Questions to ask when selecting a cleft team

We know finding the right team can be overwhelming. This is why we have come up with questions to ask yourself and your team to decide if they are the right fit for you and your child.

Is the team approved by the American Cleft Palate-Craniofacial Association (ACPA)?

“Children born with cleft lip, cleft palate and/or other craniofacial differences may require individualized treatment into adulthood. Their care is best managed when a team of specialists works with the family to develop and follow a treatment plan. ACPA is dedicated to team care and to optimizing outcomes for patients. ACPA approves teams that meet the Standards for Approval of Cleft Palate and Craniofacial Teams, based on the Parameters of Care.” — American Cleft Palate-Craniofacial Association (ACPA)

The University of Minnesota is an ACPA-approved team and our nurse coordinator, speech pathologists, surgeons, orthodontists and pediatric dentists are all ACPA members.

Up to what age are patients seen at the cleft team?

Your child will need different services based on his/her age. Choosing a team that can care for your child from birth until young adulthood allows for continuity of care and limits disruption to treatment that can occur when a child has “aged out” of a team that sees children only.

Do the speech language pathologists (SLP) on the team have experience in cleft speech and feeding?

Speech pathologists are integral members of the cleft team.  They provide training, collaborate and coordinate feeding, speech and language evaluation and treatment plans with local and school speech therapists. They also serve as a liaison between the school and healthcare system.  Well trained speech pathologists identify and carry out the most effective and efficient treatment goals and strategies for the cleft and craniofacial related disorders.

Also, the team’s SLP also works closely with the surgeon to discuss surgical treatments for the child should he or she need additional procedures to improve speech.

Does the team offer NAM (Nasoalveolar Molding)?

NAM is an oral appliance, much like a retainer, that is custom made for babies by a pediatric dentist or orthodontist with special training. The goal of the NAM retainer is to help close the cleft space between the lips, nostrils and top jaw by adjusting the retainer every week. By having a smaller cleft it is easier for the surgeon to bring the lips together during surgery and make both nostrils appear equal. It also helps babies feed easier as the appliance covers the palate so the cleft is covered. Some moms and dads elect not to have a NAM appliance made for their baby, but the option should be available for parents who would like to proceed with it.

Can your child receive dental care by pediatric dentists?

The American Academy of Pediatric Dentistry recommends all children be seen by a dentist by age one or six months after the child’s first tooth erupts. If your team offers a dental clinic at the same location where cleft team visits are held there is smooth communication between the cleft team and the dental team. Pediatric dentists are specially trained in treating children with special health care needs including craniofacial and developmental differences.

Can your child receive orthodontic care (at the same facility)?

As with pediatric dental care, orthodontics (braces) can be challenging to receive for your child. There is an advantage to choosing a team with onsite orthodontic facilities for the same reasons as having on site dental services available.

Do the professionals in the team work together to diagnose and your child’s needs and discuss these needs with you?

Team care has been shown to have the best outcomes for children. This means the specialists on the team take the time to listen to each other’s recommendations before deciding on a definitive plan for your child. This method is preferred over one specialist dictating treatment.

Do you (patient/caregiver) feel as the central part of the team?

Your child is the center of the team! Parents know their children better than anyone else and as such your team should strive to include you.

Learn more about choosing a team from the American Cleft Palate-Craniofacial Association (ACPA).