Collection of Experiences 2- (Speech and Language Impairment-Cleft Lip and Palate)

Jenna Vanderstelt

Introduction:

Individuals with a Speech and Language Impairments have a difficult time with speech or

language skill and development. This type of disability makes it very difficult for students to

communicate both to their peers and their elders. Unlike some disability categories, many

different diagnoses can cause a speech and language impairment. Specifically, I will be telling

you about an individual whom I am very close with, my boyfriend Matthew, who was born with

a cleft lip and palate, and as a result struggled with a speech and language impairment while he

was in school. We have been together for almost six years now, so I have heard many stories of

him while he was in school, surgeries he has received in order to repair his cleft lip and palate, as

well as witnessing his very mild speech and language impairment now. MORE!!!

Definition:

Speech and Language impairments are a group of disorders that affect a students speech

or language skills and development. The category of SLI includes many different disabilities. It

includes disabilities related to articulation, fluency, and voice and language. Students who have

been diagnosed with a speech and language impairment may experience problems with just

speech, just language or both. A language impairment is defined as a disorder that affects how

people understand or use words. A speech impairment is a disorder that affects the production of

sounds and words. Unlike many disabilities, students with a speech-language impairment may

have academic skills that are below average, average, or above average. SLIs may affect

students education in many different ways, depending on the student and the severity of his or

her disability. For many students, their impairment does not affect their ability to learn new
material or participate in classroom activities. SLIs are one of the thirteen disability categories

under IDEA 2004, and because of this, students with a speech or language impairment are

eligible for all the services granted under IDEA. According to IDEA, a Speech and/or Language

impairment is defined as a communication disorder such as stuttering, impaired articulation, a

language impairment, or a voice impairment, that adversely affects a childs educational

performance. (IDEA 2004) After students are diagnosed with a speech-language impairment,

they are assigned to a speech-language pathologist. Speech-Language Pathologists would be

someone who would be their MET representative during their IEP meetings. Including Speech-

Language Pathologists into an SLI students education will greatly aid them because SLPs are

trained specifically to help students with communication. A certain disability that can cause a

speech impairment is a birth defect called a cleft lip and palate. According to the Mayo Clinic,

Cleft lip and cleft palate are openings or splits in the upper lip, the roof of the mouth (palate) or

both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby

don't close completely. Some ways in which and cleft lip and palate can cause a speech

impairment is if the palate is open, sounds are able to escape through the nose, which gives the

voice a nasal quality. Another possibility is that the teeth and misaligned or missing, which

makes it hard for the child to produce certain sounds. Ear problems resulting in a cleft lip and

palate can also cause a speech impairment because the child is prevented from hearing speech

sounds correctly. A speech impairment resulting from a cleft lip and palate can be hard with a

child to live with at times, but with correct education and therapy, a child can be completely

normal, and speak normally as well.

Experiences:
 For the past six years I have been very close with someone who has a speech and language

impairment, and although it is mild, it is still apparent. My boyfriend Matthew was born with

both a cleft lip and palate, both of which have affected his speech. When Matt was a baby, his

mom had to feed him a different way. Matt had his cleft lip and palate repaired while he was still

a baby, but it still caused him to have some difficulties when it came to speech. To the right of

the page I attached a before and after photo of a baby after cleft lip and palate surgery that shows

how a cleft lip and palate can be fixed during infancy. Once it became time for Matthew to attend

pre-school, his parents concluded that it would be best for him to have a pre-school teacher come

to the home in order to teach him. He was too young to fully understand why he had a scar on his

lip, why his nose was crooked, or why his teeth were so misaligned. During this time, when a

preschool teacher came to Matts home, his parents learned that he definitely had above average

intelligence, and as long as they could help him to improve upon his speech difficulties, he could

become very successful one day. During preschool, Matt had an IEP. His IEP stated that he

would work with a speech and language pathologist in order to improve upon his speech. Due to

his cleft palate, Matt has a hole in the roof of his mouth that connects to his nose. This makes

speech difficult because air is able to escape through his nose. Prior to getting braces, Matts

teeth were also very misaligned. This made speech more difficult because some sounds depend

on the action of the tongue against the teeth. Also, prior to getting surgery on his ears, Matt had

