By Preston Clarke Smith
(This Article originally appeared in TODAY, the news magazine of Loma Linda University, on January 26, 2006)
Loma Linda University offered a unique opportunity to speech and language pathologists on January 8 and 9. In collaboration with Sri Ramachandra Medical College & Research Institute (SRMC & RI) in Chennai, India, LLU put on a video conference on the specialty of cleft lip and palate (CLP) and the communication disorders caused by CLP. The conference marked the beginning of the sixth year of partnership between Loma Linda University and SRMC & RI in the area of communication disorders related to cleft lip and palate.
The conference came about as a result of numerous requests for advanced training in this specialty area within speech and language pathology, both in India and in the United States. Linda D’Antonio, PhD, professor at Loma Linda University, and Professor Roopa Nagarajan, MA, MSc, course chairperson for the department of speech, language, and hearing sciences at Sri Ramachandra Medical College & Research Institute Deemed University, co-chaired the conference as an extension of their five-year relationship started with one of the first Smile Train centers established in 2000.
“Our lives and our clinical experience have been enriched by our collaboration, and we hope that this meeting will foster many more collaborative efforts. We welcome you all and hope that this conference will serve to increase speech services for the children with cleft lip and palate to whom we are dedicated,” wrote Dr. D’Antonio and Professor Nagarajan in a welcome statement to the more than 200 attendees between the United States and India site.
The purpose of the training, held from 6:30 to 11:00 p.m. each day in Loma Linda, and from 8:30 a.m. to 1:00 p.m. in India, was to provide specific information regarding practical clinical skills for evaluation and treatment of communication disorders in children with cleft palate. The program was designed to provide access to internationally recognized faculty in the area of cleft palate who can then serve as resources for increasing the knowledge and skills of speech and language pathologists (SLPs) who are involved with this population of patients.
The conference featured seven experts presenting for the two half-days, including Loma Linda’s Dr. D’Antonio; SRMC & RI’s Professor Nagarajan; Robert Shprintzen, MD, director of several programs at Upstate Medical University in Syracuse, New York; Nancy Scherer, PhD, professor and chair of the communicative disorders department at East Tennessee State University; Karen Golding-Kushner, PhD, executive director of the Velo-cardio-facial Educational Foundation, Inc., an international organization dedicated to the dissemination of educational information about VCFS; John Riski, PhD, clinical director for the Center for Craniofacial Disorders at Children’s Healthcare of Atlanta; and David Kuehn, PhD, professor of speech and hearing science at the University of Illinois in Urbana-Champaign.
These seven prominent experts in CLP emphasized practical, relevant clinical skills for immediate use by both the Indian and American SLPs. A special emphasis was placed on early identification and intervention for p revention of the disabling speech patterns that are often associated with cleft palate.
The program began with a special inauguration ceremony presided over by Professor T.K. Partha Sarathy, MD, prochancellor of Sri Ramachandra Medical College & Research Institute Deemed University.
“It’s inspiring, this is my first time in Loma Linda,” said Dr. Sarathy to the attendees. “Today, looking at the other side of the world, is exciting!
“Ten years ago there were only four or five speech institutes in all of India. Now there are more than 15. Considering a population of one billion and hundreds of languages, we are just scratching the surface.
“Caring for the cleft may put a smile on the child, but it can’t help them speak,” continued Dr. Sarathy. “We need surgery and speech working together to sustain the program.”
Dr. Linda D’Antonio inaugurated the cleft center at Sri Ramachandra Medical College & Research Institute in 2000 with the help of Smile Train, one of the video conference’s main sponsors.
Smile Train is an international children’s charity dedicated to providing free cleft surgery and related treatment. The Smile Train is committed to fostering interdisciplinary care for children with cleft palate and has sponsored specialty training concerning speech disorders associated with cleft lip and palate throughout the world. The Smile Train empowers local surgeons and medical professionals in developing countries to perform the surgery themselves. These local medical teams can then leverage the modern training and support provided by the Smile Train to perform cleft surgery on their children.
Other conference sponsors were Transforming Faces Worldwide, SRMC & RI, Loma Linda University, Adventist Health International, Rehabilitation Council of India, and Super Duper Publications, Inc.
Transforming Faces Worldwide (TFW) is a nonprofit organization dedicated to improving the availability and quality of medical treatment and care of children and adults, with cleft lip and palate and related craniofacial disorders.
TFW provides funding, support, and encouragement to improve the quality of long-term cleft management in developing countries. TFW seeks to work alongside local organizations that are committed to the full development of the individual. TFW is supported by the generous financial support of charitable foundations and individuals. The SRMC / TFW project has received contributions from Omni Cell and Bridge Street United Church Foundation.
TFW also depends on volunteer support from medical professionals, international development experts, and individuals. In the United States there is little training or readily available continuing education for school-based speech pathologists who are on the frontlines of treating speech and language disorders for children with cleft lip and palate.
Loma Linda University serves San Bernardino County, which is the largest county in the United States and has a large population of children with cleft lip and palate. As in India, there have been numerous requests for training in therapy techniques for children with cleft palate. The video conference offered the opportunity for school-based SLPs in Southern California to learn alongside their counterparts in India.
The video conference was the first part of a five-day training session in India. The next two days (January 10 and 11) included a visit to the community-based rehabilitation site at Thiruvannamalai, India, where participants focused on hands-on training in assessment and rehabilitation planning for children with cleft lip and palate. The last day of the workshop (January 12) back at SRMC included group discussions, case presentations, and closing remarks.
Approximately 40 children received free speech evaluations and treatment plans as part of the extended program in India on the fourth day of the training.