First Bite Ep 277
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[00:00:00] Michelle Dawson: Hi folks, and welcome to First Bite, Fed, Fun, and Functional, a Speech Therapy podcast sponsored by Speech Therapy. I am your host on this nerrd 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, in Cullatown, South Carolina.

[00:00:42] Michelle Dawson: And I guest lecture nationwide on best practices for early intervention for the medically complex and fragile child. First Bite's mission is short and sweet. To bring light, hope, knowledge, and joy to the pediatric clinician, parent, or advocate. By way of a nerdy conversation, so there's plenty of laughter too.

[00:01:04] Michelle Dawson: In this podcast, we cover everything from AAC to breastfeeding, 

[00:01:09] Erin Forward: ethics on how to run a private practice, 

[00:01:11] Michelle Dawson: pediatric dysphagia to clinical supervision. 

[00:01:15] Erin Forward: 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.

[00:01:24] Michelle Dawson: To break down the communication barriers so that we can access the knowledge of their fields. 

[00:01:29] Erin Forward: Or, as a close friend says, to build the bridge. 

[00:01:33] Michelle Dawson: 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.

[00:01:44] Erin Forward: Every fourth episode, I join in. I'm Erin Forward, MSP, CCC SLP. The Yankee Byway 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.

[00:02:05] Michelle Dawson: So sit back, relax, and watch out for all our stories. Hey,

[00:02:20] Michelle Dawson: This is Michelle Dawson and I need to update my disclosure statements. So my non financial disclosures, I actively volunteer with feeding matters. National Foundation of Swallowing Disorders, NFOSD, Dysphagia Outreach Project, DOP. I am a former treasurer with the Council of State Association Presidents, CSAP.

[00:02:43] Michelle Dawson: A past president of the South Carolina Speech Language and Hearing Association, SCSHA. A current board of trustees member with the Communication Disorders Foundation of Virginia. And I am a current member of ASHA, ASHA SIG 13, SCSHA, the Speech Language Hearing Association of Virginia, SHAV, a member of the National Black Speech Language Hearing Association in NBASLH, and Dysphagia Research Society, DRS.

[00:03:10] Michelle Dawson: My financial disclosures include receiving compensation for First Bite podcast from SpeechTherapypPD. com as well as from additional webinars.

[00:03:21] Michelle Dawson: And I received 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 Speech Therapy, PD. com. So, those are my current disclosure statements. 

[00:03:40] Erin Forward: Hi, this is Erin Forward and these are my disclosure statements.

[00:03:44] Erin Forward: I receive a salary from Cincinnati Children's Hospital Medical Center. I receive royalties from Speech Therapy PD for my work with First By 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.

[00:04:07] Erin Forward: I also am a volunteer for Feeding Matters. I am a contributor for the book Chasing the Swallow Michelle Dawson, which I received no financial gain. I also am a member of the South Carolina Coalition Committee with ICLDIF fulltime. 

[00:04:22] Erin Forward: 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.

[00:04:30] Erin Forward: Hello, and welcome to another episode of First Bite Podcast. I am very excited to have Dr. Gillian Boudreau on today. I actually learned about her from her podcast on Two Sides of the Spectrum, which I know y'all have heard me talk about and I vividly remember a quote talking about how we need to, and I'm, I'm not going to say it perfectly, and I'll have her fix it if I butcher it, but we were Meg was asking you about what should we teach our children and you talked about teaching them freedom and how to be free and I just found that so beautiful.

[00:05:08] Erin Forward: With how we, I think it makes you take a look as not just a therapist, but as a human of like, are a lot of the things I put on children based off of my own boxes and barriers that I place on myself. And we talk so much about, you know, I'm so neurodiversity affirming care and trauma informed care, but I think where people get a little lost is that you have to look inward first because you're going to project those boundaries and those boxes and those expectations on to the children and the families that you work with. And I said to Gillian before we recorded, if you, if she's done a lot and I was like going on her website, I was like, I want, what does her bio say on her website, because I can't keep track of everything. And, and I love that the focus is about your core values of your practice, as opposed to these are all the experiences that I've had. And they focus on attachment and connection and communication, which are all things that speech pathologists, we should be.

[00:06:14] Erin Forward: Should be our main goal. And the authenticity to like, that I find to be a core value of me as a human. Am I being authentic? Can I feel the authenticity in other people? And how do we help children be their authentic selves? I always talk about how you can't turn an apple tree into a cherry tree. And so our job is to not change a child but to help find the right fertilizer, sunlight, water, what's the support that they need to learn about, to help them grow and see the fruits of, of who they actually are.

[00:06:48] Erin Forward: But I would love for you to talk, tell us a little bit about yourself some of your experiences and, and yeah, I'm just, I'm so excited to have you. 

[00:06:58] Erin Forward: Oh, thank you. I'm so excited to be here. And I. I really appreciate everything that you'd said. And I am excited also to do some learning today because so I am a psychologist and I have a lot of background actually in eating disorders, right?

[00:07:15] Erin Forward: So things like anorexia, bulimia, things like that, that is of course different from what we're here to discuss today, which is feeding disorders. Though, Sometimes one in early childhood can become another right in later childhood or in adolescence. So, so I feel like I can bring a lot of information certainly about eating disorders.

[00:07:39] Erin Forward: And then I also work with a lot of families in the feeding disorder realm. And I think like you're exactly right. If we're trying to model freedom for kids. The only way to do that is for the adults to do the work to become as internally free as they can and food is a place in our culture where almost no one feels fully free and how easy it can be to sort of project that.

[00:08:06] Erin Forward: Whether it's on to a very small child, just even trying to figure out if they can handle the sensory overwhelm of a blueberry or whether it's on to, you know, like a middle schooler struggling with like binge eating. So it's all in there. 

[00:08:20] Erin Forward: Yeah. How, can you tell us a little bit about how you got into I love hearing people's like stories of how they, did you always know you wanted to go into psychology?

[00:08:29] Erin Forward: Did you have a moment where you were like, this is what I want to do or something like I just kind of fell into speech. Like I'm so grateful I did, but it just like things kept happening. And I was very lucky to be like, Oh, I'm just going to take these opportunities, but everybody has their own, you know, their own story.

[00:08:43] Dr. Boudreau: Yeah. I appreciate that. So, I always knew I wanted to work with kids. And I was always really fascinated by like what everybody was feeling and what made everyone tick, but I didn't know until later that that's a job and it's called psychology. So I definitely was always a camp counselor and a babysitter and stuff and I, I was like maybe I want to be a teacher or.

