Sure, okay, maybe we could do that. But in, like, in the heart of hearts, I was like, what people are really asking for and what I think can be tricky with an online course is seeing real therapy. And so we basically went out to our alumni and we said, hey, anybody has, you know, patients who are, you know, willing to let you record them and willing to let this live on a shared library for professionals. It will not be on social media. It will not. It will not leave here. But also, we will never sell it. We're not selling it as part of the course. It is basically a free thing that you get as a bonus. And because we did have one family who said, I don't want this sold, but I'd be glad to share it, like if it resource going to clinicians, because you've been so helpful to me, having had taken that course, if this person's asking for that, like, here, use everything you want. I was like, oh, well, okay, well, that's super cool. And so, yeah, we're slowly going here. We've got some more coming, but we are slowly going through some cases. I think we might have like a total of four patients right now. Maybe it's either four or five where we are going through and editing and getting more together just to give different perspectives. Like one of the things we'll sometimes talk about, especially, I know Ramya likes to highlight this in the assessment module. No two assessments look the same and you're not going to fill out your Whole checklist. And just because we give you a whole evaluation template for birth to six months and another one for six months, plus kind of dividing it by, like, when you introduce solids before and after. Just because you have that doesn't mean you're going to check all the boxes, fill it all out, or actually complete it ever. If, you know, eventually you probably will just by the fact that, like, therapy is dynamic and ongoing and all that fun stuff. But, you know, that's one of the hardest things. I find new clinicians, like, they have the hardest time grasping the fact that they're not going to complete the entire assessment form. Yeah. So I was like, you know, I wanted them to see assessments and see, hey, none of us are actually checking all the boxes. They do an assessment. It may look different than how this person does an assessment. And this therapy session, even though we had similar goals, is going to look different than that therapy session. Because I think that just the. Just that having that information, I think helps us become a little bit more confident in knowing, like, okay, we can go in and we may have a great plan in mind. But things never go as planned, do they?

I love that you say that because I think taking this course, I felt like I got some permission to maybe that first session of the evaluation is going to be just trying to get that baby or that child to be with me. You know, I trust you.

They'll report. Yeah.

And that is okay. That if I don't get in there totally until sessions later, that's okay. You know, and that I can just take my time with it and that it's not always going to be the same. And I have a lot of graduate students that come under me, CFS, etc. And I try to tell them that you're never going to do the same thing every time. Yeah. There's certain things you're going to be looking for. Yeah. But then you might get something that's totally outside of it, you know, and.

It'S so helpful for them to hear that from somebody so early in their career, because I think that we, so many of us enter coming out of grad school and we're like, I'm ready to conquer the world. And then we go, we start treating patients. We're like, oh, what just happened?

What am I doing? Yeah, I don't know anything. And I love. Also a lot of things you have in there are the encouragement part of it. You know, you are. I love that I have it on my computer. You are enough. I make the time. What's the other one, I don't have it here in front of me.

So you're enough. You are worth the time and you're worth the amount.

Yeah.

Yeah. Because really, it's. It's taking that onus to be like owning the identity of being a feeding therapist.

Right.

And we're not going to get there unless we believe that we can get there. We're also not going to get there unless we're willing to invest in ourselves. And. And I think a lot of us, you know, all the time, we question ourselves. Like, I'm starting a new business right now, completely unrelated to everything else that I already do. And I've gone through those same motions of being like, am I really the right person to do this? Like, it's not to say we're not going to have those thoughts and feelings. We all do. It doesn't matter if you make a lot of money, a little money, if you're a therapist or a business owner, you're, you know, it doesn't matter who you are. You're human. You're gonna have these thoughts. It's just knowing what to do when. When they. When you have them. So you don't get stuck there. Because I think I, for a very long time, a long time ago, would get stuck there and I would question myself and I would be like, I don't know if I'm the right person for this. And it's not because I didn't want it. It was because everybody else was telling me I didn't know enough or I didn't have enough experience or, you know, and I will tell you, I am actually bringing a CF onto my team and paying her very well because she's had extensive feeding experience in grad school and in her cf, and she's going to take over a caseload. She's almost at the end of her cf. And so, like, I will become her supervisor to kind of help finish it out. And she's taken a mile course, but she's never really done, like, a lot of myo. She's really focused a lot more on feeding. And I'm like, I would be glad to have you. You know, you've taken a course, but you can take my course. And we'll mentor you, will make sure you know exactly what to do. And, like, we'll kind of walk you through cases and, you know, everything that mentorship is. But it's really interesting for me to see this because I think it just kind of Dr. Drives home the point that we've got therapists who've been in the field for dozens of years who have never done feeding. And then we've got therapists coming out of grad school. And I really hope there are more and more of these because this is still kind of rare that have had exposure to patients in pediatric feeding settings that have gone through courses as a grad student, whether it's in their program or outside of their program, who have then continued this journey in their CF and they've actually started to become really specialized in what they're doing and they maybe been exposed to this for a year or two. And so I like to really drive home the point that like time is not the definitive factor, you know, to your level of experience always. And that's unfortunately the opposite of what most of our industry says, which is why I like to highlight that. So.

