Plastic and Reconstructive Surgery News
Speech training symposium held in China
Fall 2002, Volume 28, Number 4
from the American Cleft Palate-Craniofacial Association Newsletter
There is no discipline of speech-language pathology in Mainland China. However, there is strong interest within the fields of oral maxillofacial surgery, pediatrics and otolaryngology for providing speech services, developing training programs and conducting research. Some very limited speech services are provided for children with cleft lip and palate by clinicians already involved with their care.
In 2001, as a member of the medical advisory board for The Smile Train, Dr. Linda D'Antonio conducted a needs assessment for speech services for cleft palate in China. The needs assessment included a survey, interviews and a consensus meeting of some of the individuals who are involved in speech services for children with cleft palate. The unanimous consensus obtained from the needs assessment was that speech services were urgently needed. This need was summarized in a quote from an oral surgeon at Huaxi Stomatological Hospital in Chengdu:
Speech therapy plays a key role in the serial treatment of lip/palate cleft because it is able to bring tremendous benefits for the patient comparable to that of surgery. However, the popularity and effects of speech therapy have fallen far behind that of surgery due to the lack of theoretical recognition, which, for a long time, has undermined both the physical and mental health of lip/palate cleft patients. Therefore, we think that we should be equally committed to the training of speech therapy for surgeons as to the surgery.
There was agreement that the ultimate solution is to develop university training programs for speech-language pathology in China. However this is an exceptionally long-term goal that will require significant amounts of infrastructure and cooperation with the government, universities and hospitals. Meanwhile healthcare providers, especially the surgeons expressed a need for immediate training in diagnosis and treatment of speech disorders associated with clefting.
In response to this need, Dr. D'Antonio received a grant from The Smile Train to conduct "The First Smile Train Symposium on Principles of Speech-Language Pathology for Children with Cleft Palate." The meeting also received financial support from The Noordhoff Craniofacial Foundation. The meeting took over a year to plan and was held in Qingdao, China June 7-9, 2002. More than 200 participants took part in a 2-day general symposium. Fifty of these participants were selected prior to the meeting based on applications submitted to attend a third day workshop with extensive hands-on training in small groups.
There were 14 faculty members. Three of the faculty were from Mainland China. Three were from Taiwan affiliated with the Chang Gung Memorial Hospital and The Noordhoff Craniofacial Foundation and two were from Hong Kong University. Two of the faculty were graduate students here in the US in speech training programs and are originally from Mainland China. Four of the faculty were from the US and are ACPA members; Linda D'Antonio, Jeff Marsh, Dave Kuehn and Nancy Scherer.
Among the participants for the 2-day program, about 80% were surgeons and the remaining attendees were nurses, teachers and other hospital staff. Approximately 50% of the participants had some experience in providing speech therapy, although in most cases they reported that their experience was extremely limited. About 75% of the participants said they would provide speech therapy following the training they received at the symposium or said they would pass training on to others. According to the participants of the intensive 1-day workshop, they expected to increase the amount of therapy they were providing by a projected total of more than 2500 days of therapy per year that was not being provided prior to this training.
An important outcome of the meeting was the development and distribution of a book of handouts and references. Power-point outlines for all of the presentations were translated into Mandarin and bound in a book of proceedings along with several relevant references. The curriculum was heavily "case-based"and all of the presentations were developed in such a way that the curriculum built from basic talks on the underlying principles of speech language pathology through very practical and easily followed instructions for providing evaluation and therapy. Several handouts were developed in Mandarin for routine clinical use.
In the post meeting evaluations, participants from the meeting requested more opportunities for advanced speech training and the establishment of a local team of "speech experts" through further training. As a result of the original needs assessment and the outcome of this meeting the Noordhoff Craniofacial Foundation is embarking on a craniofacial speech fellowship to train a select number of individuals from Mainland China in Taiwan. It is hoped that these speech fellows will become the trainers who will in turn train others to provide the much needed speech services that are now missing for children with cleft palate in China.