a girl with a cleft palate looking at the camera

The Role of Speech Therapy in Cleft Palate Rehabilitation

About Cleft Lip and Palate

The term ‘cleft’ means ‘split,’ so a cleft lip is a split in the lip, whereas ‘cleft palate’ refers to an opening in the front area of the roof of the mouth. This front area is known as the bony hard palate, and the back part is known as the soft palate, which is made up of muscle. Cleft palates and lips develop during pregnancy. Adults can also be affected by cleft lip and palate, particularly if the condition isn’t identified and addressed in childhood.

An individual can have a cleft palate, cleft lip, or both. A cleft lip can occur on one or both sides of the upper lip, and in some cases, the split may also be in the gum and upper jaw. Clefts can occur anywhere on the palate or lip, and it is possible to have a submucous or invisible cleft palate. This occurs when tissue, known as the mucous membrane, covers the cleft. This is the pink tissue that is visible in our mouths. In these cases, the cleft may be difficult to see, and the individual may not know it is there.

Cleft lips and palates can significantly impact the clarity and fluency of speech. Speech therapy for cleft lip or palate can help to improve speech in children, teens, and adults affected by this condition. If you think you or a loved one would benefit from speech therapy, get started by scheduling your free introductory call today!

What Causes A Cleft Lip or Palate?

A cleft lip or palate occurs very early in the mother’s pregnancy, and the cause is still unknown. Some of the potential contributing factors include:

Genetics
Smoking tobacco during pregnancy
Untreated diabetes during pregnancy
Drug or alcohol consumption during pregnancy
Use of certain medicines during pregnancy
Improper prenatal healthcare

Testing Speech and Hearing Differences

Testing for speech and/or hearing problems as a result of a cleft lip or palate is often performed by a team of healthcare professionals and therapists. A team of physicians, therapists, and other medical professionals will work collaboratively with the individual, as well as their loved ones and caregivers, to identify the following:

The type of cleft
If speech and/or hearing are affected, and if so, how severely
The types of therapies and other interventions that will be beneficial

In many cases, speech testing is done in early childhood when speech difficulties are first identified. A speech and language pathologist can assess articulation ability and determine whether the child may potentially have a cleft palate.

Testing also often includes hearing assessments that are conducted by an audiologist. This is particularly important should the child experience chronic or frequent ear infections or have excess fluid in the ears (this occurs often in individuals with a cleft palate). An audiologist may choose to routinely monitor the hearing status of an individual with cleft lip and/or palate, particularly from birth to age 6.

If you or someone close to you might benefit from speech therapy, don’t wait to seek support. Get started with Great Speech by scheduling your free introductory call today!

How Does a Cleft Affect Speech?

A cleft can affect speech and communication skills in a wide variety of ways. There is significant variation in how children with a cleft develop their speech skills and processes, and the severity of the cleft is not always a good indicator of communication skills. Often, it doesn’t become clear how a child’s speech will be affected until they begin to speak.

Children with a cleft affecting their soft palate may experience difficulties with speech that include a very ‘nasal’ sounding speaking voice. This is the result of the soft palate being unable to properly seal off the mouth from the nose when speaking and as a result, air escapes through the nose. This is referred to as velopharyngeal impairment (VPI).

In addition, if there are holes (known as fistulas) in the palate, this can make it difficult to produce some consonant sounds, including ‘s’, ‘z’, and ‘sh’, which require the placement of the tongue on the palate to produce the sound. If teeth are missing, not fully erupted, or not in the correct place, some sounds, such as ‘f’ and ‘v’ may be more difficult to articulate.

Cleft Lip Speech Rehabilitation and Cleft Palate Speech Therapy

An experienced speech and language pathologist (SLP) will perform an initial evaluation on a child with a cleft at around 18-24 months of age, which is followed by a more extensive evaluation once the child reaches the age of 3. These evaluations assess how well the child is able to understand words and language, as well as how well they produce proper speech and language, as well as the quality of their speech. These assessment sessions are typically play-based, which allows the SLP to assess the child in a natural state and engage in typical activities.

Suppose the evaluation process shows that the child has challenges with speech. In that case, the SLP will recommend further treatment, which usually includes regular one-on-one speech therapy appointments, as well as teaching caregivers and family members specific exercises that will promote the development of your child’s communication skills at home.

Your child’s SLP will work with them for as long as they require help and support. The aim of speech therapy is for all children to possess good quality, intelligible speech skills by the time they start school.

If you are concerned about your child’s communication skills or want to improve your own skills, speech therapy is available for individuals of all ages. Get started with one of our amazing SLPs by scheduling your free introductory call now!