Relay UK
Relay UK (Previously Next Generation Text) helps people with hearing and speech difficulties communicate with anyone over the phone, using the national relay service.
While cleft-related speech and hearing issues are often resolved in childhood, it’s not uncommon for some to persist or reoccur in adulthood. This section gives you an overview of speech and hearing concerns and the support available for them.
How does a cleft palate affect speech?
The soft palate (the part towards your throat) moves upwards and backwards when you talk. This changes how much air escapes through your nose when you make certain sounds. The palate moves up and back to block off air from the nose for sounds like p, t, g, sh, and ch. It lowers to let air pass through the nose for letters like m and n.
If your palate doesn’t work as well as it should because of a cleft palate, your speech can be affected in two main ways:
- Sounding nasal – this is caused by the palate not properly separating the mouth from the nose and letting air escape through the nose while speaking.
- Sounds not forming properly – again this is caused by too much air escaping through the nose, meaning there isn’t enough left in the mouth for some sounds to be made clearly.
These are examples of velopharyngeal dysfunction, which means the mechanism to separate the nose and the mouth (in this case, the soft palate) isn’t working properly.
Sometimes speech can be affected in other ways. For example, you might have learnt to use your voice box in a different way to compensate or adjust for problems caused by your cleft, and this can affect how you sound.
Adults born with a cleft may have speech issues even if they received Speech and Language Therapy as children.
Problems with speech can be because of a learned problem where they have learned to make sounds in the wrong way growing up or a structural problem where there is something wrong with the mouth or palate.
Every day I speak to literally hundreds of people. Yes, there is often someone who fails to understand me. I simply repeat myself. I remind myself they might have not heard me, they might not have been listening, or they might not have understood me….and that is simply life!Adult born with a cleft palate affecting their speech
Why might I want speech therapy?
You may wish to visit a speech and language therapist for a number of different concerns in adulthood, such as:
- Hypernasality: too much air coming through the nose when you speak.
- Hyponasality: too little air coming through the nose on certain sounds.
- Articulation disorders: difficulties making specific sounds.
- Voice disorders: breathiness, hoarse voice or vocal nodules.
Sometimes these concerns can be resolved with speech and language therapy, surgery or both
together.
For specialist assessment and advice, you can seek a referral to your local NHS Cleft Team. Once the Speech and Language Therapist with the Cleft Team has assessed you, you may be referred to your community speech and language therapist for treatment closer to where you live.
What can I do at home to improve my speech?
Your speech and language therapist can assess you to figure out what is causing the difficulties you’re having and help put together a treatment plan that’s right for you.
There are often exercises you can practise at home which your speech and language therapist will be able to show you.
Sometimes, speech and language therapy alone won’t result in significant change. In these cases, surgical treatment or physical appliances (such as a ‘speech plate’ or ‘nasal obturator’) may be suggested as a potential way of addressing speech concerns.
What support is available if I’m having difficulties with my hearing?
You can talk to your GP to arrange a hearing test or you can talk to your Cleft Team if you think you
might be having difficulties with hearing because of your cleft. They may be able to arrange for you to
see someone in Audiology or ENT (Ear, Nose and Throat) with your Cleft Team or locally.
You may also talk to the Clinical Psychology Team within your Cleft Team if you have any concerns
you’d like to talk through, e.g. if you feel self-conscious about wearing hearing aids.
Even if you think your hearing difficulties are nothing to do with your cleft, it is still advisable to let your Cleft Team know and to seek their advice. This is because some of the routine treatments for hearing difficulties might not be appropriate for people who were born with a cleft.
If you are concerned about your hearing at any point, you can get a hearing test done at most opticians. Many of them offer this service for free, so it’s always worth checking.
You may find more information on hearing loss at rnid.org.uk.
Other Resources
RNID
The RNID are the national hearing loss charity supporting people of all ages throughout the UK.