[00:09:10] Dr. Boudreau: I was really into biology for like a brief period in high school. And I was like, maybe that means I want to be a child psychiatrist. And so then I went to college, I guess banking on child psychiatrist, but boy, am I not cut out to be any kind of medical doctor or even person who studies a lot of biology and chemistry.

[00:09:32] Dr. Boudreau: So I was just like struggling and like hating my academic life. While also taking psych classes for fun. And so finally, like halfway through college, I think it was like a student advisor, like some kindly volunteer, just like a year or two older than me, you know, was basically like, baby, you are not going to get into med school with the, with these science grades.

[00:09:55] Dr. Boudreau: But, You are getting A pluses in all of these psychology classes. Do you want to be a psychologist? And I was like, oh, those are just for fun. Those are just like papers you write like for your own enjoyment. And then this person was like, no, like that is also a thing you can be. So I ended up, I had struggled through enough that I ended up kind of keeping what really was like a neuro bio major, but I weirdly, it made the most academic sense to just add the psych major which I'm really glad I did. So while I'm not, well, I'm not cut out to be like in medical school in any way, I am really glad to know several nuts and bolts of the brain, right. Even, even beyond what we get in, in psych school, but yeah.

[00:10:41] Dr. Boudreau: So by the end of college, I was like, Oh, psychology. Oh, right. And then when I really thought about what a therapist was. I got so excited. I, I had been so demoralized by my bio major, you know, that I was just having all the fantasies. I was like, maybe I'll just. Run away to the city and try to become a rock star.

[00:10:59] Dr. Boudreau: Like, you know, this wasn't going to happen, but I remember being like, Oh, a therapist. That sounds like almost as fun as like being a rock star, which I still think it is. So then speaking of eating disorders, my, my, I did a research job for the first two years out of undergrad. Just cause I had heard that that would make it easier to get into psych grad school and coincidentally for our talk today that happened to be at an eating disorders research lab in New York. And then I went to grad school. I did my PhD at Long Island Long Island University, but it's in Brooklyn, New York That's a confusing name and Here we are today. 

[00:11:38] Erin Forward: Yeah, my sister lives in Brooklyn.

[00:11:40] Erin Forward: Actually, she She loves it. She's well and now brooklyn's very like It's the place to be for a lot of people 

[00:11:48] Dr. Boudreau: Yeah, it is. It's really, yes, it's really grown a ton. It's a great, it's a great place. And LAU was a really great school and program. 

[00:11:55] Erin Forward: Yeah. Yeah. I, one thing that I love and would love for you to touch on, but also.

[00:12:05] Erin Forward: Try to communicate in, in a lot of the conversations that I have in a lot of lectures I do which your point about neurobiology, I also love because in our field and I love this, you know, we want evidence. For what we do. Yeah. But some, but I think again, we get lost in our own bubble and box of research from our field when sometimes people ask me why I do.

[00:12:32] Erin Forward: And my answer is neurobiology. Like, why are you doing what you're doing for relationship? And it's because that's what it is. our understanding of the brain tells us. Some people don't always love that answer, but the focus on both connection and safety and how our brains are wired for connection, but we also need those things are so connected.

[00:12:55] Erin Forward: For lack of a better term, connected. And, and feeding is so intimate. And feeding is something that we also are putting inside of our body. There are so many ways during mealtime for us to not feel safe. Yes. I break it down a lot of like, what is actually happening during mealtime? And then take a neurodivergent child or a medically complex child and see all the points where these breakdowns can happen and that child doesn't feel safe.

[00:13:26] Erin Forward: So building safety should always be number one, but it's sometimes again gets lost in our goals and the progress and needing to gain weight and all of these things. And I know that safety piece carries on throughout feeding and eating as we get older and maybe have eating disorders and things like that.

[00:13:48] Erin Forward: Can you, I know that's a broad introduction to the topic, but can you touch at all on that need for safety? Yes. Specifically in mealtime and then we can, we can take it wherever we go from there. 

[00:14:02] Dr. Boudreau: Yes, totally. So the, I think the starting point is that the mode that the nervous system is in when it adjusts. Is a parasympathetic nervous system mode, right? So the, the nervous system usually runs on one of two channels, though. There are special, highly dysregulated situations where it can run on both, but in general, the nervous system has to choose two choices.

[00:14:33] Dr. Boudreau: It's either going to run itself sympathetic. Which governs sort of arousal being fired up, being ready, being excited, kind of hitting on all cylinders. But digestion doesn't happen so great in that mode because, you know, all the energy is going into the limbs, like things are not going into the internal organs.

[00:14:51] Dr. Boudreau: So, for energy to go into the internal organs for digestion, Which as you know, is an incredibly energy rich process, right? Digestion takes a lot for the body to do. The body has to be sure that it's not about to die for lack of a better word. And that is governed by the parasympathetic nervous system.

[00:15:11] Dr. Boudreau: And that mode is, is basically sometimes called rest and digest. So that's where the body is like, cool, nothing Herculean is needed of me right now. I'm not in any danger. And I also am not like elated and about to you know, ride a motorcycle over a loop to loop. And so that means that it's a good time, you know, I'm, I'm safe, I'm in a cocoon.

[00:15:37] Dr. Boudreau: I can now allow my bodily resources to go deep inside my body for digestion rather than being more on the outside to protect me. 

[00:15:49] Erin Forward: And that's also an interesting way to think about that. I've never heard it. I have heard it put in that terms, but just, yeah, I love that. 

[00:15:58] Dr. Boudreau: So to get into the parasympathetic nervous system the body needs to be coding not to be super woo woo, but essentially needs to be coding more love than threat.

[00:16:09] Dr. Boudreau: Right. Because what, you know, a fast track to safety for our mammalian systems is connection. And, you know, there's a really nuts and bolts reason for this too, right? I mean, firstly, just because of the size of a human head and the size of a female pelvis, babies come out way before they quote unquote should.

[00:16:30] Dr. Boudreau: There's no way a human baby could survive on its own, very different from a baby horse or a baby giraffe. And so, you know, I often will posit from an evolutionary psych perspective, because we survived, we're basically the descendants of those early human babies, who like, their neurology just was the most urgent about accessing connection.

[00:16:52] Dr. Boudreau: So they were the ones who yelled the loudest if they were left somewhere. So nobody forgot them, right? They were the ones who were able to like really bond so that their caregivers were willing to like sacrifice themselves often to protect the kiddos. So we're only alive because somebody felt really connected to us, you know, often enough to like sacrifice themselves in ways, big and small.

