Cleft palate is the most common craniofacial anomaly, and second only to clubfoot as a newborn congenital deformity. World-wide, every three minutes a child is born with a cleft. Approximately 1 in 700 hundred children are born with clefting, and every year, about 6,800 hundred babies in the United States are born with oral clefts each year. Speech language pathologists are at the front line of treatment – especially for children in the early intervention (0-3) stage. Therapists will learn and review material related to: classification, embryology, related anatomy, risk factors, kinesiology of the velopharygeal valve mechanism and its relation to expression of strong consonants. Understand how clefting leads to poor nutrition and why more calories are expended during suckling than received from ingested milk; comprehend why receptive language development – typically learned by normal children prior to expressive language – is delayed first with cleft palate, and how this relates to the unique Eustachian tube and pathokinesiology of the middle ear. Understand the pathokinesiology of compensatory articulation by way of Passavant's hypertrophy either prior to or following palatine cleft surgery due to velopharygeal closure impairments.
Ranging from explanatory in-depth presentation on the use of grommets, audiological testing, psychosocial impacts of clefting, prosthetic treatment, dental problems faced by these children, and why dedicated cleft lip and palate teams are superseding traditional craniofacial surgical management of cleft lip and palate – the scope of this primer is up to professional standards. With details about the multitude of speech language pathology therapeutic intervention in detail for every type of cleft pathology, this invaluable resource and reference to the most common craniofacial anomaly is available now through EITTOC. This primer is a must read for all early intervention and pre-school therapists – speech language pathologists, audiologists, and speech teachers - who service the professional needs of the infant, toddler, and child with cleft lip &/or palate.
A child between the ages of 0-5 diagnosed with dysphagia is at increased risk for aspiration, necessitating the treating speech language pathologist or occupational therapist – in accordance with the State requirement for early intervention regulations – must be trained in both CPR as well as in the use of the Heimlich Maneuver for this population. Consequently, our EITTOC offers courses for both topics which are tailored specifically for professionals in the early intervention setting and pre-school. The same applies for a home feeding therapist and the need for proficiency in the use of an Epi-pen in the case of food allergies. Also, such a course such as Infection Control in the Early Intervention Setting is an appropriate course and directly applies to SLP’s and OT’s who practice oral motor/prompt, who must insert their hand into the child’s mouth.
The Pre-School Language Scale-5 (PLS-5) is a developmental norm-referenced assessment tool for a variety of functional and educational uses, including child assessment, evaluation, student academic placement, Individual Educational Plans (IEP’s), Individual Family Service Plans (IFSP’s), instructional planning, and to determine eligibility for early intervention and pre-school programs. Our on-line course will assist you and help ‘fast-track’ your learning curve, so that you will more easily learn about this valuable instrument and how best to apply it to the children under your care. Similar to a Monarch or Cliff notes-type review, our online course and certification provides the essential information in a condensed and more easily digestible format.
The Peabody Developmental Motor Test-2 Primer in Early Intervention and Pre-School: The Peabody Developmental Motor Test-2 is a developmental norm-referenced assessment tool for a variety of functional and educational uses, including child assessment, evaluation, student academic placement, Individual Educational Plans (IEP’s), Individual Family Service Plans (IFSP’s), instructional planning, and to determine eligibility for early intervention and pre-school programs. Our on-line course will assist you and help ‘fast-track’ your learning curve, so that you will more easily learn about this valuable instrument and how best to apply it to the children under your care whether your scope of practice is physical or occupational therapy. Similar to a Monarch or Cliff notes-type review, our online course and certification provides the essential information in a condensed and more easily digestible format.
A child with Erb’s palsy suffers from a host of upper extremity dysfunctions, and requires occupational therapy to facilitate maximal rehabilitation focused on adaptive and fine motor delays, as well as muscle strengthening, re-education, stretching, hand therapy, and a host of other treatment modalities for which the occupational or physical therapist, are primary interventionists, particularly in the early intervention based setting.
A 17 month old girl who underwent mandatory hearing screen at birth, qualified for speech therapy evaluation made by the only clinician in the home – a physical therapist referred to address the child’s gross motor inadequacies. Noting the infant’s diminished equilibrium and righting reactions, the physical therapist asked and learned from both parents that the child does not respond to her name when called, and cannot pronounce a single word. The physical therapist, in concordance with the evaluating speech therapist, recommended an audiological examination which revealed profound hearing loss likely because cytomegalovirus attacked the child’s auditory nerve after birth, rendering her cochlea useless – and hence her inability to hear, speak, or balance properly. However, because the child was referred for an implant immediately, she was able to undergo surgical implant. Because the child then received intensive speech language pathology prior to 24 months of age – she was able to learn to speak, and was spared being mute for the remainder of her life. Had not the physical therapist had the foreknowledge of types of hearing loss, as well as the rapidly closing window for a child’s ability to verbalize by age 24 months, the child might have become a lifelong mute.
While a course topic for speech language pathologists on the subject of 'Cleft Lip & Palate' is directly appropriate for educational study, other courses - as a function of evidence based practice and its integrative approach – are also appropriate for speech language pathology. These other courses – mandated by State regulations (see appendix) in the practice of servicing children between ages 0-3 are a uniquely offered pedagogal methodology by EITTOC:
- Down syndrome Primer - Children with Down syndrome often have a horizontal Eustachian tube, resulting in delays in both receptive and expressive language delays.
- Autism Primer - Children with Autism have near universal delays in communication, and pragmatic language disorder is now considered by DSM V as a separate, yet related, disease of autism.
- SIDS and Shaken Baby Syndrome Primer (respectively) - Because early intervention therapists have direct and early access to the homes of infants and toddlers, they can provide critical education to prevent SIDS, and alert others to situations where potential exists for shaken baby syndrome, and thereby effect life-saving change to families at risk.
- A course on torticollis indirectly relates to the practice of speech language pathology because untreated head-tilt sets into sequence a cascade of developmental delays in all domains – including receptive and expressive delays.
Because the funding source for early intervention and pre-school is the U.S. Department of Education, which emphasizes an educational model (and not a medical model), and embraces an integrative approach. Subsequently, an early intervention provider must – because of the baby’s unique needs, for example, neurological plasticity, and immunosupression –undergo training which includes a spectrum of educational courses, uniquely provided by EITTOC.
While the Individuals with Disabilities Act legislated “Early Intervention” into existence into 1999, over two decades have passed without any single organization fulfilling the needs of those professionals who service this population. EITTOC is an heuristic and didactic tool that is too long in coming, and its emergence onto the educational stage is a significant contribution to SLP’s and the many other professional disciplines which service children between the ages of 0-3, and its impact will carry-over into the lives of children & families, and better and more educated service providers provide early intervention in a way, hereunto, never existed. EITTOC’s courses emphasize the transdisciplinary approach characteristic of evidence based practice in a manner that no other resource does, specifically for the early intervention and pre-school setting.
