Additional Treatment

Related Problems and Treatment

Children with clefts, particularly those of the palate, can have related speech, hearing and dental problems. Social and emotional concerns may also need attention. Thus your child’s condition may require relationships with a number of experts over a period of years. Some of these specialists may need to see your child frequently, others only once or twice. Additional cleft and craniofacial team members will be available to help your child in these other areas.

Speech

When we talk, most of the sound and air we generate should be directed into and out of the mouth. If the palate does not properly separate the mouth and nose, sound or air may leak into the nose, causing the speech to have a “nasal” quality. In most cases, the initial palate surgery will correct this problem. However, about 25% of cases may require additional surgery, usually between the ages of 4 and 6 years; another 25% will need speech therapy.

Speech and language development begin very early in your child’s life; babies make many sounds before they are a year old. The team speech pathologist, who specializes in speech, language and voice disorders will counsel you about ways you can stimulate your baby’s healthy progress and monitor his or her speech and language development. Regular speech evaluations will become a part of your child’s treatment plan. If speech therapy or other treatments are necessary, the speech pathologist will help determine the best type and extent of treatment.

Hearing

Children with cleft lip or palate, but especially palate, are at risk for middle ear disease and hearing problems. In a child with cleft palate, the eustachian tube, which connects the ear to the nose, does not open properly, allowing fluid to build up in the middle ear. This fluid can cause hearing loss, which in turn can affect both speech and learning.

Your child’s hearing will probably be tested in the first year and then monitored by the team audiologist. This specialist is trained to measure and identify hearing problems, suggest what symptoms to watch for, and recommend treatment. Your child will also be seen at the initial screening and then routinely by the otolaryngologist, who is an ear, nose, and throat specialist.

The otolaryngologist will examine your child’s ears as well as other head and neck structures for abnormalities.

Early monitoring and regular testing will ensure that your child’s hearing, speech and language patterns develop properly.

Pediatrics / Genetics Evaluation

The overall health of your child is important to us. Our cleft team pediatrician and geneticist will be taking a careful history and examination to assist with other conditions and help you better understand your child’s overall condition.

Dental Care and Orthodontics

Children with cleft lip or palate may have dental problems, especially if the cleft comes through the gums. Teeth are often crooked, which may affect appearance, speech or chewing. Good dental care and healthy teeth and gums are important for your child. When most of the permanent teeth are in place, the orthodontist, a dentist whose specialty is straightening teeth, will recommend treatment that may include braces. Sometimes surgery is required to reposition the jaw or further improve your child’s appearance. If so, it will be performed when he or she is a teenager.

Social and Emotional Concerns

It is perfectly natural for you to be concerned and emotional about your baby’s condition, appearance and treatment. Learning to cope with a child who has a cleft may take some adjustment on the part of all family members. And as your child gets older, development of his or her positive self-image and self-esteem is very important.

All cleft and craniofacial team members are sensitive to these concerns and are there to help you.

The social worker, in particular, has expertise in helping parents and patients cope with emotional and social concerns. He or she can provide counseling, education resource materials or help in obtaining financial assistance. The social worker can also suggest family support groups or help make referrals if social and emotional problems persist. Rest assured that help is available to you and your family.