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Episode Summary

In this episode of all about kids, Zach talks with Faye Miah, a speech-language pathologist whose path to helping kids is both unusual and inspiring. A native of Vietnam, she was first exposed to the world of speech rehabilitation through annual visits to her hometown by Operation Smile, an international nonprofit that provides a range of surgeries and complimentary services for people in developing countries with cleft palate and other orthodontic challenges. She saw first-hand the impacts of enabling communication, which set her on a course to acquire her specialty. Since graduating from Washington State University, she has not only evolved as a speech therapist, she has also developed unique digital materials to support her work remotely.

Zach and Faye discuss her pediatric practice, the transformational impacts of her experience working with adult head and neck cancer patients, tools and tips to help both practitioners and parents adapt to pandemic challenges. As an added bonus, Faye shares a bit about how she has managed to balance her professional persona as a speech therapist with her persona as a beauty and lifestyle “influencer” with substantial social media followings on YouTube and Instagram. This is a woman with smarts, heart, and a fascinating story.

Episode Summary

What Sparked Faye’s Initial Interest in Speech Pathology

  • Faye grew up in Vietnam, where every summer she encountered Operation Smile, an international volunteer organization that surgically corrects cleft lifts and palates, as well as providing a range of related orthodontic and rehabilitative services, in developing countries around the world.
    • (2:22) – “Growing up I had a lot of exposure in this field and when I was about to apply for college I decided to come to America because at this time in Vietnam we didn’t have any formal training for speech therapists. I finished my training at Washington State University.”
    • (4:32) – “I wanted to be in the field of speech pathology when I was little. One of my biggest goals or dreams was to participate in Operation Smile.”

Telehealth as a Result of Covid19: Benefits and Challenges of This New Model

  • Faye has been providing telehealth services since the advent of the pandemic in March of 2020.
    • (5:39) – “At this point we’re pretty savvy in terms of providing evaluations, providing treatments. We’ve come up with online assessment tools and online materials.”
  • There are two advantages to this development.
    • (6:03) – “The first advantage is that the child is being seen in his or her own home setting. Typically, when we take the kid into the clinic, it’s not natural. It’s a very isolated setting.”
    • (6:18) – “Kids can perform really well in the clinic setting but when he or she goes home the parents might still experience difficulties in the home setting. So this allows us to see how the child performs in the home and give practical advice.”
    • (6:36) – “The second advantage is the fact that the parents have to be there 100% of the time … It’s always better for the parents to know what actually goes on in the session and actually be trained.”
    • (7:13) – “Parents see their kids every single day. They are a much better provider than us. So giving telehealth services has allowed me to be able to address these two biggest problems that I had in the clinic.”
  • But clinical challenges nonetheless remain, particularly in the area of testing
    • (7:54) – “In the clinic, I would have the tools, I would be able to observe, I would be able to interact with the child myself and elicit the response I need. But if I’m doing it over a computer I can tell the parents what to do in order for me to see the responses, but oftentimes the parents give too much verbal prompting.”
    • (08:39) – “During the evaluation sessions, when I need to understand the skills level of the child … we need to provide standardized testing procedures and cannot do or say too much.”
  • How Faye Helps Parents Assist but Not Overly Intervene
    • (9:39) – “Usually before the evaluation session I will try to tell the parents to repeat exactly what I say and try to give the child time. Observe, wait and listen.”
    • (10:59) – “It’s not a big deal because normally in sessions we always want to include parents. What I’m specifically having difficulty with is during the testing when I need the parents not to be too much of an assistant.”

Faye’s Life-Changing Experience Working at a Cancer Institute Early in Her Career

