School Years (5-12)

This section about children born 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 experience at school and how these can be managed, including hearing and speech difficulties as well as problems with bullying.

It can be difficult for children to understand what each professionals role is in a cleft team, this resource will help your child understand who people are. Guide to Cleft Team Descriptions.

The Treatment Pathway

What will have happened already

You child will already have had their cleft lip and/or palate repaired surgically. They will probably 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

Treatment will depend on individual needs. For children aged 5-12 the 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

As a parent or carer, 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.