The Listening Brain Podcast Transcripts
Todd Houston: Welcome to Episode 20 of The Listening Brain podcast.
[00:00:14] Welcome to the Listening Brain. I'm your host, Todd Houston. In this podcast, we explore childhood hearing loss through the lives of the parents and families who are on this journey and the professionals who serve them.
[00:00:38] Hi, it's Todd Houston. Again, I just wanted to invite you to become a content creator for the 3C Digital Media Network. We want to really ramp up what we have to offer in 2021. This new year that we find ourselves in. So please reach out to us. If you have ideas for webinars courses, or even maybe a new podcast that you'd like to develop, reach out to me at email@example.com and I'll be in touch.
[00:01:15] Thanks. Today I have the pleasure of speaking with JJ Wicker. JJ is a pediatric audiologist and clinical researcher at primary children's hospital in Salt Lake City, Utah, as a clinician, JJ works with children who are cochlear, implanted, and complete diagnostic testing for infants who failed their newborn hearing screen.
[00:01:41] Dr. Wicker also runs the central auditory processing disorders clinic. As a researcher, JJ is interested in understanding the unique challenges posed to parents of children who are deaf and hard of hearing with other disabilities and how those challenges shift the parent's priority for their children's hearing related needs.
[00:02:04] He is also interested in understanding the challenges faced by adolescents who are deaf and hard of hearing as they prepare to transition to post-secondary opportunities. Here's my conversation with JJ, the DJ. Welcome to the podcast. Would you mind introducing yourself to our listeners?
[00:02:23] JJ Whicker: Sure thing. So, uh, I'm JJ Wicker.
[00:02:27] I'm a pediatric audiologist at a primary children's hospital in Salt Lake City, Utah. Um, I have a unique opportunity here, uh, where I get to both do clinical work with children, primarily with cochlear implants. I also run the. Central auditory processing disorders clinic here. Um, but then I also have research time contracted into, uh, the workload that I do here.
[00:02:52] So, um, I'm working on a few grants right now and some data collecting, um, and I'm hoping to build a large research program here.
[00:03:01] Todd Houston: Well, that's all very exciting. And as we were just talking about before we started, we have this common commonality of you went to Utah State University. I was on faculty there 10 years ago now.
[00:03:13] Uh, or I left there 10 years ago. Uh, let's start there. What made you go into audiology?
[00:03:21] JJ Whicker: Uh, so, uh, kind of, um, by really lucky chance I was, I know I've always wanted to work with children. I've had a pediatric heart forever. Um, and so by natural, um, yeah. Thought process there was to go into elementary education.
[00:03:39] Um, but selfishly I was turned away by the income and I am the sole provider of my family. So that mattered to me. Um, and I had an opera coach. Um, whose sister was a speech language pathologist. And so I talked with her and she was the one who said, well, if you want to work with children and maybe even in a school setting, you could go into speech, language pathology.
[00:04:03] Um, and so that's what started the path for me. Um, and then like, so, so, so like so many, uh, students in communicative disorders and deaf education, I went in hoping to become a speech language pathologist. Um, and then the basic audiology class in my undergrad did turn me, uh, it was a really hard decision cause I actually do quite deeply love both sides of the communication disorders profession.
[00:04:31] Um, a lot of people would joke that I went to the dark side, but I definitely never felt that I, I love audiology. I love speech. I love the collaborative practice that we can have, but anyway, so right then, uh, right. Right before, uh, grad school applications were due. I switched to audiology and it is just because I don't know.
[00:04:50] It just, yeah. Something about audiology spoke to me that seemed a little bit more fulfilling than the speech side of the profession. So I can't really pinpoint what exactly made me switch, but I did
[00:05:01] Todd Houston: Well, I think we're all the better for it. So, uh, with the work that you're doing, and of course these children and the families that you're serving, I think it's, we're all very much better for it.
[00:05:12] And so way, way back in the day, it used to be. Um, back in the dark ages, uh, when I was going through grad school, it used to be sort of the, the man went into audiology and the women went into speech, language pathology, but, you know, I was reading the other day on the actual website, but now it's, it's. It's tipped in beef, uh, female direction and audiology as well.
[00:05:37] So there's more females than ideology. Uh, so it was interesting, the, the sort of gender stereotype roles back in the day. And, and of course I kind of defied that cause I went into speech and didn't go into what was, what I do remember is that when I started at this I was at the university of South Carolina, there were four guys and one female who started the audiology program at the time.
[00:05:58] And all four of the guys filled out that could make it. So there was a class of one female in that audiology cohort that went through because all the guys, all the guys couldn't make it. You have had, uh, some, some great training. Uh, and, and so let's talk about what you want to do as a pediatric cardiology audiologist, and what is some of the research that you're focused on?
[00:06:34] JJ Whicker: So, um, I’ll kind of answer that second question first, because I feel like it leads into what my goals are as a clinician. Um, so working with Dr. Karen Munoz, she was my PhD mentor. And a lot of what she looks at is, um, looking at the psychosocial impacts of deafness or hearing loss on, um, on individuals who are deaf or hard of hearing.
[00:07:01] And she does work a lot with pediatrics, but she also does work kind of across the lifespan in that regard. So that's where, um, And that's where my thought process is started as looking at when individuals are diagnosed with hearing loss, how does that impact them? And of course, because I do pediatrics, um, my lens is very specifically looking at the parent, um, experience.
[00:07:27] Yeah. So that's, that's where I started looking at how parents are feeling about the diagnosis. What are their experiences? How did they interact with professionals? Um, to eventually make those, um, plans for care and how well are professionals doing at being family centered at making sure we're engaging with families in a way that matches their needs and responding, not to just their technical needs, but also to their emotional financial environmental needs.
[00:07:57] Um, so. Then it kind of shifted when I was an audiology student, I'm doing my first serious pediatric rotation, uh, ironically right here at primary children's hospital. It's how I got my foot in the door is I did a student rotation here. Um, and when you work in a children's hospital, one of the things you're exposed to a lot, our children who are what we call Multipli involved.
[00:08:22] And I don't know if there's a better term to use that. It's more, um, Appropriate, but that's the term that we tend to use when children, um, have multiple disabilities, multiple medical complications in addition to their deafness or hearing loss. Um, and so when I was a student exposed to these families for the first time, really, I mean, at.
[00:08:44] Other clinical rotations. I was occasionally, um, exposed to children who are deaf or hard of hearing who also have down syndrome, um, or maybe autism, but that was kind of the extent of my experience, but then here at a children's hospital, you see so many different, um, complexities going on and you would hear very, um, I would hear very emotionally, um, just powerful statements from families.
[00:09:14] Saying, you know, we aren't wearing hearing aids right now. We're not doing the cochlear implants right now, just because we need a break. My kid needs a break. We can't, we can't do this right now. We can't fight this right now. Um, it's just too hard, you know, I'd hear those kinds of things come out of families, mouths of, you know, we're not, we're not really wearing the devices.
[00:09:36] Um, And it was curious to me because, so I wanted to know what, what were families experiencing that would lead them to those, um, sort of conclusions or outcomes? Was it led me down this road of understanding how parents determined to prioritize, hearing related needs when children are deaf or hard of hearing and have other disabilities on top of their deafness or hearing loss.
[00:10:04] Um, so that, that's what led me to my dissertation. My dissertation was doing a grounded theory, looking at how parents determined to prioritize, hearing related needs for children who have down syndrome. And what emerged from that study was, um, that, you know, professionals definitely do play a role. Um, the level of how much families themselves are willing to take action to how much they believe in the importance of the hearing related, um, concerns.
[00:10:36] Um, those, those were the kinds of things that were emerging, um, which kind of just. Validate a lot of other research that's come out about the importance of how professionals interact with families and the health belief model. You know, our families, if they don't believe that there's an issue, they're probably not going to do anything about it.
[00:10:58] Um, so, so th there wasn't any like, um, huge discovery about how parents decide to prioritize. And it was really interesting to me because one thing I did think that was going to come out from that study. Where the medical needs were that the complexity of the child's medical needs were going to outweigh the hearing related needs.
[00:11:18] You know, the open heart surgeries, the breathing, the feeding. Um, I was expecting those to emerge from this study as being reasons why parents did not prioritize hearing related needs, but it didn't. I did come out in some ways, but not consistently across cases like I predicted. And so that, that's what stood out to me, um, is that even when children are, uh, have these complex multiple involvements going on, it's it could be that, um, that the medical complexities themselves are not exactly what or, um, Lending toward this phenomenon of parents not prioritizing hearing related needs.
[00:11:58] There might be something else like the professional. How are professionals interacting with families to help them understand a hearing loss, what it means for outcomes? Um, because. You know, every, every parent I've talked to so far has indicated that a priority for their child, even when they're multiple involved is the ability to communicate.
[00:12:19] They want their child to learn how to communicate for him or herself. Um, but if they're not going to take, uh, prioritize those hearing related needs, then they're going to compromise that value. So. A lot of people will say, well, hearing loss is quality of life. Whereas they've got these a life and death situations going on.
[00:12:38] So of course it's going to take a back burner. And while I think that that's valid in many, many ways, I also think that that value for communication is just as high. And there's a way to work with families in a way that maintains, um, you know, uh, families have chosen listening and spoken language. And that can only come through audibility.
[00:12:57] Um, so they, there has to be a way to balance the complexities of what the child is experiencing and being able to navigate the world of hearing health. So that was kind of a Longwood in dancer to let you know that, that that's what I do as a researcher. And then also as a clinician, that's what I really care about is helping.
[00:13:18] These families who come in, um, I do their ABR child is deaf, but they also have. Trisomy 18 or Kabuki syndrome or these other rare, you know, treat your Collin's syndrome. These other were a rare syndromes or conditions that have huge implications for the child's. Um, Life and helping families understand where hearing loss comes into play and helping work with them to establish goals in a way that meets their needs, um, in the home.
[00:13:51] So they can still prioritize here in care, but also manage the child's other, uh, needs.
[00:13:58] Todd Houston: Sure. I think you're hitting on a lot of good stuff there in terms of, of how do we work with parents? And like you're saying, how do we be family centered? And I think, or I think too many clinicians, and this is for speech-language pathologists and audiologists and others.
[00:14:18] I think it's a term that's thrown around. Yeah. And a lot of people think they're doing family centered practice, and they're really not just because you talk to the family and ask them what they're wanting to do. Uh, it doesn't mean that everything that you're doing is really family centered in terms of making sure they understand and have the information they need to make sure.
[00:14:41] Uh, a real decision. Uh, and I think too, you know, one of the things that came up, uh, before in another, uh, episode was the idea, this, you know, just one little area of, of data logging. And how we can see through data logging, you know, how, how long each day, the on average that the child is wearing the hearing technology.
[00:15:05] And, and I have seen this and, and, and, uh, and I think it's, you know, something we need to think about, but how it's sometimes used to scold the parents. Uh, which, you know, I think bringing it to their attention is the right thing to do, but how that information is used is often more, you know, being very critical.
[00:15:29] You know, why aren't you keeping the on there instead of getting to that in terms of what's, let's talk about why, you know, Johnny isn't wearing his hearing aids or his cochlear implant and, and what can we do when, when we he's having this. Downtime and he's not wearing it. What are, what is he doing? What are you doing?
[00:15:50] You know, where is he is, you know, is he at a babysitter during that time? Do we need to, you know, talk to the babysitter and then, you know, help that person understand. Uh, and so we often don't go that extra step, but really try to solve the problem. It's just, you need to do better. And then of course, the family, the parents leave that session, thinking that they've been scolded.
[00:16:09] And of course they get defensive and they build up, you know, this resistance and it doesn't often help the situation.
[00:16:17] JJ Whicker: Right, right. Absolutely. And it happens in audiology all the time. Um, there's lots of research to show that we tend to just stick to those technical data points where we'll see low data logging.
[00:16:29] And we'll say, you know, evidence is showing that your child needs to wear eight to 10 hours a day. If you want blah, blah, blah, blah, blah. And that's where we stop. Um, but just like you say there, what we don't know is that the parents are desperately wrestling their child at home and they get burnt out.
[00:16:45] They're crying, the kid's crying, um, and they don't know what to do. And so then you add the multiple disabilities on top of that, um, in telling parents what they need to do. Like that can just be a real, um, Real hindrance to their ability to develop trust in you to feel validated by you as a clinician, um, to feel heard by you as a clinician.
[00:17:11] Um, if you're just going to stick to those data. Cause I mean, you're right. The data do show that a higher, longer wear time equals improved, uh, spoken language outcomes. You know, that's true. It's there in the data. Um, but to get there. Doesn't mean that we have to just automatically flip a switch and suddenly it's happening.
[00:17:35] There's, um, goals that need to be set. There's understanding. Uh, I feel like I'm just echoing what you just said. Understanding what barriers are there in the home that are leading towards this. Do they, do parents need a resource for understanding how to manage child difficult child behavior? Do they need, um, someone in the community to come teach them?
[00:17:57] You know, when your child throws a tantrum? And you go ahead and take away the hearing aids, like do parents know that that's in a reinforcer and so they need to learn a new strategy, you know, like there's just so many things that parents need. Um, and just telling them what to do. Isn't going to get them there anyway.
[00:18:18] Todd Houston: Sure. And I think of, um, we're Singlish. She was here on our faculty, um, until recently she retired, but, you know, she talked about being too techno centric in our counseling. Um, what do you say to other pediatric audiologists who basically will say I don't have time for all of that. I don't have time for the counseling side.
[00:18:40] Right. You know, because I'm, I'm booked back to back and, and, uh, you know, I only have 10 minutes to do this or 15 minutes. Um, you know, you're, you're in a, in a sense of high productive hospital setting. Um, what do you say to other audiologists? Pediatric cardiologists who may. Okay. So yeah, it's just not in my schedule to do that kind of stuff.
[00:19:04] JJ Whicker: I think that when people say that, what they don't understand is that person centered care or family centered care is not a tangent billable thing. Um, and I th I think counseling is a tool to be person centered, and I think people get caught up, um, thinking that counseling is a, um, time structured, separate service that comes.
[00:19:30] With clinical services and I don't believe that's true. I believe being person and family centered is just a way of being a clinician it's, um, allowing, allowing the time for families to ask questions and being quiet so that they feel like they have a second to think about the questions they want to ask.
[00:19:49] You know, it's, it's just a way of being clinician. Um, and I would also argue. That, um, not being person centered, not counseling, um, is actually going to hamper your clinical productivity because if a family has this reoccurring issue and you feel like you don't have time to address it, then that issue is always going to be there.
[00:20:14] And it's always going to be a part of your clinical discussions. And Dr. Munoz, Karen Munoz did a study and I can't remember. What the study is called or where it's published, but she did a study where she has data that shows that when you take the time to directly address a concern, it will actually decrease the amount of time a family spends in clinic because it's been addressed.
[00:20:35] So that's, that's my thoughts regarding that particular concern. And I know it's out there.
[00:20:42] Todd Houston: Sure. And one thing that strikes me even. From the early intervention sort of speech path side of things and working with, with families and parents is that the whole area of adult learning theory. And how do we apply some of those concepts?
[00:21:01] You know, this is another adult and we have to understand where they're coming from. Being person centered being family center, but we're teaching them new skills. So how do they process information? And of course they're processing information about their child, you know, and then, so how do we, how do we roll all that together in a very positive, uh, learning experience really where they can be successful with the technology, as well as doing all these other things in terms of, you know, Talking to their children and doing all the things that you know, me as a SLP or the early interventionists going into the home or through telepractice, they're having to write a do as well.
[00:21:41] And so they're, you know, I feel like the, sometimes I think the, um, the bandwidth isn't there for all the stuff that we ask these parents to do, especially in the beginning, uh, when we all know that. Time is of the essence. And we want them to keep the hearing aids on and we want them to talk to them. We want them that he's saying to them, we want to, you know, and, uh, we're all just kind of throwing these things at them.
[00:22:04] I think we have to all be cognizant of what they're going through. Yeah. Yeah. So getting back to your research. Where do you want to go with your research as in, in the future?
[00:22:19] JJ Whicker: So, um, right now I'm kind of in the stages of developing an infrastructure to, um, to bring in some grants, uh, and, uh, And just develop a strong program because one of the downsides to where am I, I love where I'm at, but, um, I'm not affiliated with the university, which most of the physicians and other researchers who do research through a primary children's hospital, they're duly affiliated with the university where there's, I think a better infrastructure for, you know, grant writing and.
[00:22:54] Um, supports and all that good stuff. So I, and I'm all, I'm not duly employed by the university, so that's kind of tricky. So my, my focus right now is just getting some grants. Um, I'm, uh, looking, uh, one of the, I'm looking at two different populations right now. One is children with craniofacial differences.
[00:23:12] I want to know, uh, I just completed a study. That's looking at, um, They're trending timeline for early hearing detection and intervention. Like how does that, how is it, how is their timeline? Are they meeting those, meeting those one, three, six milestones as compared to children without can you have facial differences?
[00:23:29] Um, And so I just collected that data retrospectively. And now I'm looking to get a grant to look at that data more carefully in a prospective manner. I'm also looking at children who are being treated for cancer and, and experienced ototoxic induced, hearing loss. That's one population where I hear all the time from.
[00:23:50] Um, pediatric audiologists. Oh, I want to even talk about hearing aids if I see hearing loss because the kid is going through so much, so it's a family. Um, so it's not even something I bring up and, and, you know, I disagree with that because if we're not giving the family the opportunity to pray or a ties hearing related needs, maybe it maybe they're right.
[00:24:08] You know, who knows, maybe they're totally right. And every family is 100% agreement with that approach, but we don't know that. And so I want to know that. So I'm. Preparing a grant, uh, for that particular population to explore that prospectively as well. Um, So I'm, I'm a mixed methods researcher. So I love qualitative and quantitative data.
[00:24:28] So what I'm trying to do is, is do these interviews so that I can develop a scale to, uh, I would love to be able to quantitatively measure priority as a clinical tool. Um, so that. You know, as part of our counseling, our family centered care, if we're seeing that data logging, instead of having the pressure on us to be like, do you even care?
[00:24:49] Cause obviously it's hard to ask that we can, we can give families a way to indicate on a survey, you know, right now hearing is not important to me as of. To just measure priority, to facilitate a way to open up that conversation between clinicians and families. So I'm just starting out my research career.
[00:25:11] So that's about where my vision ends, but that's, that's what I'm hoping to do.
[00:25:16] Todd Houston: Well, that's, that's a lot to tackle what you've just talked about. So I, I. Best of luck with all of that. I know, um, the challenges that can be there when you don't have that university support, uh, behind you. And you're trying to do this, uh, because you're, uh, you work for the hospital.
[00:25:35] And so that's, that's still a little bit different and they kind of view research is a little different than, than maybe the university does and they're not. So, you know, Best of luck with those grants. I think once you get some money rolling in with some grants, you know, they'll hospital will change their mind and then they can invest a little bit more in your time and letting you do some of that stuff.
