Cleft Lip and Palate
What is a cleft lip and palate?
A cleft is a 'split' or 'separation'. A cleft palate is when the roof of the mouth fails to join properly, resulting in a split or separation. The front of the palate is called the hard palate and the back is known as the soft palate. A cleft palate can range from an opening at the back of the soft palate to a nearly complete separation of the soft and hard palate. It may also involve a cleft lip; affecting both sides (bilateral), or one side (unilateral).
A cleft palate can occur on its own and may also include a cleft lip, known as cleft lip and palate.
What problems caused by cleft lip and palate can speech and language therapy help with?
Speech and language therapy can help with the following problems that a cleft lip and palate may be associated with:
- Eating, drinking and swallowing difficulties
- Speech disorders
- Hearing loss and impairments
- Dental problems
- Recurrent middle ear infections e.g. glue ear
What causes cleft lip and palate?
Whilst the baby is developing in the womb, different parts of their face will develop and form separately and then join together. If this development is not complete and the parts don't join correctly, this can result in a cleft. The development of the upper lip and face occurs during the fifth and ninth week of pregnancy. Cleft lip and palate may occur on its own or be a part of multiple birth defects.
There is usually no detectable cause of cleft lip and palate, it is thought to be the result of a combination of factors including genetic and environmental.
Increased risk factors associated with cleft lip and palate includes:
- Maternal smoking
- Maternal obesity
- Maternal alcohol consumption
- Lack of folic acid during pregnancy
How is a cleft lip and palate diagnosed?
Cleft lip and palate can be detected in unborn babies through an ultrasound examination during an antenatal appointment. If the cleft is not detected during pregnancy, it will almost always be diagnosed at birth or soon after.
Very rarely a cleft may go unnoticed as the cleft is covered by the lining in the mouth; this is known a submucous cleft. A submucous cleft may not be identified for months if not years, when the child displays problems with their speech.
The speech and language therapist will play a key role in the identification, diagnosis and treatment of speech, language and swallowing disorders for children with cleft lip and palate.
The speech and language therapist will work closely with a team of medical and health care professionals who will work with the child throughout their development.
How does speech and language therapy help individuals with cleft lip and palate?
The speech and language therapist plays a key role in the treatment process of a child with cleft lip and palate. The Speech and language therapist will work with the child and their family to help and support the child's speech, language and swallowing difficulties.
The palate plays an important role in the development of speech for children to acquire speech sounds normally. If there is any damage to the palate or the lip, this will cause problems with the child learning to acquire speech sounds, if not repaired. Babies and children with cleft lip and palate will usually undergo surgery to repair a cleft before they develop speech, reducing the affects the cleft has on the child's speech development.
It has been estimated that around 50% of children with a repaired cleft will need some type of speech and language therapy. The speech and language therapist will provide treatment and closely monitor the child's progress of their speech, language and swallowing. The speech and language therapist will remain involved in the child's treatment plan for as long as is needed.
What would speech and language therapy treatment for cleft lip and palate involve?
Feeding advice is always the first speech and language therapy intervention for a child with cleft lip and palate. The speech and language therapist will carry out an assessment of the babies swallowing and then provide advice and support for the parents / carers.
A speech and language therapist will carry out an assessment, normally following surgery. If the assessment reveals any difficulties with pronunciation and use of language, the speech and language therapist will work with the parents / carers and teach them a number of speech exercises that can be used to help the child's speech development. The SLT will carry out a number of one to one therapy exercises with the child. Hearing problems are often associated with cleft lip and palate meaning sounds or language may also be delayed.
The speech and language therapist will create an individualised treatment plan for all children and families which will meet their specific needs and requirements.
Speech and Language Therapy treatment for cleft lip and palate can take place in a variety of settings, depending on your preference:
Following an initial assessment speech and language therapy may involve:
- One to One Therapy
- Clinic Visits
- Home Visits
- Alternative and Augmentative Communication
- advice and education
- eating, drinking and swallowing management
How do I arrange a speech and language therapy assessment for a cleft lip and palate?
To arrange an assessment with one our speech and language therapists please call 0330 0885 643.
A cleft is a 'split' or 'separation'. A cleft can affect the palate and may also affect the lip, known as cleft lip and palate, or just cleft palate. The speech and language therapist plays a key role in the treatment of a child with cleft lip and / palate and will be involved in their care from birth throughout childhood, sometimes longer if needed. Cleft lip and palate can cause speech, language and swallowing difficulties which can range in severity depending on the extent of the cleft. The speech and language therapist will create an individualised treatment plan for each child. If you feel you and your child may benefit from speech and language therapy please email firstname.lastname@example.org or call 0330 0885 643.
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