Speech and Cleft Lip & Cleft Palate
Fatema Jagmag
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Speech and Cleft Lip & Cleft Palate - Patient Education
Will my child's speech be delayed if he has a cleft lip/palate?
Not necessarily, if the surgical intervention is timely.

At what age should he be operated?
The surgery should be done between 6-18 months. But palate repair carried out at around 12 months of age is generally preferred.

Unfortunately for some children, early surgery may not be possible because of other handicapped conditions and extensiveness of the cleft of palate.

Will my child require a second surgery?
This need may arise where the cosmetic outcome of the lip & nose repairs is not satisfactory or the function of the velopharyngeal mechanism is not adequate for speech or there is a blockage of the nasal airway.

My child does not have a visible cleft lip and palate. But still, he has been advised surgery because of his hypernasality (Has a nasal voice).
Hypernasality may be due to a submucous cleft, which may become apparent when speech begins to develop.

Can my child's hearing be affected because of his cleft lip/palate?
Hearing becomes progressively impaired if palate repair is delayed. Hearing loss is usually of a conductive type. The child's hearing should be routinely checked and re- checked because of a possibility of intermittent loss. The presence of any loss will be a handicap in the development of language and speech and may be detrimental to academic progress.

What tests should be done to rule out a hearing handicap?
In addition to ENT examination, pure tone audiometry and impedance audiometry should be done to reveal any middle ear anomalies.

Will my child need any dental/ orthodontic treatment?
Orthodontic management will be required throughout the entire growth period of the child from infancy to adulthood.

Will my child's intellect be affected because of his problem?
No. Sometimes, these children have a lower verbal ability because of their handicap.

Will my child's speech be delayed?
There are many reasons why the child's speech may be delayed:
- The early mother-baby bonding in which early interaction takes place is under stress & may therefore provide a poor start
- Hearing loss
- Periods of hospitalization may interrupt periods of normal experience, which is very important for language learning
- Delay in the surgery especially surgery for the cleft palate

When should I seek help from a speech pathologist?
Once you have coped with the initial problems such as feeding & plans for surgery, the next major concern should be speech


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