[00:25:58] Yep. Well, JJ, it's been so great having you on the podcast. And is there a way for people to reach out to you maybe through the hospital website or. Or do you have another
[00:26:09] JJ Whicker: way? Um, so right now our, our hospital, our audiology website is actually under revision right now. We've had a big changes, so new, new faces.
[00:26:19] So, um, but if you were to, uh, email me, I can, um, do, is there a way that you just give that out to people? Or do you want me to just share it right here right now? You can do it right now. Okay. So my email is J J dot w H I C K E R. At gmail.org. Um, me, so I, I still am part of Dr. Karen Munoz's research laboratory.
[00:26:46] I'm her extension now. Uh, so we have a Facebook page it's called the, the hearing impact project research laboratory or the hip lab. We're on Facebook, we're on, um, Instagram and LinkedIn, the hearing impact project research laboratory. Um, so if you want to reach out to those venues that works as well.
[00:27:04] Todd Houston: Awesome. Well, best of luck to you and all that you're doing and, uh, hopefully in a year or so, you'll come back on and tell me about all the grants you've gotten written and got funded and all the new work.
[00:27:17] JJ Whicker: That sounds good. Thank you so much for having me.
[00:27:20] Todd Houston: Well, JJ is very, very impressive and I wish him the best of luck in his clinical work, as well as the research that he wants to do.
[00:27:30] And I really appreciate him being with us. I appreciate you listening to today's episode. If you don't mind. Please leave us a five star review. That way we can attract more listeners and continue to grow the podcast as well. If you would like to hear me interview someone on the podcast that you would like to hear from.
[00:27:56] Email me at firstname.lastname@example.org and I'll do my very best to reach out to that person or to yourself if you'd like to be on the show and we will try to get all of that set up for you. And with that, thank you as always for listening, be safe and be kind. This has been a production of the 3C Digital Media Network.
Todd: Welcome to episode 21 of The Listening Brain podcast.
[00:00:14] Welcome to The Listening Brain. I'm your host, Todd Houston. In this podcast, we explore childhood hearing loss through the lives of the parents and families who are on this journey and the professionals who serve.
[00:00:38] Hi, it's Todd Houston. Again, I just wanted to invite you to become a content creator for the three C digital media network. We want to really ramp up what we have to offer in 2021, this new year that we find ourselves in. So please reach out to us. If you have ideas for webinars, cars, courses, or even maybe a new podcast that you'd like to develop.
[00:01:07] Reach out to me at email@example.com and I'll be in touch. Thanks today. I have the pleasure of speaking with Dr. Melissa Hall. Melissa received her doctor of audiology degree from the university of Florida in May, 2010 and her master of arts degree in communication, sciences, and disorders from the university of central Florida in August of 2006.
[00:01:39] Dr. Hall is dually certified and licensed. As an audiologist and a speech language pathologist. Dr. Hall works as a team member on the USF university of Florida health Coca-Cola implant program and provide services such as cochlear implant, evaluation programming. And rehabilitation while working closely with otolaryngology to provide a team to patient care.
[00:02:10] Dr. Hall is a board member of the American cochlear implant Alliance. It's my pleasure to speak with Melissa. So Melissa, welcome to the podcast. Can you, uh, give us a little bit more about your background
[00:02:27] Melissa: Thanks for having me. Um, so I actually became, um, a speech language pathologist first. Um, and then I ended up going on to get my doctorate of audiology later.
[00:02:38] Um, while I was doing the program for the speech language pathology degree, I kept, um, signing up for courses in the graduate degree program for oral habilitation. Um, and I was the only students in my cohort that would sign up for those courses. So naturally, but one student wasn't enough to support having an entire course.
[00:02:59] So I kept signing up for everything that they offered and then kept not getting the cap, the class that I wanted. I went on into my, uh, My externships. And in my full-time externship, I did, um, an externship with students in a school for the deaf. And one of, one of the schools that I went to, um, it was total communication.
[00:03:22] And the other school that I went to was oral. Um, and I found it to be really fascinating, the differences in the communication abilities that each of the students had. Um, you know, I would look through audio grams and I would see, well, they have the same hearing loss. They were identified around the same time.
[00:03:39] Um, you know, they have different communication modalities, but why is one child able to do certain things and another child really incapable of doing that? Um, so when I finished my SLP degree, I ended up. In the school system. And at the same time I applied and was accepted into the audiology degree program, mostly to answer some of those questions that I had, and then the interest in therapy that I had trying to see how I could better help those patients that I was going to be working with.
[00:04:08] Um, so I ended up going to the AED program, um, and really got a lot of answers to those questions. The degree program, um, and early, uh, my husband is also, he's a cochlear implant recipient he's, um, bilaterally implanted. And I met him through taking a sign language course, and I kept thinking, you know, he's so functional, he's able to function so well in his work environment and his school environment and what makes it so different for all these other patients.
[00:04:38] So kind of all of that led me to the audiology degree. And I was, as I was going through that degree, I really saw the possibility of helping people more by being able to provide the therapy at the same time as programming their devices. Um, so after that I went to UNC chapel hill for my externship for audiology.
[00:04:57] Um, and I like to refer to UNC chapel hill pediatric program as the Disney world of cochlear implants and pediatrics. Um, it's just, it's such a wonderful place to be, to learn information for all the questions that you might have, um, as a professional and really develop skills. And at that time, I was able to work with some really great, um, therapists and really great audiologists and they let me do therapy and then let me later program patients the exact same patient.
[00:05:26] So I got to see real therapy change. And then I got to see what programming changes would do for you. Um, so I really got to have like a full circle experience there, um, and really cemented that I was in the right place and that I was doing, um, you know, what I felt like I was led to do. Um, it's funny at that time I was trying to decide, do I want to go more therapy?
[00:05:50] Do I want to go more? Audiology, you know, is there a job like that? And in reality, no, there isn't one, um, most jobs when they're posted, they're posted as an audiology line or a speech line, um, and you really have to make one. So I spent a lot of time over the last couple years, trying to find that area where I could do both and really feel satisfied that I was providing the best care for patients with the knowledge and expertise that I had.
[00:06:18] Um, so I'm the director of the cochlear implant program at USF health now. Um, and I do see patients mostly in an audiology capacity, and then I also support the SLP team. Um, I will do a lot of evaluations and kind of staff patients, and then get them to the therapists, um, for their full-time therapy. So it's been an interesting journey to get to this point.
[00:06:40] Um, but I do feel like. Having the SLP background, um, made me a better audiologist for the perspective that I wanted to have. Um, and audiologists are wonderful and they get a lot of great training. Um, but one of the things that SLPs get that I think audiologists could get more of. Um, behavior training and therapy and how to get a child to do a certain behavior for you.
[00:07:03] And what positive reinforcement means, what negative reinforcement and some of those skills could be really helpful in training for condition play, um, and different aspects of an audiologist everyday life. So, you know, some of that crossover. Even though the fields are so different. Now, some of that crossover has been very helpful for me.
[00:07:22] Todd: Yeah. That's a great introduction of yourself and your, and your background and how you ended up both in sort of in both professional worlds with speech, language, pathology and audiology, you mentioned taking a step back during your speech path framing. You were requesting those courses and you were the, basically the only student.
[00:07:43] What, what led you into hearing loss? So
[00:07:46] Melissa: the first course that I took in audiology was the fundamentals, um, in the undergraduate degree program. And I just was so fascinated by, um, the difficulties that people would have with hearing loss from the, the, uh, cases that the professor would present. Um, and I really, that population of patients is who I wanted to work with.
[00:08:07] And I knew it from that class. Um, you know, I had taken courses in articulation and fluency and feeding and swallowing, and really what I kept coming back to was people with hearing loss and what could I do in their lives to help them. Um, and so that course, really, I think, started what I consider to be a love affair with people, with hearing loss, basically.
[00:08:29] That was the area that I wanted to focus on. And I kept trying to find avenues to do that, to figure that out, whether it be placements or courses or, you know, externships later on, um, that was really the population I really liked
[00:08:43] Todd: you and I are very similar in that way. Cause I went to grad school and speech language pathology.
[00:08:48] Because I knew I wanted to work with kids with hearing loss. That's what really focused me. And unfortunately at the time there wasn't a lot of extra things I could do, uh, to get additional experience. Um, and the course, you know, the, the intro to audiology course I took was, was great. Uh, the Aral habilitation course I took at the time was more of a survey course.
[00:09:12] Here's how to troubleshoot a hearing aid and here's right. Here's some different methodologies you might see, but otherwise that's about it. You know, that was about the scope of the course. And, uh, and so I was like, yeah, I just, and this came sort of at the end of the master's degree. And, um, and so I'm like, well, I've been here this whole time waiting to get this course.
[00:09:36] And this course really. Preparing me to go out and now work with a population I really want to work with. And so it was a bit of a let down, even though I think I had overall a very good training as an SLP at that point in time. Uh, I felt disappointed that that one area where I really wanted to focus.
[00:09:57] Just didn't really prepare me and much of, uh, what I have done as a speech language pathologist, uh, and how my in terms of my professional preparation has come after I graduated with my masters, um, doing, you know, auditory, verbal, and yeah. Yeah, getting training in that area and then going back and get a PhD and focusing more on those kinds of things.
[00:10:20] But unfortunately I had to come afterwards and, um, but you know, you, as we were talking about earlier, before we started, you have sort of a reconstructed sort of. Training used to look like where it was, you know, less of a challenge to become duly sort of, and you've you've you stuck it out and got two different degrees, you know, back in the old days, you kind of, you know, go an extra semester because that's, you know, or, uh, another year maybe then you have both, uh, of course the scope of practice in both areas, both professions is so much bigger now it's you need to do both degrees, but, uh, More people could do what you've done.
[00:11:04] Or we had another way of combining the two, because I do think if you, if you're a good pediatric audiologist and, uh, you need to understand how speech development works, how speech science works, speech acoustics, and then, uh, and then what the intervention should look like and how to judge whether the intervention is being effective.
[00:11:31] Right. And the quality, right? And, and if you are a speech language pathologist, you need to understand the audiology side of things. And you need to know when you're looking at this information, what it means, uh, when you're working with an, a, an audiologist, be able to talk to them about mapping, be able to talk to them.
[00:11:50] If there's, you know, working kids with cocoa implants, of course, and, and understand speech acoustics and all of that stuff too. And so it does require that. It's sort of common knowledge base from both perspectives to be really, really effective. And I wish there was a way today where we could more easily provide that kind of training or for students.
[00:12:16] So maybe down the road, something will happen. And that will be possible. And so I, I wanted to, um, talk to you about what you're seeing today in terms of the cochlear implant program at USF. What exactly is USF health? They can have an idea, but yeah, you have health
[00:12:37] Melissa: is, um, it's a partnership with the university of Florida.
[00:12:40] Um, and UFL and us work together to provide, um, education for students and various medical, medical, and rehabilitation fields. Um, and then also we have a mission for research. And for advocacy and for awareness. So it's really a nice marriage of two different entities with similar goals. Um, the great thing about, um, being in a large hospital and a large facility is we can try some new ideas and some new things like, um, teletherapy, things like that, that other centers may not have the overhead to try to manage and try to figure out from a, um, reimbursement standpoint.
[00:13:23] Um, the other nice thing is that we constantly have an influx of new students that are ready to learn new things. Um, and I've taught a number of courses over the years in the AUD graduate program. And, um, I was pleasantly surprised at UAF to see, you know, my undergraduate and my graduate degree program.
[00:13:41] At UCF have changed drastically. Um, you know, I was the only person that kept asking for those classes in my cohort, and now it's a full fledged track in the program for hearing. Um, and so I think the things that I would have benefited from at the time are now in place. And so I'm hoping more people are getting.
[00:14:01] Be able to take more advantage of it. Um, but at USF I've been able to see undergraduate, um, speech, language, pathology, students, and graduate SLP students wanting to take audiology courses. And they know that that's the area that they want to be in. And they've actually been placed in those courses as you know, extra.
[00:14:20] Um, and so we've been able to see some more of that overlap, which I still think there's plenty of room to grow in that area. Um, especially on the audiology side too. I think that audiologists, and this is just a gross overgeneralization, but I can say it because I am one, we like puzzle pieces to fit. We like, um, to solve the problem.
[00:14:41] We like to have a point a to point Z and to be clear, And quite often children with hearing loss, it isn't a point a to point B. It's a convoluted journey and trying to get everyone on the same page can be difficult. Um, and so I think with audiology, having that kind of mindset of problem solving is really helpful, but thinking outside of the box, that's really helpful too.
[00:15:04] And I think that's. Strength of an SLP, you know, being flexible in a therapy session, getting down on the floor and playing with the child and meeting them at their level is something that I think is taught or, or maybe it's an eight and people and eight and people that, um, work with children. But I do think it's different in the way that we approach patients.
[00:15:23] Um, and I think sometimes if we had a different mind. As audiologists, we would meet people where they are differently, um, and be more successful. And I think we can learn more from SLP use and vice versa. Um, but that is something that I completely think isn't is an area of need for education and a lot of my education much like you happen after the fact so threes, but really, you know, going to the Carolina summer Institute while I was there as an extern.
[00:15:55] And doing the treatment program and, you know, working together with that team of professionals and seeing how they communicate with each other on a daily basis about all of the patients was the piece that I didn't have. You know, I had my graduate degree in speech. I had my graduate degree in audiology, and then I really didn't understand how it all fit together until I did that Institute training.
[00:16:19] Um, and that, you know, that was. I suppose everybody has that, that like, aha moment. This is where I'm, this is, this is what it's all for. And this is how I'm going to get all of my patients where they need to go. Um, and that was, that was when I had it as a fourth year audiology student. Um, You know, with Holly Teagle and Lillian Henderson and all of those wonderful people at UNC.
[00:16:44] And I know a lot of people have left there, but it's just such a, a great model that the rest of us could probably use more of, of how to collaborate, how to cook. Kind of cross train each other and, and be able to be conversant in each of those different, you know, areas of education. Um, that's just something that's a huge passion of mine.
[00:17:06] So I love talking to you
[00:17:07] Todd: about it. I will do agree with you. I should say about UNC chapel hill and I love the folks there and have a really strong relationship with those, those folks there. Um, both personally and professionally, but. You know, I think this whole idea now is that interprofessional training and, and you're describing sort of what can be possible when it does work when it's in place.
[00:17:36] When people are commuting to the professionals on the same team are communicating and they understand. What each other needs and then how to help the patient. And, and I think they are definitely one of the best models that I have ever seen in terms of pediatric cochlear implantation and having a strong team.
[00:17:56] So, um, I haven't been able to visit your program, but, um, I'm sure the it's it's quite the same, but you know, they have always been one of the models I've looked to as, as an example of that. And I
[00:18:09] Melissa: think even, even past that, you know, you have the CLP training, you have the audiology, and then you have amazing, wonderful physicians and psychologists.
[00:18:20] And if you can learn from them as a professional and keep developing. You're going to be better at what you do. Um, you know, fortunately I've worked with really good people at every center I've worked at, I've worked at three big centers for cochlear implants, um, in the Southeast and every center it's just mutual respect and that mutual respect, that just means that we can work better together.
[00:18:42] And that is a way. It's in our families. You know, we have lots of physicians that we work with here at UFL. Unfortunately they respect what the SLP says, just as much as what the audiologist says. And I don't know that it's always that way everywhere. Um, and so I think that we, when we have, we get really lucky.
[00:19:04] Todd: Yeah, I, yes, I can tell you it is not like everywhere else. That's, you know? Um, and I agree it's I think when, when everyone values truly values the input and the perspective of, of each other on that team, uh, it's just gonna be. Every one is stronger. It's gonna make the team stronger. Uh, and I like what you're saying in terms of being open to learning, um, about another discipline and, and from another person on the team who has, you know, a whole other area of training and how you guys can integrate what you're trying to do with, you know, from your perspective, from their perspective.
[00:19:48] And I think, again, it's just. I'm just, um, sort of passionate about that too, when you're able to do that. Well, it just is, it's just like a finely tuned machine that really works quite well. And doesn't mean you don't have hiccups every now and again, I have to get a tune up every now and again, uh, and address issues that come up.
[00:20:07] But at the end of the day, you have each other's backs. You trust each other's judgment, you know, everyone's there for the same purpose and for the same reason, and it just makes everything go a lot. Makes
[00:20:18] Melissa: you so much more confident as a provider? You know, we had a, I just came from a meeting this morning with our cochlear implant team and it was great because we brought up some issues with, um, scheduling or, you know, expediting certain patients or, you know, whatever the case might be.
[00:20:34] And there wasn't a time. But someone didn't come up with a solution or come up with a different workflow or something like that. And it may seem small, but that change means better access to healthcare. And I think that's something that in the field of hearing loss, whether we're providing rehab or technology or, or surgery or whatever we're doing.
[00:20:55] That is an area that we don't have the best access. We don't get people that do need the help. Like we should, you know, titration for cochlear implants still remains poor, even though this may be going up. So part of that is how do we make our flow better at our own facilities? And that's something that we do here at USF health all the time, but how do we make that better?
[00:21:17] So that patients who need services actually get to the service. Um, and I think that's another area that I see us continuing to grow as a field, um, from a rehab perspective and from audiology and surgery. And it's something that we can't ever really be lax on. Yeah. Everything keeps changing, whether it be laws or, um, you know, the, the cultural mess of it or education.
[00:21:42] There's so many ways that we can improve so that people get where they need to
[00:21:45] Todd: go. I agree. And, uh, here, you know, Haya, we kind of wrestle with that transition from early intervention. Too well with the end early invention, getting access to those children and, and on average, you know, kids get about one hour, a month of early intervention and, and yeah, that's, that's a lot, isn't it?
[00:22:10] It's a hard number we're going to do so well. Uh, and, and so it's, it is a struggle here. I know, you know, North Carolina, as we talk about them, Uh, have beginnings in a very different system and, and maybe a little bit better model of how to get families connected earlier and then services can flow here.
[00:22:34] It's, uh, a situation where, you know, kids make it to early intervention, but they don't. Yeah, additional services. They're not referring out of early intervention and connecting families to additional services in the community, which is frustrating because then by the time they hear about cochlear implants or other, uh, communication methodology, or getting enacted to an AAV therapist or whatever the case may be, it's always a little bit later than it could have been.
[00:23:04] And so even today, We fought so hard to get newborn hearing screening and tried to get issues going from screening to diagnosis to intervention, worked out, we still are struggling because of issues and professional boundaries. And this agency is fear. They fear having to pay for additional services. If they refer to another professional, you know, or another provider.
[00:23:33] And it's. It's just exhausting, but we have to keep fighting, keep fighting these, these fights to get families connected, where they need to be as early as possible. So the children can have the very best outcomes.
