By: Taylor Shorter

 The article focuses on speech and language issues that are associated with the presence of an oral cleft.  Surgery is done to repair a cleft lip/palate to improve function. Usually surgery on a cleft is completed by the age of 1, the cleft is repaired early enough to so the child can learn to speak with intact structures and get help with speech therapy. -this is where the SLP comes in!

 When a child sees an SLP, the child’s skills are considered across 3 major areas- speech production, language comprehension, and language production. Children with oral clefts are at most risk for speech production disorders related to oral and nasopharyngeal structural anomalies. It is hard for a child with an oral cleft to articulate certain speech sounds. Children with a cleft lip and palate are also at a higher risk for delays and disorders in language and reading skills compared to other children and are at high risk for impaired speech production.

 Children with cleft lip and palate are at risk for speech sound errors- *sound distortions related to malocclusion *developmental speech sound disorders *compensations made because the palate is not working properly Sounds that might be distorted are /s/,/z/, /∫/ A child with a cleft might substitute /w/ for /r/ in the initial position saying “wabbit”. Phonological process-gliding. A child with a cleft palate could have a lack of nasal resonance the words might not sound normal-the word “maybe” might sound like “baby” because there is an air leak in the nose during non-nasal speech sounds in which speech can sound hypernasal in quality. About 20% to 32% of children continue to exhibit air leaks into the nose after primary surgery to repair the cleft palate. But with surgical repair of cleft palate it restores the normal barrier between the nose and mouth which is required for normal resonance. Also, abnormal changes in voice quality (breathiness, hoarseness, reduced loudness, and unusual pitch) are common with people with clefts and are thought to be caused by the person using the vocal folds to compensate for nasal air leaks in the velopharynx. *Also children with clefts are at high risk for frequent to chronic ear infections too. But with the help of an SLP, a child with an oral cleft can receive services to help the client learn to articulate speech sounds.

The American Cleft Palate Craniofacial Association advocates an interdisciplinary team approach to care so the needs of each child and family are met. 300 cleft palate and craniofacial teams in North America. Speech Progress Video: Zoie was 15 months old and had her cleft lip repaired and then at 2 years old she had her cleft palate repaired. In the video she is 3 ½. She has had speech therapy once a month since she was around 26 months old. AtneRM&NR=1