Correction of Speech Disorders

Speech is a learned ability. The earlier in life a person learns a language, the more accurately they can produce the sounds (phonemes) specific to that language. For this reason, when people learn a foreign language, no matter how well they learn the grammar (language structure), they generally speak with an accent coming from their mother tongue.

The speech of babies who have undergone palate repair is evaluated at around 2.5-3 years of age. Babies in whom speech pathology is observed (whose speech is not proper) are taken for further evaluation. Some babies who have undergone cleft palate repair may not be able to speak properly after the repair, even though the muscles have been repaired correctly, because they do not know how to use the repaired palate. Just as people need special training to meet the requirements of a sport even though all their muscles are sound, babies in this group also need speech therapy in order to learn to use the repaired palate muscles correctly and to speak properly. With speech therapy, these babies are taught the skill of producing sounds correctly. Generally, the speech of the great majority of patients who have undergone palate repair but whose speech is not proper improves after the applied physiotherapy (speech therapy).

It is important to evaluate patients who still have speech problems after speech therapy with endoscopic and/or MRI imaging. In this patient group, if soft palate insufficiency is detected, palate function should be corrected with procedures such as repeat palate-lengthening operations or tissue transfers to the uvula from beside the tonsils or from the back wall of the throat. After these procedures, patients need to start speech therapy programmes again.

In some patients, the speech problem may stem not so much from soft palate function as from palatal fistulas (holes between the nasal cavity and the oral cavity) that form after palate repair. In this patient group, it is important to close these fistulas surgically in order to correct speech and ensure oral-nasal hygiene.

Medically, all speech disorders that appear after palate repair are called velopharyngeal insufficiency or velopharyngeal dysfunction. Investigating the speech disorder correctly and treating its cause as soon as possible, before the child gets older, is important so that language development can continue along its natural course as far as possible.