Auckland Regional Cleft Palate Service: service accessibility and speech outcomes.

Abstract

This study explored speech outcomes for five-year-olds born with cleft palate residing in the Auckland Regional Cleft Palate Service catchment, with a focus on ethnicity and geographical influences on service accessibility and speech outcomes. A retrospective audit of children born with cleft palate between 2013-2016 was conducted (n=89), including secondary surgeries, ethnicity, distances travelled, services offered and attended. Speech outcomes at five years were compared to international benchmarking. Seventy-nine children were included; 10 were lost to follow-up before their 5 years review. At 5 years, 30% children presented with moderate to severe velopharyngeal incompetence; 30% had residual cleft speech characteristics which warranted speech therapy intervention. There was no significant difference in speech outcomes for Māori vs non-Māori. Attendance at clinic was not significantly associated with distance from centre. However, Māori had significantly lower attendance at clinic appointments and were significantly more likely to be referred to community services. Auckland Regional speech outcomes are better than the national average, yet still do not compare favourably with international benchmarking. While speech outcomes were not associated with ethnicity, attendance at specialist clinic appointments was lower in Māori. Community services were offered, but attendance at, and satisfaction with, these appointments is unknown. Further work is needed to reach all children regionally in a timely manner to ensure Aotearoa New Zealand speech outcomes meet international standards.