Background: There is a critical need for speech therapy services for people born with cleft lip and/or palate in developing countries. Objective: Assess the effectiveness of a speech camp and follow-up session for children with cleft lip and/or palate. Methods: A Community-Based Model for Speech therapy was implemented at Suwanaphum Hospital District, Roiet, Thailand. Thirteen children with cleft lip and/or palate (3; 6-13 years) attended a four-day speech camp and a one-day follow-up session (six months later) for remediation of their articulation disorders. Paraprofessional training was also provided. Pre- and post-tests were administered to the participants, caregivers, and paraprofessionals to determine the effectiveness of the program. A pre- and post-articulation test, as well as an audiological evaluation were administered. Five speech and language pathologists provided speech therapy, both individual and group, for a total of 18 hours during the four-day speech camp and six hours in the one-day follow-up session. The median difference of the number of articulation errors was determined by results of the Wilcoxon Signed-Rank Test. Results: There was a significant decrease in articulation errors following both the main speech camp and the follow-up session (z = 3.11, p < 0.01; z = 2.87, p<0.01, respectively). Caregivers’ and health care providers’ satisfaction ratings for participation in the speech camps ranged from good to excellent. Conclusion: A Community-Based Model of both a speech camp and follow-up session provided an effective speech therapy treatment for children with cleft lip and/or palate.
Cells in the main cuneate nucleus (MCN) are known to provide a direct projection to the cerebellum, but the precise nature of the information these cells transmit to the cerebellum is unknown. The present study employed anatomical and electrophysiological procedures to determine the location of cuneocerebellar cells in the MCN, and their somatosensory properties in the rat. The location of neurones projecting to the cerebellum was determined with injections of the retrograde tracers, horseradish peroxidase or Fluoro-Gold in vermal and paravermal regions of the cerebellum. Topographically, the majority of retrogradely labelled cells in the MCN were found to lie primarily ventrolateral in the nucleus and rostral to the level of the obex. Single unit recordings from 69 well characterized MCN cells, identified as projection cells by antidromic activation from stimulation of the inferior cerebellar peduncle, were classified according to their responses to cutaneous stimulation and manipulation of joints and muscles. A slight majority of cells (37.7%) responded only to manipulation/stimulation of joints, and 30.4% of cells responded only to cutaneous stimulation. The remaining cells received convergent input from joint and cutaneous receptors. Cutaneous responsive cells all rapidly adapted to maintained stimuli, and had large receptive fields (RFs) that were generally located over the joints. These cells could be activated by passive movements of the forelimb that deformed the RF. They only discharged during movements and were silent during maintained limb positions. Cells responsive to punctate mechanical stimuli applied to the joint capsules, responded to passive movements of the forelimb, but typically only discharged towards the limits of joint movement, and adapted within a few seconds. Once adapted, small perturbations of joint position resulted in vigorous dynamic responses. The results indicate that the neurones in the MCN of the rat which project directly to the cerebellum are localized in the rostral half of the nucleus. They transmit predominantly dynamic information from joint and cutaneous receptors that are likely to be normally activated as a result of limb movements. These cells could signal information about evolving movements or disturbances of forelimb posture or stance.
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