Yeah, and I think it, this just, that whole validation thing was just super, super important and kind of changed my whole trajectory. It's really helped me with my autistic clients because I'm looking at their sensory differences, but also knowing that most of those are body based problems that started somewhere. And a lot of them, you know, and looking at how to treat that, but also respecting their space in their sensory system. And you've got to get them regulated before you can ever get in there and get the experience. And if you turn them off to begin with, you can't do your stuff. Right. Yeah.

I love that. You know, I know we were chatting for a few minutes before we hit record and you kind of said, I have this unique population I work with, you know. Right. And it's, you know, these, we've got that sensory component that's so key when working with these patients, with the autistic patients. But I was like, hold up, hold up, hold up, hold up. Because like when I was like, my autistic patients were the reason I think I really fell deep into the feeding world, why I think I was interested in it already. But they really propelled me forward. Especially like there's a couple in mind that I just always come to mind when I talk about this. They are so, you know, sometimes so set in their patterns. And so I'd have those kiddos, right, who. And this is not just true of the autistic population. This is very true of like other kids with feeding challenges as well, where they learn what their safe foods are. Right. But I would notice with my autistic patients that like these are like preschoolers, like pre K age, you know, 2, 3, 4, they would stick to those bland Colored foods, right? They wanted the foods that were easy to mash or munch or break down. And they didn't always even break all those foods down properly. So here we had a lot of constipated children who then had withholding issues or, you know, they. They wanted a snack, but didn't want a snack. And then we also had sometimes ABA in there, which is a whole other conversation for another day where they were rewarding them with food. And I was like, this child, I'm.

Like, please stop using food as a reward.

Can we, like. I was like, we can talk about this. Like, one of the kiddos I worked with actually had a phenomenal ABA therapist who actually was like, properly trained in verbal behavior therapy and was not just. Didn't just say they were doing vb. Like, this person was actually amazing. And the child really benefited because they were able to generalize. And it was not just a, like, with this person in this environment kind of learning situation. So that was really cool. But that person, like, they were always there with us during our sessions and. Which was also kind of cool because we got to collaborate a bit. But I had sessions where the entire session was shot because this child was withholding a bowel movement or they were really uncomfortable and kind of bouncing around and, you know, and trying to make themselves feel better. They were trying to. They were seeking a certain type of sensory input to, you know, calm their digestive upset and this chaos they were feeling throughout their body. And, you know, I started to just go, why? Why, why? Like, there's nobody. Why is nobody looking deeper? Why? We're just going to give this kid Miralax? Like, that's the doctor's only solution. I was like, there's got to be more to this. And so they really threw me down this rabbit hole of, you know, what is happening? Why am I seeing these patterns? Like, there's got to be more. No one's teaching me this. And I just. I credit them, you know, some of these patients to where I am now because I was like, they were such fascinating and intelligent beings. And I had these kids too, that just. They taught me so much. And, you know, one of them as well. I remember a therapist sat down and I was taking over a case. Therapist is down at the table. This kid loves trains, right? Gets very hyper fixed on trains. And this therapist with the kid is like, trying to get the kid to say something, say something, say something. If you say something, then you can color in. You know, I'm sitting here going like, oh, this is painful. To watch. So, right, this therapist leaves, I take over the case. I come in, I bring some trains, know the kid likes trains and other random things in my bag. And I just get down on the floor with the kid, and, you know, kid starts laying down. The kid's kind of spinning the wheel very slowly on the train. And I just got down on the floor and I started spinning the wheel slowly on the train. The kid kind of looks at me like, what. What are you doing? I was like, I'm matching.

You're engaging, right?

And.

Right.

