2.1 - Team Care Flashcards
Who is generally on a Cleft Palate treatment team?
15
Audiologist
Pediatric dentist
Geneticist
Neurosurgeon
Nurse
Oral surgeon
Orthodonitist
Otolaryngologist (ENT)
Pediatrician
Plastic/Craniofacial surgeon
Prosthodontist
Psychologist
Social worker
SLP
Team coordinator
Who are the minimum professionals required for Cleft Palate Team?
(4)
Surgeon
Orthodontist
SLP
At least one additional specialist
Who created the parameters of care for cleft teams?
4
H.K. Cooper
Surgeon General Report
American Cleft Palate Craniofacial Association
ACPA Consensus
Who created the first parameters for cleft teams?
H.K. Cooper
Management of patients with craniofacial anomalies is best provided by an __________.
Interdisciplinary team of
specialists
What are the advantages of team care for cleft patients?
4
Multiple disciplines treating patient
Centralized services with centralized coordination/
scheduling of appointments
Long-term treatment planning from birth to adulthood
Maximize communication between specialists
What is the general timeline for the treatment of cleft BEFORE 3 months?
(2)
Lip taping (at birth, in hospital typically)
Nasal-Alveolar molding
What is the general timeline for the treatment of cleft AT 3 months?
Lip repair (rule of 10’s)
What is the general timeline for the treatment of cleft BETWEEN 3-12 months?
Initial Speech-Language Eval
What is the general timeline for the treatment of cleft AT 12 months?
Palate repair
What is the general timeline for the treatment of cleft AFTER 3 months?
(2)
Post-op speech eval
Speech follow-up every 6-12 months or sooner
When is LIP REVISION typically performed according to the general timeline for the treatment of cleft?
(2)
After age 5-6
Ideally early teenage years (9-12yrs) to avoid midface growth deficiencies
When is MAXILLARY EXPANSION typically performed according to the general timeline for the treatment of cleft?
6-9 years
When is BONE GRAFTING typically performed according to the general timeline for the treatment of cleft?
9-12 years
What may also be performed during late childhood/teenage years according to the general timeline for the treatment of cleft?
(2)
Secondary surgical revision to palate if needed
Orthodontics
What does a NURSE typically do on a cleft treatment team?
3
Assesses overall physical development, growth, nutrition
Often assists family in feeding techniques, with help + direction of the SLP
Counsels family regarding surgeries, and answers specific questions
What does a GENETICIST/DYSMORPHOLOGIST typically do on a cleft treatment team?
(3)
Genetic counseling
Identifying a known syndrome if it exists
Long term follow-up
What kinds of genetic counseling is typically provided for families with children with cleft?
(4)
Diagnosis
Recurrence risk for additional offspring
Prognosis
Identify services that may be needed later
What does a NEUROSURGEON typically do on a cleft treatment team?
(4)
Evaluation and treatment of patients with craniofacial syndromes
Monitors intracranial pressure + brain anomalies (Sutures of brain + Plagiocephaly, brachycephaly etc.)
Surgery, when necessary
Often works w/ plastic surgeon
What does an OPHTHALMOLOGIST typically do on a cleft treatment team?
(4)
Evaluates congenital eye anomalies and other ophthalmologic conditions
Evaluates and treats vision
Monitors effects of increased intracranial pressure on vision
Surgery, when needed
What does a OTOLARYNGOLOGIST typically do on a cleft treatment team?
(3)
Monitors ME function and hearing
Treats ME disease
Assesses structural aspects of oral cavity, oropharynx, nasal cavity, upper airway
What does a PEDIATRICIAN typically do on a cleft treatment team?
(4)
Assesses overall medical health, growth, + development
Determines if other aspects of medical care should be done prior to surgeries
Often gets initial contact or referral
Is depository for all medical reports
What does a SOCIAL WORKER typically do on a cleft treatment team?
(4)
Assists families w/ problems
Coordinates appointments
Assists in dealing w/ other agencies (e.g., insurance companies)
May help family manage stress and emotional reactions (e.g., psychiatric social worker)
What does a TEAM COORDINATOR typically do on a cleft treatment team?
(4)
Team representative to parents, professionals, and community
Plans meetings, schedules patients, coordinates appts
Compiles recommendations, prepares team report (so there is one report)
Ensures follow-up on recommendations
Who is often the team coordinator on a cleft treatment team?
Social worker or nurse
What does an SLP typically do on a cleft treatment team?
5
Counsels parents re: comm. skills + how to stimulate normal S/L dev. @ home
Evaluates feeding + swallowing
Feeding tx and/or parent training
Assesses + treats speech and language problems when appropriate
Community outreach to treating SLP with CFT SLP
What is the SLPs ongoing role on a cleft treatment team?
6
Provide input to CF team
Provide ongoing support and direction to family/patient
Re-evaluates yearly to monitor progress
Assists in developing and implementing plan for service provision
Initiating referrals for further assessment with ENT, CF team, Dental, Genetics, Developmental Pediatrics
Resource to community
What is the role of an SLP during Craniofacial Team meetings?
(4)
Determine present level of performance related to speech/resonance
Prognosis for improvements w/ or w/o therapy
Potential influencing factors on progress
Assesses ability to tolerate further testing (ie. Fluoroscopy, endoscopy, post surgical recovery etc.)
