July is officially Cleft and Craniofacial Awareness month, but I celebrate craniofacial awareness every month.
Working with a team of more than a dozen medical and dental professionals, I follow nearly 2,000 patients with craniofacial differences through yearly evaluations, from infancy to young adulthood or beyond. After working in the profession for 28 years—when did THAT happen?!—evaluating and treating patients with craniofacial differences is second nature to me. So I sometimes forget that when these patients go home, the speech-language pathologists helping them might not know about the same strategies or resources I do.
I often get urgent phone calls or emails from SLPs who receive a referral for a child with a craniofacial difference. In some cases, this may be their first time treating a child with a cleft palate who uses compensatory misarticulation patterns. Although compensatory misarticulations sound different from most common articulation errors, they still fit within the basic attributes of articulation disorders—a change in place, manner or voicing. I also recommend not addressing moderate to severe hypernasality in treatment because this usually requires surgical correction.
Most of us develop techniques to better elicit targeted articulation sounds from clients—who doesn’t love learning a great speech hack?—and there are also many tricks of the trade to help our patients with craniofacial disorders improve their speech skills more quickly.
I often refer SLPs to the American Cleft Palate-Craniofacial Association for information on all aspects of cleft palate and other craniofacial differences. I point out resources such as the core curriculum, parent/patient information and webinars regarding speech evaluation and intervention and other aspects of care.
Of course, ASHA offers numerous resources, including the Practice Portal, Evidence Maps, and articles in the journals, Perspectives and the Leader. You can gain even more insights through ASHA Special Interest Group 5, Craniofacial and Velopharyngeal Disorders.
Here are some of my favorite articles and resources:
- “Speech and Resonance Disorders Related to Cleft Palate and Velopharyngeal Dysfunction: A Guide to Evaluation and Treatment,” by Ann W. Kummer
- “Assessment and Intervention of Speech Disorders Related to Cleft Lip and Palate and Velopharyngeal Insufficiency,” by Virginia L. Dixon-Wood
- “Speech Evaluation and Treatment for Patients With Cleft Palate,” by David P. Kuehn and Lisa J. Henne
- “Opening the Toolbox for Cleft Palate–Related Speech Disorders,” an interview with Angela Dixon and Kristen DeLuca
- The Leaders Project of Teachers College, Columbia University, offers extensive CEU video courses under “English Cleft Palate Speech Therapy: Evaluation and Treatment.”
- One of the best resources available to most of us is the SLP at your local cleft palate or craniofacial team.
So please join me in recognizing Cleft and Craniofacial Awareness Month. Remember there’s a wealth of information and support just a click or a phone call away!
Lynn Fox, MA, MEd, CCC-SLP, is an associate professor at University of North Carolina, Chapel Hill, and treats clients at the UNC Craniofacial Center. In addition, she serves as the vice president-elect of the American Cleft Palate-Craniofacial Association. Fox is also an affiliate of ASHA Special Interest Group (SIG) 5, Craniofacial and Velopharyngeal Disorders, and serves on the SIG’s Editorial Review Committee. Lynn_Fox@unc.edu