School of Speech Ep 19
===

[00:00:00] Carolyn Dolby: Welcome to the School of Speech podcast presented by SpeechTherapyPD. com. School of Speech is designed specifically for the school based SLP to come together to discuss current topics, tackle difficult situations, and share our insights. Our goal is to bolster confidence, celebrate our triumphs, and foster a community Dedicated to the excellence in the school setting.

[00:01:20] Carolyn Dolby: Hello and welcome everybody. I'm Carolyn Dolby. I'm your speech therapy pd.com podcast host for School of Speech. School of Speech is designed for school based SLPs so we can come together to explore current trends, share insights, and really champion our expertise.

[00:01:38] Carolyn Dolby: Our goal is to bolster confidence, celebrate our triumphs, and foster a community dedicated to the excellence in the school setting. Today's episode, Promoting Hearing Aid Use and Self Advocacy in Children Who Are Deaf. Who are hard of hearing. We have Meaghan Foody today as our guide for our exploration for oral rehabilitation.

[00:02:00] Carolyn Dolby: She's here to discuss key factors that predict hearing aid usage. We're going to gain insight into developing. personalize goals, and uncover practical strategies that are going to help our students communicate their needs and also their rights in order to foster independence and self advocacy skills.

[00:02:21] Carolyn Dolby: Before we get started, we will have to do some housekeeping. Each episode of School of Speech is 60 minutes long and it is offered for 0. 1 ASHA CEUs. 

[00:02:33] Carolyn Dolby: . I'm going to do our financial disclosures all right. Meaghan is salaried as a full time employee at the University of Iowa and the University of Iowa Hospitals and Clinics. And she's receiving an honorarium from SpeechTherapyPD. com for her participation in today's episode.

[00:02:50] Carolyn Dolby: For non disclosur e has no relevant non financial disclosures to disclose. For me, I receive a salary as the district level specialized support clinician for my district in Houston. I also am an adjunct professor and teach graduate courses for the University of Houston. I also consult for school districts across the nation supporting their program development and staff training.

[00:03:14] Carolyn Dolby: And I do receive compensation from SpeechTherapyPD. com for hosting School of Speech. Speech. Non-Financial. I am a member of the TISHA, which is Texas Speech and Hearing. I'm a part of their feeding of Swallowing Task force, which is amazing. I volunteer for Feeding Matters and I'm also a member of Astras Special Interest Groups 13, which is Swallowing 14 Cultural and Linguistic Diversity, and also 16 school-based issues.

[00:03:39] Carolyn Dolby: But enough about me. I want you to know all you there is to know about Meaghan. She is a speech language pathologist at the University of Iowa. And she her specialization is in oral rehabilitation across the lifespan. She provides diagnostic and treatment services in both the pediatric and adult populations, primarily for individuals who are deaf and hard of hearing.

[00:04:04] Carolyn Dolby: In the summers Meaghan co directs the Communication Explorers program for young children who are deaf, hard of hearing, as well as co directing the University of Iowa's Shine program. I love that for adolescents and teens who are deaf and hard of hearing and who stutter. Okay. Wow Meaghan is passionate about emphasizing collaboration between professionals students in professional students in their areas of speech language pathology and audiology to maximize patient outcomes post cochlear implant and or hearing aid fitting.

[00:04:41] Carolyn Dolby: Welcome Meaghan. How are you? 

[00:04:43] Meaghan Foody: I'm so good. Thanks for having me. 

[00:04:45] Carolyn Dolby: Oh, no, we are the lucky ones to have you today. We are so excited. Well, before we get started with all the questions, I know we're all going to have to ask. Meaghan, I would really, I'm so interested in your journey.

[00:05:00] Carolyn Dolby: How, how did you become the, an expert? How did you decide that this is your specialization? 

[00:05:06] Meaghan Foody: Yeah I was really lucky. I kind of knew I wanted to be a speech language pathologist from about the time I was in the seventh grade. I had a family member who had a significant language delay and watching kind of pre and post his experience with speech and intervention.

[00:05:28] Meaghan Foody: But even more than that, like watching my family and how all of a sudden his involvement and interaction with other family members changed. Just you know, it was like the doors kind of opened and that was kind of it. That was really all it took. I was really fortunate. I mean, the simple answer to your question about, like, how is mentorship.

[00:05:49] Meaghan Foody: I've been so incredibly lucky with the people that I've encountered throughout my education and stages of my career. I went to Purdue for my undergrad. So a little different here at the university of Iowa. That's a, a tricky situation. But I, again, kind of knew that I wanted speech therapy and then I took oral rehabilitation with Dr.

[00:06:15] Meaghan Foody: David Ertmer, who has since retired, but was such an impactful mentor for me. And any time that we talked about like the technology, I was like, I, I was like, Two times more engrossed in class, but I never really saw myself going the audiology track. I always thought it was speech. I was fortunate to volunteer at a school for the deaf when I was an undergrad and that really sealed the deal.

[00:06:42] Meaghan Foody: And then I kind of sought out graduate programs that would give me. Additional opportunities to really work with this population that I found myself so passionate about. So I made a huge leap and I moved to Utah. I went to Utah State for my Master's. I'd never seen a mountain before. I thought skiing just happened in Michigan.

[00:07:02] Meaghan Foody: It's very different there. And Dr. Christina Blazer, who's now at the University of Idaho, was at Utah State at the time, and she has just had such a profound impact on my career and my passion for this field. So that, you know, that kind of sealed the deal. Utah State had preschool program for kids who are deaf and hard of hearing on campus, where we got to work really closely with the kids and even more kind of impactfully sometimes got to work really closely with deaf educators as well as audiologists, both professionals as well as graduate students.

[00:07:41] Meaghan Foody: And yeah, that collaborative piece has always been something that has really made me Fall in love with and continue to love this field. After graduation, I knew I wanted to do a clinical fellowship that would really maximize my experience working with people who are deaf and hard of hearing and got incredibly lucky and wound up at Boys Town National Research Hospital in Omaha.

