The presence of a cleft and any associated speech problem should not be interpreted as an indication of a learning disorder or slowness of learning. There is no proven study, which states the possibility of children with cleft palate lagging slightly in their language development.

Because of the nature of the problem, the child with a cleft is more at risk of having a speech and/or language problem, and close attention must be given to the child's speech development. Most problems can, however, be resolved with speech and language therapy. All types of cleft palate, particularly cleft of the soft palate, are prone to problems with language development, articulation and nasality. Children will need regular supervision by the ENT surgeon until they are 10 years of age.

Children with cleft lip only rarely have any speech difficulty associated with the cleft. Speech and/or language problems in children with cleft palate are usually associated with:

Some cleft children have a nasal speech. This is due to two reasons. One may be due to a short palate; the other could be due to the hole between the nose and the mouth, in the teeth bearing bone.

The short palate could even occur in non-cleft children. These children appear to be speaking through their nose. This can be rectified with a simple surgery called Pharyngoplasty, performed at the naso-pharynx. But again the crunch is deciding on the method of surgery. After much research, Prof. Balaji has found that a stiff immobile palate requires a flap pharyngoplasty and a mobile, short palate benefits from sphincter pharyngoplasty. The child might have to undergo naso-Endoscopy for diagnosis of the defect.

The other problem about the defect in the tooth bearing, such tooth bearing bone can be corrected only by alveolar bone grafting. This also helps the proper eruption of the teeth. This bone grafting when done properly, unifies the two disjoint segments of the jaw and makes it whole. This helps in dentist and the orthodontist of the cleft care team to bring the improperly positioned teeth to proper alignment. The dentist and the orthodontist, with enough experience in teeth care of cleft play a major role in rehabilitating the cleft child.

In bilateral cleft children, sometimes the premaxilla and the front upper teeth jut forward so much that the children are unable to purse their lips. This also results in speech difficulty. Correction of this defect can be performed by a premaxillary setback together with early alveolar bone grafting.

The majority of children with cleft lip and palate who have initial speech problems will grow up to have normal speech if they are attended to at the appropriate time and have all the necessary speech therapy and surgical and orthodontic treatment.