Internationally adopted children with cleft lip and/or palate: A retrospective cohort study

Werker, Charlotte L.; Wilde, Hester de; Molen, Aebele B. Mink van der; Breugem, Corstiaan C.

doi:10.1016/j.bjps.2017.04.011

Cited by 13 publications

(19 citation statements)

References 11 publications

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“…Swanson et al showed in 2014 that 25% of IAC with CL/P in the years 1997-2011 had conductive hearing loss and 26% had a history of ear infections, but no group for comparison was described and age at assessment was missing [2]. A study by Werker et al [15] recently published a study on IAC versus nativeborn children with CL/P, middle ear findings, and hearing status during childhood [16]. No differences were found except for more tympanic membrane perforations in the IAC group.…”

Section: Introductionmentioning

confidence: 99%

Surgical, speech, and hearing outcomes at five years of age in internationally adopted children and Swedish-born children with cleft lip and/or palate

Schölin

Jonasson

Axelsson

et al. 2019

Journal of Plastic Surgery and Hand Surgery

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Internationally adopted children (IAC) with a cleft lip and/or palate (CL/P) tend to arrive with un-operated palates at an age at which their Swedish-born peers have completed their primary palate surgery. Our aim of the present study was to analyze surgical, speech and hearing outcomes of IAC at age 5 and compare with those of a matched group of Swedish-born children. Fifty children with CL/P born in 1994-2005 participated in the study. Twenty-five IAC were matched according to age, sex and cleft type with 25 Swedish-born children. Audio recordings were perceptually analyzed by two experienced, blinded speech-language pathologists. Hearing and speech statuses were evaluated on the same day for all children. Surgical timing and complications as in fistulas and requirement for secondary velopharyngeal (VP) surgery, speech evaluation results, and present hearing status were analyzed for all children of age 5 years. Results showed that primary palatal surgery was delayed by a mean of 21 months in IAC. IAC had a higher prevalence of velopharyngeal impairment that was statistically significant, a higher fistula rate, and experienced more secondary surgery than Swedish-born peers. Hearing loss due to middle ear disease was slightly more common among IAC, whereas the rate of treatment with tympanostomy tubes was similar between the two groups. In conclusion, IAC with CL/P represent a challenge for CL/P teams because of the heterogeneous nature of the patient group and difficulties associated with delayed treatment, and the results show the importance of close follow-up over time. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Surgical, speech, and hearing outcomes at five years of age in internationally adopted children and Swedish-born children with cleft lip and/or palate

Schölin

Jonasson

Axelsson

et al. 2019

Journal of Plastic Surgery and Hand Surgery

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show abstract

“…In 2005, more than 90% of children adopted from China to the United States were described as having special needs 4 . In 2015, 75% of children adopted to the Netherlands had a medical need or congenital defect 5 . Additionally, children will frequently have medical and psycho‐emotional conditions discovered after adoption.…”

Section: Introductionmentioning

confidence: 99%

“…This shift in the demographics of internationally adopted children has been mirrored by the increased number of international adoptees presenting for surgical intervention 5‐8 . Common surgical needs for these patients include repair of cleft lip and/or cleft palate and repair of anorectal malformations.…”

Section: Introductionmentioning

confidence: 99%

“…Common surgical needs for these patients include repair of cleft lip and/or cleft palate and repair of anorectal malformations. Children will frequently have had previous surgeries prior to leaving their countries of origin 5‐7 . One theory is that a “repair” may make the child more physically appealing to a potential adoptive parent.…”

Section: Introductionmentioning

confidence: 99%

“…Craniofacial teams began noticing relatively large proportions of internationally adopted children presenting with cleft lip/palate and have described care for these children in terms of demographics, surgical timing, and complications 5,6,8‐10 . These series report increased age at time of palatal repair (mean 25.6 months vs 11.6 months), higher rates of velopharyngeal insufficiency and associated difficulties with speech and swallowing (49% vs 14.9%), 9 and palatal fistulae (14% vs 5%) 11 when compared to children born domestically with cleft lip and cleft palate.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative care for internationally adopted children: Medical, surgical, and psychosocial considerations for a population of concern

Knipper

Davies

Smith

et al. 2020

Pediatric Anesthesia

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The overall number of international adoptions has dropped in the last 20 years, but a relative increase in the proportion of these children with special and surgical needs has occurred. Cleft lip/palate and anorectal malformations are two common surgical pathologies for internationally adopted children. Internationally adopted children with cleft lip/palate have high rates of speech impairment and frequent need for reoperation, and children with anorectal malformation commonly need multiple reoperations. For both groups, surgery prior to adoption may have actually contributed to morbidity. Both speech impairment and anorectal malformation negatively affect quality of life, independent of adoption. Additionally, internationally adopted children frequently have experienced trauma, single or complex, and institutionalization. Each of these can independently contribute to impaired psychosocial and behavioral development. These children face surgery, sometimes multiple surgeries, while adapting to a new culture, learning a new language, and bonding with a new family. The impact of prior medical experiences without the presence of a caregiver and/or while institutionalized is understudied. The surgical experience and perioperative outcomes within this population warrant research, and clinical coordination between teams may help improve care for this uniquely vulnerable population.

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English-Only Treatment of Compensatory Speech Errors in a Bilingual Adoptee With Repaired Cleft Palate: A Descriptive Case Study

Schleif

Mason

Perry

2021

Am J Speech Lang Pathol

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Purpose The purpose of this clinical focus article is to provide a descriptive case study of a late-adopted, bilingual adolescent with cleft palate speech errors. Specifically, we examined the cross-linguistic generalization of remediated compensatory cleft errors, following treatment in English (second language) only. The overarching goal of this study is to gain insights into the complexity of speech intervention for the adopted population with delayed cleft palate repair. Method A 14-year-old female adopted from China with a repaired unilateral cleft lip and palate and maladaptive articulation errors underwent 55 one-hour sessions of a motor-based, speech therapy approach over a 15-month span, targeting English phonemes only. Pre-, mid-, and posttreatment evaluation included perceptual and instrumental assessment of speech and resonance. Outcome measures at each time point included perceptual speech and resonance ratings, nasometry scores, and percent consonants correct (PCC) in both English and Mandarin. Results PCC in English improved from 60% in single words and 35% in sentences pretreatment to 100% in single words and sentences during posttreatment assessment. Without direct treatment in Mandarin, PCC in Mandarin improved from 56% in single words and 50% in sentences pretreatment to 100% in single words and 99% in sentences during posttreatment assessment. Posttreatment nasometry scores decreased by 20% for the nasal sample and 17% for the oral sample compared to pretreatment. Conclusions This descriptive case study demonstrated successful remediation of cleft palate speech errors, following 15 months of treatment in a late-adopted bilingual adolescent using a motor-based therapy approach. Treatment of errors in English (second language) led to generalization of correct productions in Mandarin (first language). This study presents the potential for bilingual late adoptees to achieve intelligible speech in both languages when motor-based therapy principles are applied to intervention.

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Internationally adopted children with cleft lip and/or palate: A retrospective cohort study

Cited by 13 publications

References 11 publications

Surgical, speech, and hearing outcomes at five years of age in internationally adopted children and Swedish-born children with cleft lip and/or palate

Surgical, speech, and hearing outcomes at five years of age in internationally adopted children and Swedish-born children with cleft lip and/or palate

Perioperative care for internationally adopted children: Medical, surgical, and psychosocial considerations for a population of concern

English-Only Treatment of Compensatory Speech Errors in a Bilingual Adoptee With Repaired Cleft Palate: A Descriptive Case Study

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