Speech Evaluation & Treatment
Many factors influence the proper development of speech. Defects in the palate can certainly impair this process. 
Thus, an important aspect in cleft palate treatment is thorough speech assessment, evaluation and speech therapy, if needed. As discussed earlier, an important consideration when surgically closing the palatal defect is the effect it will have on normal speech development.
Assessment of speech is performed by a speech pathologist who specializes in cleft and craniofacial patients. Part of the evaluation involves obtaining a speech sample. This simply means that the child is asked to say various sounds, words and phrases that represent the spectrum of normal speech. The child must be old enough to cooperate in the assessment. Usually, this age is four to five, although occasionally it is possible to assess children as young as three years old. Early evaluation is important.
If there are problems regarding the child’s speech, therapy may be prescribed by the speech pathologist. Parents play a very important role in working with the child to encourage the development of normal speech. The speech pathologist will provide guidance for you throughout this process.If any abnormality in speech is suspected, certain diagnostic studies may be necessary. Two of these are nasopharyngoscopy and videofluoroscopy.
Nasopharyngoscopy
Nasopharyngoscopy is a technique used by the physician to visualize or look at the back of the throat and the velopharynx. It can be performed in children as young as four to five years of age and is done while the child is awake and talking.
Nasopharyngoscopy involves placing a small tube through the nose and into the throat. The physician and/or speech pathologist can look through this tube to analyze the movements of the soft palate and throat as the child talks. Recordings of these movements are made on a videotape synchronized with the speech sounds.
Videofluroscopy
Videofluroscopy is a special X ray procedure. It helps the physician visualize and evaluate the speech mechanism while the child makes certain sounds.
