EPISODE 31

[INTRODUCTION]

[00:00:01] DAKOTAS: Our scope of practice is full of a wide variety of assessments, interventions, and clinical skills, most of which we receive extensive training for prior to graduation. What you might not find within your curriculum are lessons on leadership and advocacy, and how to specifically pursue opportunities to further and represent the profession. Leaders within a field are responsible for key decision-making, enacting policies, providing a face for the public, both, I guess, in the good and the bad. What does it take to become a leader within your field and where do you start? 

Today's guest is going to share her journey through a variety of settings to now a position of leadership for the field. Dr. Donna Smiley, Ph.D., CCC-A is the Chief Staff Officer for Audiology at the American Speech-Language-Hearing Association. Prior to coming to ASHA, she was the coordinator for the educational audiology and speech pathology resources for schools EARS Program at Arkansas Children's Hospital. Dr. Smiley has practiced audiology for 30 years, co-authored a textbook about school-based audiology practice, that's School-Based Audiology from Plural Publishing, and was named a fellow of ASHA in 2018. She received her Ph.D. in hearing science from the University of Tennessee, Knoxville.

Just a financial disclosure, I’m the host of On the Ear and receive compensation from speechtherapypd.com.

[INTERVIEW]

[00:01:12] DAKOTAS: Introducing our esteemed, well-connected, as we were just talking about, guest, Dr. Donna Smiley. Donna, thank you so much for joining me.

[00:01:20] DONNAS: Well, thanks. It's really nice to be here. That introduction is a little scary, because I'm not sure that I can live up to all that, but I will do my best to share my experiences and what I know with you and your guests tonight.

[00:01:31] DAKOTAS: I think, it's only fair that you realize, you have earned this. You've clearly worked a lot of different places. You've done a lot for our profession. I'm already grateful right off the top. Why don't we talk about that then. I want to take it all the way back before, 30 years ago. I want to go 31 years ago. What drew you to audiology specifically? Why this field?

[00:01:51] DONNAS: That's a great question. Sadly, Dakota, we have to go a little further back than just 31 years, because –

[00:01:58] DAKOTAS: You don't have to [inaudible 00:01:58].

[00:01:59] DONNAS: Okay, I won’t. We would have to go back to when I was an undergrad student, I went to a small state-supported school in Arkansas. I actually went there to study nursing. I had a non-majors choir scholarship, which I was really proud of at the time. I had the opportunity to do some work-study for the professor, who was the – she was really the only professor in the Communication Sciences and Disorders Department.

The first time I ever met with her, her name is Dr. Martha Anderson. When I met with her, she said, “I'm going to get you to change your major.” She liked students who had a pretty deep science background. As a nursing major, you had to have lots of biology and chemistry.

[00:02:46] DAKOTAS: Yeah, sure.

[00:02:47] DONNAS: And those types of courses. At first, I said, “No, there's no way.” She had a Ph.D. in speech-language pathology, but she had recently finished getting her Cs in audiology. She had two projects that she was working on. One, that had to do with looking at how significant others rate the hearing handicap of their loved one that had hearing loss, and how did that compare to how the person rated their own issues with their hearing loss.

[00:03:16] DAKOTAS: Interesting.

[00:03:17] DONNAS: Yeah. She was also doing a study related to assistive listening devices, which when I think, back up to what we were dealing with, it was very archaic, certainly compared to what we have now. She really did entice me to come over to change my major. In the beginning of my junior year, I did. I really liked the audiology pieces. I liked the equipment, and I went to a really small program, and so there were very – We had a very small class. I remember, the other students would say, if they couldn't get the audiometer to work, or the Tympanometer, they would say, “Go get Donna. She likes that stuff.”

I really was drawn to the, certainly not just the equipment, but really the story, or the information that we could obtain with a Tympanometer and with the audiometer, and the picture that it began to draw about a person's issues with their hearing. I liked all of that stuff. I ended up doing a master's degree in audiology. I practiced for a while. Wanted to go back to school, so I went to the University of Tennessee.

The great thing, Dakota, is I really don't ever get up and think, “Gosh, I wish I'd done X, Y, or Z instead of audiology. I've truly to this day, really love much about what we get to do in this field. I'm grateful that she turned me on to audiology and really set me on that path.

[00:04:43] DAKOTAS: That's great. That's great. I love that story. I also agree with your draw. It's almost like, you're a detective solving a case. You're doing all the different tests to give you the pieces of information. When I'm describing differential diagnosis to my students, it's the best way to understand it is you're pulling pieces of evidence to get to the final culprit. That's great. That's great.

Okay, so I know you've had a lot of different clinical roles. It sounds like, you finish school and then, tell me about some of your early clinical roles. Then I know, the big picture here is we're talking about, you're in a really great position of leadership and advocacy for the field. I'm curious, as we're reflecting on those positions you've been in, what moments, or experiences drew you to take on a leadership role, maybe in those settings, or shine some of your leadership skills that would project you along to where you are today? Does that question make sense?

[00:05:34] DONNAS: It makes great sense. Sadly, for you, I love to talk about all those things.

[00:05:39] DAKOTAS: Not sadly for me. This is why we're here.

[00:05:41] DONNAS: Well, let me go back to that time when I was an undergrad, because one of the things that I think is really important in my own journey in leadership and advocacy for the field was that same person, Dr. Martha Anderson. One of the things that she really instilled in us was how important it was to participate in issues related to the field, to get involved with our state association, to pay attention to what was going on around us. That it wasn't just about getting up every day and going to a job, but that there would be times in which we had to advocate for either our profession, or the people that we served. I really did get some of that from her.

