A cleft care workshop for speech and language pathologists in resource-limited countries : the participants' experiences about cleft care in Uganda and satisfaction with the training effect

Objectives: workshops and specialized training programs are often inaccessible for speech and language pathologists (SLPs) based in resource-limited countries given the lack of supply, the long travel distances and the excessive participation fees. To stimulate life-long learning opportunities for all, this study described and measured the effect of a free, two-day cleft care workshop for SLPs in Uganda. The workshop included different topics related to the assessment and treatment of children with a cleft of the palate with or without a cleft of the lip (CP +/- L). Methods: The participants who presented during the two-day course were asked to complete a pre- and postworkshop questionnaire to evaluate their satisfaction. The pre-workshop form also included some questions concerning cleft care in Uganda. Both the pre- and post-workshop forms included three visual analogue scales to investigate the evolution of the participants' estimation of their knowledge regarding speech in patients with a CP +/- L and to assess the changes in their self-confidence in the diagnosis and treatment of this population. Results: seventeen SLPs completed the pre- and post-workshop questionnaires. In general, the participants were highly satisfied with the different themes covered in the program. After the training course, the participants rated their general knowledge about CP +/- L and their self-confidence in the diagnosis and treatment of children with a CP +/- L significantly higher than before the workshop. Conclusion: the vast majority of the SLPs reported that cleft care was not easily accessible in Uganda. The most commonly reported obstacle for cleft care was a lack of knowledge about this matter in the SLPs themselves highlighting the importance of the organization of additional education opportunities. The participants reported a significantly higher level of self-confidence in diagnosing and treating children with a CP +/- L after the workshop. The content of this workshop can form the basis for future learning opportunities for SLPs based in resource-limited countries

Comparison of motor-phonetic versus phonetic-phonological speech therapy approaches in patients with a cleft (lip and) palate : a study in Uganda

INTRODUCTION : At present, there is growing interest in combined phonetic-phonological approaches to treat active speech errors in children with a cleft (lip and) palate (CP ± L). Unfortunately, evidence for these type of speech interventions in this population is lacking. Therefore, the present study investigated the effectiveness of speech intervention in Ugandan patients with CP ± L. Moreover, a comparison was made between a motor-phonetic and a phonetic-phonological speech intervention. METHODS : Eight patients (median age: 11.26y) with an isolated CP ± L were assigned into a group receiving motor-phonetic treatment (n = 4) or a group receiving combined phonetic-phonological treatment (n = 4). The participants received 6h of individual speech therapy. In both groups, perceptual and instrumental speech evaluations were performed to evaluate the patients' speech before and after the intervention. RESULTS : Speech therapy (irrespective of the used approach) was found to be effective in increasing consonant proficiency and in decreasing the occurrence of non-oral and passive CSCs. No statistically significant differences in outcome variables were found when comparing the two groups pre- and post-treatment. The descriptive results, however, revealed a larger increase in % correctly produced consonants, places and manners after the intervention in the group receiving a combined phonetic-phonological treatment compared to the group receiving a motor-phonetic treatment. CONCLUSION : This study took a first step in providing evidence concerning the effectiveness of different speech therapy approaches in children with CP ± L. The present study holds some important implications for clinical practice suggesting that an additional phonological approach may be beneficial for the patients with CP ± L. Further research including randomized controlled trials with larger sample sizes is necessary to provide further evidence.A PhD grant of the Research Fund Flanders (1120919N).https://www.elsevier.com/locate/ijporl2021-04-01hj2020Speech-Language Pathology and Audiolog

Timeline of Postoperative Changes After KTP Vaporization of True Vocal Fold Varices

Vocal fold (VF) varices are abnormal, dilated blood vessels and generally are considered to be fragile and prone to rupture. The potassium titanyl phosphate (KTP) laser has a wavelength of 532 nm and is well absorbed by hemoglobin. Therefore, minimal damage takes place to the epithelium of the VFs when the KTP laser is used correctly to treat vascular abnormalities. Several studies describe the benefits of the KTP laser in the treatment of VF varices. However, its effects on the true VF in the early postoperative period have not been described well