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see also: Dwindling Numbers, Abundant Rewards | Cochlear Implant Program Serves Military Families | "Small Steps in Speech": A Grieving SLP's Gift
Cite as: Rowden-Racette, K. (2009, Nov. 3). Cochlear implant program serves military families. The ASHA Leader, 14(14), 32.
In a tradition that began in 1938, the nation honors the men and women who serve their country in uniform by observing Nov. 11 as Veterans Day. Standing proudly in their ranks are ASHA members and their families. Some are serving stateside, providing much-needed services to the millions within the active-duty, reserve, and retired military community; some are deployed; and others are holding vigil for loved ones fighting in Afghanistan and Iraq. The following three articles, by Leader online and print editor Kellie Rowden-Racette, illustrate how the military and the professions intermingle and play an important role in each realm. It's important to note that these members adhere to the professional standards of their respective fields and also must maintain the physical and mental expectations of their military roles. We hope you will join us in extending our appreciation for their service.
Cite as: Rowden-Racette, K. (2009, Nov. 3). Dwindling Numbers Abundant Rewards. The ASHA Leader, 14(14), 30-31.
Although members of all branches of the military have access to speech-language treatment, the U.S. Air Force is the last uniformed service to have speech-language pathologists in its ranks. But even in this relatively new branch (founded in 1947) their numbers are dwindling; active-duty SLPs number only five. The work is hard, they say, but the rewards are plenty. Here are three of their stories.
DiAnna Calvin, a major stationed at Eglin Air Force Base in Florida, has practiced for 14 years, eight of them in uniform.
Q: How does the Air Force use active-duty SLPs?
The Air Force believes that each discipline needs to be in uniform. When you're in the military it's 24/7, and when they need you, they need you. For example, when I was at Keesler Air Force Base (Mississippi) during Hurricane Katrina, we were on duty non-stop for evacuation, clean-up, etc.
Q: What's your day-to-day schedule?
No day is the same. Every day I have a case¬load that is completely different—one day I'll have swallow studies, the next day I'll be working with kids. I've been able to serve on the cochlear implant board, lead a laryngectomy support group, learn about shrapnel wounds—things I wouldn't necessarily see in the civilian world. It's great experience. But it's not all professional work—we do things related to the Air Force and the military, like chemical warfare training and maintaining our physical fitness standards. But it's all for a reason. We have to support our beneficiaries no matter what it takes—that's the point of being in the military. We cater to them, we live their lifestyle, and we understand them.
Q: Why did you become an SLP? And then why join the military?
In college I wanted to find a job that was rewarding and I enjoy talking (my friends used to call me "Chatty Cathy"). I thought I was going to be a psychologist, but a friend's mom was a speech-language pathologist and it looked so interesting. Later I was working in a rehab hospital in Montgomery, Ala., and was a little bored. I had a few friends in the Air Force who said I should look into it. I couldn't believe all the training I still had to go through! But it's been rewarding. I love seeing the head and neck cancer patients when they hear their own voices again. Tears come to their eyes. And so many patients' families are grateful to me when their loved ones are talking again. Because so many military families don't have anyone around, they're grateful knowing that their son or daughter or husband is going to be taken care of. We're like their wingman. There is so much I can do here and it never gets boring.
Ava Craig, a major stationed at Elmendorf Air Force Base in Alaska, is the state's first military SLP. She began practicing in 1986 and has been on active duty for 15 years.
Q: What interested you about speech-language pathology?
I was born with unilateral cleft lip and palate. Although I didn't need speech treatment growing up, I've always been sensitive toward kids who need help. In college I went through five different majors and thought I was going to be a teacher. Then I realized I wanted to help kids more individually, not as a group. Once I was in the field, my nephew was born with a bilateral cleft palate and I wanted to make sure I could help him.
Q: What was your path to the military?
Before the Air Force I worked in public schools for seven years, then worked for a rehab hospital for a year. My sister was in Navy at the time, and she was encouraging me to join because of the benefits and security. Plus, I could travel a lot, take care of my family, and still do what I wanted to do. The Air Force was the only branch that was looking for SLPs.
Q: Any surprises?
Absolutely! My first assignment was in Germany within an Army community, so I had three culture shocks—being in a foreign country, being in the Air Force, and working with the Army. On the outside [the civilian world], people go to meetings, of course, but we also have to do things like train for chemical warfare, especially now. It used to just be every two years, then every year, then every six months, and now it's every month. I don't think civilian SLPs are doing that.