[00:08:07] Meaghan Foody: Yeah, it was the best. Again, just like incredible opportunity after incredible opportunity. I, again, have just been so fortunate. And that particular experience was really awesome for lack of a less cheesy word, because I was 60 percent clinic and 40 percent research as a clinical fellow.

[00:08:28] Meaghan Foody: So I was in Boys Town also as a preschool program for kids who are deaf and hard of hearing, and then also saw patients in our outpatient clinic with the cochlear implant team, kind of across the age range, and then again, 40 percent of that, I was on the OSAT grant or the outcome grant. Of school aged Children who are hard of hearing and got to work with professionals at Boys Town, the University of Iowa and the University of North Carolina.

[00:08:58] Meaghan Foody: It was is the largest longitudinal study of its kind for kids who are deaf and hard of hearing got to work with Dr. Mary Pat Moller, who's been a profoundly impactful in child language development with kids who are deaf and hard of hearing. Bruce Tomlin, Ryan McCreary, Beth Walker, who's at Iowa now and just had so much mentorship there, both on a research level as well as on a clinical level.

[00:09:23] Meaghan Foody: There was such an openness in terms of communication modality at Boys Town, where all communication modalities were accepted and celebrated and fostered and encouraged. And I think that a lot of the time we kind of have this idea of you have to fall on the oral side or the sign side of communication.

[00:09:46] Meaghan Foody: And being able to really explore that continuum with families and the kids themselves was just profoundly rewarding. You know, like most things in life, there's no right way to do one thing. And watching kids really flourish with multiple communication modalities was just one of the greatest blessings of my career and of my life as a whole.

[00:10:10] Meaghan Foody: I left Boys Town Kind of mid pandemic. My sister had my first nephew back in Chicago. It just felt like time to move home. And then I got an email from Dr. Elizabeth Walker, who's here at the University of Iowa, that this clinical faculty position was opening in oral rehabilitation and what I'd be interested in applying.

[00:10:33] Meaghan Foody: really was like, okay, made a big personal decision here. But professionally, this just feels like something I can't turn down. And I, you know, I'm just so lucky to work here and to have had the opportunities I've been given to collaborate with research and clinical work, audiologists, school based professionals and, and students now getting to watch students develop their own skills, their confidence and get to collaborate with other graduate student clinicians on the audiology side.

[00:11:10] Meaghan Foody: It's, it's, it's, Every day has some kind of positive highlight, and I think that as a whole, we're so lucky as speech language pathologists that we have careers that are so fulfilling where each day you can kind of pull out some kind of positive note about what happened, and the University of Iowa has given me so many of those, so that's kind of where I'm at.

[00:11:34] Carolyn Dolby: I love your passion. I mean, it is palpable. It just is amazing. I've been looking forward to this episode. Like I was talking with you a little bit before about kind of my journey too. And my, my nephew is deaf in one year and his, his journey with that. And I, I meant to say my, my stepfather recently got a cochlear implant at late in life.

[00:11:58] Carolyn Dolby: Right. So, it's very part of. And what I love about my district is we are the regional day school for the Northwest Harris County co op for the deaf and hard of hearing. So we, it's, I just love it. I love the experience that I've gained. Love it so much. But, oh, right. Okay. Just, we're all so passionate and I just love it.

[00:12:23] Carolyn Dolby: But let's get in. Into let's start. Where should we start? Maybe going into like those predictors. I think maybe that might help us get started. What are those predictors that well, that will that we need to be looking out for, or maybe encourage to, For the usage of devices. 

[00:12:43] Meaghan Foody: Yeah. So recent research studies. Again, I work really closely with Dr. Elizabeth Walker, and she's done some research to look at what outcomes look like and kind of what those primary factors or considerations are. are that we need to be aware of. And I think one of the things that we need to consider is that speech language pathologists, there are going to be factors that are completely outside of our control, right?

[00:13:07] Meaghan Foody: So degree of hearing loss, socioeconomic status of that child, maternal education is a big one, and obviously those aren't things we can. control. So I won't talk as much about those, but I want to think more about kind of the qualitative factors that we can consider. So one of the big things that leads to more optimal device use, which in turn often leads to better language outcomes, better academic success, better social relationships, between their peers is how well they understand their devices, right?

[00:13:46] Meaghan Foody: It's one of those things where when you think about kind of early elementary nobody wants to be different, right? No one wants anything to stick out. Anytime somebody asks like, Oh, what is that? In reference to a hearing aid for a lot of kids, their reaction is, Oh no, they're asking because they want to make fun of me or it's different.

[00:14:10] Meaghan Foody: But when we give them the verbiage and the language to say, It's my hearing aid and it helps me hear as simple as that is at that stage of the game. For most kids, that's enough. And they're like, okay, and kind of walk away from it. But giving them that verbiage, I think is something that starts really early on.

[00:14:34] Meaghan Foody: It sounds kind of crazy, but autonomy, in my opinion, starts with early intervention. So talking to parents about appropriate vernacular and vocabulary, I think, is really important because if we give kids appropriate terminology, they know the different parts of their devices, they know how to explain what they do they can troubleshoot them at a very basic level.

[00:14:59] Meaghan Foody: Of course, we don't want them. changing anything about their hearing aids. Right. But giving them the ability to be autonomous helps them have a better connection to that device and in turn is going to make them more likely to use that device. The other thing too that we want to think about is do they know the why?

[00:15:20] Meaghan Foody: So there have been kids that I've worked with in the past where they ask questions like, when am I going to graduate from having to wear my hearing aids? 

[00:15:29] Meaghan Foody: And that's a heartbreaking question, right? Because a lot of the time they're asking that question because they don't want to wear it anymore. And that could be for a multitude of factors, but a lot of it is kind of social emotional in nature from my experience anyway.

[00:15:47] Meaghan Foody: But if they really understand the importance of the device, the longevity of their need for that device and why it's important for them. We're all more likely to do things when we know the why behind it. And that's true for kids too. So kind of being able to help instill some of that autonomy knowing those indicators whenever possible.

