Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Is telepractice effective in speech therapy for children with cleft lip and palate during the COVID-19 pandemic?

  • Received : 2024.09.11
  • Accepted : 2024.12.02
  • Published : 2024.12.20
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Abstract

Background: The ongoing COVID-19 pandemic and the current shortage of speech-language pathologists in Thailand have limited access to speech services for children with cleft palate with or without cleft lip (CP±L). A combination of telepractice (TP) and face-to-face therapy could address the lack of continuous service and improve accessibility to speech therapy providers. This study aimed to compare the percentage of consonants correct (PCC) before and after speech therapy in children with CP±L. Methods: This study included 19 children with CP±L, aged 5 to 13 years, who underwent primary cheiloplasty and palatoplasty. A perceptual assessment was conducted using the Thai Speech Parameters for Patients with Cleft Palate in a Universal Reporting System to evaluate speech before and after therapy. The intervention consisted of five 30-minute face-to-face speech therapy sessions and fifteen 30-minute TP sessions, totaling twenty sessions. Paired t-tests were used to analyze the mean differences in PCC for pre- and post-articulation errors, as well as caregiver satisfaction levels at the conclusion of the evaluation period. Results: Children with CP±L exhibited a significant increase in PCC; the mean difference (standard deviation, SD) was 9.36 (11.87), with a 95% confidence interval (CI) of 3.64 to 15.08 at the word level, and a mean difference (SD) of 13.25 (13.71), with a 95% CI of 6.65 to 19.86 at the sentence level. Caregivers rated their satisfaction as excellent. Conclusion: The integration of TP with traditional face-to-face speech therapy has proven to be a highly effective approach for reducing articulation errors in children with CP±L. Additionally, this method was well-suited for the constraints imposed by the COVID-19 pandemic.

Keywords

Acknowledgement

This research was supported by Dr. Kaewjai Tepsuthumarat (Khon Kaen University, Khon Kaen, Thailand) and Dr. Phruttinun Surit (Naresuan University, Phitsanulok, Thailand), who gave advice on statistical content. Staff of Speech Clinic, Srinagarind Hospital, and Tawanchai Foundation, Khon Kaen University supported for assessment and collecting data.

