The “Team” Approach to Treating Cleft Palate

Treatment of oral cleft birth defects requires a team of doctors and specialists. Depending on the severity of the birth defect, the consequences for your child can be serious and diverse. Children born with a cleft palate, a cleft lip, or a combination of the two are more prone to ear infections, hearing problems, speech development problems, dental issues, and a host of other complications. Some of these issues present themselves immediately and others will arise as the child grows and develops. Being aware of these issues and developing a comprehensive treatment plan is crucial to your child’s well-being.

As a result, the typical treatment plan involves what is known as a craniofacial team, a group of highly specialized doctors and professionals that will work together to coordinate your child’s treatment over a range of possible medical and developmental issues. As a parent, of course, you are at the heart of your child’s care, educating yourself and advocating on your child’s behave. But you will need a good craniofacial team behind you, and that generally involves the following specialists:

• nurse team coordinator: a registered nurse who combines experience in pediatric nursing with specializations in the care of your child and acts as a liaison between your family and the cleft team.
• pediatrician: a physician who will follow your child as he/she grows up and help coordinate the multiple specialists involved.
• surgeons, such as a craniofacial surgeon: these are surgeons with specialized training in the diagnosis and treatment of skeletal abnormalities of the skull, facial bones, and soft tissue. The surgeon should work closely with the orthodontists and other specialists to coordinate a surgical plan.
• otolaryngologist: this is an ear nose and throat specialist, a physician who will assist in the evaluation and management of ear infections and hearing loss that may be side effects of your child’s cleft abnormality.
• audiologist: a professional who will assist in the evaluation and management of any hearing difficulties your child may have.
• speech pathologist: a professional who will asses speech issues that may emerge as your child developments, as well as feeding problems that may arise
• speech therapist: a professional who will work with you and your child to overcome any speech development issues that occur.
• pediatric dentist: a dentists who evaluates and cares for your child’s teeth.
• orthodontist: a dentist who evaluates the position and alignment f your child’s teeth and coordinates a treatment plan with the surgeon and other specialists.
• maxillofacial prosthodontist: a specialist who makes prosthetic devices for the mouth if necessary.
• geneticist, or genetic counselor: a professional who will review the medical and family history and examine your child to help with diagnosis. A genetic counselor will also counsel your family regarding risks for the recurrence of craniofacial abnormalities with future pregnancies.
• psychologist or psychiatrist: a professional who assess the psychosocial function and behavioral development of your child. The psychologist or psychiatrist will assist the family in identifying therapy resources and coordinates referrals with the social services department.
• social worker: a professional who provides guidance and counseling for your child and your family in dealing with the social and emotional aspects of craniofacial abnormality and assists your family with community resources and referrals, such as support groups.
• dietician: a professional who will monitor your child’s nutritional needs and ensure that they are met, which can be important given feeding issues that may arise with oral cleft defects