empowEAR Audiology Podcast

  • Hosted by

  • Frequency

    Two times a month
  • First Episode Date

    August 12, 2020
  • Rating

    "5" Stars
empowEAR Audiology

Listen to empowEAR Audiology Podcasts

empowEAR Audiology

Communication is connecting. Join Dr. Carrie Spangler, a passionate audiologist with a personal hearing journey, as she interviews guests who are navigating their own professional or personal journey in the hearing loss world. If you want to be empowEARed or just want to hear some great hearing and listening advice, this podcast is for you!

Meet our Podcaster

Carrie Spangler

Audiologist, Mother, Wife, Advocate, Podcaster

About Me

Carrie Spangler, Au.D, CCC-A, is a dedicated professional in the field of educational audiology with over 20 years of experience. She also has a passionate personal journey of living successfully with hearing loss in this vibrant hearing world. Dr. Spangler has turned what many view as a “disability” into an “ability”.

In November 2019, she began her cochlear implant journey, which you can follow at  hearingspanglish.blog. Empowering and helping others with hearing loss, families, and professionals is at the core of her daily work.

Dr. Spangler has numerous publications and has presented on topics related to educational audiology, advocacy, and peer supports at the state, national, and international levels. Dr. Spangler is also an active member of professional and service organizations.

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empowEAR Audiology Podcast Reviews

Ben Thompson, AuD
Host of the Pure

I recommend this podcast! Great podcast about hearing conditions and audiology!

Father of a child with hearing loss

I'm a parent of a child with hearing loss. This is an extremely helpful podcast to learn from and be a good parent to my daughter.

Listening Fun
Facebook empowEAR Audiology Group

I had so much fun with Carrie on her EmpowEAR Audiology podcast! We talked about itinerant teachers of the deaf and how we work to support our students with hearing loss! This was my first time being a  podcast guest!! I feel like I could talk about being a TOD indefinitely so it was a really fun experience. Go check it out on Apple podcasts! 

empowEAR Audiology Podcast Transcripts

Episode 64: empowEAR Audiology - Dr. Andrea Warner-Czyz

Announcer: [00:00:00] Welcome to episode 64 of empowEAR Audiology with Dr. Carrie Spangler.

Carrie: [00:00:15] Welcome to the empowEAR Audiology podcast, a production of the 3C Digital Media Network. I am your host, Dr. Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today and let's get started with today's episode. Okay, today I have with me a friend and colleague, Dr. Andrea Warner-Czyz, and she is an associate professor in the Department of Speech, Language and Hearing in the School of Behavioral and Brain Sciences at the University of Texas in Dallas. Her research investigates communication and quality of life in children and adolescents who are deaf and hard of hearing, and use cochlear implants. Her primary, um professional goal centers on a whole person approach drawing and speech language, pathology, psychology, and audiology to develop data driven recommendations to improve social well-being in patients who are deaf and hard of hearing. So, Andrea, welcome to the podcast.

Andrea: [00:01:29] Thanks so much for having me.

Carrie: [00:01:31] I'm excited. I know we've been trying to coordinate our schedules for this podcast for, I don't know, some time now.

Andrea: [00:01:39] It's been a while. Yes, but I'm excited to be here.

Carrie: [00:01:42] I'm excited to have you. And I was kind of trying to figure out when we met. I felt like it was at an ASHA convention initially.

Andrea: [00:01:51] That sounds about right. Yeah, that was a long time ago, too. I think we met through a friend of a friend, but I can't remember who the intermediary was. But thank you to whoever it was they.

Carrie: [00:02:02] Were, they were great, whoever it was. So, um, but I am so glad to have you today. And one of the things that I usually ask my podcast guests who have gotten into the field of, um, hearing sciences or audiology, do you have a backstory of choosing audiology?

Andrea: [00:02:23] I wish I had something like there was someone who was super inspirational when I was a kid, and it really wasn't that. When I was in undergrad, I wasn't quite sure what I wanted to do. I thought I wanted to do journalism, and then that wasn't for me. And I went and talked to my advisor and and she asked me what I wanted, and I said I wanted to work with something that would let me work with people that I could do psychology and something science wise. And she told me to take this intro class to speech and hearing, and that was it. I was completely hooked after that. It was that one little introductory class at University of Illinois, and I. It just made sense. It was one of those things that just clicked. And, um, and then when I started my master's program in audiology, which I didn't know if I wanted to do audiology or speech, to be honest, which probably makes sense why I do what I do, because it's not all hearing, like all audiology, and it's not really speech and language, and it kind of has psychology mixed in. And that's just the intersection that makes me happiest. I think that's where you really get to see where things come to fruition in the real world.

Carrie: [00:03:30] Yeah, yeah. No, that is great. That one person, an adviser, just said, take this class and it changed the whole trajectory for your profession. So that is awesome. And, um, yeah. So one of you kind of going into that, that research around that quality of life and your passion for that research to, uh, as it relates to cochlear implants and quality of life, you also run a lab at the university called the CHILL Lab. Can you share a little bit more about that?

Andrea: [00:04:07] Absolutely. So, um, it's called the Children and Infant Listening Lab. And so when we started it, it was all about the infants and we were studying babies. And that was really fun. Um, I loved the babies. But then I realized as my kids were getting older, the age of my participants also got a little bit older. Um, and then I got to adolescence, and it was absolute heaven, which I know nobody says that because who likes adolescence, but I actually really, really do. Um, but what we have done, we've looked at speech perception and music perception. We've looked at speech and language outcomes, and then quality of life has really been the stalwart for like the last 15 years. And really, like I said before, that's where I feel like everything kind of comes together. Um, and part of it came from what I was hearing from the parents, where the parents were telling me their children were having this issue, or they're having trouble making friends, or they didn't feel like they yeah, they just didn't feel like they were fitting in or how they were communicating. And I think all of that from getting the information from the parents and then just talking to the kids themselves, that really has changed what I look at, just really listening to them, I think that's the most important part, is learning from them what what they want or what they're experiencing helps change what I do as well.

Carrie: [00:05:27] Yeah. And I know today for the podcast, we really wanted to take a deeper dive into the role of social skills and emotion regulation and relation to children and adolescents who are deaf and hard of hearing. So how do deaf and hard of hearing children or adolescents, their social skills compare to their counterparts who have typical hearing?

Andrea: [00:05:51] Yeah, so it's been really interesting. There's not a ton of work on that. Um, in looking at their social skills, I think part of it really stems from language. And do they have the language skills to be able to communicate with their peers? And I think one of the most striking, um, pieces that I got was actually from a parent who said that their child was communicating that their best friends were always 1 to 2 years younger than they were. And so then it made me think, is that a language issue? Is it a social skills issue? Um, so a lot of the research has been trying to really disentangle what's going on with them. What we know about social skills is that the they have more difficulty making and maintaining friends. They tend to report more peer problems, like they're getting picked on more, or they're just more socially isolated or lonely. And that's kind of been what's what's been reported for the last 40 plus years. And that didn't matter if they were using hearing aids, if they were signing, what kind of residential school they were in, you know, was it general education or residential? It didn't really matter. Those were the types of things that kept coming out. So that's still the case. Even with as good as our technology is and early identification of hearing loss, we're still seeing some issues that kind of need to be teased apart, in my opinion. Yeah.

Carrie: [00:07:16] And it's interesting because like what you just said, we have early intervention and newborn hearing screening and technology, and a lot of these kids are probably graduating from like a more clinic program for their maybe speech and language skills. However, how does that translate into the real world then? Do you have anything to say about that?

Andrea: [00:07:41] I, I do, I think we prepare them really well to respond to us when we're when we're in the Audiologic booth and they're, you know, responding to questions. And it's really kind of a contrived situation. So even if they have noise, it's a really controlled and they know what to expect. They know exactly what's coming. And in speech and language testing, they can do really well on those tests, but they get all the time in the world, they can have as much time as they want, and that's not what real conversation is like. So even if they do really well in the clinic, I don't think those skills are always 100% transferring over, especially when they're communicating with people their own age versus adults who are going to fill in those gaps for them. So I don't want anyone to think that I'm saying they're doing horribly, and I don't mean that at all, but there is a little bit of a disconnect between or there can be a disconnect between how they're performing in clinic and how they're performing with their peers in day to day. Interactions.

Carrie: [00:08:44] Yeah. And does their level of auditory status impact that at all? I know you said, um, you know, as far as, like peer victimization and things like that, it really, you know, was kind of the same. But is there any evidence with that?

Andrea: [00:09:05] Do you mean like if they're deaf and signing versus using hearing aids or cochlear versus cochlear implants? Is that.

Carrie: [00:09:11] Yeah, that or like unilateral or mild versus more severe to profound.

Andrea: [00:09:17] So that's a really good question. Most of the kids in my studies are ones who are have severe to profound hearing loss, who use cochlear implants. So in our peer victimization study, we also had children who used hearing aids. So there was a broader degree of hearing, um, access for that particular study. But most of what I do is is working with children who have and adolescents with cochlear implants. Um, so is there a difference in in our study for peer victimization? There wasn't a difference. If they used hearing aids versus cochlear implants, there didn't seem to be a big difference between them. Um. I can't answer that question. I'm not trying to avoid it. I just can't answer it.

Carrie: [00:10:01] Maybe there isn't an answer for that. Um, right now, I was just curious if there there happened to be anything, you know, related to that challenge or whatever. Um, well, you know, we kind of shared about, like, the difference between clinic and then going into the real world setting. Um, and you mentioned how, um, communication is really different outside of the audiology booth. So what are some of those common challenges that you've heard from parents or from students, um, facing, you know, the real world situation for those social interactions?

Andrea: [00:10:40] So I think one of the big ones is with when we as adults are working with these children, if they're struggling, if they're if they need a moment to process that information, we are willing to be patient and wait for that. And that's not necessarily what you're going to get. So I think the timing is a big part of that, that temporal, um, access to the information and response time. So if they're taking a little bit of time to process what they've heard, especially in a noisy environment, that's going to throw off the timing of the conversation. So I think it's partly that, um, I think communication breakdowns for them to recognize the problem there, a breakdown has occurred and to know what to do about it and to do something about it. That's a three part task that they don't always do. Sometimes they just don't feel comfortable. They're worried about what other people are going to think about them, and so they're more willing just to let it slide and not get the information they need to participate in the conversation. Um, I think the other thing is opportunities for them to have to practice those skills.

Andrea: [00:11:46] So there was a a kid, he was in ninth grade, and I just remember him telling me point blank that the first five years of his life he spent going to therapy and and getting his device, he had cochlear implants and working with his audiologist and his speech language pathologist and this therapist and that therapist. And he spent all the time doing that, and he didn't spend the time in playgroups and learning how to play with others his own age and, and how to navigate the social situations with his peers. And for me, that was, you know, coming from a ninth grade boy who would have thought I'd ever say I really learned from from this ninth grade boy, but I really did, because it was such a huge aspect that we spend so much time with them in, in clinic and in therapy that they need to be kids also, and, and making sure that they're really fostering that aspect as well. I think it's important to emphasize that to parents, too. Um.

Carrie: [00:12:44] Yeah, that's a really good thing to learn from a ninth grader. I mean, that's huge to learn that. What are some. So, you know, you talk about the clinic and going to the real world, but what are some techniques or strategies that parents or educators or, you know, maybe related service providers that are working with these students in the more inclusive school environments? What could they be doing to maybe help build this in a different way?

Andrea: [00:13:20] So I think one of them is to make sure that there are those social activities with other kids their own age. And there was a mom years ago, and she said she felt like she had to be the concierge, so she would be the one that would arrange for the play dates or the Or when they got older, to go to the amusement park or go to the mall or whatever it was, because then, number one, she always knew that her kids were going to be included. And number two, she could also, um, make sure that, you know, those things were happening and that she could kind of be around in case they needed some help with those interactions. So I think making sure that they're involved in those activities, if they can be involved in some type of group, seems to be another one. Um, so that could be a sports team. It could be, um, band if they like music, you know, there are different ways that you can do that. It could be in any other type of group. Um, the other so those are things that parents can do, what clinicians can do. I know that there are certain groups, um, certain cochlear implant teams or teams for children who are deaf and hard of hearing, and they have social groups for their kids. And so they let them all get together. And that way they get to be with other children who are deaf and hard of hearing. They get to do something together, and they get to see that they're not the only ones also, but it gives them a kind of a place away from clinic that they get to practice those social skills.

Carrie: [00:14:47] Yeah, and it's such an important part of the whole person picture when they realize that they're not the only one and that they can kind of develop some positive self esteem in that way, too.

Andrea: [00:15:01] I think that's also oh, sorry, something that you see with the a lot of the kids in general education is a lot of times they don't have other peers who are deaf and hard of hearing in their class. And so having that reminder that that they aren't the only one that you can get that through those local groups. There's also lots of camps. And I know you, you have a camp, um, where you are, and I've been working in camps in Dallas and in Colorado as well. And I think that's another place not just for the kids, but also for the families to get more information on. And, and just, I don't know, learn, learn from each other. I think they learn from each other sometimes better than they learn from us, to be honest.

Carrie: [00:15:43] Yeah, well, I think that's true. No matter, um, whether they are deaf or hard of hearing or typical, um, they're going to learn from, from their peers more than they're going to learn from adults. But, you know, you're saying that and I love that you are so involved at your place as well with that social groups and connecting teens and kids together, because I that was a huge part of what I was missing, like growing up as someone that had hearing aids and going to a general or, you know, my neighborhood school, never knowing anyone else. Um, and it really impacted me, um, socially and emotionally through especially those transitional years of going, you know, trying to figure out who I am as a teenager and then thinking I'm the only one in the entire world that has to wear hearing aids and really kind of propelled me into making sure that the kids that I get to work with are connected in some way. And I feel like even if they're connected once with someone just realizing that they're not the only one one time, it could make a huge impact.

Andrea: [00:16:59] It can. And I think also with those camps, they forge those relationships. There are some kids that have gone to the Dallas camp since they were itty bitty like toddlers, and now they're in their 20s and they are still as I there are some of them and they're just still a super close knit group, you know, almost 20 years later, which is pretty amazing that they have just developed that so early. And I think it's it's that bond of having that commonality. Is that why you did that camp? Is that why you guys started the camp up there?

Carrie: [00:17:32] Yeah, I started a program more like a local program. That was a day kind of a thing or a half a day that we would meet a couple times a year, and we would bring middle school and high school kids together and do just self-advocacy, development. So our group was called Alps Now, advocacy, leadership and peer support for deaf and hard of hearing. And it's like, um, I want to say it's where the magic happens. I mean, you cannot. Replicate what happens in this group any other way, but by bringing them together and you come up with a couple of activities, but you give them the space to be who they are and connect with the others. And like you said, they make these lifelong connections. And with social media and different, you know, things like that, they stay connected. Yeah.

Andrea: [00:18:33] I agree that it is magical. I know we're not supposed to say that because in a way we're setting it up to be that way, but it just is.

Carrie: [00:18:41] It is? Yeah. And I have kids who were, um, you know, dragging their feet. They didn't want to go. And I'm like, just come one time. If you don't like it, you never have to come back. And I would say 95% of them have come back.

Andrea: [00:18:59] Yep.

Carrie: [00:19:00] So the hardest part is getting them there.

Andrea: [00:19:04] I agree I agree.

Carrie: [00:19:07] Yeah. So we talked a lot about like the adolescent phase too. But how important is it to address this early like early intervention and preschool for social skills.

