Study Sessions are included in registration and are open to all attendees, regardless of registration. Attendees are not guaranteed a spot in their first choice sessions.
Wednesday, April 10, 1:00 pm – 2:30 pm
Presenters: Kelly Nett Cordero, Angela Dixon, Kris Wilson, Adriane Baylis, Anna Thurmes Barigayomywe
Description: This study session will be interactive in format. The session will begin with definitions of the speech parameters, using audio and video speech samples to illustrate each parameter discussed. Attendees will be given the opportunity to rate these parameters in different samples, allowing time for discussion. To conclude, 1-3 case studies will be provided where attendees will have the opportunity to rate four main parameters at one time, consistent with the SLP’s role in the clinic setting.
Presenters: Megan Lane MD Katelyn G Bennet MD Christian J Vercler MD
Description: Description: In this presentation, we will use a case-based approach to present and discuss the ethical dilemmas common in cleft care and challenge the audience to address the ethical principles highlighted in each case. Multiple approaches of moral deliberation will be presented. The panel will then discuss the ethical principles highlighted in each case as well as touch upon the American Association of Pediatrics (AAP) guidelines on consent and assent. Following this discussion, the panel will open the floor up to members of the audience to discuss ethical issues and conflict faced in their own team settings with time for discussion and comment.
Presenters: Yong Jong Park, Michael Oppedisano, Joshua Stone
Description: Description: This study session will illustrate some of the prosthodontic dental needs of craniofacial patients, will discuss some of the access to care and funding issues related to dental treatment, and will present some cases describing the interdisciplinary coordination between the orthodontist and prosthodontist. Main objectives: 1. Each learner will be able to list the typical prosthodontic needs of craniofacial patients. 2. Each learner will understand that when working with a prosthodontist, the orthodontic treatment plan will likely be modified. 3. Each learner will be able to formulate a multidisciplinary treatment plan for comprehensive cleft/ craniofacial care
Presenters: Silvia Blemker Jamie Perry Catherine Pelland Vi Tran
Description: This panel will describe the state-of-the-art techniques in computational modeling and how models can be leveraged to inform clinical studies aimed to improve therapies and surgeries in cleft palate populations. Computational models use patient anatomy as input to create a finite-element mesh that represents the three-dimensional geometry of the velopharyngeal structures. The models include the biomechanical properties of muscle and soft tissues, and the models are then used to computationally simulate the in vivo function of the soft palate during speech. These simulations can then be analyzed to develop a better understanding of the biomechanical function of muscles in speech. Further, new simulations can be performed to test multiple what-if scenarios like how altering surgical approaches impacts patient anatomy and velopharyngeal function in speech. After providing an overview of the modeling process, we will first highlight our previous work in developing image-based computational models that reveal the functions of individual muscles of the soft palate. Subsequently, we will describe how these models have been used to understand how variations in anatomical features (both in typically developing children and children with cleft palate) influence closure biomechanics and speech function. We will finish by opening the floor to discussion and brainstorming for future work.
Presenters: Pravin Patel
Description: This study session will provide a comprehensive discussion focusing on dento-skeletal aspects from birth, through adulthood through an integrated surgical, dental, orthodontic and prosthodontic management. The session will focus on infant orthopedic appliances, timing of cleft alveolar bone grafting, indications for premaxillary repositioning, management of cleft orthognathic surgery, dental and orthodontic intervention and prothodontic management with osseointegrated implants and bridges. With over 2 decades of experience , emphasis will be placed on a thoughtful restrospective assessment, technical nuances, management of failures and complications from each specialty. The material will be presented in a lecture format, but with active open dialogue for audience participation. Audience members will gain an appreciation for an organized, concrete algorithm to managing the skeletal component of cleft deformity grounded in experience.
Presenters: Moderator: Sara Kinter, MA, CCC-SLP Panel: Kaylee Paulsgrove, MS, CCC-SLP; Craig Birgfeld, MD; Randall Bly, MD; Kelly Evans, MD
Description: This 90-minute panel will include a speech-language pathologist, plastic surgeon, otolaryngologist and pediatrician with experience treating children with complex craniofacial conditions. Panel will be moderated by a speech-language pathologist. Several cases involving complex decision-making around VPD management will be discussed. Key decision-making points for each case will be highlighted and discipline-specific insight will be shared. Following panel discussion, audience will be invited to comment/question regarding case. Information presented is meant to be of interest to SLPs, nurse coordinators, pediatricians, surgeons and any others involved in treating children with complex medical/craniofacial conditions. Attendees will be invited to submit their own case for discussion via the ACPA Online Community in advance of the annual meeting. Privacy requirements and a link to the HIPAA-compliant sharing platform will be provided at that time.
