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Episode
Kate Grandbois: Hello, everyone. Welcome to SLP Nerdcast. We are very excited for today's episode. We are welcoming a new guest to our show, Jennifer Myers. Welcome, Dr. Myers. Thank you so much for having me.
Amy Wonkka: Jennifer, you're here to discuss From Pathology to Prevention: Reimagining [00:02:00] Medical SLP Interventions. Before we get started, can you please tell us a little bit about yourself?
Jennifer Rae Myers: Absolutely. Uh, so I am a medical, uh, speech language pathologist and neuropsychologist by training. Um, I'd say with the exception of the past two years, my prior life, uh, was actually in industry working in digital health tech startup- Uh-huh ... companies. And so I have that direct experience on developing digital health tools, particularly for, uh, cognitive health, Alzheimer's disease and, and related dementias.
Um, and in the past two years, uh, I've had the privilege of working as an assistant professor at the University of Maryland College Park. So taking all the things that I've learned in industry, uh, and hopefully preparing our future SL clinicians, uh, to prepare for technology and all the things that come with it in, in that space.
Kate Grandbois: That's amazing. Uh, random little tidbit that nobody asked for, but I'm from Baltimore. I'm from Baltimore originally. Go Terps. Okay. [00:03:00] So missing my crab cakes and my burger cookies for sure. Oh, I'm sure. I'm sure. Um, but that aside, I know that's a tangent. We're not here, we're not here to talk about my childhood.
Um- I'm very excited for today's conversation. You come to us clearly with a wealth of knowledge, and there's nothing I love more, that we both love more, than integrating different disciplines- Mm ... into really complex conversations because that's how we elevate science, that's how we elevate our field. So we're very, very glad to have you.
Um, before we kind of get into all of the good stuff, I do need to read our learning objectives for the day. Learning objective number one, identify at least three benefits of preventative health in medical speech-language pathology. Learning objective number two, describe at least three ways preventative health can be integrated into medical SLP practice for neurodegenerative disorders.
And learning objective number three, evaluate one benefit and one [00:04:00] implementation challenge related to using digital health tools in prevention-oriented medical SLP practice. For anybody who is listening and would like to use this course for ASHA CEUs, the link to take the post-test is in the show notes.
Additionally, there is information provided in the show notes and on the landing page related to the financial and non-financial disclosures for both the hosts and the presenters of this episode. Okay, boring stuff is over. Let's start talking about all of the goodies. Would you like to launch us into, um, our first learning objective, just kind of talking a little bit about preventative health in- Yes
medical speech pathology practice? Absolutely. Um, for context so that we're all on the same kind of foundation, uh, for this conversation, when I'm talking about preventative health, I'm talking about any action that is taken by an individual, um, or entities, institutions, clinicians like ourself, [00:05:00] uh, to make sure that we're keeping individuals healthy and well.
Jennifer Rae Myers: Um, and that's for the purpose of not just preventing, um, the actual condition or disorder from, uh, happening, but also reducing or eliminating any symptoms or impairment once it exists. And I'll talk a little bit about kind of the different levels of preventative health. It's not novel in- You know, the world of SLP or medical SLP more specifically, but it is something that we, uh, can definitely think differently about in terms of where we currently practice under the umbrella of preventative health, uh, and where we could potentially practice a little bit more or focus our energy on, um, a little bit more.
Uh, we really act in a, a reactive model in our care. And not to go off on a tangent, but the broader theme of our field, oftentimes even in our name, right, speech language pathologists or pathology, um, we're often meeting [00:06:00] people when the worst has happened as opposed to meeting them before those things happen.
Uh, and as a result, when we're talking about neurodegenerative disorders, um, in particular, um, and even more specifically things like Alzheimer's disease and dementia, by then it's almost too late, dare I say. Uh, and so if we're trying to really make the work that we do client-centered, if we're really trying to maximize the success, uh, of our clients and their loved ones, their caregivers, um, I think it's really important for us to look at things from a different lens.
And so, um, there has been literature in our field about communication public health, um, interdisciplinary approaches, integrating the work of public health, um, by way of preventative care and preventative approaches, and this really looks at the individual, the community, uh, and the population levels at large.
So what can we do in our one-to-one therapy? What can we do [00:07:00] from a community-centered approach? Um, and then what can we do at a systematic or policy level? Um, and for some of us, we stay at the individual, which is great. Um, for others, we may, you know, tap dance in some of these other spaces as well, and I think there's room across the board, um, for a more, again, preventative-focused, um, approach.
Because the public health strategy allows us to intervene earlier. And I know, um, or at least I assume to know, that from the education side, you know, early intervention is a big thing because we know the value of intervening early for our little ones. My argument is, hey, maybe we can do the same for our adults and older adults, uh, when it comes to these cognitive disorders and, and cognitive communication impairments.
Kate Grandbois: I love this so much. I'm immediately obsessed with it because- ... this is, again, something that is, in my opinion- overlooked in our [00:08:00] education, right? So we are, I can see for everybody listening, sh- she's nodding her head, she agrees with me. Yeah. I'm, I'm, I'm not totally off of, totally off topic. But the, the ways in which we're trained in graduate school, very medical model, very pathologizing, very you have a problem here, I'm, I've got my expert h- my expert hat on and I'm here to, I'm here to fix it, right?
That completely ignores not only the person as a whole human being, but everything that happened that led them to- Absolutely ... your office. And as, as you're, you were talking, I was also, and I know this is a- another tangent we're probably not gonna go down, but I was also thinking of these components of health literacy in terms of prevention, right?
In, in, um, an individual's awareness around some of these kinds of things. And the analogy and comparison you made to EI is brilliant. It's brilliant. We, this is like- Oh, yeah ... This is something that we know and, you know, in pediatrics- Yes ... every, most SLPs know the [00:09:00] value of EI, the value of EI, the val- we, we know this.
It is- crazy to me that we're not having the same conversations about through the rest of life. Absolutely, and I, I do think it's unfortunate, and, you know, I'm willing to, to, um, have this debate. We're late to the party, and I feel like as a profession we often are late to a lot of the parties, um, despite our scope, despite what we are, you know, the superpowers that we have as, um, clinicians, um, regarding this.
Jennifer Rae Myers: And the health literacy is spot on. I'm very much into education because I do have a firm belief that we need to support and inspire individuals to create and shape their own health landscape, um, and not necessarily tell them what to do. Um, and it kind of speaks to, uh, and I don't know how long ago this was, but you had, I, I believe Jackie Rodriguez on who talked about- Yes
health literacy- Yes ... and how that's so [00:10:00] important for things like engagement and adherence, and all the things that, uh, really speak to the prognosis and the outcomes of our individual. And it starts before the treatment, and that's where, again, preventative health really comes into play. Um, and I, I just... I do wish that we had better training around that.
