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- Cleft Home
- What is Cleft Lip and/or Palate?
- Prenatal Diagnosis
- Feeding Your Baby
- What is a Cleft Team?
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- Managing Feelings
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- Letter to a Teacher
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- Learn More: Downloads
- Cleft Home
- What is Cleft Lip and/or Palate?
- Prenatal Diagnosis
- Feeding Your Baby
- What is a Cleft Team?
- Surgery
- Hearing, Speech, and Dental Care
- Paying for Treatment
- Managing Feelings
- Craniofacial Conditions
- Toddlers and Preschoolers
- The School-Aged Years
- The Teenage Years
- Letter to a Teacher
- Information for Adults
- Support Organizations
- Learn More: Downloads
What can I expect from my speech during adulthood?
Although certain facial and jaw structures may continue to grow and develop into the late teens and sometimes beyond, your speech structures have probably been adult-sized for several years. The size and shape of the structures involved in speech are typically finalized by 13 to 16 years of age.
By early adulthood, you may not be making annual visits to your cleft palate or craniofacial team. But you may still have concerns about your speech. If you do, it is important to try to address them. Below are some questions to consider:
What are some questions to consider about my speech?
Am I satisfied with my speech now?
This is a very important question, and only you know the answer. Perhaps you are quite satisfied—and that is good. But perhaps you are not. You may not know precisely what concerns you have about your speech, only that you are not totally satisfied. Your speech is part of your self-image, and your opinion is important.
What were my expectations for my speech some years ago?
This question is somewhat related to the first, because current satisfaction is most likely the result of what you expected your speech to be like as an adult. Was your expectation perfect speech? Acceptable speech? Able-to-get-along speech?
Acceptable speech is the minimum goal that your medical, dental, and speech-language professionals had for you from the start. Perhaps your speech has always been very good and you have not really thought much about it. But some adults feel that the expectation they once held for their speech has fallen short. You should feel comfortable expressing that feeling of dissatisfaction. Speech improvement may still be possible. You may have options now of which you were not previously aware.
Is my speech understandable to others?
Ideally, your speech is almost totally understandable to others, a quality known as speech intelligibility. If frequent words and phrases are not understood by your listeners, your speech should be evaluated.
What are some common issues for speech during adulthood?
Nasality: If your soft palate doesn’t reach the back of your throat, sound can escape into your nasal cavity, causing your speech to sound nasal. Your speech pathologist may call this problem hypernasality or velopharyngeal insufficiency (VPI). VPI can be associated with food or liquid coming through your nose when you are eating or drinking. Similar problems can exist if you have a fistula (a small hole) in your palate.
Some people have mild nasality in their speech but consider it to exist within acceptable limits.
Denasality: Some people born with cleft palate have a lack of nasality (called denasality) when they speak. If your nose is obstructed by crooked or enlarged structures or if you experience persistent congestion or allergies, you may sound like you have a cold when you produce certain consonants (“m” as in “make,” “n” as in “new,” and “ng” as in “ring”). Denasality can be treated by opening the nasal passages surgically and/or undergoing treatment from an allergist, depending on the cause.
It is possible to have too much and too little nasality. Careful evaluation by a speech-language pathologist with experience in cleft care should help you identify of the cause of the problem and help you decide whether and how to treat it.
Articulation: Some people born with cleft palate have trouble with articulation, the act of making precise consonant sounds. Cleft-related difficulties include making “s” and “z” sounds or “sh” and “ch” sounds. It is also possible for people born with cleft palate to experience an escape of air from the nose (called audible nasal air emission) when producing sounds like “p” or “b” and “ch” and “j.”
For persons born with cleft lip and palate, there is no reason to believe that all consonant sounds cannot be made in the correct place in the mouth. Be sure to speak with your speech-language pathologist for more information.
Voice: Voice is the part of speech that is produced by your larynx or “voice box.” Your voice may sound too high or too low in pitch, too soft or too loud, or too hoarse or raspy. Having a cleft lip and palate does not involve the larynx directly, but sometimes the way we use the voice box to compensate or adjust for velopharyngeal problems affects the quality of voice.
How can I improve aspects of my speech?
It is important to undergo an evaluation by a qualified speech-language pathologist who has experience with cleft palate. Some people need speech therapy. Others need physical treatment such as surgery, a prosthesis, and/or help with hearing. Your speech treatment will depend on your individual needs.
Where and when can I get help?
Your cleft team should be your primary resource for cleft-related concerns at any time of life. Some adults born with cleft lip and/or palate are able to see their pediatric cleft team into adulthood, even if the team is located in a children’s hospital. Other adults will need to transition to an adult-centered healthcare system. Be sure to ask members of your current cleft team for more information about the transition to adult care.
The medical, dental, speech/language, and hearing professionals who make up your team will be able to evaluate and provide treatment or recommend treatment resources for you. It is never too late to change if you want to change.
