EPISODE 242

[0:00:01] MD: Today's episode is completely for fun. We are talking about the ASHFoundation and the scholarships and the research grants and how they support our current colleagues, our future colleagues, and expediting research to practice. Continuing on our gratitude journey for 2023, oh, my God, the year's still going. It hasn't ended. I am grateful. Hell, I'm grateful for every single dollar that goes out that we're supporting, because I have worked with students that were recipients of those funds. I've worked with colleagues that were recipients of those funds, and it truly does make a difference.

I mean, sometimes that money is rent money so that the student can finish grad school because they wouldn't have been able to afford it otherwise. Other times, it's that those funds allow for interprofessional education opportunities to occur so that we can better collab between two different professions. Y'all, those monies come from us. Those monies are that little checkbox come December when they say, ÒHey, do you want to donate $32 to the ASHFoundation?Ó Yes. The answer is yes.

I am grateful that the monies have come because our students aren't hungry and research is growing. ASHFoundation, y'all, I'm grateful for you. Folks, if you're coming to Boston, buy a ticket, meet me there. I would love to celebrate the awesomeness of this organization with you. I think their shindig is Wednesday night this year, so I'll see you in Boston.

[INTRODUCTION]

[0:01:56] MD: Hi, folks, and welcome to First Bite: Fed, Fun, and Functional. A speech therapy podcast sponsored by speechtherapypd.com. I am your host on this nerd venture, Michelle Dawson, MS, CCC-SLP, CLC, the All-Things PFDs SLP. I am a colleague in the trenches of home health, early intervention right there with you. I run my own private practice, Heartwood Speech Therapy here in Columbia, South Carolina. I guest lecture nationwide on best practices for early intervention for the medically complex children. First BiteÕs mission is short and sweet, to bring the light, hope, knowledge, and joy to the pediatric clinician, parent, or advocate.

[0:02:43] EF: By way of a nerdy conversation, so there's plenty of laughter, too.

[0:02:47] MD: In this podcast, we cover everything from AAC to breastfeeding.

[0:02:52] EF: Ethics on how to run a private practice.

[0:02:54] MD: Pediatric dysphagia to clinical supervision.

[0:02:57] EF: And all other topics in the world of pediatric speech pathology. Our goal is to bring evidence-based practice straight to you by interviewing subject matter experts.

[0:03:07] MD: To break down the communication barriers, so that we can access the knowledge of their fields.

[0:03:12] EF: Or, as a close friend says, ÒTo build the bridge.Ó

[0:03:16] MD: By bringing other professionals and experts in our field together, we hope to spark advocacy, joy, and passion for continuing to grow and advance care for our little ones.

[0:03:27] EF: Every fourth episode, I join them. I'm Erin Forward, MSP, CCC-SLP, the Yankee by way of Rochester New York transplant who actually inspired this journey. I bring a different perspective, that of a new-ish clinician with experience in early intervention, pediatric acute care, and non-profit pediatric outpatient settings.

[0:03:48] MD: Sit back, relax, and watch out for all [inaudible 0:03:50] and enjoy this geeky gig brought to you by speechtherapypd.com.

[EPISODE]

[0:04:02] MD: All right, everybody. We have an episode that I don't know how we managed to pull this off, because I literally lost power on the first iteration with a fabulous double-chinned shock of all on video camera, and these ladies had to look at that. Shocked face for an extended period of time. Once the thunderstorm passed, we were able to regroup their cellphone usage and recreate it, so we're here today. I am grateful that this all-star lineup is sharing so graciously of their time for a topic that is incredibly important to expediting research to practice for our colleagues and our interprofessional practice partners.

In case you're not aware, we are talking about the ASHFoundation today, which some of us may think it's an extension of ASHA, but it's actually its very own entity. Yes, there is overlap and support, but they truly are down to the nitty-gritty details on pen and paper, i.e. computers, laptops. Two separate entities. The work that they do funds our researchers, funds our future, funds the opportunity to make the world a better place, and we are better for it. I am hoping that by the end of today, everybody has found a little bit of funny money, or love money to donate to the ASHFoundation, or you will join us next month for the ASHFoundation 5K.

Without further ado, our first guest is Dr. Julie Barkmeier-Kraemer, who is an actual board member of the ASHFoundation. But on her Monday through Friday, she is a professor with the Department of Otolaryngology, Head and Neck Surgery Director of the Voice Airway Swallowing Translational, VAST research lab, the Clinic Director of the Voice Disorder Center, and adjunct faculty at the Department of CSD at the University of Utah. That is a lot, man.

We also have Julie Feuerstein, Ph.D., CCC, who is an assistant professor with the School of Communication and Sciences Disorder at the University of Central Florida. Her focus is actually, this is a topic I want to talk to her again in the future on. It's all about early communication and play. She runs the ESAP lab at the University of Central Florida. Then we have Shirley Huang, Ph.D., CCC, SLP, who is a bilingual language developmental researcher. I'm hoping I pronounced her last name correctly. Yes, yes.

Everybody's laughing because they know how Ð I do struggle with multisyllabic words, which is why my youngest was in therapy. But she is currently a health and science policy fellow with the Society for Research and Child Development with the American Association for Advancement of Science and the National Institutes of Health at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. She actually focuses on health equity to reduce healthcare barriers for bilingual children and their families through culturally competent clinical care, which is absolutely awe-inspiring.

We have a non-SLP in the mix. Huzzah for interprofessional education, which will lead to professional practice. We have Jennifer Tucker, Ph.D., PT, DPT, PCS, and clinical associate professor in the program of physical therapy at the University of Central Florida. Florida is incredibly well represented today. She's a board certified in the area of pediatrics by the American Board of Physical Therapy Specialists and the director of University of Central Florida's Go Baby Go! program, which there's actually a book called Talk Baby Talk. When I saw the Go Baby Go, I was like, yes, we're covering core vocab. Ladies, thank you so much for coming on today.

[0:08:11] JBK: Thank you.

[0:08:12] JF: Thank you for having us.

[0:08:13] SH: Thank you so much for having us.

[0:08:15] JT: No, thank you for having us.

