Problem-Solving with Catherine: Essentials for Pediatric Dysphagia Practice

How to Develop Whole Brain Thinking?


I did infant feeding many, many years ago. Just got referrals for a 4-month-old, NG tube, congenital heart disease, some bottle feeding, and a 3-year-old with a trach. What CE courses would get me up to date ASAP? Most of my feeding work in the past 10 years has been food avoidance and oral motor/chewing related difficulties in toddlers.

Catherine’s Answer:

The key is finding the course that best aligns with your current needs, is functional, brings the current pertinent research, promotes critical thinking not just information, and offers you a deep dive across multiple components of assessment, intervention, and co-morbidities—because you will likely see many of them across your career— often in a complex combination that will take patient problem-solving to peel apart. The outpatient population you follow often will be NICU graduates or toddlers and beyond in the midst of being “sorted out” with families who need both information and support. The key is to commit to being a lifelong learner. No one knows everything, or if they get to the point that they think they do, it is time to step away and retire. Expect that there will be clinical missteps along the way. We all have them. As Drs. Evangelista, Blumenfeld and Coyle told us, “In our work as dysphagia practitioners, we’ve found that a combination of clinical experience and deliberate, effortful reflection on our own practice picks up where graduate school left off. This combination continues to serve an invaluable developmental purpose as we hone our clinical expertise in dysphagia.” This perspective is perhaps more essential to your journey than the invaluable information you will learn along the way. Always remember that.

I bring my passion for feeding and swallowing to every course I teach, and I remember what it was like 45 years ago to start out but not know where to start. I designed my Pediatric Swallowing and Feeding: The Essentials course to provide what I really needed back then — a foundation in typical development through the age of 5 (our template for therapy), atypical development, oral-motor, sensory, sensory-motor, development of the swallow from birth on, tools of the trade, tubes, trachs, preemies, TOTs, airway, swallow studies, weaning tubes, a wide variety of interventions and the “why” behind them. I weave in the research to help you, resources to take away and integrate multiple levels of learning to build critical thinking. I’ll be in Indy (July 19-20), Yonkers NY (Sept 20-21) and Boston (Oct 13-14).

Our discussions will include critical thinking across all ages and co-morbidities, because it’s not just learning “what to do” but what “not to do” clinically. And the weaving in of compassionate family-centered care, which must go hand in hand with the clinical expertise we bring. So that every feeding experience matters. It is, as one of physician mentors told me years ago, all about finding the balance between the art and science of what we do. The communication from the infant, the child, and the family must always be the lens through which we problem-solve and intervene. Each of us has had a moment when we really “listened”, and it changed our practice forever. Mine was in 1985, with a wonderful mother of a critically ill preterm infant, and it has stayed in my heart. This relationship-based nature of our work, and its potential to influence lives in so many ways, must remain as much a part of our day-to-day interactions with families, always inextricably linked to our critical thinking and problem-solving.

See: Evangelista, L., Blumenfeld, L., & Coyle, J. (2022). How Do We Cultivate Critical Thinking in Dysphagia Decision-Making? Leader Live.

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