Andrea: [00:19:24] So I think that's what we're looking at right now, because a lot of the research that I've done is really focused on the adolescence. Um, just because they will tell you anything you want to know or things that you don't want to know. Um, which again, is why I like them so much. And I think some of the things that we see. Are things that could be addressed really early. I think a lot of times what we do is as audiologists, we want to make sure they're getting the best signal and speech language pathologists that they have nice, clear articulation and that their language is on par. And that's great. But then that social piece doesn't always fit into the, you know, as far as those high priorities. And I think those early play groups, I think there are things that we can work on in clinic to make sure that they know how to self-advocate early on. I mean, they can tell you when their device is working versus when it's not, or if they're having trouble. I think those are things you can work on really early and teaching them to know how to interact with other people. I think Theory of Mind and some of the not not just being able to identify their own emotions, but to identify emotions in other people. And that's that's a skill that as parents, we need to talk about, too. As you know, when you're reading books or if you get mad about something to explain it and, and explain to them how you're thinking, I mean, you don't have to say I, I'm feeling mad right now, but, you know, but but I'm feeling upset and this is why. And, you know, then they can see this is how someone shows it, either in a movie or a book. Like, I think there are lots of ways that we can address it really early. Um, and there's lots of books on emotional intelligence. I think that's one of my favorite things right now to even in preschool books.

Andrea: [00:21:11] My, um, I mean, I, I vividly remember there's a book called my, My Many Colored Days by Doctor Seuss, which I didn't remember until my kids were little and someone gave them the book. And when you first read it, you think it's all about colors, but it's actually all about emotions, and it attaches the emotions to the different colors. My son read the cover off that book, and I think those are things that I mean, then that was a board book. So those are things really early to have those conversations and if they can recognize it, I think sometimes the children who are deaf and hard of hearing need to be explicitly taught some of those things, and I think those are really good avenues to do it is you can take those little opportunities. It doesn't take a lot of time, but it has a huge impact on how they interact with others, whether they're their own age or whether it's an adult. That was a really long answer. Sorry.

Carrie: [00:22:01] No, that's great, but I know that, um, you know, to add on to that, you have been doing some research kind of in that area, um, with what is it like, more like visual recognition. Recognition and emotions. Do you want to share a little bit about that?

Andrea: [00:22:20] Sure. So what's really interesting when you look at visual emotion recognition. So we show them different faces. And and there was no difference between the groups for visual emotion recognition at all. It like for accuracy or reaction time, they looked exactly the same whether, you know, for static photos. But then when we use dynamic videos and they looked at the image and they had either part of the image or all of the image, there was a difference between the groups. And what I mean by that is that the group with typical hearing, these are all adolescents. The group with typical hearing was faster and had higher accuracy when they had 80% of the video. So they didn't have all the video. They could make the decision and be accurate faster than the group with cochlear implants. So even with visual emotion recognition, they just need a tiny bit longer for the cochlear implant group to be able to get the right emotion identified. Um, for auditory emotion recognition, it's all over the place. But we included, um, kids with typical hearing, with hearing aids, and with cochlear implants. So, um, and we didn't have we need to collect a little bit more data on there. So there's a lot of variability in the deaf and hard of hearing group. But overall they aren't as good as emotion recognition at emotion recognition compared to their peers with typical hearing. And I think Monita Chatterjee has been showing the same exact thing that, um, it's just hard, especially with a cochlear implant, to pick up some of those emotion cues auditorily. And that's when everything's straightforward. But what happens when you have sarcasm and you have a mismatch between what's going on visually and auditorily? And I don't think we've actually nailed that down for how well they do as good at recognizing things like that. When there is a mismatch, I think that's the next thing we need to look at.

Carrie: [00:24:23] Yeah, which kind of makes sense when you think about, um, cochlear implants aren't as good as giving a lot of low frequency information. And when you think about emotions and inflection of people's voices, right, that it would be harder to recognize that, especially if it's a nuance and somebody's being sarcastic and their face doesn't match what they're meaning to say. Right?

Andrea: [00:24:51] Right. And some I mean, there are some people with typical hearing who aren't savvy at that either. They miss it all the time. So you have to pay attention to that too. But I think that's really important for kids who are in middle school and high school because sarcasm and making jokes, I mean, that's that's the bread and butter for that age group, right? I mean, whether they're talking to their parents or to their friends, there's always jokes or sarcasm going on. And so it's really important for them to know how to navigate that as well.

Carrie: [00:25:23] Yeah. Which kind of is a great segue into um, I know you've done some work and some, uh, research in the area of like, bullying and that kind of, uh, you know, written about it. Is there a higher incidence of, um, bullying or peer victimization in this population when compared to, um, typical hearing or other populations?

Andrea: [00:25:54] There. There is. So in the general population, it's about a third will report that they've been picked on at least once. Um, when we look at special populations. So any kids with Exceptionalities, regardless of what that exceptionality is, it's somewhere between about 47 and 70%, depending on the group that's included. Um, and so we ask the same exact questions of children who are deaf and hard of hearing, who used hearing aids or cochlear implants and half of them. So 50% of them said that they had been picked on at least once. So that's compared to it was 28% in the typical hearing population. And the way that they get picked on the most is they they're excluded. They're socially excluded. I should say they feel socially excluded. Now, it doesn't really matter if they were or not, but it's their perception because it's the same sense for them. Right? Um, so yeah. So, uh, it was 20 I think it was five, five times the rate of feeling socially excluded in the group with cochlear implants and hearing aids compared to typical hearing. So 25 versus 5% or something like that. It was crazy. It was it was I was unbelievable how high that was.

Carrie: [00:27:13] Yeah. Which is really important for providers for parents to to recognize that. So how would we as professionals really, um, capture that or make sure that, you know, you have an adolescent coming in and you're doing their annual checkup and then you oh, everything looks great and you have them leave or what else? What else should we be doing?

Andrea: [00:27:44] Well, I'm nosy, so I'm always going to ask about, you know, do you have friends? Do you, do you get along with people? Do you have a boyfriend? Girlfriend? You know, but that's kind of just my personality. I don't think we have to do it from a nosy standpoint. Um, but I think those are questions you can ask. Um, you know, how how are things going at school? Do you have friends? I think those are really valid questions to ask. And if they say they don't have friends, then that's when you can maybe probe a little bit more like, oh, like, you know, are you getting picked on? Is everything okay? I think there's an easy way to do that. And actually, there was a group you were involved with, right? With Carol Flexer and Jane Madell years ago. Um, I remember I think it was Kris English.

Carrie: [00:28:30] Kris English. That's right. Yeah, yeah. And we looked at like and actually had like a bullying questionnaire that you could use in the clinic just to ask some of those questions. And if, like you said, if they said, you know, no, I don't really have any friends. And here's a follow up question, how can you kind of expand and get more information too.

Andrea: [00:28:52] Yes. And I think it's also really important to know, um, that one of the things that came up in our research, we would have the kids complete the surveys on an iPad and sometimes the parents would be around. And some I mean, of course we got consent. Don't worry. Sometimes the parents would, you know, look over their kid's shoulder to see what's happening. And one I remember there was this one parent who came and said, she said that she has lots of friends and that's not true. She only has 1 to 2 friends and the others are acquaintances. And I think that's something else that we need to kind of pull apart. Is are these true friends? Do they have true friends or are they just acquaintances? And do they have someone to kind of share their inner thoughts with, to share time with, to do things after school? And I think sometimes you can dig a little bit more into that, but I think it's more than just do you have friends? I think kind of digging into are these is it a true friendship or not? Is it and is it bi directional? Right.

Andrea: [00:29:51] Do you want to be with each other or not?

Carrie: [00:29:54] Yeah, exactly. Well, and I think that's a bigger like conversation in the general like population for this, this next generation, because they're so involved with their phone and texting and Snapchat. So yeah, you have how many people following you or snapping you. But you could say I have 400 friends, but you haven't talked to anybody in real life.

Andrea: [00:30:22] Oh I yes, yes. I mean it's the same thing for us old people on Facebook, right? Um, I'm friends with lots of people on Facebook, but I'm not really friends with them. I mean, I am, but some of them are really acquaintances at this point. I'm friends with a lot of them. Don't be offended if we're friends on Facebook.

Carrie: [00:30:42] You're going to get all these un friends in a minute.

Andrea: [00:30:44] I know, please don't unfriend me.

Carrie: [00:30:48] Oh, but I think, you know, I when you ask that question in a clinic, it makes.

Andrea: [00:30:57] Yeah. But I but I think those are questions that we can ask. And it doesn't have to be like it's a prying. I mean, these are kids. These are adolescents that you're spending a lot of time with. You know them sometimes they know you and they're more willing to confide in you than maybe there are their parents, because sometimes the parents can become kind of helicoptering and they're so concerned and they, um, push their concerns onto what they're they think their child is thinking, too, right? They, um, what is that called? Do you know? Oh, there. Anyways, so they think that their kids have the same exact concerns that they do, and that's not necessarily the case. So sometimes I think the kids will hold in and not tell the parents if something's going on, but they're more willing to tell you, kind of as a trusted outside adult who is safe to tell things to.

Carrie: [00:31:47] Yeah. And sometimes they might not want the parents to worry or go into the school and maybe make it a bigger deal. I mean, there's probably a lot of that that might be going on as well.

Andrea: [00:32:04] Exactly, projecting. That's a word I wanted.

Carrie: [00:32:07] Yes, projecting. Thank you. I was thinking like executive functioning, but that wasn't it either. Oh, so it's been a long week, right? So we're getting through. Um, but just I guess, you know, we've talked a lot about, like, social skills and and bullying and you know starting early, but are there any other specific strategies or supports that you can kind of think about that we may want to be? Teaching our students or clients.

Andrea: [00:32:47] Um. I do think making sure that they're they're involved in something. Um, when you're on a team and this is kind of across the board, whether it has nothing to do with hearing loss. But basically, if you're on a team or you have, um, some type of group, intramural group, whether it's with the school or outside the school, that kind of gives them a little family where those kids are going to have their back and they have each other's back. And that's something that's been shown in the friendship literature. Um, for kids, with typical hearing in the general population. And I think the same is true for these kids. Um, I do think that's, you know, I expect it to be better in the future, kind of as we go forward, as we have earlier identification, we have earlier fitting of devices and better communication and a lot of these, these kids. So I think kind of the next generation, I would expect that to be better. I think the other thing is this generation, um, is more accepting and more inclusive than I think some past generations. And I think that's something that's going to bode well for these kids, that those things that were viewed as huge differences, you know, when you and I were growing up aren't necessarily as big of a deal. And I think, you know, making them aware. You talked about self-advocacy before, um, having them where they're not necessarily hiding their devices and they're proud of them and they can talk about them. I think that openness really opens up a lot of avenues for them as well.

Carrie: [00:34:25] Yeah. And like you said, that can start in preschool with just like reporting whether or not their devices are on or not working and then building those, you know, developmental self-advocacy skills, which is going to help with their self-perception and identity of who they are and hopefully help with the lesser peer victimization, because they're going to be very confident.

Andrea: [00:34:52] Exactly, and knowing how to describe their hearing loss or their hearing aid or cochlear implant and how it works. You know, these are like glasses for my ears. I think there are things that we can give them the language for, to help them kind of figure out how they want to handle that as well. But it's going to differ. Just like everyone, you know, adults are different. All kids are different too. And so trying to match that strategy with who the child actually is from a temperament standpoint is important to do as well.

Carrie: [00:35:23] Yeah, but what a great skill to develop and be able to role play. Or just like you said, give them some of that language that they would be able to build within themselves and then personalize it as they grow.

Andrea: [00:35:37] Right, absolutely.

Carrie: [00:35:40] So is there anything that I didn't ask you that you were wanting me to ask you.

Andrea: [00:35:50] Oh, I feel I like how this conversation went. It was a little organic and how it evolved, but I feel like this was covering exactly what we had talked about before is just giving a little bit of a shout out to looking at things beyond just speech, language and hearing and how they actually implement those skills in the real world. Um, I think that's just important for us to think about.

Carrie: [00:36:14] Yeah. And I just applaud your work and your passion in this area because it really is the end result, right? We as human beings, we want to be able to interact and have meaningful relationships with other people. And if we're not addressing this, um, and helping support this, then it's going to the outcome isn't going to be the same. So to be able to just, I don't know, have a way to really strategically look at it and then, um, implement it into the clinic setting into the school setting is really important for us. I children who are deaf and hard of hearing because they need that extra support in social and communication a lot of times.

Andrea: [00:37:05] They do, they do. And I think we're the right people to help. But I think it's also important to get the parents involved and sometimes the siblings too. The siblings know a lot more than we give them credit for so yeah.

Andrea: [00:37:17] They're a big key to this as well.

Carrie: [00:37:20] They are. And just to kind of wrap up, are there any like specific resources that you would recommend or networks that you would recommend? I know you talked a little bit about your camp and things like that, but anything that you can think of that people might want to look into.

Andrea: [00:37:41] Sure. So there are camps all over the United States? I'm sure there are around the world too. I just haven't looked into the global global camps. But I think looking into camps is one thing. Looking into local resources for support groups. The Dallas Hearing Foundation, for example, has a teen squad that they get together. And I know you you mentioned that that you have one up in Columbus as well. Um, I think there's also some websites that are really helpful. The supporting success for kids with hearing loss is and I know I'm sure you've talked about that a million times. Um, and there are websites like that I think just provide great resources for the families so they can kind of get what they need and connect with others. There's also lots of groups on Facebook for the parents, and sometimes there's also ones on Reddit. I haven't looked at those in detail, but I think there's good information there as well. But, um, I think pretty much anything online, lots of social media platforms will have different resources for the families.

Carrie: [00:38:48] Yeah, well, Andrea, I thought this was an incredible conversation and a very important conversation to have, um, on the Empower Audiology podcast. And I just want you to I want to thank you for being an incredible guest today. And it was an amazing conversation.

Andrea: [00:39:06] Thank you. It was fun connecting with you, too.

Carrie: [00:39:09] All right. Thank you, listeners, for listening to the Empower Audiology podcast. If you like this, please give a five star review and share it with, um, those who may also benefit from this conversation today. Thank you.

Announcer: [00:39:25] Thank you for listening. This has been a production of the 3C Digital Media Network.

Episode 63: empowEAR Audiology - Dr. Kari Morgenstein

Announcer: [00:00:00] Welcome to episode 63 of empowEAR Audiology with Dr. Carrie Spangler.

Carrie: [00:00:14] Welcome to the empowEAR Audiology podcast, a production of the 3C Digital Media Network. I am your host, Dr. Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today and let's get started with today's episode. The airing of this episode also marks the beginning of 2024. Happy New Year, everyone! This episode that you will be listening to was recorded a little while back with Dr. Kari Morgenstein. This episode actually motivated me to sign up for her energy leadership, assessment and personal coaching session. Wow, what an insightful investment to dive deeper into ensuring that I am the cause rather than the effect of my life. These sessions with Dr. Morgenstein also propelled me into exploring becoming a certified coach. As you listen to this episode today, take inventory of you. A certified coach can help you redefine your career goal or personal goal, overcome obstacles, help you clarify and make difficult decisions, increase leadership and energy, and become confident as well as develop deep self knowledge and awareness. Tune in today with Dr. Kari Morgenstein and stay tuned for future empowEAR Audiology episodes as I will be sharing my coaching journey as well. Okay, before we dive into today's episode, I wanted to take a moment to give everyone a background about my guest that I have today, Dr. Kari Morgenstein.