Then, when I finished my master's degree, I worked at Arkansas Children's Hospital. I actually have worked there on and off since the late 1980s, because I did some graduate student work there. I began to work there, and I saw patients in the clinic. This is back in the day when behind that your hearing aids were quite large, and we saw a big percentage of the pediatric patients in Arkansas.

One of the things that I became interested in was this idea of educational, or school-based audiology. I think, part of the issue for me was, I loved being that detective that you talked about, being that diagnostician, and helping a family navigate those initial parts of their journey of learning that their child had a hearing loss and getting new amplification and all of that. I wanted to figuratively go home with them. Because what I knew was that, while they were there with me, that we could make sure that they knew how to use the amplification, that they were gaining some information about what this meant for their child and the child's communication journey.

Especially in a state like Arkansas, and there are so many examples of this across the country. A state that's really rural, they were going to have some difficulties, because they were going to go back to a community, where their child might be the only child that had hearing loss. Their child might be the only child in school, or preschool that had hearing loss. There was not going to be a wealth of knowledge in those areas about how to work with that child, how to support that family.

It was just like, it was a calling. I really wanted to go with them. I ended up leaving Arkansas Children's as a clinical, or clinic-based audiologist and I became a consultant for the state, where I traveled, basically, all over the state and tried to support school staff in working with kids that were deaf and hard of hearing. The challenge with that is while I had some amazing people to work with, it was a lot. I basically had almost the entire state. We weren't doing what I would call true school-based audiology. It was more of a console-type model, which again, was certainly better than nothing. It was exhausting. it was a lot of travel and I was young.

I ended up coming to the – going to the university to teach for a bit, and then I ended up going back to school. When I came back to Arkansas after I did my Ph.D., I ended up teaching for several more years. Then, the door opened for me to have an opportunity to be a part of building a program of school-based audiology services in Arkansas. We did it as consultation or contracts through Arkansas Children's.

In terms of my professional journey, that's a lot about continuing to try to figure out how to get to do what I wanted to do. I'm very blessed that I have a lot of people along the way that opened doors and that saw my vision and saw what I really wanted to accomplish. When I left that position at the beginning of 2021, I left it in great hands with a team of audiologists and a couple of speech-language pathologists, who carry on that service today. I'm really thankful for that.

I think, part of being able to get to do that, though, does relate back to a leadership pathway. Again, I go back to my very first job. I worked at Arkansas Children's Hospital. I worked for an audiologist, whose name was Dr. Patti Martin. Patty was young. Also, she's a couple years older than me and had a little bit more experience than me, but she was always open to “Let's get involved. Let's participate in the parent support group for children who are deaf and hard of hearing. Let's support the state association. Let's do some presentations for them. How can we get involved?” From her perspective, she was very service-oriented. She allowed me to have some of those opportunities.

Then, I think, early on, I just had some opportunities where people saw that I had some interest in participating in state-level types of activities. A couple of people reached out to me, asked me to get involved with our state association, which is the Arkansas Speech-Language-Hearing Association. I had an opportunity to develop some leadership skills and to watch other people become, or be leaders. I learned from some really wonderful people in the area of Speech-Language Pathology, and audiology.

In the state association, I had the opportunity to advocate for our professions, with our state legislature and with our Department of Ed, with our Department of Health and Human Services, and all those different agencies. It was really, by having people invite me to come along on this journey of serving my profession, that I really had an opportunity to develop some great leadership skills. I'm still on that journey, because I still have lots to learn. I think, one of the things I would say to anybody that's listening, if you are in a leadership type position, or a volunteer leader, and you have the opportunity to invite someone to come along with you on that journey, I really want to encourage you to do that.

If you're a person that's looking for ways to get involved, and maybe you think you're too young, or that you don't have enough experience, then what I would tell you is: look around. Look around, not necessarily at the national level first, but look around in your state, maybe even look around in your place of employment. If you have the opportunity to set up, let's say, May is Better Speech and Hearing month, then you have the opportunity to set up a couple of professional development opportunities for your co-workers. That's a form of leadership.

It's not always about having a title, or being the person that everybody sees as the leader, but just being willing to serve in ways that are helpful to your co-workers, or to the people that you serve, or to even at your state level. I always say that what I know about state association work in our fields is that there always is a need for volunteers. Even if you just call up the person who's in charge of your state convention, and say, “Hey, can I volunteer to help with registration? Or can I volunteer to put together the set of people that will moderate your sessions?” You would be stunned at how much that's needed, and how easy it is to do that type of opportunity, and what a help it is. Then, it gets your foot in the door.

Especially in a state association, there are a couple of states that probably have enough volunteers, but most of our state speech-language-hearing associations, and maybe some of our state-level academy of audiology-type chapters are always on the lookout for people to volunteer. Volunteering is really a part of leadership. Just some ideas. Just a few ideas.

[00:13:38] DAKOTAS: Yeah. That's great. Thank you so much for sharing that. I mean, I think you have such a great journey. I really like the picture that you said at the beginning of you really mentioned several mentors. I think, that's a really big part of anybody who wants to be a leader. I mean, I guess some people are really gifted with leadership skills, but almost everyone models it after someone who was a leader to them. I think, this is something we've talked about on this podcast before, but finding mentors is such an important part of longevity in a field, right?

