Cleft Speech and Language Therapy


Welcome to the Cleft Speech and Language Therapy Team

We are here to assess, monitor and help you/your child develop the best possible speech


How does Cleft Lip and Palate affect your speech?


A cleft is a gap or split which can affect one or both sides of the upper lip and/or the roof of the mouth that connects the mouth directly with the nose cavity.

A child with cleft lip only should not develop cleft related speech difficulties.

The soft palate closes off the nose from the mouth during speech. Most speech sounds produced in the English language are made with the palate raised and the nose cavity closed off. Such sounds are called ‘oral’ sounds (p, b, t, d, k, g, f, v, s, z, sh, ch, j). In addition there are three sounds, (m, n, and ‘ing’) that are produced with the palate lowered allowing air into the nose. These sounds are called nasals.

Soft palate moves up against the back of the throat to close off the nose allowing all air to pass into the mouth for oral sounds.






Soft palate remains level allowing air to pass into the nose for nasal sounds.





When do Speech and Language Therapists see Children?
Ward Visit 

All children born with a cleft lip and/or palate are seen on the ward following surgery by a member of the Speech and Language Therapy team. You will be provided with information on how to encourage speech and language development at an early age. 

Babble Therapy Workshop 

All children who have a cleft palate will be invited to attend a ‘babble’ workshop session between the ages of 9-12 months. This is a preventative measure to reduce the risk of babies developing speech difficulties related to cleft palate. The session aims to:

•Provide parents with ideas and activities to encourage early speech and language development
•Allow parents the opportunity to meet other families who have a baby born with a cleft palate
•Provide early advice on dental hygiene from a Dental Hygienist

You will find ideas on encouraging babble by watching the video linked in the picture or here . Also here is a leaflet to help you use your Babble Bag




Assessment and Monitoring

Your child’s first speech assessment will be when they are 18 months of age. This is very informal and carried out through play. 

Following this, children are assessed again at 3 years of age. (Though some children may require more frequent monitoring).  The 3 year assessment is a more detailed speech assessment to check that your child’s palate is working properly and to monitor the sounds they are using. 

Children born with a cleft palate are also routinely seen at the ages of 5, 10, 15 and 20 by the Speech and Language Therapists as part of the cleft team’s monitoring process and in line with national recommendations.  The results of these assessments are fed back to the Cleft Surgeon, which helps to assess the success of the surgery and will help the Team to know whether further intervention is required.  Some children may need additional monitoring or help with their speech and this will be arranged locally. 

If there is concern that your child’s palate is not working as well as it should, your child may be seen for a palatal investigation which involves a ‘talking x-ray’ (Videofluoroscopy).  Some older children may also require an assessment using a ‘magic eye’ (Nasendoscopy). 

The Speech and Language Therapists will monitor your child’s speech while they are attending cleft clinics and also if they require further treatment at a later stage such as orthognathic (jaw) surgery.

A child born with a cleft lip only does not routinely attend these assessments, as it is rare that a cleft lip will cause them to have any speech difficulties



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