(Used with Permission, Courtesy of the Cleft Palate Foundation www.cleftline.org)
Throughout the United States, there are many qualified health professionals caring for children with cleft lip/palate and craniofacial anomalies. However, because these children frequently require a number of different types of services which need to be provided in a coordinated manner over a period of years, you may want to search for a n interdisciplinary health care team. The principal role of the interdisciplinary team is to provide integrated case management for your child, to assure quality and continuity of care, and to render long-term follow-up.
When you are selecting a team, here are some points to consider:
1. The number of different specialists who actually participate on the team
The more extensive the group of specialists who participate on the team, the more likely every aspect of treatment can be considered during the team evaluation. The specific staff will be determined by the availability of qualified personnel and by the types of patients served by the team. When the team cannot provide all types of examinations or other services required by its patients, team members are responsible for making appropriate referrals, and for communicating with those to whom patients are referred to facilitate the implementation of appropriate and coordinated treatment plans.
You should ask how many of the following are represented on the team:
- Oral Surgeon
- Plastic Surgeon
- Social Worker
- Speech-Language Pathologist
If your child has a craniofacial anomaly, the team you choose may also include the following:
2.Qualifications of the individual members on the team
You should inquire if all the members of the team are fully trained and appropriately certified in their areas of specialty, as well as licensed. This may become an issue that will also affect insurance coverage.
3. Experience of the team
Each team must take responsibility for assuring that team members not only possess appropriate and current credentials but also have requisite experience in evaluation and treatment of patients with cleft lip and palate and other craniofacial anomalies. You should ask how often the teem meets and approximately how many patients are seen at each meeting. You may also want to try to determine how long this group of professionals has been meeting as a team and also how much experience the various individual professionals have had.
4. Location of the team
The distance of the team from your home may NOT be an important consideration in choosing a team. In general, the team will be seeing your child only periodically throughout his or her growing years. Usually routine treatment such as general dental care, orthodontics, speech therapy, and pediatric care will be provided by professionals in your own community who will be in regular contact with professionals on the interdisciplinary team. Thus your travel to a team will usually be limited to several trips a year or even once a year. If a larger, more experienced team is available a few hours away, this may be preferable to a less experienced local team.
5. Affiliation of the team and its members
You may want to ask if the Team is listed with the American Cleft Palate-Craniofacial Association and how many of the individual members of the Team are also members of the American Cleft Palate-Craniofacial Association. Staying current with recent developments in the field is one sign of a conscientious and concerned health care professional. You may also want to determine whether the team has any relationship to an established hospital or to a medical school or university. Facilities for diagnostic studies and treatment frequently are better with such an affiliation.
6. Communication with the team
Your child may require care over a period of years so you want to make sure you are comfortable communicating and working with the members of the team. Treatment recommendations should be communicated to you in writing as well as in face to face discussion. The team should assist you in locating parent patient support groups and any other sources for services that are either not provided by the team itself or are better provided at the community level.
For a list of cleft palate or craniofacial teams in your state or region or for further information, you may contact the Cleft Palate Foundation:
Reference: Parameters for Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Anomalies. American Cleft Palate-Craniofacial Association. Cleft Palate-Craniofacial Journal 1993; 30 (Suppl 1).