If you're looking for upward mobility, if you're looking for – trying to be a leader in the field one day, you can't just figure it out all on your own. You're going to really need someone to model after. I love that comparison you started off with, and that in each of these positions you were in, it wasn't just you figuring it out. It was either you with a mentor, or you with a team of other people. I think, that's such a great starting point for everything, as well as just the point of just being service-oriented. One of the first things you mentioned, I think, is you just noticed this need for school-based audiology. Rather than saying, “Oh, that's interesting. Hopefully, someone else will figure it out.” You were actively looking for opportunities.

Of course, that's where leadership arises, right? Where there's an opportunity to serve something, well, somebody is going to lead that effort. I think, it's really interesting. That's where a lot of this has come for you is just seeing a need, doing what you can to help and you know what spawns out of that is the ability to lead others into the same thing. I think, that's a really cool way to tie all those things together. I love that thru-line. Are there any really big, just highlights from your career, things that you'll never forget? Maybe it's a patient, or an interaction, or an accomplishment really, that you're just like, these are the things I want on that list of awesome, that when I finally retire?

[00:15:20] DONNAS: Well, your podcast is not long enough for me to list all of the wonderful opportunities I've had. I do, as you ask that, I do have – I think, this is a great lesson for all of us to look for opportunities to learn from the patients, or clients, whatever we call them in our places, from patients and their families. I think, that is particularly true for me. I have a family that I worked with, and I began working with them.

Actually, this was when I did some home visits for them. This was back in the mid-90s. It was a little girl, and she had hearing loss. This was something that was provided through the early intervention program. They contracted people, because we typically did it at night. I had the opportunity to work with this family. I was a pretty young audiologist. Of course, I thought I knew everything. The lessons that I learned from that family and their journey, that patient of mine is now in her 20s. I still have some contact with her family.

She taught me a lot, because her hearing loss was not textbook. Her family taught me a lot, because their journey didn't follow any textbook, and most of our family's journeys don't follow the textbook. I think, what I like to tell students and other professionals that I get an opportunity to work with, that we have to learn those things in the textbook, but we also have to be open to allowing our patients and our families to show us that hearing loss affects them in a different way, or that their family dynamic is different than my family dynamic was. 

I learned a lot about the grieving cycle, because this family, and they would say the same things if they were here, but that it was difficult for them to really wrap their heads around this hearing loss. I think, one parent sailed further along in that grieving cycle than the other parent. Then I learned a lot about how that cycle is a cycle, and it comes back around and that you think, “Okay. Well, this family's doing great. They've accepted this and they're moving forward,” and then something happens. It puts them back into that, “Oh, gosh. We're back to knowing that this is not how every other kid her age functions.”

I think, the lesson that I want to take away from that particular family was that I need to be open to listen to what the patient tells me, what the family tells me. That I'm an audiologist and I often think, “Okay, now, I've got all the information about the hearing aids, or cochlear implant, or how we should do this, or how you should do that.” The truth is, they're the people that are living with it.

I know, early in my career, we didn't talk much about patient-centered care, and we certainly talk about it a lot more now. I think, we were trying to practice that, but we didn't quite do it as well as I hope we do it today. I hope, we have a much bigger awareness of that. I think, that family to me, this young lady is, I get to see her through some social media now and her parents, and I just love seeing the person that she's become, and the things that she has overcome.

I would say, probably, Dakota, the other thing that is – one of those things that I am really excited to be able to have been a part of was that creation of the EARS Program at Arkansas Children's Hospital. I didn't do that by myself. It was a team effort with several audiologists, as well as Dr. Patty Martin, who was the director of audiology, and Dr. Steve Epson was one of the other audiologists that he and I were two of the first that really started doing that. We had this vision and we really wanted to do it. I will always be happy that we were able to develop it and that we were able to develop a program that appears to be sustainable, and appears to be needed. I hate to use the word proud, but I am very proud of that work.

[00:19:33] DAKOTAS: No. That's the perfect word for – Yeah, that was really what my question was, too, those accomplishments that you're proud of. It seems like, another big thru-line here, too, is just your connections with other people and the – I mean, again, we were talking before we really started the recording, but we were talking about audiology is not that large of a field, but it can be an even smaller world. If you're one of those people who really networks a lot and makes a lot of connections and you're really one of those people. I was just telling you some of my career journey and you knew somebody at every single place I've ever been. That's no small feat. I think, that's a really big aspect of it, too.

I think, just some of the things we're talking about in terms of leadership skills to foster. Finding a mentor, watching their leadership style, so you can learn from that, looking for opportunities to serve and jumping into those opportunities. Then another one is just networking with others. How has that been a big aspect of your leadership style, or what led you here to your role today, in terms of networking and connecting with others?

[00:20:32] DONNAS: Sure. Let me make one comment about the mentoring piece, because I think it's important. That is that, I don't think – I haven't had just one mentor. I've been really fortunate that I've had a lot of mentors. I think, you have to be open to that, that in the different parts of your journey, that you need to look for people, that you can model after, that you can get to know, that you can learn from. That, it'll probably change through your career and if you take different paths.

I certainly had some mentors early on that were pediatric cardiologists. Then when I was the state consultant, in Arkansas I had a boss who was a teacher of the deaf, and she was a great mentor for that time. We're still friends today. Then when I did my PhD work, I had a mentor in my advisor. That worked out. I mean, it doesn't always happen that. Then I've had speech-language pathologists, and audiologists and places that I've worked. What I would say is that don't assume that one mentor, you're one and done. Look for mentors along your path. If you feel that you're having difficulty making those connections with somebody, look around, do some reading, ask some questions of other people about, how can I choose, or how can I get a mentor type relationship when it's not happening naturally, or [inaudible 00:22:04]? That was one thing I wanted to comment about the mentoring piece. Then in terms of networking, there are times in our life when we think, okay, networking is just a fancy word for you talk too much.