[00:17:17] Dr. Boudreau: And even though maybe as adults. Connection is a little bit less directly tied to literal survival. I don't think there's much evolutionary benefit to the amygdala or to the lizard brain, like knowing that or really switching its orientation in adulthood. Right? So firstly, a part of our brain is always walking around like a tiny defenseless baby who really feels it literally needs connection to stay alive.

[00:17:44] Dr. Boudreau: And also, right, if we think back to early human times. Belonging or even feeling like you're okay in a group, even after infancy is really important because, you know, if humans were like not doing so well in a group, they used to get left and the rest of the group would go. Right. So even being liked, right.

[00:18:05] Dr. Boudreau: Even having social belonging really strums a very intense survival cord in, in the brain too. So kids really need to feel fully okay in themselves and also in their relationships for that parasympathetic nervous system to come on board. And that's the only place from which feeding can happen very effectively anyway.

[00:18:32] Erin Forward: Yeah. And I think I also love there's so much hearing everybody's like perspective of viewing, like we're all coming at it from our own lens of, and that's what I talk a lot about too. You're building a lens. For how you view a child and how you view an experience and so everyone I learned from is just building this lens of what I look through when I'm working with a child and I think it's important to remember that especially when we're talking about because a lot I think of the conversation is growing around neurodivergent children and feeding especially because we're trying to support their needs.

[00:19:16] Erin Forward: that need for connection. We're trying to support the understanding that their brains are different and not bad. But because finding safety may be more challenging in an environment that's not set up for their brain, it means feeding is also going to be more challenging. But that doesn't mean that we push feeding.

[00:19:35] Erin Forward: It means we support safety more. And how a lot of children I've found have dealt with that is that they find these foods that have felt safe. These foods have not hurt my stomach. These foods are easy to break down. So from a safety standpoint, it makes complete sense why a processed food is going to be more more accessible for a neurodivergent child because they're digestive system.

[00:20:04] Dr. Boudreau: It's so consistent. Right? Like, I mean, this is not groundbreaking. I think I saw this in a meme once, but it's like, if we even think about all the different ways a blueberry can present, Oh my goodness. Right. Sour, sweet, squishy. Like, I mean, I don't think I've ever eaten the same blueberry twice in my life and I'm 43 years old, 

[00:20:22] Dr. Boudreau: but I've eaten the same spray cheese.

[00:20:26] Dr. Boudreau: Every time. It's exactly the same. 

[00:20:28] Erin Forward: Mm hmm. And I've, I've had this conversation as well about when we can build these foundations of safety in all these other realms, whether it's communication, it's connection, it's supporting their sensory system, feeding does tend to improve because of all those, those improved safety nets.

[00:20:51] Erin Forward: And in order to learn about more new foods and to. Be interested in more new foods that involves that curiosity component, which what did you call it in the podcast? A luxury? What was the terminology used for 

[00:21:06] Dr. Boudreau: like, so yeah, luxurious brain functions are things that our brain can only fire up once safety is established and curiosity is one of them.

[00:21:15] Erin Forward: And so we're expecting these children to have all this curiosity towards trying this new food, but we haven't built this capacity of, of feeling safe. And then. Unfortunately, there's been really bad feeding therapy that's been done for a while. A lot of very behavioral, you have to eat this food, you have to try this food, is a very common, unfortunately still, practice.

[00:21:43] Erin Forward: I will say, I think it's bad feeding therapy. That's my opinion, but I don't feel it creates the safety and then it builds more distrust with feeding. But I love the, the understanding of how much connection can also build safety, but where I think there's difficulty is from that double empathy problem.

[00:22:08] Erin Forward: It can be difficult to build connection with our, with our neurodivergent clients. What are ways that we can, especially in the context of mealtime and we'll get, I want to get into caregiver as well from like an eating disorder perspective. I don't know if we want to start with connection in general, if we want to also go into like, we're building, we want to build connection between caregiver and child.

[00:22:31] Erin Forward: That's the most important part of mealtime, not us as the clinician, but that involves understanding that caregiver and that parent and their experience. And it wasn't even until you started talking that I was thinking more too about how. Often our caregivers triggered by their child's experience with food that has to be so challenging on like a deep, the way my body I can't control my response feeling 

[00:22:59] Dr. Boudreau: it's so mammalian. Yeah, so there's. I want to get back to many jumps there. 

[00:23:06] Erin Forward: My brain, I have ADD if you can't tell. 

[00:23:08] Dr. Boudreau: No, me too. I'm following you. 

[00:23:09] Dr. Boudreau: I'm following you. I'm right there with you. I just don't want to lose any of those things because they're awesome. But I have a map in my mind. We've got it. I want to start with such great empathy because caregivers are trying so hard and the, the, you know, the mirror neurons are between caregivers and their kids are so intense, especially around feeding.

[00:23:32] Dr. Boudreau: Like this is, you know, this is sort of a funny sensory thing that I have, but ever since I was a child, I really cannot, I love a good peach, but I, I really don't prefer to touch peach fuzz because it will just make All the hairs on my whole body stand up. It will just make me like, it's visible. Like, you can really see my whole body.

[00:23:54] Dr. Boudreau: She's like, and because of that, we don't have a lot of peaches in the house, I guess. So I was, you know, like this week years old when, which was the first time that I watched with my own eyes, my son, who's now six. He picked up a peach and my body did the same exact thing as if I had picked it up and I was like, Whoa, cause that definitely doesn't happen with any other humans.

[00:24:19] Dr. Boudreau: Right? So yes, we all have a lot of, of emotional and survival loading around food. It's one of the most primal things and it's going to be so hard for caregivers not to overlay whatever their own stuff with food is on their kids. Because they're like, If they think their kid is not eating, they're like viscerally feeling that hunger, right?

[00:24:43] Dr. Boudreau: Just like my hairs were standing up as if I was holding the peach, like, you know, it's almost impossible for caregivers not to quote unquote, go urgent about trying to get their kids to eat and trying to get their kids to eat the right thing. But this is, I think, The trickiest thing about parenting right and one of the most counterintuitive things about co regulation or, you know, trying to bring hopefully some measure of calm in my nervous system to soothe the next person is that.

[00:25:13] Dr. Boudreau: If we are urgent, they will be urgent because of something called emotion contagion. So no, unfortunately, no matter what a caregiver is saying, if in their body, they are holding urgency and agenda. And like, we've got to get this figured out or like, it's just gonna be right. Or like, I'm going to feel like a failure if we don't get these carrots down.

