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This one is about: Early Speech Treatment in Infants

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Hi Folks:

As an SLP (Speech and Language Pathologist) on a CLP Team (cleft lip & palate team) I, of course, have very strong feelings on this topic. Children with Cleft lip & palate are at very high risk of developing speech disorders because of the "anatomical" difference and the high incidence of hearing problems due to fluid during the speech development years.

When they are babies these kids appear to be "developing normally" mainly because the items which are evaluated are things like:

   -recognizes name
   -plays at age level with toys
   -coos, uses vowels, says three consonants (m,n, and y count here)

The things which are difficult to test are the actual forming tongue movements for future consonant sounds and that old soft palate (VPI). The kids develop atypical tongue movements early, but we don't have much research to back up that these are "abnormal" and thus need direct treatment by a trained professional. The tongue tends to make contacts further back in the mouth so t, d, k, g are all made in the middle of the palate and sound the same. Sometimes nasal noises (like snorts) are substituted for some sounds (usually s, sh, ch or p, b,t, etc). Other times the child will produce s, sh, ch further back in the throat. If all of these things are learned initally and practiced, they are then much harder to correct later, from an SLPs point of view.

I prefer to test kids at birth for feeding, at 4-6 months to progress feeding to solids and give parents advice, and at 7-9 months to listen for the development of the above described habits. If any baby is developing them we recommend treatment right away. The treatment is primarily to teach you the parents how to stimulate correct tongue placements and how to listen for other developing problems. We have occasionally had problems referring kids for this treatment: Some SLPs outside of our center and closer to the parents' home don't work on teams and often think the kids are "developing normally" and don't know what to work on or how to do it. Others may try, but be unsuccessful. One recent case came to us from such a professional and this child is now making GREAT progress with a more CLP experienced SLP.  Experience pays with all of the little "tricks" of the trade.

I wouldn't put my own child in treatment unless I had clear evidence from an experienced SLP on a team that my child was developing the above described speech habits. Prevention of that is very important for those that need it. There is SO much more to life than speech therapy that I would be opting for those fun options instead! Don't get me wrong I love my profession and have fun doing it...but I just want you to carefully weigh your options.

Take care and Happy Talking!
Margie Wells-Friedman

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