Combining Speech Language Therapy and Clinical Psychology for Adolescents and Adults With CL/P: A Pilot Clinic in New Zealand

Abstract

Objective

This pilot study sought to determine whether adolescent and adult patients benefit from weekly cleft-specific speech language therapy (SLT) services, and to understand how concurrent psychology clinic services influence patient-reported outcomes.

Methods

Twelve patients (12 y+) with cleft-related speech concerns were seen at the University of Canterbury Speech and Psychology clinics in 2023. Patients elected to receive SLT and psychology services in-person, online, or a combination of both. Patient-reported outcome measures of speech function, intelligibility and acceptability, speech distress, and psychological and social function were completed before therapy, midway, immediately post, and 3 months post their 4- to 8-week block of treatment. Quantitative data were analyzed using descriptive statistics. Patients and clinicians completed exit interviews to understand their clinic experience. Interviews were analyzed using conventional content analysis.

Results

Participants reported improved speech function, intelligibility, and acceptability following the clinic. Participants also conveyed improvements in speech distress and in psychological and social functions, which peaked after receiving psychology services. Patient exit interviews suggested positive clinic experiences and that the intensity saw improvements realized in a short timeframe. Facilitators and barriers to the clinic's success were identified. Clinicians gained confidence working with patients with CL/P and valued the cross-discipline working opportunity.

Conclusions

Cleft-specific SLT services and routine psychological care should be available across the lifespan, and with regular frequency. Accessibility options enhanced engagement with the clinic. Regular multidisciplinary working between SLTs and psychologists facilitates clinical success, and university clinics can provide a valuable adjunct to hospital CL/P services. Ongoing clinical training opportunities such as collaborative clinics to gain experience working with CL/P are warranted.