  • Fresh Out of School and Ready to Change the World
    • (12:22) – “I had such high expectations of myself because I was ready. I spent so much time learning, studying and I came all the way from Vietnam just to make an impact. So for me, I put a lot of responsibility on my shoulders and that was why it was challenging.”
  • The Particular Challenges of Working with Head & Neck Cancer Patients
    • (13:04) – “We worked with a lot of patients who had their whole vocal box removed and I would try to give them their voice back via multiple methods. The problem with cancer that is so devastating is that it might come back.”
    • (13:50) – “ It’s not just speech therapy. It’s psychological assistance as well. And during the sessions, I would observe a lot of people who are healthy, young adults like myself. They don’t smoke or live an unhealthy lifestyle, super-smart and intelligent. And things just happen. It’s devastating for them not to be able to speak normally. We have great technology, but still. It’s not like it was before. It was very hard for me to acknowledge that I could not give back what they once had.”
  • Faye Wasn’t Ready for the Work with Adult Cancer Patients, So Made a Change
    • (15:30) – “At that time I realized that in order for me to maintain my positivity and be able to continue working I needed a change, so I switched to the pediatric side. I wanted to be able to see that I could do my job well.”
    • (15:50) – “At this point now, if the opportunity presents itself again, I would love to get back into (the adult) side of it. I think I’m ready at this point.”
  • What Faye Took From Her Work with Adult Cancer Patients
    • (17:09) – “What I realized working at the Cancer Institute is that our health is the most important thing that we have. Knowing that has allowed me to keep a positive mindset working there.”
    • (17:32) – “A lot of the time parents tend to deny the fact that their children might have issues. So I use that same approach with parents. I stress the most important fact: that we are healthy.”
  • A Speech Diagnosis is Far Better than Denial – the First Step Towards Resolution
    • (18:30) – “A lot of the parents that I’ve worked with at the clinic do not like the fact that their kid has had issues, diagnoses, and when we try to tell them to get an expert opinion to rule out any underlying problems they tend not to follow through with the recommendation because they don’t want to acknowledge the problem. In those cases, I try to focus on the perspective of health and improvement.”
    • (19:08) – “I try to explain that the reason we want the diagnosis is not to label the children but because then we will be able to obtain more services and work with insurance companies. In the end the goal is to help, not to label.”
  • Why Some Parents are Resistant and Worried
    • (20:17) – “Parents think that if we put a diagnosis on their child that we are labeling the child and they are afraid that their children will eventually be put in a special education setting. In general, it’s the stigma.”


    • (20:55) – “If we are giving a diagnosis or disorder a name, it’s because we want to be able to provide more services. We want to be able to address all of the ongoing problems.”
  • Obtaining a Full Diagnosis is Critical to Accessing Appropriate Services
    • (21:15) – “If there are other problems going on, for example, difficulty with self-care, dressing him or herself, feeding him or herself. If the child has problems with temper tantrums, self-injurious behaviors – those are behavioral problems that can be addressed, but we won’t be able to ask for services and insurance companies will not authorize these services (without the diagnoses). We need the child to obtain as much help as he or she can.”

Materials Faye Has Created for Telehealth Sessions

  • The Preschool Language Scale (5th Edition) forms the basis
    • (23:50) – “One of the testing items that a lot of children miss are spatial awareness, learning what it means to put things under, on top, right, back and left. So I had materials created for that specific purpose.”
    • (24:26) – “During the session, we play a game … I get the child involved and am also addressing the expressive part of the spatial concept. Not just the understanding part, but also the ability to express it.”
  • Leveraging Zoom to Teach Lessons
    • (25:16) – “I just have to structure the session a little differently. Since the child is in the home setting, I have an opportunity to make spatial concepts become a practical, everyday life skill.”

Workarounds for Common Tele-Session Obstacles

  • Distraction at home versus in a more unfamiliar setting
    • (27:06) – “If you put them in a structured clinical setting they might act differently because they feel a little uncomfortable, so they might be more likely to comply than in a home setting. That’s one of the problems I noticed very consistently.”
    • (27:30) – “It’s just hard to ask a three-year-old to sit in front of a computer for a whole hour straight. It’s just impossible. We all have our attention spans. What I found is that it helps to give them a little bit of a break.”
  • Faye creates breaks in treatment sessions by alternating between structured tasks with 5- or 10-minute breaks during which they address other skills, like kinetic tasks for fun and to practice action words.
  • If a child has reached his/her limit, Faye uses time remaining for parent training:
    • (28:59) – “I find it very helpful because then the parents have that one-on-one training time so they will be able to address things at a later time outside the session.”
  • Zoom Evaluations: Getting Past the Technology Hurdle.
    • (30:16) – “In the past, we’ve spent half an hour of our allocated hour of testing just for setting up the cameras and making sure it’s working. We came up with a solution, filming a little video clip of how to actually set up the cameras, prop up the device to make sure it’s facing the child and the computer screen correctly.”

