ACPA Family Services

Part 3–One From the Team: Speech Therapy and the School-Aged Child

Part 3–One From the Team: Speech Therapy and the School-Aged Child

Timing and Need for Speech Therapy

Do school-age children with clefts always need speech therapy?

No.  Some children receive early intervention services through their Early Intervention (EI) programs and have no need for further speech therapy.  Some children have secondary surgeries to address speech issues that otherwise aren’t responsive to therapy alone. Many of these children progress to normal speech and resonance.  Another small percentage of children will not require speech therapy at all.  However, the goals of team care, timing of surgeries and early intervention for children are all aimed at speech and resonance typical of their family and peers! Achieving these goals may take some years of therapy and/or additional surgeries, but the goals are still the same.

For example, if an elementary school-aged child demonstrates hypernasality or speech issues that are not age appropriate, speech therapy may be needed.  I have met patients at a follow-up cleft team visit who’d been told previously that their “speech was acceptable for a child with a cleft!” That is not the expectation.  At times, a child’s speech may be impacted due to orthodontic needs or orthognathic surgery plans that are not yet age appropriate. The child may be wear an expander that reduces speech clarity, but this is typically a temporary issue and speech therapy may not be recommended at that time. However, follow-up evaluation should be in your child’s team plan.  This point speaks to the benefit of your cleft palate team guiding you through the timing of therapies, surgeries and procedures. Sharing all of this information with your school-based speech pathologist will make for easier transition and planning in all aspects of your child’s school years.

I understand most of what my child says, but his school says teachers and other kids don’t. What should we do?

As a fourth grader, Jena Keith created a class project that helped her classmates learn about her cleft, surgeries, and speech.

As a fourth grader, Jena Keith created a class project that helped her classmates learn about her cleft, surgeries, and speech.

Most parents and siblings can understand their own family members at a level that others in their schools or communities cannot. It is very important to take this message to heart and follow-up with your team speech pathologist or your school-based speech pathologist.

At times, it has been difficult to qualify some children with speech or resonance (oral vs nasal) issues for school-based speech therapy. If it is determined that speech issues do not impact a child’s educational success–the common standard used for determination of services–that child may not qualify. However, if your child is not understood at a level equal to his peers, by teachers and peers, that is an impacting issue for educational success! Many parents have verbalized their concern for their child’s self-esteem and fear their child is not fully participating in school activities because of their speech. Every school district is different, but most will see this as an educationally impacting issue and qualify a child for school-based support.  Let your team, community-based or school-based speech pathologist provide an evaluation and follow-up with the classroom teacher’s concerns.

 How can parents help support healthy speech development for school-age children with clefts?

  1. Be a good model! This will not eliminate the need for speech therapy, but it is a good start for any child. Imitating your child’s speech errors as “cute” can prolong the use of these patterns.
  2. Access the resources in your community, including Early Intervention (EI) programs (Birth to 3 years) and Child Find programs (Birth to adult).  These free programs are available everywhere and most children with a cleft palate will be eligible for services as needed.
  3. Follow-up with your team according to your team’s recommendations! If a long lapse in team assessment has occurred, children may have needed another surgery, another set of ear tubes, a dental procedure or a palatal appliance. The later a necessary surgery or procedure is done, the more challenging it is to correct articulation and resonance errors in the child’s speech.

Miss earlier posts in this series?

Part 1– Speech with the Team, Speech at School here.

Part 2–Building the Relationship Between Parents, Team and School here.

 
About this series: We recently asked Theresa M Snelling, M.A.,CCC-SLP, to help us learn more about speech development and support for the school-aged child. We are so pleased to share her response with you in this special eight-part, One From the Team series, Speech Therapy and the School-Aged Child.

Teresa is clinical coordinator for the Cleft Palate and Craniofacial Center at Rose Medical Center, Denver, CO and has been working with patients and families affected by clefts for more than 30 years. If you need assistance locating a team or a cleft-specializing speech therapist, please, drop us a line or give us a call! 1.800.242.5338 or info@cleftline.org.

Part 3 of 8
Miss earlier posts in this series?

Part 1– Speech with the Team, Speech at School here.

Part 2–Building the Relationship Between Parents, Team and School here

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