[00:16:10] Meaghan Foody: Of course, we don't know the ins and outs of every child and kind of what they're, what home life looks like and what those more external factors are. But if we can help them develop a positive relationship with their device, which is where I think we can really come into play as speech language pathologists, I think that that makes a pretty profound impact on them, you know, years down the line, even into adulthood, which is pretty powerful to think about.

[00:16:39] Carolyn Dolby: Yeah, absolutely. I'd like the things that you've said that really hit home is, and I think part of speech pathology is making relationships and there was a huge, right? Psychosocial. You brought that up and having, and it just made me think about diversity and, and really honoring diversity. And and it's kind of what you're saying is giving the words for them to use it.

[00:17:08] Carolyn Dolby: Yes, it might look different, but this helps me. That was so powerful and gives them I think sometimes when you just, when you don't know what to say, then you, you want to shy away from it, but giving them those words that, that, well, you know, this is me, this is me is powerful. it is important to know about, outside of school, their relationships outside of school.

[00:17:35] Carolyn Dolby: And getting that bigger picture for students, like in, in this population for sure. 

[00:17:40] Meaghan Foody: Yeah. 

[00:17:42] Carolyn Dolby: But I guess maybe we're kind of getting into like, okay, so we're trying, we're trying I think the first thing start at the very beginning, giving them the words to use to discuss of the, what it is and why I think you're right.

[00:17:55] Carolyn Dolby: If we don't know why we have to do something, we're not going to do it, you know, it's over. That's great. It's, you know, it's cute. It's pink. But 

[00:18:03] Meaghan Foody: right. That stuff like it seems so trivial. I think on the surface level of, you know, the different colored ear molds and brand processor colors and All of these things, but those are big, especially when they get to make a decision about what it looks like.

[00:18:22] Meaghan Foody: The thing I always go back to that, like I can pull from a personal experience is I was a nineties kid. So I had this pair of like blue shiny sketchers that were horrible. They were hideous, but I loved them. And I wore them into the ground. And my mom was like, we need new shoes. We got to get new shoes.

[00:18:42] Meaghan Foody: And I just wouldn't. And I didn't want to do it. And as a mom, which I've learned to let go of, she threw them away one day when I was at school. But I think the reason I remember those is because they were mine. Like, it's one of the first things that I got to pick. And again, when you give them the power and the control to say, I want pink sparkles, I want blue and red because I love Spider Man.

[00:19:07] Meaghan Foody: Like, that is the stuff that makes a big difference. difference because they can tailor it to themself. And again, on the surface, it looks kind of small and how much of an impact is that really going to have, but it does help foster that sense of autonomy and kind of ownership over their devices, which is huge because a lot of the time, you know, parents are scared to let them change troubleshooting because they're small, they're fragile, they're expensive.

[00:19:36] Meaghan Foody: But the more ownership they feel, the more apt they are to want to use them and to feel connected to their devices. 

[00:19:46] Carolyn Dolby: I, I think you hit it. That they need to know it's theirs. This isn't being done to them. You know, you know, and, and most, I think as children, so many things are just told to them or done to them.

[00:20:01] Carolyn Dolby: And no, you're like, no, this is yours. And we are here. We are your customer service providers. Basically, we're here to help you with this and what you need because it's yours. Yeah, right. And I think we do take care of things when we, when they're ours versus, I mean, it's children, you know, that way. 

[00:20:23] Meaghan Foody: Yeah.

[00:20:24] Meaghan Foody: Yeah. They still get lost. They still end up in places that you shouldn't, but the goal is just that kind of connection. And then, and the same thing with, I think as like a society in general, There's been this push toward representation and so like finding books that you can incorporate into treatment sessions that feature kids who are deaf and hard of hearing that have hearing aids or cochlear implants.

[00:20:51] Meaghan Foody: There's quite a few available. Seeing things like in the most recent Toy Story movie, just in like the background, there's a kid with a cochlear implant and he's not a character. He's just a background character. But again, Just getting to see kids that share this common feature that they have in media, whether it's books or shows or whatever it is, like, that makes a big difference for kids.

[00:21:18] Carolyn Dolby: Oh, I agree. And especially for I know the difference that my district there, we have that community, but I'm thinking about those that are listening that don't have that built in community of like the regional day school that we have and finding ways. To build that community for them. And I, I love literature and bringing that in.

[00:21:40] Carolyn Dolby: And when you said that, yeah, we do lack representation and finding Books that are respectful and represent. Is, you know, it's hard but we need to do it. Thanks for letting us know about Toy Story. I think we're gonna all Google that and try to get that clip because I think that's powerful.

[00:21:59] Carolyn Dolby: Yeah. You know, we're not, we're not islands. You're not alone. This isn't, you know, I think that's important for them to see that it's, they're okay. Yeah, yeah. Talk about, yeah, the building just autonomy. I love it. When you, I guess when we're looking at, you know, we're those that are listening, you know, we're school based clinicians.

[00:22:25] Carolyn Dolby: So when we're looking at maybe talking about formulating, goals because that, you know, we're a goal based society here in the schools. And yeah, you know, and I, you know, we can't have 15 million goals, but I do think you're saying that, you know, we do need to make sure that we have a goal in self advocacy.

[00:22:45] Carolyn Dolby: Is that what I'm hearing? 

[00:22:46] Meaghan Foody: Yeah, absolutely. And I know like being in primarily outpatient settings, there's so much more kind of flexibility and adaptability that can come with goal development. So I want to make sure that I, I recognize that there's going to be variation from school district to school district.

[00:23:05] Meaghan Foody: But even if it's something you work on in person, formally and just kind of have counseling based conversations. You know, you can start these goals really early. For some of my young kids, it's just about do they replace the ear hook if their hearing aid kind of flops and is wobbling on their ear?

[00:23:25] Meaghan Foody: Can they do that? Or do they tell an adult that they need help? That's a big one because, of course, Again, devices are expensive. Little humans can be hard to predict. We don't want to lose devices. And so if they know to ask for help, that's big. As we move kind of into the school age population, like can they remove their hearing aid appropriately?

[00:23:48] Meaghan Foody: So, you know, coming down to where the ear mold is versus. pulling by the tubing, which could crack the tubing. Can they insert it by themselves or reposition it? Because again, that's all autonomy. And then we have to think about like peer to peer correspondence and interaction. And this is totally true across the lifespan.