Presenters: Savannah Brown
Description: At our Tertiary Children’s Hospital Plastic Surgery Clinic, we have established a dedicated ear molding clinic. All patients referred with neonatal ear deformities are evaluated and, if appropriate treated either with the Earwell system, or more commonly with our technique combining custom molded dental clay secured to the ear using Micropore tape. Ear molding is reviewed, adjusted and reapplied every 3 weeks throughout treatment, and the treatment is undertaken by physician assistants. To date, 285 ears have been treated in 153 patients. Our patients’ age at treatment initiation ranged from 3 to 116 days old with median of 10 days old. We have evaluated our treatment outcomes to date by having 3 plastic surgeons rate the severity of ear deformity pre- and post-molding on review of standardized photographs of pairs of ears pre- and post-treatment. The evaluation was conducted using a 5-point Likert scale ranging from 1-Normal to 5-Severe. Incompletely treated or non-compliant patients were excluded. The mean pre-treatment deformity was 3.8 with a median of 4. There was significant improvement (p<0.01) from molding therapy with a post-treatment mean deformity of 1.9 (median 2). Overall, success rate was excellent with improvement noted in 99.0%, and 73.3% of ears were categorized as normal (severity rating of 1-2) following treatment. Outcomes were further stratified based on deformity subtypes and treatment age and will be presented. This practical, hands-on instructional course will review our treatment technique and algorithm, and will enable providers interested in developing an ear molding service to gain the skills necessary to undertake neonatal ear molding in a predictable and effective way. The course will include the use of flexible 3D printed models to enable participants to gain hands-on training in creating and applying the appropriate molds for a variety of ear deformities. On completion of this course, participants will be trained in and have practiced the skills necessary to undertake neonatal ear molding effectively and safely.
Thursday, April 11, 1:00 pm – 2:30 pm
Presenters: Kelly Nett Cordero, Angela Dixon, Kris Wilson, Adriane Baylis, Anna Thurmes Barigayomywe
Description: Similar to part 1, this study session will be interactive in format. Initially, time will be spent defining a variety of common articulation errors in children with cleft palate, using audio and video speech samples as illustrations. Attendees will be given the opportunity to rate these parameters in different samples, allowing time for discussion.
Presenters: Helen Sharp, Anne Hing, Loredana Cuglietta, David Wilson, Laura Garcia, Brittney Sprouse, Steven Goudy
Description: Description: This study session will be led by a moderator and six professionals each from a different discipline and each representing a different region of the US (Midwest, Southeast, California, Pacific Northwest) and Western Canada. Speakers will bring a broad perspective to address the variety of constraints that limit patient and family access to community-based services including lack of trained providers, economic, geographic, linguistic, and cultural barriers. Each speaker will each give a brief description of the: 1. specific barriers to follow up care in their region, for their team, and for their discipline, 2. strategies implemented, and 3. strengths and limitations to achieving optimal care for the children and families they serve. The moderator will facilitate a participant discussion of common themes and identification of additional strategies and solutions.
Presenters: Ann W. Kummer, PhD, CCC-SLP, FASHA
Description: In this study session, the presenter will discuss the basic techniques of nasopharyngoscopy and also describe some tips and tricks to elicit necessary cooperation from very young children. The presenter will then explain how nasopharyngoscopy can be used to determine the size, shape, location, and cause of the velopharyngeal opening. Numerous short videos of nasopharyngoscopy examinations will be presented for participants to evaluate and discuss. The presenter will describe how the nasopharyngoscopy findings can be used to determine which surgical procedure has the best chance of a successful outcome for the patient. Finally, the presenter will discuss how nasopharyngoscopy can be used to evaluate secondary surgery for velopharyngeal insufficiency in order to develop appropriate strategies for revision, when necessary.
Presenters: Ms. Rosemary Seelaus Dr. Janine Rosenberg Dr. Pravin Patel
Description: Lecture Slides and Video
Presenters: Oksana Jackson, Emily Gallagher, Jill Arganbright, Daniela Schweitzer, Donna McDonald-McGinn, Courtney Hall, Susan Hughes, Alexis Johns, Kaylee Paulsgrove, Adriane Baylis
Description: ACPA’s 22q Special Interest Group offers this session which will follow a ‘show and tell’ approach with contributions from five 22q teams from across the Unites States. Each 22q team will present the structure and format of their team including specialist composition, clinic format, care coordination strategies, team conferencing, as well as approaches to patient education and outreach. In addition, the presentation will include discussion of several complex clinical scenarios that providers manage for children with 22q11.2DS. Topics will include management of clefting and VPD, perioperative management, evaluation and support of learning needs, assessment and counseling of psychological/psychiatric disorders, and overall care coordination challenges. This presentation will be informative to centers instituting new 22q teams, as well as clinicians from various specialties who participate in management of these patients from infancy through adulthood.
Presenters: John Girotto, John Polley, Deji Fashemo, Kongkrit Chaiyasasate, Ann Schwentker
Description: This upper level course will start with a brief discussion of HFM and its etiology. We will then review our extensive experience with distraction osteogenisis. Emphasis will be placed on long term follow up and the significant relapse that is experienced with these unique patients. For patients with class IIB and III HFM, we will present our techniques for customized TMJ reconstruction. The role of orthodontic coordination is emphasized. Goals of orthodontic care at various ages will be discussed. The soft tissue envelope will be addressed next. Comparisons between microsurgical interventions and fat grafting will be presented. Finally, our preferred method for autologous ear reconstruction and the unique technical challenges of the patient with HFM are reviewed. Objectives: Attendees will: Explore traditional treatment options and their shortcomings. Understand the significance of relapse following distraction. Gain new knowledge regarding patient specific/customized prosthetic TMJ. Be able to discuss the pros and cons of soft tissue reconstruction methods. Understand the various stages of orthodontic treatment. Construct a surgical algorithm for timing/sequence of treatment in HFM.