[00:23:49] Melissa: And I'm sure you guys have done this in your area, especially knowing your reputation. Um, but there are, you know, there's so many ways that I think providers think that they can't get involved in certain things or they think they are part of certain conversations.
[00:24:04] And I think sometimes, you know, this is something that's just coming from personal experiences that I've had with early intervention in our state. I think sometimes we get kind of frustrated with things and then we don't extend at all grant or we don't reach out. Or we don't ask for who should we talk to about how to make this better?
[00:24:21] It's kind of stayed frustrated. And I think that's an area that really all of us could be doing better. You know, I know I've reached out, but it's only one person reaches out. We don't same amount of people and we don't affect the amount of change. And, you know, once you get a physician backing that, or you get, um, an SLP, who's very vocal in the community, backing that.
[00:24:41] And then you get parents backing that. Then you get a movement, you know, if we have people kind of reaching out here and they're trying to extend all the branch and improve referral sources and things like that, it's just not going to be as effective as if we're all on the same page. And I think that's something that we just need to always keep working towards and, and trying to be empathetic of other people.
[00:25:01] But also, you know, this is the research and this is what it shows, um, in terms of early intervention and outcomes. And, you know, what do you hope for your child? The at age 10 at age 20, what do you think they're going to be doing in college? And if we're not having those conversations openly with early intervention, we can't really expect it to change.
[00:25:23] And I know you have, I'm sure done all of that outreach just because I've followed you for a bit from my time at the university of South Carolina. Um, and I think people like that, that go out and change and actually. Reach out, that's going to be the change and the more we can get people to do it the better.
[00:25:43] Todd: Oh, I, I agree a hundred percent and I think I'm continuing to have that outreach and that contact and continuing to be the, you know, that drip, drip, drip of the water that never goes away, that leaks that now can never be fixed. Um, because you know, that that's just what it takes and, and. And then I think the other thing is, is really involving the parents.
[00:26:08] I think if parents can take on more and more ownership, I mean, professional, certainly being at the table and, and advocating. But when parents are in there making calls and testifying before a state, legislature committees and things like that, and you know, it's hard to say no to the parents, you know, when they're saying.
[00:26:29] We need these services, we need, you know, we want these things to happen. And so some of that sort of grassroots organized organization has to take place, uh, is, is really critical as well. And, uh, but yeah, you know, unfortunately it's, it's still a lot of work that needs to be done, you know, and, and we'll just have to continue to keep up the good fight and hopefully, uh, we'll continue to see, uh, uh, positive things that will eventually come out of it.
[00:26:55] So, um, going back to the team for a moment there, um, talk to me about what, or maybe, maybe on the same sort of, uh, uh, chain of thought here, uh, in terms of what's going on in the field, how can teams better serve families? What do you think are some of the key issues that are out there today?
[00:27:21] Melissa: You touched on one already with early intervention.
[00:27:25] Um, and I think not knowing what they're counseled on when they're, um, initially connected with early intervention services is an issue. And then I also think kind of expediting all of our services, making time in our schedule to expedite patients who have reason to be expedited. So if they're identified, you know, later on and they.
[00:27:48] A significant hearing loss and they need to get hearing aids. You know, we still, we run into insurance issues. That really is an impediment to a lot of patients getting to a device that they need. Um, so we're fortunate. We have, um, early steps in the state of Florida. Where, if a patient, a child's insurance doesn't cover hearing aids that we can apply for them through early steps before the age of three.
[00:28:11] Um, but you know, not all kids are identified before the age of three. Um, we're still struggling with some of those late identified children due to loss follow-up or whatever the reason. And I think the insurance issue for us is a huge issue. And so one of the, the things that we've, we've kind of started to do here at USF health as we have, because we have that partnership with us, we have a, um, A great amount of undergraduate students that are trying to figure out how they can help their community.
[00:28:39] And so what they do for our team is actually raised money every year to buy devices for patients that are going through trial for cochlear implant candidacy, so that we don't have to wait for insurance. Um, and we can kind of. Get to the next step in a timely manner without having to wait so long for insurance authorizations, um, Turkey part two, I think the team could do better is, um, you know, one of the things that I like that we do is we meet once a month as a team.
[00:29:08] You know, some of those things, we kind of handle through emails or through things like that to try to expedite. Um, but I think more teams. Kind of going through and saying, what is it that we could do for this patient that would get them to what they need faster? How can we counsel them differently? Do we need to see them back to make sure that they really understand, um, all of those things from a scheduling standpoint are difficult and they take a lot of time.
[00:29:33] And if we don't have good people on our team, figuring out how to schedule that and what's a priority and we don't outline that for them, then the patient loses, you know? So I think keeping better handle on. When a patient needs to be expedited, what the situation might be and really kind of trying to serve convent insurance issues is probably one of our biggest problems, um, aside from the early intervention issue.
[00:29:58] So that would for me, make my life better. If insurance wasn't quite so such an impediment. Um, I do think the education of providers in general, in the community is something that, um, is. I don't want to say lacking, but lacking is probably the right term. You know, pediatricians, general practitioners, the training that they get in medical school is not really sufficient to helping them know that cochlear implants are the best treatment option for significant hearing loss.
[00:30:27] And so getting that information to general practitioners or pediatricians, um, that is something that I think, you know, the ACAA is working on trying to do presentations. They're trying to train people to be more equipped, to make the referral when they may not even know that that's an option. Um, and so I know there's been, there's been talks at more of the GP conferences and things like that, but that's something that I think from a community standpoint, the centers in a community could be doing to really do more outreach and teach people.
[00:31:00] Okay. What does a candidate look like? And it's not just what is on an audiogram, you know, At that functional ability of a patient or, or a child, you know, being able to communicate or not communicate. Those are really overlooked and well visit sometimes. Um, and we kind of do screeners and we think we're doing the right thing and we're missing people situations to improve.
[00:31:25] So I think the general, the general practitioner awareness could be improved greatly.
[00:31:30] Todd: Well, I agree. A hundred percent. Where I am now, Akron children's hospital there two days a week with her cochlear implant team and, um, you know, doing more of the AAV stuff and with my grad students, but we still have referrals that come in sometimes from rural areas or, you know, just, it's just weird that, you know, these kids are three, four years old, you know, showing up with minimal.
[00:32:01] You know, early intervention or no identification of hearing loss, uh, prior to getting referred, you know, later. And, and we're still hearing these weird, you know, uh, testimonies from parents about, you know, well, I went to my family practitioner cause maybe in the rural area, You know, just the general practitioner who served everyone in the family.
[00:32:24] And he thought he was fine. You know, he didn't, didn't say, you know, it wasn't, you know, he thought it was something else. It wasn't hearing loss. And, uh, he assured me it wasn't hearing loss and I didn't need to do anything more, but you know, kids now, you know, three years old, not talking and you know, and so it's like, here we are 20, 21, and we're still having issues where.
[00:32:46] Yeah, those kinds of things are still have the conversation. You know, we still hear of clapping the hands and ringing, you know, shaking the car keys and doing all this stuff and saying, oh, he's hearing fine, boys talk later than girls. Don't worry about it. Or you, you you're a first time. Um, you're, you're being a little too over-anxious, you know, because you're a first time mom and kind of.
[00:33:10] You know, dismissing concerns. And, and so I have to say it's not as bad as it used to be, but it's still a problem that needs to be addressed,
[00:33:19] Melissa: but it's still not where it should be. Yeah. Great.
[00:33:23] Todd: Okay. Right. Right. And I wholeheartedly think, you know, with all of the medical pressure, uh, personnel and, um, and physicians, especially, and even nursing, you know, giving more information about cochlear implants and who's the candidate.
[00:33:38] And then. Going back to how we started this conversation about how we train more, uh, audiologists and SLPs. I think we need to get more experience at the pre-service level with kids, with hearing loss beyond just the survey course or making it optional. I think back when I was getting my masters and how Astro had divided the number of clock hours up into actual areas.
[00:34:07] And so we had to get, I think, 20 hours of pediatric oral habilitation. Yeah, it was defined, had to get those hours and now it's more child speech childhood. Right. Right. And do you know,
[00:34:22] Melissa: a child's hearing loss in that
[00:34:23] Todd: exposure. Right. Right. And so, you know, kids, you know, being in a training program today, I'm like, you know, these kids can go through their graduate program and right.
[00:34:34] Be, or work with a child with hearing loss because those hours are gotten with other populations.
[00:34:40] Melissa: Right. And you hope at some point that they had training in communication modality, you know, unless, unless they've had a course with a preceptor that understands the different communication modalities, they may not have.
[00:34:52] Um, may think they understand what sign language really means or what cued speech really means or oral or, you know, auditory verbal. Unless you go through that and you actually educate someone on that. They don't understand how hearing is even involved in those communication modalities. So then when a parent's choosing and they're incapable of counseling about them, not super surprising that the outcomes aren't what everyone was hoping for, you know?
[00:35:22] So from a graduate level standpoint, we can do better for sure. We
[00:35:27] Todd: could do a lot better. I was, this is just kind of fits a bit. I got an email from a student, a grad student right now who's taking my class. She's about to graduate in may. And so I teach a course, uh, for students. I have courses for students who specialize in auditory, verbal.
[00:35:49] But, um, or other students who don't take those courses? Uh, I teach a course called, uh, audiology for the SLP and I do approach it sort of like that oral habilitation stuff and what, you know, how to work with the child with hearing loss, uh, as a speech language pathologist, what do you need to know? How do you work with an adult with hearing loss?
[00:36:12] You know, what do you need to know? But she said, yeah, This was the first time. Uh, she watched a lecture and she watched electrical speech acoustics and speech science and how it all fit together with the audiogram and. Vowels and, and all this stuff. And she said it was the first time that I realized what, how speech, speech science, stuff that I learned way back when actually applied to anything in the profession.
[00:36:38] And it was the first time I realized what speech language pathologists could actually do with kids, with hearing loss. And I'm thinking, huh? Comes at the end of her, her training with one lecture, she's being exposed to something and it's like, ah, we gotta do a better job. Cause you know, if she had gotten that information a lot earlier on, in a different way, she could have been maybe a very powerful clinician who really wants to do this, but you know, it was like, oh, this is the first time I've made those connections of what I would do.
[00:37:13] Melissa: I certainly wish as a student, those connections would have been earlier, you know? And then what, what would that path look like for another SLP? Now, if, if we did do that earlier, they could be even that much more effective when they start seeing patients when they graduate. Um, yeah, it's huge, especially because we don't want to have trial and error on babies.
[00:37:32] We want to. Successful outcomes. Yeah. And that connection earlier is better.
[00:37:38] Todd: Exactly. Exactly. Uh, well, where do you, what do you guys hope to go with the team there in terms of, um, the next three to five years, what would you like to see happen? Oh,
[00:37:51] Melissa: I would love to see us expand our rehabilitation services. I would really love to see us see more adults for therapy.
[00:37:59] Um, you know, I think that's one of the areas in, and speech and cochlear implants that it's just really underserved that population from a rehabilitation standpoint. And there's so much that we can do to help people process the sound from their implant. You know, we send them home. Some people live really far from our center and they can't come and we try to do things online or, or, you know, telehealth.
[00:38:22] But I don't think that providers really see the importance like they do in kids. You know, the kids it's really apparent that they have a communication difficulty and that if we don't do something to help them, you know, they're really lost and they have to fend for themselves and a child shouldn't have to do.
[00:38:38] But we really should be applying a similar mindset to adults in that they've never heard with electrical hearing, either the cochlear implant and their brain needs to figure out how to process it also. And we could really help them do that and get them at a more functional level faster and not struggling for as long and their family members not struggling as well.
[00:38:58] And I think the whole, the whole aspect of how hearing loss impacts families. That's something that, you know, there's more psychologists on teams now, but I would love to have more dedicated personnel to help in that area. Um, we ha we don't talk about it enough. We don't talk about. As hearing loss really impacts an entire family unit.
[00:39:18] Um, how, you know, we do a little bit of marriage counseling sometimes for really in our scope of practice and, you know, when should we be referring out? And I think we should probably be referring most of our patients, if not all of them, for some level of court or at least a screening to see if we can provide some.
[00:39:37] So I think those areas for our team specifically, I would love to see adult rehab. I would love to see, um, mental health support as they go through this process, whether they be, uh, um, a pediatric patient or an adult. Um, and then I think if we keep growing from an audiology perspective, so I don't have any doubt that we'll have plenty of providers to see people and we keep growing from it.
[00:39:58] From a surgical perspective. Um, but really the rehab, I would love to see us expand more into telepractice and for reimbursements really cover it more readily and not have to fight so hard for certain things. Um, and just, you know, the benefits have been shown in research. So it's not that the work hasn't been done, it has been done and, and now we just need to lobby and get people to pay.
[00:40:21] Um, and I think that's going to be an ever persistent issue in this case.
[00:40:26] Todd: Well, I think you've just summed up the next three, three to five years. There is some forks that we need to tackle a little bit of work, a little bit of work. Yeah. So we have our goals set for, you know, at least through what, 20, 25.
[00:40:41] Well, yeah. Yeah. Well, I, it's been just a delight talking with you today and really appreciate you being on the podcast and best of luck with you and with everything you're doing there.
[00:40:55] Melissa: Thank you so much for having me. It was great to talk to you.
[00:40:57] Todd: I really admire Melissa's drive. I mean, after all she got two degrees, speech-language pathology and audiology, and I think she's combined that knowledge base to just be an incredible professional.
[00:41:14] Who's serving her patients. Well, yeah. Directing a very, very widely respected cochlear implant team. So best of luck to her and everything that she's doing. And again, just a Meyer, everything that she's accomplished. And with that, I can admire you. If you leave us a five star review that helps us to attract new listeners and to grow.
[00:41:42] The program. We want to get this podcast to reach more people. And we do that by having good reviews and by you, dear listener, sharing the podcast and sharing episodes with people you think should hear this information. And with that until next time, be safe and be kind. This has been a production of the 3C Digital Media Network.
Todd: Welcome to episode 22 of The Listening Brain Podcast.
[00:00:14] Welcome to The Listening Brain. I'm your host, Todd Houston. In this podcast, we explore childhood hearing loss through the lives of the parents and families who are on this journey and the professionals who serve.
[00:00:38] Hi, it's Todd Houston. Again, I just wanted to invite you to become a content creator for the three C digital media network. We want to really ramp up what we have to offer in 2021, this new year that we find ourselves in. So please reach out to us. If you have ideas for webinars, cars, courses, or even maybe a new podcast that you'd like to develop.
[00:01:07] Reach out to me at firstname.lastname@example.org and I'll be in touch. Thanks today. I have the pleasure of speaking with Jennifer Borgatti. Jennifer is a wife and mother of two young boys ages five and two. Her youngest son was born deaf and wears bilateral cochlear implants. Her family is based in Northern California, where her sons attend an oral school for deaf and hard of hearing.
[00:01:42] Prior to becoming a mom. She graduated from the University of Tennessee and worked professionally in medical sales. Jennifer now helps families of deaf and hard of hearing babies as a parent mentor. She also writes a blog called the cochlear mom where she offers support and advice for families on the journey of raising a child with hearing loss.
[00:02:09] Jennifer is passionate about advocating for deaf and hard of hearing kids and proving that they are capable of anything. Here's my conversation with Jennifer, the Coppola, your mom. Well, Jennifer, welcome to the podcast. Tell me about your family and your family's journey.
[00:02:32] Jennifer: Sure. So my husband and I have two sons, um, our oldest turned five, um, in January and he has typical hearing.
[00:02:41] And then our youngest turns three next month. And he was born with severe to profound sensory neural hearing loss, uh, bilateral and, um, We were shocked when we received his diagnosis. Um, I expected to have another son just like my older son and, um, so to not pass the newborn hearing screening in the hospital was a big surprise for us.
[00:03:05] And, um, we. Our family has built in support for, um, having a child with hearing loss though, which I'm very thankful for. So I'll explain that a little bit since you're asking about my family. Um, so my father-in-law was born deaf. Um, he uses sign language only. Um, so my husband is a Kona and. Um, my mother-in-law, so my husband's dad, uh, my husband's mom is a speech therapist.
[00:03:32] Um, and her sister, who is my sons, both of them, my son's godmother is also a speech therapist. And, um, so they, that support's been great for us, but we, um, That's a little bit about what our family dynamic looks like. Um, we, we're just, we're lucky to have those support systems built in.
[00:03:56] Todd: That's wonderful to have those family members who have knowledge of deficits and, and language development and communication.
[00:04:04] Um, I did read a little bit on your website. We'll talk a little bit more about that in a few minutes. Uh, so your, your father-in-law. Is deaf has been deaf his whole life and his first language is ASL. Right. And so was your husband, I read if it was ASL, right?
[00:04:23] Jennifer: Yes. What was his first language and then obviously spoken
[00:04:27] Todd: English and your, your, uh, father-in-law has been supportive of, uh, your voices in terms of, uh, education and technology.
[00:04:38] Jennifer: 100%. And he says that he, he wishes he could get a cochlear implant. It just, he was born at a different time. And, um, he's very set and used to not hearing and using ASL to communicate. So, um, he's been very supportive of Nico though this whole entire time, um, once to read about cochlear implants, anytime I get new material, um, he and Nico uses, uh, cochlear Americas, uh, in seventh.
[00:05:07] Cochlear implants, uh, for his processors. And in the time I received new material, he wants to read about it. Um, he he's very supportive and really when it comes to, you know, that there is that controversy, um, unfortunately that's, that's out there. Um, his opinion is the only one that matters to me because he is a member of our family.
[00:05:29] And if he supports his grandson and he's proud of him and happy for him and. Encourages him then that's it means everything to me.
[00:05:41] Todd: You know, I think it's, uh, admirable because, you know, sometimes I see deaf adults in that situation would say, oh, it didn't work for me. So it's not going to work for children today.
[00:05:56] And they sort of compare their experiences, which are, are sometimes. Tragic and in terms of what they had to go through. But I've always thought, well, what you experienced all those years ago, isn't the same of as what we can do today. And so it's a very different world. Uh, and so it's really like comparing apples and oranges.
[00:06:20] So it's great that he sees that that today is a very different landscape in terms of what's available in the early identification. Like you guys had the technology, the schools, everything is very, very different than. When he was growing up. Yeah.
[00:06:37] Jennifer: So 60 plus years ago, it's a completely different environment, different technology.
[00:06:43] And, um, yeah, it's been really nice that he has been so supportive and we actually went through genetic testing, um, after we had Nico and it came back that he has connects in 26 while our family does. And that was information for all of us because my. Husband's family. Um, they thought that his dad was born deaf because his mom was sick while she was pregnant with him.