[00:24:07] Meaghan Foody: I have this conversation with like first graders and I have this conversation with 90 year olds. When we don't hear something, our tendency is to say what or huh, and in turn, that person is probably going to say the exact same thing in the exact same way, at the exact same rate, at the exact same volume, looking in the same orientation they were looking before.

[00:24:33] Meaghan Foody: But if we can help kids understand the why behind a communication breakdown, or maybe why they weren't successful in hearing what was said by a peer, an adult, whoever the situation might be, then they can advocate for themselves in a really specific way. So, can you say that again more slowly? I wear hearing aids.

[00:24:57] Meaghan Foody: Sometimes that helps me. Can you look at me and say that again? I couldn't really understand you when you were facing the opposite direction. And we're all guilty of it. We all talk to each other while we're in the next room or we're trying to find something in our bag, but we're still having a conversation.

[00:25:16] Meaghan Foody: And again, When you can ask for really specific things, it helps you as the listener be more successful. But what I really like about it is it also kind of puts the onus on a communication partner. A lot of the times people who are deaf and hard of hearing, they feel like a burden because they have to ask for repetition multiple times.

[00:25:37] Meaghan Foody: And they're like, well, I don't want to do that. That's annoying. You know, my brother doesn't like it when I do that. So I don't want to do it to my family. But when you give them something to change now, all of a sudden you're sharing the responsibility of making that a successful exchange, which is so powerful, regardless of how old you are.

[00:25:59] Meaghan Foody: As SLPs, as audiologists, we see it as such like an obvious thing, right? Advocate for yourself. Communication is important, but people get impatient. Again, no one wants to feel like a burden on anybody else, but the more specific they can be in repairing those communication breakdowns, the more likely they are to successfully facilitate that.

[00:26:22] Meaghan Foody: Another piece of self advocacy and things we can work on is do they know? The basics of their device. Can they label the different components of their hearing aid? Do they know what the indicator light means? If they use a remote mic of any kind or any kind of hearing assistive technology? Do they know the basics about how to set that up?

[00:26:45] Meaghan Foody: Do they know what it sounds like when the teacher has the microphone on versus off? Because again, the more that they can really understand the technology, the more likely and more quickly they can become the expert on it. So that, you know, as they get older and have maybe less supports in place, They can advocate for themselves appropriately newborn hearing screenings have been so beneficial and, you know, before newborn hearing screenings were required, we were really late in identifying lots of kids who are deaf and hard of hearing, especially in that kind of mild to moderate, even mild to severe population.

[00:27:28] Meaghan Foody: But because of newborn hearing screenings, they're getting fit sooner. They're getting services sooner. follow up is happening appropriately because families have appropriate guidance, and in turn they're ending up in mainstream classrooms and mainstream environments, which is awesome because it means that they're developing relatively similar to their same age, typically developing peers, but it also means that they might end up in a classroom With a teacher who's never worked with any kind of hearing assistive technology before.

[00:28:01] Meaghan Foody: And that's difficult. Because as teachers, of course, the child's best interest is always at hand. But when they don't have the background, it makes it really hard to Fulfill the need at 100 percent capacity anyway. But if the child has the ability to say like, oh, you forgot to unmute your microphone or give them a little wave or whatever kind of system they want to work out like.

[00:28:28] Meaghan Foody: Now all of a sudden, everybody's more successful. So there's pros, you know, of course, to kids ending up in mainstream environments when they use spoken communication in particular, but there's also challenges. And again, the better we equip the kids to be able to advocate for themselves the more successful, hopefully, of course, they'll be when they get into those situations.

[00:28:52] Carolyn Dolby: I think I think the word for this episode is why. Yeah. Yeah. You know, first of all, like you started with why to begin with, why do you need this device? Then why, why isn't it, why is it important for you to be able to explain how the device works? Because then you can ask for help when you need it.

[00:29:14] Carolyn Dolby: And then I think where you, you're taking us now is the why it's important for educators also to know their part. 

[00:29:24] Meaghan Foody: Yeah, it's hard. New technology is scary. Of course it is. I mean, I have no envy for a teacher of a 28, you know, third grade classroom. That's a lot to manage and a small piece of technology You know, I think we have this idea of like, oh, it's not that hard, but it is that hard when you're managing everything else going on in that classroom.

[00:29:52] Meaghan Foody: It's tough. And so we all need support wherever we can get it as providers, as well as children receiving services.

[00:30:02] Meaghan Foody: I

[00:30:02] Carolyn Dolby: think it comes down to, you know, as speech pathologists in the schools that that counseling component that we do you, you indicated, you know, doing the counseling with the student and the family.

[00:30:13] Carolyn Dolby: Absolutely. But I think also you're showing us the importance of the counseling with the educator, with the teacher. 

[00:30:20] Carolyn Dolby: And they need to know why. Cause I mean, I think all of us are, you know, with ASHA doing the, you know, diversity, equity, and inclusion, we're, you know, everybody has needs a voice.

[00:30:34] Carolyn Dolby: Everybody has the right. And 

[00:30:36] Meaghan Foody: I think we're all learning, you know, it's okay to make mistakes. It's okay. I can't tell you how many times I've had a child's cochlear implants in my hand and then ask them a question. Oh, they can't hear you. You know, we all do things but it's important to just kind of own it, to be able to articulate what we don't know so that we can fill in those gaps and to give each other the space to be able to be honest, right?

[00:31:06] Meaghan Foody: You can't come off as if a teacher comes to you and is like, Hey, I gotta be honest. We didn't use the hearing assistive technology today because I kind of forgot how to set it up. If you approach that in a brazen, like, I can't believe that you did that kind of way. We just talked about it last week.

[00:31:25] Meaghan Foody: They're never going to come to you again. Absolutely. But no shaming. Yeah, if you take the time to walk them through it one more time, you encourage them to come to you with questions. Everybody's going to be more successful. And the hard part is SLPs. And one of the things that makes me so passionate about like the graduate level with education is research studies have shown that SLPs are so seen as the expert on hearing assistive technology because even educational audiologists, if they're there in that school, they're probably not there every day.

