Team Care, Surgical Repair, and feeding Flashcards
Who is typically on a team?
Audiologist
Pediatric dentist
Geneticist
Neurosurgeon
Nurse
Oral surgeon
Orthodontist
Otolaryngologist (ENT)
Pediatrican
Plastic/Craniofacial surgeon
Prosthodontist
Psychologist
Social worker
SLP
Team coordinator
What is the minimum members for a cleft palate team?
Surgeon
Orthodontist
SLP
At least one additional specialist
What are the advantages of Team Care? (4)
- Multiple disciplines treating patient
- Centralized services with centralized coordination/scheduling of appointment
- Long-term treatment planning from birth to adulthood (same people)
- Maximize communication between specialists
When does lip tapping usually happen?
birth, in hospital typically
When does lip repair usually happen?
3 mos, rule of 10’s
When does a palate repair usually happen?
12 mos.
When does a speech follow-up usually happen?
every 6-12 months or sooner
When does lip revision usually happen?
after age 5-6, ideally early teenage years (9-12yrs); avoid midface growth deficiencies
When does maxillary expansion occur?
6-9 years
When does bone grafting happen?
9-12
What is the general timeline for surgical, speech and dental intervention for CLP?
- Lip taping = birth, in hospital
- Nasal-Alveolar molding
- Lip repair = 3 mos., rule of 10’s
- Initial S&L Eval
- Palate repair = 12 mos
- Post-op speech eval
- Speech follow-up every 6-12 months or sooner
- Lip revision = after age 5-6, ideally early teenage years (9-12yrs); avoid midface growth deficiencies
- Secondary surgical revision to palate if needed
- Maxiallary expansion, 6-9 years
- Bone grafting, 9-12 years
- Orthodontics
What is the job of the nurse? (3)
- Assesses overall physical development, growth, nutrition
- Often assists family in feeding techniques, w/ help and direction of the SLP
- Counsels family re: surgeries, and answers specific questions
What is the job of the Geneticist/Dysmorphologist?
- genetic evaluation
- identify a known syndrome, if it exists
- Long term follow-up
- Genetic Counseling
What do Geneticist/Dysmorphologist do in genetic counseling?
- Diagnosis
- Recurrent risk for additional offspring
- Prognosis
- Identify services that may be needed later
What is the job of the Neurosurgeon?
- Evaluation and treatment of patients with craniofacial syndromes
- Monitors intracranial pressure and brain anomalies
- Surgery, when necessary
- Often works w/plastic surgeon
What is the job of the Ophthalmologist?
- Evaluates congenital eye anomalies and other ophthalmologic conditions
- Evaluates and treats vision
- Monitors effects of increased intracranial pressure on vision
- Surgery, when needed
What is the job of the Otolaryngologist?
- Monitors ME function and hearing
- Treats ME disease
- Assesses structural aspects of oral cavity, oropharynx, nasal cavity, upper airway.
What is the job of the Pediatrician?
- Assesses overall medical health, growth, and development
- Determines if other aspects of medical care should be done prior to surgeries
- Often gets initial contact or referral
What is the job of the Social Worker?
- Assists families w/ problems
- Coordinates appointments
- Assists in dealing with other agencies (e.g., insurance companies)
- May help family manage stress and emotional reactions (e.g., psychiatric social worker)
What is the job of the Team Coordinator?
- Team representative to parents, professionals, and community
- Plans meetings, schedules patients, coordinates appts
- Complies recommendations, prepares team report
- Ensures follow-up on recommendations
What is the job of the Speech-Language Pathologist?
- Counsels parents re: comm. skills & how to stimulate normal S/L dev. @ home
- Evaluates feeding & swallowing
- Feeding tx and/or parent training
- Assesses and treats speech and language problems when appropriate
- Community outreach to treating SLP with CFT SLP
What is the SLP’s ongoing role?
- 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 SLP: Craniofacial Team Meetings?
- 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 (i.e., Fluoroscopy, endoscopy, post surgical recovery etc.)