[00:22:17] DAKOTAS: I agree with that.

[00:22:19] DONNAS: I don't agree either. I sometimes wonder, if people think, “Okay. Now, she's the person who her report card from elementary school says she talks too much. She’s too social.” Which, weirdly enough, I wasn't when I was that age. I was actually really painfully shy. I think, one of the things that first, you have to get over the hump with and that is that. Networking, it really can be a very organic occurrence. It does not have to be forced. It doesn't have to be small chitchat. It really can be more about looking around, finding people that are doing things in the field, or whatever, that are doing things in the field that are similar to what you're doing. Reaching out to them.

These days, “Hey, can I set a Zoom call up, and ask you about how you made this happen, or how you do that?” Most of the time, especially in our field, and both of our professions, most of the time, people are more than happy to do that. It's just who we are. It's how we ended up in fields like this, because we all say it, we like to help people.

A lot of times, the networking piece, sometimes you have to set it up. Sometimes it does, like I said, happen organically. You go to conference, you participate in some program, you get involved with your state association, or state academy. You have to look for those opportunities to do that networking. What I have learned, Dakota, is that, across my years of having an opportunity to volunteer for different, whether it be ASHA, or my state association, volunteering, the reward of that was huge. I got more out of it than I put into it. Because now, I have this network of friends all over the country, as you and I discovered, because there are people that along the journey, when I've stepped up and said, “Hey, I'll volunteer to do that, or I'll volunteer to participate in that activity.” Then I've had the opportunity to meet people.

Now, I feel like, I have this friendship network of audiologists and speech pathologists all around the country, and a couple who aren't even in the country, around the world. Really, I think a lot of times people say, “Well, you just need to be good at small talk.” I actually really hate small talk. What I do like to do though, is I do like to interact with people and get to that, what do we have in common? When you and I began our conversation before we started recording, it's like, “I want to know who you are.” I asked you a little bit about your background. Yeah, we began to figure out that we have all these connections. I’m getting a little too philosophical, probably.

[00:25:03] DAKOTAS: No, that's what we like out here.

[00:25:06] DONNAS: I think, one of the things that making connections, like what you and I did before we started recording is that, it helps us see each other more as humans, and not as “Okay, she's the Chief Staff Officer of Audiology.” I'm a human. I love my work. I want to do this, because I want to serve the field of audiology and the patients that we serve. I also am a human being. I want to be able to see other people. I think, that some of the issues that we continue to have in our professions, if we would stop and look at each other as humans, and not as adversaries, or whatever, that we would find that we have a lot more in common than we have that's not in common. I hope, I got to that.

I do think networking is something that a lot of people, I think just feel that they don't want to do it, or that it's a negative. Really, networking is really about making connections with people that may be doing similar things to what you're doing, or that you have the opportunity to learn from. One of the places, and again, Dakota, this was one of those things where there was a need. I was interested that back many, many years ago, the way that some of the leadership councils for ASHA were set up, there were two representatives from – Well, actually, there were representatives from each state, and it was based on the number of SLPs and audiologists that you had in your state.

We had an opening in Arkansas. I was like, “Well, we had never had, or hadn't for a long time had an audiologist in one of those roles, typically had been speech pathologists.” I was like, “Well, I would run for that. That sounds interesting.” That helped me learn some advocacy tools, because then, I had the opportunity on behalf of ASHA to do some Capitol Hill visits, and I was terrified.

One of the nice things about the way that when we pre-pandemic, and hopefully, when we get around the pandemic, we'll go back to doing those Capitol Hill visits. We have staff that give you all of the information and help you understand how it is that you connect with your legislators from your state, and how it is that you talk to them about issues that are important to you. That was very helpful at a national level, to really help me figure out, how do I advocate on such what felt like an enormous scale? I just had to get the education about it. I had to keep doing it. I kept doing it. Every year when we came back for the meeting, it was somewhat optional for you to do Capitol Hill visits, but I always opted to do them, because I knew that it was something that was hard, and that I would grow from it. I kept putting myself out there.

I can't tell you that any legislator or any of their staffs know who I am. We did have one person that worked in one of our senator’s offices, and we probably saw him seven, eight years in a row. I promise you by the end, he knew who we were.

[00:28:04] DAKOTAS: That’s great.

[00:28:05] DONNAS: Because he’d always remember. He had a son that had had tubes in his ears, and so we always connected on that. You just have to look for those opportunities. Sometimes, there are opportunities that stretch you and that aren't as comfortable. There's usually other people that will be happy to support you in doing those kinds of things.

[00:28:22] DAKOTAS: Yeah. I think, that's a great reminder, too. For you, stretching it was doing advocacy at the federal level. Then, you mentioned before that, even just the idea of networking with others can be stretching to someone else, you know what I mean? That's just the idea of starting up a conversation with someone. I think the way that you phrase it is so wonderful that these are just other people. There's no requirement that you have to start every conversation with some chitchat about the weather in your area.

I mean, you can just find common ground. The field is small enough that somebody is going to know somebody that you know. I think, that's a really great starting point for a lot of these conversations. I love how you just brought that to how they lead to opportunities that you wouldn't have expected before. I think, that's a really, really great. You got such a good way of tying it all together. I can just see the ribbon threading through this whole conversation.