[00:32:01] Meaghan Foody: And so if a breakdown happens, oftentimes the classroom teacher goes to the SLP, but research has shown historically that lots of SLPs have discomfort with that. And again, That's a problem, of course, when the expert in the school doesn't have the comfort level to do some essential troubleshooting. And again, that's not passing judgment on anyone.

[00:32:30] Meaghan Foody: It's just really highlighting the importance of making sure that we support each other in our understanding in whatever way that can be. And a big part of that is continuing ed sometimes Finding colleagues who can help support you. Those are, those are the things that make us all better. Cause at the end of the day, this field changes every hour.

[00:32:52] Meaghan Foody: It feels like there's always something new to learn and develop and that can feel overwhelming, but it's also really exciting. 

[00:33:00] Carolyn Dolby: It is. And I think when you were talking about the journey of how you got here, the first thing you said was your mentorship. Yeah. And the support that you received. And I think those of us that are listening today me included resources in finding mentors, finding, I mean, thank you for those that are listening today.

[00:33:24] Carolyn Dolby: You're coming to get some, you know, some continuing education. This is a great step for that. Any other resources that you can provide us would be great. Anything you can think of that, you know, to help us find a mentor, find continuing ed. 

[00:33:38] Meaghan Foody: Yeah, I mean there are We have like the AR little niche of our field is it feels like this like teeny little bubble sometimes.

[00:33:49] Meaghan Foody: We're always in like one corner of the ASHA convention. We like stay in the same like six rooms the entire time that we're there. And I think For me, you know, those experiences can be so intimidating to walk up to someone and just be able to say like, Hey, I have a, you know, kid who's bimodally, whereas one hearing aid and one cochlear implant.

[00:34:13] Meaghan Foody: And I've never worked with anybody like that before. Like, can you help support me? The other thing to, to think about and look into is whether or not you can make a connection with the child's audiologist. Okay. Especially when it comes to the technology piece, they're going to be a huge resource and still continue to be for me all the time where I'm kind of noting something and I'm not really sure how to appropriately counsel, especially when it relates to the technology.

[00:34:44] Meaghan Foody: Because at the end of the day, I'm not an audiologist. Right. I'm never going to be an audiologist. I have no intent of getting an additional degree and it's okay to not know everything. So in terms of like a day to day mentorship opportunity, I would encourage connection with if you have access to that child's audiologist.

[00:35:08] Meaghan Foody: and really just connecting with other people within your school district. There's lots of great, you know, websites and resources. All of the different hearing aid manufacturers, cochlear implant manufacturers have extensive resources on their websites. And just kind of. Putting yourself out there I think sometimes is one of the hardest parts, but also one of the most rewarding pieces that come from it You know, I think as SLPs we all really like to talk and we all like to talk about what we love So I also think just reaching out, if you ever have the opportunity to, you know, attend a Continuing Ed talk or you read a really interesting piece of research, like, I don't think there are too many people who wouldn't be excited to talk to you about it.

[00:35:59] Carolyn Dolby: Agreed. Agreed. One of our listeners, Gresser J, thank you they indicated that go straight to the teacher of the deaf and hard of hearing as a resource. Go straight. Yeah. Research in your district. Who is that person? That was great. Thank you for sharing that. That's a great resource. 

[00:36:15] Carolyn Dolby: I agree. 

[00:36:16] Meaghan Foody: Teachers of the deaf and hard of hearing are superheroes. I mean, they do literally everything. They provide instruction for everything. teachers, they provide counseling for students, they do direct instruction with students, they work with families, they work with audiologists, they're usually in like eight different places at once it feels like and seems like.

[00:36:37] Meaghan Foody: Yeah, they're a phenomenal resource that I think as a field, we kind of don't highlight them enough because of all that they have to offer to kind of those collaborative offer Collaborative. What's the word I'm looking for? Opportunities. Maybe we'll say opportunity. 

[00:36:55] Carolyn Dolby: I'll go with that. I like it.

[00:36:56] Meaghan Foody: Yeah, it works. 

[00:36:58] Carolyn Dolby: And I mean, in, in, in schools, really, we really are inherently collaborative. Yeah. And, but I think sometimes I know I do. Sometimes I can get so soon. Yeah. Focused on my, I forget. Wait a minute. There are other people. It isn't just on my shoulders. I think we think it, I think it's speech pads.

[00:37:16] Carolyn Dolby: We take everything on. And I think if we just go, wait a minute, who else is in our district? Who else do we have out there? And grab those teachers. That's a great idea. 

[00:37:29] Meaghan Foody: It's tough as a school sLP, like, to feel like sometimes you feel like you're a one man island. I mean, you're the only one providing that service in the school.

[00:37:41] Meaghan Foody: It's really difficult to manage schedules and caseloads and try not to pull kids from times teachers don't want you to pull them. I mean, Yeah, it can be really isolating from that perspective. So again, it's important to like take those blinders off and remember, like we do have people that we can rely on, whether they're, you know, interprofessional collaboration or just reaching out to, somebody else in a different school district because it can feel isolating.

[00:38:13] Meaghan Foody: It doesn't have to, but, 

[00:38:15] Carolyn Dolby: but I think if we, okay, when you say the word isolating, it makes me think our student is feeling isolated. What, what would we want for that student? We would want them to have community. 

[00:38:29] Carolyn Dolby: We would want them to advocate. And now we're thinking, well, wait a minute. If I'm feeling at isolated. I need to be doing what I would do for my student. And I think that's fair, absolutely fair. 

[00:38:41] Meaghan Foody: Yeah. To be talked super briefly. This makes me think about what we call like UI shine. So that's our program for kids who are seven to 17, who are deaf and hard of hearing, and then who stutter. And it's an unlikely kind of.

[00:38:54] Meaghan Foody: Pairing in terms of population, but it is so powerful to watch them create these, like, you can see the wheels turning of like, wait a second, you and me are different because you're someone who stutters and I wear hearing aids. But you're talking about how you don't like to have to repeat yourself or to ask people to say things again, or to.

