Speech therapy Treatment for Cleft lip & Palate Children (ACNRC)

Help your child with cleft lip or cleft palate communicate What is a Cleft Lip? A cleft lip is a birth defect that occurs when the tissue that makes up the lips doesn’t fuse together correctly. This can cause a split in the upper lip, ranging from a small notch to a large opening. Cleft Lip types

1. Unilateral cleft lip- This type of cleft lip affects one side of the upper lip and is the most common type of cleft.
2. Bilateral cleft lip- This type of cleft lip affects both sides of the upper lip. This is less common than unilateral cleft lips.

What is a Cleft Palate? A cleft palate is a birth defect that occurs when the roof of the mouth doesn’t form properly. This can cause an opening in the palate (the roof of the mouth), which can range from a small slit to a large hole. Cleft Palate types

1. Unilateral cleft palate- This is one of the cleft palate types that affects one side of the roof of the mouth. This is the most common type of cleft.
2. Bilateral cleft palate- This is one of the cleft palate types that affect both sides of the roof of the mouth. This is less common than unilateral clefts.
3. Submucous cleft palate- This is one of the cleft palate types that occurs when there is a small slit in the palate. It is the least common type of cleft palate.

Speech therapy can help children with cleft lip and palate in many ways, including:

• Articulation

Speech therapists can help children learn how to make the sounds needed for speech.

• Resonance

Speech therapists can help children learn how to resonate speech sounds using their nose and mouth.

• Feeding

Speech therapists can help children with feeding difficulties caused by cleft lip and palate.

• Social skills

Speech therapists can help children with social interaction skills like turn-taking and conversation.

• Fluency

Speech therapists can help children who stutter learn how to speak more fluently.

• AAC

Speech therapists can help children who are unable to speak learn how to use AAC, which includes devices and methods to help children communicate.  Speech therapy is typically most effective when a speech-language pathologist works one-on-one with a child, but sometimes therapy is done in small groups.  Some other treatments for cleft lip and palate include: 

• Surgery

Surgery can help reduce the amount of air that escapes through the nose when talking.  SLT professional can create a speech prosthesis to fit in the child’s mouth to improve their speech.  The main goals to help children with “cleft palate speech” are to: Establish correct articulation (placement, manner, and voicing) using articulation therapy techniques. Ensure there is good oral pressure during speech sound production. Establish new motor speech patterns that replace speech sound errors. Speech-Language Therapy for Children With Cleft Lip or Cleft Palate If your child has a cleft lip and/or palate, you may be wondering if speech-language therapy is right for them. Cleft lip and palate are both birth defects that can affect a child’s ability to speak. Thankfully, speech-language therapy can help them learn how to speak properly! So they can overcome any challenges they face! Keep reading to learn more about speech-language therapy for children with cleft lip and/or palate. How Does Cleft Lip and Palate affect Speech? Cleft lip and palate can both cause speech problems. Children with these conditions may have trouble producing certain sounds, such as “p,” “b,” and “m.” They may also have difficulty making certain consonant sounds, such as “k” and “g.” Additionally, children with a cleft palate may have trouble pronouncing words correctly. They may speak with a nasal tone. Common speech problems that can be caused by cleft lip and palate Articulation disorders Articulation disorders refer to difficulty making certain sounds. For example, a child with an articulation disorder may replace the “th” sound with a “s” or “f” sound. Children with cleft lip and palate may have difficulty making certain sounds. This is due to the way their lips and palate are shaped. Resonance disorders Resonance disorders refer to problems with the way sound is produced. For example, a child with a resonance disorder may speak with a nasal tone. This is common in children with cleft palate. The opening in the roof of the mouth can cause air to escape through the nose when speaking. There are three types of resonance disorders:

1. Hypernasality This is when too much air escapes through the nose when speaking. This can make speech sound nasal. For example, the word “dog” may sound like “dong.” This is a result of an opening in the palate that affects the velopharyngeal valve.
2. Hypo nasality This is when not enough air escapes through the nose when speaking. This can make speech sound unclear. For example, the word “cat” may sound like “bat.” This is a result of a blockage in the nose that affects the velopharyngeal valve.
3. Cul de sac resonance This is when air gets trapped in the back of the nose, making speech sound echo-y. This is a result of a blockage in the nose that affects the velopharyngeal valve.