Q: Is there any pressure being the first-ever military SLP in Alaska?
It's like the movie Field of Dreams—"If you build it, they will come." The number of people needing services was astronomical and I like that I can be here and make a difference in such a short amount of time. We see a huge amount of active-duty Army members with mild TBI. I haven't seen this before; it's new to me. Because of the active-duty Army, the majority of my patients are ages 18 to 32, which is unique. On most other bases, it's birth to 3 and then age 50 to 80. I'm getting this group that you usually don't see.
I'm doing a little of everything and have to be a master of all trades in our field. I don't have the ability to specialize. Our field is so huge and this keeps it fresh for me.
Beth Harrison is a lieutenant colonel who serves as the chief of health professions assignments at the Pentagon. She has been an SLP for 18 years, 14 of them in uniform.
Q: How did you become interested in being an SLP?
Actually it was by accident. I was at the University of Arizona on a music scholarship for percussion, and one semester I made a mistake with my registration. All my classes had been dropped. I had to get into any class I could find. There was political science and Chinese history, and then I walked by the speech and hearing table. My mom was an SLP, but I never really knew what she did. There was room for me in the classes. I loved it and a few semesters later I said to my mom, "Hey, I never knew you had such a cool job!"
Q: How did you decide to join the Air Force?
As a graduate student, I did an externship at Wilford Hall Medical Center at Lackland Air Force Base in Texas. It was such an exciting place for a new clinician—there was a variety of patients and it was such a rich learning environment. After I graduated I worked for a few years and then got a call from Wilford Hall asking me to come work there again. I was excited but didn't quite get that it would mean I would need to join the Air Force. When I was there I was focused on the clinical part and hadn't paid attention to all the uniforms around me. Once I figured it out I thought it would be good for a few years, I'd learn everything I'd ever need to know, and then I could go anywhere. But once I got in, I began to like having that other side to pay attention to. It's not all about speech-language pathology—you also have to work on being a military officer, too. It all just kept going so well that I stayed.
Q: Why do you think it's important for SLPs to be in the active-duty Air Force?
It helps you relate to the active duty person's experience. We all have been there, we know what their situation is, what their challenges are, and I think they see you more as an ally because you're wearing the uniform.
Q: You're no longer practicing in the clinical setting. Why the change?
I stepped into a human resource position in 2005. It was a good opportunity because if I want to make this a career, I needed to branch out and look at the big picture. It's been good so far, and who knows if I'll ever go back to the clinic? Maybe once I retire—we'll see.
Q: Any regrets?
None. I'd do it again in a heartbeat.
Cite as: Rowden-Racette, K. (2009, Nov. 3). Cochlear implant program serves military families. The ASHA Leader, 14(14), 32.
When Air Force Colonel Ben Sierra first joined the U.S. Air Force in 1975, he described himself as a "baby" audiologist.
"I started when eyeglass hearing aids were a big thing and everyone wanted them," he chuckled. "I was really, really young."
Little did he know he would become part of a life-changing program for the military community. In the early 1980s, while Sierra was working at Lackland Air Force Base in San Antonio, Texas, the Wilford Hall Medical Center's fledgling cochlear implant program began. Although there are other military programs today (Walter Reed Medical Center and Portsmouth Naval Base, to name a few), at the time it was the first Department of Defense program of its kind and the hearing health profession was on the brink of exciting growth.
"The services today are dramatically better when compared to our capabilities in the '80s," Sierra said. "The digital revolution, advances in cochlear implant technology, and the development of programming algorithms have improved sound perception and speech recognition. Over the last 20 to 25 years, hearing health professionals have dedicated their lives and work to pushing forward this technology."
Developments in audiology prompted changes in service provision. In 2001 Sierra, along with Drew Horlbeck, an Air Force major, made significant changes by restructuring the program to include a cochlear implant board. By adding this layer, the board (which comprised audiologists, speech-language pathologists, developmental pediatricians, social workers, psychologists, and educators) ensured that cochlear implants were offered only to candidates with realistic expectations, good prognosis for full function, and high probability of receiving maximum benefit from the implant.
"We needed to make sure they understood this [cochlear implants] isn't a miracle cure and that there's a long process of intervention that must be followed," Sierra explained. "The procedure by which we select our candidates isn't meant to slow down the process, but to ensure they tailor their expectations and understand that the brain plasticity process needs time to take place."