[0:08:17] MD: Your bios read like, who's who of colleagues. It's always like, oh, man, these are really smart women. We're just going to go through. I promise, if I drop a four-letter word, we'll edit that out, so we're just going to roll. Yay. Okay. I always like to know a little bit about where our colleagues came from, what made them want to be in the profession that they are. We have a lot of us today, but I thought when I segued to each one of us, you could take us from the top.

We have two Julies. Dr. Julie Barkmeier-Kraemer with all the fancy labs. You are actually serving as our ASHFoundation board member representative. Hi. Can we start with you and tell us how did you become an SLP and then do all these amazing labs that you do?

[0:09:09] JBK: Oh, thank you. Yeah, sure. I started out thinking I wanted to be a physician. I started out pre-med. I also, in my younger years, was an athlete. I have several family members who pursued a medical career and I watched how that went. I didn't think maybe that was exactly a perfect match, so I decided physical therapy. When I got to the University of Iowa, the pre-professional program required you to work and have total Ð some direct experience as a physical therapist. In a group home I worked in, I had exposure to our field and it was brand new to me. I thought, ÒWow, that's a career choice? That's a perfect match for me.Ó

I started out very interested in kiddos. Some of my first experiences were with behavior-disordered kids. When I got placed during my graduate training program at the VA hospital, I fell in love. I found my people and my place and I decided I wanted to pursue a career in the hospital with adults and really loved aerodigestive anything. That's how I landed in this field.

[0:10:14] MD: See, I love aerodigestive. But for the tinier size, honestly, when I was working with adults, every time I had to remove dentures and do oral care, the boogers were too big. I was like, that was not going to work for me, because you can't retch on a patient. That's frowned upon.

[0:10:32] JBK: No. That would be frowned upon. Yeah. I guess, laryngectomies are not for you either.

[0:10:36] MD: Oh, God. No. It's a visceral response. But I can totally get puked on by somebody else's breast milk and it doesn't faze me one bit. I mean, we all have our literal place in the world to quote a Matthew West song from the 90s. I made myself old. Okay. Let's start with the very large question. What is the ASHFoundation? Preface this with I hadn't heard about the ASHFoundation when I was a graduate student. It wasn't on my radar. Then I got out in the world and I started working as a clinical supervisor for University of South Carolina for their outpatient practicums, and they would send me CVs, student CVs and resumes to review for practicum sites. A couple of these kids came through with ASHFoundation scholarships and I was like, ÒWell, that looks fancy.Ó

They were exemplary students. I mean, they strove and work hard. I think strove is a word. I don't know. Could be a regular past tense. That sounds weird. We're going to roll with it. If it's not, it's a new word. But they were dedicated. That was my first experience actually seeing the ASHFoundation in action. It was very awesome to Ð awesome and not like, ÒHey, man. Cool rad.Ó But just, wow, that's inspirational. What is it?

[0:12:04] JBK: Yeah. No, it's a great question. Like you, I don't think I was aware of the ASHFoundation until I was on faculty. Yeah. Now I try to make a point to share about the ASHFoundation with students early on, starting as undergraduates going into graduate school. I like them to know about it. The ASHFoundation is the philanthropic arm of the American Speech Language Hearing Association that we commonly refer to as ASHA. As we know, ASHA is the National Professional Scientific Credentialing Association for over 220,000 members and affiliates, including audiologists, speech-language pathologists, speech-language-hearing scientists, support personnel, and students.

But the ASHFoundation is the non-profit organization. Like you mentioned on the front end, it is separate, yet linked with ASHA. It operates slightly independently. We are a nonprofit organization funded in part by the tax-deductible contributions of individuals, corporations, and organizations. We support innovators. We try to spark innovation in communication sciences and disorders in our discipline.

Our commitment is to give early support to promising researchers, students, and clinicians. We like to create a culture of quality research, helping to advance clinical practice, empower speech language and hearing professionals and ultimately, change individualsÕ lives, both are professionals in our discipline, but also, those we serve benefit. We do that by providing resources to our scholars and investigators, explore forward-thinking solutions, conducting groundbreaking research.

We invest in big ideas. As our disciplineÕs foundation, we can take some risks and fund novel ideas, accelerate discovery and treatment advances for millions of children and adults. For ASHA members, it's important to know ASHA members do's can help support the professional journey by providing everybody who's a candidate with resources to grow and strengthen your practice.

A gift to the ASHFoundation will go beyond supporting your own career, but also, support the trajectory of our whole profession. We offer grants and scholarships, but we also have clinical achievement awards that recognize clinician accomplishments and contributions to our discipline.

[0:14:31] MD: Disclosure, I know our next three guests have been recipients of some monies. I have not been a recipient of money, but full disclosure, I was a recipient of one of the state clinical achievement awards from the ASHFoundation a couple years ago.

[0:14:44] JBK: Wow. Congratulations.

[0:14:46] MD: I set up the very first pediatric feeding and swallowing lab at a university in South Carolina. Had never been done before, but PDF doesn't stop. When you turn three and go to the public schools, it continues. It follows you, to quote Christian West.

[0:14:59] JBK: That is right.

[0:15:00] MD: Yes. Folks, when you get your annual dues reminder, which cracks me up, because that now comes out in the early fall, and I'm like, ÒNo, no, no, no. This is not in the budget. The budget will get paid with the last paycheck in December, like always.Ó But when that annual dues reminders come out and they have that little checkbox for a $25 donation to the ASHFoundation, may I ask you to check it, because check it, make the donation, because it truly does go directly to the researchers.

Also, I have it on good authority and from past experience that the ASHFoundation shindigs that they host at ASHA are amazing. There's always excellent mommy juice, or daddy pints as we call it in our household, available if you should like to partake. But it's a fun way to meet recipients of some of the scholarships and awards, as well as get to really know these people that are volunteering of their time to review countless applications for the scholarships. I have also served as a reviewer. To sit there and see the brilliance of our colleagues and what they actually are studying and want to put forth into the universe, it is very humbling and honestly, freaking overwhelming to pick one.

[0:16:24] JBK: We were just talking about how many applicants actually get awarded. I think that it's something like 26%.

[0:16:34] MD: 26% of the applicants. Wow.

