What does the speech rehabilitation consist of?
When should the first visit at the speech therapist be appointed?
The speech rehabilitation in people with cleft lip and palate is quite complex and requires wider discussion. To make a long story short the therapy depends mainly on two factors: the age of the patient and the type of the defect.
The age of the patient
The improvement of speech might be initiated already before the operation. It is very important to maintain the sucking and swallowing reflex, stimulation of correct position of the tongue without any movement. An important role is played by the massage of the articulation organs, i.e. those parts of the oral cavity which are active in the process of speech. The massage sessions should be continued also after the operation.
Older children who begin the cooperation with speech therapist are rehabilitated mainly with the help of exercises connected with fun and whole body movement.
Children of school age are encouraged to exercise and do the visual monitoring (exercising in front of the mirror) and aural self-control (recording the exercise with the any kind of recording device).
The types of defect
In case of cleft palate a special attention is paid to the functioning of the velopharyngeal sphincter, i.e. the correct functioning of the palate and throat muscles. Its malfunction causes the so called hypernasality. The rehabilitation consists of exercises improving the soft palate, massages, improving tone exercises, isometric exercises. Equally important is the functioning of the tongue – its position while eating, while articulating particular sounds as well as its standstill position. In cleft lip usually attention is paid to the functioning of the orbicularis oris muscle while speaking and eating. In all the cases it is very important to pay attention to the route of breathing, which should be nasal.
To sum up:
First appointment with the speech therapist should take place before the first operation.