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

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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.

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