[0:16:37] JBK: Yeah. It's highly competitive. I love that you're identifying the opportunity to make a donation when you do your renewals. Also, one thing that was really instrumental for my interest in continuing to be a donor to the ASHFoundation, when I became ASH fellow and when I was awarded as an ASHA fellow, several people made donations in my name. I just can't even tell you what that felt like. I was so honored by that.

Another very meaningful gift, if you're not sure how if somebody's been awarded something, or had an accomplishment, you want to recognize, making a donation in their honor, they will receive notification of it. It is incredibly meaningful when people do that. Or, we have these fun Ð like you mentioned, we have several fun fundraising activities. We have three coming up this month, July 14th. We have the Sunset Wine Down.

[0:17:34] MD: It's a whirlpool of SLPs. They know what wine means.

[0:17:38] JF: Wine down with the ASHFoundation. That will be during the ASHA schools connect. That takes place in Long Beach, California. Then August 26th is our virtual 5K walk or run event. You can do that virtually anywhere you are in the world. Then November 16th, during our ASHA Convention, will be our event and evening with the ASHFoundation. That will take place in Boston, Massachusetts, and will be recognizing our awardees during that event. This event promises to be wonderful.

[0:18:09] MD: I have exciting news. I have it on good authority from Dr. Gregory Lough, who I got an email from. If you ever get an email from the Dr. Gregory Lough, everything stops. My heart stopped. I was like, ÒOh, my God. He lived.Ó Because, y'all, he's the reason we know non-speech oral motor exercises have no place in articulation, phonological recovery, treatment, methodology at all. Thank you, Dr. Lough. Also, he's just a brilliantly, fabulously kind soul.

He was telling me that they're doing silent auctions this year at the ASHFoundation. I love silent auctions. I mean, they're not always silent, but I love the competitiveness and the play. Bring your funny monies, pack extra funny monies. I'm going to be cut off from the Amazon card, but we're getting points. This is how I view it in my mind, but I get my points. But then come in and celebrate for a silent auction. They've got, I know on good authority, a ton of PFD stuff, but I'm sure other non-swallowing related statements as well.

[0:19:11] JBK: Yeah. It was across the gamut. They always have wonderful baskets put together. I think our ASHA award announcements came out yesterday.

[0:19:19] MD: Yes.

[0:19:20] JBK: If somebody you know and love was recognized, consider making a donation in their honor to the ASHFoundation.

[0:19:27] MD: Also, the convention chair this year, Dr. Kelly Farquharson.

[0:19:32] JBK: She was an honoree.

[0:19:34] MD: Yes. Yes. Kelly, thank you for you and Jennifer planned an amazing convention this year. Thank you for all of the work.

[0:19:41] JBK: Agreed.

[0:19:43] MD: Awesome. Okay. I want to transition to how the actual scholarships have funded research and how it's moved. Do we cover everything that the board is and does and how to support?

[0:19:58] JBK: I think almost, I can just Ð I know you had an interest in how long have we been around and I can answer that question. The ASHFoundation is currently in its 77th year of life, so to speak. In the course of our life, the ASHFoundation has awarded a total of $12.8 million to more than 2,500 recipients. We are looking at how have those folks done and we're finding that over 90% of our funded researchers go on to get additional external funding and a majority of them have gone on to have highly successful careers and become thought leaders in our profession. This all has occurred, because of our generous donors. Thank you to the generosity of our 58,000 donors, and that number grows every year. We look forward to more individuals supporting our profession and our exciting innovators and sparking our future growth by contributing and growing our donor pool to. Please join our family of donors.

[0:21:02] MD: Y'all, it really is a hoot. It's so much fun. I mean, I go to ASHFoundation every year. Well, I did it last year, but there was extenuating circumstances. I had a board responsibility somewhere else, but yes.

[0:21:14] JBK: You're right. Those ASHA events are always wonderful.

[0:21:18] MD: Yes. Well, thank you. Thank you for coming on.

[0:21:20] JBK: Y'all, thank you for having me and for this opportunity to share about the ASHFoundation. I'm a huge fan, obviously. I want to also disclose, I have never been a recipient of a scholarship, or award. I am just a huge fan. My students and my colleagues have. I see what a huge difference this organization has made in our field and to our patients who we serve. For that, I really love contributing to this organization. I highly value it.

[0:21:49] MD: Yes. I'm telling you, for all the negativity we put in the world about ASHA and ASHFoundation, when you actually look at it, we should disseminate all negativity. Be gone. Because there's so much joy and positivity of what's actually happened. It's my weakness, but yeah.

[0:22:08] JBK: It's a high value on your dollar.

[0:22:11] MD: Now, Dr. Julie Feuerstein, I almost said Firestone. Please tell me that that has happened in the past.

[0:22:18] JF: That one I actually haven't gotten, so you would be the first.

[0:22:22] MD: Really? Oh, man. It's right there. I mean, again, words. Thank you for coming on. I want to hear about how the scholarships, grants, what you received and how it impacted. Take me from your beginning, like everybody's origin story, right? What is your origin story? What made you want to be a speech pathologist?

[0:22:42] JF: Yeah. Well, thank you for having me and my partner here, Jen Tucker, my partner in clinical and research crime, I need to say. My origin story, I haven't thought about this in a long time, but I went to a very large private urban university as an undergraduate student. I was an English major during that time. I really had this affinity for language and particularly understanding how language helps us connect to one another and form relationships and how social communication serves such a valuable role in our place in the world.

I studied language for a while, but I was a small fish in a very big pond at this university. I had a roommate at the time who I had been placed with in the quad, as you do when you're an undergraduate student, who happened to be an upperclassman, and she was studying CSD as a graduate student. She said, ÒYou know, if you really love language and you want a job, you might want to come take a look at some of what's going on in the allied health profession.Ó I took her up on her offer and I observed some intervention, pediatric intervention sessions and just knew at a visceral level that this was the right fit. I think it took just a week to change my major, and I never looked back.

