SPEECH AND LANGUAGE PATHOLOGY

The speech-language pathologists (SLPs) at the clinic will evaluate your child’s specific speech and language development and resonance to determine the best therapeutic course for your child and provide appropriate resources. These services are available across all ages from birth through adulthood.

SPEECH AND LANGUAGE DEVELOPMENT IN CHILDREN WITH A CLEFT

A cleft of the lip and/or palate does not prevent a baby from learning to talk, but can influence how quickly speech develops and the speech sounds the baby is able to produce. Some children with clefts are slower to say their first word or build their vocabulary, even after the lip and/or palate is surgically repaired. Due to these challenges, around 70% of children with a cleft palate require speech therapy to address developmental speech-language concerns or cleft-related speech sound errors.

Since communication is such an essential part of expressing basic wants and needs, our speech-language pathologists work closely with children and their families to identify any challenges and address any concerns the family may have. Early diagnosis and intervention provide opportunities for education, which can improve overall quality of life and reduce frustration for all.

Speech may be difficult to understand because of one or more of the following:

• Language Delays
• Articulation Errors
• Hypernasality (resonance disorder)
• Nasal Air Emission
• Compensatory Articulation Errors
• Voice Differences

Resonance refers to the way airflow for speech is shaped as it passes through the oral (mouth) and nasal (nose) cavities. The soft palate moves to touch to the back of the throat, which closes the space between our mouth and nose. We do this when we produce “mouth sounds”, which are most sounds we produce. However, a few sounds, like “m” and “n,” come out of our nose. The soft palate does not move for these sounds.

A child with hypernasality will be diagnosed with velopharyngeal insufficiency (VPI). VPI refers to when the soft palate cannot touch to the back of the throat when producing “mouth sounds” due to being too short or not moving the right way. This allows sound to escape through the nose when speaking. VPI may occur in children with or without a cleft.

A child may need speech therapy, surgery, or both to increase their speech intelligibility. A child may need surgery to address their VPI. Whereas, speech therapy would focus on placement of their tongue or lips for production of speech sounds on top of surgery.

COMMON SERVICES

Team Evaluations

Our SLPs evaluate speech and language development and resonance on team days. We provide resources and parent education on how to best promote speech and language development, from as early as 6 months of age through adolescence and into adulthood. As expressive language begins to develop, we will closely monitor the child’s articulation and resonance (palate function). If you have questions about Velopharyngeal Insufficiency, please refer to our VPI Handout.

Speech Therapy

Children born with a cleft may need speech and language therapy to help address articulation disorders, phonological disorders, and language disorders. The Lancaster Cleft Palate Clinic offers speech and language therapy with an emphasis on treating articulation disorders and cleft-specific speech sound errors as well as language disorders. Our SLPs have special training in recognizing and treating specific speech sound errors common in children with a cleft palate and/or hearing loss. Therapy will usually focus on:

• Establishing correct articulation (placement, manner, and voicing) using articulation therapy techniques
• Monitoring palate function by ensuring there is good oral pressure during sound production
• Establishing new motor speech patterns that replace speech sound errors

Please contact the clinic if interested in enrolling your child in speech therapy.

FREQUENCY OF APPOINTMENTS

Team patients will be seen every 6-12 months to monitor their speech and language development and resonance until orthognathic treatment is completed. If speech therapy is needed, services are typically provided weekly or biweekly.