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Changes and challenges

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Dr. Donna Geffner—Professor, private practitioner, presenter, and past president of ASHA, Dr. Geffner speaks to the SLP Forum about her work and the changes she's seen over three decades in the profession.

SLP Forum: Tell us a little about your work. Looking back, what has changed over the years?

Dr. Geffner: The field has grown and expanded so much. It's a different discipline from the years when I was a student, and that's very exciting. Our technology is so much better. We have access to information in seconds.

At the same time, though, there's still much to understand about language processing, and the impact on learning and learning disabilities. As an educator, I feel it's critical to learn more about language processing, reading problems, writing and spelling problems—how they all interact and affect a child's growth.

SLP Forum: How do you see speech-language professionals incorporating new findings in these areas into their work?

Dr. Geffner: With reading, as an example, we've learned how phonological awareness, children's ability to discriminate sounds, and their acoustic skills all affect their ability to learn, decode, and learn to read. So we can't operate in a vacuum. We have to collaborate and participate in support teams, to interact with teachers so that the work we do with students is relevant in the context of the classroom.

I have a private practice, too, so I'm really aware of how crucial and how difficult it is to find time to communicate with teachers and other professionals involved in the child's care. They're busy and we're busy—but we have to find ways to talk, consult, and work together to ease the burden on the children.

Some of our students are walking around with a huge burden of guilt; they don't know why they are not processing the information, and why they're not succeeding in the classroom. They're confused, and they think it's somehow their fault (feeling "I am stupid."). It's like they're wearing a big backpack, and we have to work together to lift that pack off their back. We have to let them know that it's not their fault, they are not stupid, and that we can address the problems they're facing and help them learn and succeed. Sometimes we have to find their learning styles. We know from brain scans and f MRIs that the brain can adapt and develop new learning patterns because of neural plasticity.

SLP Forum: Describe your experience as president of ASHA.

Dr. Geffner: I loved every minute of it! I had the brightest, most hard-working, most dedicated team. It was exhilarating to get to know so many others committed to the profession. I met wonderful people from all over the country and even international members. I made new friends.

There were some real challenges. I learned about government regulations, lobbying, federal law guidelines, and so much more. There was a lot of responsibility, a lot of travel time, which took a great personal toll. Fortunately, I had an understanding husband, faculty, and students who realized the importance of what I was doing. I was gone a lot—even missed my brother's big birthday celebration.

But there are great rewards. I've taken away friendships that will be lifelong. And I'm very proud of some of the things we accomplished during my watch. We championed universal infant hearing screening, achieved a moratorium on the Medicare cap for rehabilitation services, accomplished reciprocal certification with Canada, and reciprocal continuing education credits for ASHA and AAA conventions, and so much more. We made inroads to the Health Care Financing Administration regarding fees for services.

And I have some really wonderful memories. I'll always remember Kirk Douglas speaking at Convention, with thousands of people in the audience. Do you want to know how I got him to come to ASHA Convention in San Francisco? I got his home address from a friend and sent him a letter. He's played a hero, a champion so many times, and I implored him to use his stature to champion people who have suffered strokes, as he has done. He responded through his publicist and insisted on coming to make the address. He volunteered to speak to us, and never charged us a speaker's fee.

SLP Forum: So you'd recommend the experience of working for ASHA at an organizational level?

Dr. Geffner: Yes! I have to tell our younger members—I remember when I was starting in the profession. I looked at the members of the executive board, and wanted to be among them, helping my colleagues, the organization, the profession. So I want to tell younger members: If you want something, it can happen. If you want to effect change, you can. In the profession, we make a difference every day. I get calls from parents telling me that my suggestions have helped their child. That makes me feel good, it gives me a sense of inner peace. What a wonderful feeling.

SLP Forum: Do you see any special challenges facing the profession right now?

Dr. Geffner: There are many. First, we as an association still have to be recognized by third party payors. We need to continue our vigilance in seeing that provisions are made so that kids can get services they need and professionals can be paid equitably.

We need to continue expanding our knowledge base, to learn more about the relationships between language disorders, learning, and reading to understand how we can help children succeed in the classroom.

We need to fight to maintain the status of audiologists with other associations. Right now, physicians are training techs to do audiology work for less pay. That's dangerous for us and for the patients. Audiology needs to unite, to put aside our differences to work together to resolve this issue.

And we need to continue helping hearing impaired people. We need to find affordable devices to reach more people and help them in their day-to-day lives.

SLP Forum: What about you—what challenges have you taken on recently?

Dr. Geffner: Well, I'm finally getting to finish my book on what Speech-Language Pathologists and Audiologists need to know about ADHD, and I'm working on a listening test. Since I've finished serving on the ASHA board, I have been able to develop an Au.D. consortium for St. John's University with Adelphi and Hofstra Universities. I'm concentrating on writing and speaking and putting thoughts in print. Workshops are still a joy to do and I love to meet our colleagues around the country. Right now I want to put my ideas down on the page. I want to translate my years of direct clinical services into something that can help others. I also want to enjoy my students. Some of them have become dear and special friends to me and I have learned from them. They are tomorrow's hope.