Early speech and language development: for carers of babies born with cleft palate

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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  • Learning to talk is a gradual process that occurs in small steps over many years.
  • Children born with a cleft palate vary in their speech and language development. The severity of the cleft is not always related to how much difficulty a child will have in developing normal speech.
  • About 60% of children with cleft palate develop normal speech without the aid of regular speech therapy.
  • A small number of children develop speech problems related to their cleft palate. Many of these speech problems can be corrected with speech therapy.
  • Children who have had a cleft may develop speech and language difficulties that are quite common in other children without a cleft, eg stuttering, slow language development. They usually respond to speech therapy.

What is the palate?

  • The palate is the roof of the mouth. It has 2 parts:
    • The hard palate at the front which is made of bone.
    • The soft palate at the back which is made of muscle.
  • The palate separates the mouth (oral cavity) from the nose (nasal cavity).

Why is the palate important?

  • When we swallow, the soft palate moves upwards and backwards to close off the nose from the mouth and stop food and fluids from going up through the nose.
  • When we talk, the soft palate moves upwards and backwards to close the oral cavity off from the nasal cavity. The majority of English sounds are made with the soft palate raised to close off the nose from the mouth.
  • There are 3 nasal sounds in English, "m", "n" and "ng" (e.g. as in "ring"). The palate does not need to move to make these sounds
  • When a child has had their palate repaired and it has healed after the operation, the mouth is now intact and they are able to learn to make the wide range of sounds used when talking.

When should a child with a cleft palate start to talk?

  • Children with clefts usually start cooing and babbling at the same age as other children. However, as with all children, this can vary.
  • By the age of 15 months, most children have started to talk, using a few words regularly.
  • If your child is not starting to talk by this age, it is a good idea to contact a speech pathologist.
  • It is recommended that at around the age of 2 years, children with a repaired cleft palate have a speech pathology assessment to check how their speech and language skills are developing.

Helping babies with cleft palate learn to talk:

Before babies learn to talk, they need to be able to listen to and watch people making sounds and talking.

Here are some ideas on things you can do to help your baby learn to talk, even before the cleft is repaired:

  • Sit facing your baby and sing songs, or make funny faces and sounds e.g. raspberries, kisses. This will get a giggle from your baby and teach them how to watch for and copy sounds.
  • Chat to your baby - talk to them in short sentences about what you are doing.
  • Look at simple picture books with 1 or 2 pictures to a page. Name the pictures and talk about them in simple sentences.
  • Repeat what you say, eg., say "up" every time you lift your baby up in a game, "more" every time you give them more food/drink.
  • Try and talk during routines e.g. say the same things every time you give your baby something to eat.
  • Encourage your baby to copy early developing lip sounds "p", "b", and tongue tip sounds "t", "d". in babble and simple words, e.g. "puppy", "bubba", "teddy", "dadda".
  • Use exaggerated facial expression and gesture.

After the cleft is repaired, keep doing the things mentioned above and:

  • Play sound games. Turn off the radio/TV. Look at your baby and ensure your baby is looking at you. Babble sounds such as raspberries, Indian war whoop i.e. "wah-wah-wah" with hand to and from mouth, and early sounds that use the palate eg /ba-ba-ba/, /pa-pa-pa/, /da-da-da-da/, /ta-ta-ta/, /ga-ga-ga/, /ka-ka-ka/.

Your baby will probably not copy the sounds straight away but will enjoy watching you make the sounds and listening to them.

  • Play turn-taking games. Turn-taking is an important early communication skill. If your baby makes a sound, say something back and then wait for them to make another sound.
  • Play games in front of the mirror e.g. poke out your tongue/ clap your hands then encourage your baby to copy.
  • Point out sounds that you hear around you e.g. a dog goes woof, woof; ooh look car, brrm brrm; train goes toot toot. Encourage your baby to copy the sound.
  • Words that start with the lip sounds "b", "p", "m" and "w" are sometimes easier for babies to learn, eg., "mum"; animal sounds such as "moo", "woof" and "baa", and other words such as "bath", "bye-bye", "wee-wee".
  • Bubble makers are fun. Practise words such as "bubbles", "pop" and "more".
  • Practise simple words such as "up", "down", "in" and "out". Concentrate on these words when playing at the park, outside with a ball etc.
  • Action games and songs are great for encouraging turn taking, copying gestures and sounds. E.g. Everybody Clap, Twinkle Twinkle Little Star, Old MacDonald Had a Farm, If You're Happy and you Know it.

Remember

  • Not all children who have had a cleft palate will need speech therapy.
  • Your baby should start to make new speech sounds in the months following cleft palate repair.
  • Most babies who have had a cleft palate have started trying to talk by 15 months of age.
  • Children who have had a cleft palate should have a speech and language assessment by 2 years of age.
  • If you are worried about your baby's speech and language development, see a speech pathologist.

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Tel: (02) 9845 0000
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www.chw.edu.au
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Sydney Children's Hospital, Randwick
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