Carrie: [00:02:08] Dr. Kari Morgenstein is an experienced, genuine, and goal oriented certified coach and speaker. She received her coaching certification from the Institute for Professional Excellence in Coaching, or iPEC, and is a master practitioner of the Energy Leadership Index Assessment. Dr. Morgenstein is the co-owner of DB coaching Group with over 15 years of experience teaching, mentoring, presenting and coaching and her coaching group, she helps early career to mid-career health care professionals find their voice so that they can lead with confidence, courage and she began her career at the University of Miami Department of Otolaryngology as the founding director of the University of Miami Children's Hearing Program. Under her leadership, she designed, developed, and led a multidisciplinary team of healthcare hearing healthcare professionals. In this role, she managed a multi-million dollar budget while gaining international recognition. Dr. Morgenstein was the youngest individual to have served as the president of the Florida Academy of Audiology, and sit on the American Academy of Audiology Board of Directors. She is a proud member of Women in Academic Medicine, and was chosen in 2019 to attend the AAMC Early Career Women Faculty Leadership Development Seminar. Dr. Morgenstein has a passion for supporting women in medicine and challenging the status quo. I am so excited to have you today. Thank you for joining me.

Kari: [00:03:52] Oh, I'm so happy to be here. Thank you for having me.

Carrie: [00:03:56] Well, I love your passion statement, supporting women in medicine and challenging the status quo. And that's another reason I'm excited that you're going to be on the EmpowEAR Audiology podcast. And I'm sure all of the guests listening today will really enjoy everything that you have to say. But as I read in your bio, one of the things that you started out as a career in audiology and I just love to hear how people somehow get started in that direction. Do you have a story behind that?

Kari: [00:04:32] Yeah, I do have, um, I do have a little bit of a story. So, you know, just like many people, I was trying to figure it out in undergrad. And, um, at the time, I really knew that I wanted to help people. Um, from a very young age, I knew that I wanted to be in a profession that helped, um, others, whether that was children or adults. And, um, you know, so through that one thing kind of led me to another. And I was at home in Chicago and was able to do, uh, shadow a pediatric audiologist. Um, her name is actually Beth Dr. Beth Tournis at um Children's Hospital of Chicago. And I give her a shout out because she she forever changed my life. Um, I was able to shadow her for a couple days. She was mostly pediatrics, a little bit of, you know, audios and hearing aids, and then a lot of cochlear implants. And just getting to see a kid hear for the first time, and how it has the ability to forever change the life not only of the child, but also of the parents and the extended family. Um, I was sold, I was I was like, I, you know, I could do this. And I was super excited about it. So I'm forever grateful that, you know, they let me come in and observe. And that Dr. Tournis was so willing to let me learn and just be a part of her days for a couple days.

Carrie: [00:06:12] Well. Wow. And then you landed in Florida, obviously, and had a career at, um, with children who have hearing needs too in Florida. So how long were you there?

Kari: [00:06:28] Yes, I did my graduate work at University of Florida and then did my last year externship at the University of Miami, and I was there for about ten years. I ran and directed the children's hearing program there, and, uh, it was awesome. It was a really neat opportunity. I was able to step into leadership early in my career, which had it was amazing and awesome, and it had its own struggles. So it was really, really neat to be a part of a large university and to just be part of such a well rounded, incredibly smart, amazingly supportive team.

Carrie: [00:07:17] And I'm sure all of those stepping stones in your early career with leadership kind of got you to where you are now. And in your bio, you mentioned that you're a full time with DB coaching group and that you wear many hats in your own family. You're a survivor of several life threatening health conditions. You're a former Division one college athlete. You're a TEDx speaker alum, and a recovering workaholic, as you call it. Did any of these personal characteristics, characteristics that you mentioned with you and your website lead you to pursue what you're doing now, which is coaching?

Kari: [00:08:01] I, I think yeah, it's a good question. I think in many ways, um, for all of us, like our, our past experiences, especially our past hardships, often mold and shape the direction that our lives lead. Um. And I was no different. I, um, I think a big part of, uh, for me was being always an athlete. Um, growing up, I was always involved in athletics, went on to Indiana University to play college volleyball. And it was through that experience that I, I remember at any given time, just having six, seven coaches surrounding me, and there was coaches there for conditioning and strength and your mental health and you know, your your specialty coach. Right? So if you play defense, you had a specialty coach, then you had the head coach. And it just felt like an environment that was so rich in supports and, um, grace and compassion and also people there that were willing to challenge you to make you better. And when I got into the real world. I guess I was a little naive because I felt like, yeah, like this, this sports bubble is going to be, you know, in, in, in the real world. And I remember just kind of like looking around and being like, wait, like, where are my coaches? Like, where are my people? And I remember thinking that like, wow, like this is really hard to navigate without a coach, without a playbook, without kind of guidelines to, you know, boundaries to kind of work within. And then you had mentioned I, I battled a few health conditions that were life threatening. And I think through that experience, you just see the world completely different, you know, for good or bad. And I remember through one of the conditions I was battling, um.

Kari: [00:10:23] A colleague had a coach and part of that part of that of having a coach. The coach, um, met with me and talked to me just to get input. And I'll never forget, she said to me, like, have you ever thought about coaching? And I was just sitting there like, no, I'm just trying to get through the day, you know? Like, I am just trying to survive. Like you have no idea, like what's going on in my life right now, like coaching? And I remember getting off the phone with her and saying to my husband, like, do you know that there's like, professional coaches? Like it's not just, you know, on a field or arena or a court, like there are people that are coaching professionals. And I remember thinking, gosh, two things. Gosh, that makes so much sense. And the second thing I thought is, could I do that full time? Because that sounds amazing. And, you know, through my illnesses, it was just always it was always on my mind. And then I, you know, I, I when I got healthier and stronger, I looked into different programs. And that's kind of what led me to IPEC and, uh, started the coaching group with my business partner, Dr. Amy Badstuber. And it's it's just been so much fun and such a neat experience. And so, yeah, I think the answer is, yeah. Like my lived experiences being an athlete, battling health issues, having different leadership roles early in my career, and then also being a mom and transitioning to that role and wearing that hat. I think all of it kind of led me to where I am today.

Carrie: [00:12:11] Yeah, that makes so much sense about your college career and coaching and having all of these people supporting you. And then you get out into the real world and you're like, wait, I need to have these people to kind of get me to the next level or to keep me going and whatever path I want to go, or thinking bigger however that might be. And I feel that coaching is really kind of a growing certification or a career pathway in different areas. Can you you you mentioned professional coaching and can you just maybe share a broaden a little bit more about how professionals and individuals might view coaching? Because I think what you said coaching typically you think about athletes, right? But you don't think about, oh, wait, there's a whole other world out there that people can benefit from coaching.

Kari: [00:13:10] Yeah, totally. I always I always say this line, I always say professional athletes have coaches. Professionals need coaches. and the so coaching really you're right Carrie. It really has taken um it's become more popular and it's become almost like a buzzword that people talk about. Or some companies, you know, say, oh, we offer coaching. Um, and I think it's important to recognize that. True coaching is very different than, let's say, consulting or mentorship. Um, so consulting, right. It serves a purpose. It's great. But it's really hey, here's a roadmap. This is how you're going to do it. And here's our advice. Mentoring also serves a purpose, right? I have incredible mentors that supported me and my career and still support me. But the issue that can happen with mentors is that sometimes it's a let me show you how I did it and hey, come with me, which can be okay and it can be really helpful. But if your path and your desires and your interests are a little bit different than your mentor, that can be kind of how you go on a path that might not be a good fit for you. Um, and then the other one that gets thrown in with coaching a lot of times is therapy or counseling, and that is a bit different too, than, than coaching.

Kari: [00:14:41] Um, therapy really is something that kind of stays in your past. It looks at your your past experiences. What about your past is showing up today. It often takes people from dysfunctional to functional and with true coaching, the coaching that we do with our group, it really gets at the core of who you are today and where you want to be tomorrow. And the neat thing about coaching is that it's a true partnership so we don't guide it. We're not telling you do this, do that. It's really having that person to ask the right questions, ask the tough questions so that you can kind of go inside and say, hey, you know what? For the first time, I'm listening to myself, my heart, my head, and I'm choosing to move forward a certain way. And so coaching, they often say, takes people from functional, right? They're they're doing pretty good. They're functional and makes them more optimal. So that idea of taking someone good to great. Hmm.

Carrie: [00:15:53] I love that and I, I think I know your answer, but why? Or who should get a coach or want a coach?

Kari: [00:16:05] I mean, obviously everyone.

Carrie: [00:16:08] I thought that was going to be your answer.

Kari: [00:16:12] You know, and we laugh about it and we joke about it. But man, like, it's so true. Like, everyone could benefit from a coach. Um, you know, I guess I guess there's three things that stand out to me. Um, I think besides everyone, I think somebody who's. Looking to be to show up, like to just show up in their life and show up authentically and show up in a raw form. And it's just like, okay, bringing all of themselves to the session or to the appointment, the good, the bad, the otherwise right. They're just ready to, to be, to, to show up all of themselves. They don't want to put a mask on anymore. They really want to dig deep and show up. Um, I think the second thing is someone who is just open to growing. You know, I think a lot of times lately we hear about this growth mindset. And for me, it's just having the ability to to have the courage to self-reflect because my goodness, it is way easier in this world to just go, go, go work, work, work and not stop and think about your feelings, your emotions, your actions. It is your thoughts. It is so much easier to just hit fast forward and go, go, go. I'll worry about that later. I'll worry about that later.

Kari: [00:17:54] That's not my problem. I worry about it later. And so I think someone who's ready to have a mirror held to them, which is not always easy, you know, and to do to do the work of reflecting and being willing and open to grow. And then I think the third thing is they're ready to accept a partnership. You know, we know in health care that there's many professions, one of which is audiology that is dominated by women. And women often struggle with asking for help and asking for support. And so it seems like such a. Simple thing, but we often have clients that'll say, like, I just had a client last week who said to me, wow, for the first time in my career. I'm asking for support, and it finally feels like I'm not alone in my career. And so I think someone who's ready to accept that support and they don't have to be like, oh my God, I'm ready, you know, let's do this. Yeah. Give me all the help. But just like has an openness to it that like getting support and having a partnership in your career and your leadership journey and your transitions that happen in your life and in your career. They're open to getting support and collaborating in a true partnership that is coaching. Mm.

Carrie: [00:19:33] That's a great explanation of the everyone but drilling down to really, who you know, may benefit being open and ready to kind of, um, have that mirror held to them. Is that the person that you've probably looking for in that partnership? So if there's someone who's out there who's listening and thinking, yeah, maybe this is something that would be beneficial for me. Can you share what maybe a coaching session might look like or how does that work?

Kari: [00:20:09] You want to do one now?

Carrie: [00:20:12] We could I don't know how good it would be. Yeah.

Kari: [00:20:15] We'll do that for the next podcast.

Carrie: [00:20:17] Okay. There you go.

Kari: [00:20:19] Um, yeah. What does it look like? So. Logistically it is typically 60 minutes. We um, with our coaching group, we have two different programs. Um, we have a program that's three months or 12 sessions and then a program that's six months, 24 sessions. And the reason that it's the three month or six month commitment is that it in order to see sustainable changes for yourself, it's really requires a good amount of sessions, you know, to look at things, to kind of pull back the layers and get to that core of what your blocks are, what your limiting beliefs are, what your assumptions are. Because we all show up with filters and baggage that we see the world with. And coaching, you really need that time and that commitment to identify those blocks and those limiting beliefs and to break through them. Um. Outside of the logistics. And of course, we have people who are like, I just want to work on this problem. And so we offer some smaller opportunities where there's 2 or 3 sessions where we might do an assessment and then offer 2 or 3 sessions. And that's really for people who are like, I have a meeting in a month. And I, you know, I want to ask for a promotion. Can you support me with that? So it's really specific to a specific issue or problem that they want to work through. And then, like each session, looks a little different. The client really guides the sessions and what's on their mind, what's showing up for them personally, professionally. And it's kind of becomes this harmony, this like beautiful, beautiful song that just comes together with the client and with the coach, and you just harmonize through your journey together to figure out how you can best support them to achieve whatever their goals may be.

Carrie: [00:22:27] Mhm.And how do you is there ever like a determination of who would be a good client or that kind of thing. I know the harmony and I can't imagine anybody not clicking with you because you have this personality that just shines. And I feel like I could just spill out anything to you right now, and you would be such a great listener. But I'm sure there's just different personalities. And how does that work?

Kari: [00:22:58] Oh, that's a great question, Carrie. So we do, um, we do offer, uh, complimentary, uh, 45 minute intro call. And in that, in that call, like, we can, we can figure out, you know, is coaching right for that person? Um, maybe they need some other support. Maybe coaching is not the right fit for them. Um, and then, like you said, you know, if there's. You know, different. You know, everyone has different styles, right? Just like different athletes click and resonate with different coaches, right? I know even for me there's some coaches I had that like it just it just worked. You know it was I appreciated the how they gave me feedback. Um, I appreciated the way that they they connected with me, the way that they coached me. And so you yeah, you see that a little bit with clients as well where maybe it's not a great fit. Um, but I most of the time, people that reach out and jump on these intro calls with us, most of the time it does work, it does click. And the reason for that I think, is, well, two things. Um, we're unique. We have more than one coach, so we have myself and Amy. And so Amy and I are both different, right? She has a different personality than me. And so maybe they click with her and they don't click with me. So we're really unique that it's not just one person. If they feel more connected with her or they feel like her skill set might be better for them, then she can see them, or I can see them, you know, vice versa. And so we're really, really unique in that sense that most of the time, like whether it's either a good fit for me or it's a good fit for Amy. And like I was saying, most people that jump on these calls like they're ready, you know, they're just they're tired of feeling drained and overwhelmed and anxious and they're ready to show up with having more peace in their life, finding more joy, and not being that workaholic that I can so relate to.

Carrie: [00:25:13] That. Yes, that makes a lot of sense. And I can see how when somebody sets up that 45 minute call with one of you, they've already done a lot of thinking and research, and they're just ready to take that next step. So I can see how that would click really quickly to. In your bio, you also mention that you are a master practitioner of the Energy Leadership Index Index. How does that play into your coaching?

Kari: [00:25:46] It is. It is plays in a ton. Um, so the ELI so the Energy Leadership Index is a really cool, really powerful assessment. It's different than a personality test. So I think many of us are used to personality tests, maybe a disk or a Myers-Briggs. And it's different because this is an attitude test. So it looks at the attitude and the filters that you show up with on a day to day basis. And then what's really cool is it shows how you show up and what energy you bring when you're under stress.

Carrie: [00:26:36] Mm.

Kari: [00:26:37] And what's really important about having this assessment for us in our coaching group is that we know that many people in health care are kind of living in that constant state of stress.

Carrie: [00:26:49] Mhm.

Kari: [00:26:50] And so we, we care of course, how you're showing up on day to day. But we really want to know how you're showing up under stress and what stress is doing to your energy and to your attitude. And the other thing that's really neat about this assessment is that, you know, with a personality and you have kids Carrie like I think in a lot of ways, like they're just kind of born with their personality. Wouldn't you agree?

Carrie: [00:27:18] Like, oh yeah, both my kids are so different. And I'm like, they've been raised but under the same roof. But I'm like, they definitely were born with their personality too. They're enhanced by us, but they're definitely different kids.