[00:39:24] Meaghan Foody: You know, have to speak in front of the class. Cause you're nervous about what's going to happen. I feel that way too. And watch these wheels, like slowly turn of like, okay, we have more in common than I thought we had. It's just, it's my favorite week, like of my entire job, because watching them make those connections with each other is just amazing.

[00:39:46] Meaghan Foody: So profound. It doesn't always have to be with us. It can be with other kids that have a similar lived experience, even if it's not the exact same. 

[00:39:57] Carolyn Dolby: Oh my . Amen. Oh my gosh. Powerful. I love that when you talk about them making that connection. I do. I want to share Julie shared with us, Julie With the reminder to make sure that when we are writing those goals, especially those self advocacy goals that we need to be sure that we're sharing those with the classroom teachers so that they can also be supporting it, maybe co implementing that goal and that we help monitor We also need to be monitoring the classroom throughout the year.

[00:40:26] Carolyn Dolby: So as the classroom changes, oh, this is so important. If seating assignments change, we can make sure that the child is getting those accommodations for preferential seating, make sure that our students are facing the teacher. Oh, she says, make sure they're not next to the air conditioner. Some of the things that we might not automatically, we might not automatically Think about, but how impactful that is for a student to be with that ambient noise.

[00:40:53] Meaghan Foody: Yep. Yeah. 

[00:40:54] Carolyn Dolby: Thank you, Julie. 

[00:40:56] Meaghan Foody: Air conditioners, fish tanks is a popular one, pencil sharpeners. The door to the hallway. I mean, yeah, it's the other thing, too, about communicating with the teacher is sometimes, especially like in my current setting, I'm in an outpatient setting. And so we can kind of orchestrate communication breakdowns and then give them the opportunity to repair them.

[00:41:21] Meaghan Foody: But it's a pretty comfortable setting. And I always tell students this, like, it's really great if they can do that here. But if they don't do that in the settings that actually mean the most to them, then what is it? What's it doing? Probably not much. But again, if you can connect with the teacher and say like, Hey, this is something we're working on.

[00:41:44] Meaghan Foody: Can you look for opportunities where they either are or aren't doing this so that we can see like, is it generalizing? Because if it's not, you know, 

[00:41:56] Carolyn Dolby: I'm hearing another collaboration between the school SLP and the, if the student is getting outpatient, making sure that connection there, I think that would be huge.

[00:42:09] Meaghan Foody: Yes. Getting access to their school goals is monumentally impactful for us as outpatient clinicians, because if we're working on completely different things, it's It's going to take probably twice as long for us to see that same level of growth versus if we're on the same page, and they're working on it in different settings, that's just going to maximize that generalization for, for sure.

[00:42:38] Meaghan Foody: I love getting to log on to like the kids I work with IEP meetings and get to hear kind of what's going on at school because again, that's the stuff that matters. If they can do it one on one in a therapy room, it's great. But if it doesn't go anywhere else, we're not 

[00:42:56] Meaghan Foody: really. 

[00:42:58] Carolyn Dolby: That leads me into my thought because you're working with students. You said 7 to 17. So you're working with. 

[00:43:04] Meaghan Foody: Just for that one camp. 

[00:43:06] Carolyn Dolby: Oh, okay. 

[00:43:07] Meaghan Foody: Yeah. Yeah. So my youngest right now is about 22 months. And then again, I have some 80 year olds. 

[00:43:14] Carolyn Dolby: So wow. Okay, you are. Yeah. You're the entire lifespan. I love her. But when you are working with those adolescents and that you see that maybe the families have indicated that they aren't on it, they aren't supported by special ed, meaning that they don't have an IEP.

[00:43:31] Carolyn Dolby: Yeah. What are you recommending for families in that case? 

[00:43:36] Meaghan Foody: A lot of families don't really know that 504 plans are an option and obviously there's different, you know, qualifying factors in different states and that's going to vary from state to state, but Sometimes, you know, as material gets denser, as the cognitive load increases, kids who, you know, at the last time they were evaluated for speech and language looked like they were doing okay, but as that kind of cognitive fatigue increased, they were picks up, especially for our kids who are deaf and hard of hearing, we might see some gradual decline, and the last thing we want is for it to get to a point where that decline or the fact that they're falling behind is like, bolded in red.

[00:44:23] Meaghan Foody: because then we've got this big gap, right? But if we can get kids on 504 plans where we're checking in and we're just really making sure that they're developing at a positive trajectory, it just gives a little bit more of peace of mind. And I, I've found that it really helps parents feel better too because it's exciting when you hear like, okay, they're going to get released from speech services.

[00:44:48] Meaghan Foody: A lot of parents are like, that's so exciting. You know, they've done so well, but. What if 

[00:44:55] Carolyn Dolby: I'm thinking about what about those accommodations, especially one that the ones that Julie was saying about making sure that they have seating consideration full stop, making sure that the accommodations are still in place for them for education access 

[00:45:11] Carolyn Dolby: because 

[00:45:12] Meaghan Foody: yeah, and that's, they're not facing heart. of the 504 plan is all of those things can be really specifically outlined. And as kids get older too, I think it's so important to like counsel with them about like, what do accommodations mean to you? Because a lot of the times teachers hear like, okay, preferential seating. And that means like, Front row, front and center.

[00:45:36] Meaghan Foody: But classrooms are more dynamic now. Teachers move around. They use different resources. So preferential seating might not mean front and center. So asking the kids, like, hey, when do you do the best? You know, it, it seems so simple, but like, do teachers use captioning when they show videos? So that kids can hear them appropriately and use that support.

[00:46:02] Meaghan Foody: Again, it's one of those things of like, of course, but it's easy to forget to do those things. You know, checking in for comprehension, making sure that kids are given the processing time that they need and not like, oh, you didn't answer right away. So I'm going to move to the next person or I'm going to repeat the question right away.

[00:46:23] Meaghan Foody: Because again, that auditory processing load is there. Sometimes that listening fatigue is starting to set in. Then we have language formulation. And then if the teacher represents the question, sometimes their stress level jumps then. I mean, it's a lot to manage all at one. time. You know, we have this idea of like, oh, kids are so lucky.

