Did you know that cleft lip and palate, a type of craniofacial disorder, is the second most common birth defect in the United States? A cleft is a separation or opening in the lip and/or palate (i.e., the roof of the mouth). Cleft lip is a separation within the lip, and cleft palate is an opening in the roof of the mouth. Cleft lip and palate can occur on one side (unilateral) or on both sides (bilateral). Cleft lip and palate may impact speech, language, and/or resonance (quality of airflow coming from throat, mouth, and nose). Individuals with cleft lip and palate may show deficits in speech sound production following primary lip and palate repairs, and these speech differences are dependent on the type and severity of the cleft. Furthermore, individuals with cleft lip and palate may exhibit resonance disorders such as hypernasality (too much nasality), hyponasality (not enough nasality), cul-de-sac resonance (trapped airflow/sound), and/or mixed resonance (a combination of nasal characteristics). Fortunately, speech language pathologists (SLPs) trained in the assessment and treatment of cleft palate related speech and resonance disorders are here to help.
SLPs play a large role in the craniofacial team, starting from birth, carrying on through young adulthood. Prior to a baby’s first words, cooing and babbling may be impacted due to the size and severity of the cleft. SLPs can help facilitate early communication by teaching parents how to help stimulate speech production at home. As individuals with cleft lip and palate grow older, speech and resonance therapy is crucial to eliminate compensatory articulation errors. Speech therapy can also help treat phoneme-specific nasal emissions or hypernasality due to incorrect articulatory placement. Intervention targeting articulation and resonance will increase overall speech intelligibility to familiar and unfamiliar listeners in a variety of settings (e.g., school, work, etc.).
Individuals with cleft lip and palate are cared for by a multidisciplinary team of professionals that may include: plastic surgeons, pediatricians, otorhinolaryngologists (ENTs), dentists, orthodontists, audiologists, SLPs, and social workers. Another very important part of the team is…parents! Research studies have revealed that daily parent-implemented speech/language stimulation, supplemented with SLP interventions, can improve speech and language development at a faster rate. SLPs can help train parents of children with cleft lip and palate by demonstrating techniques to carryover into the home environment. Here are some tips to stimulate speech and language development in the home:
- Language stimulation in the home promotes both language and speech sound development. Research has shown that an increase in vocabulary production leads to an increase in speech sound inventories in children with cleft lip and palate. When your child increases their speech sounds, they will have more access to vocabulary words with those new sounds.
- Pay attention to what sounds your child uses in their speech. You can introduce new words that include the same sounds your child already uses.
- Follow your child’s lead and use toys and books as a backdrop for play. Continue to provide rich language and expand on phrases your child is saying.
- Do not be discouraged to talk to your child even if you do not understand exactly what your child is saying.
- Using a natural play-based environment is a great way to promote speech sounds!
- Create a language-rich environment: reading to your child, narrating everyday tasks, labeling actions and items in your environment.
- Encourage your child to be assertive and responsive by asking open-ended questions and allowing sufficient time for their responses.
Thank you for reading! If you have any questions about cleft lip and palate assessment and treatment, please feel free to reach out by calling our clinic at (208) 793-7006 and leaving me a message.
~Mollie Glaspell, MS, CCC-SLP
Resources:
● https://www.idahocleftandcraniofacial.org
● https://acpacares.org
● https://www.asha.org/practice-portal/clinical-topics/cleft-lip-and-palate/
● https://www.leadersproject.org/english-cleft-palate-directory/