By: Michelle Hsieh, AuD, PhD, CCC-A, Vice President of Audiology

Howdy, TSHA. Time has really flown these past four years, and I can’t believe that it’s time for my final Communicologist submission as the Texas Speech-Language-Hearing Association (TSHA) Vice President of Audiology . I still remember so clearly the day I found out I had been elected. It was in the spring of 2020, at the height of the COVID-19 pandemic, and I was sitting through yet another stress-laden virtual meeting about modifying clinical practices to foster safety in the face of the unknown. We were all still getting used to Zoom and the logistics of remembering to unmute ourselves, turning off our cameras when internet connection was slow—things that all feel, for better or worse, second-nature now. Some days I miss in-person meetings (confession: many days). When I heard the news that I had won the election, I remember feeling a sense of extreme excitement, with extreme panic hot on its heels. How would I live up to my predecessor, Tori Gustafson? How would I carry the newly budded torch of audiology and carry on its legacy? How did any of this even work? Thankfully, as it turned out, I found the people serving on the Executive Board to be not only exceptionally competent and capable but also extremely patient and eager to help guide me as I navigated the waters.

This is the time of year when I would usually write a cheerful update about everything that the TSHA Audiology vice presidency and its subcommittees (Education and Audiology Issues) have been up to for the year. Though I am always happy to chat with anybody about this, I wanted to write a more personal story for my final entry—a story that embodies why I continue to dedicate my time to TSHA, even outside the scope of my leadership duties.

At my core, I do what I do (for reference, I am a hospital-based pediatric audiologist) so I can connect with my community and take actions that will generate positive impact on the families around me. I join organizations like TSHA so I can do these things more effectively outside the scope of my day-to-day job. I get roped into leadership sometimes because, well, it’s the easiest way to badger your friends and colleagues to convince them to do the same (I admit this freely). One of the hardest things I’ve learned over the years is that it is, in fact, quite difficult for an organization to demonstrate its value to busy professionals who are already at the limits of their bandwidth. “Why should I join TSHA?,” one might ask. “What is it going to do for me as a professional, and how is it going to help me help my patients?” These questions also occurred to me in the past, but I now have witnessed firsthand the very direct impact from active engagement within a professional organization.

I want to pivot now to tell you about congenital cytomegalovirus (cCMV), the leading cause of acquired congenital hearing loss in infants and children. CMV is a common cold virus that most of us will undoubtedly have during our lifetimes. However, if a mother contracts it during pregnancy and passes it to her child, it can lead to a number of very serious issues such as microcephaly, seizures, neurodevelopmental impairment, growth restriction, vision loss, liver/spleen dysfunction and sensorineural hearing loss that is often progressive. It is thought to occur in about 1 out of every 200 births. Furthermore, as only about 10% of those who test positive for cCMV are symptomatic, an early diagnosis is often missed, leading to missed opportunities for early intervention or treatment, including for those infants who are born with normal/typical hearing but who lose it later in life. The effects of missing an early diagnosis can be devastating for these children and their families.

As there is no federal mandate yet for cCMV screening, the onus falls upon the individual states to lobby for legislation that promotes screening, intervention, and preventive measures such as education. Utah became the first state in 2013 to enact targeted CMV screening; in other words, it is mandated that an infant be screened for CMV if he/she does not pass the initial newborn hearing screen. Since then, 20 other states have passed CMV-related legislation—and Texas joined the list in 2023, thanks to a group effort organized by the national CMV Foundation in collaboration with audiologists (including me and several of my colleagues), ENTs, speech-language pathologists (SLPs), and parents.

Last April, I delivered testimony in the Texas Senate chamber, representing myself, along with another audiologist and a parent of a child with CMV. The committee meeting had run its course in the morning without the opportunity for public comment, so we went back to the Capitol after the Senate reconvened in the evening. We ended up telling our stories around 8 p.m. and left exhausted but happy. The next month, we were informed that Texas had passed a bill mandating: (1) targeted CMV screening in infants following a failed newborn hearing screen, and (2) increased education regarding CMV in the community. It went into effect last September, and I can say anecdotally that I have seen a significant increase in patients with the CMV diagnosis in my day-to-day at the hospital here in Austin. This is evidence that our efforts are indeed bearing fruit.

I had minimal experience giving legislative testimony before joining TSHA in 2018. Frankly, I assumed that, as individual citizens, we had little to no real influence over the decisions that were made in the Capitol apart from the ballots we cast from time to time. I slowly became more comfortable delivering testimony to legislators over the past several years with TSHA’s guidance. I was particularly blown away by the Texas Capitol visit orchestrated by the Vice President of Advocacy during TSHA Convention 2023. The Advocacy committees painstakingly made notecards for every member who registered with a list of their local lawmakers based on their given address. Members were each given a list of upcoming bills for which TSHA was in favor or against, along with recommended talking points. The association essentially walked us step-by-step through the process of connecting with legislators in person to discuss issues important not only for our patients but for SLPs and audiologists as well. I felt much more educated and prepared to approach our lawmakers from a place of expertise and confidence.

I was floored by the impact we made. We had been coached that it typically takes several legislative cycles to get a bill passed, especially one that would require additional spending (always a tricky ask). The fact that the CMV bill passed the first time around made me realize the impact we had, not as a lobbying organization or a government agency but as individual professionals with the power to move the needle for ourselves and for our patients. I realized that our legislators not only value but need the insight we bring as the experts of our fields as they consider the laws that are brought before them for review. I have little doubt that the advocacy training I received as an active member of TSHA ultimately contributed to the passage of this extremely important bill that has already helped countless families in Texas. Last week, I had the honor of sitting down and chatting with Clint and Jenn Jarrett, whose daughter was born with congenital CMV. Clint was with me that fateful night in the Senate and was able to witness the positive response from the Senate committee. The interview is linked here, and I hope you have the chance to view it to see the lives of the people who are affected by our efforts.

We move as individuals, but we gain momentum with the support, education, and guidance from our embodying professional organizations steering the ship. I hope you consider this narrative when you ask yourself this fall whether or not you will renew your membership with TSHA. Over the past four years, I have observed that our leadership works tirelessly to keep its pulse on the issues that matter to its members and will always do its best to empower individuals to take the next crucial steps to improve the life of someone in his or her community. But we bear the responsibility as those individuals to take the work and move it forward. And I promise you, it is worth the time spent to do it.

I will be stepping down at the end of the year, and the ever-capable Kelsey Hatton will be taking the torch as TSHA’s newest Vice President of audiology. From the bottom of my heart, thank you for entrusting me these past four years, and here’s to many more as an active member.
 

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