Cleft lip and palate is one of the most common birth defects, with one to two out of 1000 babies being born with a cleft in the United States. Even though clefts are typically treated with surgery while a child is still very young, speech development is often affected. This means a speech-language pathologist is usually a critical part of a cleft palate team. How does a cleft impact speech, and how can therapy help?
A cleft palate means that there is an opening in the roof of the mouth which leads into the nasal cavity. When we make most speech sounds, we close off the nasal cavity so that air flows out of the mouth; the only sounds that usually direct air through the nose are m, n, and ng. A cleft makes it impossible to close off the nasal cavity. This can make speech sound hyper nasal (like you are talking through your nose). It can also make some speech sounds that require a build-up of pressure in the mouth difficult to produce. Even after the cleft is repaired, sometimes this problem persists; children with clefts often have velopharyngeal insufficiency. This means that the soft tissue at the back of the roof of the mouth doesn’t seal off the nasal cavity during speech. While surgery is required to fix structural issues, speech-language therapy is critical in helping a child learn to produce sounds correctly. Speech therapists use a range of tools that can help a child see when there is air flowing through their nose during speech to increase awareness and improve production. They also train specific sounds that require pressure within the mouth.
Children born with a cleft also often move their tongue in atypical ways during speech. Because they’ve gotten used to avoiding their cleft, even after surgery, children may have difficulty producing sounds that require the tongue to touch the roof of the mouth. For example, t and d are often mispronounced as k and g. A speech-language pathologist will identify the sounds that are problematic for the child, help them increase their awareness of their speech patterns, and provide training to produce those sounds in a clear way.
Want to learn more? If you have any questions or would like to know more about speech-language therapy, give me a call at (212) 308-7725 or send an e-mail to firstname.lastname@example.org. I’d be happy to chat and answer any questions you may have.
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