Community-based model for speech therapy in Thailand: implementation.

OBJECTIVES To establish a Community-Based Model for Speech Therapy in Thailand and to implement it. MATERIALS AND METHOD The development of a Community-Based Model for Speech Therapy was based on the principles of primary healthcare, community-based rehabilitation and institutional sharing. Workshops for speech and language pathologists (SLPs), including "Training for Trainers" and six "Smart Smile & Speech" workshops were held. We held 1) a workshop for training SLPs in how to manage speech and language problems in cleft lip and palate (CLP); 2) a workshop for training healthcare providers who are not speech and language pathologists (para-speech and language pathologists: para-SLPs) how to identify speech, language and hearing problems in CLP and undertake early intervention; and, 3) four speech camps for continuing education via life demonstration and practice. RESULTS Standard guidelines were produced for SLPs to remedy speech and language disorders in children with CLP in Thailand and para-SLP manuals for speech and language intervention for CLP were developed. Para-SLPs will be better equipped to identify and then provide early intervention for individuals with CLP, as well as to refer children with CLP and complicated speech and language disorders to speech clinics for the further management. Percentage of agreement among SLP, audiologists and para-SLPs ranged 50-93.33 while the Kappa coefficients ranged -0.07 to 0.86. CONCLUSION The Community-Based Model for Speech Therapy for Children with CLP was an appropriate approach for coming up with solutions for the lack of speech services for children with CLP in Thailand.