Profiling the Roles and Responsibilities of Professionals and Non-Professionals Providing Speech Language Services for Individuals with CLP in Resource-Limited Regions.

Fourteen Speech and Language Therapists/Pathologists (SLT/Ps) from 13 countries across 5 continents made up the International Confederation of Cleft Lip and Palate and Related Craniofacial Anomalies (ICCPCA) CLEFT 2022 Speech Taskforce. Following a group consensus activity led by an external facilitator using Lightning Design Thinking principles, "task-shifting" was identified as the topic for this Taskforce. Absence and scarcity of SLT/Ps in many parts of the world have led to non-SLT/Ps delivering speech and language therapy services to individuals with cleft lip +/- palate. This narrative is the first known attempt to develop a framework, describing the different types of providers and their scope of practice.

Adapting Elements of Cleft Care Protocols in Low- and Middle-income Countries During and After COVID-19: A Process-driven Review With Recommendations.

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need.A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care.Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention.A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

Efectos de la ortopedia prequirúrgica en el rendimiento lingüistico de niños fisurados / Effects of presurgical orthopedics in the linguistic performance in children with cleft lip

El propósito del presente trabajo es determinar si existen diferencias en el rendimiento lingüistico entre niños fisurados que han recibido ortopedia prequirúrgica y aquellos que no la han recibido. Se revisaron los antecedentes clínicos de 62 menores pertenecientes al Programa de Atención Integral al Niño Fisurado del Hospital Luis Calvo Mackenna, Santiago, Chile, que cumplieran con el requisito de presentar fisura labial (unilateral o bilateral) más fisura velopalatina en ausencia de patologías asociadas. Se encontró que el nivel de rendimiento lingüistico adecuado era similar en niños sometidos y no sometidos a ortopedia. Lo mismo ocurrió al comparar el rendimiento lingüistico inadecuado en ambos grupos. Por otro lado, al comparar los niños con fisura de labio unilateral más fisura velopalatina (FLU + FVP) y los niños con fisura de labio bilateral más fisura velopalatina (FLB + FVP) se encontró que los antecedentes lingüisticos eran significativamente mejores en el primer grupo. Se discuten las implicancias clínicas de lo anterior