School Years (5-12)

This section is for children with a cleft aged 5-12 who have entered school. Here you will find information not just about what will happen to them in terms of treatment, but also about common issues children with a cleft may face at school and how these can be managed, including hearing and speech difficulties as well as problems with bullying.

The Treatment Pathway

What will have happened already

Your child will already have had their cleft lip and/or palate repaired surgically. They should also have been assessed (and treated) for any issues to do with hearing and speech.

The NHS standards state that by 5-6 years old, children with a cleft should have:

  • Any hearing issues addressed
  • Dental health which is at least as good as children without a cleft in their region
  • Good quality, intelligible speech

Your child’s treatment will depend on their individual needs. For children aged 5-12 their care pathway may include:

  • Full assessment by the multi-disciplinary Cleft Team at 5 and 10 years old for all children, including hearing checks, speech and language assessment, dental checks, etc.
  • Assessment between 7 and 9 years of age by the Cleft Team’s orthodontist, paediatric dentist and surgeon responsible for Alveolar Bone Grafting (ABG), followed by surgery if necessary between ages 8-12.
  • Support from the clinical psychologist for the child and/or their family
  • Paediatric dentistry and orthodontic treatment (e.g. braces) as needed
  • Speech and Language Therapy
  • Surgery to revise a cleft lip repair and speech (velopharyngeal) surgery if necessary

You will probably have taken your child to many appointments during their first few years of life, but as they get older they won’t need to be seen as regularly. This may mean you won’t be in contact with the Cleft Team as often, which can be a cause of concern for some parents. If you aren’t sure when your child will have their next appointment, or if there is any part of their care you are concerned about, call your Cleft Team.


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Published: November 2015

Next Review: February 2017

Source(s): Range of existing literature from CLAPA, including a leaflet produced by the Royal College of Surgeons in association with CLAPA. Stories and suggestions from our community have been included throughout. Information from Changing Faces and Kidscape was also consulted. This information has been reviewed by cleft health professionals as well as members of CLAPA’s community. An Independent Education Social Worker was also consulted regarding the information about schools.

If you have a comment or question about the information in this page, or would like to know more about the sources of this information, please contact Communications & Information Manager Anna Martindale at anna.martindale@clapa.com or 020 7833 4883.

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