[00:46:45] Meaghan Foody: They just go to school and they learn, but it's hard. They're working really hard. Especially our kids who are deaf and hard of hearing because the listening fatigue element is very real and very evident across grade levels from the time they walk into preschool up through college. It's tough.

[00:47:08] Meaghan Foody: Yeah, those accommodations are huge. And again, the more we can help kids identify what accommodations mean for them, the more likely they are to, I mean, thinking really long term, seek those out at the college level, because To get accommodations at the college level, students need to seek those out. It's not something that's going to be granted without them exploring that.

[00:47:35] Meaghan Foody: And I think, again, the more they understand what helps them, the more likely they are to use those Further and further down the line.

[00:47:43] Carolyn Dolby: Hey, we have a question, about working with a young, early, early two point two and a half year old ish. Sure. Trying to get somebody that young on board wearing hearing aids outside of maybe daycare or so, you know, if the child's saying, oh, it's too loud, or maybe they refuse to wear them.

[00:48:02] Carolyn Dolby: What are some suggestions for a little, little, little one. 

[00:48:06] Meaghan Foody: Sure. First step for me when kids seem to have any level of discomfort with devices is always going to be a referral to go see their audiologist. You know, I think that we often think like, okay, well, loud is bad. Perceptual and maybe they don't fully understand that concept at two and a half, which is totally possible.

[00:48:28] Meaghan Foody: But it's also possible that they're not fit appropriately. And if children develop this connotation with like, okay, the hearing aids mean the sound is loud and that either scares me or potentially hurts me, of course, they're not going to want to wear those. And once they establish that negative correlation between the device and discomfort.

[00:48:49] Meaghan Foody: or fear or whatever the case might be it's going to be a heck of a journey to get them back on a good page. So if there is discomfort, that would be a really quick and easy step. Like most things with kids, I think that Kids present differently in different environments. I can't tell you how often I've, you know, talked to a family and I'm like, oh, you know, they're doing so well and they're so kind to their classmates.

[00:49:19] Meaghan Foody: And parents are like, my child, my child is, is doing that. Because at home, they're brutal to their siblings, right? But kids have different expectations set for them in different environments. And oftentimes home is where they are the most comfortable. And in turn, sometimes that's where they kind of push back on expectations the most.

[00:49:42] Meaghan Foody: And so it's important to not compare between environments because Every kid's going to be a little different at daycare, at home, at school, whatever the case might be. But really helping parents set up kind of like dosages that they feel like they as a family can manage. So those birth to three cases, It's so important to see them holistically because we're not necessarily, you know, we're working with the child, but more than that, we're trying to equip the parents with the skills that they need to help support the child at home.

[00:50:21] Meaghan Foody: And so a big piece of that is incremental dosage of like, Okay, if you have access to any of their data related to device use or data logging, which you could probably get from their audiologist if you're in touch with them, if they're at, let's say, two and a half hours per day, okay, the next time that we see you, I want you just to work toward three and a half hours per day.

[00:50:48] Meaghan Foody: And it sounds kind of silly and a little trivial potentially, but sometimes with parents, we sit down and we make a schedule and we make a chart. And sometimes it's a sticker chart that the kid, you know, completes and gets to mark off. And sometimes it's just something that parents track themselves. But I think the important thing that we really want to avoid is expecting parents and families to go from two and a half hours of average use to 12 hours of average use.

[00:51:18] Meaghan Foody: because that is a really big gap. The other thing to think about would be discussing that with the child's audiologist and thinking about some kind of accessories for their hearing aids that might be helpful. So retention devices and things like that, because of course the last thing we want our kids removing devices and having them be kind of free.

[00:51:41] Meaghan Foody: Flying because that obviously creates a whole nother challenge. So I would say in, in short, and it's a much more complex, the most appropriate answer to this question would be much more complex than this and would really involve like, what's their hearing loss look like? What types of devices are they wearing?

[00:52:02] Meaghan Foody: How much time is spent at home? Who are they spending most of their time with? What's their communication modality? I mean, we would have to do like a full background. But really just like incremental dosages is kind of the simplest answer that I would have to try to help them support that device use and, you know, Telling parents is going to be hard.

[00:52:25] Meaghan Foody: Changing schedules and changing expectations and helping kids know and understand new routines, especially in the environment at home. That's supposed to be their like, safest space. Yeah. Brutal and it's gonna involve probably weeks where it's really really hard and then one day they're gonna go to bed that night and be like oh my gosh he wore the hearing aids all day minus nap time and bedtime and it's all gonna feel worth it but those first few weeks are tough.

[00:52:59] Carolyn Dolby: I like that talking looking at the dosage you said that's interesting I mean we all need to take a break right maybe to tune things out 

[00:53:09] Meaghan Foody: Yeah. Sure. Yeah. And it's, I mean, there are plenty of kids, like even, you know, our middle school, high school where parents are like, Oh yeah, he comes from home from school and takes both his hearing aids out and just goes into his room for a half an hour by himself.

[00:53:25] Meaghan Foody: And again, that listening fatigue is, is tough. And it starts from a really young age and it might not be listening fatigue at that point. It might just be kind of, orientation and getting used to it. to what it sounds like with their hearing aids but it's, it's still challenging. And again, they don't know the why behind it.

[00:53:48] Meaghan Foody: And at two and a half, it's very difficult to reason with a two and a half year old. 

[00:53:55] Carolyn Dolby: Yeah and I think yeah, our person asking the question gave us a little bit more. She, she also said dosing. So obviously that is really an important part and allowing to break time during the day. I like that.

[00:54:09] Carolyn Dolby: Right. I think you know, we're getting towards the end of our time, but I could we talk a little bit about that social emotional component before we go, because I think that's huge with our Children with hearing loss. 

[00:54:25] Meaghan Foody: Yeah, one of the really interesting things for me is always when I talk about what I do with people, and I tell them like, oh, I'm a speech therapist, and they ask kind of, you know, oh, do you work in a school?