Um, I think it took kind of the shift from a societal level around preventative care, um, again, speaking, um, across the board but wanting to stay- stick to, uh, today's conversation about w- uh, neurodegenerative disorders, um, before it was very pharmacological. What medications, um, can we- Mm-hmm ... develop to address these symptoms?
Only within the past 10 years or so have we seen a broad shift around preventative measures, and taking it even a step further, um, thinking creatively outside the box where education is now looked at as a medical intervention. Um, that wasn't the case not too long ago. [00:11:00] Um, we're finding the value in some of the simple things.
Uh, not to be silly here, but it's- I kind of think of it as, you know, using vinegar or baking soda to clean versus buying, um, a chemical product at the store. Um, we drifted away because we wanted the fancy scent and we like the nice bottle, but in some cases, vinegar and baking soda works just as well. And so I do think not dismissing some of those what might seem simple, um, preventative strategies and what that can save us down the line is something that is worth investigating, something that's worth considering, again, at a more broader, more intentional lens.
Amy Wonkka: Well, and I think back on our conversation with Jackie too, that was such a great episode as well for people. Yes. Maybe we can link that in the notes too, but some of the, some of the risk factor mitigation strategies are also tied to behavior change. Mm-hmm. So I think that, you know, maybe that's a piece that you can [00:12:00] talk to us a little bit about.
But just the idea that perhaps some of these, modifying some of these risk factors can be, like, pretty impactful. Yes. Um, so depending on the literature, the number will change, but we'll say for sake of conversation about 12 modifiable risk factors, particularly for dementia. So things like... And some of these probably aren't surprising, right?
Jennifer Rae Myers: Physical health, mental health/social support, um, engaging in cognitively stimulating activities, uh, making sure that your cardiovascular health is being monitored and, and healthy. Um, also hearing, um, if we wanna talk really close to home, the relationship between hearing and cognition. Um, and kind of if I can, tag-team interdisciplinary work in here as well, so I mentioned public health at the top of our conversation, um, but really emphasizing the importance of interdisciplinary work.
I think that any time we mention, [00:13:00] um, some type of framework or approach, whether it's trauma-informed care or being culturally responsive leaders, and now, um, you know, preventative care, the question becomes, you know, is it within my scope, and how do I approach those things? I'm not gonna tell somebody that they need to start exercising, right?
But that's the beauty, and that is the important rationale behind working on interdisciplinary teams, um, and utilizing our colleagues to ensure that, again, the work that we're doing is actually going to be, uh, impactful. Um, for example, if we're talking about, you know, physical health, sleep is such a big thing in the context of, uh, cognitive health.
And while it is not necessarily our place to create a sleep hygiene protocol for our clients, um, it's almost a disservice. And you know what? I'll go on record in saying that it is a disservice not to inquire about their sleep [00:14:00] habits, not to recommend or refer in some cases to see someone about, um, their sleeping, um, and to make sure that that is not going to impact the work that we're doing in therapy, the carryover, and then the long-term sustainability, uh, of their strategies, um, and then also making sure that they're able to return as close to baseline, uh, as possible.
And so there's a lot of modifiable risk factors. There's extensive literature from the well-known FINGER study, um, to lesser-known, still important studies that have examined the benefits of just social support Healthy eating, exercising, et cetera. I know what Amy's gonna ask. I do not know What's the FINGER study?
Amy Wonkka: I do not know the well-known FINGER study. Neither do I. Well- Can you share that with us, please? Yes, absolutely. So the FINGER study is, is associated with dementia, Alzheimer's disease, um, specifically, and this is a, a long [00:15:00] ongoing study, um, that found basically things like the Mediterranean diet. I don't know if that sounds familiar.
Jennifer Rae Myers: Um, but eating healthy, you know, a little bit of olive oil, fish a couple times a week, um, vegetables and fruits being the bulk of your diet as opposed to red meats, and things that we kind of already know already, and how some of these things have, uh, shown to reduce risk in dementia. Also, doing, um, digital health interventions and how that can play a role in reducing or helping to change those behaviors in terms of modifiable risk factors as well.
And there's, um, a few studies that have branched off of that FINGER study, and so I'm merging a couple of those. But the larger kind of takeaway from that study is that there are modifiable risk factors that, if addressed, can reduce, um, the likelihood of, uh, dementia in later life. I have two questions. Uh, [00:16:00] first I have to know why they call it the FINGER study.
Kate Grandbois: I was in... I... When you didn't say anything about fingers I was sho- I was shocked. Yes. Okay, so you know everybody loves a good acronym. I'm probably going to mess it up, so don't quote me on it. Uh, but it's, uh, Finish Geriatric, um, FINGER... Finish Geriatric, uh, Intervention Study for- Excellent ... something disability.
Jennifer Rae Myers: That, that works for me. If, yeah- Yes ... it's, if, I, it being an acronym- I think it's the Finish- ... makes a ton of sense. I just, I just- Yes ... I have to know. I think it's Finish Geriatric that makes up the FINGER. That's amazing. I, I wanna go, now that I have my curiosity satisfied with the, with the FINGER conundrum, I would love to go back to something that you said a minute ago about the power of interdisciplinary care, because what it made me think of is the reality of the contexts in which we work as SLPs, and how amazing it [00:17:00] is to have interdisciplinary colleagues to draw on- Mm-hmm
Kate Grandbois: to learn from. Absolutely. Um, how a lot of us don't have access to robust relationships with colleagues because of whatever barriers in our workplace, right? They don't employ them, they're in a different building, they're down the hall, they're grouchy, I don't like them, whatever. Um, and how much that touches our own idea of competence.
Um, and I think it's- Everything that you're saying, it's clear that these preventative, um, paradigm shifts are so important, but how that's related to us needing to be able to look at our own competency and say, "Geez, I don't really know what this... I don't have that nutritionist to, to p- to pull off of. I don't have a neurologist- Yeah
to bounce something off of. I don't have pharmaceut- you know, pharmaceuticals down the hall in my large, my tiny little rural hospital," or, or whatever. Yeah. Um, I wonder if you could tell us [00:18:00] a little bit about how an, you know, SLPs who are listening who are trained as generalists or who are newer to the field- Yeah
might navigate Those intersections of competency and, and m- and leveraging interdisciplinary care. I hope my question- Yeah ... made sense. No, it, it does, and it is, it's one of those things that when it works, it works great, but to your point, there's a lot of barriers to entry. Um, one of the biggest being if I am literally the only SLP and there's no psychologist, there's no audiologist, there's no, um, dietician who is there regularly, maybe they come once a month or once every other week, um, it kinda makes for a large challenge.
