1. Identification Information
Debbie Sell PhD FRCSLT
Lead Speech and Language Therapist,
North Thames Regional Cleft Unit,
Head of Speech and LanguageTherapy
Department, Great Ormond Street
NHS Trust and Honorary Senior
Lecturer University of London

2. Demographic Data Cleft Palate/Craniofacial team/Centre/Unit
Name/gender/DoB/
Cleft Type ..which classification
Syndrome
Language in which assessment was conducted
Date of Assessment
Rated by

3. Salient Orofacial Exam Findings ?Heading
Oronasal fistula present who decides, pinhole/slit, location (choices?)
Residual cleft in alveolar process
Other ….how will these data be used?
Nb. Upper respiratory tract infection

4. Palatal Surgery History
Initial palatoplasty: age/procedure
Primary veloplasty (Delayed Hard Palate Closure)?: age at veloplasty/ age at hard palate closure
Secondary speech surgery: age/ procedure
But what is the Question?

5. Evidenced Based Practice
Population
Intervention
Outcomes
+/- control
group
Evidenced Based Practice in Speech Pathology, Reilly et al, 2004, pub. Whurr

6. Speech Therapy History
Age at which therapy began:
Reason for therapy: Choices?
Number of Sessions per week: ??
Age at which therapy terminated:

7. Scancleft Total number of visits (team or local SLP)
Type of management: routine, review, counselling patients, counselling oithers, treatment
Reason for intervention: language delay, phonological problems, articulation problems, voice problems, other

8. UK CSAG study Location: Regional Centre
/ Local Site / Health Centre /
Educational Setting / Home /
Other
2. Focus – language
/consonant sound
errors/nasality / voice
/other
3. Type of schooling:
Mainstream / Statemented
in mainstream / Special
school / Language unit / In
process of being
statemented
Frequency – block / >once a week / weekly / intensive within a day/other
Number of sessions received
6. Number of missed sessions? - Did not attend - Cancelled by professionals - Cancelled by parents

9. Age at Assessment 5.0 – 5.11 10.0 to 10.11 15.0 to 15.11 > 20 years
Issues:
Audit versus other research outcome studies
Eurocleft: 5.00, 10.00, 15.00, years
UK - CP , 10.00, years
BCLP/UCLP , 10.00, 18 years or end of treatment

10. Level of Assessor Trained or credentialed as speech specialist
A speech specialist in cleft palate speech
The same person who collected the data
Not providing speech therapy to this individual patient
Not participating in/providing physical management for this individual patient

11. Trained or credentialed as speech specialist
A speech pathologist not specialising in cleft palate
A speech specialist in cleft palate speech
A specialist speech pathologist in cleft palate/palatal anomalies
The same person who collected the data
Not providing speech therapy to this individual patient
Not participating in/providing physical management for this individual patient
Involved/Not involved in clinical care of the patient
Member/Not a member of the Cleft/Craniofacial Team caring for the patient

12. Level of Mapper The same person who collected the data
A speech specialist in cleft palate speech
Other

13. Level of Mapper The same person who collected the data
The same person who analysed the data
A speech specialist in cleft palate speech
A specialist speech pathologist in cleft palate/palatal anomalies
Other
A speech pathologist not specialising in cleft palate/palatal anomalies
A student
A member of another profession

14. Speech Sample
*these items should be included at each age of assessment
Is this necessary on a mapping system?
For older patients sentences can be read or repeated?
Discussion of process of elicitation

15. Perceptual Judgements based on:
Live speech
Audio recordings without video (digital/analogue)
Video recordings including audio (digital/analogue)
Both audio and video recordings

16. Reliability measures for speech judgments
Were obtained for this individual patient (briefly describe method)
Were not obtained
Consensus listening for speech judgments

17. Results gained by:
Consensus listening by speech pathologists in the Team
Consensus listening by independent non-team speech pathologists
Team speech pathologists with reported inter- and intra rater reliability for the study
Independent non-team speech pathologists with reported inter- and intra rater reliability for the study
Live clinical judgements
Listeners: Non-blinded
Blind assessment

18. Other thoughts Identify baseline assessment mapped from?
Storage: where and how should data be stored and retrieved