References

  1. Mossey PA, Little J, Munger RG, Dixon MJ, Shaw WC. Cleft lip and palate. Lancet 2009;374:1773-85. https://doi.org/10.1016/S0140-6736(09)60695-4
  2. Fuangtharnthip P, Chonnapasatid W, Thiradilok S, Manopatanakul S, Jaruratanasirikul S. Registry-based study of prevalence of cleft lip/palate in Thailand from 2012 to 2015. Cleft Palate Craniofac J 2021;58:1430-7. https://doi.org/10.1177/1055665620987677
  3. Timmons MJ, Wyatt RA, Murphy T. Speech after repair of isolated cleft palate and cleft lip and palate. Br J Plast Surg 2001;54:377-84. https://doi.org/10.1054/bjps.2000.3599
  4. Priester GH, Goorhuis-Brouwer SM. Speech and language development in toddlers with and without cleft palate. Int J Pediatr Otorhinolaryngol 2008;72:801-6. https://doi.org/10.1016/j.ijporl.2008.02.004
  5. Vallino LD, Zuker R, Napoli JA. A study of speech, language, hearing, and dentition in children with cleft lip only. Cleft Palate Craniofac J 2008;45:485-94. https://doi.org/10.1597/06-207.1
  6. Prathanee B, Thanawirattananit P, Thanaviratananich S. Speech, language, voice, resonance and hearing disorders in patients with cleft lip and palate. J Med Assoc Thai 2013;96 Suppl 4:S71-80.
  7. Pamplona C, Ysunza A, Patino C, Ramirez E, Drucker M, Mazon JJ. Speech summer camp for treating articulation disorders in cleft palate patients. Int J Pediatr Otorhinolaryngol 2005;69:351-9. https://doi.org/10.1016/j.ijporl.2004.10.012
  8. Pamplona MD, Ysunza PA. Speech pathology telepractice for children with cleft palate in the times of COVID-19 pandemic. Int J Pediatr Otorhinolaryngol 2020;138:110318.
  9. Ha S. Effectiveness of a parent-implemented intervention program for young children with cleft palate. Int J Pediatr Otorhinolaryngol 2015;79:707-15. https://doi.org/10.1016/j.ijporl.2015.02.023
  10. Prathaneel B, Makarabhirom K, Jaiyong P, Pradubwong S. Khon Kaen: a community-based speech therapy model for an area lacking in speech services for clefts. Southeast Asian J Trop Med Public Health 2014;45:1182-95.
  11. Prathanee B, Pumnum T, Yoodee P, Makarabhirom K. Speech therapy model for patients with cleft palate in Lao People's Democratic Republic: lack of speech services. Int J Pediatr Otorhinolaryngol 2020;138:110366.
  12. Prathanee B, Lorwatanapongsa P, Anantapong D, Buakanok N. Thai speech parameters for patients with cleft palate in a universal reporting system. Asia Pac J Speech Lang Hear 2011;14:31-49. https://doi.org/10.1179/136132811805334902
  13. Prathanee B. Thai articulation screening test. In: Prathanee B, editor. Cleft lip and palate: speech problem and multidisciplinary approaches. Vol II. Khon Kaen University Printing; 2014. p. 393-441.
  14. Mecham MJ, Jones JD, Jex JL. Use of the Utah Test of Language Development for screening language disabilities. J Learn Disabil 1973;6:524-7. https://doi.org/10.1177/002221947300600811
  15. Strong EB, Buckmiller LM. Management of the cleft palate. Facial Plast Surg Clin North Am 2001;9:15-25. https://doi.org/10.1016/S1064-7406(23)00376-0
  16. Nagase Y, Natsume N, Kato T, Hayakawa T. Epidemiological analysis of cleft lip and/or palate by cleft pattern. J Maxillofac Oral Surg 2010;9:389-95. https://doi.org/10.1007/s12663-010-0132-6
  17. Yilmaz HN, Ozbilen EO, Ustun T. The prevalence of cleft lip and palate patients: a single-center experience for 17 years. Turk J Orthod 2019;32:139-44. https://doi.org/10.5152/TurkJOrthod.2019.18094
  18. Butali A, Adeyemo WL, Mossey PA, Olasoji HO, Onah II, Adebola A, et al. Prevalence of orofacial clefts in Nigeria. Cleft Palate Craniofac J 2014;51:320-5. https://doi.org/10.1597/12-135
  19. Hosseinabad HH, Derakhshandeh F, Mostaajeran F, Abdali H, Davari HA, Hassanzadeh A, et al. Incidence of velopharyngeal insufficiency and oronasal fistulae after cleft palate repair: a retrospective study of children referred to Isfahan Cleft Care Team between 2005 and 2009. Int J Pediatr Otorhinolaryngol 2015;79:1722-6. https://doi.org/10.1016/j.ijporl.2015.07.035
  20. Mapar D, Khanlar F, Sadeghi S, Abdali H, Memarzadeh M, Davari HA, et al. The incidence of velopharyngeal insufficiency and oronasal fistula after primary palatal surgery with Sommerlad intravelar veloplasty: a retrospective study in Isfahan Cleft Care Team. Int J Pediatr Otorhinolaryngol 2019;120:6-10. https://doi.org/10.1016/j.ijporl.2018.12.035
  21. Kummer AW. Speech therapy for errors secondary to cleft palate and velopharyngeal dysfunction. Semin Speech Lang 2011;32:191-8. https://doi.org/10.1055/s-0031-1277721
  22. Mahura OO, Pascoe M. The acquisition of Setswana segmental phonology in children aged 3.0-6.0 years: a cross-sectional study. Int J Speech Lang Pathol 2016;18:533-49. https://doi.org/10.3109/17549507.2015.1126639
  23. Menke MR. Development of Spanish rhotics in Spanish-English bilingual children in the United States. J Child Lang 2018;45:788-806. https://doi.org/10.1017/S0305000917000460
  24. Likkhasit B. A survey of articulation problems in grade 5 students in Satitprasarnmit Demonstration School. J Res Dev Spec Educ 2018;7:56-64.
  25. Oh EY, Kim YH, Lee HS, Lee IG, Lee JS, Jang ES. Clinical aspects of functional articulation disorder. J Korean Child Neurol Soc 2008;16:189-97.
  26. Makarabhirom K, Prathanee B, Suphawatjariyakul R, Yoodee P. Speech therapy for children with cleft lip and palate using a community-based speech therapy model with speech assistants. J Med Assoc Thai 2015;98 Suppl 7:S140-50.