Jennifer Rae Myers: What I strongly recommend, um, and part of this is also putting my psychology hat on, is I know oftentimes, and it's not always, um, some of us do feel the sense of we have to do it all. [00:19:00] Um, we're already, uh, from a psychological standpoint, having to, to show our worth in some, in some spaces, particularly in the medical spaces, although I'm sure in the educational spaces you, you both can speak to, um, some of the challenges in that in, in, as well.
And so first, recognizing that you don't have to bear all the weight. You w- do not have to be the dietician now and the sleep hygienist and all of the things in order to integrate some of these strategies. Um, the second thing I would say is that you're not limited to purely your institutional setting.
Um, so for some of us, yes, maybe within our building we don't have the luxury of these teams, but maybe outside of the building we do. So other, uh, professionals that are in the area that you can reach out to, cold email, call. Um, I think it works twofold. One, it brings awareness to what we do and what's in our scope.
I think similarly, uh, we [00:20:00] can argue a lot of individuals unfortunately don't know who we are until they need us. Um, I'd argue the same for our colleagues. Many of them don't know that we work with dysphagia and cognition and all of these other things outside of, you know, stuttering, for example. Um, and so doing that can also help.
Um, ASHA has great resources as well. Um, if you navigate there and look for various, um, resources as it relates to interdisciplinary care, they've done a, a pretty decent job at creating a landing page and resources for exactly that. Um, I would strongly, strongly recommend, especially for those of us who are just getting our feet wet into the field, if you don't have a resource list of different, uh, professionals that would be on your interdisciplinary team, this is your call to action to do so.
Um, you should know- A local [00:21:00] audiologist. You should know a local, um, dietician if they are not in your building. Um, if possible, advocate for that, even if they can't, uh, you know, be a full-time employer, let's say. Um, advocating for having, you know, a contract where they can consult or something to that effect.
Um, yes, it is more work. I don't wanna diminish the fact that it is effort. Um, but again, we're thinking long-term positive benefits to that. Having those resources that you can extend to your caregivers and the clients, having those resources so you don't have to go it at it alone, and recognizing that, yes, while they may not be right there in front of your face, there are tangible things that you can do, whether it's creating that rapport with professionals within your given community, or identifying resources online even, fact sheets, um, strategies from reputable, um, websites and platforms that you vet out and then, um, provide as [00:22:00] support or additional resources as well.
Um, so I will say very respectfully, there's no excuse for us not to work interdisciplinary, um, or, uh, trans-disci- disciplinary. Um, we have the resources. It just does require a little effort to, to do it. I love that, and I wanna follow up with another question I was s- kind of sitting with listening to you talk about the call to action, right?
Kate Grandbois: Because a lot of this, uh, para- this lens of a paradigm shift is really about us taking a look at ourselves, at the lens that we're looking through problems, right? The training we've had, competency. Mm-hmm. Um, and in that skill acquisition, that skill development, um, and thinking about the lens of public health- We've already talked about health literacy, but I don't think that you can talk about public health without talking about communities that [00:23:00] are marginalized, underserved, under-resourced, um, and the role that we play in supporting those individuals.
And again, I'm, I'm using the word public health from, like, an economics - Yeah ... you know, true, big-picture public health lens. Like, the public means all of the public, all of everyone. Mm-hmm. Yes. Right? And we really need... And this is, again, training that we might not have gotten in our medical model settings, in graduate school, in terms of having the vocabulary awareness, cultural competency, all of these things, to center, um, the needs and perspectives of the entire public, including marginalized and under-resourced groups.
I wonder if you could tell us a little bit about shifting that paradigm, um, and, you know, what perspectives might be helpful for anyone listening who is maybe thinking about this from a public health lens for the first time. [00:24:00] Yeah. I think the biggest thing is recognizing that capital is beyond just monetary.
Jennifer Rae Myers: Um, I had the opportunity of, of being part of this, like, change maker fellowship, if you will, and I learned about various different capitals, social capital, financial capital, so on and so forth. And recognizing that regardless of if you are reflective of the community that you're working in, it's important to have community lia- liaisons or brokers who can really shed light on the population that you are serving.
What are their needs? What are their strengths? What resources do they already have, don't they have? Um, and recognizing that therapy is beyond just the strategies that we're working on, the goals that we're working towards. It's recognizing the transportation considerations. It's recognizing the health literacy.
It's recognizing, um, the access to things outside of therapy, [00:25:00] um, that all contribute to the wellbeing of that individual, and then also, um, obviously to the success in therapy. So when we're talking about, um, what I like to call priority communities, those who are often underserved, under resources, yet often are at high risk, um, for cognitive disorders or high risk for, um, very poor prognosis once diagnosed with cognitive disorders, it's really thinking about the why.
Um, unfortunately, oftentimes it gets, uh, mischaracterized by, oh, they just don't wanna engage, or it's their stigma, right? So that's why they don't seek treatment, or they don't seek care. Um, sometimes we may also, uh, have income enter the chat, right? Not financially. One thing that I think gets often overlooked, and I think what you're speaking to, Kate, is the cultural accessibility.
How are we making sure that the work that we do are cu- [00:26:00] is culturally relevant? And that extends to preventative care as well. When we are providing educational tools or information, are we doing it in a way that's not just at an appropriate reading level, but also is relevant based on that individual's culture?
What examples are we using? What representation in the images? Um, because that's going to determine whether or not they look at it and toss it away, or look at it and actually, um, engage with it I think also something to keep in mind, um, is that a lot of community organizations are already doing the work.
We just need to s- find out what that work is and work with them, not against them. Um, I think a, a easy example that comes to mind is, um, you know, often hearing screenings are a big thing. Do a hearing screening. Again, given the relationship between cognition and hearing, very important. Um, but recognizing that there might be community organizations that's already doing that work, and so how do you as the [00:27:00] therapist contribute to the work being done in a way that, um, brings buy-in, in a way that helps you understand and exposes you to the culture, the dynamics of that given community.
And then from there, tailoring your preventative efforts, um, in a way that is conducive, um, to the culture around them. And so, um, I think arguably, regardless again, if you reflect that community or not, um, it's important to have stake in that community. That all ties into ensuring that at a public health level, um, we are reaching the masses.
So identifying the needs, identifying places, whether it's a library or a community center, um, and then identifying the strengths and needs of that community and, and, and working in tandem with, uh, organizers. I hope that answered your question. It did, and I love this so much, and I'm trying to stay focused because-
Kate Grandbois: now I wanna talk about 10 million other things at once. Uh, I think the one thread that I'd [00:28:00] love to pull for a second maybe before we move into our second learning objective is a word you used, uh, that I love, that I am now gonna be using with my entire team- Please ... which is, um, priority communities.
Because when you use the term, and this is I think so beautifully reflective of a paradigm shift instead of using words like under-resourced and marginalized, because when you use the word priority communities, it implies that they are a priority, which implies that they have your resources as a first step.
