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This one is about: Stimulating Early Speech Development - 12 months to 3 years

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by Kelly Mabry Downing MS, CCC-SLP

The child with a cleft palate will have two major area of concern in his speech development. First, he may make certain sounds in a different way than non-cleft children due to his unique mouth structure. Second, his voice may have a nasal quality.

Early speech stimulation is not difficult for the parent to achieve. In fact, it is done best when the parent simply does what comes naturally, keeping in mind two specific goals. Those are: 1) Teach your child to imitate. Imitation is an important learning and social tool, especially in the speech development of a child with a cleft; and 2) teach your child to direct the airflow through his mouth, rather than his nose.

These skills are best encouraged through parent/child play. The following are some age-specific suggestions for your toddler/preschool aged child.


Up until now you have been providing your cleft affected child with the same kind of stimulation that all children need. At this age you will want to start focusing on airflow. Remember, a cleft-born child may have difficulty with air coming out of the nose, giving him a "nasal" voice. Several games to encourage your child to direct his airflow to his mouth, rather than nose, include blowing games such as bubbles, feathers, tissue, ping-pong balls, low-pressure whistles and pin-wheels. Be creative! You might want to hold your child's nose while he blows so that he can get the "feel" of it.

This is also a great age to further develop imitation skills. Puppet play is excellent for working on imitating tongue and mouth movements. Play silly games with your mouth and tongue (stick in in/out, back/forth, smack lips).


You can now progress from blowing to sucking games. Drinking liquids from a straw is a great way to teach your child how to build up negative pressure in his mouth. Start with thin liquids such as juice and progressively get thicker with milk shakes, frappes or even jell-o! Continue to play blowing games. Remember, these games are not meant to strengthen muscles. Rather, they are to encourage correct lip and tongue placement of consonants, such as /p,b,t,d,m,n,w/. Playing with pop beads is a great activity to stimulate p, b, and lip smacking. If your child is not producing these sounds, or not saying them correctly, DO NOT correct him. Instead of saying, "No, that's not the way to say 'ball'." Repeat your correct model while encouraging him to imitate you.


This is a time of enormous speech growth! Your child should be talking in simple sentences by the time he is three year old. Continue to sing nursery rhymes while emphasizing correct production of various sounds. This is also a good time to talk about sounds. "What sound does a cow make?" "What sound does a truck make?" etc. This will encourage your child to develop good listening skills that will be important for further speech development. You can also continue playing your blowing games, but be careful that your child does not exert too much pressure while he blows. This may lead to articulation errors (errors in speech sounds). Introduce your child to a mirror and play speech imitation games while he can watch himself. Let him take the lead and you imitate him.

Most importantly - have fun! Speech and language are social skills. Your child will learn them best in a social setting. And in the earliest months, you will be the one to provide that setting best.

The following books are great sources of activities to stimulate speech and language within a play context. If you are concerned about your child's speech development, don't hesitate to contact a speech/language pathologist through your craniofacial team for an evaluation.

---------------Kelly Mabry Downing, MS CCC-SLP, is a speech and language pathologist for the Craniofacial Team of Newington Hospital Cleft Palate Clinic in Newington, Connecticut. She is also the Speech/Language Consultant for WIDE SMILES Magazine.

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