And I'm like, and I'm not. I. I will tell you, I have never taken, like, these sensory courses. I don't know the right terminology. I do not call myself, you know, I don't know any of this stuff. You are. So you can speak. You know, I just was like, I'm just gonna match what this child is doing and see if I can enter into their world and some rapport and gain some trust. And, like, look, at the end of the day, if I can't, they're not going to do anything I want, as we saw at the table the other day. And so as soon as I started doing it, the kid, like, said something to me. This is like a kid who does not speak, right? And I was like, oh, okay. And then he kind of, like, moved into my space and pushed his train towards me to see what I would do. And so I kind of sent it back to him and we started to engage. And what do you know, within, like, a couple months, the kids putting two word phrases together, and now we're starting to put three word phrases together. Now we're spending, you know, starting four and five. And at that point, I said, okay, can we start working on, like, the snacks? Can we start working on, you know, we've. We've now accomplished what mom wanted to accomplish, at least on the first stage. Now let's start, like, bringing the food stuff in, which is not why they were there. But I knew it was a major issue at home. I also didn't feel like I was. But at that point, enough, like, I didn't feel like I had enough knowledge to even know how to help this child. That I was, like, willing to try and take courses. And so anyways, I'll stop talking. But, like, all that to say, I really feel like, what are we even doing if we can't meet our kids where. Where they are? And I just give so much credit to the autistic community and those children for really helping me move into where I am. Today and kind of making me think a bit differently and go, huh, There's a reason for all. There's always a reason for a certain behavior, if you want to call it that. What is the antecedent? What is leading to what they're doing and how do I enter that space and hang with them really, to get them, to help them, to help them push forward and gain some function.

And that's kind of the whole thing with the approach that I'm using as far as sensory is, which is the inside out program approach, which is starting at regulation engagement. And then we get to language, then we get to feeding. If it's the issue, which 99% of the time is you have to look at the whole thing. And it's not only they don't get the practice. So Hallie, they're it. They, you know, are two. And we get a diagnosis and finally get to see them. And parents are like, we just give them what they want, you know, And I understand that totally. And they have their safe foods. Well, we need to validate that first, you know, and then we can get through that barrier. And it's all about getting into their space. And autistic adults tell us, you know, this is how I felt. This is why I'm at this point. How can you help me, you know, or help the little ones that we're seeing now to have better progress, you know, so it's all kind of dovetailed into this little niche that I have, I guess.

Yeah.

You know, and you never know what a NICU baby is going to experience. And then they get to a certain point. Yeah, well, other thing I think I wanted to mention for sure, and I think we talked about this a little bit before we recorded was how those. That intake form was just like really special to me. So I do a private practice on Fridays, which I just gave the feeding intake form. We have a speech one. Da, da, da. And I was getting a patient coming from a preschool and they just wanted extra speech therapy is what the referrals are. So I'm like, okay, send them over intake form and I'll see them whenever. So I go in to get the form and they sent the feeding form. And I was like, oops, okay, I'll still get information because it's great. Let me just tell everyone. It's really a cool intake form. And it does have some speech and language things on there, by the way. So I look at it. Breastfeeding was painful. Painful didn't work very difficult. Feeding issues. About to have Our tonsils and adenoids out. The kid walks in, long face, open mouth. I'm like, okay. And so we went through very unintelligible, very sensory seeker all over the room, you know, So I thought, let's get that out. And I told mom, I said, I'll need to do an oral mechanism exam. And she's like, oh, yeah, sure. So he opens his mouth, his tongue was in the bottom of it, did not move. I finally got it elevated a little bit with my throat scope in there, so tied, and it just came out quickly. His tongue is died.

I was like, oops.

And she burst into tears. And I thought, oh, no. So I went over to the mom, I said, I said, I'm so sorry, is this upsetting you that I'm telling you about the tongue tie? And she said, no, thank you so much. No one else believed me. This is a 4 year old. No doctor, no ENT about to have the tonsils and am noise out. No. Anybody? No. Speech therapist all said, no, there's nothing that doesn't cause a this. So I'm like, well, I disagree, I.

Respectfully disagree with all those colors.

And also his pallet was like, you know, high and narrow. So I was like, there is no way here. So because he was about to have his tonsils and noise out, I'm like, you're going to my dentist that I know will take care of this for you. So she did go quickly and yes, she's like, this got to be released. So I think, I think the trajectory was we did the talks with adenoids, did some work, and then he had it released. But all to say a mistake was a plus. And so now everybody's getting that.