Mm-hmm. And one of our biggest resources is our attention. Yes. Right? And, and I- Yes ... and I'm thinking about all of us listening and ex- and listening to you for the first time, myself included Thinking about the families we know, thinking about our caseloads, right? A lot of our, uh, s- our ability to translate some of these really high-level conceptual ideas about public health and priorities and all these kinds of things, it's, it's a [00:29:00] matter of thinking about just think about your caseload.
Think about the families that you're working with based on these ideas, these frameworks of public health and risk, who is a priority? Who gets your attention? Who gets your resources? Who... If you have the extra five minutes that you kind of don't have in your schedule because- Yeah ... you've got a caseload of, of productivity expectations of 100% or whatever it is, but you have that extra five minutes, who gets those five minutes, right?
Um- Mm-hmm ... I just absolutely love the idea of using the word priority, and I am very, very grateful to have heard that from you, um, as a paradigm shift of my own. Uh, so that was- Yeah ... a super fun little learning moment for me, so thank you very much. Absolutely. Absolutely. Um, you know, I'm a little biased. I love words, so I, I do try to be very intentional in how I think about and how I talk about, um, the individuals that we serve, the work that we do.
Jennifer Rae Myers: Not, not just [00:30:00] for, you know, not for the sake of it, but again, thinking about who I'm going to be talking to. Mm-hmm. How I talk about them. Um, even, you know, given what you just mentioned, when I'm talking to an individual who may come from a community where they're at high risk, letting them know they are a priority community to me, and I think that goes back to your earlier question of, um, you know, getting, getting your, your hands dirty, feet wet, being involved in the community, um, so that they recognize and, uh, the work that we do as clinicians.
Um, and so that again, the whole point of this is to hopefully increase the number of people that come see us or consult with us, uh, or somebody who knows us even I'll take, um, before it's too late. Um, and whether, again, that's a potential client or a caregiver, because we know the, the increased risk of our caregivers who are taking care of those who have dementia [00:31:00] and other neurodegenerative disorders, um, and the stress that elevates their risk for these things as well.
And so if we can reach one or both of those individuals, um, in being mindful in how we approach these things and, and making it a priority public health initiative, a critical need to be addressed, um, again, it, it pushes us not from just the change in the thinking, but also motivates us in the actual work I lo- I, I'm gonna just repeat myself and say I love this so much.
Kate Grandbois: I feel like I'm just gonna say that- ... on repeat the rest of this episode. Um, I wonder if this idea of, you know, using words intentionally, thinking about, you know, the, the resources that we have as clinicians and how we can use them intentionally and purposefully, if that leads us into a conversation about integrating this care into our day-to-day.
Um, because we all know that our day-to-day is not pretty sometimes, you know? Yes. I've [00:32:00] met many SLPs over the years who work in broom closets, who are... I've actually interviewed two SLPs in the last two weeks. One had a hun- a productivity expectation of 100%, and the other one had a caseload in a school of 174 students.
Um- Yikes ... and so, you know, the reality is, our realities are, are sometimes it's rough out there. Um, does that mean that our values shift? No. Does that mean that our priorities shift? Not necessarily, but it does mean that integrating some of these principles can require strategizing. And I wonder- Absolutely
if you could talk to us a little bit about what that might look like. Yeah. Um, again, as we talk about the integration, I think it's now a good time to talk about preventative care, uh, and the moving parts. And so again, preventative care within our field is not anything new. Um, the goal of this conversation is to shift where in that realm or umbrella of prevent- or spectrum I should say, [00:33:00] of preventative health we focus our efforts on.
Jennifer Rae Myers: And so, uh, again, depending on the literature, you'll get anywhere from about three to five different types or levels of prevention. But for the sake of conversation, we'll talk about the main three that you'll see across the board. Um, so primary, secondary, tertiary, very easy to remember. We, uh, often live in the tertiary, but before that we'll get to the, the primary, secondary.
Primary is what we all think about when we think about preventative care. It is the intervention that you implement in order to stop or, uh, prevent, as the name's sake, um, any condition or impairment. Um, and so that's often done by health promotion or health education. Next, or the secondary level, is the level where we do things like screening.
So the goal is to reduce or eliminate any of the risk factors, those modifile- modifiable lifestyle, um, risk factors, for example. Um, again, with the goal of preventing that disease or condition. Now, where we [00:34:00] live again is a tertiary level. At this point, the individual has already been diagnosed with the disorder or already has the impairment, and so our goal is to reduce or eliminate the, that impairment.
Uh, and so that individual, uh, hopefully returns back to baseline. Um, and so- When we talk about integrating preventative care into SLP, uh, it's, it's not fully integration because it's already integrated. We, we, again, we live in the tertiary world. It's how do we integrate that primary or secondary level of preventative care, those type of approaches, more routinely in the work that we do.
Um, and, you know, I'm very curious from your lens, um, where you think that the educational kind of SLP lives in terms of preventative care. I know from the medical side, we live in the tertiary. Um, at times we might do screenings, right? We, you know, [00:35:00] we give out the MoCA, we give out the SLUMS to see, but by that time, that individual is probably already diagnosed, um, and we're just confirming, uh, or identifying what areas of concern we need to address.
And so in terms of integration, it's kind of threefold. Um, the first is, how can we mitigate any of the dementia risk and potential trajectory? So going back to some earlier talking points about those modifiable risk factors. So if there's any lifestyle variables that we can address through some type of behavior intervention, um, to lower that risk, that would be ideal.
This is where that interdisciplinary team comes in. So if we are doing intake or we just ask our client, you know, "How are they feeling today?" And they let us know a couple of times, "I've gotten three hours of sleep, four hours of sleep." "Hey, have you talked to someone about, you know, your sleeping? It seems like [00:36:00] it's really impacting your daily life.
You're, you're not paying attention, and I know that's really important to you, so that you can get back to work," et cetera and so on. Um, if they say no, go to that resource list. Is there someone that you can refer them to? Or go to their, you know, can, uh, their PCP, their primary care, uh, provider. Um, and so that's like low-level integrating preventative care.
You, in fact, are not the one actually, uh, implementing that primary or secondary, uh, approach, but you are referring or providing a way, a trajectory, um, for them to get the help from a primary, uh, or secondary lens. Um, this is particularly important when we talk about caregivers, right? So they, they don't have, um, a diagnosed, you know, cognitive disorder or impairment...
dot, dot, dot, yet, and the hope is that it stays that way. And so while we're doing that informational counseling, are we providing that caregiver with the support that they need? [00:37:00] Um, let informing them that it's really important that you, um, keep your stress levels low. You don't forget about you, because we wanna make sure that you don't find yourself, um, having concerns or worrying about your cognition and related, um, uh, uh, areas as you age, right?
