Overview
A cleft (lip and) palate is the most common congenital abnormality of the face and skull with a significant social impact, affecting speech, hearing, feeding, oral behavior, dentition and satisfaction with appearance. These consequences have a long-term and negative impact on social integration and well-being. The World Health Organization (WHO) highlights the significant financial costs, including morbidity, health care costs, emotional distress and social exclusion for patients, their families and society. The purpose of this study is to compare high- and low-intensity speech intervention in children with a cleft (lip and) palate based on the perceptions of the providers of the intervention (primary care speech-language pathologists) and the recipients of the intervention (children with a cleft (lip and) palate and their parents). Individual semi-structured interviews will be conducted with both intervention providers and recipients to explore perceptions and experiences, as well as acceptability of the two speech intervention intensities. Potential participants will be told that the interview will be recorded. The actual interviews will take place at a location and time that is most convenient for the participants. Each interview will be recorded using a Roland R-05 high-quality audio recorder. After conducting the interviews, all participants will be asked to complete a questionnaire regarding their demographics. In addition, data regarding the type of cleft, time and manner of closure of the cleft, any secondary surgery and otological/audiological data will be collected from the medical records of the children with a cleft (lip and) palate. Based on this qualitative study, possible adjustments to the high-intensity therapy protocol can be made. In doing so, these modifications will be relevant to these key stakeholders. This will also facilitate the implementation and widespread use of high-intensity speech therapy in clinical speech therapy practice.
Description
- Objective
This study will investigate the effect of high-intensity therapy through a large-scale study. The aim is to compare high- and low-intensity speech and language therapy for children with a cleft (lip and) palate, based on the perceptions and experiences of the intervention providers (speech and language therapists in primary healthcare) and recipients (children with a cleft (lip and) palate and their parents).
- Hypothesis
Qualitative studies do not start from the researcher's perspective, but from that of the participant. Consequently, no direct hypotheses are formulated. Nevertheless, a hypothesis is put forward based on previous qualitative studies by the research team. We hypothesise that a high-intensity speech intervention will result in more positive experiences and will be considered more acceptable by both the healthcare providers and the recipients of the intervention. This assumption is based on the expectation that an intensive intervention can reduce fatigue, dropout and the emotional burden of therapy, increase intrinsic motivation to participate in therapy, and improve articulation and speech intelligibility in the short term.
Eligibility
Inclusion Criteria:
- Belgian Dutch-speaking children with a cleft palate with or without a cleft lip
- Aged between 4 and 12 years,
- Presence of at least one compensatory speech error in their speech based on the perceptual assessment of one experienced speech-language pathologist
Exclusion Criteria:
- Children with syndromic clefts
- Oronasal fistula
- Velopharyngeal insufficiency
- Hearing disabilities based on pure tone audiometry (\>25 dB HL)
- Cognitive and/or related learning disabilities or neuromuscular disorders
