One in 700 babies in Ireland are born with a cleft lip and palate, a condition that results from incomplete development of the upper lip, the palate or both during the early weeks of pregnancy.
Around 40-50 per cent of children born with a cleft lip and palate will have speech difficulties.
Early intervention by a group of specialists including a speech and language therapist means that many children will go on to have perfect or near-perfect speech. However, the Cleft Lip and Palate Association of Ireland (CLAPAI) is concerned that the current generation is not receiving the treatment they need.
CLAPAI committee member Laura Fingleton, now aged 23, was born with a bilateral cleft palate, meaning there was an opening on the roof of both sides of her mouth.
She received speech and language therapy for a couple of years up to the age of four, learning to practise sounds with her therapist while playing with toys.
Later, her parents would encourage her to continue speech exercises at home and Ms Fingleton remembers continually blowing up balloons to strengthen her facial muscles.
"Sometimes the amount of therapy you need depends on the initial repair job you have done," she explains. "Cosmetically, the way mine was done would be considered a crude operation, but at the time they were limited in what they could do," she says.
But, crucially, the way the palate was fused together meant it was easier for Ms Fingleton to overcome her speech difficulties, which involved slurring the odd consonant sound.
On the recommendation of her parents, Ms Fingleton continued with speech and drama classes throughout her childhood. She is now completing a degree in Communication Studies in Dublin City University.
Other children she has come into contact with who have a cleft palate have "liquidy sounding" speech and have difficulty pronouncing "F" sounds, she says.
Speech and language therapists usually see children with cleft lip and palate at around six to nine months for assessment of communication skills and give advice to parents on how to encourage normal speech and language development.
They will also advise on how to feed babies who have difficulty sucking.
Children with cleft palates sometimes have nasal sounding speech, because the normal closing action of the soft palate does not occur, resulting in air escaping into the nasal passages.
Children with significant speech problems may later require special assessment of how their palates move during speech through the use of two techniques known as videofluorocopy and nasendoscopy.
Not many people know about cleft lip and palate, says Ms Fingleton, who had two bone grafts at the age of 10 and 11 to rebuild her palate, as well as orthodontic treatment and rhinoplasty procedures.
"Back when I was born it was up to parents to look for information, but now there is a cleft team at the hospitals to look after you."