Kari: [00:27:38] Mhm I love that I love that word enhance right. You're right. So like it's almost like a work with approach. Mhm. Right. Like this is your personality. Like let me do all that I can do to enhance that. And so. Well, it's it's kind of difficult with a personality test. You're like, well, that's your personality. And like, we're going to do our best as the, the, the leader here to kind of work with your personality and enhance it, like you said. And the neat thing about attitude is that we can all change the way that we it's a choice, right? The attitude that we show up with on a day to day is a constant choice. And so what's neat about the ELI and the debriefs that we do is that it just you just gain a lot of awareness, a lot of clarity about how you're showing up. And then you can choose if you want to change that. And so we're, we're, we're it's a really, really, really neat, really powerful assessment. And. Yeah, it's. I can't say enough about it.

Carrie: [00:28:43] Well, I know that you had put that bug in my ear a while ago about the, um. ELI. And you're making me excited to, uh, connect with you about doing that and kind of pulling, seeing what filters I have and what I bring to stressful situations. Because, as you said, in health care and in our jobs, we just are under the, you know, like under a lot of stress. And what you said earlier, we don't take the time to think about anything. We just kind of get up and go and never have that reflection time. So I'm sure that shows up too, within the assessment, too, of how we look at life.

Kari: [00:29:31] Absolutely. I'm ready for you. Let me know.

Carrie: [00:29:33]  I know you are. I know you are. We'll set this up for sure. This would be like a whole another reveal after, um, see what's happening. But I know that you said that it's Amy, right? Is your, um, the other coach. And tell me a little bit about your name. Do you dB coaching group and where did that come from?

Kari: [00:29:57] So D is my married last name. So Dermer and Amy's last name is Badstubner. So there's the D, there's the B, but it's of course lowercase and capital like decibel. And it's done on purpose. We both Amy and I met in graduate school at University of Florida, and Amy went on to, um, build and run her own audiology practice, which she recently successfully sold. And I obviously had a very fruitful, amazing career in audiology on the academic university side. And it was really important as we were creating our business, to have a tribute to audiology and kind of where we came from. And for me, I'm forever grateful for all the people in audiology that shaped me as a person and as a professional and ones that continue to to I mean, just last week I was talking to a mentor of mine, um, and, and it was just really important to both of us to just kind of give a shout out to where we came from and to not lose our connection with audiology, which, as you know, is such an amazing profession and has given me so, so much. And then the last thing was dream big. And I think, Carrie, when we first started, I think you said like think big.

Carrie: [00:31:27] Mhm.

Kari: [00:31:29] Um, which I was like, oh like I totally yeah think big, dream big. You know, Amy and I live by that. We really try to challenge each other within our business and on our team to challenge the status quo. To what? No idea is too big, no thought is too crazy and just kind of see where it lands. You know, life is too short to play small and to, you know, be timid. And so it's a reminder of, hey, you know, building a business might be hard. It has its own ups and downs, but never to forget that dreaming big is important.

Carrie: [00:32:11] I love that with it. Keeping your roots in audiology with the with the name, and then having a partner that happened to be in grad school with you. So that is so cool. And I know on your web page you and within your bio, you said you focused a lot on supporting those early career to mid-career professionals in healthcare. Why did you kind of use that as a focus?

Kari: [00:32:40] I think it was, you know. I think because that was the area that we found that we needed the most support, and it wasn't always available or easy to find. I think that group is interesting. Um, you know, early career, you're trying to figure things out. You're trying to figure out your professional fingerprint, mid-career. Sometimes your personal life changes, things get a little crazy, and that might show up professionally and I think. It's a group that needs a lot of support. There's a lot of things happening, a lot of transitions, again, personally in people's lives or professionally and or professionally. And Amy and I really wanted to be support to that group and make sure that. You know, I don't believe that you need to learn things the hard way. A lot of people say that, that you just got to figure it out yourself and that you got to figure things out the hard way. And it's I don't believe that. And so I think that if you know someone is in their early career or mid-career and just trying to figure it out, if we can make it a little bit easier, that feels incredibly rewarding. Mm.

Carrie: [00:34:20] Do you have any other target groups that you have besides health care professionals? And I know you like women is a big part of of your group too. And supporting women who are in leadership positions too. But outside of that, do you have focuses?

Kari: [00:34:37] Yeah. We're really focused right now on health care. You know, there's such a need, especially post-pandemic. We have clients that range from nurses to audiologists to speech language pathologists to physicians. And there's a lot of patterns, you know, that they're showing up with. And there's a ton of burnout and a ton of just kind of reflection happening. And so for right now, our group is really focused on health care. You know, who knows, maybe in a year from now or two years from now, you know, Amy and I have different interests and different passions. We both have pretty diverse backgrounds and we have ideas in mind. Um, but for right now, we're really focused on supporting those early career and mid-career professionals in healthcare.

Carrie: [00:35:29] Well, that's where your dB comes back into play, right? Your dream big.

Kari: [00:35:34] Exactly.

Carrie: [00:35:36] If listeners wanted to get connected where they're like, hey, this sounds like something I would like to explore or get more information about, how can they get in touch with you or with Amy?

Kari: [00:35:49] Yes. So they can go to our website. Our website is dB coaching Group. Com, or you can find us on LinkedIn. Uh, I'm on LinkedIn. Kari Morgenstein Dermer, you can send us a message. Um, Amy, is Amy Badstubner. Um, and you can send her a message. We love just talking to people. You know, we do, like virtual coffee dates and things like that. And, you know, I really encourage any of your listeners that if they just are, they just want to chat or want to hash something out, or they heard about coaching, but they don't really know what coaching is and they want to just talk about it, reach out. We're we're we're super available. We want to have conversations. It's really fun to meet new people. And, um, yeah, just send us a message and we're we would love to connect.

Carrie: [00:36:42] Well, I can definitely link the website or the your website in the show notes too Kari. Is there anything that I forgot to ask you that you were hoping I would ask you?

Kari: [00:36:56] No, I think you covered it all. It was so fun. It was so good to talk to you.

Carrie: [00:37:01] Thank you. I'm so glad that we had this conversation. And I'm sure there are a ton of listeners out there who are just feeling that burnout, whether it's if they're the healthcare or the schools or whatever. But as professionals who are, um, in this focus in speech and hearing, who just really want to kind of see what their next step might be or just kind of make it a little bit easier. And I hope that they reach out to you guys. So I just want to say I am amazed at what you guys have done to, um, with dB coaching and just kind of, you know, taking, I guess, that, um, dream big that you both had together and just making a move and, and going in that direction. I know that takes a lot of courage too. But obviously it was the right thing for both of you and how exciting to kind of have your roots in audiology, but really go in another direction to, to to help more people in a different way. So thanks for all that you do.

Kari: [00:38:08] Oh, absolutely. That's so kind of you. Thank you. Thank you for all you do, Carrie. You're incredible. And yeah, and you're changing so many lives. So I'm really grateful for the opportunity and to be able to chat.

Carrie: [00:38:21] All right. Well, thank you, listeners for listening to the Empower Ideology podcast, and I hope that you will visit Dr. Kari Morgenstein at her website and reach out to her in the future. Thank you.

Announcer: [00:38:34] Thank you for listening. This has been a production of the 3C Digital Media Network.

Episode 62: empowEAR Audiology - Sydney Bassard

Announcer: [00:00:00] Welcome to episode 62 of empowEAR Audiology with Dr. Carrie Spangler.

Carrie: [00:00:15] Welcome to the empowEAR Audiology Podcast, a production of the 3C Digital Media Network. I am your host, Dr. Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today, and let's get started with today's episode. Okay, today I am excited to introduce to all of you Sydney Bassard and she is an ASHA certified Speech-Language pathologist. She received both her Bachelor of Science and Public Health and her Master of Speech Pathology from the University of South Carolina. Sydney is licensed in Virginia, North Carolina, and South Carolina. Her clinical focus areas are working with individuals who are deaf and hard of hearing, and those with literacy challenges. Her motto of listening, learning, and advocating stems from the three principles that guide her clinical practice. Sydney, I want to welcome you to the empowEAR Audiology podcast. Thanks for being here.

Sydney: [00:01:29] Thank you so much for having me, Carrie. I'm really excited.

Carrie: [00:01:32] I'm excited to have this conversation with you, too. Before we dive into today's topic of health literacy, I would love if you could share with our audience a little background of how you ventured into the field of speech-language pathology, and then your interest of working with children and individuals who are deaf and hard of hearing.

Sydney: [00:01:56] Yeah, so I have like an unconventional way that I came into the field. So I actually went to school to be a pharmacist and thought that that was going to be what I was going to do. And then over time, my brother, who's younger than me, got diagnosed with dyslexia and ADHD. So I ended up working for a literacy intervention company and loved the work that I was doing there. It was far better than the hard sciences that I was having to take in order to try to become a pharmacist. So I ended up switching my major and became a public health major, and then ultimately went to grad school to become an SLP. So that's kind of how I got into speech language pathology. And then specifically with the deaf and hard of hearing population, I met a professor who does research in that area, and she was looking for people to help volunteer in her lab. I signed up and said, sure, I'd love to. Like I want to make connections. And that's where I started learning a lot more about this particular population, specifically looking at listening, spoken language and literacy outcomes. And ever since then, I've been here.

Carrie: [00:03:03] Well, yeah. That's exciting. I love hearing everybody's stories of how they kind of venture into it, because everyone has such a lot of people have an unconventional way that they get into it. I also wanted to ask you a little bit about your listeningSLP. I feel like that's how I know you because of a lot of your social media, which is amazing what you put out there. But can you just share about your work experience and your business?

Sydney: [00:03:32] Yeah. Thank you. So I used to work outpatient pediatrics on a cochlear implant team, and I loved what I was doing. But coming from a public health background, one thing that I always was able to notice is when people had a good grasp and understanding of some of the things that they were being asked to do for their child with following up for audiological appointments, whether it was going to weekly speech therapy sessions, charging the device, all of those different things. Right. And so when people had a good understanding, you saw that they did them pretty naturally versus when people didn't have a great understanding. Sometimes it came, it could come off to professionals as if they didn't care. They weren't trying when really it wasn't any of those things. It's that they didn't have a good understanding or knowledge of what they were supposed to do. So I was like, you know, I have all of this knowledge about hearing loss and working with the population from grad school. I would love to just share like little tidbits and things that people could do at home. So it really started on. I just wanted to share about listening and spoken language on Instagram, and it's kind of morphed since then, as my own thinking has morphed a little bit too. And now our goal is really just how do we support language development for deaf and hard of hearing children, and then also to how we can find different resources and supports that families may not know about.

Carrie: [00:04:59] Yeah, well, I know your little tidbits are just like those little bytes of information kind of stick with people. So it's nice to have that. And I know today we had talked ahead of the podcast and wanted to dive deeper into a conversation about health literacy and how that can impact a lot of the families that our listeners are working with. And I can see now that your combination or your background with public health and Speech-Language pathology really kind of tie into this. So on a general level, can you just share with the audience what is health literacy and what are some of those key components of health literacy?

Sydney: [00:05:45] Yes. So health literacy just actually got a new definition. So we can think of it as two kind of constructs. You have personal health literacy. And that's just really more so about the degree to which an individual or a person is able to find, understand and use information in order to make health-related decisions and actions for themselves and others. And then the other one is about organizational health literacy. So that's being able to understand how to navigate and work within a system in order to make those informed healthcare decisions for themselves and for other people. And both of those are based on the CDC definition of what health literacy is to this point. So when I think about health literacy, there's the three A's that we can always have. And this is what I encourage people to think about when we are looking for information or creating information. It should always be accurate, accessible and actionable.

Carrie: [00:06:46] I like that acronym or the accurate, accessible and actionable and. For having those three A's. How can how does that impact the well-being for families and and individuals? How can we make the three A's come alive for families?

Sydney: [00:07:09] Oh, I mean, I personally think that having a good understanding of whatever is going on is like the driving force to really committing to care, but also understanding the importance of it. So when we think about like information needing to be accurate, right, we know that sometimes pseudoscience is excuse me, we know sometimes that pseudoscience is out there. So that just means like information that's not accurate. So whenever we're sharing things we want to make sure that it is accurate. It's based on evidence that's based on the science that we know is there. So that we want to share with families like things that they're actually able to understand from that perspective. Then it should be accessible. So accessibility sometimes is not always in like just the print form. That may be multimedia. It could be video. And then we should always think about the fact that the average reading rate is around eighth grade for adults across the US. So when we are looking for resources, if they have a higher reading level and in order to understand them, meaning that they're filled with professional words and jargon that may not be accessible for people, like for the general public or population and then actionable. So one thing that we know, like coming out of the field of public health, is that information alone is not enough. So it's great that they have accurate information that it was accessible for them. But if there's no actionable steps based on what's being presented, what exactly are they supposed to do with that? And so sometimes too, when we don't talk about what is actionable, that's maybe where we see like a breakdown in communication and fall off with care.

Carrie: [00:08:53] Yeah. Which is kind of leads directly into my next question is like, what are some of the challenges that families face as it relates to health literacy, too? I mean, you talked about this breakdown with actionable items, but it probably breaks down on all of these three A levels.

Sydney: [00:09:17] I think the biggest one that I've seen is like lost to follow up with care. So we see a lot of people who we know in the US. We're really fortunate that we have a newborn hearing screening program that's universal in all 50 states, but people go through that, right. And then there's no sometimes kids have no follow up and no follow up can happen for many reasons, right? The parents just don't follow up. People move. Things happen. Like somebody may be feeling overwhelmed with having a newborn and then also having to do an additional appointment. In addition to like the well-baby appointments, there's so many things that can happen. But when we're talking about after the screening, if it just says your child, you know, did not pass, this is what we want you to do. But it's not like written in a parent-friendly way. If it like the steps are not actionable in the sense of like you just told them that they should follow up, but like a list wasn't provided or hyperlinks to a website for them to make the appointment online weren't provided. Is that actually actionable? Maybe. Maybe not. So we see that, I think on the early end, but then even to his kids kind of progressed. I mean, sometimes people have difficulties where they don't go to mappings or they're not able to make it to mappings. Do they understand the importance of like why we do CI mappings, why going to those appointments are important? Do they understand the importance of speech therapy and not just being like, oh, so my kid can talk, but to have like a better and more accurate understanding of exactly what they're supposed to be doing in order to benefit their kid. And if they're not provided with that information, maybe they just don't know, especially if this is their first encounter with like, children, or if it's their first encounter with like navigating the deaf and hard of hearing space.

Carrie: [00:11:09] Which is statistically about 90% of our families who are kind of navigating through that space. Because a lot of times that the child is the first person that they've met who happens to be deaf or hard of hearing. Do you see? Um. Any other barriers as it relates to maybe cultural differences or language differences that kind of contribute to the health literacy challenges too.

Sydney: [00:11:44] Yeah. So we know that these kind of what sometimes are called disparities in the field exist across the board. And so we see it even with health literacy and how it comes into play, is that information being presented in a way that is culturally mindful. So just because I have an infographic, maybe knowing that, like a family might have distrust of the medical system or people is like giving them a handout and sending them out the door. The best way to do it? Maybe not. If I have a video version of the same thing that shows real people talks about real experiences, maybe that would resonate more, especially if we know that there are people that like, look like them or that are within their culture kind of represented within those spaces. Um, I think too, sometimes, like we as professionals tend to be some of that barrier when it comes to health literacy and health information. We want to think that we're not gatekeepers of information, but I've sat on many different sides with many different families, and sometimes it's the professionals like we are not freely sharing all of the different resources in a responsible way. We might just start rattling off about 5 or 10 things, but what we never did was spend time to send a follow-up with actionable hyperlinks that people can go and look for more resources, or even sometimes to like after you give people information, asking them what questions do you have and not do you have any questions? Because most people will be like, no, no, no, no. Like what questions do you have? Most times somebody at least comes up with one and it kind of opens that door for a conversation.