Um, and then the second one, um, I think that's really important is the preservation of the cognitive function. So transitioning now to if we can't mitigate some of those lifestyle, uh, behaviors, are there ways that we can preserve the cognitive function, um, in terms of proactive modifications, uh, with the goal of maintaining or improving, uh, different domains, memory, attention, executive function, so on.
Uh, as I mentioned before, stimulating cognitive activity. So not just doing word search or crossword puzzles. I think those are often, um, kind of the default activities, but it has to be something complex. It has to be something that's gonna shake that, those neurons up [00:38:00] a bit. Uh, so even if you don't plan on, you know, taking a trip to, I don't know, Paris anytime soon, practicing French, learning a few things.
Um, something that's really practical is if you, uh, if your client is working or patient's working with a nurse who is bilingual, "Hey, let's work on a few common phrases so that you can speak to your nurse in Spanish, in French, in Farsi," um, whatever that language might be, to help stimulate, um, cognition.
Um, even if you're working on dysphagia, for example, because we know the implications of cognitive impairment on dysphagia and other functions. And then the last thing I would say in terms of implementing Preventative care, uh, into practice is really, uh, enhancing access. So if, if we're not talking about the direct what are we doing within therapy, whether it's referral pathways that I talked about initially, to the actual activities that you are [00:39:00] implementing that promotes, uh, protective factors for dementia risk.
Uh, the third option there, the third opportunity to integrate would be the actual, um, access and equity component, and that's where we're taking this kind of public, uh, health model or communication public health model at its, at, at its highest level. And so are we ensuring that there are accessible means to cognitive health?
Um, do they have access to tools, whether it's for their physical health that impacts their cognition, to their mental health, their social support system, um, to access to, you know, books at the library. Maybe part of your goal or, or part of your therapy is, "Let's get you a library card so that you can take books out and read more," since that has a positive impact on your cognition.
And so thinking functionally, I am team function all the way. [00:40:00] Um, thinking functionally, there's different opportunities. Um, and not to ramble too much longer, but kind of circling back to the actual question where time is a barrier, um, productivity is a barrier, um, the ask is not to do anything differently really than what you're already doing.
It's just being more targeted. So do you have certain resources in place should someone be at great risk, um, so that you can provide that primary, secondary level of prevention? Um, if, if you do, great. In addition to that, do you have different therapeutic activities that help to promote cognitive health and reduce, um, the likelihood or identify early, early intervention through screening?
And then thirdly, making sure that you create the access for long-term sustainability. I tell my clients, patients all the time, "I don't ever wanna see you again." And one of the ways that we ensure that happens is making sure that they're set up for success [00:41:00] after our therapy. So making sure that they have access to those resources to maintain that healthy lifestyle.
Kate Grandbois: I- this is just so... You're so full of information. This is awesome. One of the things that I was thinking about while you were talking was the how, right? So how do you, you know, if you're in your sessions, a- and I love the point you made, you don't necessarily have to do anything extra. You just have to do what you're doing a little bit differently.
Yeah. Um, and if we're talking about wanting to make sure that a patient has access to something, then we need to learn a little bit more a- about them, right? And I think in so many instances, the intake workflows we have, the ways that our, our, our, the, you know, our workplaces create these norms of, like, you walk into the patient's room, you walk out of the patient's room.
Like, there might not be a lot of embedded opportunity to cultivate [00:42:00] trust with the patient- Yeah ... or- Very true ... you know, engage in, um... You know, w- a lot of us are trained that are, you know, before you see a patient for the first time, you just read the intake paperwork and go in there. And it was making me think of the power of some of these, again, softer skills that we're not necessarily taught in graduate school, like active listening, like learning ethnographic interview styles- Mm-hmm
using open-ended questions. Um, letting the patient talk, right? Like, learning about- Who did that? ... their favor- Just, just, you know, be a human- Yeah ... and have some chitchat for a minute. Um, because when you engage in all of these softer skills, you create these, you have more lik- the, the higher likelihood of creating trust, where you learn a little bit more about the patient because they share a little bit more with you, and then you understand, oh- You are having transportation issues to get to your appointments, or you are at risk because you just shared this little piece of me- you know, this little extra tidbit that [00:43:00] you wouldn't have learned from- Yes
an intake form, right? Um- For sure. For sure. I don't know if, if you all experience this, but I could, I could have probably retired the number of times I've had someone when I go to see them say, "My speech is fine. I don't need speech," or, you know, "I don't wanna be charged anything extra for you to see me," or, "Why do I need this?"
Jennifer Rae Myers: I mean, maybe not from the little ones, but maybe from the parents or guardians where they, they don't understand our full scope, uh, of what we do. And so, um, the comments you just made kind of reminded me of the importance of building that trust, um, especially again for those priority communities where medical mistrust is absolutely a thing- One million percent, yep
for a multitude, uh, of reasons. And so I think, you know, I'm not gonna try and s- sell snake oil here and say preventative care is the end all be all, but it... I, I would argue if we meet people a little earlier before [00:44:00] everything has been completely changed, their life has been completely uprooted, um, they are in an emotional state because, you know, life will not be the same from this point on, um, we, again, we get a little bit more buy-in.
Um, I think it's a little easier to see from maybe an audiology lens, right? Where, uh, you know, you go in annually for your hearing and we wanna promote annual hearing checkups so that way when you're 65, 70, you're not, uh, hopefully you don't need hearing aids or even sooner. Uh, my argument is why can't they see us at a little bit more frequency or at least know the resources that are there before they get to the point that treatment, um, is needed.
And so that trust piece is important. I think being out in the community, um, identifying the actual needs and more importantly the strengths of that community and working alongside that [00:45:00] from a public health preventative lens, I think is crucial so that if they do need to see you at some point, that relationship has already been built and not, and, and that's both literally and figuratively, whether it's a one-on-one clinician or just as a field or as a profession
Amy Wonkka: As I've been listening to you speak, I've, I've thought about... So I've had so many different thoughts. Um, one of them has been around having your work that you're doing with your clients be meaningful in expanding their access in life. So when you were speaking about, you know, maybe we're gonna work on a few phrases in Farsi so that you can communicate with your carer at home, uh, maybe we're gonna help you get your library card so you can go to the library.
Um, I was wondering, as you were speaking, I'm trying to conceptualize the type of work that you're doing with patients or that you're... Like, are you mostly seeing people who are in an outpatient setting, and are you seeing them for an extended period of time? [00:46:00] Um, and are you finding, to Kate's point, like none of us have enough time, and I could go on- Yeah
my soapbox about our healthcare system in this country. Um, but I do feel like when you're, if you're able to have a more extended relationship with people, and if they're coming on an outpatient basis, how is your relationship with them changing over time, and do you see changes in their buy-in for some of these other strategies as you move forward in your relationship together?
