Speech Therapy

Expect to meet with the speech-language pathologist before your child’s cleft palate surgery (about 7-9 months) to review the impact of the palate on speech and what to expect in speech development after surgery. An overview of treatment and ways to stimulate speech and language development will be discussed. After the cleft palate surgery, the speech-language pathologist will continue to closely monitor your child’s speech and language and recommend therapy if needed.

Some kids with cleft palate will not require speech therapy after cleft palate repair. Others will have abnormal speech and will need intervention. After cleft palate repair, about 15-20% will have hypernasal speech and may require additional surgery or other forms of management to improve speech. Although surgery might improve nasality, it may not result in immediate correction of certain speech errors and speech therapy might be needed.

Some kids may require speech therapy for speech problems unrelated to the cleft. Whether or not your child will depends on the results of a detailed evaluation done by a certified speech-language pathologist.

• A cleft lip is evident by a narrow gap in the skin of a child’s upper lip that goes to the base of his nose. It is a condition that may be detected during a prenatal ultrasound. According to Kids Health, cleft lip is more common among boys than girls. Cleft lip alters his appearance, which can result in self-esteem issues. It has commonly been referred to as harelip.

Cleft Palate

• A cleft palate is a gap between a child’s nasal cavity and the roof of her mouth. It may run from the front to the rear of the palate or may be only a partial cleft. According to Kids Health, this condition is more common among girls, and in many cases they do not have a cleft lip along with it.

Causes

• According to Kids Health, the cause of cleft lip or palate is not known, but it is thought that it may be influenced by genetic and environmental conditions. Environmental factors can include illnesses, drugs and the use of tobacco or alcohol during pregnancy. There is a higher risk for your child to be born with a cleft if you have a family history of the condition, or if you have other children that were born with clefts.

Complications

• Complications of cleft lip or palate include hearing loss, speech defects and middle ear infections. Because the cleft may prevent the child’s eustachian tubes from draining fluid from his middle ear properly, the fluid accumulates and can develop into an infection. There may be dental problems as well, including missing teeth, malformed or displaced teeth, cavities or extra teeth. Feeding an infant with a cleft lip or palate can also be difficult. Special equipment and nipples are available to help with this problem.

Treatment

• Treatment for cleft lip or palate is reconstructive surgery and, in some cases, plastic surgery to help with the child’s appearance. It usually takes place between three and six months of age for cleft lip and between nine and 14 months for cleft palate. The treatment and surgical team may involve an otolaryngologist (ear, nose and throat doctor), an oral surgeon, a plastic surgeon, an orthodontist, a dentist, an audiologist, a nurse coordinator, a speech pathologist and a psychologist. These specialists will monitor the child’s progress, including the areas of speech, hearing, nutrition, emotional state and dental health.

Considerations

• Dental work and orthodontia may be necessary for the alignment of the child’s teeth and to attend to gaps in his teeth. He may also need speech therapy to develop his communication skills. You can expect the child to have emotional and social issues due to his appearance. If you have a child with these problems, you may find psychological counseling necessary for emotional support. The Cleft Palate Foundation offers information and education regarding cleft lip and palate.

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Carter and Mason Osborne have a lot in common. Not only are they brothers who love to laugh, they also share one unique characteristic; they were born with forms of cleft lip and palate…
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