Clinic service review for speech and language-delayed children with cleft palate

Carli Maddocks1, Rachel Kerr1, Emma Holmes1

1Royal Children’s Hospital, Parkville, Australia


Children with a history of cleft palate are screened at 18 months of age using the Communication and Symbolic Behaviour Scales (CSBS) questionnaire, due to increased risk of speech and language delay. Children who fail are offered an appointment with Speech Pathology. This clinic review involved trialling a group clinic with the following aims:

  • Ensure timely access to services prior to routine 3 year old review
  • Ensure early identification and referral to community Speech Pathology
  • Provision of standardised education for parents via e-health
  • Increased time efficiency of group format compared to individual


A 6 month trial of group service delivery was compared with individual appointments in the same time period the previous year. Various data were collected regarding number of children seen, attendance rates, and outcome of the appointments e.g. referrals to community services, patient demographics etc. Parent questionnaires obtained information on satisfaction with the clinic information and structure.


All project aims were achieved, including a 400% increase in children seen and 95% of the children requiring follow up or referral. Standardised education was provided within the clinic appointment with plans to be converted to e-health.

Significance of the findings to allied health:

Review of service delivery models, including tertiary care, can result in improved utilisation of clinic resources, increased time efficiency for clinicians and parent satisfaction. The results also reinforced the importance of early identification and service access for children at risk for communication delays.