Carrie: [00:13:23] Yeah, those open-ended questions are really important in that kind of a situation, and probably giving some wait time to just let them process and think about all of that. You shared a lot about some of these barriers, especially as professionals that we kind of, you know, put up, I guess, are kind of gatekeepers of information. Do you have some specific strategies that could be employed in order to enhance health literacy for families, especially our families who have children who are deaf or hard of hearing?

Sydney: [00:14:02] Yeah. So I always think that before you provide anything, you need to have gone through it yourself. That sounds a little silly to say, but in being transparent, I've done it like I have done the thing of like, you just pick up a resource, you skim over it really quick and you're like, okay, this looks good enough. And you, you hand it to somebody because we know that we're busy and sometimes things happen, but really making sure that we take the time to read this through, is it riddled with a bunch of technical terms that may make it difficult for a family, that maybe that's not one that I'm going to share, or I might modify it in a way and like on my own, make notes on the side for somebody to be able to follow along with it. So looking at it from that standpoint with accuracy and making sure like the readability of the information is good, I think with accessibility, especially with individuals who are deaf and are hard of hearing, not just always providing things in printed form can be helpful. And then even like an aside, thinking about where the printed materials are. So if they're readily available but they're, you know, not in a place that's easily seen, that can be challenging.

Sydney: [00:15:14] So having them in multiple different places around the office could be good. But then also thinking about the way that the media is presented. So printed form tends to be the way that we do things. But we know that like the reading rates for adults are low in this country. We also know too that most people don't actually read. I mean, think about when your doctor gives you something about your health, or even better, when you get medication from the pharmacist. And it's like, here's this pamphlet for you to learn all about it. And you do what? You rip it off and you throw it in the trash. Same thing is happening with most people. So if you can provide something in a video format, and then we know that with videos we always want to make sure like captioning is available. So looking to see if those things are kind of out there as well. And then always, always, always there's something actionable that there's a website or even a statement like, you know, call your pediatric audiologist now or contact your local speech-language pathologist for questions. Here's how you can find one. If you don't have like, give the people something for them to have to do after they've soaked in that information.

Carrie: [00:16:20] And you talked about the different ways of presenting it, like print and like video and different ways like that. Do you feel that actually sitting there with them is helpful too, or that's just probably not always. A way to do it or it's not available. You're not with them?

Sydney: [00:16:44] Yeah.I think sitting with people as they watch it is really beneficial. Well, one, you can assure at least if nothing else, they got the information right, but two, then you're there for whatever questions they may have. I think the internet is a beautiful place. I don't know what I would do without the internet. It provides lots of great resources, but the internet is not a replacement for a professional. So sometimes if we give somebody a resource and we're not there to help guide and scaffold their understanding of what is available, they turn to the internet. And sometimes they may get really good responses and advice, and sometimes they're getting advice and responses that were going, oh no, that's definitely not where we need to be. So kind of handholding. I don't see it as hand-holding. I see it more so as like you're ensuring that people at least have the baseline of what they should.

Carrie: [00:17:45] And. Going off of that. You know, I know all of us use like social media, whether it's, you know, Instagram, Facebook, TikTok, all of that good stuff that is out there. How how can families really discern reliable and accurate health information because they're getting it from these different avenues?

Sydney: [00:18:12] Yes. And I think that's where the tricky part comes in. Right. Because as professionals, to a certain extent, we have a little bit of training of how to evaluate for this information of being good. But if you're a family and you're like, I'm just grasping for anything, you may not have the skills to do that. So the one thing that I look for when I'm looking for any type of support is, is this citing other resources? Right. So one person should not be like the sole idea bank, even when you look at the CDC website, which is very helpful when looking at different information, they are citing research articles or other places for where they got some of the things that they're supporting. So for families, I think always looking to see like are they referencing some other bodies of work in some aspects is going to be good because you know that they're not just relying on themselves, they're using something else. To kind of seeing like across different things. And now this is going to take a little work. Sometimes we like having that one stop shop of I got this and I'm good to go and I'm walking out the door, but especially if you don't know a lot of information about it, I think getting a couple of different things. And pulling from multiple places is going to be beneficial and helpful, because then you're able to do a little bit more of a comparison of what this particular resource says, that this resource says and what this resource says as well.

Carrie: [00:19:41] Yeah, which can kind of be overwhelming for families. As we shared at the beginning, you know, 90% of families, this is the first time that they're going through that. And if they have these different resources that they're looking at, how can families really make that informed decision as far as like, which one should I be? You know, I guess believing or kind of investing so that they're making the best decision for their child.

Sydney: [00:20:16] Yeah. So I think that doing your own research is good. I am a big personal believer in, like, we are our own health advocates. Like we have to have understanding, but that's where professionals come in too. So like, even if you've kind of looked at a couple of different resources and you still have questions, reach out to reach out and get professional support and help. And I know that sometimes that comes with a cost, but there are definitely opportunities out there that are not as expensive. Um, or places I think where you can like basically phone in a question and see if you're able to get a response. I think that that helps alleviate a little bit of the burden on families like your goal is to be informed, but your goal is not to become the doctor. So you may have to do a little bit of your own research, but you don't have to take on fully understanding and comprehending everything on your own.

Carrie: [00:21:10] And kind of on the flip side, to help families along, what can we as communication professionals, speech-language pathologists, audiologists, teachers of the deaf, anybody kind of related in our field? What role can we play in educational programs or initiatives to really address health literacy with families?

Sydney: [00:21:33] Yeah, I think the biggest thing is looking at the readability of text and start curating resources. So I always like to have multiple resources that talk about the same thing, but they might talk about it in a slightly different manner. So depending on who's in front of me, I'm not just constantly saying like, here's here's this information on this, it's no, you're able to modify and adapt for the individual and the needs that are in front of you. And then I think we have to spend time. And I know that time is limited. Like, this sounds lovely. And in a perfect world, we do this, but we do need to have time within our days and our schedules to look for these resources we do not know at all. Like I love audiology. If I could, I would be dual certified, but there's so much that I don't know and it would be an injustice to the people that I serve to try to like, give them all of this information and say, here you go. Like, no, no, maybe I have 1 or 2 pieces of information about audiology, and then I'm putting it back on, like referring to the professional helping to direct them and kind of guide them back. And then we as professionals too, can whenever we see some of these initiatives or things take place, like reach out and figure out how we can support and help, and then also to kind of learning from these other people that have started doing some of this work, how to present information that way. I mean, 90% of the things that have come from the Listening SLP are because I couldn't find it somewhere else. And but these were things that I needed or things that I wanted for people to know or to be able to share. So being able to kind of create your own is also something that you can do too.

Carrie: [00:23:24] Yeah. And kind of looking forward. I know you're you have creative mind and the comment that you just made of like I couldn't find it anywhere else. So I did some of that accurate research myself to put something accessible together that might be actionable for someone else. But how do you envision the future of health literacy as a whole?

Sydney: [00:23:51] Oh, I see health literacy coming into play more and more, and I'm really excited to hear that more grad school programs are doing a little bit more with public health and realizing, like the impact of public health within our field, public health impacts every aspect of an individual's life. Being able to have good understanding, like the decisions that we're asking people to make when it comes to health-related things, are going to impact them or their child for the lifetime. So we can't take these things lightly and just be like, okay, well, you're making a decision like, no, people should be able to make well-informed decisions, and the only way they can do that is by fully understanding and grasping all of the information there. So as we see like the not the invention, but like more prevalence of people using video as a way to communicate and things like that, I think we're definitely going to see more of an increase for all populations, but especially like this population, about what exactly like initial steps look like, what follow up looks like and supports that are there.

Carrie: [00:25:04] You. And hopefully, with all of that, we will have more informed parents who, like you said, that have the direct impact on the outcomes of children who are deaf and hard of hearing because they are the number one advocates and they're always going to be there for them.

Sydney: [00:25:25] Yeah, absolutely.

Carrie: [00:25:28] So Sydney, as we kind of wrap up today, is there anything I didn't ask you that you wished I would have asked you?

Sydney: [00:25:37] I don't think so. Um, no. I was just so happy to be here and kind of chat about health literacy. Like, this is definitely been my first love. Um, long before doing anything like super speech-related. I've always loved health literacy and just have seen it as such an important thing that we as professionals just don't talk about enough. But we are now. And so that, I think, is the the best thing that we can do.

Carrie: [00:26:12] Well, Sydney, if there are listeners out there who would like to get a hold of you, how can they do that? How can they find you?

Sydney: [00:26:26] Uh, so you you can find me at the Listening SLP on all social media platforms, dot the listeningslp.com. Or you can send me an email at hello at the listening slp.com.

Carrie: [00:26:41] Okay, well, I will definitely make sure to put those links in the show notes so that people can directly link and follow you and all of your social media platforms, as well as get a hold of you through email. And Sydney, thank you so much for being a guest today on the EmpowEAR Audiology podcast. It was a great conversation about health literacy and where how we need to be thinking in order to be advocates and in our profession, but also for the families and children that we work with on a daily basis.

Sydney: [00:27:20] Yeah. Thank you so much for having me. Really appreciate it.

Announcer: [00:27:24] Thank you for listening. This has been a production of the 3C Digital Media Network.

Episode 61: empowEAR Audiology - Valli Gideons

Announcer: [00:00:00] Welcome to episode 61 of empowEAR Audiology with Dr. Carrie Spangler.

Carrie: [00:00:14] Welcome to the empowEAR Audiology Podcast, a production of the 3C Digital Media Network. I am your host, Dr. Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today, and let's get started with today's episode. All right, welcome to the empowEAR Audiology podcast. I am going to read a little bio about a return guest that I have on the podcast today, and I'm really excited about our conversation that we are about to have. I have Valli Gideons with me, and she is an author, speaker, and mother of two teenagers who were born with hearing loss with a degree in journalism she transitioned from everyday stories to sharing her family's hearing loss journey to date. Her work has reached millions of people across multiple platforms with an engaged community. She is passionate about her role as an advocate for children who are deaf and hard of hearing. Valli is also the author of the children's book Now Hear This Harper Soars with Her Magic Ears, which she co-wrote with her daughter. Um. And you can also follow her journey at mybattlecall.com. So, Valli, welcome to the empowEAR Audiology podcast.

Valli: [00:01:47] Thank you for having me back.

Carrie: [00:01:49] Well, I'm excited to have you. And for all of our listeners out there, I actually had the opportunity to interview Valli, and she was a guest for episode 29, and we talked a lot about her, um, social media and her blog called The Battle Call. And since that time, she has become a author of the book Through the Fog Navigating Life's Challenges While Raising Kids with Hearing Loss. So I just wanted to encourage all of our listeners to go back and listen to episode 29, which I will link up in the show notes today, and you can hear a lot more about her story of raising her two children with cochlear implants, and also about her social media reach with my battle call. But again, welcome. Thank you for being a return guest. I was excited that your book was published. I know it was in the works the last time we were together. Um, and I'm still bummed we haven't met in person yet.

Valli: [00:02:55] I am also bummed because I see you in pictures at conferences, and when one I'm always sad I'm not there, I have the biggest FOMO. And then also you're always in other. You're in pictures with other people who I may know virtually but haven't met in person, and I just get very jealous. So someday.

Carrie: [00:03:15] Someday it's going to happen. It's going to.

Valli: [00:03:17] Happen one day.

Carrie: [00:03:18] Going to happen.

Valli: [00:03:18] Yes.

Carrie: [00:03:19] Well, I know that people can go back and listen to episode 29, but just to give everybody a frame of reference for Through the Fog and what we're going to talk about, is there anything you just want to give a background about for your kids or your backstory?

Valli: [00:03:38] When was episode 29? What was the date? I couldn't goodness.

Carrie: [00:03:43] I'd have to go back and look. I want to say, I mean, it was before you had your children's book. You were just releasing it and remember I had just ordered it.

Valli: [00:03:58] Okay, because that was February 2020.

Carrie: [00:04:01] Okay. So I think it was right after that because you talked about having to cancel all of your, like, book. You know, you were going to go on your tour with Harper and then we shut down.

Valli: [00:04:14] Yes. Wow. That seems like yesterday. And it seems like a lifetime. So, yeah, I mean, I'm not going to bore your audience. You're my bio. My gosh, that's embarrassing. It's kind of long, but, yeah, I'm just, uh. Now my kids are. Well, now a junior and senior in high school. Battle and Harpe;  Battle’s the oldest. He's who the blog is named after. And I started writing about kind of what it was like raising two kids with hearing loss and being a military wife and, um, all different aspects of my life, but particularly, you know, focused in on what it was like to raise two kids with hearing loss. So.

Carrie: [00:05:00] Yeah. And so you went from this blog and social media presence to, hey, I'm going to write a book. So how did that what prompted you to go from that blog to a book?

Valli: [00:05:14] It probably depends on what day you asked me if the story changes. Um, because it's a blur. It's a bit of a fog, but I didn't actually have any motivation to write a book, so it's just kind of still baffles me that one came to fruition. That was my story. I thought our next book would be another children's book, this one about B attle, because the first one is about Harper, and we're creatively that one's in the works. But. I think what it how it initially came to be was I was doing a lot of speaking engagements, and I thought it wouldn't it be nice to have something when I am there to, for people to leave with? There was more about my story, not my kids. And so I talked to one of my best friends from college, Vinnie. She writes the opening, the introduction in the book. She had helped edit my children's book, and I asked her if she'd be willing to help me edit some essays that I'd already written together, and just I was going to self publish and it wasn't going to be a big to do. Oh my gosh, I think it must have been getting Vinny involved because what she did, she does nothing.

Valli: [00:06:36] Halfway. She printed out everything that she dug and dug and printed out everything I had written. And she's like, I'm going to send this to you. I want you to print it, and I want you to lay it out on your dining room table. And when I did that first I was overwhelmed. It was like 25,000 plus words. And the themes were just jumping off the pages, which was navigating, navigating through the fog. It was just I didn't purposely have that metaphor. It was just all over the place. And then she's like, I think this is more than just putting some essays together. I think you really should rethink this. And then that's kind of where we started adding, you know, I added more stories, lengthened stories. It if I had been more patient, the book probably would have been fleshed out even more because, you know, you put these kind of deadlines in your head. And so I was trying to really make that deadline. Um, so and at a certain point, you think, okay, I'm done, I need to just stop or it'll never. You hear people or spend 20 years writing their book.

Carrie: [00:07:49] Right.

Valli: [00:07:50] So that's kind of how it evolved.

Carrie: [00:07:53] Yeah. So you were talking about spreading everything out on your dining room table, and then the theme kind of popped out like through the fog. Do you want to expand any more on the title and.

Valli: [00:08:08] Well, I think I realized that in every experience in my life, I had gone through, like most people, like, periods that felt like you're kind of in a fog. You don't have your footing, you can't see clearly. And then after the fog comes the light, the rainbow, after the storm. And like I realized that pattern was just kind of throughout every experience I had had. And it I mean, it was really profound. During the initial hearing loss, when Battle was identified with hearing loss at birth, it literally felt like we were living in a fog. I mean, like I can remember like yesterday and he's 18. Like I can remember just feeling a fog and then just realizing how we got we got through that. And then there's another fog and then we get through that and it's just a constant all. And so the theme for me is just always keep looking for the light like fog was going to come and go. It'll be dense sometimes it'll be hazy sometimes, but there is always light. You just have to believe. Yeah. I mean it's so corny, but it actually, no.