Jennifer Rae Myers: Yeah. So outpatient, I think... So thinking about some of the medical settings, from hospital to long-term care facilities, um, obviously if, if the individual's at the hospital, probably a different conversation, right? Um, if we go to the other end and we're talking long-term care facility, um, the fact that you will likely see them five days a week, whether or not they're on your schedule, that also helps.
So your example, Amy, of that outpatient where you may see them once a [00:47:00] week or once a month, unfortunately, for, you know, the c- for the obvious, um, building that rapport, um, for me it's how are you, what is your touch point? What is your communication cadence? Um, how much effort does it take to send a weekly check-in?
Um, you could schedule that in Gmail, right? Um, and it's those little touch points that can still keep that momentum going because to your point, Amy, you want that momentum, um, especially if you're not going to be able to see that, that patient or a client on a regular basis. Um, also utilizing, uh, that carryover strategies and exercises as it relates to those functional goals.
And so how can you craft or create goals that speak to positive, beneficial lifestyle changes that promote cognitive health, cognitive communication skills, that also help to [00:48:00] minimize the risk? Um, and so getting into things like, "Hey, s- let's start a journal," or "Here's this email check-in. What have you done today?
What have you done this week to promote your cognitive health?" And then using whatever the response is at the top of your next meeting, um, or having the caregiver do it if it's more appropriate. Um, making that a thing between the caregiver and, um, the client or patient as well, all hands on deck here, um, I think is important.
So, you know, we are clinicians, we're SLPs, we're creative by nature, I like to think. And so there's ways that we can do it that doesn't eat into our productivity and time, um, that can be flexible for the cadence of and frequency of how you see individuals. Um, and then thinking about, I think, again, an important piece to this is once things are wrapping up, right, and the discharge planning, and making sure, again, that resource list I'm gonna go back to, what are you [00:49:00] providing them that prepares them for the road ahead so that they feel like they're able to do it?
Um, I'm saying on their own with air quotes, um, recognizing that on their own might look different for some people, on their own to the best of their ability, I'll say, um, to ensure again that they don't have to see you again if they don't need to. Um, and I think that goes back to a lot of the talking points that we had thus far about if you're involved in the community, it's a lot easier to create that resource list.
Um, if you've built that rapport, it's a lot easier for them to have buy-in and to adhere, where even if you don't see them every day or every week, the trust is built, you've provided them resources, and so they are not dependent on us for the success of their cognitive health.
Amy Wonkka: Thank you.
Jennifer Rae Myers: Yeah.
Amy Wonkka: That really
Jennifer Rae Myers: helps.
I am curious though, if I may, um, in terms of the early intervention from, from a little one's [00:50:00] standpoint, how do you navigate that with parents and guardians to ensure, you know, that carry over, especially given, you know, critical period of language development? You know, you wanna make sure those strategies are being employed routinely
Amy Wonkka: Do you want, do you want me to take this, Kate?
So I Yeah. So I'm in the, I'm in the school, so, and I have the, the good fortune of working with kiddos all the way from three to 22. Um- Wow ... and so in part of that EI transition, you know, d- we do a lot of communication at the public school level with the sending EI team. Um, and oftentimes we have kiddos come up who have been really well served by their EI teams.
Um, we will have a meeting with the families. Uh, often members of the EI team are able to come. We're able to share both, like, written information as well as have a bit of a conversation. Uh, but that [00:51:00] doesn't always happen, right? We don't, would not- Yeah ... not all the students have, have had access to EIs.
Sometimes kids don't get referred. Um, so similar to your point, you know, there are priority communities for us as well, uh, where we may see kiddos who didn't get the supports that, that maybe are customary for, for a lot of the students who are coming into the public education system. Um, and then again, we have a lot of those same barriers, um, to access in terms of even just making sure that materials are available in multi- in the languages represented by the members of our community, right?
Yeah. So some of those really basic things as well. Um, Kate, I don't know if you have anything else to add in the kinda like private practice domain.
Kate Grandbois: Yeah. I mean, I, I think a lot of these concepts are really interesting when you're talking about pediatrics, because so many of the patients and families that we work with, I don't know if anyone listening is a parent, my kids are teenagers now, but [00:52:00] having little kids is really overwhelming.
And you're not- Yeah ... necessarily thinking about who they are when they're 10 or 15. You're thinking about, uh, "Do I have macaroni and cheese for dinner, and will they eat it?" You know? Mm-hmm. It, it's a, it's a very different mentality. Um, so I can only speak to the approach that I've, that I've used and that I've seen used, which is a lot of counseling.
Yeah. Um, a lot of active listening, because these families in many instances, they're playing the role of care partner, caregiver, um, and they may be having like, a secondary, you know, impact, um, from the disability, um, or from the communication disorder, whatever may be going on. I think there's a lot of complexity.
I mean, there's- Yeah ... a complexity with all of this. Um, but it's a, the, the preventative like, saying, "I don't ever wanna see you again," or, "Let's talk about [00:53:00] preventing something that could happen 10 years from now" is just a really interesting conversation- Yeah ... to have. For a kid who's two or, you know, or even a little bit older.
Um, so in my experience, it's, it's, it's something that's in my mind, but I am being a lot more careful about how I, how I say it out loud, using a lot more, like, counseling strategies, making soft suggestions instead of being like, "Well, when your kid's 10," they're like, "What?" You know?
Jennifer Rae Myers: Yeah, yeah. Oh, absolutely.
Kate Grandbois: It's just, it feels like too much.
Jennifer Rae Myers: Absolutely. Oh, that's a great point, too. Um, because counseling is, I think, an instrumental part. I'm a bit biased because I do teach counseling, um, at my, uh, in my department. Um, but I always tell students, right, you don't... Like, the counseling is not this like, now I'm gonna just throw out everything I've ever learned to you to educate you.
And so doing it in a way that's culturally relevant, doing it in a way that is mindful of where that person is. Like, to your point, I'm just worried about [00:54:00] macaroni and cheese today. Right. I'm not worried about, you know, ten-year-old, uh, my kid when they're 10 years old. And I think arguably the same, um, for older adults as well, 'cause oftentimes we're working with the spouse who has their own medical complexities- Right
and challenges and concerns, or the adult child. You know, uh, if my parent is 80, I'm probably 60, 65, maybe 55, and things are happening to me as well, managing my children, my own health, et cetera. Um, but doing it, I think the, the takeaway for me is the consistency. Are we consistently creating those touchpoints, those routines?
Are we... It's almost, um, and I'm, I, um, I like to use different analogies, but it's kind of like my, my sister just recently had a baby, and so she, she needs diapers, but she's asking for diapers in a larger size, right? Because if everybody gets the newborn [00:55:00] diapers- Right ... then she's not prepared for the, you know, as the child grows.