[00:54:40] Meaghan Foody: And I talk a little bit about the population, and I typically say like, I work with children who are deaf and hard of hearing. And the first reaction I always get is like, oh. Those poor kids. And it's kind of like, well, actually, if you ask most of them, they think they're pretty great. And like, they're doing pretty well.

[00:54:58] Meaghan Foody: And I think a big piece of that comes from, again, that connection and autonomy over their devices and understanding that kind of the why behind it. But I also think that it's encouraging and celebrating what makes them different, like we talked about a little bit. And You know, doing our best. We, I would love to wrap every kid I work with in bubble wrap and protect them from the universe and, and having anyone step on their self esteem, but that's just not how the world.

[00:55:32] Meaghan Foody: works. But when we can instill and celebrate the things that make them different and help them begin to believe that, that's a really big step, right? So, you know, it's as simple as being like, Oh my gosh, you got new ear molds. Those are phenomenal. I love them so much. Can I take a picture of those? Like, obviously we can't.

[00:55:54] Meaghan Foody: Keep their face in it. But, you know, just really kind of hyping them up, for lack of a better word, about what's cool and different about them. The really interesting thing that has been found in research, like I said, Dr. Walker does a lot of research about kind of social emotional and trying to get a pulse on what these kids feel about themselves.

[00:56:17] Meaghan Foody: Most of the kids feel really positively about themselves and their hearing loss, at least on the surface level. They love their hearing aids. They know that it helps them. They know that it makes it better. And I will say that this population is pretty heavily skewed in terms of like SES and maternal education.

[00:56:40] Meaghan Foody: So we always have to kind of factor that in where they come from higher SES families and, you know, level of maternal education is higher. But I think that those Kids kind of go to show like what outcomes can look like and you know Not every kid comes from a home where they have that level of celebration And so I think that it's a heavy burden sometimes to bear as a provider But I think that that kind of means that we have to give that to them somewhere else.

[00:57:17] Meaghan Foody: And we never know, you know, everything that's going on at home, of course, but I think, again, it's really finding those opportunities to celebrate what makes them different and to say, like, you know, how cool is that? I try to find, like, similar Things and parallels, right? Of like, I wear glasses sometimes, they help me see, your hearing aids help you hear, but I also think it's a delicate balance because I never want to minimize their experience, because as kids get older, they're like, yeah, well, a million people wear glasses, but.

[00:57:50] Meaghan Foody: But I'm the only kid in this whole school that wears hearing aids. Right. And they can figure that out. I don't feel like I'm answering your question very clearly, . No, I, but I think it's really, 

[00:58:00] Carolyn Dolby: I think you're kind of wrapping it all up, you know, of the, it's, it, I think it's. I think it's interesting, interesting, the comparison that you make with the, the hearing aids, the deaf and hard of hearing with the stuttering of a talk, talked with, I've had episodes on, on stuttering as well.

[00:58:21] Carolyn Dolby: And the importance of. Accepting. Yeah. Acceptance. 

[00:58:27] Meaghan Foody: Yeah. 

[00:58:28] Carolyn Dolby: And it, and the one thing we all know, we are all different and you know, different is good. And I liked when you said don't minimize You know, because I think, you know, we might say, Oh, everyone stutters. No, no, no, they don't. No, 

[00:58:45] Carolyn Dolby: that is, that's a lie. And then saying, but making that comparison that some of us do need devices to help us do different things. 

[00:58:55] Meaghan Foody: Yeah. 

[00:58:56] Carolyn Dolby: And I think is that's where you're kind of bringing us back around is the why why it is okay. Okay. Yeah. Because it is, it could be a lifelong. It's a lifelong. 

[00:59:07] Meaghan Foody: Mm hmm. Yeah. And that acceptance isn't linear.

[00:59:10] Meaghan Foody: We wish it was, right? We wish like one day they turn the page and they're like, oh, now I love my hearing aids. And I think sometimes too, it's, it's given them the space to be like, yeah, that's annoying. Your brother's gonna have to wear hearing aids and you do. That's annoying. It's not fair. Yeah. It's not fair.

[00:59:26] Meaghan Foody: You're right. Totally. Yeah. Yeah, which I think is true for just about every single diagnosis and who needs therapy for literally anything. Yeah, 

[00:59:37] Carolyn Dolby: it is. Oh my goodness. I can't believe I know, I know, I know. Oh my gosh. Thank you so much, Meaghan. This has been amazing. And I hope that you'd be Willing to come on again.

[00:59:50] Carolyn Dolby: I know. Oh, I'd love to. Oh, I love it. You just have such a passion that we can feel and that's what we want. That really, that's what we need, especially as we're starting our new school year. You know, we, we want that. We want that passion. So, we're just so thankful to have you 

[01:00:08] Carolyn Dolby: thank you so much. This has been amazing and I can't wait to get you back on again.

[01:00:13] Meaghan Foody: Yeah. Thank you guys for coming and thanks for having me.

[01:00:16] Carolyn Dolby: Yep. Thank you. Bye everyone. 

[01:00:18] Meaghan Foody: Bye. Thank you. Bye everyone. Thank you.

[01:00:21] Carolyn Dolby: Thanks for joining us on today's podcast. Remember to go to speechtherapypd. com to learn more about earning ASHA CEUs. We appreciate your positive reviews and support and would love for you to write a quick review and subscribe. If you have indicated that you were part of the ASHA registry and entered both your ASHA number and a complete address in your account profile prior to the course completion, we will submit earned CEUs to ASHA.

[01:01:00] Carolyn Dolby: Please allow 1 2 months from the completion date for your CEUs to be reflected on your ASHA transcript. For our School of Speech listeners, we have a special coupon code to receive 20 off any annual subscription to SpeechTherapyPD. com. Head over there to get ASHA CEUs for listening to this podcast and all other episodes.

[01:01:21] Carolyn Dolby: The code is SCHOOL20. That is S C H O O L 20. Hope to see you on our next episode. Also, please don't hesitate to tell us which topics you would like us to cover in future episodes. To get in touch, drop us a line in the comment section or send us a message on social media.

[01:01:49]