Speech-Language Pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of speech and language problems that children with cleft lip and/or palate may have
Dr. Maram Al-Khaledi
Assistant Professor (PhD)
Department of Communication Disorders Sciences, College of Life Sciences
Children with cleft lip and/or palate can develop speech and communication difficulties in different ways. There are differences in how children with a cleft lip and/or palate will develop in terms of their speech and language. It is usually not until the child begins to speak and form speech that the problems in his/her speech will be clear. Most children with a cleft lip and/or palate will need speech therapy at some point in their life. Any problems noticed in the child’s speech or language must be treated early, therefore, a child with a cleft lip and/or palate will have an many assessments from birth onwards. Speech and communication monitoring begins from birth, however a speech and language assessment begins at around 18-24 months of age, and another assessment is done at around 3 years of age. Treatment and management will be recommended if the speech-language pathologist (SLP) thinks it is necessary.
Speech-Language Pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of speech and language problems that children with cleft lip and/or palate may have, along with the feeding and swallowing problems that may also be present at birth. This is because a cleft lip and palate will affect the lip, nose, gum and/or palate leading to many problems including swallowing and feeding difficulties. Sometimes the ears are also affected indirectly, causing hearing problems. It is important that hearing is also checked for children with a cleft lip/palate.
The first two years of a child’s life are the most critical years for speech and language development. This is why newborns with cleft lip and/or palate will require continuous monitoring and management by a team of professionals that includes the SLP. If a child has a cleft lip only, speech should be typical or very close to typical as long as there is no hearing loss or other problems. A SLP should see a child with cleft lip and/or palate often in the first two or three years of his/her life to monitor the speech and feeding development over time and watch for any changes.
The SLP’s professional roles include the diagnosis, assessment, planning, and treatment of speech, language and feeding problems that a child with a cleft lip and/or palate may have. The SLP will work very closely with other healthcare professionals in a team (Cleft Lip/Palate or Craniofacial Team). More importantly, the SLP will work with the parents. Parents will be the “therapist at home”, and they will follow and encourage correct speech habits and correct the wrong speech habits that can cause more problems for the child.
Working with the child on his/her speech and language will begin early before they have surgery to correct their cleft lip and/or palate and will continue as they grow older. The aim of speech therapy is to have the child gain good quality (clear), intelligible (understandable) speech by age 5 or 6 years.
Children with cleft lip and/or palate may develop speech and language at a slower rate compared to other children, and will have speech that does not sound clear or typical before surgery is performed.
Another common problem is the delay in language development for some children with a cleft lip/palate. This is usually because parents and caregivers may not understand a child’s early attempts at words; therefore, they will not reinforce or encourage the child’s speech to help in the development process of language.
The speech of children with cleft palate tends to improve and recover after the surgical repair of the cleft, and as a result speech will take around 5 years to “catch up” with the speech development of other children their age. During this critical time, some children will require more surgeries, or a speech aid prosthesis (devices) as well as speech therapy to help them catch up and improve their speech. This is why it is important that there is continuous follow up with a SLP who is experienced in cleft lip and palate care to assess and monitor progress of the child.
Speech, language and feeding assessment is usually done by a Speech-language pathologist (SLP). This is to help in diagnosing a speech, language, resonance (forming speech sound) and/or voice problems as well as any feeding difficulties at birth. A speech assessment also helps to understand the type of speech and/or language problem the child may have, its severity, and what is causing it. More importantly, it will help with knowing if speech therapy will be needed and when.
Speech therapy is usually initiated anytime from 20 months to 2 years of age or even later. This depends on if the child shows unclear speech, nasal sounding speech or if there is a delay in language skills.
Below this article a file is included which is an example of a timeline that is generally used for speech issues during the first few years of the child’s life.
Early intervention is very important in the correct development of speech and language in children with cleft lip and/or palate. These children can have problems with language and difficulties producing some speech sounds making their speech unclear and difficult to understand. Speech therapy will focus on speech skills and language before and after surgery. This helps prevent further problems with speech and/or language delays that can happen later in the child’s life.
Speech and language difficulties can be any of the following:
Communication problems can be identified before a baby begins to speak; therefore, to prevent future speech and language problems and help normal development, SLPs must see the baby early.
Parents can help in this process by being involved early on with their child’s speech therapy. This can be by:
If you have any further questions, contact a speech-language pathologist.
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