Okay, so then let's talk a little bit – speaking of Capitol Hill, let's speak a little bit about your current role. Do you live in DC? Do you have to be in DC for that? I know, that's where our headquarters are for you guys. Tell me a little bit about how you became the Chief Staff Officer of Audiology and what that role looks like for you.

[00:29:28] DONNAS: Well, I do currently now live in Maryland. About 25 minutes outside of DC when there's no traffic, which is never.

[00:29:36] DAKOTAS: Nice.

[00:29:39] DONNAS: ASHA’s headquarters are in Rockville, Maryland. We also do have an office that's down in DC, on Capitol Hill that in normal times our legislative staff, our governmental affairs and public policy staff have offices there. Interestingly enough, I think, well let's see, in 2013 to 2015, I served on the board of directors for ASHA. Again, it was one of those things that I had done a lot of volunteer work for ASHA. I had been on some committees. I'd been asked to do the scope of practice back in 2004, that update, I'd been on that committee for the scope of practice for audiology. I've been on the legislative council.

Again, those were just things that often I did. They were short assignments, or short-term types of issues, and then the legislative council really served my state for that. Probably, sometime in 2012, someone from the Committee on Nominations and Elections reached out to me and said, “You have been nominated to run for vice president for audiology practices. Would you allow us to put your name forward. Because if you are willing to go forward, then you could end up on the ballot, but they have to know, can they consider you and they need some information from you?”

I said yes. I ended up being elected to that position. I had three years on which I served on the board of directors. Probably, any of your listeners and yourself that when you think that to times when you've had opportunities to serve that close to the inside of an organization, you really do get to learn what is it that happens on the inside, what really is going on, and what I figured out, although I had always had great experiences in my volunteer opportunities with ASHA, what I figured out is that ASHA spends an enormous amount of time and effort and resources on issues that are important to audiologist. Lots of advocacy efforts, lots of resource development efforts.

My time on the board really made me think, “Wow, somewhere in my career it might be interesting to work for ASHA.” Because ASHA does employ – We have almost 300 employees, and we have, I think, nine or 10 audiologist and probably, I'm going to guess, maybe 30 speech pathologists, and then of course, all the other people are experts, or have expertise in their different fields.

I just had this interest in, now that I could really see what – it wasn't exactly a behind the curtain look, but it was a little bit of an understanding of what ASHA did on behalf of audiologists. I just became really interested, and for me personally, the timing really worked out. My husband and I have a son who's in his first year of college. He was getting close to graduation, or he was in his senior year when I applied for this job.

Fortunately, the job became open, because Dr. Neil Desarno, who had been in this role, and he was the Chief Staff Officer when I was on the board of directors, he passed away in April of 2020. This position opened up, and they posted it, and I interviewed for it late in 2020. Started in early 2021. For the first, pretty much eight, nine months, we lived in Arkansas. My son finished high school. We were working virtually and not in the office as much. Then in September, my husband and I moved to Maryland. My husband had never lived outside of Arkansas, and he's loving it. We live in an urban area, so we're really taken advantage of that. Our son is in college in Arkansas. That's hard for this mom's heart, but he's having a great experience.

[00:33:34] DAKOTAS: That’s great.

[00:33:35] DONNAS: On a day-to-day basis, it's interesting, Dakota, because I feel like, while I do have a lot of – I have to spend a lot of time thinking about things that are related to audiology, I also have a couple of other things that come up under my CSO role. One of those is ethics. The board of ethics and the ethics office, that's part of my leadership responsibility, accreditation of all academic programs, both in speech pathology and audiology. That also is one of my responsibilities. And certification of all 218,000 members, and that I need to take out the students. Let’s say, 217,000 members somewhere thereabouts.

Dakota, what I’m really happy about is that I have some amazing people in the roles that take the leadership for those. We have a director of ethics and accreditation and certification. All three of those people are not in the professions, but they are certainly experts in their field. Then we have an amazing director of audiology, and she has a whole team of audiologists. They are wonderful to work with. I wish that I could capture all the brainpower that's in those four groups, and that you could see all the things that are going on behind the scenes on behalf of the professions. While I do like to spend time thinking about audiology, I do have some other responsibilities. Again, it's been a great learning opportunity.

I've learned more about accreditation and certification, and how a board of ethics works than I ever thought I would know. I have had the great opportunity to have an inside view of what's going on with audiology. You mentioned, we talked a little bit about advocacy. We've spent an enormous amount of time in 2021, advocating for services for audiologists to be recognized in a different way through the Medicare Act. We've also spent an enormous amount of time looking at our response, what our response would be to the FDA, related to over-the-counter hearing aids and their proposed guidelines that came out.

The great news is, while I have been privy to all those conversations, and see the end results, it's wonderful, because we have this great team working together through the Governmental Affairs and Public Policy staff, as well as our audiology practices staff. We are really blessed at ASHA to have a couple of people within our governmental affairs and public policy group that have actually worked on Capitol Hill.

They really understand like, who are the people that we need to go to, to try to advance our issues? How does it work? Do I need to get alarmed that it doesn't appear to be working, like I want it to be working? Because they really understand the inside piece of that. Every day is a different day, and there's lots of new and different activities to be involved with. I think, one of the things I've enjoyed, I've gotten to have some great conversations with some international partners through the WHO, The World Hearing Forum through WHO. You have some great partners at the IDA Institute, which is in Copenhagen.

[00:36:45] DAKOTAS: I love their resources.