[00:07:09] And it turns out that's not the case. And, um, so my father-in-law and my youngest son, Nico, they have. A genetic connection that is wonderful. And one that I'll never be able to understand as well as both of them do together. So it's been really eye-opening I think for all of us as a family and I'm, I'm really, it was nerve wracking to go through that and do and decide to do genetic testing because you don't know, going to be found.
[00:07:39] Um, but I'm really happy that we did because it was just information for everyone.
[00:07:45] Todd: Right. Exactly. You know, I wonder, you know, his, his mother, the grandmother.
[00:07:52] Jennifer: Yeah, my husband's grandma.
[00:07:54] Todd: Yeah. I wonder how much guilt she felt. Cause we often read about how moms feel a lot of guilt because they give birth to the child who has special needs or is later diagnosed with hearing loss.
[00:08:09] And for, and we know now that it was, it had nothing to do with her getting sick. It was nothing she could have prevented, but she may be lived her whole life. Thank you. It was my fault. I got sick, you know, three months when I was, you know, whatever it was, you know, and, and she probably carry that all her life that it was something that she did or maybe she could have prevented.
[00:08:32] And so she'd probably carry that weight with her.
[00:08:34] Jennifer: Yeah. And that guilt, I mean, we, I, I don't feel it anymore, but I remember feeling that right after Nico was born thinking, did I do something wrong? What happened? Of course, this was before we had the genetic testing. That's. I talked to a lot of families that, you know, they are fresh out of the hospital with some of these failed ABRs and they feel the same way.
[00:08:58] And there is that grieving period that you have to go through as a mother. And, um, It's something when you receive that news, I've never been so shocked in my life. I really, I did not know that this was going to happen. And, um, but that's okay to feel that way. Um, there's nothing wrong with you. There's nothing wrong with your baby.
[00:09:19] This is just, you're now on a different path than maybe you thought you were going to be on, but it is a wonderful, wonderful journey. One, I wouldn't change in an instant because you get to appreciate so many things. These children are capable of anything. And it's, it's wonderful to be able to see that right before your eyes.
[00:09:40] And I think that's what I try to help families focus on. Picking themselves back up and start moving forward and advocating for your child because you have to, you are the best person to do that. And, um, yeah, so it's, she did feel grief and, um, guilt from that diagnosis. And he, my father-in-law was sort of three or four years old when he was diagnosed.
[00:10:04] So. It was a late diagnosis as it was many times back then. So it was definitely a different, different time and a different world. Um, and it's, but he has had a wonderful career. He's retired now, but he, um, designed cars for Nissan. So, uh, clay shaping that they show on the commercials, which, um, he's so creative and, uh, it's just, it's so nice for my son to see that example too, because we.
[00:10:34] Friends and family members, obviously that have cochlear implants and better amplified and, and use spoken English, but then to have a grandpa too, that is deaf and has had a wonderful career and life without being able to hear too, is, is great for him to see that and, um, had the full support of everybody.
[00:10:58] Todd: Well, I love the photograph of him, the fishing, you know, they're fishing together. I just love that photograph and I encourage anyone. Who's listening to go check out your website and just go find the photo of grandpa with Nico. Nico, uh, fishing on the bank there. Yeah. It's
[00:11:17] Jennifer: just really great. Adding behind a tree to take that picture.
[00:11:21] Well, this is such a precious moment and I didn't want to miss it. And we were camping and that's one of our favorite activities to do as a family and Dana, my father-in-law always comes with us and, um, it it's just that, like I said earlier, that connection that they have is just, is amazing. So it's thank you.
[00:11:40] I love that picture.
[00:11:42] Todd: Yeah, it is wonderful. So you guys get the diagnosis and talk to me a little bit about the services that you guys, that journey of getting services in place, um, for Nico and, and how that went. You mentioned being an advocate. Um, I did, uh, see, uh, on your website, you talked about. The ABR was going to be weeks out.
[00:12:07] And then you had to fight to get, uh, an earlier test done. But talk to me about the services you guys have gotten since diagnosis and how that has gone.
[00:12:17] Jennifer: Sure. So, yeah, as we were being discharged from the hospital, um, was when he didn't pass the hearing screening again and they said, well, you know, we'll set you up for a follow-up ABR and it was months away.
[00:12:31] And. That's not an option for me as a parent to know, to not know if my child could hear me. And, um, so I actually, I stayed an extra night in the hospital, so they would give him another chance to pass the newborn hearing screening, um, in the quiet nursery, he didn't pass. And so we were discharged not knowing what was ahead of us.
[00:12:53] And, um, I hadn't. Um, for a follow-up ABR, but like you said, it was months out. And so I called them, I got put on a cancel list, um, to receive hopefully a phone call when someone canceled and that very next week we had an appointment. So he was 10 days old when he had his follow-up ABR. And it was confirmed that severe to profound actually at that point, the first ABR was profound, no responses at all, um, across the board and.
[00:13:23] That was just one of the lowest of the low points. And because you're holding this child and you don't the future, someone. Um, and yet the pure innocence in a 10 day old baby, it's just, um, unbearable at times to not know. Um, and so at that point we started looking into what kind of programs were in the area.
[00:13:45] What could we do to educate ourselves? I remember we went to Barnes and noble and we bought books, my husband and, and I just started reading. And, you know, luckily we had his mother, his mom and her sister to call a speech therapist to start talking to them about it. Um, But we found a school in our area and it was actually mentioned to us, um, by the, I believe she was an audiology intern or a tech that administered the ABR at the ENT office.
[00:14:14] And she said, have you heard of chat? And I said, No. Why would I, no, I have no idea what that, and so we looked up chat, which is an oral program school that's in Sacramento. Um, and I also got LinkedIn with obviously our, our county services. So early start and, um, we. At 10 days old, we had that information and then we started receiving services from our county, from the infant development early start program, but we also started attending chat and chat had a grant that allowed us to attend.
[00:14:50] We kind of double dip essentially on our services because my approach was anything and everything. I'll double dip on any kind of services that we can receive that will help him. Um, and I think this time I was still working full time and so he was going back into daycare with my older son. Small in-home daycare, but I had my county services happening inside the daycare, and then I would pick him up and bring him to chat also.
[00:15:24] And we attended the baby and me class, um, at chat, um, starting at when he was three weeks old. And, um, so we, yeah, so we were doing everything right. All I kept hearing about was the language, no, zero to three, got to get it in here while you can. And so I knew that kind of dropping everything was what we needed to do and to be around as many professionals as we could.
[00:15:50] Um, and that's, you know, really when we were at chat and we started really learning a lot about listening and spoken language and, you know, using that, um, Ave, you know, as, as an option for us. And, um, Nico, just, he flourished and he's, he did so well. And, um, it just was the perfect fit for our family. And so, yeah, so we, we received a lot of services.
[00:16:17] We're fortunate that we live in an area where we have an abundance available to us. I feel for the families that don't, um, but then, you know, those parents have to become those. Um, almost professionals to educate themselves on what their child needs,
[00:16:35] Todd: right. And the parents become, uh, the first misspells, first teachers really, you know, language models and communication and reinforcing everything throughout the day.
[00:16:47] Right. And it's a way of life. As most as, as other parents have talked to me about.
[00:16:54] Jennifer: It is, it becomes, it becomes your life. And I I'm ahead of Nico receiving his first cochlear implant. He received his right side on, um, when he was 12 months old. So when he was a year old, um, a month before his surgery, I quit my job.
[00:17:10] Um, my full-time job. And, um, because I knew that all of his speech services and everything was going to ramp up and that I couldn't. Continue to be the level of working professional that I want it to be and the level of mom that I wanted to be. And so I thought, you know, this he's going to be my job. And, um, and so I, and I back, I mean, it's been 100% the best decision for us as a family.
[00:17:39] And that allowed me to. Very present at school, um, observed him in class. Unfortunately I can't now because of COVID but last year we were allowed in, um, we'll get back to that eventually. I'm sure. But, um, yeah, it's, uh, it really, it is a sacrifice, but I think for some of these children, um, including my own, it was the best decision for us as a family.
[00:18:05] Todd: And Nico has bilateral implants now. Correct. Um, and so he's in, he's in chat and doing well. And, uh, so how is he communicating today? Oh my
[00:18:18] Jennifer: gosh, full sentences. Um, he, he, when he, yeah, when he wants to get out of his car seat, he says, get me out of here. And, uh, he, he just, you know, we're working on, um, him saying, please, when he's asking for things, I mean, he's, uh, he can tell you about his day.
[00:18:37] Um, he says, mom, do you know how much I love you? And then I'll say, No, what? And he says so much. And so it's, he is he's fully caught up, um, to his hearing peers. We've just gone through, um, his testing, um, ahead of his third birthday next month. And he is just doing so well. And. His language has his voice, his speech.
[00:19:02] It's, it's beautiful. And I'm so thankful and it's been a lot of work, but he, you know, on our part, but also on his, and I'm so proud of him because he worked so hard on it. And you know, it's also, you know, we talk about us as moms and dads and what we do to sacrifice. But my older son, my five-year-old, he goes to chat also.
[00:19:27] He's in the pre-K class as a language model, even though he does not have hearing loss, siblings are allowed to attend. And, um, he knows his link sounds. He works with Nico with his link sounds and he'll ask him, oh Nico, can you say this? Ask Nico to repeat whatever he's saying and he's all into. And I'm so proud of my older son also for really adopting all of this as his life and, um, to have a little brother that needs a little bit of extra support can be difficult and he hasn't missed a beat.
[00:20:03] And, um, he's a huge part of Nico success too, because those two are best friends. And they're only two years apart, so they spend every moment together. So, um, yeah. At chat, we're so lucky because he receives daily speech therapy. Um, that's part of the services that they offer. They have audiology on site too, which is amazing.
[00:20:26] Um, and he's around peers where he sees other cochlear implants and hearing aids, and he knows how to put them on by himself. He knows how to connect himself to the Rogers system. That's in his classroom. He says, connect me if you ask him, um, when he connects, he says, I heard the beep and I mean, he's just going to be in such a great place to mainstream out to our neighborhood school.
[00:20:53] Um, and we're just so, so.
[00:20:58] Todd: It sounds like he's, he's doing all the right things and, and you guys have done all the right things so that he can be successful. So that is wonderful. I wanted to talk about the website and, and your, your, um, alias now, the cochlear mom,
[00:21:19] which is great. Um, and so what do you want to achieve with the website, which I think is wonderful.
[00:21:26] Jennifer: Thank you. I want people to feel like they have the level of community that I have here in my local area of Sacramento in my school and this chat. I mean, I am surrounded by parents on a daily basis that are going through exactly the same thing that we're going through and I get to see them in person.
[00:21:47] And I get to say, you know, gosh, this bike helmet, I cannot get this thing to work. It always knocks his magnet off. What helmet do you use? And just things like that. Um, oh, I, you know, I forgot a battery. Do you have an extra rechargeable battery that I could use? Having that kind of community is so critical for us as parents, because it's hard and it is life changing.
[00:22:11] And to be surrounded by a support system that believes in you as a parent and believes in your child, then who's going to benefit is our children and our future. And what's better than that. And I am so lucky to have all this, and I want people. To feel like they have this same level of community, even if they're in Ohio, like you and they're in different states.
[00:22:36] And I just, I want to let people know that they're not alone. And that's why I wanted to start the blog, the cochlear mom, because I have learned a lot over the last three years. And, um, it's been. Just so nice to be able to share that level of support with other families. And just even with my, what I've learned from my family, from my mother-in-law, from the boys godmother as speech therapists and what I've learned from my father-in-law, you know, being, you know, a member of the deaf community and, um, From my husband growing up, you know, with a deaf father.
[00:23:12] I mean, it's, there's, I have so much information to pull on here. Then I felt the need to share it with others. And, um, it's been great so far. It's just a really nice outlet to reach other people.
[00:23:25] Todd: I was extremely impressed with what you've done with the website or your blog and, and enjoyed reading, uh, most, most of everything that was posted.
[00:23:34] So I really appreciate everything that you're doing and, and it takes some courage sometimes to share your family's journey and, and kind of let it all be out there for everyone to, to receive and consume. Yeah. And I hope everyone sees it as this, in the spirit that it is presented as being helpful. And if it's not your cup of tea, then move on.
[00:23:57] You don't have to, you don't have to say anything or do anything, but if it is helpful, it's there for you. And, uh, and I think that's wonderful.
[00:24:07] Jennifer: We have to choose the best option for each child. Right. So just because this is what's worked best for my son doesn't mean it will, for yours, it really depends.
[00:24:18] And, um, children learn differently and, um, they respond differently to different languages. So, yeah, absolutely. This is just an example of what has worked well for me, but, um, I think the parents, parents ultimately are the best at deciding what's what's best for their children. And, um, so yeah, it's. It's it's been great and I look forward to sharing more and I'm going to do, I learned all about, um, listening and spoken language strategies in baby and me.
[00:24:48] And so, um, you know, I know all about, you know, expectant look and auditory sandwich and, uh, wait time and mother ease and all of that. And so I look forward to sharing more of that on the blog too, you know, as I continue to publish new posts and, um, because that's something that. Just becomes second nature to us now.
[00:25:09] Um, almost narrating our life. I think of myself as I like to watch sports. So, you know, I'm the announcer who is saying, who's got the ball next and this person's running towards this end zone. And, um, so that's how we, that's just how we are right now. It's become second nature. And I think it's been a huge part of Nico's success.
[00:25:29] So I look forward to sharing more and connecting more.
[00:25:34] Todd: Yeah, that'd be wonderful. Now I'll have to recruit you to be a grad student in, in speech, language pathology. You know, you could come right in. That's what my
[00:25:41] Jennifer: mother-in-law says. I said, oh, I don't know if I'm ready to go back to school yet.
[00:25:48] Todd: I have a third one in the family.
[00:25:49] That's you know, out there doing stuff. Right,
[00:25:52] Jennifer: right. It's it's been it's it's a wonderful field. I had just, I had no idea. I'm happy, happy. I was thrust into it.
[00:26:00] Todd: Well, I wish you nothing, but the best of luck with everything you're doing, but also with Nico and your whole family. And, um, hopefully in another, another year or two, I'll have you back on and we'll, we'll get an update on how he's doing.
[00:26:15] Jennifer: That would be great. Yeah. Hopefully he'll be mainstreaming for kindergarten and it'll be a whole new, um, you know, journey for us. Um, but one that I know we'll be prepared for and ready for. I really appreciate your time. Thank you.
[00:26:29] Todd: It was a real pleasure speaking with Jennifer and learning more about her family.
[00:26:37] And of course, learning more about Nico. You can follow their journey on her website at. The cochlear mom.com. So if you want to read more about what's going on with Nico and some of the other things that have occurred, go check out what Jennifer has to say on her wonderful, wonderful website and blog.
[00:27:04] And thank you for joining us for this episode. We really appreciate you being a subscriber and a listener. If you don't mind, please leave us a five star review that helps us to attract new listeners and to grow this podcast and to reach more people, which is what it's all about. And with that until next time, stay safe and be kind.
[00:27:32] This has been a production of the 3C Digital Media Network.
Ep 23_Maura Berndsen_TLB_FINAL
Todd: Welcome to Episode 23 of The Listening Brain Podcast.
[00:00:14] Welcome to The Listening Brain. I'm your host, Todd Houston. In this podcast, we explore childhood hearing loss through the lives of the parents. And families who are on this journey and the professionals who serve them.
[00:00:38] Hi, this is Todd Houston again. I wanted to mention the 3C Digital Media Network, which is our new company that we've developed here. And I wanted to just encourage you to sign up on the site. All it takes is just putting your email in and that way you can stay in touch with us and we can stay in touch with you and you will hear and get information.
[00:01:05] All of our new, uh, blogs that might come out, uh, you'll hear about our new webinars and courses. And so it's a way just to stay in touch and that's important these days staying in touch. So if you don't mind go over to three C digital media network.com and sign up and now back to the unit. Today I have the pleasure of speaking with Maura Bernsen.
[00:01:34] Mora holds her BA in deaf education from Fonte bond university and her Ma and early childhood education from the university of Texas San Antonio. Maura is also a listening and spoken language specialist, certified auditory verbal therapist as executive director at Listen and Talk in Seattle Washington.
[00:01:58] She fosters relationships while providing leadership and oversight of operations and staff that ensure the delivery of quality listening and spoken language services. During her career, Maura has been involved in local state and national efforts to build sustainable systems that optimize opportunities for families and their children who are deaf and hard of hearing.
[00:02:23] Here's my conversation with Maura, Tamara, welcome to the podcast. Give me a little bit more about your background and how you got into this little world.
[00:02:34] Maura: This Lisel world. Um, it, it was actually quite accidental. Um, I was 15 years old and like many teenagers, um, just exploring what opportunities might be out there and had a high school field trip to St.
[00:02:54] Louis, which was about an hour away from my very small hometown in Illinois. And, um, we went to this small. College, um, called font bond. And, um, now known as font bond university and my tour, my groups tour guide was a deaf education major. And at a point in the tour of the campus, I asked a question that opened the door for her to talk about her major.
[00:03:28] I didn't realize it would do that. And I was fascinated. Um, just had never heard of deaf education. Um, Had never met a person who was deaf or hard of hearing. And just again, I w I was just drawn to it. Um, so my, my mother in particular will probably tell you that. The day I came home from that field trip.
[00:03:58] She absolutely knew that that's what I was going to do. And I still floated back and forth for at least a year or so. And just kept coming back to this idea of blending science and education and, um, And I loved working with children's. So all of these things came together and, um, I started my under degree undergraduate degree at Fontbonne in, um, and became a teacher of the deaf.
[00:04:34] So that was the first step then. Um, my first job. Was at sunshine cottage in San Antonio, Texas. And, um, Jackie Patton, whom I think you, you know, uh, was the audiologist on the team and right across the hall. And, um, at a point in time, somebody took me by the arm and said, if Jackie tells you. That that rock on the ground can hear this frequency.
[00:05:10] Just know that she's right. So I learned so much at, um, at Fontbonne and then went to sunshine cottage and learned so much more about the auditory potential, um, that children who are deaf or hard of hearing. Um, then that led me to explore the, the, um, at the time it was certification as an auditory verbal therapist.
[00:05:40] And, and again, just drawn in to that blend of, of art and science and family and children and, and building those communication skills. And, um, and I've been at it ever since. So been at it awhile.
[00:05:55] Todd: So how long were you in.
[00:05:58] Maura: Um, I was in Texas about six years. So I started teaching, um, in 1990, you can probably see a little gray hair and a few wrinkles here, but I started teaching, um, the year that, that cochlear implants were FDA approved for children.
[00:06:18] Um, just, uh, fortunate timing. Um, the training at, um, at Fontbonne, there were many, many children at St. Joseph Institute where I did my student teaching, who were there because they had recently received a cochlear implant and, and, um, And St Joe's Institute was, was part of that data collection and that, that review process, um, that goes along with the FDA approvals.
