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Speech and Language Development in Children Born with Clefts

Speech and language development is a common concern for parents of children born with clefts.  The first few years of life are important years for language development in all children.  If a child has an isolated cleft of the lip (without palate involvement), speech should be developmentally normal as long as hearing loss or other problems are not present. 

Approximately 80% of children born with a cleft palate develop typical speech once their palate is repaired.  Speech therapy may be necessary.  Other children may also require a speech surgery or a prosthetic device to improve speech. 

A major goal of cleft palate repair is to ensure good quality of speech at the earliest age.  Usually, the palate is repaired in the first year of life.  Circumstances such as airway issues or other medical issues may factor into the decision by the cleft team members on when to repair the cleft palate. 

Children born with a cleft palate tend to be a bit slower than other children in their speech and language development.  Speech may not sound typical before palate repair, but it tends to improve afterward.  Children tend to catch-up for 4-5 years.  Speech therapy is often necessary during these years in order to improve the quality of your child’s speech.

Children born with a cleft palate are at an increased risk for delay in their language development for several reasons.  For example, early attempts at words might not be understood, and therefore not reinforced by parents.  Because of these risks, it is important to continue to follow with your cleft team with periodic evaluation by the speech-pathologist.

From birth onward, speech and language continue to develop.  Months before babies say their first words, babies can communicate with their parents, making cooing and babbling sounds.  These sounds and other social behaviors are important components of early development.  By 6-8 months of age, your child should be babbling, producing syllables that combine vowels and consonants, such as mama, nana, or yaya.  If the palate is unrepaired at this age, as is usually the case, you will notice that the sounds that your child is producing in babbling are different from what other children without clefts are producing.  

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