Is telepractice effective in speech therapy for children with cleft lip and palate during the COVID-19 pandemic?

Abstract

Background: The ongoing COVID-19 pandemic and the current shortage of speech-language pathologists in Thailand have limited access to speech services for children with cleft palate with or without cleft lip (CP± L). A combination of telepractice (TP) and face-to-face therapy could address the lack of continuous service and improve accessibility to speech therapy providers. This study aimed to compare the percentage of consonants correct (PCC) before and after speech therapy in children with CP± L.

Methods: This study included 19 children with CP± L, aged 5 to 13 years, who underwent primary cheiloplasty and palatoplasty. A perceptual assessment was conducted using the Thai Speech Parameters for Patients with Cleft Palate in a Universal Reporting System to evaluate speech before and after therapy. The intervention consisted of five 30-minute face-to-face speech therapy sessions and fifteen 30-minute TP sessions, totaling twenty sessions. Paired t-tests were used to analyze the mean differences in PCC for pre- and post-articulation errors, as well as caregiver satisfaction levels at the conclusion of the evaluation period.

Results: Children with CP± L exhibited a significant increase in PCC; the mean difference (standard deviation, SD) was 9.36 (11.87), with a 95% confidence interval (CI) of 3.64 to 15.08 at the word level, and a mean difference (SD) of 13.25 (13.71), with a 95% CI of 6.65 to 19.86 at the sentence level. Caregivers rated their satisfaction as excellent.

Conclusion: The integration of TP with traditional face-to-face speech therapy has proven to be a highly effective approach for reducing articulation errors in children with CP± L. Additionally, this method was well-suited for the constraints imposed by the COVID-19 pandemic.