All children born with a cleft lip or palate are seen by a specialist speech and language therapist in the cleft service. If your child has a cleft lip only, individual appointments are not required. However a speech and language therapist is always available at the cleft clinics if you have any concerns about your child's speech and language.
Your child will be seen by our speech and language therapists at specific points in their development, but we also offer additional assessment and therapy if needed.
You child's care plan
0 to 6 months old
A speech and language therapist will be present at the cleft clinic you attend with your child. Please let us know if you want to have a separate appointment with the therapist to discuss speech and language development.
6 to 12 months old
After palate repair surgery, a speech and language therapist will spend time with you to talk about speech and language development. They'll give you advice on how you can help your child's speech and language and they'll also give you more detailed information about how the palate functions during speech.
2 years old
A therapist will assess your child's speech and language to see how it is developing. We'll spend time talking with you about all aspects of your child's development and we'll watch you and your child play together in order to assess their communication skills.
At this age your child may be able to use a range of single words and may be starting to put them together into short sentences. We may give you advice on how to stimulate language or sound production. You'll be able to ask questions about any concerns you may have.
Follow-up appointments will depend on the outcome of your child's assessment. Sometimes we will carry out another review 6 months later.
3 years old
Your child's speech will be assessed at a cleft clinic and we'll continue to monitor your child's speech sound progress. We'll also check whether their palate is closing effectively in order to make strong oral consonant sounds for speech.
As your child grows
We'll carry out assessments and speech recordings of your child when they attend cleft clinic appointments at ages 5, 10, 15 and 20.
Your child will be seen in the local cleft clinic nearest to your home for routine speech assessments by our service. If regular speech and language therapy is needed, it will be offered as close to home as possible. This could be a local clinic, school or at an outreach cleft clinic. Specialist investigations take place at St Thomas' Hospital.
Patients without a cleft palate diagnosis
We also see children where there is a concern that their velopharyngeal function for speech is not working well enough. This is where the soft palate does not close with the back of the throat properly in order to make strong oral pressure sounds such as “b, d, s, k”. Speech may sound overly nasal in tone, it may have some accompanying nasal airflow alongside it or unusual speech patterns may have developed. We'll provide any assessment, management and therapy that is needed.
For further information about how to refer children with suspected affected velopharyngeal function please email gstt.cleft@nhs.net.