[0:24:02] MD: I haven't done therapy since we moved. I hadn't been in a therapy session since the last week of March and we're having summer camp, Scottish Rite Camp here at JMU this Ð oh, my gosh. I was supposed to just be the supervisor, right? Well, today was one of the day, you were not keeping me a Pisces out of water. It's going to happen. I was right in there with the thick of it, like three, two, one, go. Then with the sprinklers and stop. I was like, wait, I'm having too much fun. But you find it, right? It calls you. Then you're like, ÒThis is what I need to do.Ó Yes, yes, might be a pediatric seat. It was more than boogers, Dr. Julie, Dr. Julie. The level of play, yeah. Then you went through school, when did Ð so, how did ASHFoundation impact you? Where did that enter your walk?

[0:24:54] JF: Sure. It certainly entered a bit later. I was a practicing clinician for a number of years and had always had this interest in research floating around in my periphery and just happened to be at the right place at the right time and met a fantastic mentor on Dr. Lesley Olswang. I worked for her as a research clinician for a number of years and then joined her lab as a doctoral student. Lesley is very, has historically been very active in the foundation. I credit her with introducing me to the great work that goes on in the foundation. She really encouraged me to apply for some funding during my pre-doctoral training.

I applied for some funding as a doctoral student and I received a graduate student scholarship that's helped support my dissertation work. I felt like from that introduction, I was folded into this family that is the ASHFoundation. I stayed connected with the foundation through the different activities that went on. I remember selling tickets for the ASHFoundation, and events at the ASHA convention. Then when I launched my faculty position here at UCF, I started and started thinking really strategically about where should I put those first grant external, extramural applications. The researcher-practitioner collaboration grant was just such a perfect mechanism for the type of work that I'm so motivated to do. It really became a no-brainer that Jen Tucker and I should apply for this because it was a mechanism designed specifically to fund a team, a researcher and a clinical person as a team to go out and conduct intervention work, or really clinically meaningful work.

The mission of the foundation and in particular, this particular funding mechanism was a natural fit and we feel really fortunate to have been seen as competitive in that application process and to have received that grant, so many years later now in my academic life.

[0:27:05] MD: Yes. I think my favorite part of what you said is that it was clinically meaningful. IÕm super happy that you got the money. That's amazing. For those of us that are in the trenches, right, my Monday through Friday has historically been early intervention. I am out there driving to patientsÕ homes. For those of us that are a little older, maybe a little hair dye going on, I went through school under the impression that research was lofty, far away, and not applicable, right? I would love for nothing else to pull back that veil.

What happens in research, at least the researchers that I've been fortunate enough to meet and have on the podcast, it is directly applicable to my Tuesday afternoons when I was working in a double-wide trailer in Red Bank, South Carolina as applicable when I am in downtown and had supported housing in inner city, Columbia, which is funny, because it's all 15 miles away through a pinpoint. You go from one to the other. Columbia is very small.

I love that it's clinically applicable. Can you talk a little bit about the speech side of your research? Because then I want to go through alphabetically and then come back to the PT side with Dr. Jennifer at the end. Could you talk to us about the speech side? How is the shape you're Ð what are we doing now?

[0:28:33] JF: Of course. The origin story of that work really begins at the University of Washington, as when I was a doctoral student and working as a research clinician to investigate a particular intervention protocol that focuses on really supporting pre-linguistic signals of communication for young children with really complex clinical profiles. I have the great privilege of working on this particular project with Lesley Olswang and packed out in and exploring the efficacy and the effectiveness of this intervention.

The one thing that we always were missing and didn't have the opportunity to further explore is how this intervention fits into really, early intervention and service delivery, which by nature is conducted in a team-based approach with interprofessional collaboration. I feel like the baton was passed and I was able to, with Jen Tucker's enthusiasm and support in this shared vision for how do we really support children who are living in complex bodies and have many medical needs in the earliest stages of life, how do we support the developing the building blocks of pre-linguistic communication?

That's really what our work currently aims to do is to look at high-quality early intervention for young children with complex needs in their families and to think strategically and systematically about how those components can be moved into our early intervention system, so that they don't stay in the lab collecting dust, or sitting in a research article on somebody's Ð well, nobody has hard copies anymore. Some folder on your hard drive somewhere.

[0:30:25] MD: I don't know. I like paper clips. I'm pretty sure I have everything on the family routines-based interview and the supermodel right there, hard copy.

[0:30:35] JF: I mean, everybody in the eye has some Nick Williams on their shelf, that's for sure.

[0:30:39] MD: Passing that one.

[0:30:41] JF: Yes. No, but really thinking about how to conduct work that has immediate applicability to everyday clinical settings. The ASHFoundation was very encouraging of that mission and provided us with the funding to get this work launched here at UCF. Together, Jen and I are just ultimately motivated by this fundamental belief that all children have agency and autonomy, and capacity for play and communication and engagement. As I'm sure Jen will describe mobility, and our job is to unlock those doors and figure out those strategies and support them and their families.

[0:31:24] MD: Agency, autonomy and capacity for play. That's like, yes. That could be a tattoo, or the opening of a book somewhere.

[0:31:35] JF: IÕm going to keep that for later.

[0:31:38] MD: Yes. But really truthfully, that's Ð Those are my patients. Those are the little ones that find me. I'm going in and we're setting up AAC and long-term loan trials and coaching the caregivers on how to engage with this. This is exactly what we need in our world. Because, again, folks, we have said this numerous times on the podcast. Early intervention is not a bag of tricks. Don't bring a bag of toys into that home and then take it away when you leave, because the message you're telling the caregivers, whether or not you're stating it, is you have to have this toy in order to make language happen.

A lot of the times, the families that we're called to serve, they can't afford this. We have to take away that approach and really get into seeking to understand what the caregivers' goals are. Also, one of the things that I find is that, and this may be an overstatement, but sometimes and our push to teach the ASHA Big 9, we don't always teach the comorbidities and the base analogies, so we have to align the caregivers' knowledge and understanding of whatever their child's specific disorder disease is, especially when it's complex, with realistic outcomes given what we know about that.

That requires us on the professor end to make sure that when we're teaching typical language norms that we take into account, yes, but if you have this disorder disease diagnosis, it could prolong this. You might have to go this route. That time back in, that's just a call to action. This is amazing.