Yay, everybody. Well, and that's one of the reasons we made them, like in my own private practice, we make them so comprehensive and it's electronic and I know it can take a few minutes to complete, but it gives us so much good data from the get go that it also lends itself to certain conversations when we do initially meet. Like the child's sitting there playing and you know, for a little child, maybe slightly older, you know, a toddler or something, they're sitting there playing and maybe I'm talking to the parents. So the kid's getting a little bit, you know, more comfortable with the environment before we dive in and start like interacting with them. I've got time to ask some questions, right? So I love to sometimes approach some of these questions where I'm like, I need to know about what you checked here and what you filled out here. And, you know, and then I have parents come in to. And they're like, well, we're coming for speech. But I saw you ask all these questions about feeding or about, like, their tonsils and adenoids or their sleep or whatever. And I'm like, oh, yeah. Because it's all related and interconnected. They're like, why? And so it's just. It's such a beautiful educational opportunity when we can, like, dive into those conversations. It just. It makes me so happy. Yeah. And.

And just like in this facility here, we have this just fabulous team of OTPT speech. We also have a developmental program where developmental pediatricians, several nurse practitioners, and a psychologist, and lmft. So we have this pretty comprehensive program, and everybody is just on board with each other and just getting that understanding of the whole team and what they can bring to the table. All of our OTs and PTs and all the other speech therapists, of course, they're on board, you know, for sure. And it's just really kind of snowballed, and I feel like our program has become really cohesive. And we have the two other therapists who have taken the course, and one is about. Is working on her clc. So we're trying to get that full gamut. And a lot of that has to do with you, Callie, kind of getting. I just want to say yay. Thank you so much. Because it really did give us kind of a jumping off point to expand and really have the knowledge. So when we're getting these medical babies, and because we're in central Georgia, we get a lot of the South Georgia, but also the South Atlanta, because a lot of those families don't want to go all the way into Choa or into downtown Atlanta, whatever. It's further for them to drive up there with traffic than to come to Macon. So that has been super cool. So we're pulling a lot of different areas, and I'm just very thankful. And my really woohoo. Yay for today. Is that because I went down the little rabbit hole of the tots and the feeding and all of the things we've been talking about. Every time you come up with your Mayo membership and the course and all that, I always like, oh, gosh, I really want to do that, but I just don't know. I just don't know. So I just throw myself in the giveaway. And this last time, I was the winner, which I never win anything like that. So I'm so excited already. Jumping into the office calls and study calls. And all of that. And it's been wonderful so to have that opportunity. It's just really exciting.

And when I pull, like. So I. I use this like, little, like, electronic picker thing and you put in, like the Instagram handle and all the rules and everything. And so, yeah, it does this, like, little, you know. Totally. What's the word that I'm looking for? You know, not generically, but anonymously. Whatever, you know, it's. It's picking it itself. Like, I have no part. Yeah, it's good. Exactly. Don't know why I'm having word finding issues at the moment.

It's all good. Happens all the time.

So I saw your name pop up as, like, the main winner of it with, like the, you know, the myth, of course. And the. My membership.

I was like, yes, I know her. It always makes me these little Instagram. I know, but you're so sweet to answer them. You know, I appreciate it. Even though I'm done with everything, you always answer me and kind of give me that needed push, but always let you know and your team know how meaningful this has been for me, so. And continues to be now.

Yeah, I know. You're back in it. We're never letting you go. No.

You know, in a. It really is wonderful because I think about. Oh, you know, I wonder what these people are thinking. This old lady is trying to get into these things.

No.

Shouldn't you be retired? But it's. It's like so wonderful. And I did hear from a friend of mine who's a little bit younger than me, but she said every. I don't even want to say senior. Older. I don't know what you call us.

Experience. Seasoned.

I like that so much better. I was trying to come up with a nice, sweet.

I know earlier I said that, you know, it's not all about experience, but I didn't mean it like in totality. I just meant like sometimes you get younger clinicians who are very specialized already. So I don't want anybody to take that the wrong way because obviously you're. You have a lot of experience and a lot to teach me, I'm sure. And others, so. That's so funny that either.

Yeah, but what. What she said was that we need mentors that are in their 30s. And I'm assuming you're kind of in that.

I'm like late 30s, like getting towards, you know, the other side.

