Children with a cleft lip or cleft palate are more likely to receive
recommended age-appropriate health care when that care is provided by an
interdisciplinary team rather than an individual provider. In a study
encompassing three states, Arkansas, Iowa and New York, 24% of
participants were not receiving team care.
The authors of the report, published in the January 2010 issue of the Cleft
Palate Craniofacial Journal, found that mothers of children with
orofacial cleft were twice as likely to give a lower rating of their
child’s cleft care when that care was provided by an individual rather
than a team. Beyond surgical care, children with orofacial cleft may
need dental care, hearing tests and speech therapy, emotional or
behavioral care, help with learning difficulties, and genetic counseling
about their condition.
A cleft care team consists of at least a surgeon, a prosthodontist, like Dr. James Courey
and a speech professional. This interdisciplinary team approach is
recommended by the American Cleft Palate Craniofacial Association to
ensure that these special-needs children are given appropriate care and
referrals.
Study subjects were children born between 1998 and 2003 with a cleft
lip, cleft palate, or both, and were identified through the National
Birth Defects Prevention Study. Mothers of 253 of these children were
interviewed for this study.
Children who do not have team care were less likely to have received
noncleft-related medical care in the past 12 months. They were less
likely to have had a hearing test in the past year and to ever have
visited a dentist or received genetic counseling since the cleft was
diagnosed. Those who did receive team care had more severe cleft
conditions, however. Eighty-six percent of children with both cleft lip
and cleft palate were receiving team care.
The study did not find a difference in maternal perceptions of the
child’s overall health, satisfaction with the child’s facial appearance,
or assessment of the child’s difficulties with speech. More than
three-fourths of mothers rated these items positively, regardless of
team care status.
“Interdisciplinary Craniofacial Team Compared With Individual Providers:
Is Orofacial Cleft Care More Comprehensive and Do Parents Perceive
Better Outcomes?” Cleft Palate Craniofacial Journal, Volume 47,
Number 1, January 2010. Published by Allen Press.
About Cleft Palate Craniofacial Journal
The official publication of the American Cleft Palate Craniofacial
Association (ACPA), the Cleft Palate Craniofacial Journal is a
bimonthly international, interdisciplinary journal on craniofacial
anomalies. The journal explores and reports on the study and treatment,
including experimental and proven surgical procedures, of cleft
lip/palate and craniofacial anomalies. It also keeps readers in touch
with the latest research in related laboratory sciences.
