Five-year speech and language outcomes in children with cleft lip-palate.

OBJECTIVE: To investigate 5-year speech and language outcomes in children with cleft lip/palate (CLP). MATERIALS AND METHODS: Thirty-eight children aged 4-7 years and 8 months were recruited for this study. Speech abilities including articulation, resonance, voice, and intelligibility were assessed based on Thai Universal Parameters of Speech Outcomes. Language ability was assessed by the Language Screening Test. RESULTS: The findings revealed that children with clefts had speech and language delay, abnormal understandability, resonance abnormality, and voice disturbance; articulation defects that were 8.33 (1.75, 22.47), 50.00 (32.92, 67.08), 36.11 (20.82, 53.78), 30.56 (16.35, 48.11), and 94.44 (81.34, 99.32). CONCLUSIONS: Articulation errors were the most common speech and language defects in children with clefts, followed by abnormal understandability, resonance abnormality, and voice disturbance. These results should be of critical concern. Protocol reviewing and early intervention programs are needed for improved speech outcomes.

Khon Kaen: a community-based speech therapy model for an area lacking in speech services for clefts.

Absence of speech rehabilitation services is one of the critical difficulties in care for clefts in Thailand and some other developing countries. The objective of this study was to determine the effectiveness of the "Khon Kaen Community-Based Speech Therapy Model" in decreasing the number of articulation defects in children with cleft palate and/or lip. Sixteen children with cleft palate and/or lip in 6 districts of Maha Sarakham Province were enrolled for study. A three-day intensive speech camp was held in Srinagarind Hospital and followed by an outreach program of six one-day follow-up speech camps in Maha Sarakham Hospital. Six paraprofessionals, speech assistants, provided home- or community- based speech correction every week for one year. Numbers of various articulation errors were compared pre- and post-treatment using the Wilcoxon signed-rank test. The number of articulation defects showed a statistically significant reduction (mean difference = 10; Z = -3.52; p < 0.001; 95% CI: 8-13). The "Khon Kaen Community-Based Speech Therapy Model" is one of the best models for solving speech therapy problems in areas of Thailand lacking speech services and can be applied to other developing countries.

Comparison of the reliability of parental reporting and the direct test of the Thai Speech and Language Test.

OBJECTIVE: To find reliability of parental or caregiver's report and testing of the Thai Speech and Language Test for Children Aged 0-4 Years Old. MATERIAL AND METHOD: Five investigators assessed speech and language abilities from video both contexts: parental or caregivers' report and test forms of Thai Speech and Language Test for Children Aged 0-4 Years Old. Twenty-five normal and 30 children with delayed development or risk for delayed speech and language skills were assessed at age intervals of 3, 6, 9, 12, 15, 18, 24, 30, 36 and 48 months. RESULTS: Reliability of parental or caregivers' testing and reporting was at a moderate level (0.41-0.60). Inter-rater reliability among investigators was excellent (0.86-1.00). CONCLUSION: The parental or caregivers' report form of the Thai Speech and Language test for Children aged 0-4 years old was an indicator for success at a moderate level. Trained professionals could use both forms of this test as reliable tools at an excellent level.

Speech and language therapy model for children with cleft lip/palate in Lao People's Democratic Republic.

BACKGROUND: Surgical treatment can reduces disfigurement for children with cleft lip/palate (CLP); however, most children have persistent speech and language problems especially if speech and language services are not available in underserviced and/or developing regions and countries. Children in such areas cannot reach appropriate and timely speech therapy services. OBJECTIVE: To establish a speech and language therapy model in Lao People's Democratic Republic (Lao PDR), by combining the principles of Community-Based Rehabilitation (CBR), Primary Health Care (PHC) and institutional medical approaches. MATERIAL AND METHOD: Participatory workshops during which a speech and language therapy model would be developed. RESULTS: A speech and language therapy model for children with CLP in Lao PDR was established based upon the existing healthcare system and regional context. CONCLUSION: A speech and language therapy model should be implemented among children with CLP in Lao PDR as well as other developing countries where there is a paucity of speech and language therapy services.

Satisfaction of speech and treatment for children with cleft lip/palate in Lao People's Democratic Republic.

BACKGROUND: Surgical treatment and speech therapy for people with cleft lip and palate (CLP) in the Lao People's Democratic Republic (Lao PDR) are either limited or not available in some areas. There continue to be patients needing surgical correction for abnormalities but they are past the age when surgery would be appropriate. Moreover, they have not been given speech services or received integrative multidisciplinary diagnosis and treatment. OBJECTIVE: To explore satisfaction on speech and treatment outcomes, as well as the further treatment needs for CLP in Lao PDR. MATERIAL AND METHOD: A literature review was undertaken and a background conducted on the problems of services for CLP in Lao PDR. A questionnaire was then developed to explore the magnitude of effects on speech and treatment outcomes as well as further treatment needs for CLP. RESULTS: Average scoring of children with CLP speech and configuration indicated that they have the least satisfaction with articulation and figure of lips. The majority of caregivers and patients agreed that correction of articulation defects was the aspect of their care most needing further treatment. CONCLUSION: Satisfaction with speech and treatment outcomes was critical issues in Lao PDR requiring development of an appropriate therapy model for children with CLP.