Over the course of my presidential year, I have profited from conversations with ASHA members, the ASHA Board of Directors, and ASHA staff, and benefited from their counsel and gracious response to my attempts at humor. I have also been fortunate to enlist the professional insights of column coauthors and leaders. I have enjoyed the support and patience of my husband and sons and the loyalty of my friends.
I am thankful to colleagues for applauding my good ideas and suppressing those that were less distinguished; my students for their interest in my work and their tolerance of the disruptions it caused; and my administrative assistant for her remarkable diligence. I am continuously humbled by my interactions with individuals with communication disorders and their families, as well as members of the public sector for their ceaseless optimism and perseverance. I am filled with gratitude for the opportunity to have met audiologists and speech-language pathologists around the country and to envision ways in which we can continue to work together. This year has reinforced my determination as a member to seek ways ASHA can remain vital, yet become more nimble, to fulfill our shared vision.
I am indebted to those who came before me for their foresight and fortitude. As I near the end of 2012, I thought it fitting to re-engage those who embody the true spirit of volunteer leadership, so I sought the wisdom of ASHA's presidents by posing the following question:
What are the questions that our volunteer leaders should be asking?
The responses I received were as diverse and insightful as the 19 individuals (spanning 35 years of service) who provided them, indicated below with their year of service as president. These individuals have touched upon areas of relevance to all of us and observed the need for ASHA to prepare for the changes that will affect our professions.
Professional and Continuing Education
The academic preparation of and assured access to quality, affordable education for all students interested in our discipline is crucial to the future of our professions. Paul Rao (2011) asked volunteer leaders to assess the outlook for specialty programs and certifications that will prepare future clinicians to work with increasingly diverse populations. He and David Yoder (1984) broached how ASHA plans to address gender parity, with males comprising less than 5% of membership, and Sue Hale (2009) joined them in asking how ASHA can assist in the recruitment of qualified students into doctoral programs to offset the large number of retiring faculty expected in coming years. Charlena Seymour (1997) emphasized the importance of conveying the relevance of ASHA's mission in today's classroom, preparing for changes in our professional roles and responsibilities, and setting a positive example for new students, practitioners, and faculty. Nancy Swigert (1998) deliberated on the challenges of continuing education, addressing the question of how to advocate for stringent standards while being mindful of the daily demands placed on clinicians.
Public Policy, Science, and Professional Practice
Health care policy reform has brought to the forefront our need to demonstrate the significance and necessity of our professions. We are positioned to be major voices in advancing innovative approaches to research and clinical service. This will require creative alternatives to current models. Dolores Battle (2005) asked volunteer leaders to anticipate ASHA's role in assuring that culturally and linguistically appropriate care is available given the challenges presented under the Affordable Care Act, budget restrictions, and other policies that may affect how and to whom we deliver services. As we shift from fee-for-service to value-based care, we are pressed to reconsider how best to partner with our clients and service providers (Judith Montgomery, 1995) and how ASHA can advocate with Medicare to mitigate risks to patients who are in need of, but are not covered to receive, our specific care (Jerilynn Logemann, 1994, 2000). John Bernthal (2001) built on these sentiments, asking, "What events will impact our service delivery, including scientific advances outside our discipline, policy decisions, and funding streams, and how will our scopes of practice need to change to account for services that clients need and that we are not now providing?"
The potential benefits and influence of technology are real and nuanced, and the efforts and direction of our research will echo our priorities and inform our practices. Donna Geffner (1999) and Noma Anderson (2007) urged us to take into account how we will embrace emerging technology to extend clinical practice without losing the personalization and individualization of our services. The importance of finding a proper balance in our research was noted by Daniel Boone (1976), who posed a provocative question as to whether evidence-based practice (EBP) may inhibit the development of new treatment ideas and applications of old approaches, while Nancy Swigert asked how we should continue to advance EBP in ways that practicing clinicians can better use, easily interpret, and apply. John Bernthal and Jerilynn Logemann encouraged us to explore advocacy techniques to ensure that our disciplinary research—and by extension, advances in treatment efficacy—are funding priorities, especially given the nationwide decrease in funds to grantor institutions and a dearth of SLPs and audiologists on review committees.
Advocacy and Volunteerism
With more than 150,000 members and affiliates, volunteers are one of ASHA's greatest strengths. Thomas O'Toole (1993) commented that most improvements in service to members and consumers have been driven by ASHA volunteers. Glenda Ochsner (2003) suggested we each ponder our unique skills and abilities and approach volunteer service and advocacy in accordance with the outcomes we hope to achieve. Laura Ann Wilber (1982), Nancy Swigert, Nancy Creaghead (2002), Dolores Battle, and Alex Johnson (2006) challenged us to balance the needs of clients locally and internationally and always to consider the many constituents that make up ASHA, while building bridges across settings—all to the best advantage of our discipline and those we serve. Roy Koenigsknecht (1990) asserted that the collective efforts of members are what assure the best results and that intellectual, financial, and community resources advance the role of our professions, urging us to consider, "What have I done in recent months to enhance and promote the good work of my immediate colleagues and to influence decision-makers to champion the contributions of our professions?"
Looking Ahead: Future Leaders
Reflecting on this year with past presidents reminded me of how far we have come and that our work is not complete. These dedicated leaders looked outside themselves, posed hard questions, and emboldened us to seek answers. I join Tommie Robinson (2010) in asking, "What do we need to know about the things that are changing around us? How will we prepare ourselves and our colleagues for transformational changes, so that we are not left behind?" With Alex Johnson I seek, "How can we, as volunteer leaders, responsibly use evidence and experience to develop the next generation of leaders?" With Nancy Creaghead I contemplate, "Are we willing to take a chance to help make something positive happen?" And, with candor and humility, I ask, how can we ensure that the ASHA of the 21st century remains agile, determined, and unstinting in our advocacy and at the forefront of innovation? How can ASHA's leaders better see the association through your eyes?
What questions should you be asking?