But it's all okay. And I think about you. And then with my inside out course, Jesse's like 30 something. And so I'm like, you need a mentor that's younger than you. Not a. Not a mentee, you know, not someone you mentor, but someone to kind of bring you into just excitement, I guess, about learning and life and all of that. And I feel like you've done that in a lot of different ways and all the things that you put out there.

Yeah, well, and I think there's just. It's such a beautiful community that has been developed out of creating Feed the Pete's, because there are now various levels of experience and, you know, years in the field and, you know, even. Even niche areas that we work in, because some people are more NICU based, some people are more home based, less medically complex. Some people are in a clinic. Some people are, you know, inpatient, outpatient. And then we've got people who work with adults, and we've got people who work with speech and language and mayo. And, you know, and I think that it's really cool to see the interaction between so many of us because a lot of, like, a lot of it really lends beautifully to the conversations that happen. Like, that's. That was my whole goal for the Feed the Peds alumni group, too, is, hey, okay, you've taken the course. I want you all to have a free. Free, you know, group where you can basically go and interact with each other and ask your questions. Because I might have a response. Ramya or Caitlin may have a response. You may have a response. But what about all the other people who've gone through the course? And, you know, they have maybe different backgrounds, different perspectives, other trainings, you know, other clients and experiences that I think really lends to a very holistic conversation around a case sometimes, and that I love that the most. And I. My eyes are really open to that. When I got into the Maya world, and we had a local study club that myself and my dental colleague created, and we did refer to, like, a group of individuals. And so I remember one time, like, sitting around my kitchen table. It was me. I had another SLP biotherapist. I had the dentist. I had a oral surgeon. I had two physical therapists. I had one who was a physical therapist and an osteop. Osteopathic doctor, his wife, who's an osteopath. Then we had a vision therapist. We had a registered dental hygienist who's a myotherapist. And we also. I think I maybe like a pri trained pt, right? And so you have all these people sitting around one table, all looking at the same case and we're literally passing around a laptop, looking at images, talking about what we see after having heard about the case, like, what we see holistically on this patient's body and see and hear and like, experience it through everybody's different lens and background, even, you know, I know this example is more like, like, we're talking, like, cross discipline here instead of, like, internally. It just kind of opened my eyes to the fact that, like, we have that even within our own field. And if we can have more conversations, you know, with similar backgrounds and at least understanding, like, what, you know, what this patient's. What the question is surrounding the patient, the specialty, maybe eating, being it, for example. Here I was like, I just think that's very cool. We can all come to the table and have this very holistic conversation and go, well, hey, have you thought about this? Or, hey, have you tried that? Or, you know, what happens if you do X? Or have you refer them to why? Or, you know, let's tell me more about this. And so that was really my goal there. I'm like, you guys get to take a course, but at the end, I really hope that you all use the community, the free group, to lean on each other too and, you know, get help with cases that you have the have permission to discuss.

Yeah. And that's been really a great thing for me too. Just even finding, like, looking for other therapists, like when a patient moves or that kind of thing. That's been helpful as well. You know, who. Who can help me with this kind of thing. What have you done with xyz? You know, has been helpful, and I think there have been some, like, next step things that I've learned from the alumni group as well. And the fact that it's not. You're not charging for that. You know, that's a whole cool thing too, you know?

Yeah. Yeah.

And it's just like an extra added bonus. Yeah. You know, I can't say enough about that. That's just.

Yeah. And we thank you. Well, and we recently did update pediatricfeedingtherapist.com so that we're trying to make things more functional. There's a map that's been added to there too, so that hopefully it's easier to find people. Because I think that before it was like, okay, it's great. Everybody's on a website. I can type something in, but I felt like it wasn't always pulling everybody up. It may even be close to a location if you didn't put the specific location. So now you can search within like, 25 miles, 50 miles, and, like, still get more people pulled up who might be in the, you know, general vicinity. So we made that a bit more functional. And I tell people, I'm like, I use that all the time myself because I get people coming to me on social media saying, hey, like, parents being like, hey, who do you have in my area? Or, you know, sometimes therapists going, hey, you know, who do you have here? Like, you said, somebody moving or my friend's child, or this therapist came to me, and I feel like maybe you can help them find the right person. So that was one of my big goals, too, was like, I want to help you all. You know, I want to help therapists feel really confident in what they're doing and give them information and help them step into the space if they're not in it yet, but I also want to make it a lot easier for patients to access the care they need. And so that's always been, like, forefront of my mind.

