Cleft lip and palate services

The Cleft Lip and Palate team at CHI is part of a national service for children born with cleft lip and palate and children with speech problems associated with palatal problems when there is no obvious cleft palate (Non cleft velopharyrngeal dysfunction).

The speech department is recognised both nationally and internationally as a centre of excellence for the management of these speech disorders. The SLT assesses feeding skills in babies born with cleft palate and offers advice to parents/caregivers in relation to feeding an infant with a cleft palate. The SLT is also involved in assessing, diagnosing and treating communication disorders related to the cleft palate as well as decision making regarding future team management and non-cleft velopharyrngeal dysfunction management. The therapist liaises with SLTs in Community Care regarding treatment of children with velopharyrngeal dysfunction or cleft palate.

The following assessments may be carried out:

• Early monitoring of speech production and resonance
• Regular speech reviews at MDT Cleft clinics
• Perceptual Assessment of articulation, resonance and nasal escape of air during speech.
• Instrumental Assessment:

1. Computer-based assessment of nasal acoustic energy (Nasometry) and measurements of airflow through the nasal cavity ( Pressure Flow Assessments)
2. Direct assessment of palatal function during speech using Videofluoroscopy (continuous x-ray recording of the movement of the palate while the child is producing speech samples.) and Nasendoscopy: (insertion of a small scope (nasendoscope) into the child’s nose to observe palatal movement)

Results of the above assessments are reviewed with the PS and/or other team members to decide on future management. SLTs accept referrals from outside agencies/ professionals for second opinion assessments of resonance disorders, as the department is a recognised specialist centre for such assessments. As a centre of excellence, the cleft SLTs provide ongoing training nationally on assessment and management of cleft palate and VPD speech disorder. For Temple Street referrals may be directed to:

The Speech and Language Therapy Manager,
St Frances’ Clinic,
Children’s University Hospital,
Temple Street,
Dublin1.