We've Got Some Growing Up to Do: An Evidence-Based Service Delivery Model for the Transition of Care for the Young Adult with Cleft Lip and Palate As a child approaches adulthood, many transitions take place; physically and psychosocially. There are new roles and responsibilities. For the young adult with cleft lip and palate (CLP), one of the most significant transitions is moving from the pediatric interdisciplinary team to the adult-centered health care system. There is a ... Article
Article  |   August 07, 2017
We've Got Some Growing Up to Do: An Evidence-Based Service Delivery Model for the Transition of Care for the Young Adult with Cleft Lip and Palate
Author Affiliations & Notes
  • Linda D. Vallino
    Craniofacial Outcomes Research Laboratory, Center for Pediatric Auditory and Speech Sciences
    Nemours, A.I. DuPont Hospital for Children, Wilmington, DE
    Department of Pediatrics, Sidney Kimmel Medical College – Thomas Jefferson University, Philadelphia, PA
  • Brenda Louw
    Department of Audiology and Speech-Language Pathology, College of Clinical and Rehabilitation Health Sciences, East Tennessee State University, Johnson City, TN
  • Disclosures
    Disclosures ×
  • Financial: Linda D. Vallino is co-author (with Dr. David Zajac) of Evaluation and Management of Cleft Lip and Palate: A Developmental Approach (San Diego: Plural Publishing, Inc. 2017) and is employed by Nemours/A.I. duPont Hospital for Children, Wilmington, DE.
    Financial: Linda D. Vallino is co-author (with Dr. David Zajac) of Evaluation and Management of Cleft Lip and Palate: A Developmental Approach (San Diego: Plural Publishing, Inc. 2017) and is employed by Nemours/A.I. duPont Hospital for Children, Wilmington, DE.×
  • Brenda Louw is employed by East Tennessee State University, Johnson City, TN.
    Brenda Louw is employed by East Tennessee State University, Johnson City, TN.×
  • Nonfinancial: This paper is based on the presentations of Linda D. Vallino and Brenda Louw at the 2016 Convention of the American Speech-Language-Hearing Association and 2017 74th Annual Cleft Palate-Craniofacial Meeting.
    Nonfinancial: This paper is based on the presentations of Linda D. Vallino and Brenda Louw at the 2016 Convention of the American Speech-Language-Hearing Association and 2017 74th Annual Cleft Palate-Craniofacial Meeting.×
Article Information
Special Populations / Genetic & Congenital Disorders / Part 1
Article   |   August 07, 2017
We've Got Some Growing Up to Do: An Evidence-Based Service Delivery Model for the Transition of Care for the Young Adult with Cleft Lip and Palate
Perspectives of the ASHA Special Interest Groups, August 2017, Vol. 2, 4-17. doi:10.1044/persp2.SIG5.4
History: Received April 24, 2017 , Revised June 12, 2017 , Accepted June 27, 2017
Perspectives of the ASHA Special Interest Groups, August 2017, Vol. 2, 4-17. doi:10.1044/persp2.SIG5.4
History: Received April 24, 2017; Revised June 12, 2017; Accepted June 27, 2017

As a child approaches adulthood, many transitions take place; physically and psychosocially. There are new roles and responsibilities. For the young adult with cleft lip and palate (CLP), one of the most significant transitions is moving from the pediatric interdisciplinary team to the adult-centered health care system. There is a shift in focus from the cleft itself and clinician-reported outcomes to patient self-report about the perceived impact of the cleft on quality of life. Transition also befalls the parents and team providers who, through the course of some 18 years, were active participants in the young person's care. Their roles, too, have changed. The International Classification of Functioning, Disability, and Health (ICF; World Health Organization, 2001, 2004) is a conceptual framework for considering the totality of the cleft by addressing the interaction between the person and their personal and social environment. This model is suitably applicable to the transition of care of the young adult with CLP. In this paper, we propose an evidence-based person-centered delivery model of care using the concepts of the ICF to facilitate the transition of care for this population. A case example is presented highlighting the use of these concepts for the speech-language pathologist.

Acknowledgements
We would like to thank the reviewers for their enthusiasm for this work and their valuable comments. We have incorporated some of their ideas into the manuscript because we believe that they will enhance the care we provide to young adults with CLP.
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