CRANIOFACIAL RESEARCH

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这项提案的目标是开发一个多学科的唇裂和颅面部疾病项目，在该项目中，夏威夷的儿童可以从出生到成年进行跟踪。该诊所的研究目标源于研究独特的儿科人群的机会。在近代历史上，夏威夷的每一位唇腭裂患者都没有在同一个多学科团队中得到过服务。一般的做法是将主治医生转介给几名成年整形外科医生之一进行初步修复和重建，并对门诊进行零星的随访。牙科和正畸通常不包括在这些转诊中。虽然许多人由卫生署特殊健康需要处的一名护士病例经理和社会工作者跟踪，但许多人在系统中迷失了方向，没有得到足够的听力和言语跟进。据推测，该诊所的成立将改善对这些婴儿和儿童的全球医疗保健，首先通过积极的喂养评估和康复护理改善生长和发育。改进的听力筛查和听力损失治疗将包括在内，并在需要时进行言语和语言评估和治疗。这些因素共同改善了这些儿童在出生后头两年的神经发育评估中的认知结果。在持续的照顾下，这些儿童的语言和语言技能将有所提高，从而更好地融入主流学校系统。这将导致儿童随着年龄的增长在学习成绩、日常生活功能和自我概念方面的改善，这是通过与儿童健康相关的生活质量问卷来衡量的。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The goal of this proposal is to develop a multidisciplinary cleft and craniofacial disorders program where children in Hawaii can be followed from birth through adulthood. The research goals of this clinic stem from the opportunity to study a unique pediatric population. At no time in recent history has every cleft lip/palate patient in Hawaii been serviced within the same multidisciplinary team. The general practice has been primary physician referral to one of several adult plastic surgeons for initial repair and reconstruction, with fragmented outpatient follow-up. Dentistry and orthodontics are often not included in these referrals. Although many are followed by a nurse case manager and social worker from the DOH Special Health Needs Division, many are lost in the system and receive inadequate hearing and speech follow-up. It is hypothesized that the formation of this clinic will result in improved global medical care for these infants and children, beginning with improved growth and development via aggressive feeding evaluations and rehabilitation care. Improved hearing screening and treatment of hearing loss will be included, with speech and language evaluation and therapy when needed. These together should improve cognitive outcomes in these children as measured in neurodevelopmental assessments in the first two years of life. With continued care these children will have improved speech and language skills, improving integration into mainstream school systems. This will lead to improvements in school outcomes, function in daily living and self-concept as the child ages, as measured by a Pediatric Health-Related Quality of Life Inventory.