[00:06:47] So, um, it, it was, uh, a great time to be a student. And, um, and then again, I, as I mentioned, I, I moved to, um, from the Midwest to, to San Antonio and I was at, at sunshine for about six years.
[00:07:05] Todd: Well, I, I love sunshine cottage. I've only visited there a couple of times, but certainly the, they have that reputation of just being an excellent place, an excellent school, or sell the materials they've developed over the years.
[00:07:21] We all use, I use their stuff just in fact, placed a big order to get more stuff in. Um, through the university. So, uh, it's, it was just probably a perfect training ground for you, uh, as, as someone coming out of college and, and being able to go there.
[00:07:40] Maura: And, um, I have to also call out, um, Dr. Wally, Bruce.
[00:07:45] Um, he was the director and, um, and Dr. Bruce had a way of helping. Helping you discover the answer. Um, I think it would have been very easy for him to say do it this way. And, um, and he would meet with you and, and had high expectations. I mean, detailed lesson plans, um, the ability to collect data, um, very, very, very careful, um, tracking a progress and.
[00:08:23] And what that meant. I mean, I think without knowing it at the time Dr. Bruce exemplified diagnostic teaching, I'm one of those cornerstones of, of, um, listening and spoken language practice that, that you, you needed to know why you were doing what you were doing and how it was helping that child in that family grow.
[00:08:45] But he, he just had this way of. Engaging you in a conversation about what you were doing that helped you discover your next step. And, and I will be forever grateful to, to him, um, for, for being one of my first mentors.
[00:09:08] Todd: It reminds me of that, that quote in terms of you really don't learn until. You reflect on what you're learning.
[00:09:16] And so it's, it's nice that he sort of, um, sort of integrated all of that together and the experience that he had for you guys there, uh, really figuring out why exactly you're doing these things. And what does it mean and how does it help the kid that you're working?
[00:09:36] Maura: Yeah. And I think another thing he did Todd, is he, um, he.
[00:09:43] He gave you the space to find ways to do things or find new things that if you could explain the why and what you anticipated the impact to be you, you have room to try these things. They, they definitely had to be founded in. And, um, now we would say evidence that, that there would be an evidence-base, um, for, for why you would do this, but, but he would give you the room to explore and, um, and apply something you had learned in the work you were doing at sunshine.
[00:10:20] And, um, and I think that that led to the direction I went with my master's degree. Cause I, I feel a little bit like an odd duck these days. Because my undergrad degree is, um, in-depth education, not my master's degree. And, um, and I'm still, uh, very grateful that I went that path, that I had four years to absorb the information and the experience with, with working with, with young children in particular, who are her deaf or hard of hearing, but for my master's degree, Dr.
[00:10:54] Bruce actually encouraged me not to pursue a master's in deaf education. And that was because of the strength of the program at Fontbonne. Um, he, um, he said, you know, take what you know about teaching kids who are deaf or hard of hearing, working with their families. And add to that. Don't repeat it. And, and so, um, a colleague of mine, um, Judy Odendaal, um, and I both, um, she was a little bit ahead of me, but we pursued an early childhood focus, um, in our master's degree, which really transformed, um, what I understood about how children learn and, and how, um, I could help them learn.
[00:11:44] When I was in my role as a classroom teacher, and again, just really aligned with those listening and spoken language principles of following a developmental approach. And
[00:11:56] Todd: so how did you go from Texas to Seattle? How was that? What were the steps in between another accident?
[00:12:07] Maura: Another accident, another accident.
[00:12:12] This, this postcard landed, um, in our mail box. I I'm sure that at the time, um, star Leonard Flatman, who is the founding director, Atlas and, and talk, um, used a mailing list from ag bell or something. But, um, it, it talked about listen and talk in Seattle and, uh, Had a Tucker max and return address. And at the time, um, in, in that era, Tucker Maxon was publishing quite a bit.
[00:12:44] And, um, and so I thought that they were, um, perhaps writing a new curriculum and I had just finished my masters, um, completed my, my auditory verbal certification and thought this is. This is a new project. Like I I've, I've got time on my hands now. I didn't know what to do after I finished grad school while I was working full-time so I, I sent a letter and, um, and very quickly learned that it wasn't a, it wasn't a book.
[00:13:18] It wasn't a curriculum, it was a program that was trying to open. So, um, that's, that's how I met, uh, sorry. Leonard flack men and, um, made that transition from, from some sunshine cottage to, uh, listen and talk and Seattle.
[00:13:36] Todd: And describe, describe that experience because it was a new program. You guys were starting from scratch, right?
[00:13:45] Maura: Definitely starting from scratch. Um, so it was, uh, starts, um, private practice. And, and that was based in her home and it moved from that private practice and into a program. Um, and I, I really don't think I had it and any idea what I was getting into. Um, I, I don't know the foolishness of, of youth or something like that, but, um, but I, when, when I heard.
[00:14:19] Star and the family she worked with and eventually met, um, a couple of their board members. It reminded me of sunshine cottage, quite honestly. And, and when I made the decision to leave sunshine cottage, that's what I told, um, blame Trautwein and Carolyn waffle the leadership there. The team in Seattle was trying to do what dealer white did in San Antonio, which was establish, um, a strong program that gave children and their families, the opportunity to connect and learn through listening and spoken language.
[00:15:00] And, um, Seattle didn't have that. And I think at the time, you know, Microsoft was, was everywhere and, and so we all, um, or I naively thought that that just Seattle was essentially cutting edge across. Across all things and, um, arrived and learned that in terms of, uh, opportunities for children who were deaf or hard of hearing, it was very limited opportunities for listening and spoken language.
[00:15:31] So I, you know, I left a team of probably close to 50 people total and came to a, a team of two and, um, We had, we had our building, um, we, we didn't have, um, computers and that we had one computer in the office as my memory. Um, I mean, it was starting from scratch. And so, uh, Kim Hammerman who joined a year, joined our team a year later.
[00:16:07] Um, we would, we would stop by Kinko's on the way to work because, um, we didn't have a photocopy. In in the building. And so our business manager one year, it said, um, you know, oh, it's getting time for Christmas. What do you want for Christmas? And I am not an early bird by nature. So getting up at six in the morning to be first in line at Kinko's was, it was hard for me.
[00:16:34] And I'm like, I want a photocopier and George, we want a photocopier. And, um, right after, right as we got ready for Christmas, we got our first photo copier Atlas. So, um, so it was definitely an adjustment. Um, you know, that, that just, uh, we, we, I star and I both relied on the colleagues that we had in other places and, um, just networked and.
[00:17:06] And, um, did everything to make sure we, we were we're following solid practices and building, um, a program that that would stay strong. And, um, and so we are approaching our, the start of our 25th year, um, this coming September.
[00:17:29] Todd: Hopefully not the same photocopier. Um, so how many did you start with in that first year or so?
[00:17:38] Maura: Um, how, how many families did we? Um, we were providing auditory verbal therapy to 13 children and their families. Um, the following year, um, we were in a, I remembered at the time being, I'm not sure what, what adjective to use, but we had auditory verbal therapy and we had classes.
[00:18:05] And my memory is, is that it wasn't very common for those two, um, types of settings to exist within the same agency. And, um, so th there were a lot of conversations with our friends at was auditory, verbal international at the time, going, what are you guys doing with classrooms? And then there were lots of conversations with our friends at ag bell about what are you guys doing with that?
[00:18:34] Verbal therapy and, um, I'm I think star and everyone at listen and talk is, um, remains very proud of the fact that we were able to honor the principles of, of both of those settings. So that. Children had those children and families had those opportunities, um, that, that we were able to take, um, take both of those approaches, settings, um, values and, and support more, more children.
[00:19:11] Um, So we started with 13. I think the following year we were eating close to 20 and we were doing a strategic plan and we had to project out our growth and enrollment. And at the time it was just mind boggling. At least to me that we could possibly anticipate serving 25. 30 35. Um, I think when we looked at the five-year plan, we might've eked our way up to 40 children, and I just could not imagine how we were going to meet.
[00:19:57] That many children. Um, yeah, last year we served in total between our birth to three program classroom program. Um, Lisel therapy and outreach. We served over 200 chills.
[00:20:13] Todd: Wow. That's that's that's huge. That's great. Yeah,
[00:20:18] Maura: no. So it's, um, it's very humbling to, to meet families and, um, Have them, them trust us to, to kind of take them on this journey and, and help their children, um, master communication, achieve things that, that some people don't think is possible.
[00:20:43] So, yeah.
[00:20:45] Todd: Well, you know, we've, we've both been doing this for, for at least a few years. What do you think is the biggest, uh, Positive outcome that you're seeing right now, and then I'm going to go with the opposite way. And what's the biggest thing we need to work on.
[00:21:04] Maura: Yeah. So, um, in, in Seattle, there, there were, there were a couple of, um, pivotal events that, that I think changed the, the dynamic, um, is how I'll describe it.
[00:21:23] Um, Washington is actually still a state that doesn't have a newborn hearing screening mandate. It's it's voluntary. Um, we hit great numbers with that. Um, I think everyone is still, um, um, challenged by loss to follow up, but, but what that effort to establish newborn hearing screening in Washington state resulted in and, and.
[00:21:53] Will forever give credit to the families, is that no matter which communication approach your family had adopted your family was following, there was something we had in common, and that was ensuring that, that children's hearing levels were identified early and families were connected to the resources that aligned with their desired outcomes.
[00:22:20] And, um, And so the professionals, um, followed the families lead and said, you know, we're, we're not, we're this, this situation establishing this reality is brought people together. And, um, opened the doors for conversations on not only what our practices were, but how do we, how do we evaluate our systems so that families have accurate information, have supports in place to, to access those services and realize the outcomes that are possible for, for children and families?
[00:23:08] Um, We have been able to continue that, um, for the last 20, 23 years, um, since, since that event, it's, there are times where it's not easy. There are times where it's not comfortable, but we're able to bring professionals and families around the table to improve systems. So that all changed. Who are deaf or hard of hearing benefit?
[00:23:37] Um, not only children using one approach or the other. So, um, there are times where I think that's happening. In several places, many places in other times where I think that that Washington and the Seattle area, um, is still perhaps a little unique, but that I would challenge professionals, um, anywhere to w to keep in mind that systems change can benefit.
[00:24:11] All children, each child who is deaf or hard of hearing and that in addition to remaining committed to our professional values and, um, maintaining the integrity of, of the supports that we offer, stay committed to making sure those systems support family access.
[00:24:32] Todd: And I read about what you guys have done there and the state of Washington.
[00:24:36] And I think it's incredible to be able to eat everyone for the most part of, you know, on the same page with the focus on families and making sure all families have options available to them. Um, so that's, that's. And if, since, you know, one of the models around the country that I think other states have looked at.
[00:24:57] And so that's a very big positive where either in Washington or just nationally or more in general, we already, we, where do we go from here? What do you think we need to do as little clinicians, um, focused on kids with hearing loss? What are we still missing?
[00:25:20] Maura: I, I not sure that, you know, that that missing is, is the, um, the term I would use, but, but I do think that as we meet children with additional special needs, um, That, that that's an area that I personally our team at listen and talk is, is constantly thinking about and looking for what, what are.
[00:25:51] The right resources, the right models, the, the, the way to support these children and, and their unique needs. Um, so, so there are children that come to us, either with known or unknown, additional challenge. And as we, as we learn about them, how do we adjust what we're doing to support that family, to, um, support that child.
[00:26:19] So I think that, that, that's, that's an, a conversation that just needs to continue and will, will evolve as we learn more. Um, and. And so that that's one piece. And then another piece, you know, I would be, um, be remiss without acknowledging just the, the equity, um, conversations, the diversity, equity, and inclusion.
[00:26:48] Um, it, in our experience, it's, it's extremely difficult to find, um, Qualified providers that speak more than one language. Um, we work with language interpreters, so Atlas and, and talk among our 200 plus families. They speak 26 different home languages. And I'm trying to imagine how. We as adults learn new information and then understanding that and thinking, how are we learning that new information when we're having to navigate those conversations through an interpreter?
[00:27:38] And just, what, what do we do to support that? How do we plan for that? Um, so, so that, that children in their families aren't limited. So, so those are our two, I think, topics that are, are. Um, are big for us at present.
[00:27:58] Todd: And I think those, yeah, if I had to list the top two or three right there with you, I think the issues around those kids that have additional needs, we still, we all struggle with that depending on what that additional diagnosis might be.
[00:28:17] And yeah. You know, the diversity, you know, income inequality, getting services to families that are lower socioeconomic status. Um, finding those clinicians that have, that are also diverse. I know just from a perspective of being a faculty member and trying to recruit students to come in and be trained, it's extremely hard for us to find.
[00:28:49] Um, I sort of a diverse cohort of students, uh, and, and Akron is considered sort of an urban area, you know? And, uh, and we just still struggle with trying to get students with, you know, more varied backgrounds and, uh, it's, it's a challenge, you know, across the country. And, and then beyond that in the list, Community.
[00:29:18] We need to work even more to make sure those things are happening. Great. And so at this point, um, what would, what advice would you give? We have someone who is maybe starting out, who's interested in maybe becoming Lisel certified. What advice would you give them today?
[00:29:39] Maura: I think just, um, Understanding as Jace Wolfe says not what's possible, what's, what's probable.
[00:29:48] Um, I think that really having a solid understanding of that, um, and, and setting that, um, that bar high in terms of your expectation, I think. Being reflective. Um, so some of the things that, that come to mind for me really have nothing to do with death or education or, or, um, or speech, speech, and hearing science it's that, that active, reflective nature, so that we are constantly reminded and mindful of the fact that this isn't.
[00:30:33] What I'm what I'm doing. It's, it's what that family's doing and how that family impacts that child. Um, so, you know, naively, I. I am a hundred percent sure that when I graduated from college and got my first teaching position, I was thinking about me. I was thinking about what I was doing and the importance of what I was doing, and really didn't have that lens on the power of the family.
[00:31:09] Um, so. I, I would encourage new professionals to really think about that and to explore that and to be mindful and reflective of their practices and relationship of, um, igniting that confidence in parents. Um, After all these years, I, I, and as much information as families come to us with because of the internet, because of, of materials and access to information and other people, it, you still here unbelievably.
[00:31:55] Empowered parents saying, but you know, more than I do or in some way, shape or form. And, and I'm like, I might know more about this, but you are the reason your child is, is progressing and will reach these goals. And we'll, we'll find that fulfilling life. So, um, and, and I know when I started out, I didn't really have a sense of that.
[00:32:23] But, and then I would also say, um, somewhat quickly, I, I never thought. I would be in quote unquote administration. Um, and so I, I do, um, when teachers are sick and there's a chance to go back into the classroom. I love it. Um, when a family, um, needs someone in a session, you know, there, there needs to be someone to cover sessions or, or to, uh, To, to serve and support a family for a longer stretch.
[00:33:02] You know, I'm, I'm the first one to, to justify or rationalize why I might be the best person for that job. Um, but I think that, um, regardless of your title, we can all influence systems. That ultimately support families. So don't underestimate the impact you as a professional can have on raising awareness of a gap of, um, sharing an idea that can increase access and, um, And really becoming, seeing yourself as a leader, no matter what your title is.
[00:33:49] Todd: I think those are great words of wisdom. And I, I think, yeah, I think those are wonderful. I think th the idea of always seeing yourself as capable of having an impact and being a leader and recognizing that and being family centered and parents centered is. Very good advice, uh, for, for anyone, but especially those that are just starting out or worried about maybe that I do this right.
[00:34:18] Or do that right. Then just being authentic and, and bonding with the family and really trying to understand what the family needs and then how you can help them get to that next. And
[00:34:30] Maura: I'll add one more thing really quickly, Todd. Um, I think when I first started to work with, um, with families and children, I thought I always had to have the answer right.
[00:34:42] When the question was asked and, and I think it's important for all of us in all parts of our life, when we're posed with the question to, to recognize it, but to give yourself the space to explore. Um, to network to gather more information. Um, so that, that, uh, a full answer of full, um, clear, clear information can be shared with somebody instead of thinking, they asked this question, I'm, I'm the therapist, I'm the teacher, I'm the coach.
[00:35:19] I should be able to answer this right now. Right?
[00:35:24] Todd: This actually came up not long ago. I was working with my grad students and the parent, um, at Akron children's hospital, uh, asked a question about some very rare, very, very rare, uh, diagnosis. And I, I couldn't remember. I just could remember the answer. And, uh, it's like, I don't know.
[00:35:45] I have to say, I just, I don't know, but I will look that up for you now I'll be back in touch. And we talked, I talked about that to the grad students, after the session was over. I said, you know, it's, you know, it's okay to do that. I mean, I would rather, you know, say something along those lines. Then tell them misinformation, just share misinformation.
[00:36:06] That is not accurate. And then you have to go back and correct. You know, it's okay that you don't know everything. No one knows everything. And you're going to get asked questions. You're going to be put in that spot. And if you don't know the answer, don't make something up. Just say, you know, I don't know the answer to that, but I will go find out.
[00:36:27] I will learn and I will be back in touch. And that's what the families want. You know, they want someone who can, they can trust. They don't want someone just to make stuff up and just to set aside them in that moment, they want them to be themselves and share what they know. And if they don't know, find the information for forward or help them find it, whatever the case may be.
[00:36:50] Well, it's, it's been absolutely wonderful catching up with you today. Yeah. How can someone get in touch with you if they would like to reach out? Yeah.
[00:37:00] Maura: Um, we're, you know, phone, email, um, website. So, uh, I, I probably should have had a slide that you could show in the background right now, but, um, uh, www listen, Talk.org is listening talks, uh, website, um, we're on Facebook, Instagram, all of the, that, uh, social media reach.
[00:37:27] And then, um, my email address is I'm. I'm happy to connect with, with anyone. Um, M a U R a B as in boy. At listen, talk.org is a great place to start and figure out next steps, but we we've got an amazing team. So don't be surprised if you reach out to me and I connect you to someone else. So, so I, I I'm, I'm unbelievably grateful for the team that we have.
[00:38:03] Todd: Well, thank you for sharing all your wisdom today. Absolutely. I really appreciate Maura being with us today and having such a great conversation. I have been set. I fan of listen and talk for many, many years and, uh, and a fan of Maura's for what she's done over the years as well. And so if you have questions or want to learn more about their program, reach out and visit the website, um, I'm sure they would love to hear from you and, and, uh, share more information about what they're doing.
[00:38:43] And thank you for listening. And if you don't mind, leave us a five star rate. That always helps us to attract new listeners and to grow the podcast. And we want to really express the news about listening and spoken language and what it takes for families and professionals to make that happen for children with hearing loss.
[00:39:06] So please share this podcast with at least five people. Yeah to get that listenership up, we want to continue to grow. So that's my call to action for you. Share this podcast with five people, let them know that we exist, and this is a place that they need to listen, uh, to, in order to, to hear more information and connect with individuals who are in this little committee.
