Children with cleft lip or cleft palate more likely to receive age-appropriate health care when provided by team

Children with a cleft lip or cleft palate are more likely to receive recommended age-appropriate health care when that care is provided by an interdisciplinary team rather than an individual provider. In a study encompassing three states, Arkansas, Iowa and New York, 24% of participants were not receiving team care.

The authors of the report, published in the January 2010 issue of the Cleft Palate-Craniofacial Journal, found that mothers of children with orofacial cleft were twice as likely to give a lower rating of their child's cleft care when that care was provided by an individual rather than a team. Beyond surgical care, children with orofacial cleft may need dental care, hearing tests and speech therapy, emotional or behavioral care, help with learning difficulties, and genetic counseling about their condition.

A cleft care team consists of—at least—a surgeon, a dental professional, and a speech professional. This interdisciplinary team approach is recommended by the American Cleft Palate-Craniofacial Association to ensure that these special-needs children are given appropriate care and referrals.

Study subjects were children born between 1998 and 2003 with a cleft lip, cleft palate, or both, and were identified through the National Birth Defects Prevention Study. Mothers of 253 of these children were interviewed for this study.

Children who do not have team care were less likely to have received noncleft-related medical care in the past 12 months. They were less likely to have had a hearing test in the past year and to ever have visited a dentist or received genetic counseling since the cleft was diagnosed. Those who did receive team care had more severe cleft conditions, however. Eighty-six percent of children with both cleft lip and cleft palate were receiving team care.

The study did not find a difference in maternal perceptions of the child's overall health, satisfaction with the child's facial appearance, or assessment of the child's difficulties with speech. More than three-fourths of mothers rated these items positively, regardless of team care status.