[00:36:46] DONNAS: Yes, me too. I knew of them. I mean, now it's like, I'm talking to the people. Once again, I think they're amazing and they're the nicest people that you could possibly meet, and they come up with some amazing resources. Every day is pretty exciting. It's exhausting, but it’s exciting.

[00:37:04] DAKOTAS: Yes. It's so many different roles. It just sounds like, it's the perfect culmination of all of the roles you've served in so far. Then also, expanding into the skills you probably never thought.

[00:37:14] DONNAS: Exactly.

[00:37:15] DAKOTAS: I just think that's such a great – again, with the through-line, too, with a lot of those skills that you've mentioned, the networking. I'm sure at this point, now that you're really in a more leadership position, it's a lot more mentoring with some people you've worked with in the past. At least, when you were talking to me beforehand about some of our connections, it sounds like, you've been a real mentor for a lot of these people.

Then, now you're not just looking for opportunities to serve, you're way more on the big picture. How do we improve as a whole profession? Not just more micro-opportunities. That's great. I really think that's really interesting. I think, now that you have this from the top perspective, we talked a little bit about getting involved at a state level. I do think that is like, I can't be more of a proponent. I'm on the board for my state audiology academy and state Speech and Hearing Association, because I'm like, I got to help somehow. I think, that's something that we could probably even continue to chat about, if you like.

If there's other things you can think of maybe that are as, set up for your state level organization that are ways to either advocate more for the profession, or I guess, these are two separate questions. Either advocate more for the proficient, or refine some leadership skills. I guess, we've talked about the leadership skills. I guess, we could speak a little bit more to the advocacy side of things, just ways for audiologists they might not have considered before.

[00:38:31] DONNAS: Sure. Well, and if the person is a young audiologist just coming into the field, or maybe even if they're an AUD student, definitely, there are some easy ways to get involved with advocacy. One, I know that ASHA has on our advocacy site, or website, that portion of the website, we have a take action opportunity. I believe that AAA has that also. What I would encourage people to do is that when – Well, first of all, you can just go to those sites right now. If there are opportunities that we need constituents to reach out to their legislators about, you'll see those on those sites. It's a really easy way to do it.

Basically, you put some information in about where you live, and typically these days, the systems will be able to say, “Okay, well Senator so and so is your person, or representative. So and so is your person.” It gives you a way to, typically, there are pre-formulated messages that you can send to those folks. What I would encourage people – sometimes they think, “Oh, it's just a pre-formulated message,” but take that message and really customize it. I remember, I would always take those letters, and I would rewrite them a little bit to talk a little bit about what I was doing specifically that related to that issue.

Right now, I can tell you one of the issues that's out there is the reauthorization of EHDI, of the Early Hearing Detection and Intervention Act. I mean, the simplest thing that you could do is to go to the ASHA site, find that within the advocacy, and there's a button at the top that says, “Advocacy,” so it's pretty easy to get to, and send your legislators a note about why you want them to reauthorize and additionally fund EHDI. All the correction is there. That's a really easy thing to do.

I think, the second next thing that I would encourage people to do, and again, this doesn't matter how much experience you have in the field, but look for opportunities for when your legislators, when your representatives and senators are in your home districts, and you can go and visit them. Now, that may sound scary. I have done a couple of things over the years; many years ago – it is from about 20 years ago, one of my state representative was going to be back in the home district, and he was doing a round of going to public libraries, and people could come. You weren't going to get to spend more than about two minutes with him.

I went to the ASHA website, I printed off something about whatever the issue was at the time that I was interested in. I took a little thing to go, because we, at ASHA, we have some one-page flyers about the issue. I took it, put my name and phone number and email on it and invited him to contact me if he, or his staff had any questions about it. I got one second. I mean, it was a half a second. But still, I did. I stood in line. Then other times, I have made appointments.

The point of that is that it's not just about coming to DC to do that. It's about meeting people in their home districts. A lot of our legislators and/or their staff want to do that. Never discount meeting with a staff person. The first couple of times I made [inaudible 00:41:53] visits, I was like, “Well, gosh, darn. I'm so sad that I didn't get to meet the senator, or meet the representative.” What I figured out is that those staff people, they're the ones that actually know about the issues, and they're going to be better – I'm going to have a better conversation and have more influence, because they actually are the person that's supposed to know the depth of that issue.

Don't be disappointed if you end up just meeting with somebody like staff, because honestly, you can still develop those relationships with them, whether they be in your home district, or if they're here in the DC area. Those are some really simple things that people can do that are advocacy-related, and that don't require you to travel across the country to do them.

Of course, right now, most of the offices on Capitol Hill, you're not going to be able to get a face-to-face visit, because of the time that we're in. Even more so, set up a Zoom call, or those kinds of things. That's even easier. You might actually get to talk to somebody who's up on Capitol Hill, but you didn't have to do the travel, or the parking, or the metro, or any of those kinds of things.

[00:43:01] DAKOTAS: Absolutely. I think, of all the emails I've sent, and I normally just go to that link, I click the link, I type in my name, and I'll add in a sentence here or there, if there's something relevant. I have had it. I think, it was at least once. It might have been twice that they emailed me back. It was specific. It wasn't just a canned response. I was like, “Oh, gosh. I wasn't expecting you to really read this. I was hoping you would, but I guess, I couldn't say I was expecting it.” It is really great, how it doesn't take that much effort to do and it really can't have an impact. It's all of us together putting in those little impacts that really can make a really big wave of change. Yeah, those are really great pieces of advice. Thank you for that.

