>> Families can expect, when they come to see us, that we’re going to do our best
to treat them over the span of their childhood and teenage years. We are going to perform
their surgical repairs. But we’re also gonna monitor all aspects of their child’s health
and development as they grow up.
>> It’s not just about your surgeon here at CHOP, treating your child. They have an entire
team dedicated to cleft lip and palate.
>> You’re going to be in chair two.
>> When a parent comes to CHOP with their child for a cleft clinic visit, they’re gonna
find every specialist that they could possible need.
>> Say, “Ahh”
>> Ahh
>> That was perfect.
>> The kids benefit from seeing the same providers as they grow up because those providers get
to know them well.
>> 60, 60.
>> Good, great.
>> Our team consist of surgeons, pediatricians, speech pathologists, nurse practitioners,
nurses, psychologists, and social workers.
>> Can you tell me what this is?
A speech pathologist is a very important person in the life of a child
with a cleft palate. A speech pathologist’s role is to determine if a difficulty is present,
what the nature of that difficulty is, to collaborate with the team so that we can develop
treatments for that child.
Say “baby.”
>> Baby.
>> Having the ability to do nasendoscopy, a technique where we can watch the palate work
during speech — with a speech pathologist that’s specifically trained to look at cleft speech —
is something that’s unique to this institution and the quality cleft programs.
>> Nasendoscopy is a diagnostic test where we insert a narrow tube, with a
camera and a light, to observe the function of the palate during speech. Then the plastic
surgeon and the speech pathologist will analyze the various characteristics of the palate
function and determine what type of treatment might be indicated.
>> We want the child to have the ability to communicate and interact
for the best quality of life possible.
>> The orthodontist and the dentist are here to check the health of the teeth and make
sure the teeth are in the appropriate location.
>> What we do in the team is collaborate and we come up with the best overall plan. So
we’re not just looking at the teeth. We’re not just looking at the surgical needs. But
we come up with what’s gonna be the best plan for the patient as a whole.
>> Nurse practitioners offer a unique addition by looking at the patient in a very holistic
sort of sense.
>> I can be a vital contact for that family to help explain the process, clarify the process,
or help just provide that comfort.
>> We are the first line responders, if you will, to patient concerns.
>> I’m the constant that can communicate with the orthodontist, the surgeon, the speech
pathologist, to help families better understand the recommendations our team may have.
>> The other thing I think we do particularly well is provide support to the
new mothers as soon as their children are born.
>> Keeping them upright is not only good to help with…
>> Helping families find a strategy to allow them to feed their babies with minimal frustration.
>> It’s gonna work on aligning …
>> You don’t get them through that critical period with proper feeding, you can have many,
many negative health consequences. So we’re fortunate to really have great nurses who
are experts in cleft care and feeding of the infants.
>> Every time we have an issue, whether it’s hearing, feeding, speech, whatever it may
be, there’s somebody waiting right there to answer that question.
>> So we talk with kids about feelings, and thoughts and school.
>> We also have psychologist that see many of our children. And can help them in many ways.
>> Having a psychologist on the team was very helpful for me. Because going through this
was very difficult and I didn’t know how to open up and talk about it. I just broke
down in tears.
>> We’re dealing with additional stressors like major reconstructive surgeries, appearance
differences, speech differences, things that really affect kids coping and functioning
at home and in school.
>> I just told her, like, what was going on. And she told me that, you know, “This is
normal. You’re not the only one. You’re not alone.” She helped me so much.
>> This type of team care is very important for children with cleft lip and palate. And that’s
because they have many needs.
>> We have team meetings where we get together and we discuss what are the next steps.
>> It’s a very collaborative group meeting. Everybody weighs in, everyone renders an opinion.
>> As a result of all of us talking together and the input from all of the different specialist…
>> We formulate an overall assessment and then put a cohesive plan together, which we
think is the best formula for success for that patient.
>> This team, they’re just amazing people. They’re passionate about what they do. They
care about you on such a personal level. They’re just so genuine in everything that they do.