Treating What Children Know as Themselves

Seattle Children's Craniofacial Center: Treating What Children Know as Themselves

Richard Hopper and Dr. Michael Cunningham

Leading Children’s Craniofacial Center are Dr. Richard Hopper, surgical director (left), and Dr. Michael Cunningham, medical director.

The very nature of craniofacial conditions poses an interesting challenge in medicine. Whether an isolated malformation, like simple craniosynostosis, or part of a more complex multisystem genetic syndrome, like Apert syndrome, craniofacial issues require care that crosses traditional medical specialties and academic disciplines.

To meet the range of needs presented by children with abnormalities of the head and neck, Seattle Children’s Craniofacial Center brings together 48 team members from 19 distinct disciplines — from plastic surgery to speech pathology.

An Interdisciplinary Approach

Rather than a loosely affiliated group of specialists that see the same patients on different days in different clinics, members of Children’s craniofacial team work together and see patients together. Each child is assigned a core team that includes a pediatrician who oversees the child’s care, as well as surgeons, dentists, orthodontists, nurses and social workers. A wealth of other specialists is available to help as needed. The team meets weekly to map out the best plan of care for each child on their panel, and follows the child until age 21 or until the child graduates from the program.

“Having a pediatrician coordinate care makes a difference,” says Dr. Michael Cunningham, the center’s medical director. “We take a holistic approach and care for the entire patient, not just the condition. That means caring for the medical and surgical needs of each child in the context of their family and community.

“Our team members have different strengths, but shared goals. We all want to do what’s in the best interest of the child. When our team meets, everyone’s input counts. A patient may be scheduled for a surgery or a procedure, but if a social worker says ‘I don’t think this patient or family is ready,’ the plan is adjusted until it fits the family’s unique situation.”

National peer organizations have praised the center as a model for addressing the interrelated medical, surgical and social issues presented by patients with craniofacial abnormalities. Recognized as one of the busiest craniofacial programs in the nation, providers at Children’s Craniofacial Center are available to see an average of 60 patients on a typical clinic day.

A Focus on Research

The Division of Craniofacial Medicine was created within the University of Washington’s Department of Pediatrics in 2005. Currently composed of pediatricians and basic scientists with expertise in genetics, epidemiology and developmental biology, the division is poised to make significant research contributions in the field. This interdisciplinary division allows its members to address shared clinical and research challenges from different perspectives — in much the same way the Craniofacial Center functions, but on a larger scale.

The Center for Craniofacial Research is working to answer several important questions: What are the molecular, genetic and environmental causes for the conditions we treat? What are the outcomes of the treatments we provide? What are the social and psychological ramifications of being a young child or teenager with a facial difference?

This interdisciplinary approach to research will allow close working relationships needed by physicians and scientists to ask the most critical questions, while having the intellectual resources available to find important answers. The significance of these answers is more than just academic.

“Craniofacial conditions get right to the heart of a child’s identity,” Cunningham notes. “If you were asked to identify three photos — one of your hand, one of your shoulder and one of your face — you would undoubtedly reply ‘my hand,’ ‘my shoulder’ and ‘me.’ We treat what children will come to know as themselves.”

Learn more about craniofacial research at Seattle Children's.