[00:39:37] And with that. Thank you for listening again. And, uh, I'll see you in two weeks until then be safe and be kind. This has been a production of the 3C Digital Media Network. .
Todd: Welcome to Episode 24 of The Listening Brain Podcast.
[00:00:14] Welcome to The Listening Brain. I'm your host, Todd Houston. In this podcast, we explore childhood hearing loss through the lives of the parents. And families who are on this journey and the professionals who serve them.
[00:00:38] Hi, this is Todd Houston. Again, I wanted to mention the 3C Digital Media Network, which is our new company that we've developed here. And I wanted to just encourage you to sign up on the site. All it takes is just putting your email in and that way you can stay in touch with us and we can stay in touch with you and you will hear and get information.
[00:01:05] All of our new, uh, blogs that might come out, uh, you'll hear about our new webinars and courses. And so it's a way just to stay in touch and that's important these days staying in touch. So if you don't mind go over to 3Cdigitalmedianetwork.com and sign up. And now back to the interview. Today I have the pleasure of speaking with Paige stringer.
[00:01:34] Paige is the founder and executive director of the global foundation for children with hearing loss, born with a severe to profound hearing loss. Paige benefited from early identification and early intervention services as a baby to learn, to listen and speak. In 2009, she established the global foundation for children with hearing loss to help young children who are.
[00:01:59] And hard of hearing and living in developing countries access the locally based services, better that they need to listen, talk and thrive prior to her current role role. As the organization's executive director, Paige held various marketing positions for 15 years, including at amazon.com and the Clorox com.
[00:02:26] She served on the board of directors of the coalition for global hearing health from 2014, until 2016, Paige has been involved in committee work at the world health organization since 2015, to raise global awareness for hearing loss, including in her current role on the advisory group for the who resolution and world report on here.
[00:02:56] She lived for a few months in Geneva in 2019 to lead the development of the communication strategy for the 2021 release of the who world report on hearing. She has been honored with several awards for her work in developing countries, including the 2019 world of children health award, the 2018 ag bell association award for international services and the 2014 humanitarian of the year award by the American academy of page earned full tennis scholarship to the university of Washington.
[00:03:39] Where she earned her bachelor's degree. She holds a master's of arts degree from the university of San Francisco and her master's in public health, global health degree from the university of Washington. It is my pleasure to welcome Paige stringer to the podcast. Well, Paige, welcome to the podcast. Can you share more about your personal journey?
[00:04:07] Paige: It's an honor to be here. So thank you for having me. Um, so I still, I was born with a profound hearing loss, um, and at the time newborn hearing screening was not something that was available across the United States. And I was born to a family, um, with typical hearing. Uh, there was no history of hearing loss anywhere in my family.
[00:04:29] So, uh, there was no. No indication that that hearing should be a concern to us. And shortly after I was born, we moved to England. Um, I was about three months of age when we moved over there. And actually, you know, when I, when we moved over there and, um, they, they have the British health system allows a nurse to, um, check out.
[00:04:58] Just my vitals and to make sure that I was developing as a typically, um, typical baby would be developing. And so these public health nurse came to my family's home. And when they tried to test my hearing, simply by having me turn around and make some noise behind me, I didn't respond. And after some more tests like that, they thought there may be a problem.
[00:05:23] So they came back later and. Um, and confirmed, confirmed. I was still having difficulties hearing, so they referred my family to an audiologist. And, um, that's when they confirm my degree of hearing loss. And unfortunately in England at the time, they did have some wonderful resources in place to help my parents to understand what this meant and to, um, offer, uh, uh, kind of speech therapy related services.
[00:05:54] And so my family always wanted me to learn to listen, to speak if that was possible, but also recognizing that if it wasn't possible, they were willing to learn sign language. It was, it was kind of a try to figure out how to best help this child type of thing. And, um, I always say that I must have had a lot to talk about.
[00:06:14] And so, um, I was able to develop my mission, new spoken language with the support of hearing aids and this, uh, teachings teachings, the point that was provided by this therapist over in England. Then when I was three years of age, age, we moved back to the United States and I was involved in Tierra early intervention program.
[00:06:36] Um, I've been when I reached mainstream or sorry, when I reached kindergarten age, I was entered into mainstream school where I had always been able to, um, participate with hearing peers and, um, typical schools. And went through my academic career in, in regular school setting.
[00:06:59] Todd: Wow. And so you went to public schools and, and you had support through the public schools and then college.
[00:07:10] Paige: Yeah. So, um, I did receive support in public schools until, um, I was in, they kind of tapered off by the time I was in junior high, but I did get that, um, the point, um, in general had the, by the time I reached high school, I was pretty much done with all of that. But, um, there was, you know, of course an IEP set up and, and, um, I'd had my services, uh, for auditory.
[00:07:36] Um, just practice type me practicing my auditory skills in the morning before school. And then I would also see a speech therapist during the day, um, and be put out of class for like 30 minutes or whatever the time wise in order to get that support. But it was, um, pretty minimal, um, and more just to make sure that I was staying on track.
[00:08:00] And, you know, keeping out of with the other case in school. And then, um, by the time I said, by the time I was in high school, um, all of their services were not needed anymore. And then I, uh, graduated from high school. I went to the university of Washington. Um, I tell you. Um, growing up and when his point of I was a nationally ranked tennis player.
[00:08:25] So I got to, unfortunately I was fortunate to get a, um, kind of scholarship to the university of Washington. And so, um, my parents were happy about that.
[00:08:41] So I played tennis for the university of Washington and earn my degree there. And then, um, I went on later in my master's degree, um, at the university of San Francisco and then recently got a master's in public health degree. The university of Washington. So, um, I'm feel very fortunate that I had all that support when I was young and enabled me to achieve the level of academic success that I was able to have to be able to do.
[00:09:09] Todd: sure. And you you've used hearing aids.
[00:09:14] Paige: Yeah. So when I don't, you know, when I was born coconut and implants for, um, not really, I don't think they were even developed yet, or if they were in session in the early days of that technology. Um, so I, I first became a candidate, um, uh, retested for candidacy in high school.
[00:09:36] And I thought time, they were implanting children who, um, really, really, we had like significant, like profound hearing loss who, um, didn't score very well on their, um, on their speech recognition tests. And I was doing well enough with my hearing aids that I had just didn't qualify for the cochlear implant at that time.
[00:10:01] But then, um, further along as I got older, I definitely qualified. And so I got, so, yeah, so I had, I started off with analog hearing, um, which was available back in the Chevron days. And so really, um, my first pair of hearing aids with body aches and should we have all these pictures of me really be like wearing these big bodies on my chest.
[00:10:25] And then, um, then it went to the behind the ear hearing aid, which is analog. I then moved to digital hearing aids. And then, um, in, uh, 2017, let's get into 2013. I received my cochlear implant and it was just amazing to me, um, that I was able to do. As well as I did with hearing aids, which is recognizing how much of the world I really was missing.
[00:10:54] So I'm a start today. I have a cochlear implant on one side and hearing it on the other. I am a candidate for bilateral implant, but it hasn't happened since vertigo. And she said the recommendation. To maybe lay off on getting that second implant, um, for now and maybe down the road, I might get that stuff.
[00:11:14] Todd: Awesome. Well, congratulations on the implant and transitioning to do that. Um, and, and you, you remind me of, uh, a dear friend of mine here in Ohio is Carrie Spangler. Who's a. Audiologist. Uh, and she's just recently got her cochlear implant and it's like been like amazing what she can now hear versus what she assumed he was hearing before.
[00:11:43] But now she's, you know, definitely it's been a big difference for her.
[00:11:47] Paige: Yeah, I always, um, I always kind of joke with my friend cause normal hearing that as their hearing gets worse, as they get older, they might could actually improve a little bit in that area. So it was kind of a screening and it really is remarkable because even, even now, um, I think it started to plateau certainly in the last few years, but I was noticing just really minuscule improvements.
[00:12:10] Um, Years after getting the implant. So it's funny. I just really fascinating how the brain works and learning to adapt to, um, what is presented with. And, um, my, I actually implanted my worst year and today is by far my better ear. And it's just really, it's really striking how the brain can do. No auditory input, um, through the hearing aid on one side, and then they input and put through the coconut I'm playing on the other side and somehow mix it up and it comes out Saturday.
[00:12:50] Fine. Yeah. It's pretty great. You know,
[00:12:53] Todd: that neuroplasticity is, is very interesting, you know, see all that happened. Yeah. That's, that's, that's really wonderful. Well, I'm very happy for you that you've, you've gone through that and, and things are sounding good. How's that sound? Um, so, um, you then, um, You, you were involved with listening talk, is that right?
[00:13:17] One time?
[00:13:18] Paige: Oh, I was, yes. Um, back in, let's see, 2007, I think it was, um, I, I was working for amazon.com at the time and I was interested too. Give back into the community. I was trying to find ways like that could be contributed in a meaningful way. And I just stumbled across. Listening to Taka was not familiar with the program back then.
[00:13:47] Um, and. And so I learned about it, um, and met with the ex who was the executive director at the time. And so, um, was asked to volunteer, but he felt like a better home would be for me to be on the board. Um, so I am interviewed with different board members, got to and got to know the school, meet the t-shirts and that, you know, it would be a wonderful program to be involved with.
[00:14:15] And so, um, so I D I was on the board of directors for several years. And then for a short period of time, I actually served as the communication development director for . Um, and it was just really, I. Personal personally, um, gratifying and tremendous, tremendous experience because I could see the evolution of technology from the time when I was very young to what was available in today's day and age and the, you know, the outcome than the children are dramatically different.
[00:14:51] And so it really was just, um, Yeah, it was just remarkable to be able to be a part of that and to learn and experience what the, um, evolution has gone through with tech technology, with early intervention, with brain research and all of these wonderful things that the field has managed to issue. Um, and see, see how it's really is impacting so many people's lives.
[00:15:19] So there's an entire, um, re I hold them very dear to my heart. It's a great program, which the adults,
[00:15:24] Todd: well, the, the current issue, the current episode that's out now of this podcast is an interview with Maura.
[00:15:32] Paige: I saw that I stumbled on it. Um, on Facebook, I thought they're posting several. Yeah. So that's great.
[00:15:39] Todd: It was really wonderful. Talk with her last time and, uh, and really get more about the history and she's been there from the beginning. And so it was interesting to hear about all of that. Yeah. It's been a great program over the years and, and still is considered one of the best programs in the country.
[00:15:58] So it's a phenomenal place.
[00:16:00] Paige: Yeah. Really that they do a lot of amazing things. The entire staff there is just really incredible people. Yeah,
[00:16:09] Todd: I would agree. So from, oh dude, did you buy stock in Amazon while you were there?
[00:16:17] Paige: Um, well, part of my job, they gave me a stock options. Um, and unfortunately I still have tomorrow too soon to figure it that way.
[00:16:30] Todd: Which, which we all would have recognized that early on. Right. Um, so from listen and talk. There is now in your life, uh, around that time, the country of Vietnam comes into play. And so, so how did that happen when you, when you got connected to Vietnam?
[00:16:57] Paige: Yeah. So, um, I was, as I mentioned, I was at Amazon for, uh, about six years, five and a half years or so.
[00:17:05] And previous, prior to that, I had been working at Clorox and my whole career up to that point had been in business development, marketing type world. Um, and also towards the end of my Amazon career, more like marketing communication. Especially because internet was really coming to be a big thing as we are now and Amazon restorative and the forest sign of that.
[00:17:29] So, um, during that time, I was kind of going through a reflective phase about how I wanted to see the rest of my career evolve. And I wasn't sure of that the corporate world was something I wanted to stay in for indefinite period of time, but wasn't quite sure what the next step might look like. Um, so I took some time actually I left Amazon.
[00:17:53] I took some time to, um, think about what that next step might look like. And, um, during that time, I, I was, um, offering my services in, in internet, you know, website copywriting and, um, marketing communication for several of small companies here in the Seattle area. And particularly in the travel space, cause they was only doing a huge need, but there's type of understanding and you know, how does this all work?
[00:18:24] There's online staff and there was an organization that, um, I got connected with that. Um, they actually do a lot that they're no longer around, but at the time they did a lot of consulting and work with different countries to help develop their tourism, um, programs and make sure they do it in a sustainable way.
[00:18:46] And they also had a, um, like a magazine. And so it was contributing a lot if my writing to this magazine effort and they asked me to write an article about customized vacations. When you tell the tour company what you want to see and do on your trip, I suppose, just following a sec, I can vary. So today I think that's pretty common today travel, but back then, there was a totally new thing.
[00:19:13] So I have talked to several, um, travel companies about this new, new, new way of doing things in travel. And there's one company tour companies that, that they offered, um, not only customized trips, but they also offered volunteer placements for people to be able to engage with the local kosher and give back to the community as part of their customized trip for sounded really interesting.
[00:19:42] And then the name of the trick can be special tours and they, um, so they, they have been doing this for awhile quite successfully. So I asked them to send me some examples of volunteer placements, and they didn't know that I have a hearing loss and they made quite an array. It was everything from like building water while was, you know, in Africa to, um, helping out with, um, counting animals in, you know, in jungle type environment.
[00:20:14] And then this one was, um, Teaching English or helping to teach English to children who are deaf or hard of hearing in Vietnam. And, you know, I mentioned earlier that I had been on the listening top board and involved in that organization and really seeing the impact of it. Advanced made in the field and children today.
[00:20:37] And so it really led me through this whole reflection about what it means to be hard of hearing or deaf. And so I was going through a real personal, um, affection faith. So there's, there's a communication really hit me at a pretty pivotal time in my life. So when I saw this. Example that you could teach English to children who are deaf and hard of hearing you Vietnam.
[00:21:03] I finished the article that I was writing that I contacted the tour company. I said, I would like to do this myself. I have time. So I want to go to Vietnam and feed the country and end up at this program and see what there is to learn about helping kids who are deaf and hard of hearing and learn to speak English, especially when they're being me.
[00:21:25] So, um, so I did, so I went on this trip. And then, uh, I'll never forget the moment when I pulled up at this school for the deaf. And so my suggestion was, and I was more of a hybrid, but at the time there was purely a residential school for the dad, um, to get out of the car. I had the tour guide with me. He was introducing me to the staff there and I met the director and the director's name is Tuohy.
[00:21:51] And she looked, she looked at me and I said, hello. And I spoke to her and she, she, she has, she knows English and she immediately reminded. That she thought I was deaf and I said, oh, well, I am, but I we're hearing technology and I can speak. And she went away like, how, how is this possible? Like, how can this be?
[00:22:15] Because they didn't have any examples of society back in 2008 in Vietnam of adults, or even, you know, older people who are able to listen and talk or even children for that matter. So, um, she took me aside and. Immediately sat me down and she wanted to know my whole life story. But what was interesting is that she has just come back from Europe where she, and a couple of other Vietnamese professionals were sent to learn about early intervention in general, because in Vietnam they had no early intervention program.
[00:22:50] So, um, in 2008, if you had a disability. There really wasn't anything for you until you were five or six. And I've realized now that it's very late. And so, um, and, and there were no real, um, even early learning programs for typically developing children that this was an area that Vietnam is really trying to change at the time.
[00:23:11] So they had sent a contingent of professionals abroad to learn about the topic and then to come back and take them to them. We just started to implement this type of surfaces for, um, for children who are under six years of age. And so given that I was a product of the very early intervention she was looking to put into place, she was really interested to hear about how it is, how could it even be possible for somebody, with my degree of hearing loss, to be able to and speak.
[00:23:44] So, um, so we really hit it off right away. And over the course of my time that I did help the teachers, um, teach English, but it really felt like there was a larger purpose to play here where, um, so two of you might take me around to these academic meeting and she recognized me and she would say, just say something.
[00:24:04] So I would say something and then she would say, look, look and see what's possible. And it was, um, it was, it was funny in some ways. And in other ways it was quite like. It was pretty, um, significant like that there was making this much of an impact. And so, um, at one point, some of the teachers didn't think that I was as best as I said, I was.
[00:24:27] Because I, you know, have people fake being hard of hearing or deaf all the time. I'm just kidding. But you know, it just never, it's funny that they actually thought that I was pretending to be hearing, you know, having hearing loss. I really am, but, uh, so they asked me if I would be willing to. Uh, to undergo a hearing test.
[00:24:49] And so I was like, sure, show me that ideology. But, so they took me to the ideology, birds and tested my hearing. And I always tell people that it was the first time in my life that it was happy to have such a horrible audio ramp because it just shows, let me look at my audiogram and it's pretty bad. So, um, so they, you know, they took them as I was telling.
[00:25:12] There was a piece of paper and they gave it to me to take to cheery. So I went into her office and she had the audiograms. There's several of the children in her program. And this particular school has 300 children between six and maybe 20 years of age. Um, and. She had the audio games spread out on the table.
[00:25:36] And my hearing loss was better than some of them are, certainly had a lot that had a lot more hearing than I did, but because they, I mean, they're even moderate hearing losses in this, in this group. And so, um, there was just a demonstration, a real life demonstration that the benefit of that or the identification.
[00:25:59] Early intervention services that I had when I was young, which enabled a completely different outcome than what was happening for these children. So over the time, um, I had, I had reached out to Maura. They were interested to the Vietnamese teachers were interested to understand more. So with Morris being the expert, um, I did ask her to share whatever she could about, um, About, um, auditory, verbal practice, um, parenting technology, whatever she was willing to be able to provide.
[00:26:33] And she just sent me a ton of wonderful PowerPoint student resources. And if anybody knows why they, they know that she's very complete and providing, uh, we try to help as much as she can. So that was incredibly helpful. Yeah. They, um, so I was able to share that information, but also at the time that I was there, uh, Toohey and I started to kind of, we started talking about this mandate that she was given here that she's posted go and figure out early intervention for these kids in her country without a whole lot of modeling to do it.
[00:27:09] And so she was saying that it would be wonderful to bring some professionals. To some other places that could come and help them understand what was needed and then to be able to train that. And then the Vietnamese would take that information and then be able to train others and collectively they can improve services for children, with hearing loss in their country.
[00:27:33] And I really liked the science of empowerment that she has, like the shoot and responsibility that, you know, give us the information we're gonna. We're going to run with it and we're going to improve things. So we actually came up with a plan for, um, it started actually as being a very simple, um, training workshop type of thing.
[00:27:55] And then yeah. Then I went back to the United States and started contacting different organizations to see if there was any one out there that were doing something similar that would be interested in getting behind the plan that we had developed. But what I quickly learned was that there were several organizations that have a true surface based concept of, um, humanitarian, for lack of a better word, human and projects, where they go to a country, they provide hearing aids, you know, they fit hearing aids or they go somewhere and they do the work to help the kids, but then they leave and it's not very sustainable in my opinion.