I think, transitioning off of that from making big waves, this is a two-part thing here. The reason I even reached out to you in the first place is I read a great article that you wrote for the ASHA leader on OTCs, and over-the-counter hearing aids and what to expect and how to see them as a positive and how they're going to expand reach. I thought that was just a really great perspective. I wanted to talk to you about that. Then, when I learned more about you, I was like, “Okay, wait. Now, I really want her to talk about some of her leadership and how she got to this point.”

Since we've got some time, I'd love to talk a bit about maybe, if we want to start with now that you're behind the curtain, so to speak, you know a little bit more about the policies that are coming, you're connecting with other countries, what does the future of audiology look like to you? That can be as specific, or as general as you'd like to answer. Then from that, if we talk a little bit about the technology, we can talk a little bit about OTC as well.

[00:44:32] DONNAS: Well, that's a great question and a great issue to think about, because I do think we are at a crossroads in terms of where we can go in the field of audiology. I'm hearing some people who are naysayers that will say, “Well, audiology is done. We're done, because there's going to be this over-the-counter hearing aid device.” I don't see it that way. I have a lot of colleagues across the country that don't see it that way. I think, what we have to do is we have to figure out how to take these disruptive innovation pieces and work them into what we do. I think, this is not – I don't want to take credit for ideas that I know many other people have had also. I think, what we have to do is we have to get back to our roots.

Our roots are that we just – Ironically, as we talked about at the very beginning, part of what we bring to the table is this ability to take all these different pieces of information and become a detective, as you said, and a problem solver. We have to figure out, how do you take the diagnostic information? How do you take the patient report? How do you take the family report? How do you take what the patient wants out of his or her life? How do you take all those different pieces and put them together and come up with a way to help the patient with their communication needs, obviously, essentially, related to hearing? How do you put that all together in a way that you can both have a profession and support yourself?

I'm not asking people to starve, or not to ask for the value that we have in our profession. We have to figure out how to put all of that together. Like over-the-counter hearing aids are going to be a part of that picture. When the FDA released its regulations, its proposed regulations back in the fall, and we put some information out about, okay, these are out and we're going to be responding and you can respond too, we did receive a few emails from people that said, “Does ASHA support over-the-counter hearing aids?”

It was funny, because I was like, well, we don't really have a choice. That's going to happen. That's been coming for since at least 2018, if not the year before that. We don't really have a choice at this point. We are going to have over-the-counter devices. Now, we did have the opportunity to have some input about what those devices might look like, and we still might not get exactly what we wanted, or what we advocated for. We'll see here in the coming months what the FDA does with all the feedback. I think, we have an opportunity. I think, a lot of other audiologists think this also.

The opportunity is, that we get back to being that detective that helps all of our patients, whether they come in with no device, or what if they come in with a device that they bought over the counter? We have a decision to make. Are we going to say, “Oops, I'm sorry. I can't help you with anything, because you didn't buy that from me. Or, you bought that and an over-the-counter hearing that is going to be exactly that. It's something that you don't need an audiological assessment for.”

Or do we say, let's see this as an opportunity. Maybe, a patient will purchase an over-the-counter device, and maybe it will help them. Then they'll figure out, “Well, goodness. Maybe there's a little bit more that I can do. Maybe there are some other things that I can do that can help me, so I'm going to go see the hearing healthcare specialist, the audiologist.” We have to see it as a way to get more people thinking about hearing and thinking about devices. Although, we may not be attached to them directly. I think, we have some opportunities to incorporate them into our practices.

I think, there are some people out there that already have been doing that with some of the PSAP type devices, the personal sound amplification products. I think, we have a choice. Then, I was in – I’m trying to think about where I was. Gosh, I can't believe, I can't remember. I was somewhere in the last couple of months, where there were other audiologist and we were talking about that we also need to really focus in on our opportunity for audiologic rehab. What can we do to help our patients be better communicators, besides the devices that they have? Because we all know, and there's some data to support that just the device alone is not going to necessarily make the biggest difference for the patient.

We have to get back. If you go back and Dakota, I bet, if you've ever taught intro to audiology to undergrads and I have many times, there's the history. We know that the history of audiology really stems from World War II. A lot of what we did was relate it to a real oral rehab, or audiological rehab route. We have to get back to that. Now, one of the other pieces, besides the over-the-counter issue that we've been working on was related to the Medicare Act and trying to get audiologists reclassified in that act, from being suppliers to practitioners. Having Medicare recognize us for our full scope of practice, meaning that we get reimbursed for the rehab piece. Also, trying to provide patients with direct access to audiology, and not having to necessarily go through a primary care physician.

I think, those pieces which right now are hung up in The Build Back Better Act, which is stalled in the Senate. We have some other opportunities this year, potentially, to try to get those, if we can't get the – if The Build Back Better Act doesn't make any progress, we have some other opportunities to try to get those provisions in some other funding bills and some of the Medicare Act. A lot of it's probably going to depend on what happens with our politicians, and that's just reality. Whether we like it or not, that is the world that we live in. It's what happens in a democracy. We'll keep fighting for those things. The great news on all fronts for audiology is that a couple of the other audiology associations, or associations that also represent audiologists, and we've all been working really closely together to try to make those things happen.

We found some common ground, and we've been working together to advance those issues. We hope to continue to be able to do that on issues where we can work together, because that's where we're going to get the most bang for our buck.