But then I think we grow this kind of. I don't want to call it a movement, but I guess it is. It is sort of like a movement, right? And it's. I think it feels like it kind of is here, but it's like, you. You're exponentially growing that. It's like, you're not taking that just in into Melanie as a therapist, I'm going to keep this information and only sit over here in my corner. No, I think it's got to go out, like you say on the podcast to the masses. Right?

It does. It really does. I've met some providers, like, in other spaces where, you know, they have, like, a really interesting and helpful method or something that they do with their patients. And I'm like, have you ever thought about, like, training other providers in your space? And they're like, oh, no, no, no, no, no. If I'm not doing it, then, you know, it's almost like no one else can do this. Right? And I'm like, not only is that a very limited belief system and thinking, I'm like, that's actually more harmful to the patients who could really benefit from this. And, you know, and so part of me was like, it was hard for me to get to the point of feeling confident. As a feeding therapist, I spent thousands of dollars, right. I spent 10 years. Almost 10 years, yeah. Where I was like, okay, I finally feel like I can call myself this, and I feel like I can kind of hang my hat and be like, okay, guys, I'm a feeding therapist. Come to me for feeding, even though it's kind of doing it here and there already with, like, patients on my caseload that came for other things and kind of fell into that with them. But, yeah, I was like, if I can. If I can spare others from going through that same journey, that same long journey, and instead kind of shorten the journey and help them really jump, you know, jump in and get going. I was like, there's that. And then the patience, like you said, the exponential impact. That's one of the things I've always said. I'm like, if we can get more SLPs and OTS, feeling really confident about, you know, becoming and actually stepping into assessment and feeding, you know, treatment or feeding, assessment and treatment, then how many more patients can we help? Right? I'm like, if each person is able to help a certain number of patients, it just exponentially grows. And how. In our reach. Yeah. Yeah, exactly.

I don't know if you can hear that coming. The baby was born in the hospital. Oh, yay.

I love that.

That's. That's pretty cool, right?

That is so cool.

And when you say that about occupational therapy, also, when we have our ots are also. I'm like, hey, think about this course. It might be really. If you're interested, but we have a lot of ot, like, hopefuls and even codas come through here and do rotations, and they'll throw them with speech now and then to see. And all of them want to see feeding. And I always say, you, too, can take this course. You know, this is something that you might want to think about if you're really interested in it. This is going to give you a great place to start. Dark.

Yeah, it's. I. I love that and thank you and I appreciate you for, you know, sharing it with others because it's, you know, word of mouth is great, especially when you're someone who went through it, who can say, yeah, so thank you for that. So it. I know we've talked about a lot. One of the things that we did talk about beforehand was your experience with writing. Is it writing to get a grant, like, to get the course covered or. Yeah, Will you talk. Will you talk about that?

Yeah, absolutely. So when I kept, like I said, you know, Covid, the whole 2020, I found you. Actually, I think it was from Carrie Ebert, who's a speech pathologist online. She did a book club. So this is kind of an interesting little fact. And one of the books was Sleep Disorder Kids, I think was the title of it. And so we read the book and we were discussing it and all of that and your name popped up and that's how I kind of, okay, I'm going to go over here and found you. And then got going and going and like, I really want to take this course. And I kept telling my husband and goes, mel, you cannot do that.

Right now.

We're about, you know, your daughter's getting married. So I'm like, okay, let me see what I can do. Because we got like 250 or something like that for continuing it so far. So went to my manager, kind of talked about it and she says, well, there is the Navascent Foundation. Let's put you in for that. So what I did and that was a foundation within the hospital. And I think a lot of organizations are going to have something like that. Ours is just really fab that we do. And so I wrote an application. They said, you have to write an application. But for this course, the cool things to do is I started out with, I do not have to have travel money because I'm not going anywhere.

So that would normally be separate from like the 250 that goes to the actual course. Oh, yeah, okay. I think that's what's important for people to understand.

Yeah, yeah, for sure. I mean, that was just a little bit of continuing it. And that's all you get. And then you would. The travel and all that is on top of it. And they don't always pay all of that. So sometimes they do, sometimes they don't. So that was another thing I said, this is a course. You're not going to have to pay that. Not going to pay for travel, you're not going to have to pay for lodging. It's a 12 week course. So I'm really going to be into it, but I will not miss any patients because of it. Which if you go and take another course, an NDT or whatever it is, you're going to miss your patients for a long time. Even when we did the here, we had a long NDT program, it was still your missing patients, which costs your employer money. Cost money, you know. Right. But they want you educated and have this certification. So I put all that in. There was boom, you know, and they were able to do it. I said, I gotta do it now before she closes the door.

