2025 BMJ case reports

Remote guidance: enabling tele-supervised community-based rehabilitation worker intervention to facilitate communication in a child with cleft lip and palate.

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BMJ case reports Vol. 18 (1) • Jan 2025

Cleft lip and palate (CLP) significantly impact speech and language development in children. In remote areas, access to specialised services is often limited, necessitating innovative approaches for effective service delivery. This case report explores the potential of tele-supervised intervention provided by community-based rehabilitation workers (CBRWs) to enhance communication outcomes for children with CLP. A comprehensive therapy programme was developed, targeting the child's speech needs and led by a CBRW under remote supervision from speech-language pathologists (SLPs). The SLPs provided real-time guidance to the CBRWs in stimulus selection, trial administration, response monitoring and reinforcement strategies. The tele-supervised intervention led to significant improvement in the child's communication outcomes by encouraging active participation and correct exercise execution. This approach also enhanced service delivery in remote areas by improving access to specialised services, building the capacity of local healthcare providers and facilitating ongoing professional development.

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