Cleft lip and cleft palate are among the childhood language issues addressed at the Scottish Rite Childhood Language Center at Richmond, Inc.

Speech-Language Pathologists may encounter birth defects such as cleft lip and cleft palate. These are the fourth-most-common birth defects worldwide. Clefts occur when the tissues of the face fail to fuse during gestation, usually between the fourth and eighth weeks of pregnancy, and the incidence is one in every 700 births. Genetics most frequently plays a role, but there can be a number of environmental factors as well. Parents are often initially overwhelmed and saddened after the unexpected birth of a baby with a cleft. There is, however, much that can be done to help these children.

In most cases, children grow up to lead normal, productive lives, but they have medical problems that need to be addressed early in life. They are more prone to ear infections because the Eustachian tubes in the ears are frequently affected by the cleft and do not drain fluid from the middle ear the way they should. Dental issues are also quite common. Because of their multiple problems, children with clefts should be seen by many different specialists. Often they form a "Cleft Palate Team" that offers a broader perspective to the problem. Usually, such a team includes an Audiologist, Ear Nose and Throat Surgeon, a Speech-Language Pathologist, a Geneticist, a Neurosurgeon, a Pediatric Dentist/Orthodontist, a Pediatrician, a Plastic Surgeon, and others.

The role of the Speech-Language Pathologist on the team is to provide parents with the information they need regarding speech and language development and to evaluate the child's current level of functioning. This evaluation generally consists of diagnostic tests, videofluroscopy, and nasopharyngoscopy. A plan of treatment specific to the child's needs is then devised.

Clefts can be repaired, and cleft lip repairs are generally performed at about ten weeks of age. A cleft palate is usually repaired at about 9 to 12 months of age. Bone grafts are typically done around age nine. Revision work takes place as the child grows. Although surgeons are very successful at closing clefts, difficulties with speech often remain. Articulation is affected when the soft palate cannot make contact with the back of the throat (the pharynx), and hypernasality is often present. Hyper-nasality occurs when airflow leaks through the nose during speech. Early intervention can assist in developing correct sound production, minimizing hypernasality, and improving language skill development.

A newborn baby is a joy and a blessing, and a baby born with a cleft is no less a joy. He or she will need the same care, love, and support as any other child and will return the love received to family and friends throughout the years. For more information, please contact The American Cleft Palate-Craniofacial Association at (919) 933-9044.