Development The role of the speech pathologist on the craniofacial team is to provide the parents with the appropriate information regarding speech and language development and determine the child's competency of these skills. This process is generally done through diagnostic tests, nasopharyngoscopy and/or videofluroscopy. Based on these findings, appropriate recommendations for surgery and/or therapy can be made. Routine follow-up visits constantly provide the opportunity for reassessment every six to twelve months and allow the clinician to monitor progress as well as developing problems.

What types of speech and language problems can a child with cleft lip and/or palate experience? A cleft palate involves an opening or split in the oral structures that can be surgically repaired at a very early age. Although the surgeon may be successful in closing the cleft, it is often possible that difficulties with speech may develop. Problems with language delay can occur due to a child's inability to produce certain sounds. Compensatory speech patterns can develop and be very difficult for adults to understand. This in turn affects the child's interaction with adults and children. Articulation can also be affected by the cleft palate if the soft palate cannot make contact with the pharyngeal walls (wall at the back of the throat). Airflow will leak through the nose during speech (hypernasal speech). This can affect consonant sounds "p", "b", "t", "d", "s", "sh", "ch", and "f" if the seal cannot be maintained. As the air escapes, the sounds will become distorted. The voice quality can indicate signs of hypernasality and other problems with resonance. In addition to problems with language and articulation, repeated ear infections and dental issues can further complicate speech and language of a cleft palate child. Often, the early and late eruption of teeth in conjunction with the collapse of the upper jaw further complicate the cleft lip/palate child's ability to develop speech and language skills in the traditional method.

Early surgery and intervention can assist in developing competent and correct sound production as well as language acquisition.

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