Khon Kaen: a community-based speech therapy model for an area lacking in speech services for clefts.

Absence of speech rehabilitation services is one of the critical difficulties in care for clefts in Thailand and some other developing countries. The objective of this study was to determine the effectiveness of the "Khon Kaen Community-Based Speech Therapy Model" in decreasing the number of articulation defects in children with cleft palate and/or lip. Sixteen children with cleft palate and/or lip in 6 districts of Maha Sarakham Province were enrolled for study. A three-day intensive speech camp was held in Srinagarind Hospital and followed by an outreach program of six one-day follow-up speech camps in Maha Sarakham Hospital. Six paraprofessionals, speech assistants, provided home- or community- based speech correction every week for one year. Numbers of various articulation errors were compared pre- and post-treatment using the Wilcoxon signed-rank test. The number of articulation defects showed a statistically significant reduction (mean difference = 10; Z = -3.52; p < 0.001; 95% CI: 8-13). The "Khon Kaen Community-Based Speech Therapy Model" is one of the best models for solving speech therapy problems in areas of Thailand lacking speech services and can be applied to other developing countries.