Cleft lip and palate

A Cleft Lip and/or Palate is a split or a space in the upper lip, or the palate (roof of the mouth), or in some cases both.

A Cleft Lip and/or Palate can impact upon a child’s speech skills and feeding skills as children may have difficulties producing certain sounds, having the correct resonance or phonation as well as difficulties with eating and drinking.

Speech and Language Therapy can help reduce the level of difficulty your child is experiencing. A speech and language therapist can help ensure your child a safe experience during eating and drinking as well as creating an individualised programme to work on your child's speech difficulties.

Research shows that Cleft Lip and/or Palate is the most common facial defect in the United Kingdom, with 1 in 700 children being born with some form of a cleft. 50% of those children have a cleft palate, 25% have cleft lip and a further 25% have both cleft lip and palate. A unilateral Cleft Lip and/or Palate is more common than a bilateral cleft lip / or palate, only 10% of those born with a Cleft Lip and/or Palate have a bilateral Cleft Lip and/or Palate. Of these Children, it is currently estimated that 50% will require Speech Therapy to support communication skills.

The symptoms associated with Cleft Lip and/or Palate will differ according to the type of cleft and its severity. Not all children will demonstrate these symptoms and the severity of symptoms will vary between children depending on their abilities. Symptoms include:

• Difficulty with feeding.
• Difficulty with eating, drinking and swallowing, potential chance of food coming out of the nose.
• Hyper-nasal speech or hypo-nasal speech.
• Chronic ear infections.
• Impaired speech development.
• Inaccurate production of sounds.
• Reduced speech intelligibility.
• Difficult to make distinctions in the child’s speech.
• Difficulties with voice including breathiness and hoarseness.
• Difficulties with communication.

Cleft lip and / or palate can impact a child’s speech, language and communication skills. Thus having an impact on their daily activities and participation in daily life. If a child is aware of their difficulties with speech, language and communication, it can often impact the child’s social and emotional wellbeing.

Cleft lip and / or palate can impact a child’s quality of life in the following way:

• Difficulty in being understood by others.
• Difficulty expressing their thoughts and feeling in a way that can be understood by others.
• Difficulty taking part in activities in school or at home that require them to use their voice and speech skills.
• Embarrassment around eating or drinking in public.
• Difficulty making and maintaining friendships.
• Reduced self-confidence.
• At risk of bullying due to speech sound abnormalities such as nasal turbulence or nasal snort and appearance.

Speech and Language Therapy can help children with Cleft Lip and/or Palate by providing them with therapy that concentrates on the correct production of speech sounds the child is physically able to make. This in turn will increase their intelligibility making it easier for others to understand them.

The symptoms associated with cleft lip and / or palate will differ according to the type of cleft and its severity. Not all children will demonstrate these symptoms and the severity of symptoms will vary between children depending on their abilities.

Symptoms include:

• Difficulty with feeding.

• Difficulty with eating, drinking and swallowing, potential chance of food coming out of the nose.
• Hyper-nasal speech or hypo-nasal speech.
• Chronic ear infections.
• Impaired speech development.
• Inaccurate production of sounds.
• Reduced speech intelligibility.
• Difficult to make distinctions in the child’s speech.
• Difficulties with voice including breathiness and hoarseness.
• Difficulties with communication.

Cleft lip and / or palate can impact a child’s speech, language and communication skills. Thus having an impact on their daily activities and participation in daily life. If a child is aware of their difficulties with speech, language and communication, it can often impact the child’s social and emotional wellbeing.

Cleft lip and / or palate can impact a child’s quality of life in the following way:

• Difficulty in being understood by others.
• Difficulty expressing their thoughts and feeling in a way that can be understood by others.
• Difficulty taking part in activities in school or at home that require them to use their voice and speech skills.
• Embarrassment around eating or drinking in public.
• Difficulty making and maintaining friendships.
• Reduced self confidence.
• At risk of bullying due to speech sound abnormalities such as nasal turbulence or nasal snort and appearance.

Speech and language therapy can help children with cleft lip and / or palate by providing them with therapy that concentrates on the correct production of speech sounds the child is physically able to make. This in turn will increase their intelligibility making it easier for others to understand them.

Speech and language therapists can carry out assessments of speech and language to determine the level of difficulty your child is experiencing. The assessments may differ according to your child’s ability and age. Speech and language therapists carry out a variety of formal and informal assessments including:

• Speech assessment
• Receptive language assessment
• Voice assessment
• Dysphagia assessment

Speech and Language Therapy can be beneficial for children with Cleft Lip and/or Palate. Our Speech and Language Therapists will use the information from the assessments, as well as collaborate with you, your child and their school to create an individualised therapy programme that works on your child’s needs and includes their motivators and goals. We can also liaise with Specialist Cleft Palate services with your consent, to progress your child’s speech.

A child with cleft lip and / or plate may experience difficulty with producing certain sounds that require you to build up air pressure in your mouth such as /p/ /b/ /t/, sounds at the front of the mouth /t/ /d/ or sounds that require long streams of airflow through the mouth /s/ /z/ /th/ /f/ /v/. These sounds may be produced down the nose as a nasal snort or as another sound. This can be prior or post-surgery.

It is common that children need a helping hand after surgery to use sounds correctly as they are not used to producing them in the way that we do, through therapy we can build their confidence and help them use these new sounds in their talking every day.

Therapy available from our Speech and Language Therapists include:

• Speech sound therapy.
• Communication skills therapy.
• Advice and strategies for eating, drinking and swallowing difficulties.
• Voice therapy.
• Individual therapy.
• Group therapy.
• Advice, training and support for parents, carers, teachers and other professionals.
• Augmentative and Alternative Communication.