What Is Cleft Lip And Cleft Palate?
Cleft lip and cleft palate are two of the most common birth defects found in the Western world.
They involve a split or opening in your baby’s upper lip, the roof of their mouth, or both. If your baby has one of these conditions, it could be associated with another health condition, including chromosomal irregularities. More often, though, they appear on their own.
The cleft could appear as only a small notch in the upper lip, or a significant gap that extends into the child’s nostril. It’s caused by the tissues forming your baby’s mouth don’t properly fuse together. This process normally happens quite early in pregnancy – during the first trimester. But if it doesn’t, this will lead to cleft lip or cleft palate.
The exact reason why this happens isn’t fully understood yet. In some cases, as mentioned above, it’s linked with genetic factors. Family history seems to play a role as well. In other cases, it may be environmental. Other causes may include:
- Alcohol or tobacco use during pregnancy
- Vitamin deficiencies
- Exposure to rubella
- The use of certain medications
- Diabetes
- Obesity
Sex and ethnicity also seem to play a role. Male babies are more likely to have a cleft lip, while female babies are more likely to have a cleft palate. As well, these conditions are least common in African Americans, and most common in Native Americans, with the rest of us falling somewhere in between.
In many cases, though, doctors aren’t able to find a direct cause.
Complications From Cleft Lip & Cleft Palate
If your baby has cleft lip or cleft palate, they will likely also suffer from velopharyngeal dysfunction, or VPD for short. VPD is an umbrella term that describes several different disorders. What they all have in common is that the seal between the mouth and nose is imperfect, which results in air leaking into the nose during speech. This can lead to a number of different speech issues, including an overly nasal tone and low intelligibility.
Cleft lip and cleft palate aren’t the only causes of VPD, but they’re one of the most well-known ones.
Beyond VPD, some common issues children with a history of cleft palate may face include:
- Difficulty feeding
- Difficulty swallowing
- Abnormal tooth development
- Occlusion deviations
- Difficulty hearing
- Chronic ear infections
- Difficulties with social development
- Nasal speaking voice
- Speech and language development
- Stress & anxiety, due to social ostracism and frequent medical treatment
Have a speech concern? District Speech can help.
Treatments For Cleft Lip & Cleft Palate
When it comes to treatment for cleft lip and cleft palate, your child will likely have a full team of specialists behind them.
On your child’s team, you may find a:
- Plastic surgeon
- Oral surgeon
- Pediatrician
- Pediatric dentist
- Orthodontist
- Auditory specialist
- Ear, nose, and throat specialist (ENT)
- Social worker/psychologist/psychotherapist
- Speech therapist
While it may seem overwhelming to have so many different specialists involved, know that because of it your child is getting the best care they can. In most cases, cleft lip and cleft palate can be managed, and your child can go on to live a normal, healthy life.
Speech Therapy For Cleft Lip And Cleft Palate
Here at District Speech, we offer speech therapy services for children with cleft lip and cleft palate.
To start, we’ll evaluate your child’s current situation. Cleft lip and cleft palate are generally obvious, but VPD isn’t. As a result, you may not have a definitive diagnosis for VPD when you first visit District Speech.
During your child’s evaluation, your speech therapist will seek to answer the following questions:
What is your child currently doing?
and
What are they capable of doing?
By answering these questions, we can find out what the best next steps are.
During your child’s evaluation, we’ll take a look at the following areas:
1. Resonance And Airflow/Air Pressure
When we’re talking about speech, resonance refers to the quality that gives it its fullness. Resonance disorders are common with cleft lip and cleft palate.
As well, airflow may indicate a VPD which creates nasal air emissions.
Your speech therapist will evaluate your child by looking at their:
- Vowel sounds
- Nasal consonant sounds
- Vocalic consonant sounds
- Resonating sounds
- High pressure consonants
- Fricatives
- Affricates
- Stops
2. Articulation
Most young children have errors in their speech. It’s how we learn to talk. But is your child just talking about eating “pasghetti” with “farmer John cheese”, or are their errors more structural?
When examining your child’s ability to articulate themselves, we’ll explore whether their errors are obligatory, compensatory, or part of normal childhood development.
Obligatory errors are errors caused by structural or neurogenic problems, such as fistulas or velopharyngeal disorders (VPD). These errors will require physical management to correct.
Meanwhile, if your child is making compensatory errors, it’s because they’re not physically able to form the pressure needed to make pressure consonants. Think of the letters B, D, P, T, etc. These can be particularly difficult to identify without the help of a speech therapist.
Velopharyngeal mislearnings include the above mentioned compensatory errors, as well as phoneme-specific nasal air emission in which nasal air emission is noted only on particular speech sounds.
This especially occurs with the letter S and the other sibilant fricatives and sometimes affricates.
If your child displays any of these errors, District Speech can help correct them.
3. Oral Mechanism
This test will measure the physical structure of your child’s mouth. In particular, your speech therapist will examine their oral cavity structure to determine if there are any issues with:
- Tonsils
- Occlusion
- Dentition
4. Speech And Language
Finally, your speech therapist will offer some standardized tests to understand your child’s speech and language capabilities.
Book An Appointment With District Speech
Once one of our licensed speech pathologists has completed examining your child, they’ll have the information they need to put together a proper treatment plan.
Depending on your child’s needs, your plan may include:
- Proper articulation, considering voicing, manner, and placement
- Establishing new speech techniques to replace erroneous ones
- Establishing oral pressure techniques
If your child has a cleft lip or cleft palate, it’s a good idea to book a speech therapy evaluation with District Speech as soon as possible.
The younger your child can begin speech therapy, the greater their chances of success are. This is because older children have had more time to establish their bad habits, which makes it more difficult to break them.
Book your appointment with District Speech today, to find out more about your child’s unique challenges, and how you can face them together.
