Typical cleft palate speech patterns

Summary

The information in this section will cover some of the typical speech patterns seen in children with cleft palate or velopharyngeal inadequacy (VPI). Whilst some of this terminology might be unfamiliar to the generalist therapist, the speech errors are essentially articulation and phonology errors. Assessment also follows a standard articulation and phonology approach. This will be discussed in the assessment section.

Typical speech patterns associated with cleft palate or other velopharyngeal inadequacy (VPI) are:

• active speech errors / compensatory errors
• passive speech errors / obligatory articulation productions
• nasal airflow disorders
• nasal grimace
• weak or omitted consonants due to decreased oral air pressure
• short utterance length
• altered rate and speech segment durations.

Read more detail about:

• Active and passive speech errors
• Resonance
• Nasal Airflow Disorders
• Dental anomalies and effects on speech
• Other effects of cleft palate on communication: hearing, language development, literacy, voice

Nasal airflow disorders

Nasal airflow disorders occur commonly in children with cleft palate and / or VPI, and are also sometimes seen as a phonological process in children with normal velopharyngeal structure and function. The flowchart below outlines some nasal airflow disorders. Click to view more detail on nasal airflow disorders.

Dental anomalies and effects on speech

Children with cleft palate commonly have missing, rotated or extra teeth at the alveolar cleft site. The maxilla (upper jaw) may be narrow. These features may result in lateral or interdental production of /, ,, /.

Class III malocclusion, or underbite (where the lower jaw and teeth sit forward in relation to the upper jaw) is common in children with a history of cleft palate. This may affect tongue tip placement of alveolar sounds /t, d, n/ and can result in interdental and tongue blade realizations. Labiodentals /f, v/ may be inverted, being produced by the lower teeth contacting the upper lip.

Consider the effect of any existing dental appliance on the child's oral placement for speech. Click to view more detail on dental anomalies and effects on speech.