This procedure seems to work; the program's success continues to increase. Today the program runs under the command of Dean Hudson, an Air Force major, and Connie Converse, an Air Force captain who serves as chief of the Air Force Cochlear Implant Program. Sierra, who retired from the military in 2005, works as a civilian audiologist and program director of the Air Force Audiology Externship Program as well as consulting to the program. The exact number of cochlear implant procedures done before 2001 is not clear; since that time, however, an average of 22 patients per year (anywhere from five to 40) have received cochlear implants.
"Our numbers are mostly supply-driven, but the demand seems to follow," Sierra said. "If we have qualified staff, demand rises." Given this dynamic, the program could be on the brink of another growth spurt—two neurotologists and one pediatric otologist are performing the surgeries and, as Sierra said, "We're in hog heaven."
Most patients are military dependents and retirees; active-duty members are occasional because of the physical demands of most active-duty careers. It's also notable that although the cochlear implant program is located on a U.S. Air Force base, it's available to patients from all uniformed and commissioned service branches (Army, Navy, Marine Corps, Coast Guard, Public Health Service, and National Oceanic and Atmospheric Administration) and also provides services and training for military members from other countries, depending on the particular "status of forces agreement" between the country and the U.S. government.
Most of the cochlear implant recipients, however, are U.S. military dependents or retirees, and the program continues to grow. The procedure and follow-up care is free (for the most part) and, in many cases, a life-changing procedure for patients and their families. Over the years, professionals who have worked in the program have witnessed children hearing their mother's voices for the first time, children learning to speak, and retirees regaining their independence, and now are even straddling the generations by treating children of the program's earliest patients.
"One Army patient came in, and I recognized the last name, but didn't think anything of it," Sierra recalled. "When I started talking to him, he said, ‘My family owes a debt of gratitude to this hospital.'
"It turns out we had implanted his mother with a single-channel CI in the '80s," Sierra said. "She was our first implant patient and is still doing well. It feels so good to hear that."
Cite as: Rowden-Racette, K. (2009, Nov. 3). "Small steps in speech": A grieving SLP's gift. The ASHA Leader, 14(14), 32.
They say that hope rises out of many tragedies. Such is the case with Amanda Charney.
The 28-year-old school-based speech-language pathologist was engaged to be married the end of 2009 to Marc Small, a Special Forces medical sergeant for the United States Army. The couple met five years ago at her brother-in-law's Halloween party and the relationship blossomed into a true romance. Small and Charney dreamed of traveling, she as an SLP and he as a physician's assistant, and one day opening a private speech clinic. Small even came up with the name, "Small Steps in Speech," which not only incorporates the name the couple would share, but also symbolizes the small steps it takes for some children to learn how to communicate.
"He loved my profession. He loved what I did, knew I loved working with children, and he always encouraged me to start my own practice," Charney said.
On Feb. 12, 2009, Marc Small was killed in the line of duty only three weeks after arriving in Afghanistan. Charney learned the tragic news the next morning. Although devastated, Charney refused to give up all her immediate dreams and moved into action quickly. The grieving bride-to-be created a nonprofit organization, Small Steps in Speech. She asked that well-wishers, instead of sending flowers, donate money to get the fledgling organization started.
Since Small's memorial services less than a year ago, Charney and her volunteers have worked feverishly to collect donations and support. And it's working. On Aug. 1, 2009, three days before what would have been Small's 30th birthday, Small Steps in Speech and Small's sister, Megan MacFarland, organized the first "On Your Marc" 5K. Organizers expected the run, held in Small's hometown of Lower Providence, Pa., to attract 300 runners at most. Much to Charney's surprise, almost 600 people participated, raising more than $25,000.
"We just thought it would be a local event for friends and family, but people really came out," she said. "It was amazing!"
Small Steps in Speech continues to grow and Charney hopes to begin awarding grants soon. Although her original idea had been to provide services focused on speech, Charney has been working with children with a variety of communication disabilities, and the goal now is to expand the offerings to children with communication disorders who need help paying for treatment, devices, surgery, or other services. She and the organization's board members are accepting applications and are looking for professionals to nominate children who would benefit from such a grant.
"We want this money to go for treatment for children in private practices, schools, hospitals—wherever this money is needed. We want to hear from professionals who can recommend students or patients who would benefit," Charney said. "I love working for children and I've seen what extra help can do for a child's communication."
As for what her fiancé would think of her efforts, Charney is candid. "I cry every single day and I'm still so sad," she admitted. "But it puts a smile on my face knowing what we're doing and I know somewhere he's excited about what we're making."
For more information, including nomination and application forms, visit the Small Steps in Speech Web site.
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