[00:25:37] Dr. Boudreau: That's going to go right into the nervous system of the kiddo and is going to make it impossible for them to, you know, access that rest and digest state. So the, the first and hardest, like three steps. For finding the type of calm connection that's going to help a kid eat is first slow down, literally slow down movements and speaking, slow everything down because slowness cues that we must not be running for our life right now.

[00:26:12] Dr. Boudreau: Right? So just to our mammalian body, you know, my nervous system kind of says, well, Jillian wouldn't be able to move or talk this slowly if there was an imminent threat. So let me kind of ramp down the threat chemicals in the brain then. So first, slow. Second, caregivers, this is so hard, need to be doing their own work to identify and shift their own sources of urgency and agenda.

[00:26:36] Dr. Boudreau: So maybe there's positive self talk happening, like all food is good food, right? Like kitten, no, you know, hopefully they won't eat string cheese only ever for the rest of their lives, but we've got time. Sometimes having permission from a professional like you or I, I think can be really helpful. Cause I think sometimes caregivers are worried about what like the helper will think.

[00:27:01] Dr. Boudreau: A lot of times my intervention with parents starts with being like, remember all food is good food. And if they're only eating string cheese, that's a lot of calcium. It's great. You know, and then you can sort of see parents relax and if parents are relaxed, now there is room for that child to become curious.

[00:27:19] Dr. Boudreau: Whereas if that parent is in such a well meaning way, just coming in so hot and browbeating this agenda, the only move the kid can make is to resist that agenda because that that agenda is. And

[00:27:38] Erin Forward: it, some of these things, obviously the self work and the self talk is challenging, but some of these things can be so simple, but we just, but yet so challenging because we have to do this ourselves. Like the slowing down is something. I had to learn floor time training really helped me with that to like wait and watch.

[00:28:07] Erin Forward: That was so helpful. And, and I even find like I'll co treat with other therapists. And sometimes I'm like, because I've learned to slow down and watch, I like can feel their urgency. And I'm like, whoa, whoa, whoa, whoa. We, we need to take a minute, learn about this child, even because I always think too about that attachment connection because I, I work in the NICU as well.

[00:28:31] Erin Forward: And so I think about that experience of, and I have this conversation a lot of imagine, you know, when feeding goes great. It's great because. Caregiver reads cues, hopefully before they start crying. They feed them, breast or bottle. They, their belly is full. They feel safe. They're holding them. They're smelling.

[00:28:53] Erin Forward: Caregiver, it's great. But when a child has a medical experience or even from a double empathy problem as an infant, their cues may look different. Caregiver has a hard time reading those cues as young. And then it's building this urgency between the two of them of both trying to feel connected. Yes, but not knowing how to support the other one's connection because like you said that baby's craving that and that happens over and over and over and over again.

[00:29:25] Erin Forward: So not only is mealtime so intimate, but it's also the source for a lot of families of this feeling of not being connected. And so that urgency builds up and it's. It's almost like teaching that caregiver and that child to trust each other again, and we don't trust our like the amount of conversations I have of give that child a minute.

[00:29:50] Erin Forward: We need to learn to trust them for them to trust their bodies. 

[00:29:54] Dr. Boudreau: That's right. 

[00:29:55] Erin Forward: And to tell caregivers, I even say to like, That caregiver probably needs to hear a lot more positive affirmation than you realize as a therapist, like they need to hear they're doing a good job. They need to hear their child's doing like the best that they can.

[00:30:09] Erin Forward: They need to hear that this is where they're supposed to be. And I try to every session give to help slow them down, but also give that. You know, moment of understanding, because that's another thing. They just want to feel understood a lot of our job. And I think as a, as a speech therapist, I was taught, you need to progress. You progress need to improve. I think a lot of my job is just to help them feel understood where they are so that they can trust themselves to move forward. 

[00:30:41] Dr. Boudreau: Yeah. I see our rule is to clear the blocks to development, right? Development is really going to happen on its own, but we're there to untangle the knots.

[00:30:50] Dr. Boudreau: And a lot of times those knots are around a lack of self trust, a lack of trust in the other. Also just a lack of, you know, fear of the unknown in general, I think is an existential one that can cause all of us to grip up and get really urgent and agenda. 

[00:31:09] Erin Forward: Yeah. I and I think for caregivers hitting, like the fear of, is my child going to be okay?

[00:31:16] Dr. Boudreau: Yeah. Is That unknown? Yes. 

[00:31:20] Erin Forward: And the answer, it's. That's such a hard question to get from a caregiver because what I've learned is you unconditionally loving your child and loving who they are is going to set them up for the most success. Yes. But that's so hard, I think, because they want to protect their child from the world, but they can protect them in a different way. 

[00:31:51] Dr. Boudreau: Exactly. That's exactly right. Or if you don't fit it. And yet, right?

[00:31:57] Dr. Boudreau: You know, you're absolutely right that even one really affirming, consistent relationship with an adult is a protective factor against, like, most things, right? Psychologically, and then even, you know, sometimes physically, because the mind body connection is so strong. 

[00:32:15] Erin Forward: Mm hmm. What? Would you say having such experience of working with eating disorders, because I have had a lot of caregivers that have disclosed that to me while working on food therapy, which they don't need to. I mean, I, I'm very open, not open with, You know, I'm a very open person about my experience with the eating disorder. My experience, like, that's where I'm, I'm having to give myself a lot of self talk recently because my social media is fueled with, like, it's like, it's attacking, I feel like we're being attacked by, you know, revamped, rebranded diet culture, which is very challenging.

[00:33:00] Erin Forward: It, oh, it always finds a way and it's, it's, So I go through my own experience with that, and I don't feel like any of my families owe me any disclosure or conversation about their past experiences. Some do, and it, it does make me wonder. What, how even more challenging this may be for them and how that experience, like what mental gymnastics they're having to do on a daily basis while trying to continue to heal their experience and then watching this happen.

[00:33:38] Erin Forward: An experience with food happened to their child, and I struggle with how to support that. Granted, it's not in my scope to be a counselor for that caregiver, but we're having those conversations about food every week. And so I want to make sure I'm being as trauma informed and supportive of their own experience and not putting that aside because that's a part of the child's experience.

[00:34:02] Dr. Boudreau: Yeah. Yes. It's so true. And it, Oh, I find myself using language and sometimes in my practice, there's a risk of sounding a little unprofessional, but what I'm really trying to do is make things sound a little less clinical. So, you know, if I do have families coming in with, you know, kids who are struggling and for me, right.