[00:28:35] And so what I was hoping, and there was that, and also, uh, there were organizations that just focused on one part of the problem. So maybe a race, you know, screening or fitting hearing aids, but there wasn't anybody that seemed to have the complete continuum of care in mind. And so that's when, um, I decided that this was something that needed to be addressed and it was clearly a problem, not just in Vietnam, but in other developing countries too.
[00:29:05] So in 2009, I established the global foundation for children with hearing loss, which is an organization that helps, um, countries and organizations within countries. To establish that continuum of care from early identification to hearing technology, to rehabilitation that complete package. For children, zero to six, know that they have a chance to learn, to listen and speak.
[00:29:32] And so, um, our first program voice in Vietnam, and we still are there today. W what is that? The, we started in 2010, so 11 years later, and, uh, we've trained over 300 people. We, the project started off with just training teachers in south Vietnam. Um, and even our first summer program was significant. It was, it was, um, six weeks long.
[00:29:58] And it involved at 90 teachers from, in Vietnam, from 35 different schools throughout the south part of the country. And we had a global foundation team of professionals that, um, that I had put together to develop the curriculum and it covered many different topics and aspects. Um, and then this group traveled with me to Vietnam to teach the material that summer.
[00:30:26] And so that's not where I started. And then over time, it's just grown exponentially to the point where, where we were providing training and hospitals, um, to medical professionals, to technicians in this field who are doing audiology work to, um, therapists, to teachers in classrooms, setting mainstream teachers, even if they understood about it.
[00:30:49] Inclusion. Um, and then working with therapists in hospital settings, as well as school setting that have started in the south, went up to the north of Hanoi. And then, uh, we expanded finally to the central part of Vietnam. And a big part of what we do is to prepare them to be trained, to train others so that the benefits that exponential insustainable kind of week vision, like, you know, give us, give us the information and we can make things better.
[00:31:20] And so, um, so for that central part of Vietnam, We actually, um, asked the professionals that we had trained to lead the training and our teams will with more out of coaching the trainer. And then, and so today, you know, and we ask to fit hearing aids on children in need. We did a partnership with a coconut implant company to not only provide cochlear implants, but to make sure there was 15 years of support after the surgery.
[00:31:50] Because I think everyone on this call knows that. It's just, it's expensive to have a cochlear implant. And in these developing countries, so many families, you know, they sell everything they have in order to be able to make it possible, to get the device not understanding about the ongoing cost. So we really worked to make sure that that made wise a drive.
[00:32:13] And we also, um, partnered with the. Professionals that we had trained to provide, um, therapy and rehabilitation support to the children after they got their implants. So, um, so we, you know, as I said, we'd been in Vietnam for, um, was just about 11 years now. And. The Vietnam has been to where it is now is striking.
[00:32:36] And we can't, of course we can't take the full credit for it, but I do think we have to, um, create a lot of the positive change there where today all the cochlear implant companies are in Vietnam. There's last year, early intervention program. Um, all the hearing aid companies that most of them anyway are there too.
[00:32:55] And families are familiar with this. Um, there's the chance for kids to hear and speak? I started today. If I were to go to Vietnam today, I don't think they would even look twice at the fact that you speak and not a big deal anymore. So I feel very fortunate that I haven't had a chance to be a part of that.
[00:33:15] Todd: And so has with, with all of that it's happened and all the changes has the government embrace this and put resources in place so that children, when they are identified there's, there's a system.
[00:33:28] Paige: Yeah. So they, um, thank you for asking that. So the government still does not provide financial aid for.
[00:33:37] Hearing aids or cochlear implant for is probably the biggest barrier. I think that change is coming is slow, but it is coming. The hearing screening programs are supported, um, by the major hospitals. So it's not a national hearing screening program, but they do screen newborns for hearing loss at the major hospitals.
[00:33:58] So again, progress issue. The biggest area in progress though, is. So second ignition that, um, this is, this is possible. I mean, we really had to, we started from the very beginning with the government and trying to educate them. And it was just this, um, It, it, it took a lot to try to show that this can actually happen.
[00:34:24] That kids who are deaf and hard of hearing can listen and speak. And it took time for the kids that we trained or that our professional is trained, um, the Vietnamese professionals, but them to grow up. To be included in mainstream schools to do well in mainstream schools. And I mean, that takes years.
[00:34:43] Right. And so that's happening now. And so one of the things, the government, the ministry of education asked, um, the global foundation to. Help train a group of professionals, teachers and therapists in Hanoi who are, um, they're part of our special cause or within the ministry of education that are responsible for developing curriculum to train teachers in the country.
[00:35:12] And the goal was to standardize, uh, what, what, what the special education training would look like for a teacher working with kids with hearing loss. And so we, uh, been working with administrators. I have education on, on that and helping to, um, give them the tools that they need to standardize a training curriculum that will address auditorium over practice and, um, making sure that the professionals in the field have the knowledge and resources to be able to do what they need to do.
[00:35:45] And Vietnam has also supported a audiology. Um, training curriculum in the universities, which is also something that's pretty there. So is this coming slow? I really met, but it's definitely coming. I think that again, as more and more children continue to be successful with that, um, the government will have to be more involved in, in other ways.
[00:36:11] Todd: And you have to excuse my ignorance, but the government there is it, it is what, what's their philosophy. Is it, is it still communist government or is it,
[00:36:22] Paige: yeah, so it's a communist government. They have, um, a free and apply market system or it's different from our system, but it's, um, they still have the communist constraints around things.
[00:36:37] They do apply a more open society, um, free, um, economic policy and what they did back in the time of the Vietnam war, like, or after the Vietnam war. So, um, in, in the 1990s, they really decided to open up the country more and more
[00:36:56] Todd: they're they're like, uh, communism light.
[00:36:59] Paige: Well, it's interesting when you're there, if it's not, um, there's really not apparent.
[00:37:05] And I think it's different from other countries that have stricter communism philosophies. The, the only, uh, maybe interesting that, that I, I deal with on a regular basis, um, is that they are. But they do want to know where people are. So if we, if we have a training workshop, you know, specific part of Vietnam and we invite people to come, they do have to get permission from their local authorities to be able to travel to that location.
[00:37:41] Um, but if they're so supportive, they, the government is so supportive. Yeah. The work we've done. We, we really had name recognition in Vietnam. Um, and in order for us to work in Vietnam, we have to have a permit with the Vietnamese government. So I've worked hard in the areas to cultivate that relationship and make sure that, you know, we provided complete transparency with how we do our work.
[00:38:05] Provide reports in timely fashion, um, for your class who work in the government system. And they all just love the work we do. I mean, they see so much value that we do, and they're very grateful and thankful for it as are the parents, especially, and also the professionals we work with. So I think if such a field guide and if anything, you know, given the history between the United States and Vietnam, I think.
[00:38:29] It's been, um, it's been really nice and we've had people on our team who are older, you know, who remember the Vietnam war. Um, we've had interpreters who escaped Vietnam and came back to Vietnam with us to lend their talents and interpreting. And then kind of, you know, get to see old family and friends that they haven't seen in a long time.
[00:38:54] So there's definitely a historical connotation there. Um, but we've also done something, but the us embassy and the consulate general in, down in Pokemon city where we've been invited to share, I work at, um, constellate presentation and they've given us grants, then some, some funding support for our work.
[00:39:15] So. So I think, you know, I really think that Vietnam is a young country that they've really moved on from that animosity of that era. And, uh, perhaps in some ways more easily than we had. So, um, it's a great place, a great country. People are fabulous, very generous. It's always going to hold a special place in my heart.
[00:39:38] You say, so it was a great place.
[00:39:41] Todd: And so I know that you're expanding your mission with the foundation to other countries to other work, but where do you want to go in Vietnam? What else do you want to continue to do?
[00:39:55] Paige: I think that we are actually at a point where we're studying to phase out of our work in Vietnam.
[00:40:00] They, they have. They, they know how to do this work. And I think Maisha point where we're at, we're able to, with what we are providing a really more, um, Like coaching mentorship and, um, collaboration on maybe specific cases or topics. But we were so far away from where we were at the very beginning where we are teaching them the basics of child development.
[00:40:28] You know, they, they, they, they know all that they've developed tools of their own. They've often many. They really don't need our support as much as they think that they do. Um, and so. With that we, we moved on to Mongolia. Um, in 2016, we started, um, working that the government of Mongolia issued a mandate to establish newborn hearing screening in the country.
[00:40:55] And when I learned about it, I contacted the group. There is, um, there's a rotary group there that would kind of helping them. That the medical community raised the money to achieve this mandate connected with them. And it was really interesting first zoom call that we had, I think it was Sam for maybe it was Skype.
[00:41:13] I don't know, but it was, uh, there was, it was, it was smelling outside and there was some, like one of the participants with kind of in there, um, out in the countryside and there were some lights. Um, I believe like reindeer or something like coming, walking back and forth behind the person in the screen.
[00:41:36] And, and it was just, it felt like very like different type of cultures in that initial type. And then the initial theme that I had with them, but in that communication or that conversation, I learned that they're very focused on the screening, but there didn't seem to be. Uh, as much support as I think we would like after the screening.
[00:42:00] So it's like what happens after the children identified, like, you know, what services are in play? And the Mongolian government does provide subsidy for cochlear implants, which is impressive. And they, um, provide some subsidy for hearing aids and, um, also some subsidy for us. If they call it kind of a disability subsidy, but it could be used towards, um, everything from transportation to therapy, places, or a part for hearing aids, you know, whatever other parents, the hearing aids, you know, whatever you need it for us.
[00:42:31] So there was some social support. Um, but it didn't seem like there was an opportunity. So we ended up, I educated them about what we had been doing in Vietnam over the past decade. And we came up with that, a larger program where if that, to implement newborn hearing screening, but then also too, Really focused again on that continuum of care, making sure that children have access to the hearing technology.
[00:42:59] And then they have professionals who are trained in the country, be able to support with this population. Yeah. And so, um, in 2017 we added a funding, um, to, to, to, to implement all of that. So we, um, we started off in the Capitol of Ulaanbaatar. And made sure that all the hospitals there, um, had newborn hearing screening equipment and over half the population of the country lives in the Capitol.
[00:43:28] So it was an easy way to make a big impact pretty quickly. And then at the same time, um, our global foundation for children with hearing loss per session, um, customize our training curriculum and we. Began training the, um, medical professionals and pediatric audiology, uh, Ben providing training and auditory verbal practice to the therapist.
[00:43:53] You are working with kids after they get their hearing aids. And co-creators. And, um, that continues today. So we're still doing that. And so now in Mongolia and the Capitol, when we first started this project, there was only one hospital that had the equipment and the resources to screen children for hearing your babies for hearing loss at birth.
[00:44:15] And it was, there was such a recession that they were only screening at risk baby. They just didn't have the, where without doing more than that. And so, um, by 2018, when we've had the newborn hearing screening program fully up and running and processes in place, referrals and system in place, I'll have that in place by 2018.
[00:44:35] So in two years we, um, uh, all the hospitals. In the Capitol are screening babies for hearing loss is 30,000 baby every year. Now that I'm getting this hearing today and where we are now with that part of the project is expanding to the countryside and we've targeted three provinces. And during COVID, and this past year we've been able to continue that effort.
[00:45:00] Um, and so now the three provinces have the equipment. The Mongolian is that, um, our hearing screening partners are trained. Had been providing training to their peers on hearing screening through video and whatnot, due to restrictions on travel because of COVID. So they're hoping that by the summer they'll be able to start screening babies for hearing loss in the rural areas as well.
[00:45:25] And to reach the other half of the population. So I'm at a role where we did do some online training during COVID I'm actually in Vietnam and in Mongolia to continue to provide that information to them. So, um, one of the things that I'm really proud about, because our mandate from the very beginning with Alabama, empowering the people in the country to be able to serve their own children, it's never been about.
[00:45:54] Providing direct service. And I think that that, um, mantra has really played out during the pandemic because we've been able to continue so many of the, um, Implementation of projects. So you'll you train people and then they want to implement new things to benefit from the training. And so all of these, um, forward momentum projects in both Vietnam and in Mongolia have been able to be achieved because the people are empowered with the resources, the training and the knowledge that they need to be able to serve their own country.
[00:46:31] And so, um, So while other organizations that are more service-based really have been able to just kind of wait until these pandemic is over, we've been able to continue on in many ways we buy. We do. So I'm happy about that.
[00:46:46] Todd: Yeah. That's very exciting. And I'm very happy. You were able to do that and the way it was structured.
[00:46:52] So you didn't really miss any time there. I'm not much. Yeah. Just keep doing what you're
[00:46:57] Paige: doing. Yeah. Yeah. So yeah, go ahead.
[00:47:02] Todd: No. And I thank you. Uh, from what I've recall, you were looking at some central south America projects.
[00:47:11] Paige: Yeah. So we were in Ecuador for that's. Right. And that was. It was an interesting project.
[00:47:19] So it was with the ministry of public health and Ecuador. And it was so Ecuador is further along than some of these other countries. Um, in terms of providing services for young kids, with hearing loss, they, um, were their opportunity was, was just strengthening skills and especially in auditory verbal factors, but also an audiology too.
[00:47:42] So it was really focused on training, really focused on that. Um, and then Ecuador, they patch them. A lot of political changes, um, during the time when we were trying to work there. And so those, those ended up being challenging, um, in terms of getting the appropriate permissions and felt like it was that it was difficult, but the rules kept changing and Ecuador that you think you checked off all the boxes, and then you find out that you actually needed to be looking at these other lists.
[00:48:13] There's things that get done before they will let you in the country. So, um, it was unfortunate. I know the people that are in the government and the people on the field. We're really hoping for us to continue on for seven, eight years in Ecuador, but it's just, it's just got to be got to a point where, um, the expense and the time involved in working through their spirit phatic.
[00:48:40] Class Ash was just more than we could take on. So yeah, we were on good terms and if they ever, um, simplified their flashers, I'm sure we'll be going back right in the meantime where we're looking at. Um, so we, we started focusing on Mongolia more and I work in Vietnam and, and now we were establishing a new project in the country and through time,
[00:49:03] Todd: So that's going to be the next, uh, one, uh, your additional area of focus going forward over the next few.
[00:49:11] Paige: I think so. Yeah. We're really excited about this one. I said partnership with the United nations technology. And with, um, Medtronic labs, which is a social enterprise and the three of us, um, we have different mandates, but all sort of synergetic, transgender agenda.
[00:49:29] And so the, um, United nations technology bank is interested to, um, to address the need for, um, more services for children, with hearing loss. In in low resource country. And it's kind of part of this w ratio mandate that was issued back in 2017 to make air inheriting care more in priority in government health plans around the world.
[00:49:55] And so, um, so we've been invited actually to this project to help with the zero to six component. The overall project is for it. To 14, it has two distinct parts. The seven to 14 group is more, um, going to, um, mainstream schools, monastery, or have a public health initiative to make sure that the children are hearing well and that they don't have.
[00:50:23] You know, you know, racks or other, um, issues that might be to permanent hearing loss. So it's more for typically developing children, but then making sure that they continue to hear well. And then for the zero to six program, is this again, that continuum of care, we, and we really are starting from scratch there because they have very limited resources.
[00:50:44] So it will be a challenge, Jane, but incredibly fascinating pleasure. So we're looking forward to it.
[00:50:50] Todd: Well, it's, it's all very exciting and you are just an amazing person to be doing all this and to have seen that need in Vietnam initially, and then to see where you are now, these years later, over this past decade, what you've been able to achieve.
[00:51:10] It's just mind blowing and I, I just really compliment you on all your hard work and you are truly changing the lives of these children and the families, and, uh, having such an impact, uh, throughout these countries. That's really amazing.
[00:51:27] Paige: Thank you. Thank you so much. It's been, it's been incredibly rewarding work and so grateful to all of that.
[00:51:33] Professionals and in country people we collaborate with. Um, it's just been, it's been a very, um, it is a definite community effort, worldwide community effort. So it's, it's lovely to be a part of it.
[00:51:49] Todd: And age, if, if someone who's listening would like to contact you or to maybe donate some funds, some funds to, um, how
[00:52:01] Paige: thank you.
[00:52:02] Yeah, we have a website and it's, um, children with hearing loss.org. So the name of our organization is the global foundation for children with hearing loss. Um, and I would decide is children with hearing loss.org. And if you go there, you'll see the big red donate button, but you can also read a lot more about the different programs and, um, organization commission there.
[00:52:26] Todd: Awesome. Well, thank you for your time today. I really appreciate this and, uh, and good luck with everything that you're doing.
[00:52:34] Paige: Thank you, Tyler. I really appreciate you having me.
[00:52:37] Todd: Paige is such a remarkable person. I really admire her and everything that she's been doing and continues to do. She saw the need in Vietnam initially, and essentially built a foundation that not only address the problems of children and families and those professionals in Vietnam.
[00:53:02] But now is branching out to these other countries and continuing to have such a tremendous impact. She is changing lives. And again, I just admire everything that she's doing. So if you have time and if you have resources, please reach out to her, the global foundation for children, with hearing loss, visit the website and donate.
[00:53:30] If you can. And thank you for listening. If you don't mind, please give us. It's a five star review that helps us to, uh, attract new subscribers and listeners and to reach more people. And with that until next time, be safe and be kind. This has been a production of the 3C Digital Media Network.
Todd: Welcome to Episode 25 of The Listening Brain Podcast.
[00:00:14] Welcome to The Listening Brain. I'm your host, Todd Houston. In this podcast, we explore childhood hearing loss through the lives of the parents and families who are on this journey and the professionals who serve.
[00:00:38] Hi, this is Todd Houston. Again, I wanted to mention the 3C Digital Media Network, which is our new company that we've developed here. And I wanted to just encourage you to you sign up on the site. All it takes is just putting your email in and that way you can stay in touch with us and we can stay in touch with you and you will hear and get information about all of our new.
[00:01:06] Uh, blogs that might come out, uh, you'll hear about our new webinars and courses. And so it's a way just to stay in touch and that's important these days staying in touch. So if you don't mind go over to three C digital media network.com and sign up and now back to the interview. Today. I have the pleasure of speaking with Valerie James Abbott and her daughters, Mary Clare, and Bridgette or Bridie.
[00:01:39] Valerie has written a new book, pat, a pillow about her daughter. Brady's hearing loss. The story is told through the eyes of the sister, however, Mary, Claire, I'm sure you'll enjoy this conversation with Valerie Mary Clare and Bridie. And I know you'll love learning more about this wonderful new Pat a pillow.
[00:01:59] Here's that conversation? Well, welcome to the podcast guys. Would you like to introduce yourselves or just a moment?
[00:02:08] Valerie: My name is Valerie James Abbott, and I am the mom of two beautiful girls. Um, I also just recently published a book, padded pillow and our family lives in Richmond, Virginia.
