A brief overview of adolescents and young adults with CLP and their multidisciplinary needs will be presented and a service delivery model for transition of care described (Vallino & Louw, 2017). The key components of the clinical toolbox to be discussed are: 1) communication strategies and styles with adolescents and young adults, 2) practical strategies for preparing and supporting the adolescent, young adult, and their families for the transition of care, 3) tips for developing self-management of health through health education and health promotion, 4) assessments and protocols as outcome indicators incorporating the domains of the ICF with an emphasis on self-report to gain a holistic perspective of function and QOL, and 5) outcome indicators of transition of care for individuals with CLP.

Background and purpose: For many young adults with cleft lip and palate (CLP), traditional team services come to an abrupt end at age 18, necessitating a transition from child-centered to adult-centered care. 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. Transition also befalls the parents and team providers. We propose an evidence-based person-centered delivery model of care using the concepts of the International Classification of Functioning, Disability, and Health (ICF) (WHO, 2001, 2004). The ICF represents a shift from health condition and body impairment-centered descriptions of disability to a more comprehensive documentation, including a wider range of functionality indicators. This model of Transition of Care is proposed to facilitate a positive shift from pediatric to adult-centered care. It is timely for teams to embrace the concept of transition of care, and to provide services that recognize the importance of personal and environmental factors in facilitating holistic transition planning and service delivery (ICF, WHO, 2001), which are developmentally appropriate to young adults with CLP (Farre & McDonagh, 2017; Farre et al., 2016).The purpose of this proposed evidence based model is to provide a framework for redesigning the way services are delivered to a young adult with CLP. The concepts of this model are relevant to all specialists on the cleft palate team. The aim of this presentation is to create an awareness of young adults with CL/P who are generally a neglected population in terms of team care and to suggest a new and fresh approach to service delivery to these individuals with the emphasis on clinical resources.Content: A brief overview of adolescents and young adults with CLP and their multidisciplinary needs will be presented. A framework for a holistic service delivery model developed by Vallino and Louw (2017) will be presented. We will suggest strategies for teams to improve the care for young adults with CLP and share a clinical toolbox comprised of a compendium of resources.Conclusion: The proposed Service Delivery Model for young adults with CLP necessitates a change in perspective that embraces constructs such as person-centered care in order to ensure the best outcomes for these individuals. These concepts can be applied by all cleft palate team members. Adopting a life span perspective reinforces the understanding that living with and managing CLP is dynamic and that transition is a process rather than a point in a person's life.

Objective: The purpose of this study was to identify the perceptions of students majoring in vocal music and theatre, regarding the instruction they received in their undergraduate curriculum on vocal health education. Research questions focused on perceptions of: (a) vocal hygiene strategies, (b) the connection between the speaking and singing voice, (c) vocal rehabilitation and the professionals to contact and (d) students’ level of trust for their voice teacher. Methods: A descriptive research design with qualitative analysis was used to explore the research questions. A survey was developed by adapting questions from a similar study by Beeman (2016). Permission was granted for the adaption by the author. The survey went through two stages of review and revision by an expert panel of professionals across vocal music and theatre, followed by a pilot study of 13 undergraduate vocal music majors. The final survey contained 57 items, incorporating two forms of questions, a 6-point Likert scale and multiple choice. It was disseminated to undergraduate vocal music and theatre majors across the United States via Survey Monkey TM. Results: Students reported receiving knowledge on vocal health from their voice teachers and implementing it. However, they indicated low levels of compliance for specific vocal hygiene parameters. Additionally, students recognized the connection between the singing and speaking voice, they were unclear of the role of the speech-language pathologist in voice care, and they indicated trust in their voice teacher as it pertained to their voice and personal life. Conclusions: A new approach to promote understanding and compliance of voice care strategies needs to be implemented in the undergraduate setting. Connecting both performance majors and speech-language pathology majors in an interprofessional education collaboration may prove to be mutually beneficial to both the clinician and the performer

Objective: Although tinnitus is one of the most commonly reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related to accessibility of care and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence-based interventions are necessary. Internet-based cognitive behavioral therapy (ICBT) demonstrates potential as a means of delivering this support but is not currently available in the United States. This article discusses the adaptation of an ICBT intervention, originally used in Sweden, Germany, and the United Kingdom, for delivery in the United States. The aim of this study was to (a) modify the web platform's features to suit a U.S. population, (b) adapt its functionality to comply with regulatory aspects, and (c) evaluate the credibility and acceptability of the ICBT intervention from the perspective of health care professionals and patients with bothersome tinnitus. Materials/Method:Initially, the iTerapi ePlatform developed in Sweden was adopted for use in the United States. Functional adaptations followed to ensure that the platform's functional and security features complied with both institutional and governmental regulations and that it was suitable for a U.S. population. Following these adaptations, credibility and acceptance of the materials were evaluated by both health care professionals (n = 11) and patients with bothersome tinnitus (n = 8). Results:Software safety and compliance regulatory assessments were met. Health care professionals and patients reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability, and exercises provided in the ICBT platform. Modifications to the features and functionality of the platform were made according to user feedback. Conclusions:Ensuring that the ePlatform employed the appropriate features and functionalities for the intended population was essential to developing the Internet-based interventions. The favorable user evaluations indicated that the intervention materials were appropriate for the tinnitus population in the United States.

