Why Choose an ACPA-Accredited Cleft Team?

A cleft palate is a complex condition that requires care from multiple specialists from birth through young adulthood. When deciding where to treat your child, it is natural to wonder whether the hassle of traveling to a specialized, American Cleft Palate-Craniofacial Association (ACPA) accredited team is worth it, or if local doctors can handle the surgeries.

While local doctors may be highly skilled, research shows that traveling to an ACPA-accredited multidisciplinary cleft team is generally associated with the best long-term health outcomes for your child. Care at a centralized, high-volume cleft center is associated with significantly fewer complications, a lower need for secondary operations, and better long-term speech outcomes compared to fragmented, uncoordinated local care ^[1][2][3].

What is the “Burden of Care”?

In medical research, the burden of care refers to the total physical, emotional, financial, and logistical toll a medical condition takes on a patient and their family. For a child with a cleft palate, this includes countless appointments for surgery, speech therapy, dental care, and hearing tests.

When care is handled locally by separate, uncoordinated providers—often called “piecemeal care”—families end up with more individual appointments and a higher overall burden of care ^[4]. An ACPA-accredited team is explicitly designed to reduce this burden by centralizing and coordinating your child’s complex longitudinal needs ^[5][6].

A multidisciplinary team typically includes a plastic surgeon, an ENT (ear, nose, and throat doctor), a speech-language pathologist, an orthodontist, an audiologist, and a social worker or care coordinator. During a “Team Day” at an accredited center, your child will often see all of these specialists in a single visit. While these days can be long and exhausting, they prevent you from having to schedule and travel to a half-dozen separate appointments over the course of a month.

The Power of Coordinated Surgery

One of the most significant benefits of an accredited cleft team is the ability to combine procedures under a single general anesthesia session. Children with a cleft palate frequently experience middle ear fluid buildup, requiring the placement of tympanostomy tubes (ear tubes) to prevent hearing loss.

In an uncoordinated system, your child might have to undergo one surgery with a local ENT for the ear tubes, and another separate surgery months later with a plastic surgeon for the palate repair. A multidisciplinary cleft team coordinates these specialists to perform both the ear tube placement and the primary palate repair simultaneously ^[7]. This approach minimizes your child’s exposure to anesthesia, reduces the number of hospital visits, and lowers the overall trauma and recovery time ^[8][9].

High-Volume Expertise Means Better Outcomes

Cleft palate repair is a highly specialized surgery. Surgeons on ACPA-accredited teams generally perform a high volume of these specific repairs every year. High-volume cleft centers have been shown to significantly reduce the odds of complications and lower the likelihood that a child will need reoperations (additional surgeries to fix issues like fistulas or speech problems) later in life ^[3][10]. For example, early and expertly coordinated palate repair is associated with a significantly reduced need for future surgeries to correct velopharyngeal insufficiency (VPI), a condition where the palate does not close properly during speech ^[11][12].

Partnering with Your Local Doctor

A common worry for parents traveling for care is what to do during an emergency or routine illness. If your child gets an ear infection or a fever while you are hours away from the cleft team, you will not have to drive back to the specialized center. ACPA teams are designed to collaborate with your local pediatrician. Your local doctor will handle everyday illnesses, while the specialized team manages the cleft-specific care. Many cleft centers now also offer telehealth or virtual visits for speech therapy evaluations and routine follow-ups, which can significantly cut down on travel time.

Balancing the Travel

There is no denying that traveling to a specialized center adds its own logistical hardship, including transportation, lodging, and taking time off work. Studies acknowledge that distance can be a real barrier for families ^[13][14]. However, the comprehensive emotional support, predictable surgical outcomes, and long-term benefits in speech and hearing provided by an accredited team often outweigh the upfront inconvenience of travel ^[15][16]. Most ACPA centers also offer dedicated social workers to help families navigate travel logistics, coordinate with organizations like the Ronald McDonald House, and find financial assistance.

To find an accredited cleft team near you, you can search the interactive directory on the official American Cleft Palate-Craniofacial Association (ACPA) website.