Management of children with cleft palate and related speech disorders: A multimedia learning package to support speech pathologists
Background
- There are currently no learning packages (either DVD or e-learning) available through CHW or SCH specific to speech pathologists treating children with cleft related speech disorders
- CHW run a VPI update every 2 years in a 2 day workshop format. (This is in conjunction with our Level IV speech pathologist here, and a group of speech pathologists in NZ)
- The cleft team / speech pathologist at Royal Children's Hospital Brisbane runs a 1 day workshop for clinicians in Qld Health. This team are looking at developing teaching resources to support this in the future, but this has not occurred as yet.
- There appear to be no similar resources available through cleft pals UK or US. There are text books with DVD's included that provide "live" examples of speech characteristics / patterns (e.g. Great Ormond Street Children's Hospital GOS.SP.ASS training video, UK; Treating Cleft palate Speech book and DVD, USA). These are useful resources, however they are not specific to Australian speech or health services in Australia, there have been other developments in treatment of cleft since the UK resource was developed. These resources are more specialist in nature, rather than directed at generalist therapists.
Aims and objectives
- Develop a multimedia learning package to support speech pathologists across Northern NSW in their management of children with speech and nasality disorders related to cleft palate and velopharyngeal incompetence. This package will be interactive and incorporate theoretical as well as practical information for clinicians.
- Outline management provided by specialist cleft palate team (one of three cleft palate teams in NSW), including surgical decision making, management timeline, roles and responsibilities of multidisciplinary team. This would include Speech Pathologist, ENT specialist, Respiratory Physician, Plastic surgeon, Maxillofacial Surgeon, Orthodontist, Dentist, Geneticist, and Paediatrician.
- Give an overview of craniofacial anomalies, syndromes, and oral anatomy related to cleft and velopharyngeal disorders.
- Provide an outline of specialist speech pathology assessment for children with cleft, as well as the speech pathologist’s role in surgical decision making.
- Provide specific information regarding cleft type speech patterns of error, as well as the relationship between sound placement and production.
- Provide specific information about ‘red flags’ for speech pathologists and type of information to record and report back to specialist team.
- Provide support for development of therapy goals specific to cleft speech errors.
- Provide specific strategies for therapeutic speech pathology interventions.
- Demonstrate the benefits of multidisciplinary intervention and specific benefits of therapy using a case example.
- There are currently no resources of this nature in NSW.
Method
- A specialist speech pathologist would be employed as project coordinator to develop the content and contribute to planning of the multimedia format of the information presented.
- Contributions would be sought from other specialists in the field, including representatives from the Cleft Palate teams in the Greater Eastern and Southern and Western CHN's.
- This project would require consultation with IT/media personnel with regard to the format and end product. (For example, Production of DVD/CD Rom resource, or e-learning package, down-loadable resource etc.)
- A review of the evidence for best practice in cleft speech intervention would be undertaken to ensure information included is evidence based and current.
- Contributions from the other members of the JHCH Cleft Palate Team would be sought.
- Guidance regarding ethics and consent would be sought, particularly in relation to utilisation of a case study/example, use of video footage, and test results used to demonstrate management processes.
- Investigation into options for promotion and distribution of the learning package would also be undertaken.
- Other potential contributors for this project would be speech pathologists at CHW and SCH, NZ based speech pathologists working in specialist cleft teams, RCH Brisbane specialist speech pathologists, specialist physicians and surgeons from the JHCH Cleft palate Team. There are strong networks in cleft in NSW and abroad already established via EBP groups, interest groups, email networks, and other collaborations that will be used for comment / input regarding content. These would all be referenced / acknowledged in the final product.
- Ongoing management of the final product would occur via the Level IV clinical specialist speech pathology position at JHCH and the JHCH multidisciplinary cleft palate team as part of their normal business planning. Information would be reviewed and updated as needed based on the evidence.
Key performance indicators
The success of the project will be measured by:
- Evidence of package which has been developed
- Evidence of utilisation of the package across Northern NSW as determined through a survey
- Evidence of Speech Pathologist satisfaction of the resource as determined through a survey
- Evidence of increase in provision of appropriate assessment information from the local therapist as determined through pre and post project audit
Progress
- The successful applicant commenced on 4 January 2010 as the Project Officer.
- Meetings occurred between Resource Manager (NCHN), Project Manager & Project Officer.
- It was decided that a web based solution would be a better way to provide and update the education material.
- Consultation occurred with a multimedia company for the filming of speech sounds and movements.
- Video recording occurred and was edited.
- The Cleft Management web site was launched on 8 February 2011.
- A post project survey will be distributed 12 months after the website went “live” (February 2012).
For more information contact:
Brodie Warren
Acting Head of Department
Paediatric Speech Pathology
John Hunter Children's Hospital
Phone: 02 4985 5827