Speech therapy model for patients with cleft palate in Lao People’s Democratic Republic: Lack of speech services

Abstract

BackgroundA majority of children with cleft lip and palate (CLP) have persistent speech and language problems after repair. Speech services are critically needed for these children in some developing countries where there is a lack of or no speech services. This includes the Lao People's Democratic Republic (LPDR) where accessibility to speech therapy is not an attainable medical specialty. ObjectiveTo establish and determine the effectiveness of speech therapy model in reduction of the number of articulation errors for children with CLP in LPDR where these services are lacking. MethodsSpeech therapy for children with CLP in LPDR by using the adapted Khon Kaen University Speech Therapy Model based on combining the principles of Community-Based Rehabilitation (CBR), Primary Health Care (PHC) and institutional medical approaches was provided for children with CLP in Bokeo, LPDR. Twelve children with CLP (3.6–16 years) were recruited for this study. Demonstration and teaching services for both speech assistants (SAs), who were local health care providers, and caregivers were performed in 3-day intensive speech camps. Three 1-day follow-up speech camps and 3 site visits were conducted by Thai speech and language pathologists (TSLPs) and their teams. SAs provided speech correction at local health care units based on TSLPs’ individual monitoring and supervision. Caregivers practiced assigned exercises at home. Speech Therapy Model in LPDR was undertaken for 1 year. ResultsThe Speech Therapy Model in LPDR was one of the effective models and significantly reduced number of articulatory errors (mean difference = 6.42; 95% confidence interval = 3.01, 9.83).