Carrie: [00:09:22] It's not corny.

Valli: [00:09:23] It was an actual pattern in my life that I didn't ever really put together.

Carrie: [00:09:30] I was thinking about you. I was just sharing that. We drove down to Charlotte from Ohio a couple of days ago, and I would say 80% of the trip is going through West Virginia and Virginia, and you're driving through the mountains. And it was I knew we had this podcast coming up about through the fog. And I'm like, this is so true, because that's exactly what I was going through, through the mountains. I mean, it's just a good visual. And you're driving through the mountains and it's clear and then like one second later you can't see in front of your headlights because there's such dense fog. And then you get through and there's little patches of fog and then there's sunlight. So it is a very good visual for your book. And I was thinking about you as I was driving.

Valli: [00:10:15] I love that, you know, I just hadn't thought of this either. But we live. I write about it. I think in the opening chapter about we have settled in our favorite little beach town in Southern California that's known for what they call June Gloom. It's a coastal fog, and we kind of live up a canyon, but we can see the ocean like I'm looking at it right now, but the fog rolls in. It's just part of what living here is like. And then almost always, you can it's guaranteed that eventually it's going to part and you're going to see the sun. And I've never stopped appreciating like that. Cool coastal dewiness reminds you where you live. You know, you can smell it, you can feel it, but you can't see the ocean. And then it clears and it. And I'm grateful for it every time. Like my kids are annoyed by I'm. It's my favorite sun. It's my favorite sunshine day. Like, because the sky gets blue. The air is crisp. It's like it's so perfect and I live. This is where we live. We live in a fog of coastal fog.

Valli: [00:11:27] Yeah.

Carrie: [00:11:27] So again, a great analogy for the title of your book. So and so when you had all this on your, on your table with all of these papers and different stories and essays that you have written, can you share how you really thought about your chapters and how they were set up that collection?

Valli: [00:11:53] My process was kind of an interesting one. I think initially it would seem that it would have made sense to start in chronological order, but then somewhere along the way, I just left that whole idea and kept adding stories from childhood. Or as when I'm a newlywed or.

Valli: [00:12:20] Um.

Valli: [00:12:22] Because what that really and one of my editors was not such a fan of that. She's like, I think it would be, you know, here we are in chapter 15, and I'm talking about my marathon before I have kids, and I got hypothermia and went down. And it's a whole kind of signature kind of part in my running journey. She's like, I think if that came before, it would make more sense about some of the feelings you're having once you have kids. And I'm like, but for me, what makes sense is. I didn't learn the lessons in life linearly. And so I didn't want the story to read. I didn't want to say. For you to be reading it and go, oh yeah, that makes sense. Oh, it makes sense that you married someone in the military because your were military child, it's like, um. Because I think even talked about my childhood. Being in a military family comes somewhere in the middle, middle of the book, where I start with meeting my husband in the beginning of the book. So I feel like it was just organic how that kind of came together. It did annoy a couple people who wanted those, you know, to be more of an obvious, I shouldn't say, annoyed. But, you know, they wanted the metaphors to be more obvious. And I was like, but it hasn't been obvious.

Carrie: [00:13:53] And probably some of those stories, you didn't really know what the message was until you were later on and reflecting on it. You didn't know what that was in the moment. So it makes sense that when it kind of was clear to you to put it at that point in your life or the book.

Valli: [00:14:12] Yeah. And I would I would be curious. My daughter just reread the book this summer.

Valli: [00:14:18] Oh, did she picture.

Valli: [00:14:19] Of her sitting in our backyard in our pomp? What are the pompous chairs?

Valli: [00:14:24] Oh, yeah.

Valli: [00:14:25] A papasan chair. It's like those big cushion chairs, outdoor chairs. And she's sitting in it reading. And first she was like, mom, that's a really good book.

Valli: [00:14:39] Which I thought was cute.

Valli: [00:14:40] She complimented me, but she said, yeah, I didn't even realize like some of the the themes till I reread it the second time. Like it made more sense and I thought, oh, that's kind of cool. She knows me. And she still picked up on something different.

Carrie: [00:14:56] And that was one of my questions later on too, is did your kids read the book and what what was their reaction reading about themselves from your point of view.

Valli: [00:15:10] Yeah, so battle hasn't read it. I think he might have read his one chapter. That's like kind of a love letter to him. I left it on his bed with a little note and said, I know you're not going to read the whole book, but, you know, I think it was on his birthday. And I was like, but this is for you. Like, I don't know if he read it, but Harper was my first reader. She read it when I got my a proof copy, and she read it when it first came out, and then she just reread it. So like a year later. And her reaction, she's like, it's really weird to read because I know you, but you're you're you're a mom. But then you were like a you were like a person. You were a child.

Valli: [00:15:52] You were.

Valli: [00:15:53] A newlywed. Like I you know how kids don't really see them, their parents that way. And she's like, and you're talking about me. And it's weird because I was there, but I don't remember that. And so it was I think it just a lot of light bulbs went off for her.

Valli: [00:16:11] That's so neat.

Carrie: [00:16:12] Well, hopefully that's supportive. Yeah. Well Battle read it like when you know he's 35.

Valli: [00:16:20] Yeah.

Valli: [00:16:21] And if he doesn't want to read it I think he's not not reading it for any reason other than just. Hasn't made the time to do it, so.

Valli: [00:16:31] Yeah, but.

Valli: [00:16:32] She's more, you know, she's my writer, so I think. It was more interesting for her because she's. And she probably likes that she's, you know, the star of a book.

Carrie: [00:16:43] Well, throughout the book, you also write a lot about what you were so vulnerable and open, sharing different stages of, you know, grief and shock and just kind of coming to terms with things. What was. How was it to write about all of that, knowing that anybody can buy this book and read it?

Valli: [00:17:09] I think the only way you can publish a book that's so personal is you can't think about that. You cannot be self-conscious. Like sometimes. Now I'll think, oh my gosh, what if I decide I actually don't want to share that? I can't. That's out of the, you know, the genie's out of the bottle, but I just didn't think of it that way. I just was telling my story. And I'm not telling anyone else's story. I think that's the key is to stay true, to like my siblings see certain things differently than I do. My mom sees things differently. Sure, my husband would. My kids. I'm not very careful not to tell their story because I didn't.

Carrie: [00:17:58] Ask you about your husband. Did he read the book?

Valli: [00:18:01] I don't think he's read it completely either. I think his fear. Is it'll make him feel bad for. Are guilty for so much of the time not being there because of his military career. And I think he already feels guilty about that. And I think he fears that this will make him feel certain way. And I'm like, well, don't flatter yourself. It's not. It's not that much about you.

Valli: [00:18:35] It's about my experience.

Valli: [00:18:36] But that is a. That was a big part of what made it so hard. I was often doing it alone. Yeah, it was hard.

Carrie: [00:18:44] Yeah, well, I mean, putting those words out for other people who are going through the fog in their own journey, I'm sure is helpful to know that, hey, there's other people that have gone through the struggles but have seen the the light too.

Valli: [00:19:03] Yeah.

Valli: [00:19:05] I, I just love storytelling, I always have, I love reading and hearing other people's stories. And so probably the most meaningful thing that's happened besides having this for my kids, for them someday, is having people who connect in different parts resonate parts you would never expect, like the story I shared about being on my yoga mat and having a complete breakdown. I've had quite a few people say I have had that moment over something different, but literally come to Jesus moment on a yoga mat. And runners of the parts of my marathon training have resonated with runners. A lot of people about grief, of losing people because my dad and he. It's not a I'm not giving anything away, but he dies when he's 50 and that really shapes me. And people who have lost loved ones particularly young, that really resonates. And I love that because it just connects us.

Carrie: [00:20:18] Yeah, well I had I'm going to ask you if you have a favorite chapter, but I picked out a couple of points that kind of resonate, resonated and I thought would resonate with listeners too. So do you want to share your favorite chapter, or do you want to hear some of the things that I picked out?

Valli: [00:20:37] Oh, really excited and curious to hear what you have to say, and I would. I have some chapters. Like every once in a while I'll skim through it when somebody refers back to something because it's almost like it's a big blur. You would think I would know where every single word was, but like someone will say, I loved this part and I have to go digging for it, and sometimes I'll skim and. And there are still parts that make me cry. And I would say one of the most. Poignant moments.

Valli: [00:21:13] Um.

Valli: [00:21:14] There's a lot, but. I love the story I shared about my dad in the van, my mom backing into his car. With her custom van. And then I also love the description I use sharing me and my son snorkeling together and seeing that sea turtle and him putting his hand on my shoulder and giving me like a thumbs up that you've got this mom, because that visual is still crystal clear in my head. And now I have it in like an essay. So, you know, when I'm, you know, God willing, 9500 years old, that memory will still be there. But they're like your kids. They're all your favorites.

Carrie: [00:22:04] Okay, well, I have a couple of things that I thought I would ask, so. And I and I wrote something down. So I'm going to read a couple of things because like you said, you probably need to jog your memory. Right. So in chapter 16 it was titled I Am here. And you talk about throwing up the white flag and dragging yourself into a therapy room. And I think as women, as mothers, as caretakers, we sometimes think we need to carry all of that weight and be strong at all times. Can you share how you came to the realization that we, whoever is listening, also need to throw up that white flag in certain situations?

Valli: [00:22:48] I hope I have friends that write about it. They write about therapy. They write about depression, mental health. Like a lot of my online circle of authors and friends write a lot about it. And I think the more we normalize. These discussions that motherhood. Parenting is hard. A military. Being a military spouse is hard, like losing a loved one is hard. Having a child identified with something out of the ordinary that requires extra medical is hard and just being allowed and safe to say. It's hard. It's both. I think I do write about it can be both. It can be hard and amazing and it doesn't make you feel. It shouldn't make you. Anyone think you're a bad mother. You're complaining. You don't. You're not grateful. Um, I think therapy. I'm a huge fan of therapy. I am a huge fan for my kids, for my marriage, for myself. Like I think it's so even when things are good. To just reflect and make sense of things. I think it's just I think it's really healthy. So I went a long time in life thinking I just needed to suck it up and put on this. I don't know, perception that I was just so strong. And I had a moment. I'm not going to go into it, but where I was walking my dog when it happened, and I just felt the weight of what I had endured on my shoulders like. This has been hard. This has been really hard.

Valli: [00:24:43] We need to talk about the hard more. So people don't feel as alone because most likely someone else is going to throw their hands up and say, oh my gosh, me too. Like, I had a my first piece I wrote about military being a military spouse and deployment.

Valli: [00:25:30] Went.

Valli: [00:25:31] Viral.

Valli: [00:25:33] And.

Valli: [00:25:33] I could not believe how many people were saying, oh my gosh, me too! I've always wanted to say this, but I was afraid I was going to be judged. People were going to say, well, you knew what you were getting into or you're not, you know, you're not supportive, you're not patriotic, you're not this, you're not that. And it was like almost like ripping the band aid off to say, yeah, I, I'm married to a colonel in the Marine Corps. I've been with him his entire career. I've never stood in the way. I've been a supportive spouse, and it's been hard.

Carrie: [00:26:11] Yeah, well, I think putting that out there so other people realize it's okay to put the white flag up and wave it and be like and have a community of people that you can go to and talk to. And whether it's professional or your so-called friends and family around you is so important too. Yeah.

Valli: [00:26:34] For sure.

Carrie: [00:26:36] And then there's another chapter that you talk about being in the trenches and how one day you woke up and you have teenagers. So and that chapter, you reflect on decisions and emotion that you had and have as a hearing parent raising two deaf kids. So statistically speaking, that's probably like 90 to 90% of families. What can you say to parents or professionals listening today of like being in the trenches at the moment? And then all of a sudden you have they they grow up, but reflectively as a hearing parent, do you have any anything that you want to say?

Valli: [00:27:18] Oh, geez. Well, first, you know, it's very annoying when you have two toddlers, but when people say go so fast. But it's true. The day, the days are long and the years are fast. Is that the saying? But. Particularly people who are in a really hard maybe phase or season. You know, I can think back to like the pulling the devices off, if that's the route that, you know, if you're dealing with hearing aids or cochlear implants and. You just think it's never going to end and it totally ends. It's like phase. And I think that's why another theme in addition to The Fog is grace. And it took me a long time to be able to give it to myself. And I think that is what I would tell parents is to just give yourself grace through the process. It's, you know, it's challenging and it's okay to. You're going to make mistakes. You're going to sometimes maybe feel judged. You're going to get the opinions of so many people who want to tell you what you should do, how you should do it. I mean, that's just true in parenting in general, but. And with the internet because my babies you know, it's I write about it that, you know, it's before Facebook, it's before there's no social media groups and people can't comment and tell me, you know, I've made the wrong choice, or I should do this or I should do that. Like sometimes. Maybe parents now need it can be helpful to have that social media and. That connection, but it can also be too noisy. Letting the opinions of a few. Drown out what you think you know you've decided is best for your family.

Carrie: [00:29:22] Yeah, that's good advice. I like that it's it is noisy and so how can you kind of clear some of that fog. Right. That you, you talk about so you know and feel in your heart that you've made the best decision for your family.

Valli: [00:29:38] Yeah. I think also be willing. I feel like luckily we were pretty open to pivoting. And learn as we go. I didn't think I had to know it all. And if we had tried something that didn't work, we were kind of open to trying something different. So don't dig in and be set. There's not one way. And each kid is so different. I mean, I have two kids, same syndrome, and they experience it so differently. It's really they should be studied these two. They really should. I mean, I think siblings would be a really interesting. Thing to look at is just how different their experience is.

Carrie: [00:30:32] Right? Yeah, I know we always say like, especially if you have a boy and a girl like you do, like they live under the same household with the same family members, how can they be so different in different things? But it would be interesting to as far as hearing loss goes, to see if there's anything that stands out that way.

Valli: [00:30:53] Yeah, I think it would be. Um, and then the flip side, they're so different. Yet sometimes, like last weekend, we were at my brother's house and the two of them were in the pool together. It was just the two of them. And they were talking. It was probably for like two hours straight.

Valli: [00:31:12] Um.

Valli: [00:31:13] Floating and talking. And I'm like, they have a connection that is like nobody else in this world has, like, the two of them. It's it's really fun to see.

Carrie: [00:31:25] So just a side question. Did they do they have water devices for the cochleas or were they like just trying to read each other's lips or what were they doing.

Valli: [00:31:37] So in this case, they both had their devices on without the water cases, which, you know, normally I'd be like, you know, we're on, we're on a trip. This is a bad idea. But it was like kind of they kind of controlled the environment of just floating.

Valli: [00:31:51] Yeah.

Valli: [00:31:52] But even when like. So Battle will use his water ear and Harper because she still has residual hearing on one side. She's only single a single. What's it called.

Carrie: [00:32:04] Bimodal or. Yeah.

Valli: [00:32:06] Bimodal.

Carrie: [00:32:07] So yeah.

Valli: [00:32:08] Yeah.

Valli: [00:32:09] So she still has a residual hearing which she shouldn't really be able to make out speech as well as she does. But it's as if she's still wearing her devices. It's strange. They can communicate.

Valli: [00:32:25] Um.

Valli: [00:32:26] Yeah. It's.

Valli: [00:32:27] Yeah, it's.

Carrie: [00:32:28] Well, that was a little side note when you said that. I was like, oh, that's interesting. That connection between between them.

Valli: [00:32:35] But parents piece of advice, if your child is not 18 and doesn't understand actually, you know, impulse control and all this stuff, I would never let them be in a, in the water with their devices on and think they're not going to go under like.