You know, I remember, I remember all that. Yeah.

Because I was like, can I go ahead and just pay?

Yeah, I was like, I was like, don't worry, we'll figure this out. And that's the one thing like I know we. Because we open doors for like five to seven days at a time per year. And, and because it's a 12 week course, it's like, right, right as the courses start, you know, starting we do this and then it basically closes down until the next cohort. And so we do get emails from people all the time where they're like, ah, I'm trying to like, work with my work and you know, see if I get this covered or see like what, you know, what's possible. And so we, you know, always, we always say email us@supportepedes.com because. Yeah, because we want, we want to help you, we want to work with you. And like, we will, you know, sometimes I know people are like, hey, can you send us like an invoice for us to submit with like our application? Or can you send us a. Yeah, just. Can you send us more information? And we do have like a PDF we can send. So we try to help provide information to make it a little bit easier for you to, you know, advocate.

I did use your information, you know, kind of succinctly what the course was about, what it would give me being on the national register, you know, that you have that.

Yeah.

Registry and all of that. So that was really cool. And I think that helped as well.

Yeah.

And you can, you just have to kind of think outside the box sometimes of how you can word things. And I got so excited when I could put the little feed, the Pete's, what do you call it? Logo, I guess. Yeah. And I'm like, woohoo. How do we fit this in here? Actually, you kind of gave me the courage to go ahead and put speech pathologist slash feeding therapist in my little email thing because we were all doing it and they were redoing because the organization name changed and some things like that. So I'm like, we're putting this, y'.

All. Yeah, I love it.

I love it.

Yay. Well, and you know, and, and to the point, right, like, you're not going to put that. If we actually are not, we don't actually have the skills or we're not getting. So, you know, for you though, with the level of experience that you have even before the course, like, I would have encouraged you to do the same thing because I always say to people, how is anybody supposed to find you or know who you are if you don't like, hang that hat on a wall and say, like, this is what I do.

Right.

They're kind of just gonna go, you're a speech. I can't tell you how many times I get from people. Wait, you. But you're. You're a speech therapist.

Why are you seeing the female for feeding?

What do you mean, feeding? Like, what is this myo stuff? And I'm like, welcome to the SLP world. We're everything.

We need an extra label.

I'm like, we do it. We. We do way too much. Not common, but yes, here we are. So amazing. Is there anything else that we haven't discussed that you want to share with. With everybody? I mean, obviously, tell us where we can find you online.

Yeah, I mean, I'm just, Just. Just personal me. I don't have any, like, professional anything. It's just M. Peacock shell. Okay.

And it would they just DM you, like, on Instagram if they, like, wanted to work with you because you have. You do some consulting, right? And you do. You have, like, your own little practice. So tell us about that. Like, what do you do in your practice?

Okay, well, I'm. I'm here at the hospital for 40 hours a week, four days a week. And. And I put that, I think, in the thing I sent you and anyone in the area is welcome to come through. And here you would have to do, like, go through a process of referrals, of course. And I do a private practice on Friday mornings. And I put that also in your little thing, which is an autism practice and an RDI consultant owns it, which is relationship development intervention. So that's a little bit different kind of thing. But we do see feeding as well. And I'm doing parent coaching through the Inside out program, and that is for sensory based differences.

Amazing. Amazing. Well, yeah, though. That's perfect. And, you know, they. They'll hear it all in the. In the bio and intro and everything. They already heard that. So. So, you know, we. They'll have all the details on you now. They know where to find you if they want to possibly work with you or, you know, come your way. So.

Or even just, you know, help with, you know, funding stuff or just have questions or. Where would I go for this? That. How did you come to be what you are? I'm happy to share anything with anyone.

Amazing. So at M. Peacockshell on Instagram, Peacock.

Shell on Facebook, whatever.

Facebook too. Perfect. And we'll put that. We'll put that under the episode too, so it's very easy for them to click through and find you. But, Melanie, thank you so much for joining me. Awesome.

You too. Thanks so much.

Thanks for listening to this podcast. If you found value in this episode and want to hear more of these Myotots, Airway and Feeding related episodes. Be sure to leave a review on Apple Podcasts and share this episode on your social media platforms. You can access free resources that all I offer at how hollybalken.com or pop over to Holly Balkan on Instagram to get all the latest updates.