[00:34:30] Dr. Boudreau: If the, if it's, if it's me, that's like, maybe they have, maybe they're already working with. you know, a feeding person, which would be perhaps the most direct place to go. And then if, if they've come to me, it's like, okay, now we need a psychologist too. Right. So, so that is oftentimes a little bit more of a clue that there might be some systemic stuff.

[00:34:49] Dr. Boudreau: That's a little bit more intractable. And so that, I suppose that might make this question also A little more in context for people who might like make it to me about this. Right. But I find myself just really trying to normalize it and just ask, I'll just call it like food stuff. And I'll really just say like, we all have food stuff.

[00:35:07] Dr. Boudreau: Our society is really weird about food. You know, like, are you aware of any just kind of like ambient food stuff? Floating around the family as far as stuff, y'all may have dealt with either now or before. And I like that phrasing because that many people do say no. And I hope that means that people know that they, it feels better to me.

[00:35:27] Dr. Boudreau: They mean like, well, have you ever been diagnosed with an eating disorder? You know, that's just such a question, but I just really like being like, we all got weird food stuff. Like, do you guys have any? Cause if so, maybe Maybe it's impacting your ability to be relaxed about your kids eating, you know, because like eating disorders are a very particular and a really important and serious thing, right?

[00:35:48] Dr. Boudreau: And I have worked fully in that realm a lot. And also, I think our culture makes us all a bit weird about food. It's not a very healthy food culture. 

[00:35:58] Erin Forward: Mm hmm. Yeah, and the, and the language piece is so important to think. And coming from a podcast, Where, has the audience is mostly speech pathologists. I think we have a lot of learning to do about the language we use and model for caregivers and children because it is so, I read this study.

[00:36:21] Erin Forward: That I cried reading the study because I forget what the psychologist name was and it was written in the 80s, but he talked about how the, the narratives that we create about ourselves and how. By age two, children start to develop a pretty strong life plot of whether they're agentic in their lives or more of a victim of their lives and how there's, it can change, but it, it, it even just from until two years, it made me think so much about what narratives I'm telling in every session.

[00:36:57] Erin Forward: Like, what is the narrative I'm creating of this family's relationship based on their experience with me and how I'm talking about it? And how is that also affecting that caregiver and that family? Because like you, Talk about the fear. What if part of their fear is I'm part of the reason that this is happening?

[00:37:16] Erin Forward: What if their fear, you know, which for a lot of caregivers. 

[00:37:20] Dr. Boudreau: And that's so heartbreaking because I think 90 percent of the time, that's the core fear, right? Is that what if my kid isn't going to be okay and it's my fault. And that is, and I feel that all the time too, as a parent, right? That's, pretty much the biggest one.

[00:37:40] Dr. Boudreau: And I think the way I try to, how do I try to work with caregivers about that? You know, it's different for everybody. But I think putting everything in a context of humanity, right? So sometimes I'll zoom, zoom way out. Sometimes I will recommend to folks, the body is not an apology by I believe that Miss Sonya Renee Taylor.

[00:38:01] Dr. Boudreau: I'm sorry if I'm getting that wrong. Let me just double check because now I'm feeling like I'm having a brain fart. I love this book so much and I recommend it. 

[00:38:07] Erin Forward: I don't think I've heard of that one. I've read Wisdom of the Body, but not the Body is Not an Apology. 

[00:38:12] Dr. Boudreau: Okay. That's a really good one. And that is in fact, Sonya Renee Taylor. Woo. Thank goodness. You know, which really it's so affirming because it really helps us understand why this is really all of us. And you know, there is patriarchy, there is white supremacy culture, there are all of these reasons why this one very particular body became revered and if anything kind of fetishized, and it hurts everybody and, and so I think if parents are struggling with the idea that. I have my own stuff about this. If my kid is struggling, it's my fault. Right. That book can be really good to be like, it's not your fault. It's not any of our faults. This is sort of a systemic problem. And one that, you know, just as you're saying to shift that narrative, right.

[00:38:59] Dr. Boudreau: From, from victim to more like an agent, it's like, if we all to some degree have been victim to this messaging, then, you know, Can we all begin to be an agent of change? And all of a sudden it becomes less personal unless any one individual's fault. Sometimes when I work with caregivers in the realm of like self compassion, which is also a major part of just clearing the blocks enough to fully connect.

[00:39:28] Dr. Boudreau: This is a little hacky, but I do have a little slogan that's called going from going from a sorry to a sorrow. Because I think a lot of times caregivers will start at a very guilt ridden singular sorry, right? Like, I am messed up about food. Now my kid isn't eating. This is my fault. I'm bad. I'm sorry. Right? And the, the psyche. It's so painful. Once we're in that constricted, like I'm bad, I'm sorry, state. Well, now we are in an emergency state and our nervous system and we're just going to get stuck and we can't actually do anything to change or connect with anyone. But the psyche weirdly thinks it might be good news if it were all our individual fault.

[00:40:18] Dr. Boudreau: Because it has this magical belief that like, well, if it is all my fault, then I have total control over myself. So I'll just change myself and everything will be fixed. Right? When in fact, a lot of these things are a collectively held sorrow. Like, this is really sad. It is really sad. So many people in human bodies and most women do have some pretty intense food stuff, like that sucks.

[00:40:47] Dr. Boudreau: That is a sorrow for sure, but let's hold that collectively, right? And we'll give that some space and some room and make it okay to talk about that and make it okay to connect about that. So that then we can like accept it for the enormous, but not that personal thing it is and work with it. 

[00:41:07] Erin Forward: Yeah, and the, the, I had a conversation with somebody. A while back, too, about the, the thought of community and how that can look so different, like that connection, like community can be a philosophical community of people around you that have been through, you know, bigger community, it can be creating community within your session of we are a safe space together, this is the community of people around us, it can be a community of two people, and how do we build that sense for our caregivers as well so that they don't feel alone.

[00:41:42] Dr. Boudreau: Yes, 

[00:41:43] Erin Forward: Because that is very trauma informed to help to support that community aspect and to help you feel safe and to help you feel like you're safe. It is so interesting and I also have some pretty severe social OCD and some like health OCD, my brain kind of spirals makes me really great at my job because I can think in a million different directions, but I totally resonate with the, I'm the one that needs to fix this.

[00:42:13] Erin Forward: And even sitting back and being like, but what I have always said is my, I did not realize, well, I knew when I was a child, my parents split up. My OCD got pretty bad, but I did not realize until my Nana passed away. She was the person I was the most connected to. And when she said to me, it's going to be okay. I just believed her and felt safe. 

