Experiences of cleft team speech-language pathologists in continuity of care: building relationships beyond broadcasting

Objective: This study investigated the experiences of cleft team speech-language pathologists (SLPs) in relation to continuity of care (CoC). The research aimed to understand the processes used to promote CoC, identify key barriers and facilitators, and examine how cleft team SLPs collaborate with community SLPs and parents. Design: A qualitative study using semi-structured interviews was conducted with Australian and New Zealand cleft team SLPs. Thematic analysis was used to identify key themes. Setting: The study focused on SLPs working within specialized multidisciplinary cleft teams in hospital settings across Australia and New Zealand, as well as their interactions with community-based SLPs and parents. Participants: Ten specialized cleft team SLPs participated in this study. Experience in speech-language pathology ranged from 8 to 47 years (mean = 23.5 years), and their experience in cleft services ranged from 3 to 29 years (mean = 15.4 years). Results: Six key themes were developed: (1) The Multifaceted Role of the cleft team SLP, (2) Ways We Communicate and Collaborate, (3) Our Relationships, (4) Community SLPs are Central, (5) Families are Key, and (6) The Landscape of Healthcare is Not Working. Conclusions: This study highlights the importance of relationships in promoting CoC for children with cleft palate. While cleft team SLPs provided education and support, communication was often one-directional. A co-facilitative model, fostering shared decision-making between cleft and community SLPs, could strengthen collaboration. Parents also play a key role as advocates and active participants in therapy. Strategies such as joint sessions, structured mentoring, and intentional follow-up may enhance engagement.