The majority of children born with cleft palate will need speech-language therapy at some point in their life. A speech-language pathologist is the healthcare professional that provides speech-language therapy, which may be in the medical setting, school setting, private clinic, or home-based intervention program. The goals of speech-language therapy are to provide the child with the knowledge and skills to achieve normal speech and communication for their age or developmental level. Speech-language therapy can be initiated immediately after the child is born to improve feeding/swallowing skills and to facilitate early communication. In toddlers and preschoolers, speech-language therapy often aims to help the child expand their vocabulary, improve their ability to form sentences, and to increase the diversity of sounds that the child can say. In school-age and older children with cleft palate, speech therapy often aims to help children improve their pronunciation, verbal expression, voice and/or resonance. The speech-language pathologist will develop a care plan to meet your child’s specific needs.
Biofeedback speech therapy is a treatment that specially-trained speech-language pathologists may use to help your child improve his/her articulation and/or resonance. In older children with cleft palate or velopharyngeal dysfunction, Nasometry and Nasopharyngoscopy may be used to provide the patient with high-tech biofeedback about their speech.
In most cases, speech therapy alone is typically not effective at treating hypernasal speech and velopharyngeal dysfunction, so surgical options such as a Pharyngeal flap or Sphincter pharyngoplasty may be recommended.
In rare cases, a child with velopharyngeal dysfunction may not be a good surgical candidate, so a speech prosthesis may be an option to improve their speech. A speech prosthesis is created by a dental professional (such as a prosthodontist) to fit in your child’s mouth and is worn much like an orthodontic retainer. The two main types of speech prostheses are the speech bulb and the palatal lift.