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Speech-Language Therapy for Children With Cleft Lip or Cleft Palate

If your child has a cleft lip and/or palate, you may be wondering if speech-language therapy is right for them. Cleft lip and palate are both birth defects that can affect a child’s ability to speak. Thankfully, speech-language therapy can help them learn how to speak properly! So they can overcome any challenges they face! Keep reading to learn more about speech-language therapy for children with cleft lip and/or palate.


In this article we will discuss:


Cleft Palate Types

Cleft Lip and Cleft Palate: What’s the Difference?

Cleft lip and palate are both birth defects that can affect speech. But, they are two different

conditions.


What is a Cleft Lip?

A cleft lip is a birth defect that occurs when the tissue that makes up the lips doesn’t fuse

together correctly. This can cause a split in the upper lip, ranging from a small notch to a large opening.

Cleft Lip types

  1. Unilateral cleft lip- This type of cleft lip affects one side of the upper lip and is the most common type of cleft.

  2. Bilateral cleft lip- This type of cleft lip affects both sides of the upper lip. This is less common than unilateral cleft lips.

What is a Cleft Palate?

A cleft palate is a birth defect that occurs when the roof of the mouth doesn’t form properly. This can cause an opening in the palate (the roof of the mouth), which can range from a small slit to a large hole.


Cleft Palate types

  1. Unilateral cleft palate- This is one of the cleft palate types that affects one side of the roof of the mouth. This is the most common type of cleft.

  2. Bilateral cleft palate- This is one of the cleft palate types that affect both sides of the roof of the mouth. This is less common than unilateral clefts.

  3. Submucous cleft palate- This is one of the cleft palate types that occurs when there is a small slit in the palate. It is the least common type of cleft palate.

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How Does Cleft Lip and Palate affect Speech?

Cleft lip and palate can both cause speech problems. Children with these conditions may have trouble producing certain sounds, such as “p,” “b,” and “m.” They may also have difficulty making certain consonant sounds, such as “k” and “g.” Additionally, children with a cleft palate may have trouble pronouncing words correctly. They may speak with a nasal tone.


Common speech problems that can be caused by cleft lip and palate


Articulation disorders

Articulation disorders refer to difficulty making certain sounds. For example, a child with an articulation disorder may replace the “th” sound with a “s” or “f” sound. Children with cleft lip and palate may have difficulty making certain sounds. This is due to the way their lips and palate are shaped.


Resonance disorders

Resonance disorders refer to problems with the way sound is produced. For example, a child with a resonance disorder may speak with a nasal tone. This is common in children with cleft palate. The opening in the roof of the mouth can cause air to escape through the nose when speaking.

cleft lip and cleft palate

There are three types of resonance disorders:


1. Hypernasality This is when too much air escapes through the nose when speaking. This can make speech sound nasal. For example, the word “dog” may sound like “dong.” This is a result of an opening in the palate that affects the velopharyngeal valve.


2. Hypo nasality This is when not enough air escapes through the nose when speaking. This can make speech sound unclear. For example, the word “cat” may sound like “bat.” This is a result of a blockage in the nose that affects the velopharyngeal valve.


3. Cul de sac resonance This is when air gets trapped in the back of the nose, making speech sound echo-y. This is a result of a blockage in the nose that affects the velopharyngeal valve.


Fluency disorders

Fluency disorders refer to problems with the flow of speech. For example, a child may stutter or have pauses in their speech. This is more common in children with cleft lip because it can affect the way the lips move when speaking.


Cleft Lip and Cleft Palate: Causes and Risk Factors

There are many different causes of cleft lip and palate, but most of them are unknown. But, there are some risk factors that have been associated with these conditions, such as:

  1. Family history. If someone in your family has a cleft lip and/or palate, you’re more likely to have one as well.

  2. Smoking during pregnancy. Women who smoke during pregnancy are more likely to have a baby with a cleft lip and/or palate.

  3. Certain medical conditions. Diabetes or phenylketonuria (PKU) increase the risk of having a child with a cleft lip and/or palate.

Cleft Lip and Cleft Palate: Symptoms

The most common symptom of a cleft lip is an opening in the upper lip that can range from a small notch to a large opening. Other symptoms of a cleft lip include:

  1. Speech disorders. Children with a cleft lip may have trouble making certain speech sounds correctly, such as “p” or “b.” When the lip has a cleft, inadequate lip closure and strength can make it difficult to produce these sounds.

  2. Feeding problems: They may also have trouble with feeding and sucking a bottle or breast. This is because the cleft can make it difficult to create suction.