An Internet-based tinnitus intervention for use in the USA can address barriers that weaken the provision of tinnitus-related services. Although such interventions exist, their suitability for this population was questioned. The aim of this study was to adapt an Internet-based cognitive behavioural therapy intervention (ICBT) for tinnitus to ensure its utility for a US population. The study objectives were to ensure the program’s accessibility in terms of readability, language, and cultural appropriateness. Methods: The intervention materials were redesigned and simplified to support use by a novel patient group. Readability Studio was used to evaluate reading levels using six different formula. Cultural and linguistic adaptions were identified by clinicians in the USA. Accessibility was further enhanced as the intervention materials were translated into Spanish. Results: Accessibility measures ensured all chapters had readability levels of between Grades 5-6. Cultural and linguistic adaptations were made in terms of content, vocabulary, and spelling. To improve patient engagement, adaptions were made to the interactive elements, goal setting and worksheets. Conclusion: Internet intervention materials were revised to adhere to best practice guidelines. Further studies should determine whether these changes improved self-efficacy, engagement, and aided motivation to complete the intervention.

Objectives: Although tinnitus is one of the most commonly-reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related accessibility of care, and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence- based interventions are necessary. This presentation focuses on the adaptation of an Internet-based Cognitive Behavioral Therapy (ICBT) intervention, originally used in Sweden and in the UK, for individuals with tinnitus in the United States. Elements of the ICBT program requiring consideration included (a) adaptations to the platform’s features and functionalities, (b) translation into Spanish to extend the reach of the program (c) user acceptability and satisfaction of the program, (d) outcomes from a pilot trial from which it was hypothesized that patients would demonstrate a reduction in tinnitus distress and associated difficulties as measures using standardized self-reported outcome measures, and (e) discussion of the relative merits and appropriateness of the intervention. Design: The iTerapi platform developed in Sweden was adopted for use in the US. The platform required functional and security features modifications to confirm its compliance with both institutional and governmental regulations, and to ensure it was suitable for the US population. Acceptability and suitability of the materials were evaluated by both hearing healthcare professionals (n=11) andindividuals with tinnitus (n=8). A pilot study followed as adults with bothersome tinnitus completed the 8-week program (n=30). Results: Cultural adaptations included word substitutions, adapting counseling examples for a US population, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured the suitability of the chapters. Literacy level analysis confirmed all chapters were within the guidelines to be below the 6th grade level for readability. Healthcare professionals and individuals with tinnitus reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability and exercises provided in the ICBT platform. Preliminary analyses of pilot data indicated a reduction in tinnitus distress and associated difficulties (i.e., anxiety, depression, insomnia) and an improvement in quality of life. Conclusions: Ensuring that the ePlatform offers the appropriate features and functionalities for the intended population is an essential part of developing Internet-based intervention. The user evaluations and pilot trial outcomes indicated that clinical trials can be performed to assess the effectiveness of ICBT for tinnitus in the US.

Purpose: An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitus-related services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this study was to improve the cultural and linguistic suitability, and lower the readability level, of an existing program for tinnitus to ensure its suitability for U.S. English- and Spanish-speaking populations. Method: Guidelines for adaptation were followed and involved four phases: (a) cultural adaptations, as interventions targeted at specific cultures have been shown to improve outcomes; (b) creating Spanish materials to improve access of the materials to the large Spanish-speaking population in the United States; (c) professional review of the materials for acceptability as an intervention tool for a U.S. population; and (d) literacy-level adjustments to make the content accessible to those with lower levels of health literacy skills. Results: Cultural adaptations were made by using word substitutions, changing examples, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured suitability of the chapters. Literacy-level adjustments ensured all chapters were within the guidelines for readability grade levels below the sixth-grade level. Conclusions: The previously developed tinnitus materials were revised to adhere to best practice guidelines and ensure cultural suitability for adults with tinnitus in the United States. As it is also available in Spanish, members of the large Hispanic community also have access to the intervention in their first language. Further studies should determine whether these changes improve patients' self-efficacy, engagement, and motivation to complete the intervention.

No description available.

Objective: The objective of this study was to improve the range of standardised tinnitus Spanish Patient-Reported Outcome Measures (PROMS) available by translating and ensuring cross-cultural adaptation of three English PROMs to Spanish. Design: The Tinnitus and Hearing Survey, Tinnitus Cognition Questionnaire, and Tinnitus Qualities Questionnaire were translated to Spanish using recently established good practice guidelines. Study sample: The translation process addressed 22 items included in six main steps specified in the guidelines. The translated PROMs were field tested on a sample of tinnitus patients who were recruited through convenience sampling using cognitive debriefing (n = 5) and pilot testing (n = 10) methods. Results: The translation process employed the required steps and provided specific details about the process and procedures. In addition, practical issues encountered while translating and adapting the questionnaires that may influence future translations were revealed. Conclusions: This is the first account of translating and adapting PROMs from one language to another using the good practice guidelines specific to hearing-related questionnaires. Following the rigorous procedures should ensure that the translated PROMs have linguistic and cultural equivalence to the original versions, although psychometric evaluation would remain necessary to confirm the functional equivalence.

Speech-Language Pathologists provide services to youth with Down syndrome. The purpose of this study was to (a) determine if parents are aware that speech-language pathologists can provide services to prepare their children for secondary transition; (b) identify the parents’ perceptions of the services provided by speech-language pathologists; and (c) determine if in the parents’ opinion, the speech-language pathologist provided a vital role in preparing their child for transition. Using nonprobability snowball sampling, this cross-sectional mixed-method survey study included 85 parents of youth (ages 14-22) with Down syndrome across the United States. Parents rated their experiences and described their beliefs and perceived helpfulness toward their child’s SLP(s) regarding secondary transition. To identify further thoughts regarding parents’ perceptions of their engagement in the transition process, deductive, inductive, and thematic analysis of two open-ended questions uncovered three themes of responses pertaining to SLPs in secondary transition services, noted as satisfied, career, and unsatisfactory.