And I'd argue the same of not necessarily dumping everything that could, would, should, may happen, um, but preparing. Mm-hmm. Because the uncertainty is what causes a lot of the angst, the uncertainty of what to expect, what to do, the impending communication demands as a child grows in your instance, as the adult ages or as the disease progresses, um, if we are, if we are not, uh, at the, you know, eliminating risk phase, um, that sh- is worth considering.
Um, and we can't account for everything that's gonna happen, but we can certainly make sure that they, um, are prepared for what could happen, um, in a way that is digestible to them.
Kate Grandbois: I, I love that perspective. Um, and I think, you know, just to reiterate how important counseling is, I know you said you taught it.
I'm so glad that your students are lucky enough to have a counseling course as part of their- Yeah ... graduate training, right? Yes. 'Cause it touches so much of what we [00:56:00] do. Um, I wonder if in our last, you know, in the last segment of the show, if we could shift and talk a little bit about digital health technologies- Yes
um, and how that translates into some of these conversations. What can you tell us about the role of digital health?
Jennifer Rae Myers: Yes, digital health. Digital health, digital health. Um, I wanna preface by saying my hope is that regardless of if you are a skeptic or an enthusiast regarding digital health, in particular AI, um, that we are informed as both consumers, um, and then also as hopefully, potentially, ideally as creators, um, in the digital health space.
Um, I think for a lot of us, we think it's not accessible beyond just using ChatGPT, but I am a, I am a testament that, you know, you can be the one creating the buttons and the colors and the, you know, cognitive, um, [00:57:00] platforms, um, if you so choose. Digital health has been around for a while. There's nothing mystical or magical about it.
Um, and I think that we can leverage the way that we use it in the preventative care space. And so I've talked now at length about the different ways that we can, um, address or acknowledge or identify some of those risk factors like physical, social, cognitive, um, in order to reduce the risk, eliminate the risk, screen for the risk, and so digital health tools provide a more scalable way to do those things.
Um, so in terms of kind of the benefits of digital health, access is the biggest one, right? So I think, uh, early in the conversation, uh, an example was used about rural communities. One of the caveats has, has often been internet access, so how do you use technology when internet is spotty at best?
Thankfully, um, I think the number, uh, don't quote me on the exact, but there was a paper that said about 72% [00:58:00] of rural areas have access to broadband internet, and that was some time ago. I'm assuming that percentage has increased. Um, and there's, there are a lot of organizations that provide free or low-cost internet services, so that's no longer the barrier that it once was.
Um, so using digital health tech- technologies to create access for individuals that may not live in an area that has a lot of SLPs. Um, there's a paper that referred to it as medical SLP deserts, and so being able to provide telehealth or other things, um, of that nature to do early intervention screenings, that secondary level of preventative care that I mentioned.
Uh, also the early detection kind of as a tag-along to that. So remote monitoring is key. So let's see if we see any changes over time, um, and then we can inter- intervene sooner rather than later. Um, functional support, and so using digital health apps, um, to [00:59:00] stimulate cognition. Uh, we live on the principle as clinicians on the use it or lose it, use it and improvement mantra.
Digital health apps can help to do that. However, it's our responsibility to make sure that they are vetted, um, to make sure that they are ethical, so on and so forth, which I'll talk about here, uh, in a second. And so you can use those things. You know, there's apps already for things like apraxia, for cognition, et cetera.
They're out there. Again, our responsibility is just to make sure we're using ones that are, uh, ethical. And then adherence. So digital health tools, platforms can help with adherence to any of those preventative, uh, cognitive communication type approaches or strategies that we're trying to, uh, implement.
It helps us with individualizing care, setting reminders, providing progress feedback, so on and so forth. Um, by doing any of those things that I just mentioned, you're integrating digital health in a way that, again, is scalable, that increases access, and provides functional, um, [01:00:00] support. Um, and so those are the benefits, and I can talk about the pitfalls as well but didn't know if, um, there's anything that I can expand upon here.
Amy Wonkka: So this is a basic question, but when we're thinking about digital health- I know you mentioned apps for apraxia. Kate and I both work in the field of AAC, so I think we're familiar with AAC type apps. Um, are there other... Like, I was thinking about your example, even of just, like, schedule sending an email to a client to be like, "Hey, just checking in.
How are things going?" Um, are there other, like, examples that we should be holding in our mind while we listen to you, um, talk to us about it?
Jennifer Rae Myers: Yeah. Um, so I'll give some concrete examples. So oftentimes when we talk about generative AI, it's usually for the purpose of goal writing or maybe coming up with an activity.
Um, if the budget allows, if you use voice enabled, you can have chat interact with your client and practice different skills. "Okay, chat, I want you to pretend that you are, [01:01:00] um, an interviewer for a job. Don't help, just converse for such and such." And then have your client, uh, interact with chat. There's different voices.
Um, you could put the prompts as specific or nuanced as you need. And so that's an example of using it for functional support. Um, there's apps that, um, um... What I was gonna say. There are self-administered cognitive, um, health apps where you can, uh, complete assessments via the app or web platform to see where you are cognitively and whether or not it might make sense for you to reach out to your primary care physician.
This is something they do on their own time, so you reduce things like the stigma that might be attached to it, the need for physically coming into an office, et cetera. And then if there is something that is, is cause for concern, then you can follow up with a more, um, intimate in-person meeting. Um, another thing that you can, uh, think about in terms of different apps, uh, [01:02:00] therapeutic music app, for example, for...
So if you have someone who might be in the early stages of dementia, uh, we know that, uh, music therapy or therapeutic music has some salience on, uh, improving cognitive health. Also provides an opportunity for social engagement, so singing along and engaging in the music, seeing if you can name the different songs, um, singing songs in different languages, et cetera.
So again, it doesn't have to be your typical, "Okay, here's a memo app. Now you're going to write down all the different memories," or, "Here's an organization app." Um, you could think creatively about the different, um, apps that you wanna use for that functional support, um, piece
Kate Grandbois: Sorry. Um, I, I love the idea of leveraging digital platforms available to us for a lot of reasons. I think in some instances, these [01:03:00] digital, uh, strategies like the schedule ahead email idea that Amy just had, a lot of these strategies can really help us feel like our tasks are a little bit more manageable-
Jennifer Rae Myers: Yeah
Kate Grandbois: help us with our workflows, be a little bit more efficient so we can follow up with patients or provide, um, practice opportunities outside of our o- office or support generalization. I also really love the idea of leveraging telehealth for, to maintain a line of communication with families, particularly families who have transportation issues- Yeah
um, or families who may be in a desert. AAC deserts are something that Amy and I are very familiar with in terms of, you know, being able to get access to care. We live outside of Boston where there are many of us, right? Um- Yeah ... but that is not the ca- that is not the case i- in, um- Of course ... in a lot of, of our, um, in a lot of the country.