Speech Disorders caused by a cleft lip or cleft palate

A cleft palate can cause many different symptoms, including:

  1. Feeding difficulties. Babies may have trouble feeding because they can’t create suction. This can lead to choking and/or pneumonia.

  2. Hearing problems. Cleft palate can cause hearing problems because it can affect the way sound waves travel through the mouth and nose.

  3. Speech disorders. Children with cleft palate may have difficulty speaking clearly. This is because their mouths aren’t able to make all the sounds needed for speech. They may also have trouble with articulation (pronouncing words correctly) and fluency (stuttering).


Cleft Lip and Cleft Palate: Treatment

The best way to treat a cleft lip and/or palate is with surgery. This can be done as early as a few months after birth. In some cases, additional surgeries may be needed to improve the function and appearance of the lips and mouth. Besides to surgery, pediatric speech-language therapy can be very helpful for children with cleft lip and/or palate. Speech-language therapists can help children with these conditions. They will teach them to learn how to speak correctly and fluently. They can also help them with any feeding difficulties they may have. If your child has a cleft lip and/or palate, talk to your doctor about whether speech-language therapy is right for them. With the help of a speech-language therapist, your child can learn how to speak correctly and fluently! They can overcome any challenges they face. Working with a pediatric SLP can also assist your child in being comfortable in speech therapy, as well as make it fun and create an environment that makes your child excited to practice!


Speech therapy can help with cleft lip and cleft palate

During your first session, the pediatric speech-language pathologist (SLP) will ask you questions about your child. This includes your child's medical history and motor development. They will also conduct a physical examination and a speech and language assessment. Based on this information, the SLP will develop a treatment plan tailored to your child’s individual needs.

Exercises for Cleft Lip and/or Palate

Speech therapy can help children with cleft lip and palate in many ways. Here are just a few:

1. For articulation, speech therapists can help children with cleft lip and palate. They will help them learn how to make all the sounds needed for speech.

2. For resonation, speech therapists can help children learn how to resonate speech sounds. This can be done by using their nose and mouth. With activities such as blow bubbles and straw phonation, children can learn how to produce speech sounds correctly.

3. For feeding, speech therapists can help children with feeding difficulties. It might be caused by cleft lip and palate. Children with cleft lip may have problems with lip closure that causes spillage when drinking from a cup. Therapists can help children learn how to correct this by using different cups and straws.

4. For social skills, speech therapists can help children with social interaction. This includes skills such as turn-taking and conversation skills.

5. For fluency, speech therapists can help children who stutter learn how to speak more fluently. With activities such as slow speech and easy onsets, children can learn to control their speech and reduce stuttering.

6. If a child is unable to speak, a speech therapist can help them learn how to use AAC. AAC includes devices and methods that can help children communicate. This includes picture boards, sign language, and speech-generating devices.


Speech-language therapy can help a child to:

  1. Eat and drink without spilling

  2. Make speech sounds correctly

  3. Learn how to make all the speech sounds

  4. Improve clarity of speech

  5. Reduce drooling

  6. Prevent or correct swallowing problems

What happens when the cleft lip or cleft palate is untreated?

An untreated cleft palate can lead to serious health problems. This includes hearing loss, dental problems, and feeding difficulties. Early diagnosis and treatment are important for the best possible outcome. If you or your child have an untreated cleft palate, it can cause many problems. These include:


1. Ear infections: The opening between the nose and mouth isn’t closed. Air can escape through it when a child breathes. An untreated cleft palate can cause ear infections.

2. Speech disorders: Children may have trouble making certain speech sounds, such as “p,” “b,” and “m.” Untreated cleft palate or cleft lip can cause lifelong speech disorders.

3. Dental problems: Children may have trouble brushing their teeth and flossing. This can lead to cavities and other dental problems.

4. Feeding problems: Children may have trouble feeding. They may have trouble sucking, and they may choke or gag when they eat.

5. Social problems: Children with untreated clefts may have social problems. This includes situations such as teasing from other children.


If you think your child may have a cleft lip or palate, please contact your doctor. They can refer you to a speech-language therapist for an assessment. Together, we can help your child overcome any challenges they face and reach their full potential. Early diagnosis and treatment are important for the best possible outcome. At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.

 

About the Author

Mikee Larrazabal


I am a Speech-Language Pathologist with 14 years of experience working with children and adults who have communication difficulties. I completed my Bachelor of Science degree in Health Science at Cebu Doctors' University and have been helping people overcome their communication challenges ever since.


I have worked with individuals of different ages, including toddlers, preschoolers, school-aged children, adults and seniors. I'm passionate about speech therapy and take great satisfaction in helping people overcome their communication challenges and improve their lives through better communication skills. In my spare time I like reading books, going hiking in nature and taking care of my dog Locas.

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