The Interplay Between Faye’s Clinical Content and Other Online Tutorials She Creates

  • In both arenas, the focus is on making things clear and specific, organized chronologically and easy to access.
  • Faye uses tricks to produce the most natural possible flow of content.
    • (33:43) – “The first time I turned on the camera and started talking to it I had so much difficulty. I had to imagine that there was a friend there to speak to because it’s just unnatural. But now it’s not as difficult.”
  •   Balancing her social media influencer persona with being a speech therapist.
    • (35:25) – “When I first started posting and creating content for social media I had a lot of difficulties letting people know my actual job because I was concerned that they could look me up and find out where I work or that it might interfere with how my patients perceived me.”
    • (35:50) – “For the longest time, I just didn’t disclose that I was a speech therapist. I used a different name and didn’t say what I was doing for work.”
    • (36:14) – “Three of four years into creating content I decided maybe it was a good time to start a YouTube channel. Initially, I did beauty and lifestyle videos and then I realized that I have a skill that could actually benefit people.”
  • Many people on YouTube are studying speech therapy or have real-life problems and issues that are related.
    • (36:59) “I realized that maybe it was a good time for me to share everything I know and just be there for everybody … and that’s when I started making peace with the fact that I’m both a speech therapist and a content creator.”
  • Faye methodically manages her time: Mon-Wed clinical sessions, Thur report writing, Fri-Sun content creating
    • (37:58) – “So that’s how I manage my time: By compartmentalizing my different roles.”
    • (39:06) – “We’re all multi-dimensional. Sometimes on social media, you can only show one side of yourself and it’s restricting. I’m glad I’m able to express myself on multiple platforms, showing different sides, and encouraging everyone not to restrict yourself to one title, one role, one box.”

What Exactly is the Practice of Language-Speech Pathology?

  • People often confuse speech pathology with linguistics or language teaching
    • (40:24) – “Speech pathologists handle communication in whatever form that is – speaking, writing, in whatever language. It also involves voice. So that is one of the biggest misunderstandings.”
  • Often there is confusion because people don’t understand that a speech therapist is not teaching language. It’s actually teaching skills that are language-independent.
    • (40:53) – “I have a lot of people asking me, ‘You’re originally from Vietnam. You speak with an accent. How are you going to teach English to the little kids? Are you going to affect their way of speaking?’”
    • (41:11) – “We’re not teaching English. I’m not teaching the child how to speak like me. I’m trying to help the child learn how to communicate his or her point across to another person; his or her wants or needs in whatever language they are comfortable with. It could be in any language or even in a non-verbal mode on a computer.”

Wrapping Up

  • Faye shares the power of being present for a child’s first words.
    • (43:44) – “To be able to witness a child speak their very first words is the most rewarding aspect of my job. The thing with the therapy is that it’s producing changes in your brain from a non-invasive method. You can’t expect change right away and you don’t know when the change is going to happen. You just have to have faith, be patient and keep on going with it.”
    • (44:39) – “Usually as soon as the child breaks that threshold and speaks that very first word, he or she is going to continue producing those sounds. Typically, when they don’t speak yet or don’t have words, it’s because the connection hasn’t been made in their brain. But once the connection has been made, the work is going to be so much easier and the child is going to improve much, much faster.”
    • (45:11) – “To be able to see the happiness and joy in their parents’ faces, it’s extremely rewarding for me.”
  • Because she’s someone the parents mention or remind their children about on a consistent basis, often her name “Faye” is the first word they speak.
    • (46:20) – “I wish we could have a way where I could incorporate the parents into the session and turn them into some sort of fun novelty subject that could guarantee that their name would be the first word their child speaks!”

More About Faye

A native of Vietnam, Faye Miah graduated with a degree in speech-language pathology from Washington State University. As a child, she was inspired to pursue her professional path by visits from volunteers with Operation Smile, who came to perform surgery and related support services for children with cleft palates and other orthodontic challenges. She has gone on to build a robust speech therapy practice while at the same time cultivating tens of thousands of followers as a social media “influencer” in the beauty and lifestyle space.

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