Fluency disorders Fluency disorders refer to problems with the flow of speech. For example, a child may stutter or have pauses in their speech. This is more common in children with cleft lip because it can affect the way the lips move when speaking. Cleft Lip and Cleft Palate: Causes and Risk Factors There are many different causes of cleft lip and palate, but most of them are unknown. But, there are some risk factors that have been associated with these conditions, such as:

1. Family history. If someone in your family has a cleft lip and/or palate, you’re more likely to have one as well.
2. Smoking during pregnancy. Women who smoke during pregnancy are more likely to have a baby with a cleft lip and/or palate.
3. Certain medical conditions. Diabetes or phenylketonuria (PKU) increase the risk of having a child with a cleft lip and/or palate.

Cleft Lip and Cleft Palate: Symptoms The most common symptom of a cleft lip is an opening in the upper lip that can range from a small notch to a large opening. Other symptoms of a cleft lip include:

1. Speech disorders. Children with a cleft lip may have trouble making certain speech sounds correctly, such as “p” or “b.” When the lip has a cleft, inadequate lip closure and strength can make it difficult to produce these sounds.
2. Feeding problems: They may also have trouble with feeding and sucking a bottle or breast. This is because the cleft can make it difficult to create suction.

A cleft palate can cause many different symptoms, including:

1. Feeding difficulties. Babies may have trouble feeding because they can’t create suction. This can lead to choking and/or pneumonia.
2. Hearing problems. Cleft palate can cause hearing problems because it can affect the way sound waves travel through the mouth and nose.
3. Speech disorders. Children with cleft palate may have difficulty speaking clearly. This is because their mouths aren’t able to make all the sounds needed for speech. They may also have trouble with articulation (pronouncing words correctly) and fluency (stuttering).

Cleft Lip and Cleft Palate: Treatment

1. The best way to treat a cleft lip and/or palate is with surgery. This can be done as early as a few months after birth. In some cases, additional surgeries may be needed to improve the function and appearance of the lips and mouth. Besides to surgery, pediatric speech-language therapy can be very helpful for children with cleft lip and/or palate. Speech-language therapists can help children with these conditions. They will teach them to learn how to speak correctly and fluently. They can also help them with any feeding difficulties they may have. If your child has a cleft lip and/or palate, talk to your doctor about whether speech-language therapy is right for them. With the help of a speech-language therapist, your child can learn how to speak correctly and fluently! They can overcome any challenges they face. Working with a pediatric SLP can also assist your child in being comfortable in speech therapy, as well as make it fun and create an environment that makes your child excited to practice!

Speech therapy can help with cleft lip and cleft palate During your first session, the pediatric speech-language pathologist (SLP) will ask you questions about your child. This includes your child’s medical history and motor development. They will also conduct a physical examination and a speech and language assessment. Based on this information, the SLP will develop a treatment plan tailored to your child’s individual needs. Speech therapy can help children with cleft lip and palate in many ways. Here are just a few:

1. For articulation, speech therapists can help children with cleft lip and palate. They will help them learn how to make all the sounds needed for speech.
2. For resonation, speech therapists can help children learn how to resonate speech sounds. This can be done by using their nose and mouth. With activities such as blow bubbles and straw phonation, children can learn how to produce speech sounds correctly.
3. For feeding, speech therapists can help children with feeding difficulties. It might be caused by cleft lip and palate. Children with cleft lip may have problems with lip closure that causes spillage when drinking from a cup. Therapists can help children learn how to correct this by using different cups and straws.
4. For social skills, speech therapists can help children with social interaction. This includes skills such as turn-taking and conversation skills.
5. For fluency, speech therapists can help children who stutter learn how to speak more fluently. With activities such as slow speech and easy onsets, children can learn to control their speech and reduce stuttering.
6. If a child is unable to speak, a speech therapist can help them learn how to use AAC. AAC includes devices and methods that can help children communicate. This includes picture boards, sign language, and speech-generating devices.

Speech-language therapy can help a child to:

1. Eat and drink without spilling
2. Make speech sounds correctly
3. Learn how to make all the speech sounds
4. Improve clarity of speech
5. Reduce drooling
6. Prevent or correct swallowing problems

ACNRC