Therapy for Unrepaired Cleft Palate

by Carla
(California)

I have never had to provide therapy for a student with an unrepaired palate.

The student just turned 3 and has just now had her lip repaired but not her palate.

What are the prevailing therapy methods that one should do to best help a client such as this one.

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Sep 06, 2015
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Unrepaired Cleft Palate
by: Jessica Summers

the palatal opening needs to be repaired or obturated as soon as possible. Speech therapy twice a week would be appropriate after that happens. The parents should practice with the child daily. Even with this, the prognosis is guarded given the age of the child, and the cognitive level. If progress is not being made, then therapy sessions could be spread out more to allow for more practice at home between sessions.

Aug 03, 2012
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unrepaired cleft theapy
by: Anonymous

Hi Carla,

What a strange position for you to be in! I agree many of Luke B's comments are sound on some level but it's obviously difficult to comment without knowing why there is such a delay in the lip and palate repair.

At age 3 it will be so important that the child is able to achieve placement of articulation even if they cannot make an oral airstream at present. I assume the plan is for a repair and that the child has a normal cognitive profile?

You can practice POA with nose holding and lots of sound inputting modelling with soft, elongated word final pressure consonants. Without this the child is going to become more and more disadvataged as their phonological processing system develops incorrectly on in input as well as output level.

There is lots of evidence in the literature for this along the same principles of pre-palate repair early intervention for our usual 6-9 month olds.

Why dont you call your local cleft service SLP for some more support. Good luck!!

Mar 20, 2012
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Therapy for Unrepaired Cleft
by: Luke B

Carla,

From what I have learned about cleft palate, you should not be providing therapy for anyone with an unrepaired cleft lip or palate until it has been taken care of surgically/medically.

I could be wrong but you can't try to make something better (in this case the palate) if it doesn't work in the first place.

On another note...I also learned in college that if a school setting is not the place to work on medically related speech and language issues (cleft palate, swallowing, etc.)

So if the client you are seeing is in a school you put yourself in risk for providing therapy that is considered outside your "realm".

Anyone else have any thoughts?

Hope that helps.

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