[0:33:22] JF: Just to follow up very briefly about on that, I would take that step or a leap further and say, not only for parents and caregivers but for ourselves. I've learned so much from working with a physical therapist. I can't imagine doing this work with these families without a motor therapist by my side. Through this interprofessional collaboration, Jen and I have been able to, I believe, provide higher quality services to our families who come through our doors and who participate in our research, as well as feed all of that learning back into our educational programming, for our graduate students in both the CSD and PT programs. This particular grant mechanism from the ASHFoundation has given us the latitude to spend time to do just that. It's been really beneficial from a variety of perspectives.

[0:34:18] MD: Yes. That's something that's really Ð it's really difficult to teach IPE to IPP and put it into action. I know that CAPCSD at Council of Academic Programs for Communication Sciences Disorders, it's a different entity that streamlines how professors teach. Is that a good synopsis of that, right? They actually have an IPE, IPP initiative now. They have guest lecturers come in and talk about how do we bridge IPE to IPP. I don't know who you need to get a hold of to teach that, but that needs to happen, because that early intervention, how do we actually teach that piece would be a presentation there would be phenomenal. Actually, I know the person. I will do an intro.

[0:35:08] JF: Thank you, Michelle.

[0:35:10] MD: Yes, Dr. Julie, thank you so much.

[0:35:12] JF: Thank you.

[0:35:13] MD: Like legit, thank you all for your work, because that's going to change stars, so appreciate it. Then, Dr. Shirley, you work for the government and that sounds very terrifying and awesome. If somebody had told me once upon a time, a speech pathologist could work for the government, like the man, and that just is like a professor. I'd been like, ÒBut really? Are we allowed?Ó Because it seems very mysterious and very cool. Hi.

[0:35:39] SH: Hi. Thank you so much for inviting me, Michelle. I'm very happy to be here. Yeah, absolutely, talk about my role and the work that I do.

[0:35:49] MD: Yes. Okay. Now, how did you learn about the field of speech pathology? What is your origin story? I feel like we should have dramatic superhero music for when we ask that question. Imagine drums.

[0:36:03] SH: Well, I am bilingual myself. I speak Cantonese, which is a Chinese dialect. I grew up speaking Cantonese at home with my parents, with my family. I've always grown up with this love of language and culture. What Julie had said, too, language being a tool to communicate with people, to connect with other people around the world. Recently, I've been reminded again about this passion that I have with language and culture. As I'm living in DC now, I recently joined this language exchange group, where we just hop around at different restaurants, meet up with people who speak all different kinds of languages. We just talk in whatever languages, and so I get to practice my Cantonese, my native language. I also had picked up French in college, too, so I get to practice that. It's just wonderful to connect, use language as a tool to connect with people.

I came across this field of speech-language pathology, randomly in college. I realized it brought together, brought my passion together. I like, a helping field is a health profession. I came across the speech-language pathology profession and I started working as a clinician in Boston's Chinatown, and doing a lot of bilingual evaluations, working with this Chinese-American immigrant population, and seeing the health disparities that exist among this population, and their difficulties in accessing and navigating health care and special education services. I wanted to do more research, learn about these disparities, learn about bilingual language development. How can we accurately assess and treat this population?

That was when I pursued my Ph.D. in bilingual language development. Then during my training, my research training, I became very curious about this translation from research to policy. How can the work that we do, the science that we have inform policy decision-making to impact an entire health care system? That's how I got into the work that I do now at the National Institute of Child Health and Human Development.

[0:38:34] MD: That's amazing. I have a very dear friend, Kelly Caldwell, who loves policy and procedure manuals. I don't know her novels. I mean, she just delves into a policy and procedure manual and just tears it up, builds it, and puts it back. She's like, ÒOh, but you have to see line item four and point two.Ó I'm like, ÒHow do you remember that?Ó She's like, ÒI don't know, but it gets me excited.Ó I appreciate her enthusiasm for that because the fact that we need individuals that can go in and see how to take our science and put it into a policy, because that will guide our practice, right?

That's the very first time I ever heard of anything like this was Dr. Lemiana McNeely. I saw her talk on the World Health Organization. I think, I was maybe a year out from being seed. This woman comes in and she spoke with passion and just, she could command a room just by her presence, right? That was very, very, very humbling to watch. I hadn't even heard of the World Health Organization up until then, much less the fact that there's quality of life indicators and they have all of these tools available.

Also, folks, if you don't know that exist, don't feel bad. I didn't either. Thank you, Dr. Lemiana. Also, please go check the WHO models, because they're phenomenal. How did you hear about ASHFoundation and how Ð did you get a scholarship for your PhD, or for your research? What happened?

[0:40:04] SH: Yeah. I had not known about the ASHFoundation, until I was doing my Ph.D. program. I'll be honest, I needed some scholarship money. IÕm just a poor graduate student. I was just searching, and then came across the ASHFoundation. Yes, that was the initial draw, but in all seriousness, what this money and this grant allowed me to do was to give me the space to do community-engaged research. Community-engaged research is not easy. It is risky, it is challenging, and things do not always go to plan. It requires a lot of time, energy, and thoughtfulness. I believe in the importance of my work and the positive impact it could have on underserved children and families from culturally, linguistically diverse backgrounds. I needed the resources to give it my all, to do this important community-engaged research.

In my work, I traveled to Head Start programs. I set up lab in the community, worked with research assistants from another state in different time zones, worked with parents and teachers in the community. This is not common among graduate students. Already, community-engaged research is already complicated, and so I needed to allocate my energy, my time to focusing on just doing the research.

Then COVID hit, and it upended all my plans. I had to figure out new ways to conduct community-engaged research remotely, and new ways to remain connected and maintain my trust with the communities, who are already disproportionately impacted by COVID and are less likely to participate in research, particularly during this time. While I joked that the initial draw was to alleviate my financial stressors, but what this grant allowed me to do was to put my time and mental energy to dedicate solely on conducting my community-engaged research during the height of COVID when I needed to respond to the changes in the world.