[00:42:36] Dr. Boudreau: Yes, 

[00:42:36] Erin Forward: and so I very much resonate with the like feeling secure with and connected to a person because that just shut off all those voices in my head that one person said to me it's okay and I never questioned it because she was my community. 

[00:42:55] Dr. Boudreau: That's such trust there. She was your community. And I bet just her presence cued safety to your brain. 

[00:43:04] Erin Forward: Oh, she was so, she really, and thinking through, like, she was very and she was a very, like, I can't control, you know, the world is crazy. I can't control it. I can only control what I can control. And started to build this, like, she was one of the most neurotypical people I know.

[00:43:27] Erin Forward: I was like, Nana, how? Where did this come from? But thinking about it in that way has shifted my perspective a lot of what community am I building? Is the caregiver feeling like a part, you know, we talk about caregiver coaching and making sure caregivers are part of it. Are you building a safe space for them?

[00:43:48] Erin Forward: Yes. Are you building a space where they can ask questions? Someone, I always thought about vulnerability as this very deep thing, but I'm learning more like vulnerability can be like, Oh yeah, I'm starving. I really need, I need a snack after this. Or, Oh my gosh. Like something that's not as. Revealing about you as a person, but makes you seem more relatable to them.

[00:44:12] Dr. Boudreau: Yes. Yeah. Vulnerability can be yourself, even casually eating in a session, right? Being like, Oh, I'm just going to have a couple of notes while we talk. Sorry. I didn't, you know, not to be an almond bomb. That was the terrible, terrible. Example, you know, but you know, I do, I do think that you know, sometimes it's considered unprofessional right for professionals to be in session, but in situations like this, a little casual eating can be pretty interesting.

[00:44:40] Dr. Boudreau: I also think that, you know, caregivers are so worried. That the professional is judging them. I think more than more than we ever fully appreciate. And I didn't fully appreciate that either until I had a kiddo. Right. And so even if we think we've already done it, just as you're saying, repeating again and again, all the ways that we think they're doing a good job, right.

[00:45:04] Dr. Boudreau: As much as we can, you know, sort of saying, I've seen this before. I see this a lot. This makes sense, right? I think caregivers really need to know that what's happening makes sense. And, and because if it's something makes sense, then there's a path. But I think a lot of the caregiver panic is not only what if my kid isn't going to be okay, but what if my kid does not make sense?

[00:45:27] Erin Forward: Hmm. That's yeah. Like talking about that understanding, but that's such an interesting way to phrase it too. Like I. Want my child to like make sense within the world. 

[00:45:47] Dr. Boudreau: Yes, 

[00:45:47] Erin Forward: like they're a part of this world. Like I want to to feel like they belong here. 

[00:45:54] Dr. Boudreau: Yes, that's right. I want to make like almost like make sense in this dimension. You know, like every time we'd be like, this actually makes sense. And you know, if we can even draw, you know, even if it's just like, Oh, Sympathetic activation makes it hard to digest. So we just got to, you know, even just words like that, then it's like, Oh, you know, and then also helping caregivers build compassion.

[00:46:18] Dr. Boudreau: You know, even for just what the rules were around food in their house, I'll see a lot. I do a lot of like permitting families not to worry so much about like table etiquette or not to get so hung up on like, you know, we eat at a table or things like that. You know, I even will be a quote unquote scandalous therapist because I actually think that certain kids who are struggling with feeding due to nerves will, will eat more in front of a screen than they will otherwise.

[00:46:50] Dr. Boudreau: Right. That's, that's. For all of us in good ways and bad ways, but you know, so I, I also will be a person who will say, Hey, we're working on getting you the caregiver calm enough around this realm of eating right. That, that you kind of state, take your own emotional static out of the equation. But until we work on that.

[00:47:12] Dr. Boudreau: You can also strew stuff. You can also take yourself out of the equation, just like put snacks around the home, right? It's not a power struggle, you know, kid can be kind of like a cat and just like sidle up to it. Maybe try it or not, but they don't feel like them trying it is now them capitulating to some heavy adult agenda, right?

[00:47:31] Dr. Boudreau: Like there can be snacks to sort of around when kids are on screens. And it, you know, it's amazing how sometimes. Connection is so important for safety and safety is so important for eating and digestion, but also sometimes a little bit of a break from being perceived so hard. Is really helpful for safety and for getting into a digestive state too.

[00:47:55] Erin Forward: Yeah, I completely agree. And I give very similar advice about from a feeding therapy perspective because oftentimes because mealtime is so engrossed in almost all of our being like we, it's so there's that connection piece, there's that communication piece of like, you know, if we're looking at a neurotypical.

[00:48:25] Erin Forward: ableist view of what mealtime looks like. You know, we're talking about the food. We're having to say whether we like it or not. We're, our body's having to digest it. We're having to have the skill to, to chew it. And it's all encompassing. And sometimes we have to break down kind of what our, what our goals are and what that child is ready for and if your goal is for that child to Eat more because they're really struggling from a nutrition standpoint. It's okay for them to eat in front of a screen to, to nourish their body and then maybe work on, and there are some kids. I had a conversation with somebody the other day about a patient they were working with and this child has had a lot of negative experiences with food and very much understands that has the cognitive capacity to understand. I don't really like to eat. And so for this child, that conversation looks like this is what food is doing for your body. And you know, when you're really tired, it may be because you haven't eaten. And maybe the food will make you feel more awake if you're really, you know, you know, when you get kind of grumpy, maybe sometimes that's our body telling us I need some food and it may not be this, like, I'm Italian. I love food. I, my family loves to cook. That's not everyone's experience. And that's okay.

[00:49:49] Erin Forward: If your goal is to feel connected to your child, that might involve finding their interests. And taking those connective moments there as opposed to making it in a much more high stakes environment of mealtime and, and that's a hard shift for caregivers, the grazing, all of that. Those are hard conversations to have, especially when a lot of the rest of the world is telling them that's not how this works.

[00:50:17] Dr. Boudreau: Yeah, but it's so is how it works for so many neurodivergent kiddos, you know, especially if there's PDA. I'm bored. You think this kid is going to sit and eat when you tell them to do that? That's, now they can't because you just told them to, right? Like it's, it's so, it's so tricky. 

