2020 Volume 45 Issue 1 Pages 22-30
The authors had an opportunity to observe clinical practice and receive instruction on clinical research at the Cleft Lip and Palate Center, the Center for Complex Craniofacial Disorders, the 22q Center, the Velopharyngeal Dysfunction Program, and the Speech Pathology Department at the Nationwide Childrenʼs Hospital (NCH) in Columbus, Ohio, USA. In the Speech Pathology Department, speech therapies were based on the diagnosis and assessment at the Cleft Lip and Palate Center. Speech therapy was usually recommended before palatoplasty performed around age six months and this early intervention targeted stimulating expressive language and preventing the development of articulation disorders. Regarding patients with symptoms of VPD, speech therapy addressed correct speech that could potentially result in leading to maximum VP closure. This was advised prior to surgical planning, in order to activate attempts at VP closure during the production of accurate oral speech sounds. NCH prioritized speech therapy to eliminate articulation errors. Regarding speech therapy at NCH, the treatment goal of “acquisition of age-appropriate intelligible speech” is the same as that of SLPs in Japan. The strategy for early intervention for VPD at NCH seemed different from those in Japan. Based on the knowledge gained from these experiences, the authors consider that the strategy of preventing the development of speech errors and early intervention could usefully be introduced in Japan. In addition, the authors re-acknowledged the importance of evidence-based speech therapy.