[0:42:25] MD: I just have to start with the raw honesty of being the broke college student, because I just found out that the Panera down the street from the university, if you walk there, every two hours, you can get a free tea, or a refill on your tea. One of the students told me, but they close at 2.00, so I've been Ð They have really good guava papaya tea. She goes, ÒI'm a broke college kid.Ó She was like, ÒWe appreciate the free refills every two hours.Ó As soon as you said that, I was like, I'm a broke professor. I do appreciate the free refills every two hours.

Sorry, it just made me giggle up my head, and I had to share why I was laughing in such a serious moment. Now, did you, and this is me being nosy, because of COVID, did you have an Ð to add more time onto your actual overall studies? Did it waylay the process? Because that happened to one of my dear friends, Dr. Rebecca Wada. It took her an extra year to conclude her Ph.D. studies, because of how COVID impacted her research.

[0:43:24] SH: I'm so glad that you asked that. I know exactly what you're talking about because certainly, it impacted a lot of my fellow colleagues who were completing their Ph.D. program. Fortunately, it didn't prolong my data collection. It is, again, because of this fantastic grant that I received to help support me during such a stressful time when I had to pivot very, very quickly. When nobody knew what to do during COVID, nobody was prepared for collecting data remotely during COVID when everybody had to stay home.

Fortunately, I was able to allocate my time and my energy to focusing on coming up with creative ideas to help to recruit. I had to shift gears with my leadership and management style, managing a remote research assistant team and figure out new ways to recruit participants working on writing a news article in a bilingual Chinese newspaper, to reach out to the Chinese community, to recruit this population for my research study.

Coming up with just a lot of creative ways to try to pivot during COVID. Fortunately, it didn't delay my time in my data collection process, because I had this grant. In fact, because I had this grant, I even had the mental energy to write a fun ASHA leader article about how I pivoted during COVID times. It's called ÔHow I Revised My Dissertation During COVID With a Little Help From Taylor SwiftÕ.

[0:45:16] MD: Yes.

[0:45:16] SH: I think any researcher, regardless of whether you're a fan of Taylor Swift, would appreciate what it was like to pivot research during COVID time.

[0:45:26] MD: Oh, my God. You said Taylor Swift. You're my new favorite person. That's amazing. Can we find your dissertation? Is it published anywhere?

[0:45:39] SH: It is published in within the Ð I graduated from the University of Colorado Boulder. The dissertation itself is published. The manuscript, I am working on that right now, and so, stay tuned.

[0:45:51] MD: Yes, please. When the time is right, come back, and let's dissect it and let's talk about it, because this is amazing. Yes, I have additional ideas, but I will kibosh those for the sake of time. Folks, may I also give the humble suggestion that if you are working with patients, colleagues, or patients, or students, or clients, because I know we call them all different things in those settings, if you say you're not bilingual, then please go back to some of ASHA'S caucuses, because you have the gift of being bilingual. That is such an amazing support that you can offer. I can speak English and bad English. The patients that I have worked with over the years don't always speak my language, and I don't always have access to an interpreter. But I do know that some of the different caucuses, and we've highlighted them on the podcast in the past, do have supports available to you. This is why we have caucuses. Please go back and research, reach out to those caucuses.

It looks very odd that y'all are here and I'm turning it here, but the camera is just off-screen, just so you know why I'm looking in that direction. Shirley, this is amazing. Did we cover all the things? This was phenomenal. Wait, you received a grant. It was a grant, correct, or a scholarship?

[0:47:12] SH: Yeah, it was the New Century Scholars Award.

[0:47:14] MD: New Century Scholars Award. Amazing. I like to highlight what people can apply for. Well, thank you. Phenomenal. Jennifer Tucker, our PT in the crew, which is one, because when they sent that over, I was like, ÒDid they mean to send a physical therapist? Because I don't know that PTs can get in ASHFoundation.Ó I mean, obviously you did. Hi, that's cool.

[0:47:39] JT: Thank you for including me among other awardees from the ASHFoundation. I had spent the bulk of my career with speech and language pathologists. For me, it feels like a very natural place to be. On first glance, as to others, that may not be the case.

[0:47:58] MD: Now, what made you want to be a physical therapist? Because that's some heavy lifting right there. PTs always scare me. I've spent a lot of time in the PT office as a patient, so Ð

[0:48:10] JT: I have always known that I wanted to work with children, and so I began to explore different medical professions. I looked at medicine and I wanted to have a longer relationship with patients. Then sometimes you see are the opportunity, those individual interactions. Physicians do amazing work, but certainly, their time demands are significant. I landed upon physical therapy. I had the opportunity to have a year prior to going to physical therapy school, where I actually taught in a varying exceptionalities classroom. I had collaborations with speech and language, occupational therapy, and physical therapy.

I'm a little bit unusual in that I knew from the beginning that I was going to do pediatrics and all of the information on ACL repairs and total hips and total knees, I endured so that I could get to the classes on developmental milestones and neurological conditions and those components that spoke more directly to me.

[0:49:13] MD: Wait, you missed my favorite part of PT, the pelvic floor therapist. Because God bless them. After children, that is Ð I mean, folks, if you haven't signed up for it, I highly recommend finding you a pelvic floor.

[0:49:25] JT: While extremely rewarding and a growing part of PT practice, not one that I spend my time in.

[0:49:31] MD: Oh, practice. Sneeze pee is legit and I am grateful that they have people that can help you through that. Actually, my last pelvic floor therapist even told me that they've started in working with children for pelvic floor therapy to offset severity of constipation and all sorts. I was like, that is an aspect that I hadn't even thought about. But the application for our little ones that have cerebral palsy that with the low tone and they can't contract, it makes perfect sense.

[0:50:01] JT: Absolutely. Uresis, bed wetting at night, all of those things can be addressed by individuals with public health certifications.

[0:50:08] MD: Yes. Again, below the clavicle, not my thing. You just knew, like did you come across a physical therapist that you worked with?

[0:50:18] JT: I just have been exposed to a lot of different opportunities. I did some shadowing. I'm going to date myself with the term candy striper, but I was a candy striper. I don't think that term exists anymore. It's probably not politically correct, but that is what I did. I was aware of the profession and just made a lot of inquiries when I was looking at those opportunities. True confessions, I probably didn't pursue speech and language pathology, because I had received a lot of speech and language pathology as a child. As somebody who had spent a lot of time there, I was looking for something that had a little bit more movement involved and was moving around a little bit, because I spent a lot of time on the receiving end of speech therapy when I was younger.