ear problems that prevented him from hearing speech sounds correctly. Matts mom has told me

many stories of attending IEP meetings for Matt, both with his teachers and MET rep, a speech-

language pathologist. Throughout his childhood, Matts speech impairment significantly

improved. Working with a speech-language pathologist, getting many different surgeries, and

getting braces in order to realigned his teeth, all really helped Matts speech impairment to
improve significantly. Matts mom told me she was always very concerned that he was getting

made fun of at school, but Matt is a very strong and humorous person, so if he was, in fact,

getting made fun of for the way he looks, I know he would have been just fine. To the left of the

page, I included a photo of Matt when he was in middle school. This picture is shortly after he

got surgery in order to remove a bone from his hip to be placed into his palate, and fully repair

his cleft palate. Also in this photo, you can see how even with braces, Matts teeth were very

misaligned, which made it difficult for him to speak certain sounds. Although his teeth are fixed

now, and he no longer struggles with that specific problem. Once Matt and I started dating, I did

struggle to understand him at times. Although this cleft palate is fully repaired, he still does have

a hole in the roof of this mouth that does allow air through his nose. Because air is able to travel

through his nose when he speaks, his voice sounds very muffled and nasally. Although I did

struggle to understand Matt at times when we first started dating, now after being together for

almost six years I can definitely understand him just fine now. Occasionally I have people ask

me why Matt has a scar on his lip. Matt and I decided to just tell them a crazy story like he got in

a fight or something. People also occasionally tell me that they are unable to understand Matt at

times. Although his work with a speech-language pathologist and surgeries significantly

improved upon his speech, at times he is still difficult to understand due to his muffled nasally

voice. Whenever I can tell that people around us may have trouble understanding Matt, and of

course they wouldnt say anything to him about it, I always tell him to repeat what he said.

Although many people may feel sorry for themselves for being born with a cleft lip and palate,

and struggling with speech and not having a perfect face as a result, Matt simply sees it as a part

of him. He does not allow it to affect his confidence when speaking to others or even posing for

photos. Matthew has become very successful as a result of not allowing his cleft lip and palate to
 affect his confidence. He works two jobs, and he is close to graduating with his business degree.

Having a cleft lip and palate is not all the bad either. Matt can do tricks like make one whole

spaghetti noodle come out of his noses and his mouth. Although he is more grown up now, these

tricks definitely benefitted him at the middle school

lunch table! Matt still encounters some struggles

with his cleft

lip and

palate, like

pop coming A baby before and after a cleft lip and palate
operation.
out of his nose when drinking it, but despite all this, I

believe he is very handsome despite his imperfections.

Matthew in middle school. Shortly after his
surgery to fully repair his cleft palate. Reactions:

Obviously, I spend a great deal of time with Matt. During the past almost six years of

being with him, his confidence and humor have really rubbed off on me. Many would think that

someone who was born with a birth defect such as Matt would not be confident and would feel

self-conscious, both of their looks and their speech. Rather than feeling this way, Matt is a very

confidence person and doesnt hesitate when speaking to others. Matt has really taught me so far

that you need to make the best of the hand your dealt. Although he doesnt talk about it, I am

sure he was made fun of in some capacity in his childhood. This did not affect him at all because

he is definitely 100% confidence in himself and his speech. I recall when we first started dating,

I was afraid to say anything to Matt about his cleft lip and palate, I thought he would get

offended. But I have learned that he certainly does not get offended at all. He has also shown me

some of his tricks he is capable of doing throughout the past several years. I remember it was a
very big deal when Matts mom first showed me his baby photos when he still had his cleft lip

and palate, prior to it being repaired. His mom was a little worried it would freak me out. I

remember feeling like he was still an extremely cute baby, and I think the same thing now,

despite his birth defect. Matt has asked me many times if he should get a nose job in order to fix

the way his nose is now, I tell him no because he is perfect the way he is, and he actually agrees.