[00:50:41] Erin Forward: And going back to the beginning, what we were talking about is that self work. How much of the therapy that we do or have done is made to make us feel more comfortable as opposed to make that child and family feel more comfortable? That's a big, that's a big question I've like been thinking a lot about recently is like, okay, where is this coming from? We have to start looking at where our biases are coming from as like, I'm a, I'm a white middle class woman. I have to check myself a lot. Because I don't have the experiences of a lot of the families that I work with and so I have to make sure I'm willing to be wrong and to admit that I was wrong and to learn and to ask questions because that I wasn't necessarily the person that had those experiences. 

[00:51:36] Dr. Boudreau: Yes. And it's, it's incredibly important to be aware of that, especially in a world where the bulk of us doing this work are white ladies by a vast majority. 

[00:51:50] Erin Forward: What, from your experience, because I struggle when I lecture because a lot of this is internal work. What is some of your advice for clinicians That are being open, that are, are wanting to better understand, that are, that are looking at a more trauma informed, neurodiversity affirming perspective on how to start, like, checking ourselves, almost, and start to do that work.

[00:52:25] Erin Forward: I know that's a big question, but I, I, 

[00:52:27] Dr. Boudreau: Yeah, you know, so we talk about lenses, right? Yes. Yes. Yes. Fear and urgency really are a big part of my lens, right? So, and I think there's sort of like a parallel process to all of this, right? So we are hoping to help caregivers. Kind of do a U turn and become introspective about where their own urgency is coming from.

[00:52:52] Dr. Boudreau: So they can kind of care for that themselves and not export it onto the kid. Right. So maybe, maybe a caregiver will come to where instead of saying, you know, this is so on the nose, but instead of saying like, just eat the fricking carrot and the kid being like, maybe they can be like, Oh, I'm about to say eat the frigging carrot.

[00:53:11] Dr. Boudreau: What is happening? Oh yeah. Getting that spike of fear in my chest. Oh yeah. And that spike of fear. I figured it out. It comes with that core belief that my kid is going to starve and die and it's going to be my fault. Okay. It makes sense that, that I'm feeling bad in my body about that. Okay. But in this moment, they're not going to starve and die.

[00:53:32] Dr. Boudreau: And I'm part of a team that's helping them with this. So if they won't eat a carrot, would they eat a string cheese? Maybe let's try that. Right. So if that's what we're hoping a caregiver might do over time, we also need to do that as far as what we tell caregivers. So what I like to have, what I try to think about as a helper and what I try to have helpers think about too, is like, okay, am I giving this advice because I think it is true or because I'm afraid I'll get in trouble if I don't.

[00:54:05] Dr. Boudreau: Right. Or am I withholding this advice because I think somebody would disapprove. And if so, who, and if I stop and think about that, is that a, is that a person or. Who even exists or an entity that even exists, right? Or is this just my own, like getting in trouble stuff? Am I feeling freaked out by the idea that a kid might not eat?

[00:54:29] Dr. Boudreau: And am I wanting to distance myself from that? And maybe is there a part of me that wants to make it this parent's fault because I'm feeling helpless as a clinician, right? Might I be subtly shifting blame because I'm feeling overwhelmed, right? And if so, where can I go to manage my own feelings of helplessness?

[00:54:46] Dr. Boudreau: So I think we have to be doing just as much inquiry if not more than we have to get our agenda and urgency out of the way so the parents can get their urgency and agenda and out of the way. So this kid can eat. It's a lot of work. 

[00:55:03] Erin Forward: Yeah. And I mean, to be honest, how much of our fear like. Some of my fear comes from like not wanting to be a bad therapist, or not wanting the caregiver to think I'm a bad therapist or not.

[00:55:18] Erin Forward: You know, not wanting to, you know, maybe say something that I truly believe, but I know that might not be accepted by other people. But then that's not supporting the, there's so much. Yeah, of our own. And I think it would be interesting to take documentation of that as well. Like where are, in some of that journaling aspect, like I remember when I was the last clinic I worked at, I worked with a lot of phenomenal occupational therapists and there would be certain kids that would trigger me.

[00:55:54] Erin Forward: And I had to do some of that work of like, where is that coming from? Where is that? Why is this child? Am I having this reaction? What part of me can I work to better support and better maybe provide, you know, when I would see certain children, I would need to give me better sensory supports before and maybe have a conversation with somebody after, like, what do I need to do so I can show up in the best way and not have that urgency reaction?

[00:56:24] Erin Forward: Like you said, I love the idea of like it because it is that that's exactly how it feels. And I can, you know, Sometimes I can't always label things in a session, but when I start to feel like this, I'm like, something, I need to breathe and slow down and so much of our, our lack of critical thinking comes when we move too fast.

[00:56:49] Dr. Boudreau: That's exactly right. And it makes sense that we're feeling urgency because these are very high pressure jobs and like, it's hard. Right. But, but the more we can get used to being like, all right, suddenly I'm getting really antsy about this kid changing themselves in some way. What, how granular can I get about what it's going to fix for me if they do that?

[00:57:11] Dr. Boudreau: Right. Like, is it, is it physical? Like, am I desperate to go pee and Until we reach this goal in this session, I can't like finish and go pee. Cause if so, maybe I could actually just have someone come in and step out and go pee and come back. Right. Is it deeper than that? Is it like, this kid is making me feel like I don't know what I'm doing.

[00:57:30] Dr. Boudreau: Is it that I'm a little bit scared of this parent for whatever reason. And I'm afraid I'm going to get in trouble with them. Right. If X, Y, Z doesn't happen. Okay. Right. Like those are all important things. That we need to deal with on the adult level, ideally outside of the moment with the kid when we have some time to reflect, but those aren't going to respond to urgency.

[00:57:51] Dr. Boudreau: None of those are going to respond to urgency. The faster we go, the more mistakes we're going to make. And the longer it's honestly going to take to get ourselves out of this. 

[00:58:02] Erin Forward: Yeah. And I think too, it's a lot of this is just learning how to be a better human working with humans. Because 

[00:58:12] Dr. Boudreau: yeah, 

[00:58:13] Erin Forward: this I, you know, a couple of times we were talking about, you know, the certain things may not seem professional, but there's a lot to what is professionalism from a like white supremacy perspective that we don't have time to go on.

[00:58:31] Dr. Boudreau: Who decided what is professionalism?

[00:58:36] Erin Forward: And the more willing I feel like I've been to, like, push those borders a little bit with the understanding of, you know, this doesn't, I'm not putting my trauma and my experiences on my families or my caregivers. I find that's not the boundary pushing I'm talking about, but making sure that we show up as more of a human and take the time to question.