[0:51:02] MD: Yes. As have both of my children to be the SLP and both your kids have been in. Also, my 10-year-old's future bar trick, if it doesn't drop is do you want to see my epiglottis? Because he loves to show that to the grad students. I'm like, I hope that drops in the near future, because Ð Yeah, I don't need that being his pick-up line for my future daughter or son-in-law, but I digress. How did you find out about the ASHFoundation scholarship? Because I'm envisioning in my head that Julie ran down the hallway at your office and was like, ÒI have an idea,Ó but I don't know if that's how it transpired.

[0:51:37] JT: Well, it is.

[0:51:38] JF: You're not entirely wrong.

[0:51:40] JT: That is how it unfolded. Again, I am really fortunate to work within a college that has an exceptionally strong CSC program, and so I had an opportunity to hear about that the foundation and obviously the work a little bit prior to. Julie and I, when she came to campus, I run a program called UCS Go Baby Go. Go Baby Go is a national movement, but I run the program here. She heard the kids in my lab and she's like, ÒThese are my kids.Ó We just really very naturally started practicing together and spending time together with children. From that really emerged our shared research agenda.

Then when this particular grant came forward, again, it just seemed like a really natural opportunity for us to really highlight that potential for clinically meaningful research and then and furthermore, interprofessional clinical research.

[0:52:39] MD: Yes, that IPP piece is just so profound.

[0:52:44] JT: I'm really grateful to the foundation for having a mechanism by which we could highlight that, because I think that really this grant allowed us to feel like, yes, these are people that will understand what our goals are from an interprofessional standpoint and that can have the vision for the interprofessional practice.

[0:53:05] MD: How did that translate to your Monday through Friday? When y'all received the money, what did that do with your Monday through Friday?

[0:53:13] JT: We spend a lot of time together serving the children. We run several initiatives that are designed to serve these medically complex children to provide them with offerings for play. Now what we had an opportunity was to really dedicate our energy and efforts towards research and looking at interventions. It really has given us dedicated time to look at intervention development and to really document it for the purposes of really scaling it up and getting it to clinicians as quickly as possible. That I think has been the greatest gift is just to have an opportunity for that dedicated time and to do it in a way that gave us the freedom to be funded for research in the way that we practice.

Those are not always natural opportunities. We've been able to spend time in the lab serving children and really are excited about what we believe will emerge from that and what those implications are for practice. Because in early intervention, we know that it is about interprofessional practice. That really is the foundation of early intervention. For us, this just made the most sense in terms of being in alignment with best practices for clinical work, as well as what we hope to be best practices for additional research.

[0:54:44] MD: When you say lab, and this is always interesting to me, because different researchers have different labs, the way the lab is set up, is it like a preschool, or are they coming in for set appointment times? Can you describe to me what the lab looks like, so I can see it in my head?

[0:55:02] JT: Yeah. I can tell you what my lab looked like that Julie wandered into when she arrived, is really just a big open room. We had a number of devices that were up, some portable harness systems and other devices that were up for play, and we had children in our lab with their parents and we were playing. That is really what it looks like. Our shared space now looks like just an early intervention room. There's mats on the floor, there's toys around, there's places for parents to be engaged in a part of that.

The only part I think that looks lab-like are the cameras that are on the wall that allow us to capture the work that we're doing for later analysis. But otherwise, it looks very much Ñ there are no magic toys, there's no magic bag. It looks very much like what we would see in clinical practice.

[0:55:56] MD: Yes, thank you. Because there are no magic toys. I don't know, I'm pretty sure bubbles will always be the magical toy of all time, but that's just my mom life going right there. Also, I still have yet to find an automatic bubble maker that lasts beyond a season. I think there's a secret conspiracy somewhere on that one.

Now, when you're working with the caregivers and both of y'all alluded to this ever so briefly in your comments, my understanding is that y'all are bringing the caregivers with you into the labs. That they're not waiting in the lobby for y'all.

[0:56:33] JT: Oh, no. Absolutely.

[0:56:35] MD: Can you please just touch on the importance of why we don't greet and leave caregivers and why we bring them back?

[0:56:42] JT: Well, I think that we both believe this as clinicians. It really felt very serendipitous that we landed in the same place because we think very much the same clinically. I think that we both are very grounded in best practices for early intervention and really, what happens in two hours a week doesn't move the needle for a small child. That's what happens the other hours of the week that they're with those caregivers.

I think for us, really having the opportunity to have caregivers present has been a gift. They're a rich source of information about their child's preferences and what their child responds to. There can be this ongoing teaching. Even though it's research, the feedback that we're hearing is that they're learning so much from just being in the room. I think that that really speaks to Ð it's really a three-legged stool between the three of us. It's Julie, myself, and the parent. We are the team that is identifying how best to engage their child.

Certainly, we're looking at specific interventions, but how do we best engage their child? How do we, like I said, identify their preferences and what they respond to? Then the other thing that I will say just very briefly is, in the world of early intervention, Julie and I continue to talk about the level of trauma that many of these families have been through on their journey to bringing a little one into the world. For some of them, they spent a long period of time in NICU. I think there's tremendous value in being in a room with clinicians who are talking about your child's strengths, who are talking to you about things that you can do.

It takes what I think can be a really overwhelming experience that removes parents. Instead, it empowers them that they are an equal member of this team, and that really just acknowledges this has been really traumatic. We're here to help you leverage your strengths to get you and your child through this next part of the journey.

[0:58:52] MD: My podcast cohost, Erin Forward, just interviewed Kim Bartell, who is OTRLC/NDT-NDTA. That episode will go Ð went out. We're recording a little early, but it went out on Tuesday, all about trauma-sensitive practices for that reason exactly. Because we don't know the traumas that they've been through, and what may be a trauma for you or I may be fortunately run of the mill for some of their experiences, or they may have a lower threshold. A smaller blip on our radar may be a profound trauma for them.