In some cases, cleft lip and palates can be genetic. This is something both Matt and I have to be

aware of when we decide to have children in the future. If I have a child someday with a cleft lip

and palate, I hope that child is like Matt in that they radiate confidence and do not let their birth

defect define them or define how successful they are in school and in life. To the right of the

page I have included a photo of Matt and I recently. He has been really into working out lately,

so you can definitely tell he is flexing his arm muscle in the

photo. This just shows his confidence, and the fact that he does

not let his cleft lip and palate scar keep him from doing normal

things such as taking photos with his girlfriend. A question I

have for his mom would definitely be how she felt when she

first gave birth to him and noticed he did not look normal. This

is a question I have not yet asked her but may be something I

ask in the future. I would also like to ask Matt how he has been

able to stay so confidence him himself. Sometimes I feel that if

I were in his position I would feel self conscious at times. I Matthew and I, Summer 2016

am very glad that Matt was able to receive special education services when he was a child

because that definitely improved his speech impairment, which in turn strengthened his

confidence and made him into the man he is today.

Impact on my Career:

Other than my roommate, Matt is definitely the person that I spend the most time with.

Due to this, he has definitely taught me many lessons that will be carried with me into my future

career. The children diagnosed with Autism that I will be doing therapy on someday may also

have speech or language impairments. Through having so much practice understanding someone

with a speech impairment, it will give me the ability to better understand my future clients when

they have SLIs. Matts mom has also taught me a lot of dealing with IEPs and IEP meetings. She

told me many struggles she had as well as many joys. In my future career, I may have to attend

IEP meetings at times for children with Autism who need behavior intervention. I will be sure to

avoid these frustrations in which Matts mom has told me about. Lastly, in my future career I

hope to carry the confidence with me that Matt always radiates. He is very driven and lets

nothing get in his way. This is very inspiring and is something I believe will help me someday in

my future career.

Assistive Technologies

One of the most common pieces of assistive technology for students with speech and

language impairments is assistive communication applications. Students with speech and

language impairments have trouble communicating, either in speech or in language. Assistive

communication IPad apps can significantly help these students communicate what they need to

communicate. One particular application is called, Proloquo2go. This application is a full

featured argumentative and alternative communication for children who have trouble speaking.

To the left of the page I have included a photo of the application, showing some different

commands students can use to communicate what they are unable to say. Another very common

piece of assistive technology used for students with speech or language impairments is known as
 PECS, Picture Exchange Communication system. This

includes picture representations of different objects and

actions. A child will recognize what the picture card means,

and hand it to the individual in which there are attempting to

Proloquo2go Ipad Application Screenshot communicate with. PECS works very well with many

children who are unable to afford technology. Through the

use of this system, teachers and parents are able to understand what a child needs. Although not

something a teacher provides, a hearing aid can be a very beneficial piece of assistive technology

for students with speech and language impairments. In Matts case, he had very bad hearing due

to his cleft palate. He eventually had to get tubes in his ears, and this improved his problem.

Many children have ear problems that prevent them from hearing their speech sounds correctly.

A hearing aid could significantly help a child with this because it could allow him or her to

correctly hear sounds.

Conclusion:

Speech and language impairments can be very difficult disabilities to live with. A humans

natural reaction is to communicate what they are feeling, but an individual with a SLI is unable

to do so. Although living with this disability can be challenging, it is important to be like Matt

and remember to be confident and never allow any disability to dull your confidence. Matt

embraces who he is and does the very best he can with what God gave him.

Bibliography

Powell, S. R., & Driver, M. K. (2013). Working with Exceptional Students: An Introduction to
Special Education. Bridegepoint Education.
Chapter 6: Students with Speech and Language Impairments
Mancuso , R. (2011). The Cleft Lip and Palate Foundation of Smiles; Special Education Issues
IDEA. Retrieved February 22, 2017.

Before & After Cleft Surgery Photos. (n.d.). Retrieved February 22, 2017, from
https://www.childrenscolorado.org/doctors-and-departments/departments/surgery/programs/cleft-
lip-and-palate-clinic/before-and-after-photos/

7 Assistive Communication Apps in the iPad App Store - Friendship Circle - Special Needs Blog.
(2015, April 14). Retrieved February 22, 2017, from
http://www.friendshipcircle.org/blog/2011/02/07/7-assistive-communication-apps-in-the-ipad-
app-store/

Assistive Technology for Non-Verbal Special Ed Children. (2012, January 05). Retrieved
February 22, 2017, from http://www.brighthubeducation.com/special-ed-speech-
disorders/76036-assistive-technology-for-non-verbal-special-ed-children/