[00:59:03] Erin Forward: And. Take the time to just understand that person in front of us. There's a lot of agendas that we have, and we, like you said, we have to give the understanding that we live in a society that puts a lot of expectations on us. And that sorrow, that, that, we are all experiencing that, and that is so challenging.

[00:59:26] Erin Forward: By taking that step back and taking the time to just understand that caregiver and understand that child, it's going to serve them so much better and build a trust all around. But that does involve losing that sense of urgency, giving ourselves grace to not have the answers. I think sometimes when you go in somewhere being like, I'm not going to have all the answers.

[00:59:48] Erin Forward: It already sets a foundation for, I'm going to be more open and slow down too. 

[00:59:55] Dr. Boudreau: I think so too. And I think that that is such an important thing ethically for helpers to do. Because otherwise, because of the authority we hold, the assumption is going to be that we know all, and that's going to throw whoever we're helping out of their own self trust and self advocacy.

[01:00:16] Dr. Boudreau: So I actually try to name at least once or twice in most sessions when I don't know something and there's always plenty, right? Like, but I've worked with a lot of peers who struggle, right? To ever say to someone they're working with, I don't know when in fact, like every child is a mystery thing and digestion themselves are mysteries. Like we don't, we don't know we let's dwell in the mystery together. 

[01:00:45] Erin Forward: Yeah, yeah, and to, I will say to families too when I have an evaluation, it would be unkind of me to assume that I know even a small percentage about your child by this first time I've met them. They are so much more than that and I'm going to spend our time together learning about them and learning about you so I can just continue to support.

[01:01:15] Erin Forward: this experience that you're having. Because we, we can't put these families into boxes and we can't assume we know everything about a child when we first meet them. And I feel like I learn so much from every family that I work with and that informs how I move with. With the next family and the experience, like the, the, the, again, the lens, like I'm building these lens, but we have to be open.

[01:01:42] Dr. Boudreau: We have to be open. And, you know, my belief system is that actually all humans are the expert on themselves, including children. We just are sometimes helping them access the interception and the language to fully, you know, know what they're looking at. Right. But they, they are the experts on themselves.

[01:02:02] Dr. Boudreau: Caregivers are the experts on their kids. Right. So we're just there as like kind of a third strain person. You know, it's like, I know some things, I know some things cause I've studied and because I talked to a lot, excuse me, of families all the time. But of all of us here in the room, I, I, I know by far the least, right?

[01:02:21] Dr. Boudreau: Like y'all are the experts and I'm here to kind of link up with what you already know and then see what might be applicable from the extra that I know. 

[01:02:30] Erin Forward: Yeah. And I would encourage speech pathologists to, to think. very strongly about the language they're modeling and how they're communicating that because it Kim Barthel, have you, have you heard of Kim?

[01:02:46] Erin Forward: She's the OTA. I love, I'm, she's wonderful. She talks a lot about trauma sensitive practice and she, um, she's everywhere. She, listening to her is like a hug. Like she just, Oh, I love that. And she talks about, you know, especially from an emotion standpoint, like the language we model builds this, you know, Emotional connotation in our brain and then that child carries that with them onto those other experiences.

[01:03:13] Erin Forward: So we can't take lightly. What we're modeling during mealtime and the language that we're using and what we're modeling for caregivers, because that in and of itself can shift the way our brain, our brain thinks about it. So every, you know, in the therapeutic intentional relationship model, like it talks about how everything that we do, our body language or facial expression has an impact on the relationship, which is a very scary thing to think about because we're not perfect, but that means those subtle, subtle things can make such a difference.

[01:03:46] Dr. Boudreau: They can, and that there's such a power in that too, right? It's like simple solutions to complex problems. Like if we can get even a subtle energy shift in a caregiver, right, if we can help that caregiver feel more confident, feel more like things are going to be okay, feel more like they know what they're doing, that is going to make some micro differences into the neurobiology of that child to where their gut might then be more interested in the carrot.

[01:04:14] Erin Forward: Yeah. Yeah. That's it. All coming back to that digestion. Yes. Yeah. 

[01:04:21] Dr. Boudreau: Yeah. You know, in this moment, I'm gonna need to wrap up soon just for some parenting stuff. Oh, yeah, yeah, yeah. Yeah. This is such a helpful, this, I really learned a lot from this and how

[01:04:35] Dr. Boudreau: Yeah. The subtlety of it, like digestion. 

[01:04:39] Erin Forward: It's so complex, but so simple. Yes. 

[01:04:42] Dr. Boudreau: Yeah. It's really, really cool. 

[01:04:44] Erin Forward: Mm-Hmm. . Mm-Hmm. . I appreciate this so much. I. Love hearing your perspective and the way that you communicate things. I think people are really going to take a lot from this. 

[01:04:59] Dr. Boudreau: And I'm really grateful for your time. I learned a lot from you today, so thank you for this conversation. 

[01:05:05] Erin Forward: Is there anything you would like people anything you want people to take away from this or that we missed before we wrap up? 

[01:05:15] Dr. Boudreau: I mean, I think the main thing, you know, I guess for caregivers or for helpers, right? Because those are both people who are just really trying to do the best they can.

[01:05:21] Dr. Boudreau: Remembering that we are just there to clear the blocks. We don't have to be some magical level of enough or perfect to like make it happen for kids to eat, right? Like eating, sleeping, these are all mystical mammalian things. All we can do is create the conditions. And our grounded regulation is a big part of those conditions.

[01:05:50] Erin Forward: Yeah. Thank you so much. 

[01:05:52] Dr. Boudreau: This was so exciting. 

[01:05:55] Erin Forward: Yeah, I, well, what I'll do I'll put all the resources that we talked about in the show notes too. So everybody, everybody can see those, but thank you so much. And we'll, we'll talk to y'all soon. 

[01:06:06] Dr. Boudreau: That sounds great.

[01:06:07] 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.

[01:06:30] Announcer: 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. 

[01:06:46] Michelle Dawson: Feeding Matters guides system wide changes by uniting caregivers, professionals, and community partners under the Pediatric Feeding Disorder Alliance.

[01:06:58] Michelle Dawson: So 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. So 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.

[01:07:20] Michelle Dawson: To date, 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. That's a wrap, folks. Once again, thank you for listening to First Bite, Fed, Fun, and Functional.

[01:07:46] Michelle Dawson: I'm your humble but yet sassy host, Michelle Dawson, the all things PEDS SLP. This podcast is part of a course offered for continuing education through SpeechTherapy PD. 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.

[01:08:05] Michelle Dawson: And as always, remember, feed your mind, feed your soul, be kind and feed those babies.