Then to pull in Dr. Shirley and her work, that health disparity piece, that health literacy piece for our individuals that speak a different language come from a different background. Are y'all familiar with the I-95 corridor of shame in South Carolina? The I-95 corridor of shame, historically post-Civil War, all freed black slaves, were put on along this very poor dirt of land. It is where it's very typical to grow crops. Those individuals, unfortunately, a lot, became generational, and they couldn't move from it.

The I-95 corridor of shame is part of it, something called the Abbeyville School District Lawsuit, where the schools that run along the I-95 corridor got together and they sued the state of South Carolina for equitable distribution of taxpayer dollars to fund education. It's a lawsuit in South Carolina that's been going on for 25-plus years and the schools, some of the schools are literally falling apart. They have part of the school shut down because the ceilings have fallen in and it's still not addressed. But that corridor tends to have higher health needs and they don't have full access to broadband services, internet services. Dr. Shirley, when you were talking about what you were researching in Boston, I'm envisioning I-95 on a very large scale, because this is generational racism is what it is that we're witnessing.

Yeah. I moved back to Virginia and we're right here, throwing snow from the mountains and not much is different there. It is profound to me how each one of y'all's work intimately overlaps and it's right there, and how because of your work, we will have policy and practices, so that my Monday through Friday will become easier from an intervention perspective. ItÕs very humbling and makes me cry a little. But in a happy Ð my Irish eyes are leaking kind of way. Thank you.

I know we hit our hour very quickly, and I honest to God just want to have y'all all practice to talk about all this in detail, because this is pretty cool stuff. I like research to practice. It makes me happy. Did we cover everything that y'all wanted to share about your research and about what the foundation has meant for y'all and for our fields?

[1:02:07] JF: Yeah, I think so. Thank you so much, Michelle.

[1:02:09] MD: Dr. Shirley, good?

[1:02:10] SH: Yeah, I think so.

[1:02:12] MD: Beautiful. Dr. Jennifer, yes?

[1:02:14] JT: No, I think so.

[1:02:16] MD: Well, thank you. The other Dr. Julie, who sits on the board, thank you. This is, bloody hell, y'all are doing cool work. This is awesome. Please keep giving away money. I promise to buy adult beverage tickets if you continue to give away money. Well, so let's go through, if you have what grandma would call a little bit of love money lying around at the end of the month, then please check out the ASHFoundation. You can find them on LinkedIn. You can also find them on, they now have an Instagram account. Thanks to, I believe it is Kelly. Kelly runs the Instagram account, I think. You can check them out there. Also, we'll have it hyperlinked into the show notes at the end.

As always, hit us up on First Bite Podcast. You can find us on Instagram, Facebook, and Erin and I have individual accounts on LinkedIn. Also, this week we rolled out our very first research Wednesdays, where we're actually interviewing the researchers on the First Bite Instagram account. If you're not familiar with that, two Wednesdays a month, we are going to be directly interviewing the researchers, because as much as I love a good tick of the talk and a good reel, sometimes I think the information gets misconstrued and twisted and the message could be lost.

Research Wednesdays is Erin and I's attempt to elevate the voices of those that are conducting the work to grow our clinical skills. Hit us up there. We just had Dr. Amy Delaney with Marquette pedes feeding lab on. At the end of the month, we're having Meg Siamoni. Meg, I got it that time because you taught me the hand trick, on to talk about caregiver coaching for pediatric feeding disorder. There we are. Ladies, thank you so much for coming on.

[END OF INTERVIEW]

[1:04:04] ANNOUNCER: Feeding Matters guides system-wide changes by uniting caregivers, professionals, and community partners under the Pediatric Feeding Disorder Alliance. What is this alliance? The alliance is an open-access collaborative community, focused on achieving strategic goals within three focus areas; education, advocacy, and research.

Who is the Alliance? It's you. The Alliance is open to any person passionate about improving care for children with a pediatric feeding disorder. To date, 187 professionals, caregivers, and partners have joined the alliance. You can join today by visiting the Feeding Matters website at www.feedingmatters.org. Click on PFD Alliance tab and sign up today. Change is possible when we work together.

[1:04:58] MD: That's a wrap folks. Once again, thank you for listening to First Bite: Fed, Fun and Functional. I'm your humble, but yet, sassy host, Michelle Dawson, the All-Things PFDs SLP. 
This podcast is part of a course offered for continuing education through speechtherapypd.com. Please check out the website if you'd like to learn more about CEU opportunities for this episode, as well as the ones that are archived. As always, remember, feed your mind, feed your soul, be kind, and feed those babies.

[DISCLOSURE]

[1:05:44] MD: Hey, this is Michelle Dawson, and I need to update my disclosure statements. My non-financial disclosures. I actively volunteer with Feeding Matters, National Foundation of Swallowing Disorders, NFOSD, Dysphagia Outreach Project (DOP). I am a former treasurer with the Council of State Association Presidents, CSAP, a past president of the South Carolina Speech Language and Hearing Association, SCSLHA, a current board of trustees member with the Communication Disorders Foundation of Virginia. I am a current member of ASHA, ASHA SIG13, SCSLHA, the Speech Language Hearing Association of Virginia, SLHAB, a member of the National Black Speech Language Hearing Association in NBSLHA, and Dysphagia Research Society, DRS.

Additionally, I volunteer with ASHA as the topic chair for the Pediatric Feeding Disorder Planning Committee for the ASHA 2023 Convention in Boston, and I hope you make it out there.

My financial disclosures include receiving compensation for First Bite Podcast from speechtherapypd.com, as well as from additional webinars and for webinars associated with Understanding Dysphagia, which is also a podcast with speechtherapypd.com. I currently receive a salary from the University of South Carolina in my work as adjunct professor and student services coordinator, and I receive royalties from the sale of my book, Chasing the Swallow: Truth, Science, and Hope for Pediatric Feeding and Swallowing Disorders, as well as compensation for the CEUs associated with it from speechtherapypd.com. Those are my current disclosure statements. Thanks, guys.

[1:07:41] EF: The views and opinions expressed in today's podcast do not reflect the organizations associated with the speakers and are their views and opinions solely.

[END]
FBP 242		Transcript

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