We believe that it is our obligation to provide the best evidence-based care. Some of our current clinical research includes assessment of surgical outcomes, the Americleft Outcomes Project and studies investigating early speech-language development in infants with cleft palate.
Outcomes of treatment for cleft lip and palate can be measured in a number of different ways. These include intelligible speech, normalized facial appearance, normal hearing, and favorable facial and dental growth and development. There is currently no universal or national treatment protocol to ensure an optimal speech outcome for a child born with cleft palate. Each cleft palate center across the United States utilizes its own methods of surgical treatment and individualized speech therapy. The Americleft Project (American Cleft Palate Craniofacial Association, Americleft Task Force) has been developed as a means of comparing assessment and treatment protocols across centers. The purpose of this study is to describe and compare speech outcomes of children with cleft lip and palate, across multiple centers in North America. Nationwide Children's Hospital is one of several participating sites in the Americleft study. For more information about this study, contact Adriane Baylis, PhD, CCC-SLP at (614) 722-3895.
The Americleft Project is a task force of the American Cleft Palate Association for the retrospective comparison of outcomes derived from a variety of treatment protocols used in cleft palate centers across North America. Nationwide Children’s Hospital is one of the participating centers and has completed assessment of dental relationships and facial esthetic outcomes in children with unilateral cleft lip and palate. Dr. Ana Mercado is one of the core members of the Americleft project and the principal investigator for the facial esthetic component. A five-part article series on the Americleft Project will be published in the Cleft Palate Craniofacial Journal in 2011. Other outcomes to be evaluated in the near future are alveolar bone grafting, speech, and burden of care.
While it is well known that cleft palate is associated with increased risk for articulation and resonance disorders (e.g., hypernasality), less is known about the early vocal development of babies born with clefts. Most babies with cleft palate will demonstrate delays in babbling and early speech-language development, and while many will “catch-up” after palate repair, others will require speech-language therapy to achieve normal communication skills. The purpose of this study is to describe the early vocal behaviors of infants with cleft palate, before and after palate repair surgery, and to identify predictors of speech-language skills at 2 years of age. For more information about this study, contact Adriane Baylis, PhD, CCC-SLP at (614) 722-3895.
Patients with repaired cleft lip usually have a residual deformity of the nose and lip which may be more noticeable in some individuals than in others. Parents and patients often ask plastic surgeons about the indications for undergoing additional, or “revision”, surgery to reduce the deformity in the lip and/or nose. Surgical revisions are thus aimed to improve the esthetic appearance and function achieved by the primary surgical closure done in infancy. Once the surgical revision is done and healed, is there a real change in the appearance of the nose and lip? Is the resultant change always in the desired direction of “improvement”? The purpose of this collaborative study between The Ohio State University and University of North Carolina at Chapel Hill is to evaluate nasolabial esthetic outcomes before and after lip revision surgery in patients with cleft lip, and compare those outcomes to maturational changes in patients with cleft lip who have not received revision surgery. This is a supplemental study funded by NIH grant R01DE03814 to UNC-CH. For more information on this study, contact Ana Mercado, DMD, PhD at (614) 292-4842.