[00:51:16] DAKOTAS: Yeah. I think, that's a great perspective to have. I think, it's the necessary perspective to have, because we're only going to move forward if we're all on the same page. I do think, yeah, I've seen a lot of that jabber about OTCs. What does this mean? Is this the end? I mean, I feel like, in my day-to-day, I'm not spending too much time just programming a hearing aid. I think, there are so many opportunities out there for audiologists to diversify what they're doing in their day-to-day. Then, definitely to include over the counter is, like you said, this is the entry point for so many people into just recognizing your hearing health care as an important part of their care. Yeah, I'm with you on that. I definitely see how this is a big open door.

I remember in grad school, when I first learned about – for some reason, the exact term is escaping me. Not uptake, but people who are diagnosed with hearing loss, who actually are fit with something, and it's so incredibly low. There's a lot of barriers. The first thought is like, “Oh, well, it's because of cost.” All of the research says, that's certainly a barrier for some people. That's not even the main barrier for a lot of people. I think, the whole conversation just about what hearing healthcare is, and what people think about it, it's got to change at some point. I do see just as people just become more comfortable walking around with something in their ear, this whole culture and conversation is just definitely shifting a lot. I agree that I think it's for the better.

I think, it's our opportunity to be the experts there, too. Or not just hearing or communication, too. I think, all of those layers have to work together. I think that's a really great perspective. Thank you for peeling back the curtain there a little bit, too, into where the work is heading.

We're coming up on the end of our time. I was wondering, let's say there is a student, or a recent grad, or not even a recent grad, a seasoned clinician, and they're saying, “I really want to take on more leadership. I want to see myself as a leader and an advocate in my field.” What kind of either skills at a much smaller level, whether in the day-to-day or the week-to-week should people be focusing on honing, building that leadership resume to reach that goal for themselves?

[00:53:28] DONNAS: I think, one of the resources that I would love to point everybody to and it's really available to anybody that would like to access it. On the ASHA website, if you go to the ASHA website, and you type in Leadership Academy in the search bar, you will come to the ASHA Leadership Academy. The ASHA Leadership Academy has some – it has 11 webinars that are free. If you want to get continuing education credits for them through ASHA, if you're an ASHA member, you can do that for a small cost. If you just want to get the information about, how do I develop relationships with other people in a leadership role? How do I understand how to deal with conflict? How do I coach other people? Those 11 webinars are really, really good.

They were done with a group, a couple of folks that have done a lot of consultation for ASHA around leadership development. There's also a lot of articles that are attached there. There are a couple of assessments that you can print off and do for yourself to see where are your strengths and leadership and what are the areas that you might need to try to gain some more skills? What I would say is if I'm – whether you're a student, all the way to a seasoned professional, that's one place to start where things have been curated for you. They certainly aren't unique to speech pathology and audiology, but they certainly were developed with audiology and speech pathology in mind. Start there.

Then, the other thing, and it's so funny, because I often have people say, “Well, what's your leadership style?” It's like, well, I don't know. I don't really know that I have a style. I do think that in this day and age with all the different social media outlets, I find people that I like their quotes, or I like the way they think, or I pick up a book. Somebody recommends a book. Then I start to follow those people on social media. I'm a sound bite person in the sense that some days, that's just all I have time to get, is a little soundbite from people. I like some of the folks like Simon Sinek, and Adam Grant, and Brene Brown. Those names may be familiar to your listeners. They may not be familiar at all.

The point is that what I've done is find people that are talking about leadership, that I can relate to, that matches up with my own personal beliefs and my style. I just try to spend some time figuring those things out. When I learn things, I share them with other people. I have lots of friends that share those kinds of things with me also. At the very minimum, Dakota, often in your work setting, you'll probably find somebody in your work setting, even if they're not in our professions, but somebody in your work setting who wants to also grow their leadership skills, read something together, have lunch together, talk about it. There's no right answer to most of those questions, but sometimes we learn by just having an opportunity to process that information out loud with another person.

Those are, again, some real practical things that people can do. I think starting with the ASHA Leadership Academy, which again, has a ton of resources and is available to anybody, is a great place to start.

[00:56:55] DAKOTAS: That's great. As we were talking, I was just clicking around here. I mean, there are so many great resources in here, and further reading. I think, you're exactly right. Resources like this, those are the – other than connecting with others, which honestly, if you were going to ask me your leadership style, I think your leadership style is just connecting people with positivity. I think, you're right. There's just so many ways to foster these skills and work on these skills. I love that too, that you talk about these things with someone else, bounce ideas back and forth, because you might learn something else in that process, too. That's great.

Well, we are just about out of time. Donna, it's been so great talking with you. I really appreciate you taking the time and sharing your experience and your story with our listeners. I know, there are a lot of leadership and advocacy nuggets in here that I'm sure people are going to take on and use in their careers. As many people as you've inspired so far, I'm sure you've just inspired a lot more. Thank you for that.

[00:57:47] DONNAS: Well, thank you. I'm grateful. Happy to do it.

[00:57:50] DAKOTAS: Of course. If our listeners have any further questions for you, or just wanted to connect with you, what's the best way to do it?

[00:57:54] DONNAS: I would say, the best way to do it is to email me. My email is my first initial, so the letter D as in Donna. Last name, Smiley. S-M-I-L-E-Y, dsmiley@asha.org. I love to interact with students and professionals and early career professionals, late-career professionals. I'm always happy to have conversations. If you give me a couple days, I will do my best to get back to you.

[00:58:22] DAKOTAS: Perfect. Thank you so much again for joining us. It's been great.

[00:58:25] DONNAS: Thank you. It was fun.

[END]
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