Clefts are a physical defect that manifest during pregnancy. Cleft lips and cleft palates affect roughly 1 in 700 newborns in Ireland, or roughly 92 a year. Understandably, clefts can have an impact on a person’s ability to speak, so this blog will look at how speech therapy can help overcome these issues.
How do Clefts Form?
Clefts form as the foetus is developing the womb. They are a result of insufficient tissue in the mouth or lip area, which causes the existing tissue to join improperly. It is not known exactly why clefts form, but it is believed that genetics play a large role, as they often run in the family. However, viruses, bacteria, and drugs or medication may also play a role in some cases.
Boys are twice as likely to get a cleft lip as girls, while girls are twice as likely to get a cleft palate. About half of all cases in Ireland involved a combination of both a cleft lip and a cleft palate, while 30% get only a cleft palate, and 20% a cleft lip.
How Can SLT Help?
Although cases vary from person to person, and most people with a cleft will be able to achieve a more typical appearance and functionality, clefts require years of medical attention to address fully. In terms of SLT, this will begin with the monitoring of speech production and development. The therapist will give the child regular check-ups, monitoring not only their speaking ability, but factors such as the escape of air from the mouth as well. X-rays and nasendoscopies (the insertion of a small tube camera into the nose) will also be used in order to give the therapist a more comprehensive understanding of the movements involved.
The initial stages of SLT typically start to occur between the 6 and 12 month mark. During this time, the therapist will work with the parents, not the child, to encourage two-way communication. This will involve working on getting the child to express their emotions and understand their emotions. At the same time, parents should encourage the child to move their mouths, tongues, and lips as much as possible, to build up strength and minimise the risk of stiffness or rigidity. From the ages of 1 to 3, your child will have at least one review a year with the therapist. During these visits, the therapist will monitor their development and their hearing.
Once the child is old enough for a proper session with the therapist, which is generally around three years old. Once the child can understand and cooperate with instructions, the therapist will be able to distinguish between velopharyngeal dysfunction, which is the term for a speech impediment that comes as a result of a cleft, and unrelated difficulties/baby talk.
Another reason therapy is left until the age of three is that up to 60% of people with clefts will not having difficulty speaking. So even though the child may not be able to take part in therapy, they may not need to. This reinforces the importance of the therapist identifying when an impediment is linked to the cleft, and when it is not. Blaming the wrong thing or treating your child as if they are having difficulty when they are not will impact their development, so remember not to jump the gun, and take the child in for regular check-ups with a professional.