Cleft Lip and Palate

Information taken from American Speech-Language Hearing Association (ASHA) and Cleft Palate Foundation

WHAT IS CLEFT LIP AND PALATE?

A “cleft” is defined as a split or a divide; therefore, a cleft lip can be defined as a split in the lip and a cleft palate can be defined as a split in the palate.  Children can be born with different types of clefts as well as variable severities and sizes.  Cleft lip and cleft palate develop very early in pregnancy.  In a cleft lip there is a divide of the upper lip which can also include the bones of the upper jaw and/or the gum.  A cleft palate is formed when the palate (roof of the mouth) did not fuse together in utero, thus resulting in an opening in the roof of the mouth.  A child may have a cleft lip, a cleft palate, or both.  Furthermore, a cleft lip and palate can form on one side of the mouth (unilateral) or on both sides of the mouth (bilateral).    

HOW IS SPEECH AND LANGUAGE AFFECTED?

Studies have shown that children with cleft lip/palate have delayed expressive language, slower development of sounds and words, and a smaller inventory of sounds in infancy.  Therefore, it is important to talk to your child and encourage your child to talk to you.  Some children will catch up after the cleft repair; however, others will require continued speech therapy for a longer period of time following surgery.  If your child’s teeth do not properly align your child may have distorted production of the /s/ and /sh/ sounds.  Children who have cleft lip/palate may have the following:

  • Atypical consonant productions (especially with /m/, /n/, /ing/)
  • Speech may sound nasal like they are talking through their nose
  • Abnormal nasal airflow through the nose
  • Nasal or facial grimaces to compensate for difficulties with speech

HOW IS FEEDING AFFECTED?

Children who have a cleft lip may have no problems breast feeding or using a bottle.  However, babies who have a cleft palate may require adaptations to the nipples and bottles.  The palate keeps food and liquid from entering the nose; therefore special bottles may be needed to stop this from happening.  A feeding specialist would work with you to achieve an adequate feeding method to ensure proper nutrition.  The speech-language pathologist may work closely with an occupational therapist and nurse to determine the best position for feeding as well as the best bottle for your child.

WHAT CAUSES CLEFT LIP/PALATE?

Studies have found that there is no known cause of cleft lip/palate; however there are a few possible causes which include the following:

  • Genetic problems
  • Exposure to chemicals during pregnancy
  • Substance abuse
  • Certain medicines
  • Poor prenatal health care

It is estimated that cleft lip/palate affects 1 in 940 births in the United States making it the most common birth defect in the US. 

OUR APPROACH AT KEY THERAPIES:

As mentioned earlier, there are varying severity levels of cleft lip and palate and we will develop an individualized treatment plan for each child based off of his / her current needs.  We will work closely with physicians, nurses, occupational therapists, and other medical professionals.  Furthermore, a home program will be taught to caregivers so that follow-through can be completed at home.      

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