In terms of speech and language development of babies born with a cleft palate and/or lip (CP±L), it is recommended for families to apply to a speech and language therapist/pathologist. Children with CP±L may be at risk for language delay, speech, resonance, and communication disorders, which might be due to dental and/or occlusal differences, vocal path obstructions, hearing loss, and velopharyngeal dysfunction.
In the first year of life, speech and language therapists/pathologists primarily assess and, if necessary, intervene with the nutrition, language development, and the development of physical prerequisites for speech. The development of the baby is followed by information gathered from the family, direct observation, or development charts. If any delays related to development are observed, families need to be referred for a comprehensive assessment. The primary focus of the speech and language therapy of the first three years of life is to support language development for children with CP±L. Immediate assessment of language development is recommended if there is a hearing loss after diagnosis. If there is no hearing loss, assessment of language development is recommended within the first six months. Language and speech development of children should be assessed comprehensively around the age of 3. It is recommended that children with CP±L undergo language and speech screening annually until the age of 6, and if there is a deviation from age in any communication area, they need to be referred for a comprehensive assessment.
If the child is able to communicate with speech, this might also be an accurate assessment time for speech sounds, resonance, and velopharyngeal function in terms of the quality of speech. However, if a delay in the expressive language skills of the child is observed, the assessment time of speech sounds, resonance, and velopharyngeal function might be postponed. Speech assessment is also required before and after possible surgical, behavioral, and/or orthodontic treatments.
Early surgical intervention usually provides a much improved mechanism for speech and language. As the child grows, the development of speech and communication skills should be followed closely by a speech development professional.
Some children who have had their palate repaired will have VPD. This makes it difficult for the child to make certain speech sounds. Especially those sounds that require the palate to be in the closed position. Some children also develop speech sounds made in the nose or the throat which are not typical of their native language.
These ‘cleft type’ speech sounds can make the child difficult to understand and they will need speech language therapy. If there are any concerns regarding nasal speech, further tests may be required.
How can I help my child develop good speech?
• Talk to your child and provide language acquisition opportunities. Suggestions for home activities.
• Encourage your child to talk to you.
• Work with your child’s speech therapist to get home activities that are directly related to your child’s therapy plan.
• Remember that to improve speech your child has to work on speech tasks.
References
American Cleft Palate–Craniofacial Association (ACPA). (2017). Parameters for Evaluation and Treatment of Patients with Cleft Lip/Palate or Other Craniofacial Differences. The Cleft Palate-Craniofacial Journal, 55(1), 137–156.
Kummer, A. W. (2014). Cleft Palate and Craniofacial Anomalies. In Effects on Speech and Resonance (3rd ed., pp. 325). Delmar: Cengage Learning.
Peterson-Falzone, S. J., Hardin-Jones, A. M. & Karnell, M.P. (2010). Cleft Palate Speech(4th ed., pp. 265). Iowa, MO: Mosby.
