Chapter 6

Question 1

cleft lip and palate are the most ?
how many
-can occur on ?
since the lip and the palate develop separately, it is possible for the child to have a ?

Answer 1

common birth defects in US

• 1/600-6800 newborns affected
• one side (unilateral) / both sides (bilateral)
• cleft lip, cleft palate, or both

Question 2

cleft lip:
-often includes

cleft palate:

Answer 2

separation of the lip

• bones of the upper jaw and or upper gum
• an opening in the roof of the mouth in which 2 sides of palate did not fuse as unborn baby was developing

Question 3

craniofacial abnormality:

embryology

Answer 3

reflects involvement of the bony features of the skull, as well as tissue features of the face
-study of prenatal growth and process of development

Question 4

face embryology
-development of the face occurs :
in normal development the facial tissues and bones ?

Answer 4

during embryonic period of pregnancy

-grow toward the midline and fuse together

Question 5

the lip and the palate meet at ?
so around week 6 the ? and by week 12
degree of clefting is related to the amount of ?

Answer 5

midline and develop from front (lip) to back (uvula)

• lips fuse/ soft palate fuses
• embryonic damage to the lip and palate

Question 6

disorder of the cleft lip and palate
cleft lip and cleft palate can occur on ?
since the lip and the palate develop separately it is possible
the cleft may be further characterized as

Answer 6

one side or both
-for child to have a cleft lip, palate, or both

complete cleft lip 
incomplete cleft lip 
complete cleft palate 
incomplete cleft palate 
submucous cleft palate

Question 7

characteristics of CL/P 
cleft lip and palate =
cleft lip =
cleft palate= 
2:1
2:1

Answer 7

50%
25%
25%

males to females have cleft lip with or without cleft of palate
females to males have cleft of palate only

Question 8

etiology
cleft lip and palate are ? which occur

majority of clefts appear to be due to ? or a combo of ?

a child born with a cleft frequently requires ?

Answer 8

congenital defects/very early in pregnancy

multifactorial causation/genetics and environmental factors

several diff. types of services eg surgery , dental/orthodontic care, speech therapy

Question 9

assessment of CL/P
aside from the obvious physical features which serve to confirm the ?
there are related areas that are assessed in regard to the childs health status

Answer 9

assessment of cl/p

feeding
hearing
dentition 
voice 
speech

Question 10

feeding
feeding difficulties are often experienced by infants with clefts include problem with providing adequate nutritional intake due to

Answer 10

nasal regurgitation 
poor suction 
excessive air intake 
frequent burping 
prolonged feeding times

Question 11

hearing
children born with a cleft palate commonly experience
if left untreated this can cause
many children with a cleft will require ?

Answer 11

middle ear prob. and associated hearing loss

• permanent hearing loss
• tubes to be inserted into the eardrum to allow drainage of fluid from the middle ear

Question 12

dentition:
clefts can cause ? such as?

in addition children with cleft often have

children with a cleft may also be at greater risks for ? since they often have ?

Answer 12

dental prob: missing, misshaped or irregularly aligned teeth

alveolar ridge defect

cavities/ weak areas in their enamel and thicker less effective saliva (in adults can cause oral cancer)

Question 13

Communication assessment: Voice

the particular voice problem assoc. with CL/P concerns the ability to regulate ?
3 types

Answer 13

air flowing through the nasal cavity during speech production

velopharyngeal closure
velopharyngeal inadequacy or insufficiency (VPI)
hypernasal speech

Question 14

assessment of VPI

goal

Answer 14

to detect nasal airflow

2 devices: seescape and a nasal mirror

Question 15

Speech Concerns:
cleft lip or palate can make the voice ?
children frequently exhibit articulatory errors because of ?

Answer 15

hypernasal and diff. to understand

nature of cleft 
inadequate or too short palate 
misaligned teeth 
hearing loss 
delayed development

Question 16

common sounds affected

if surgery delayed past age 2 the childs articulation becomes ?

Answer 16

phonemes that require build up of intra oral pressure
-glottal stop 
-pharyngeal fricative 
vowels esp. nasal 
disordered and harder to correct

Question 17

Treatment of CL/P
cleft palate team:

the team will evaluate the childs progress regularly examining ?

Answer 17

audiologist 
geneticist 
orthodontist 
otolaryngologist (sometimes same as surgeon, anything that is going on with hearing/tubes) 
pediatrician 
psychologist 
SLP 
surgeon 

hearing, speech, nutrition, teeth, emotional state

Question 18

treatment of CL/P
surgery

SLP: fewer than 10% are likely to require ? major focus on

psychology: psychological issues are a critical part of the ? and must be

Answer 18

repair of lip and palate
pharyngeal flap
pharyngoplasty

therapy/ reducing hypernasal speech

management of child with CL/P / addressed from onset of care

Question 19

cultural considerations and CL/P
management with CL/P may require ?
including

Answer 19

special multicultural considerations

religious and philosophical beliefs