Valli: [00:32:51] Right. Yeah. It's been a lot of.

Valli: [00:32:53] Years in the making and all their cousins know and everything. So like you're not going to jump in and Cannonball and.

Carrie: [00:33:00] Yeah yeah yeah.

Carrie: [00:33:02] And then you have a mini heart attack in the process. Right. Thinking about that. Oh so you did know earlier that the days are long, but the years are short. And since writing and publishing this book, Battle and Harper are a little bit older and entering almost into, like the young adulthood of you, late teens and 20s. Before long, if you could add another chapter to Through the Fog, what would that title be and would do you have any thing that you jumps out to share?

Valli: [00:33:40] Oh, dear.

Valli: [00:33:42] That chapter still being written because now we're in the Battles going into senior year, and he's been been pretty heavily recruited for football. So we're going through this whole process pretty I mean, it's early in. He still has a senior year ahead of him. But it's the preparing to launch. And I know this is going to be filled with lots of stuff.

Carrie: [00:34:09] Yeah.

Carrie: [00:34:10] So that's the title preparing to launch.

Valli: [00:34:12] Right to launch.

Carrie: [00:34:14] Love it.

Valli: [00:34:15] I'm tethering. Just trying to mentally prepare. Um, baby steps I can't imagine. I mean, I still can't imagine.

Carrie: [00:34:26] Yeah, it goes like you said. It goes really fast. I have a daughter who will be a senior this year too. So that lots of decision to be made in the next year.

Valli: [00:34:38] Yeah. It's again, how did we get here? I'm so proud of the kids though. I mean, I'm it is really this stage in life is so fun to see who like they really are. You know, you see who they're becoming. And I love hanging out with them. You know, it's traveling is fun. Like, just hanging out is fun. They're really interesting, cool people. I like the people they are so.

Carrie: [00:35:08] Yeah.

Valli: [00:35:09] Worth the wait.

Carrie: [00:35:10] It's worth the wait. In the moment it's hard. But reflectively you get through and you're always going to be their mom. So you're always going to have some kind of fog that you're going to be looking through.

Valli: [00:35:25] Exactly.

Valli: [00:35:26] That's what my mom says. She's like, you think kids are stressful? Wait till you have grandkids. You know, you worry about them even more. I'm like, oh dear goodness. But that's what for anyone who's in the fog, you know, and you in the young, you know, the younger years.

Valli: [00:35:45] Um, it's.

Valli: [00:35:46] Just like, stay the course. It's gonna pay off everything you invest in your kids. It does. It pays off.

Carrie: [00:35:53] And then you enjoy it differently later. Later on.

Valli: [00:35:58] Yes.

Valli: [00:35:59] That's the goal.

Carrie: [00:36:00] Yeah.

Carrie: [00:36:00] So wrapping up today Valli with today's episode. Do you have any final thoughts that you want to share?

Valli: [00:36:09] Besides, I hope we get to see each other in person.

Valli: [00:36:12] No.

Valli: [00:36:14] I don't know. I hope that people will support the book. It's, you know, it's a labor of love. I don't have a marketing team. It's just me. It's available on Amazon. I love hearing people's feedback. Um, the reviews are very helpful. And then just following along on social media so we can connect. I really read every comment. I respond to as many as I can. My message is like, I love connecting with people and hearing their stories. So, um. I would love to hear from people.

Carrie: [00:36:51] Well, I just want to say thank you again for being a guest on the empowEAR Audiology podcast. And like I said earlier, I will link up the previous episode if people want to go back to that. And as you said, people can get onto your web page, My Battle Call and I can link that up too. And they can find your book on Amazon and order it and have it delivered right to their house, too.

Valli: [00:37:19] Oh, I know.

Valli: [00:37:19] What I was going to say is for organizations, audiologists, class classes, groups, I can also do bulk author copies for a better rate and ship them right to those. I've done it for quite a few. Our audiologist has a stack of them on hand that she gives out to new parents, and so somebody if anyone's interested in that, I'd love to offer that for people. They can contact me through my website. I think my email address is on there or through any of my social media. They can message me, just say they heard about the book. Book bundles.

Carrie: [00:37:57] All right. Well, that's a great way to get the book out there, and probably a great tool for parents to have and read. So again, thank you, Valli, for being a guest. And, um, I can't wait to meet you in person sometime soon.

Valli: [00:38:14] Thanks, Carrie. Take care.

Announcer: [00:38:16] Thank you for listening. This has been a production of the 3C Digital Media Network.

Episode 60: empowEAR Audiology - Drs. Ashton and Riley

Announcer: [00:00:00] Welcome to episode 60 of empowEAR Audiology with Dr. Carrie Spangler.

Carrie: [00:00:14] Welcome to the empowEAR Audiology Podcast, a production of the 3C Digital Media Network. I am your host, Dr. Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today, and let's get started with today's episode. Welcome everyone. It is Educational Audiology Awareness Week and this is going to be from October 16th through the 20th and it's 2023. And it is an honor to be able to coordinate with the Educational Audiology Association leadership to spread awareness. The goal of the Educational Audiology Awareness Week is to foster public awareness and knowledge of educational audiology services, including the benefits that these essential services provide children, their caregivers and other professionals. And the mission is to educate our stakeholders by enhancing interprofessional perception of educational audiology and strengthening community knowledge through promotion, outreach and advocacy efforts. And today on the EmpowEAR Audiology Podcast, I have leadership from the Educational Audiology Association. Joining me today, I have Dr. Tori Ashton, who is the president elect of EAA, and Dr. Kathi Riley, who is the vice president of Advocacy. And I'm just going to share a little bit about both of them, and I'm going to welcome them onto the podcast.

Carrie: [00:01:57] So we have Tori, who will be starting her ninth year as an educational audiologist with a cooperative educational service agency number 4 in Wisconsin. She provides services to 12 school districts within a 60 mile radius. Tori started as one of the Wisconsin state reps for EAA and then became the VP of Membership and Public Relations for three years, and she is currently the president elect for EAA. And I also have Kathi with me, who was an educational audiologist for 34 years in Delaware, where she provided services to students at the Delaware School for the Deaf and provided outreach and consult services across this tiny state through Delaware statewide program for the deaf, hard of hearing, and deaf blind. She now teaches educational audiology and oil rehab at the university level. Kathi has been an EAA state rep for Delaware for many years and she joined the advocacy committee a number of years ago and accepted the role as VP for Advocacy two years ago. So Kathi and Tori, welcome to the podcast and I'm so excited to collaborate for Audiology Educational Audiology Awareness Week.

Tori: [00:03:19] Hello.

Kathi: [00:03:21] Thank you.

Carrie: [00:03:22] Thanks for being here. What an exciting week as we kick off this week and just to kind of get the conversation started, I thought I would ask Tori or I mean, Kathi, how did the idea of Educational Audiology Awareness Week come about?

Kathi: [00:03:42] Well, it actually happened very organically. We had a member who on our community page, our listserv posted a request for ideas and templates for creating a PowerPoint. She was asked to do a professional development activity for her school district and she was looking for some ideas. That then led to several responses and one member kind of sparked this idea that we could create a national EAA day or a week to promote our profession. So the idea was approved by the board, and then a subcommittee was set up for this project and it was placed under the advocacy umbrella.

Carrie: [00:04:29] All right. And that's how you've been really involved in this. And Tori for listeners who might not know what the Educational Audiology Association is, can you share a little bit about this great group?

Tori: [00:04:43] Yeah. So we are an international organization that consists of audiology or audiologists as well as related hearing professionals. So that could be speech language pathologists, our teachers of the deaf and hard of hearing. We provide a full spectrum of hearing services to children, primarily those in educational settings.

Carrie: [00:05:05] Okay. And so when we have an educational audiology week and we're really focusing on that, how is that different than maybe a pediatric audiologist or a clinical audiologist? I feel like there's so many different roles that audiologists can play, but what is kind of that difference with education?

Tori: [00:05:26] Sure. So the difference mainly is or I feel is the location that we work in. So for educational, obviously we're primarily in the schools. Um. You know, we do a lot of similar things to clinical or pediatric, but there's also things that we do that aren't done at the clinic. So we might assess how a student is hearing in a classroom, um, provide accommodations and modifications for them so that they're successful in those classroom settings. Um, we also help schools with hearing screenings and promoting good listening environments with classrooms. Um, and then just making sure our students have the full access to their education. Where clinical is more in the clinic testing, hearing, fitting the hearing aids. There is um, collaboration between the two, but also a lot of cross of what we do. Kathi, i f you have anything you want to add to that?

Kathi: [00:06:29] Sure. You know, I think one of the issues is that programs, most of them do not have strong educator national background provided in terms of educational audiology. So the learning curve is very steep from being a clinical audiologist to being an educational audiologist. Educational audiology requires you not only to know all of your audiology, but also to understand the entire education system and how it works. We all know both regular and special ed law. We focus on classroom acoustics and how the environment impacts access to instruction. We coach teachers on effective teaching strategies. We manage and fit their hearing assistive technologies across the school day, which might look different in different environments. We take data on the effectiveness of those and we make recommendations for changes to their IEP or 504. We sit in on those meetings and we are an advocate for the student.

Carrie: [00:07:41] And does a student legally need to have an educational audiologist on their team, or is this just something that might be nice to add?

Tori: [00:07:56] I mean, legally it is in IDEA that they have access to educational audiologists. Um, each state does have different criteria that to for a child to receive an IEP or to qualify for a 504, you do have to go through the steps and show the evidence that they do need those added supports. Um, but legally, yes, they can all have access to it if they qualify for it.

Kathi: [00:08:24] Right. Right. That makes.

Carrie: [00:08:26] Sense. Go ahead, Kathi.

Kathi: [00:08:27] We are also working on strengthening the regulations around children who have 504s and their access to educational audiology. Educational audiology is by far the least utilized service that appears in IDEA. And there's a misconception that it is only a medically based service rather than an educational service. So we are working hard as an organization to change that perception and part of our EAA awareness week is to get the word out about who we are and what we do.

Carrie: [00:09:05] But that makes a lot of sense.  In addition to the advocacy that we do as educational audiologist for students who are deaf and hard of hearing, who have maybe auditory processing, different auditory needs within the classroom, educational audiologist are also concerned about ALL kids who are learning in the classroom. And I know through the advocacy work that EAA has done, you have been working on a couple of different projects that really promote access for any child that is being educated. Do you want to share a little bit about some of those other projects that EAA is working on?

Kathi: [00:09:53] Sure, um, part of our role in the advocacy committee is to create resource documents that provide best practice or best guidance, best practice guidance for educational audiologists in a wide variety of situations and responsibilities that we encounter. And we hope that those members then can use those documents to advocate for specific practices and share that with administrators, teachers, school professionals. So one of the things we've been working a lot on lately is hearing screening importance, and ASHA is actually rewriting their guidelines for the practice portal. So we've been involved in that. And oversight of the hearing screening program is one of the responsibilities that is written into IDEA for audiology. So we've been working a lot on that arena, especially on a document that explains the legal rights of hearing screening for children with significant disabilities who are often overlooked or marked as could not test. We also have another subcommittee that's working on classroom acoustics. So we have a committee that has not only audiologists but researchers and an architect and an acoustical engineer. And we are working hard to update classroom acoustic regulations across the US. So part of that work we created a one page document that explains the components of acoustics and how it decreases auditory access for deaf and hard of hearing children, as well as other children with special learning needs, such as kids with auditory processing disorders, children who are English language learners, children who have attention issues, and a whole host of other kids. So we're really proud of that and we hope that educational audiologists will share that with their school teams.

Carrie: [00:12:00] That mean educational audiologists really wear quite a few hats when you think about it in the school and educational setting from the advocacy piece to actually working directly with students and teachers and teams and parents and everyone that is involved. So it's exciting to be in the schools and be an educational audiologist and this week is so amazing because we get to really promote everything that we are doing. And one of the things that I thought we could talk about next would be what are some of these activities that we have planned for Educational Audiology Week? Does somebody want to just share some of the excitement that's going to be happening this week?

Tori: [00:12:52] Yeah, I can touch on. So for like social media, we are encouraging, you know, all educational audiologists to share on their social media throughout the week. Um, you know, whether it's sharing those advocacy documents that we have, um, different graphics that might be posted up by EAA if they reshare them and just kind of getting the word out that way. Along with that, We do have two primary hashtags that people can use when they're making their posts. We have hashtags for #EdAuDweek and then at #EdAuDadvocacy.

Kathi: [00:13:31] Right? The other things that we're working on is a Zoom background that educational audiologist will be able to download. And we actually have come up with three of them. One is for Educational Audiology Week, and then the other two are simply Educational Audiology Association and those are going to be approved by the board hopefully next week and then they'll be posted on our. You'll be able to, to find them by using the QR code that we have created. So the educational audiology QR code right now that page is blank, but we are working on getting everything uploaded into that. Unfortunately, Facebook has really restricted who can have a ribbon. So you know that frame for Facebook, you have to be an approved and recognized organization. So that won't be able to happen this year, but we hope to have it in the upcoming years because we do expect this to be an annual event in the third week of October.

Carrie: [00:14:48] Okay. So that was another question. Is this going to be an annual event? And Kathi, you just said that it will be. So that is that is exciting, too. For the activities. Do you guys have different topics that you're going to kind of be sharing out on social media every day that really highlight educational audiologist or educational audiology week or that a surprise for all of us to see this week?

Kathi: [00:15:17] We actually are targeting different groups every day. So our infographics will be hopefully valuable to a variety of stakeholders. So school administrators, parents, clinical audiologists. I actually forget what the other two are. But we have a different we have a different focus for every single day. And we have different team members from this subcommittee who are putting together the resources for that.

Carrie: [00:15:50] Well, what a great way to share out and for educational audiologists to have access to important resources to share with their school teams and families and whoever they might might might need to raise that awareness about for educational audiology during that week. Is there anything else that you guys can think of that you want to share as we kick off Educational Audiology Awareness Week?

Tori: [00:16:18] I think we're all just very excited about it. This is something new and a great way for us to obviously bring what educational audiology is more out there to everyone, you know, whether it's our schools, our families, just explaining what we do and then how we can support schools and our students.

Carrie: [00:16:41] And how would people make sure that they're getting that information if they maybe if they're not a member of EAA, how can they find membership information and how can they make sure they stay in the loo this week as we kick off Educational Audiology Awareness Week?

Tori: [00:17:01] And they can always go to our website which edaud.org. And there's all kinds of information not only about this week and what will be taking place and different links to our um, you know, like our zoom backgrounds like Kathi mentioned and those different. Outreach advocacy documents, but also about our membership and who we are and just more information about us as an organization.

Kathi: [00:17:31] And don't forget social media. So we have a team that works on social media. And so there will be posts on all of our social media sites. So that's a great way to take a quick look at what's there and download it and share it with colleagues.

Carrie: [00:17:51] Yeah, share it, put the hashtag out there for everyone and it would be a great way to promote. So Tori and Kathi, thank you for joining today for the kickoff of the Educational Audiology Awareness Week. And we're just hoping that all of our members and hopefully new members really join us and promoting everything that we have to offer as educational audiologist in the schools. So thank you.

Tori: [00:18:20] Thank you.

Kathi: [00:18:21] Thank you.

Announcer: [00:18:22] Thank you for listening. This has been a production of the 3C Digital Media Network.

Episode 59: empowEAR Audiology - Dr. Erika Gagnon and Erin Thompson

Announcer: [00:00:00] Welcome to episode 59 of emmpowEAR Audiology with Dr. Carrie Spangler.