[00:02:20] Bridie: My name is Bridey Abbott.
[00:02:22] Um, I'm kind of one of the main characters in the book. I'm the one that has hearing loss. Um, and I'm
[00:02:28] Mary Clare: Mar, Clare Abbott. I'm Bridie's sister. And, um, uh, I narrate a pillow, so it's told through my eyes.
[00:02:36] Todd: So Valerie, I think let's start at the beginning, uh, with Friday's, uh, diagnosis and then we'll we'll work from there.
[00:02:45] Valerie: Sure. So, um, Brighty, uh, who's her formal name is Bridgette, but her nickname is Bridey. She was born, um, with. Uh, hearing, she passed her newborn hearing screen and, uh, was a very happy healthy child. And the two girls were just happy, healthy children. And at some point in toddlerhood she lost her hearing, but we didn't notice no one noticed as a matter of fact.
[00:03:12] And so it wasn't until she had been enrolled in. Preschool for about six months that her preschool teachers asked us if we were concerned about her speech and our answer was no, we're not concerned about her speech. We know that she speaks a different language, but we weren't concerned about it. And she said, well, I think might.
[00:03:37] Benefit from having early intervention, come out to the house and maybe talk. And so we did, we reached out to early intervention. They came right away and, uh, that very first meeting in the house when they're doing the intake, um, it became obvious that we were probably looking at a hearing issue and that caused.
[00:03:56] Everybody by surprise. And, um, they quickly referred us to, uh, an audiologist and we quickly did the audiology exam and then quickly sedated ABR. And it was confirmed that Brighty had a bilateral sensory neural hearing loss, moderate sloping to severe. Um, and no one could tell us how that happened.
[00:04:20] Todd: Sort of no history of hearing loss.
[00:04:23] Valerie: Absolutely no history of hearing loss in the family and no history of ear infections. She was an incredibly healthy child. Um, in fact, we, the only reason we ever brought her in work for well visits, she was never sick. So it really caught us by
[00:04:40] Todd: surprise. And so she. Gets diagnosed and hearing aids. So what happens after that?
[00:04:48] How was that first, uh, diagnosis? How, how did that affect you as a parent?
[00:04:56] Valerie: Yeah. I remember, um, you know, I know some families will describe that, that time as very, uh, gray and foggy. Um, but that time was, is still crystal clear in my mind. And I think it's because the emotions kind of steered it into my mind.
[00:05:13] Um, when, when she did the first test, which was in a booth, you know, she was two and a half at the time. And. Um, and they said, we're, we are looking at hearing loss, but we need to confirm that with a sedated ABR. And, um, and then that, that was confirmed with the day-to-day BR. That was, um, I can still, I can still see that room that we were in, in St.
[00:05:40] Mary's, uh, waiting for her. And. It was, it was, um, it was awful. It was awful because of the unknowns. I had so many questions. When did this happen? Why did this happen? Is it progressive? Will she eventually need a cochlear implant? And no one at that point had really any answers for us. And, um, I would describe that time as I was in a panic, I was in a panic for several, several months.
[00:06:10] Until we eventually did do genetic testing and, uh, discovered that she had inherited connects in twenties. And we are in good company. There's a lot of children out there who have inherited connects in 26 and that has impacted their hearing. And, um, it really wasn't until we had that answer and she had been enrolled in early intervention and receiving services, um, pretty significant services, um, that I started to see the light that I started to realize.
[00:06:40] I think everything's going to be okay. But it was, it was a while.
[00:06:44] Todd: Yeah. And so, uh, Bridey, do you remember any of that time?
[00:06:51] Bridie: I did not remember anything. And if I did, it's just from stories. I don't actually remember it. I know
[00:06:58] Todd: were very young at that point, Mary Claire. So you remember some of that of getting, just according to the book, you remember her getting hearing aids.
[00:07:07] I remember
[00:07:08] Mary Clare: parts of it, for sure. Um, so pat a pillow is technically fictional, um, and, uh, for several of the scenes where I am in, you know, the doctor's office in the book, I was not present for, uh, I was applying at friend's houses, but I do remember a lot of, you know, Pulled out of school or me having to be picked up by, you know, different friends, um, because my parents were at doctor's appointments.
[00:07:35] So, um, I did not see the panic that, you know, my mom describes or that my dad, you know, had. But, um, what I do remember was like why all of a sudden is all of the attention on Friday and you know, it just was kind of odd. You know, that had never occurred before. And it was just very sudden. Um, so I don't remember a lot of it.
[00:07:57] I do remember her getting her hearing aids. We throw a big party. Um, we used to, we used to, every time she'd get new molds, get cupcakes that matched the colors. Um, and so that's more so what I remember it was kind of the positive ones. The craziness and the mixed emotions had kind of past that was, you know, okay, we're going to be excited about this.
[00:08:18] Um, and we're gonna cheer Bridey on and encourage
[00:08:21] Bridie: her.
[00:08:23] Todd: So let's talk about know sort of, uh, elementary school and those years. How did that go? Righty. Do you remember any of that time?
[00:08:36] Bridie: Um, I briefly remember staying after school, sometimes working with a speech therapist and I just remember putting stickers in a book.
[00:08:47] I still have that bottle, but I don't, I don't. And I had to sit in a special chair that was like really unique. And it was like the only chair in the whole school that looks like that. I always got to sit in that one. Um, But like school when I would be like in the classroom, it wasn't much different.
[00:09:06] Other than I think I ,
[00:09:09] Valerie: you did have an FM system today. Um,
[00:09:11] Bridie: it's like a teacher where this microphone and I haven't been connected to my hearing aids and I had that pretty much. So, yeah, that's all, I remember elementary school,
[00:09:22] Valerie: there was a memory that I have of her in elementary school. Um, she came home off the bus and her eyes were just really big.
[00:09:33] And she said, I, I think I have to tell you something. I was like, okay. And she said, um, can you tell the teacher not to bring it? Her microphone into the bathroom. And I was, I was just giggling and I said, sure, I will, I will, I will recommend that. And it's funny because that has been part of the beginning of the year.
[00:10:00] She feels, since that point is a reminder. You know, the FM system travels with you wherever you go, including the restroom and teachers generally laugh at that. And is that ever happened again?
[00:10:10] Bridie: I think it happened once or twice. And then my fifth grade teacher went on like a really, really important phone call for her daughter or her son.
[00:10:18] And it ended up her thunder. And her husband had to pick him up, but I was like, oh, no way, shoot. I'm not supposed to know this information. Like something really bad happened to her
[00:10:28] Mary Clare: son became very popular in class because she heard all of the private conversations
[00:10:32] Todd: with the teachers.
[00:10:35] Bridie: Like students would get pulled out for getting in trouble and be like, it's fine.
[00:10:42] Todd: Yeah. Yeah, the writing. That's great. That's great. Yeah. I've, I've heard those stories where the teacher forgets and goes into the bathroom and you hear all kinds of things, or it goes into the teacher's lounge, you know, and, uh, eating lunch. Broadcasting everything that is being said. So, uh, yeah, those, those are, are terrifying experiences for the teachers.
[00:11:09] I'm sure. So how was Friday? How was, uh, the social life and in school in elementary and even through high school, how, how was, uh, how was that sort of social life?
[00:11:23] Bridie: Yeah. Um, I'm a very talkative kid then now, especially now. Um, I think it was in my opinion, cause I don't know what it would have been like to go to elementary school as a hearing person with normal hearing.
[00:11:38] I feel like it was pretty normal. Nobody really ever asked me about my hearing aids and my thought would be like, oh, I have to go to the clinic. My battery died. Maybe like. Oh, you wear hearing aids. Like nobody even noticed because I talk so much and I think people kind of assume that people with hearing aids don't talk, I don't know, got an impression over the last 13 years.
[00:11:58] Um, but I think it was like any other person for me. I never really got bullied on. Like maybe once or twice, but it wasn't like a big deal. It was just people who wish that they had a super power that they could turn off the world. Right. So people, they wish they could be like me. I'm not really sorry for them, honestly,
[00:12:19] Todd: but well, and I know for, you know, sometimes you have situations in the younger kids that.
[00:12:26] Uh, want to get hearing aids themselves because the popular kid has hearing aids or cochlear implant or something, you know? And so it's like, it's not, it doesn't quite work that way, you know? But, uh, so those are positive experiences. You know, people want to be like the person that has hearing aids. So that's a, that's a good thing.
[00:12:43] And I think sometimes that we w we as professionals worry about sometimes is an impairments as well. Is that sometimes there could be some isolation with hearing loss where children can be sort of, you know, they, they may be teased or bullied and, and there's not that sort of social network that forms of good friends and the hearing loss ends up isolating the student or the child.
[00:13:10] And so I'm really thrilled that that didn't happen in your case. So that's, that's wonderful.
[00:13:18] Bridie: Pride is a special kid.
[00:13:21] Valerie: And I do think a lot of it had to do with, um, just her demeanor since the very beginning. Um, kind of, this is me go bigger, go home. You know, if you don't like me, I'm fine with that. Let's move on to, you know, a group of friends that do.
[00:13:36] And, um, you know, her, her circle of friends is small, but fierce and, um, And it's so funny because you had been friends with somebody for a long time and it wasn't until a couple of years later. I think that they said, oh my gosh, what are
[00:13:52] Bridie: those? We have been like, I mean, we still are, but, um, she didn't even notice.
[00:13:59] And then I was like, oh crap, my hearing aid died. And she was like, you're what? And I was like, never know, cause it's not just like, it's not an everyday topic. Like I don't even notice it in myself sometimes. Like when I'm talking about metering laws, I feel like it's very new, even though it's not new at all, because I just never talked about it.
[00:14:17] Cause it was really. It was just part of like, talking about your glasses. Right, right, right.
[00:14:23] Todd: Just normal to me. It's a good place to get to, I think, where it's just not, I mean, it's a big deal, but it isn't a big deal. It's just like who you are. It's just a part of you. And so I that's, that's a great thing.
[00:14:37] I think when you can arrive at that point, and of course you had maybe this big, bad, big sister who could step in and, and take on anyone. Right. Yeah,
[00:14:52] you probably sent word down as like you're watching. Everyone, leave her alone.
[00:15:02] That's good. That's good. Um, so how so, how are things going now? So update me on what you guys are doing now. So Brighty, where, where are you right now? In school and plans and
[00:15:18] Bridie: yeah. Um, I'm in virtual school right now. Hopefully I'll be in person next year. It's going pretty well, as well as I think it could.
[00:15:27] Um, I play the violin and playing since I was five. Um, I played the upright double bass for about three years and still talking
[00:15:44] Todd: Mary, Claire, where, where are you? And all of it.
[00:15:47] Valerie: Yeah.
[00:15:48] Mary Clare: Um, so like personally, I graduated from high school last year and deferred from college for a year on just with COVID. I did not think that that was for me, but, um, this past year, uh, with my mom having just published a book, um, I helped her a lot with the behind the scenes of that.
[00:16:05] So we joke when Brian and I get asked how we've helped probably says that she was just the inspiration
[00:16:11] Valerie: to put everything
[00:16:12] Bridie: together. Um, I was in school, so yeah. So
[00:16:16] Mary Clare: that's been kind of the busy and yeah.
[00:16:19] Todd: Yeah. Awesome. Awesome. So let's talk about the book. So how did, how did the idea like let's, this is a good idea.
[00:16:27] Let's put all this in a book and put it out there for the world to consume. So how do the idea.
[00:16:35] Valerie: So a lot of people think that's kind of how it works. It happened, right? Because I do think for many people who write books, children's books, especially that is how it happens. But, um, for me, it, it didn't start that way.
[00:16:48] Um, I'm an eater economics major and yes, I did go to, which is a school that specializes in creative writing, but writing a children's book was never on my radar. Um, and it wasn't. Until, um, about a year and a half, two years after, uh, Brady's diagnosis that I really felt the need to write down what I had experienced.
[00:17:15] Kind of like a, you know, not a journal entry, but just get it all out there. I had this, this concern that I might not remember some of the details and I've thought it was important to just kind of write about it. I wrote about what happened as factually as I could, and then rewrote it and rewrote it and, um, shared it with some family members.
[00:17:38] And they were like, oh my gosh, you could totally write a book about this. And as you know, not for public consumption, but just to write one. And I was like, oh, and so I did, I started writing, um, a book. It, it was in. Intended to be a children's book, but it was originally through my viewpoint as the mom. And, um, I wasn't really happy with it.
[00:18:00] And I worked with a professor at the university of Richmond. They have a continuing education course and he said, you know, I wonder if this were told through a different lens, what this might look like and feel like. And so I, I did, I decided, all right, I'll read it through Mary Claire's perspective. If, if we could go back in time and.
[00:18:22] Imagine what her perspective was. Um, so I wrote it that way and, uh, and then I took the course again and the feedback was, yes, it's so much better through the lens of the older sibling, but the older sibling in this is, is too friendly as too supportive as to, you know, there needs to be, not all sibling relationships are sweet.
[00:18:46] Um, and so I struggled with that and. The professor said, what if this wasn't strictly true? What if you allowed yourself the flexibility to reword things and to, you know, who said what in the order, in which things happened. And, um, I struggled with whether or not to allow myself to do that, but I'm so glad that I did, because that allowed me to take it.
[00:19:12] So many of the emotions and the behaviors and what, what I did, what we did as a family and just put it where it made sense within the story. And so our book, pat, a pillow, um, is all based on fact, it is based on the true story of our family's journey with discovering variety's hearing loss and then coming to terms with it.
[00:19:32] But, um, it is done. So in a way that is more helpful for the reader. And more, I think more families can connect to it the way that it's written now. Um, pat a pillow was always the title that I envisioned for the book because we start in the store. With language and how we didn't notice the signs. We didn't notice this strange language that she had created on her own.
[00:20:01] Um, we just assumed that was normal, but someone noticed someone noticed and in real life it was her preschool team. But in the story, it's the older sibling. Again, we, you know, she had invented a language, pat, a pillow was her word for caterpillar. Um, she had probably thousands of words that she had reconfigured based on what she heard.
[00:20:25] And, um, and then I've sent it out to a few large publishing houses. This is several years ago and, um, got their rejections letter rejection letters back, but several of them had really positive cards. Um, things like great story, not our wheelhouse or have you tried this publisher? Which told me, okay, I've got something here.
[00:20:51] I need to keep looking. And then life got in the way, right? I mean, I'm raising two kids, I'm running a business. Um, you know, it's just a busy time. So I put pat a pillow manuscript in the closet and closed the door and said, I'll, I'll revisit it when I have time. And that time never really became, um, until COVID.
[00:21:11] And it was a chance conversation that a friend of mine had with a publisher here in town that, um, I was introduced to Kim with Kiwi publishing and we had a conversation and I realized, oh my gosh, this is going to be published during COVID. And it was a, it was a race to get it published by may because it's better hearing and speech month.
[00:21:34] And I felt it was important to launch it. Well,
[00:21:37] Todd: that's, that's a great, that's a great story of how it all came together. And it's thrilling that even though these other publishers didn't. You know, didn't publish, but they gave you that feedback and tried to help you in the process. That's a, that was a good step because you'd often don't get that.
[00:21:57] Valerie: Well, I was told during these classes that I took, you know, I was told, this is the process. This is exactly how you submit a manuscript. And I followed it to the letter and they said, You know, you will never get personal notes. You will net you know, you'll get a form letter. That's been photocopied 3 million times along with your main new script back saying, thanks.
[00:22:16] But no thanks. But if you get feedback that is so rare to really listen to it. And so the fact that I got it back from three or four different big houses told me. Okay, this, we have something here. This is worth continuing. And so I never really got discouraged when those letters came back. Um, I actually was excited that, oh, I'm doing it the right way.
[00:22:41] I'm submitting. The right way and, oh my gosh, um, I'm getting feedback and I was told that wouldn't happen. So I must be on to something.
[00:22:50] Todd: It reminds me of a quick story of Walt Disney, who apparently went to 457. Banks asking for money for Disneyland. And I didn't even know you didn't get funding until that last one, you know?
[00:23:08] And so you got to keep pursuing it and that perseverance paid off. So that's wonderful. So what happens from here? Are you going to be able to. Uh, certainly it's published now. And so you're, you're in the process of marketing that book. And, and are you going to have sort of a lecture circuit or book signing circuit and, and going out and doing those kinds of things?
[00:23:36] Valerie: We are, um, you know, this has been a family project, um, and we are taking it on the road as a family, um, both virtually and literally we have some events lined up in July, in New York, on long island where I was born and raised. And I'm excited about those events and we're working on events with organizations in other cities.
[00:24:01] Um, so our hope is that we will devote June and July to, um, Building awareness about pat a pillow that it exists, what it is, how it can be helpful. Um, my hope is that audiologists keep a stash in their drawers so that when they are, uh, officially giving a family, a diagnosis of hearing loss and they see that look on the family's face.
[00:24:24] I know all too well that, um, this is something that they can reference that they can give the family. In addition to the audio gram that the family doesn't understand yet. Um, in addition to the hearing aid manufacturers, brochure, which frequently accompanies the audio gram, um, but something to acknowledge the emotional aspect of this journey and to open the door for better, a better relationship between the provider and the family, because we've found in our experience.
[00:24:54] Having a close relationship with our audiologist has made a huge difference in everything from, um, our keeping appointments to calling them when we've, you know, if we've had any concerns whatsoever, um, and celebrating with them. So we really are hoping that this becomes a standard tool in the toolbox and we are, we have a minivan and we have books, so we will hit the road.
[00:25:21] Todd: Well, that sounds like a fun time as a, as a family to go and do these kinds of things. And, and it's for the right reasons. I mean, you're, you're sharing something that's not only very personal to you guys, but also very helpful as for are helpful to many other families in the same situation. So I wish you guys the best of luck and, uh, and maybe in another six months to a year, you guys can come back and give us an update on how everything went.
[00:25:48] How would that be? Okay.
[00:25:51] Valerie: We would love that. Thanks for the
[00:25:53] Todd: invitation. Well, thank you guys for joining me on the podcast and good luck with your travels and hope everything goes well.
[00:26:02] Bridie: Thanks so much. Thank you.
[00:26:05] Todd: That was Valerie James Abbott and her daughters, Mary, Claire, and Bridgette, or Brighty check out their new book, pat, a pillow about their journey with hearing loss and.
[00:26:18] And I, like Valerie mentioned, I do hope audiologists will keep copies of this book in their offices and be able to hand these out to families when families experience that diagnosis, that would be a great resource to have. And I just appreciate this family for putting their story into a book like this and sharing it so openly.
[00:26:42] So thank you again, Valerie. Claire and yeah. And thank you for listening to the podcast. If you don't mind, leave us a five star review that always helps us to grow the program too, to reach more people with the podcast. And that's exactly what we want to do. And until next time be safe and be kind. This has been a production of the 3C Digital Media Network.