On April 14, 2022, Smith was named to the roster to represent the United States at the 2022 World Para Swimming Championships.[3] At the World Championships, she won a gold medal in all seven events she participated in, to lead all swimmers in gold medals. Her seven gold medals were the most in a single championships by an American since Jessica Long also won seven gold medals in 2010.[4]
Following the 2022 World Para Championships, she fell ill with a respiratory infection. As a result, she spent several weeks in the hospital with a partially collapsed lung, including time in the intensive care unit. During this time she had to relearn how to eat, speak, swallow and swim.[5] After extensive rehab on April 29, 2023, Smith was named to the roster to represent the United States at the 2023 World Para Swimming Championships. During the event she won a bronze medal in the 200 metre freestyle S3 event.[6]
Personal life
In 2012 Smith was diagnosed with dystonia, a progressive disease which affects all four of her limbs, her vocal cords and her trunk. She was also diagnosed with lupus.[7][8]