Carrie: [00:00:14] Welcome to the empowEAR Audiology Podcast, a production of the 3C Digital Media Network. I am your host, Dr. Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today, and let's get started with today's episode. Today I have two guests from North Carolina with me, and I am going to take a second and read a little bit about their bios. They are an SLP and audiology duo. I have Erin Thompson, who has been working with the Children's Cochlear Implant Center at University of North Carolina since July of 2004. She earned her bachelor's from Appalachian State University and her master's in speech and hearing science from UNC Chapel Hill. She became a listening and spoken language specialist in 2009. Erin conducts listening and spoken language parent participation sessions, speech and language diagnostics for children who are deaf and hard of hearing. A passion has been mentoring students and professionals across North Carolina, the US and abroad. Erin has been a member of the Global Foundation for Children with hearing Loss and has traveled to Vietnam on three occasions and also Mongolia on one occasion to help provide mentoring and training abroad. She has spent time coaching a team of speech language pathologists in Auckland, New Zealand. Erin expanded her interest in 2019 to include the role of Family Care coordinator for the Children's Cochlear Implant Center at UNC. She helps manage, facilitate and coordinate cochlear implant consultation referrals supporting all families through the CI consult process at UNC. I also have Dr. Erika Gannon. She is earned her bachelor's and doctorates in theology from the University of North Carolina at Chapel Hill. She is a pediatric cochlear implant audiologist at the Children's Cochlear Implant Center at UNC. In addition, she is the Audiology Clinic manager and program director of the CDP Grant. Erika's research interests include pediatric cochlear implant, device use and pediatric electric acoustic stimulation. Erika enjoys teaching and mentoring students. She co-teaches the cochlear implant course to UNC's audiology graduate students. So Erin and Erika, welcome to the EmpowEAR Audiology podcast. I'm so excited to have both of you.

Erin: [00:03:03] Thank you so much for having us. This is really great.

Carrie: [00:03:07] Yeah. So I know before the podcast started, we spoke a little bit and I had heard Erin talk at, I believe, the AmErikan Cochlear Implant Alliance Conference as well as the EDHI conference. And then as I reached out to Erin, she also looped in Dr. Gannon and Erika. And we to talk about two important topics today. And I am really excited for our listeners to hear all about their work with full time use of hearing technology and its impact on language development, as well as the importance of co-treatment and strength based coaching to impact device where time and probably many other things with strength based coaching. So I am glad both of you are here and because this is kind of a audiology, professional and related services podcast, I always like to find out from my guests, how did you actually venture into the field of audiology and speech language pathology? So I don't know. Erin Do you want to start with your venturing into speech language pathology?

Erin: [00:04:23] Sure. This is kind of funny because I think it's kind of a throw out to like all the moms out there who encourage their kids or think, Hey, you'd probably be really great at X, Y or Z. And my mom in high school was like, Really I think you'd be great as a speech pathologist? And I took one of those, or she had said that and I had taken one of those personality typing, What should you be when you grow up kind of thing? And speech pathology and audiology were in the top three and I was like, Oh, absolutely not. My mom wants me to do this. No way am I doing this. So I went in. I went to Appalachian, undeclared and undecided. And my roommate at App my freshman year was in the speech pathology program. And so I got to see what she was doing and I was like, you know what? Maybe I do want to take some intro classes. And so I did and loved it and then had the challenge when I graduated from APP. On whether I wanted to go into speech or audiology. I was really torn and then found my my perfect match at UNC as a speech pathologist working with kids with hearing loss. So kind of a perfect fit. So that's a.

Carrie: [00:05:43] Great story about my mom's, right? Yeah. I was just going to say, your mom's always right. Right? Yeah. Um, Erika, how did you venture into audiology?

Erika: [00:05:55] I knew I always wanted to be in health care. I originally thought I wanted to be a nurse and figured out quickly that I don't do needles or blood. And so as I was trying to explore other options that still left me in health care, I had a friend who was in the audiology program and recommended I observe a little bit and I was volunteering at the hospital and got to observe someone like two weeks out from their cochlear implant activation. And I was I was hooked ever since.

Carrie: [00:06:26] Another great story, too. So both of you are at UNC. Do you want to do you want to share a little bit about the Children's Cochlear Implant Center? There you have a lot of great people that are part of your network. So one of you wants to take that lead.

Erika: [00:06:46] Sure. So the Children's Cochlear Implant Center at UNC. We've been seeing children with hearing loss in North Carolina for over 30 years and have performed over 2000 pediatric cochlear implants. We are a part of a multidisciplinary team and we have both pediatric cochlear implant audiologists, speech language pathologists that specialize in listening and spoken language. We also have a pediatric research group in the office as well, and we are a teaching clinic for both audiology and speech language pathology grad students, and we work with a greater interdisciplinary team at UNC, with our pediatric pediatric diagnostic team and our ear, nose and throat physicians.

Carrie: [00:07:30] Yeah, lots of opportunities to see lots of kids and be involved in a lot of research, which kind of is a great segway into the things that both of you are interested in, and that is that language development and how that impacts kids who are deaf and hard of hearing. And I think when you think about the world of pediatric deafness, a lot of the studies talk about the importance of early identification. We have newborn hearing screening, all of those important things. We talk a lot about technology and early interventions as part of language development, but one of the things that is typically not talked about that your group has spent a lot of time on, is that focus on on wear time can you one of you start sharing a little bit about your research and clinical experience in this in this area and why this is really important to consider?

Erika: [00:08:26] Sure. So wear time or getting the objective data from the speech processor regarding device usage for cochlear implants is a lot more recent than it is for hearing aids. We've only had access to this since maybe around 2014 or 2015. And so as this as a clinician, as this information became available, we felt like this was really a game changer because we're like, is this explaining why somebody isn't doing as well as we would want or not making the progress that we'd expected? And so we just we had all of this new information about patients we were seeing, you know, different where time and trends for babies versus teenagers. And it felt like we really had this key piece to something important. And so we really wanted to dive harder into that. And so we've looked at some some wear time information for this youngest group of babies, like birth to three. We have several articles on that. And also have looked a little bit about where time and the single sided deafness population.

Carrie: [00:09:32] So when, as you said, you know, for cochlear implants, this is been about 2014, 2015 that we've been able to have this data logging and hearing aids was a little before that. But again, a lot of great information. Do you as practitioners, whether from speech pathology, audiology? Do you ever ask parents like, Hey, how often is your child wearing the cochlear implant? And then do you ever see kind of a mismatch between what you're pulling up on the computer and what a parent might be reporting?

Erika: [00:10:09] Yes. We always try and ask the question, How's it going? How? How is wear time device use, especially, you know, use of like retention Aids. And unfortunately there is a trend that. Over or over reporting device usage. Parents often say they're wearing it more than the objective data shows. This is a trend in more than just cochlear implants. It's also present in hearing aid literature as well. And I think it's likely just little ones are so dynamic with eating and napping and multiple care providers. I think it's I think it's easy to overestimate the usage.

Carrie: [00:10:47] And that's kind of another way that you started thinking about looking at this was looking at this concept of hearing hours percentage. Can you share or explain what this is and why this might be a better way of looking at things rather than like kind of full time usage?

Erika: [00:11:10] Sure. So full time usage in the literature, it wasn't consistent. We were seeing, you know, 8 hours or 10 hours or clinicians were using phrases like eyes open ears on, which is a wonderful phrase and a and a great goal for parents. But sometimes, you know, that vague term isn't concrete. And then 8 or 10 hours, we were just seeing that, you know.

Erika: [00:11:34] It.

Erika: [00:11:35] Sleep wake time is so different for babies versus teenagers that.

Erika: [00:11:41] You know what is.

Erika: [00:11:41] Actually the best way to talk about wear time. So we noticed trends are like teenagers are wearing their equipment, more toddlers are wearing their equipment a little less. And we started to incorporate the sleep wake into how we define full time use or this hearing hours percentage. This was first published and Lisa Parks age at full time use predicts language outcomes better than age of surgery. In children who use cochlear implants and essentially the takes where time as a percentage of wake time based on the age of the child. So an example is a 15 year old is awake 15.5 hours a day on average. A 12 month old is awake 11 hours a day. If you take eight hours, if we were using, you know, full time use at eight hours for the 12 month old, that's 73% of their waking hours. But for a 15 year old, it's only 52% of their waking hours. So HHP better reflected the age of the patient.

Carrie: [00:12:43] Wow. Just out simple example right there with the difference of the age and the average sleep time really is telling of the you know, what we want to achieve. Is there a. I guess, percentage that as audiologists and speech language pathologist you would like to see for the hearing hours percentage.

Erika: [00:13:09] We would always love it to be 100%, but we are practical. Our research has found 80 to 100% is really the goal.

Carrie: [00:13:19] Okay, that makes sense. So it kind of factors in maybe bath time, shower times, those waking up and just kind of getting started with your day and then kind of going to bed having a couple of hours right there.

Erin: [00:13:33] Yeah. And that's where we really saw the research to show that kids had typical language scores when they hit that 80%. And that's where we were really seeing kind of the magic number kind of all align. 80% equaled some of those those stellar language scores.

Carrie: [00:13:52] Okay. And yeah, I would love to dig a little bit deeper into that as well. One of the other questions I know, Erika, you had mentioned that you there was some different research, too, with single sided deafness. And, you know, we're seeing younger kids get cochlear implants who have maybe typical hearing in one ear and a profound hearing loss in the other ear. Does the hearing hours percentage matter for those kids, too?

Erika: [00:14:25] Yes.

Erika: [00:14:26] So. The information we have for the single sided deafness. Population isn't for language scores on the whole, but we have that linked with single word scores for CNc, and so the higher the hearing hours percentage, the better the CNC outcome. There's also a positive correlation with HP and spatial release of masking scores. So a true measure of binaural hearing. So we are seeing that HP is a factor for those things in that single sided deafness population.

Carrie: [00:15:00] Okay. Do you see that? This is just a sidebar question to more acceptance of the cochlear implant if they increase their wear time to. What have you not looked into that.

Erika: [00:15:14] For.

Erika: [00:15:15] Patients or in.

Erika: [00:15:16] General, just.

Carrie: [00:15:18] Patient? Because I know sometimes they may not always kind of acclimate to the cochlear implant, but do you find that with the increased hearing hours percentage, they may acclimate or be better users of the cochlear implant?

Erika: [00:15:34] What we saw was.

Erika: [00:15:35] That as kids got into their teenage years wear time dropped. And we think that's just a matter of calling attention to something and kind of those really vulnerable teenage years, but started to see an uptick as patients got a little bit older. So I'm hoping once they get past some of those teenage years, we can expand our data and and look a little bit more into that. But honestly, a lot of it was related to age.

Carrie: [00:16:01] Okay. That makes sense too. So I know that article that both of you authored with some of your colleagues titled Age at Full Time Use predicts language outcomes better than age of surgery and children who use cochlear implants. And you kind of touched on this a little bit, but you found that for both receptive and expressive language, age of full time use was found to be a better predictor of outcomes than than the age at the surgery. So in your literature, you also found that it took an average of 17 months for children to establish that use, and only 52% reached that milestone by the age of three. So as you guys are thinking about where you're at in a big cochlear implant center and co treating and certain occasions and thinking about that whole child and the family and everybody else that's involved. Educators, early interventionist. What are some of those factors that might contribute to that statistic? Because I feel like. That is kind of a lower statistic overall.

Erin: [00:17:13] Yeah. So a couple of things there. I'm going to take over for a second and kind of jump in. Um, one of the things is that I want to touch on because I always stress this in our presentations as well whenever we're talking about this. We were finding that full time use is a better predictor of language outcomes at age three than age of surgery. We are just clear, always clarify. We are not questioning or saying that they shouldn't have surgery later, that we still absolutely you know, are proponents and promoting earlier is better. We aren't questioning that. We aren't looking we're not changing that at all. But they do have to wear it after surgery. You can have surgery at any time at six months. Not that we're doing them at six months right now, but eight months, 12 months. But if they aren't wearing it, then it does impact outcomes. Um, but back to the, you know, it takes an average of 17 months to reach full time use and only 52% did that by age three. It's almost, you know, the question of what are the factors that contribute to this.

Erin: [00:18:20] It's almost in reverse of what doesn't impact this. Everything impacts it. Um, some of the first things that we that I think folks notice or think about are any additional diagnoses. Are there other things that are even more of the higher priority for a child's health and well-being is and taking care of of those other health factors. Um sensory needs we find impact where time we of course see differences with different socioeconomic factors, parents schedules, um, kids at home versus in daycare potentially pending what education or what the what the what the the families or the child care providers have been taught about the importance of where time not that they aren't educated, but what have they been taught about where time and how important that is. Um, distance from school, distance from clinics, those kinds of things. Then the access to that education about the importance of, of wear time and then sometimes just the differences in counseling techniques and coaching techniques and, and how have their school providers, clinic providers, private providers, audiologists, um, pediatricians, ENTs explained the importance so many things have have impacted and can impact this these statistics.

Carrie: [00:19:58] Yeah, which is, I think, a great way to kind of get into what your team at UNC has really looked at to try to maybe close some of those gaps and increase the number that reached that milestone by three years of age. And I think our conversation about hearing hours percentages is really an important factor in that too. But one thing that you have shared is that you have talked about the need for strength based coaching, and that's really helping with working with families. Can you share a little bit more about this model too, of co treating with audiology and speech and how this really impacts families as a as a whole?

Erin: [00:20:46] Absolutely. So the the quick, easy definition of co treating is audiologists and speech pathologists working together in an appointment and treating a child and family at the same time. Um, it's something that has kind of been brewing at UNC since 2011 when we actually got to hear Dimitry Dornan and the Hear and Say crew from Australia talk at the AG Bell Conference in Scottsdale, Arizona back in 2011. But then we weren't able to kind of put it into practice at UNC until a few years later. We had our director at the time had to work to find some grant money to help us be able to account for our time because you couldn't bill for coach reading. Um, and so we were able to, to put that in into play in 2015. But in depth it's speech pathologists and audiologists collaborating. We talk ahead of time before an appointment to see what are the needs of that child and family. What are some things that we want to work on together? Um, make a goal. Make a plan. We collect information during the appointments about auditory skills, we use our functional listening index to track audiological audiology skills, audition skills. Um, we are providing caregiver support and that's where our strengths based coaching comes in. And then we are also communicating afterwards. We're talking to local providers, sharing, updating school professionals, educational audiologists, early interventionists, private therapists. So we're all kind of working on the same page. Um. And then that kind of leads into that strength based coaching. Yes.

Carrie: [00:22:44] So share a little bit more about that and how your team's kind of been trained and how that impacts family connections.

Erin: [00:22:53] Um, yeah. So we have all and Erika has done this as well. Think all the audiologists have had some level of training exposure to the formal, um, program, which is through the Center for School Transformation. Um, and it is an Evocative Coaching, strengths based coaching program that we have all been through. Um, and it is looking at things and very asset based, strengths based taking what is important and a strength for a professional, a parent and building off of that. Um, in all very positive ways. Um, it is learner driven. It's what is important to the family and it's based on evocative coaching and positive psychology, adult learning theory, appreciative inquiry and nonviolent communication so that you should do versus how could you what would you want to do? What would that look like moving forward with your family?

Carrie: [00:24:02] So if I would put both of you on the spot here as kind of thinking about all of the topics we've talked about in particular, like maybe you have a family who comes in and says, hey, you know, I'm