When Egos Collide in Treatment

I stood before the group of registered dietitians and nutrition professionals, around 400 in all, hoping that my message would be well received. As a speech-language pathologist specializing in pediatric feeding disorders, I was honored to be invited to speak at the Food and Nutrition Conference and Expo with registered dietitian Jill Castle, co-author of "Fearless Feeding." The 90-minute presentation was sponsored by the Pediatric Nutrition Practice Group and titled Picky by Nature: How Collaborative Care May Optimize Health Outcomes for Feeding Disorders.

Our presentation yielded three outcomes:

1. Recognize and review the signs of avoidant/restrictive food intake disorder (ARFID), and determine optimal health care services to benefit clients.
2. Set up a team of nutrition and allied healthcare professionals, using current evidence and best practices to address ARFID.
3. Determine gaps and overlaps among health care providers and implement best practices for collaboration to optimize client success.

Most importantly, we wanted to communicate the importance of creating a team that respected each professional’s scope of practice, yet understood that overlap will always exist if implementing a transdisciplinary model. This delicate balance is something I witness whenever professionals come together to assess and treat children with feeding disorders.

When I first worked in the neonatal intensive care unit (NICU), I had to be careful to walk carefully on the traditional turf of nurses, pediatricians and other infant specialists who weren’t familiar with an SLP in their territory.

When treating kids with feeding disorders in early intervention, I often hear, “But isn’t that OT’s [occupational therapist's] job?” It’s understandable. I’m never offended by it. Everyone is just trying to stay in their lane.

However, as noted in the graphic below, each professional has one primary focus. For example, for OTs and SLPs, the focus is the child’s feeding skill and ability. For registered dietitians, the focus is nutrition. Yet, without overlap among professionals, we risk that we may do harm by not knowing at least some aspect of each other’s roles. With a certain level of knowledge and interdisciplinary skill, the child and the family benefit. Even the child has a primary focus in feeding treatment, and that’s internal motivation. The team members support each other while helping the child learn to enjoy eating a nutritious diet, building skill and ability over time and across all environments.

Our final message to our audience? I slowed down as I spoke to the group, hoping they would taste every word when I stated, “Teamwork is about communication. The best way to break down communication is with an ego.”

When we allow our egos to collide, it might hurt a bit for us as professionals, but the person who suffers the most is the child in feeding therapy. Bruised egos build walls between the team members and that’s counterproductive to following a transdisciplinary model of treatment. Keep in mind that it’s the overlap of knowledge that can be the most powerful key to progress, and that’s essential to the concept of teaming.

To view the presentation for a non-member fee of $37. (Please note that I do not benefit financially from these links and the fee is charged by the Food and Nutrition Conference and Expo.) Check out the complimentary preview.

Melanie Potock, MA, CCC-SLP, treats children birth to teens who experience difficulty eating. She co-authored “Raising a Healthy Happy Eater: A Stage-by-Stage Guide to Setting Your Child on the Path to Adventurous Eating” (2015), “Baby Self-Feeding: Solid Food Solutions to Create Lifelong Healthy Eating Habits” and “Happy Mealtimes with Happy Kids,” and produced the kids’ CD “Dancing in the Kitchen: Songs that Celebrate the Joy of Food!” Potock’s two-day course on pediatric feeding is offered for ASHA CEUs. She is an affiliate of ASHA Special Interest Group 13, Swallowing and Swallowing Disorders (Dysphagia). mymunchbug.com/contact-us/