Speech & Hearing


Around half of all children with a cleft palate will need some form of speech therapy. This usually starts before you start school, and some young people will continue to need support from a Speech and Language Therapist into their teenage years.

If you’ve had further treatment such as orthognathic surgery (page __), it might change the way you sound. Your Cleft Team will carefully monitor your speech before and after any relevant operations to make sure you’re getting the help you need.

How does a cleft palate affect speech?

The soft palate (the part towards your throat) moves upwards and backwards and closes off the mouth from the nose when you talk. It does this for sounds like p, t, g, sh, and ch. And it lowers to let air pass through the nose and mouth only for sounds like m and n. Try it now!

If your palate doesn’t work as well as it should because of a cleft, your speech can be affected in two main ways:

  1. Sounding nasal (hypernasality), or having puffs of air escape on sounds. Sometimes this will only happen when you’re tired or talking too quickly as you won’t have as much control of your soft palate.
  2. Consonant sounds not being made properly

Speech can also be affected in other ways. For example, you might have learnt to use your voice box in a different way to make up for problems caused by a cleft, and this can affect how you sound.

Speech and Self-Confidence

There’s nothing wrong with sounding a little different, but if your speech is affecting your confidence or your ability to participate in school, it’s important to get help.

You might find that feeling self-conscious about the way you sound means you don’t speak up as much in the classroom, or that it stops you from taking part in other activities you might enjoy like music or drama. Even if you hate the idea of public speaking, most jobs will need you to talk to customers, clients, supporters, or at the very least to others you work with.

Being able to communicate clearly and effectively is an important part of growing up to the person you want to be, so if you think your speech is holding you back it’s important to talk to your parents, teachers and your Cleft Team to see what can be done. Your Speech and Language Therapist can figure out what is causing any problems you’re having and help you put together a treatment plan that’s right for you.

This doesn’t always mean more surgery (see page __). Sometimes, treatment will involve sessions with a Speech and Language Therapist where they will teach you techniques to make your voice sound clearer.


You may have had grommets or hearing aids when you were younger to help with hearing problems related to having been born with a cleft. Usually, these problems are temporary and are gone by the time most children reach Secondary School.

If you think you might still be having trouble with your hearing but nothing is being done about this, it’s important to say something as soon as you can, because it can affect your speech as well as your participation in class and in social situations.

You can talk to your family doctor to arrange a hearing test, or talk to the Clinical Psychologist with your Cleft Team if you have any concerns you’d like to talk through, for example if you feel self-conscious about having to wear hearing aids.

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