PROGNOSIS IN CLP
PRESENTED BY: RUTH VICTOR JIJI MATHEW
GUIDED BY: Ms. ANITA REDDY, Ms. GRACE MATHEW
• • • • • • • Prognosis Counseling Diagnostic Report Focus Cleft Lip and Palate Assessment Protocol in ISH CLP Proforma
• • • • • •
Case Presentation Factors Affecting Prognosis Prognostic Profile Conclusion Acknowledgements References
Once a diagnosis has been made, the most frequently asked questions by the parents (or the clients themselves) are: ―WILL MY CHILD IMPROVE?????????‖
―FOR HOW LONG IS SPEECH THERAPY NECESSARY?‖
• Answers COUNSELLING questions on prognosis
• Supports the above answers
What Is Prognosis?
―…..Prediction of judgment concerning the course, duration, termination and recovery from a disease or disorder….‖ Terminology of communication disorders (4 th Edition) Nicolosi, Harryman, Kresheck.(2004)
―….Prediction of course and end of disease and the estimate of chance for recovery….‖
Taber’s Cyclopedic Medical Dictionary (2001)
What Is Counseling?
―….Counseling is a process through which one person helps another by purposeful conversation in an understanding atmosphere…..‖
Communicating Quality - Royal College of Speech and Language Therapists(2006)
Individual being counseled can express his/her thoughts and feelings in order to clarify the situation ,come to terms with a new situation and be enabled to approach particular aspects of his/her life with less anxiety and tension.
What Should A Diagnostic Report Consist Of ?
As cited by Hutchinson et al. (1979)…..
A report should be limited to verifiable facts and also the opinions of the clinicians.
A diagnostic statement is essential.
Judgments about prognosis should be part of the diagnostic statement.
Nation And Aram(1977) List 3 Diagnostic Goals:
1. Describing the particular speech and language variation, deciding whether it constitutes a disorder and judging its severity.
2. The authors advised the clinicians to look at interaction among potential causal factors while identifying the cause, which is the second diagnostic goal.
3. The third goal requires making of a plan of therapeutic management. The goal is to help the client quote, clarify his/her problems (the main one being that of prognosis) and strengthen him/her to overcome them.
―….Experience and a well-defined diagnostic plan will help the diagnostician consider all factors to reach a prognosis that time will substantiate…. !!!‖ - Nation and Aram(1977)
To investigate the basis on which, clinicians in our college, determine Potential For Development In The Speech Program, with respect to cleft lip and palate(CLP).
elaborate on the Factors Affecting Prognosis of CLP (as per studies) and thus help diagnosticians answer the question on prognosis accurately.
emphasize on the Need For Knowledge of Factors Affecting Prognosis for all disorders so that our diagnostic reports are more relevant.
What Is CLP…?????
1. Cleft lip and palate is a structural anomaly of the bony processes of lip, alveolar process, hard palate, soft palate and uvula. A cleft of lip and palate occurs during embryonic development when there is failure of these structures to unite. Assessment and remediation of articulatory and phonological disorders – Creaghead, Newman, Secord(1989)
2. A cleft is an opening that passes through one or more structures that are normally closed. Introduction To Communication DisorderM.N.Hegde.(1995)
Incidence Of Cleft Lip And Palate
• Incidence of clefts - 1 in every 750 live births varying with racial background. (Mc Williams, Morris & Shelton 1990, Cleft Palate Foundation 1999)
• Higher among males than among females.
• Isolated cleft lip, unilateral cleft lip and palate, isolated cleft palate: 0.6–0.7/1000 live births.
• Bilateral clefts :0.3/1000 live births.
(The Cleft Palate-Craniofacial...
References: • Cleft Palate and Craniofacial Anomalies – Ann Kummer • Diagnostic Handbook of Speech PathologyBarbara B, Hanson, Mecham •Communicating Quality – Royal College of Speech and Language Therapists •Taber’s Cyclopedic Medical Dictionary •Webster’s Medical Dictionary
Human Communication Disorders ( 5th Edition)— George, Elizabeth and Wayne. • Terminology of Communication Disorders (4th Edition) -Nicolosi, Harryman , Kresheck • Introduction to Communication Disorders – M.N. Hegde • Management of Cleft Lip and Palate— Watson, Sell and Grunwell
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