Speech services by speech volunteers for children with cleft lip and palate in professional lacking area: Pilot study

Background: Cleft lip and cleft palate are the most common birth defects. Children with cleft lip with or without cleft palate (CP±L) face a vary of challenges, depending on the type and severity of the cleft including speech difficulty, dental problems, feeding difficulty, ear infections and hearing loss. Articulation error is the most common residual defect in children with cleft palate with or without cleft lip. Objective: To compare the numbers of pre- and post- articulation errors after using the Model of Speech Therapy by Volunteers (STV) for children with CP±L. Materials and methods: 9 children, aged range 6; 4-14; 2 years old, were included in this study and completely participated in the study. Pre- and post-articulation tests by Myanmar Articulation, Resonation, Nasal Emission and Nasal Turbulence Test were assessed at Mahamuni Monastery, and Thiriyadana Guha Pone Htoon Shan Monastery, Tachileik, Myanmar. STV is composed of a 3-day speech camp (1st month), 3 times 1-day site visits for complicated cases (2nd, 6th, and 10th months) and 3 times of 1-day follow-up speech camps (4th, 8th, and 12th months), Phonological approaches, traditional strategies, and specific techniques for speech correction in children with CP±L were taught to speech volunteers (SVs) and caregivers. Homework was assigned to SVs and caregivers. SVs provided a session of 45-minute speech correction every week. Caregivers practiced 5 sessions of 30 minutes in speech exercises /weeks at home. Results: STV revealed significant reductions in the numbers of articulation errors including articulation screening test [median difference: MD=6 (95% confident interval: CI=5.2-9.2)], and Myanmar articulation standard test at both word and sentence levels; [MD=8 (95% CI=6.5-10.8) and MD=5 (95% CI=4.2-8.3), respectively]. Conclusion: STV significantly decreased a number of articulation errors in children with CP±L of Myanmar, a professional lacking area, and could be applied in any area that has a similar situation. The result was a primary study, the further research should enroll more participants for generalization.