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The Role of the Speech Pathologist in Treating a Cleft Palate

It can be scary and heartbreaking to watch your child with a cleft palate struggle.  When treating a cleft palate, a multi-cleft palatedisciplinary team approach is the best way to provide the highest level of care to your child and your family. Allowing multiple team members to communicate often and coordinate approaches will result in a more comprehensive plan of care overall.  One indispensible member of this team is the speech pathologist.

How a Speech Pathologist Can Help Your Child with a Cleft Palate:

A speech pathologist is a critical part of your child’s cleft palate team.  Speech pathologists provide support from the early days by assisting with feeding and into childhood as your child masters speech with the continuous changes they will undergo the first few years of life.

From birth, feeding a child with a cleft palate may be a concern for parents. A speech pathologist will be able to provide strategies for adaptive techniques and useful tools to ease this difficulty. He or she will work closely with nutritionists and nursing specialists to provide the most effective care for your child and to ensure your child can maintain adequate nutrition orally.

As your child grows and develops, regular, consistent assessment of your child’s articulation skills is critical to determine if any production errors are the result of structural difficulties or compensation for your child’s weak/insufficient muscles.  The cleft palate team will determine if your child’s speech and language is appropriate for development.  A trial period of speech therapy may be suggested prior to an additional surgery. A speech pathologist will also screen for hearing impairments, which may co-occur with a cleft palate.  This can cause difficulty with understanding and/or acquiring sounds and language.

Finally, the role of advocate is also a critical piece to the team offered by the speech pathologist. The speech pathologist can assist you by providing information regarding useful websites, helpful publications and information regarding local school districts and the care that is available to you and your family.

Helping your child with a cleft palate can be a difficult journey, but with the right help, your child will overcome the challenges of this condition.

Do you have more questions about helping your child with a cleft palate?  Click here to learn about our speech pathology program or call us at 877-486-4140.

Acquisition of Speech Sounds by Age

Speech sound development varies greatly between boys and girls as well as between ages. Below are two charts that provide information about age of acquisition of speech sounds.  Speech Pathologists have researched the age of acquisition of consonant sounds in Standard American English for many decades. Each study found slightly different results regarding the age of mastery. I have provided the norms listed from the Goldman Fristoe Test of Articulation, 2nd Edition (GFTA-2). The GFTA-2 has been a widely-used articulation assessment for over 30 years. The age of mastery was determined by 85% of the sample population having the target sound mastered in the initial, medial, and final position of words. You can view a chart below with each sound and the typical age of mastery.

These charts should be used as a reference, not as a definitive means of determining if speech services are warranted. If your child is difficult to understand or is experiencing challenges with pronunciation of sounds, please contact a licensed speech language pathologist for a full evaluation.

Male

By Age Children should be able to say
2 ½ m n h w
3 p b g
3 ½ k t
4 f
4 ½ -ing y (yellow) d
5 j (jumping)
5 ½ s “ch” (chair) “sh” (shovel)
6 r l
7 v z “th” (this)
8 “th” (thumb)

Female

By Age Children should be able to say
2 m h
2 ½ n p
3 f w b T
3 ½ k g
4 d
4 ½ -ing y (yellow) r j (jumping) “sh” (shovel)
5 l s “ch” (chair)
5 ½ z
6 “th” (this) v
8+ “th” (thumb)

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References:

 Goldman, R., Fristoe, M., & Williams, K. (2000). Goldman fristoe test of articulation supplemental developmental norms. (2 ed.). Circle Pines: American Guidance Service.

6 Ways to Support your Child through a Dining-Out Experience

I worked in the restaurant industry for many years as a hostess as well as a waitress. I recently observed a family out at dinner on a Saturday night. After seeing some of the behaviors of their son and hearing some feedback from their waiter, it became obvious to me that this family had a child with special needs.  Shortly after ordering food, the family had to request that their food be boxed up to take home instead of eating at the restaurant. I found this to be very unfortunate, as there were many actions the restaurant could have taken to accommodate this family’s needs.

Mother and daughter restaurant

Eating out at a restaurant is like participating in a dance. Everyone needs to know the right steps to make the dance smooth and make sure no one’s toes are stepped on. What diners don’t understand is that they are very much a part of this dance. Typically, waiters are able to read their tables and determine their needs. As a server, I am able to determine the timing and tempo desired by diners and make sure their food is delivered appropriately. Knowing what accommodations you can ask for is important.

The following tips will better prepare you to make the requests you need. A restaurant staff should be able to accommodate these needs no matter what time of day:

Know the menu

Before going out to a restaurant, look at possible food items you would like to order. You do not need to pre-order your food as cravings change when you get to the restaurant, but becoming familiar with the available foods will help make an order quicker. This can also assist in talking to your children about the restaurant. They could choose what they want to eat and become excited about going! It will also make an unfamiliar environment feel more familiar.

Request a quiet table

Request a table in a quiet area that has some space for movement. Try to avoid tables in the middle of dining areas or ones that are far from the exit or bathroom.

Call ahead and ask about existing reservations

Parties of 15 or more tend to be very loud and take up a lot of the dining space. Avoid going to restaurants during the time of the party. Once my restaurant had a reservation for 70 people! It took up the entire dining space. Also, the time it takes for the kitchen to prepare the food was extended for other diners in the restaurant at that time.  From the time the waiters placed the food order, it took the kitchen one full hour to make it!

Order everything all at once

Order your drinks and food all at the same time. Waiters control the pace of your meal and how soon your food arrives.  Let your waiter know what your dining experience looks like.  Do you want your food all at once?  Do you want your child’s food first?  If you need your meal fast, just inform them and they can make it happen. Restaurants are able to deliver food within 10-12 minutes of ordering, maybe sooner.

Tell your waiter about your child’s needs

Be an advocate for your child. Create a “menu” of your child’s needs before going to the restaurant. For example, you can say, “my name is _____. I like to have my food delivered quickly. When this does not happen, I can become upset. When I am upset, it may look like this­­­_______.”  By doing this, your waiter will understand your child’s needs and can work to have them met. This also helps further prepare your child for going out to eat.

Be prepared

Bring tabletop activities for your child to enjoy while waiting for the food to be delivered. Perhaps ask for a table with extra space so that there is plenty of room on the table for cups, plates, and activities.  Also, talk with your child ahead of time about the restaurant experience. Create a visual schedule to follow and label the dining expectations.  First, we sit down, then the server takes our order,  then we receive our drinks, then we color/read/watch a show for a certain amount of time ( you can ask your server how long the food will take),  then we receive our food,  and finally we eat.

Knowing what accommodations you can ask for is important.  By knowing these tips, you will be better prepared to make the requests you need to make your “dance” smooth.

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