So really just using these tools to maximize care and efficiency I [01:04:00] think is a, is a wonderful, um, idea. Of course, that doesn't come without pitfalls, right? Yes. And very careful consideration. Can you tell us a little bit about the ethical concerns or strategies around using some of these tools e- ethically?
Jennifer Rae Myers: Yeah. I think the two biggest things, um, are access and, and the ethics like you mentioned. In terms of access, the usual suspects here, the internet, which I talked about already, tech literacy along the lines of health literacy. Although, you know, as a, a bonus part of therapy can be, "All right. Let's see if you can navigate this platform.
Let's follow-- Can you follow these instructions on setting it up?" Um, so everything, I learned a long time ago, everything can be therapy, right? So again, going back to how do we not add extra time that we don't have, um, productivity percentages that we already are having difficulty, uh, meeting, and that is everything can be therapy if you think long and, and hard of it.
Asterisk there on the everything, though. [01:05:00] Um, in terms of the ethical concerns- It has to match a few things. The cognitive level of that individual, um, and ideally, hopefully be adaptable as it changes. Um, any sensory, so hearing, vision, language, the cultural relevancy I'll, I'll emphasize through and through, and the safety needs of that individual.
Do they feel safe using this app, providing their information? They're providing sometimes health information, and so making sure that that app, uh, how is that, um, app collecting the data? Who is that app sharing the data with? A lot of this is in the term condition, and, you know, probably by design, very dense.
Um, but a good control find will help you look up third party, and then find what third party. Legally, they have to disclose that information. Um, I, I actually served as a clinical safety officer. It's a way long story, um, another podcast session. Um, [01:06:00] but it was based in the National Health Service, uh, across the pond, where they have required, um, required digital health, uh, criteria that tools have to meet, from security to user accessibility to technical components.
And I wish we had the same in the US, because anybody, unfortunately, can say, "Hey, I created an app. It's gonna improve your brain cells." Right? Um, and so thinking about our responsibility from an ethical lens to ensure that if we're going to recommend an app or use a app, if our client or caregiver comes to us and say, "Hey, we found this app.
What are your thoughts on it? Do you know about this app?" We do our due diligence from an ethical standpoint to identify the security risk, the privacy risk, the cultural relevancy of the apps. Um, digital health is not for everybody. Any concerns or moral considerations. Um, [01:07:00] you know, let's address the data center in the room.
Not everybody is on board with using AI, and so being transparent in when we're using AI, if our clients, caregivers would be comfortable with us using AI and other technologies as part of therapy is also part of that important ethical consideration, um, as well. So much like doing your due diligence for any assessment or therapeutic strategy, the same is, is said with digital health.
Um, it shouldn't be contingent on a law or requirement. It should be contingent on making sure that we are, are really doing best practice.
Kate Grandbois: I love this, these suggestions and consideration, especially since we're talking about a field where our newly, newly licensed SLPs are digital natives. Mm-hmm. But we may be treating patients who are, you know, didn't get a computer until they were 30 or 30 years older.
Yeah, yeah, yeah. I'm, I'm probably not doing math well, right? But the older generation is definitely not digital natives. [01:08:00] Um, and so some of the things, some of these ethical concerns and comfort levels we may take for granted. Uh, and I really appreciate you- Absolutely ... pointing all of those things out. In our last-
Jennifer Rae Myers: I mean, even us.
Even us. Yeah. I mean, right, technology is changing by the day. Yep. Sorry to cut you off.
Kate Grandbois: Oh, no, no. Um, A- Amy and I are '80s babies, '70s babies, so, so- Yes ... we are also not born digital natives- No ... but adjusting as we age. When... I think we're doing an okay job. That's not too bad. Yeah. Not, not too bad. Um, in our last couple of minutes, I wonder if you could just share any parting words of wisdom.
If there are any SLPs listening, if this is their first exposure to, um, digital health literacy, health literacy in general, prevention, do you have any last suggestions or resources where someone else might be able to learn more or, you know, dig a little bit deeper?
Jennifer Rae Myers: Yeah. Um, kind of my final words for thought, um, and while this could certainly go across the board, [01:09:00] I, I will say I'm, I'm speaking to, uh, those of us who are in the medical, um, setting here.
We're uniquely qualified to do the work that we do as it relates to preventative care. Our scope is broad enough. We have the tools from counseling to actual therapy, um, implementation. And so it's just thinking strategically on how we meet the people that we serve, including caregivers Mm-hmm. That's really the shift, is how do we do more screening?
How do we get into the community and reduce those risks altogether in creating more accessible, equitable ways? Um, one of the ways that we talked about today is digital health, although it's not, um, the only one. Um, I do challenge all of us to really think, uh, about one tangible. If I could, like, triple dog dare, uh, those listening to within the next three months identify an intentional way that you can, you can implement a preventative approach or strategy that's [01:10:00] different than just, uh, addressing the current impairment.
Um, you're already a step, uh, towards that communication public health, um, effort. And then for, uh, my responsibility is to make sure that I leave you, uh, with something. And so I do want to, um, note here- That, um, let me think of the name really quick or find the name really quick here. Um, okay. So the interprof- I wanna make sure I get it right.
The Joint Committee of Interprofessional Relations, uh, between the American Psychological Association and ASHA, um, created guidelines on how to incorporate preventative care approaches and models. Um, they have a paper, it's, uh, Cohen 2026. And so if you need something tangible that you can read through that has resources, um, I think that's a great starting place for those of, of you who are interested.
Kate Grandbois: Thank you so much for this. We will be linking all of these resources in the show notes. Um, we [01:11:00] are so grateful for all of your knowledge and all of your time. For anybody who is listening who would like to take this course for ASHA CEUs, the p- uh, link for the post-test is in the show notes. Just a really quick round of thank yous to everyone who helps make this show possible.
Dr. Anna Paul-Muemi, our CE administrator, um, Darren Lopez, who's our production manager, Tracy Callahan, our advisory board liaison, Dr. Mary Beth Schmidt, who supports our peer review process, our advisory board who elevates our content, and last but not least, Jen, thank you so, so much for being here. I learned a ton, and I have new favorite words and new-
favorite paradigms that I am going to be carrying forward in my life, and I have you to thank for that.
Jennifer Rae Myers: Thank you so much. Thank you so, so much.
Amy Wonkka: Thank you. This was awesome.
Jennifer Rae Myers: Thank you both.
Outro
Announcer: Thank you so much for joining us in today's episode, as always, you [01:12:00] can use this episode for ASHA CEUs. You can also potentially use this episode for other credits, depending on the regulations of your governing body. To determine if this episode will count towards professional development in your area of study.
Please check in with your governing bodies or you can go to our website, www.slpnerdcast.com all of the references and information listed throughout the course of the episode will be listed in the show notes. And as always, if you have any questions, please email us at [email protected]
thank you so much for joining us and we hope to welcome you back here again soon.
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