VietNamNet Bridge – Speech disorders caused by a congenital cleft lip and palate prevented a 22-year-old graduate of Industrial University of HCM City (name not disclosed) from getting a job, but subsequent sessions of speech therapy have helped her gain confidence.

Many children who have surgery on their cleft lip and palate have the same speech disorders, said Dr Nguyen Van Dau, head of the Paediatrics Hospital No.1's. — Photo healthplus

"Many employers have turned me down because my voice is difficult to understand, and their staff have had a hard time interacting with me," she said.

Thanks to her relative's help, she then got a job as cashier at a restaurant. But her articulation slowed down the billing process and the owner of the restaurant wanted to sack her. So she quit.

Her cleft lip and palate formed when she was 11 months old, but she never had a chance to receive speech therapy when she first began to talk.

"The inevitable consequence is that my articulation has been completely wrong for 22 years," the young woman said.

At school, she was teased about her speech disorder. "I never dared give a presentation on my own at school."

"I always wanted to be able to live like a normal human being. I want everybody to understand what I am trying to say," she said.

In 2010, she began searching for information on articulation practice on the internet. Five months ago, she found an article on speech therapy for children with a cleft lip and palate on the Paediatrics Hospital No. 1 website written by speech therapist Hoang Van Quyen.

She went to the hospital and Quyen conducted an assessment and then provided a consultation. Later, he taught her how to practice sounds in the right order.

Many children who have surgery on their cleft lip and palate have the same speech disorders, said Dr Nguyen Van Dau, head of the Paediatrics Hospital No.1's.

"Closing cleft lips for children is not enough," Dau said, adding that patients can have a deformed face or lips as well as psychological and speech disorders.

Treatment of cleft lip and palate is long-term and multidisciplinary, he added.

"Treatment starts in the womb to adulthood, including nine phases such as prenatal ultrasound for early diagnosis of kinds of cleft lip and palate and then psychological intervention for parents. Then, cleft lip and palate repair surgery, speech therapy, and dental treatment."

Ultrasound doctors should not unilaterally decide to abort the fetus if ultrasound results show cleft lip and palate, Dau said.

A cleft lip and palate is common in many countries, including Viet Nam, he said.

A survey conducted by doctors at Tu Du and Hung Vuong obstetrics hospitals showed that one out of every 700 babies in Viet Nam are born with a cleft lip or palate.

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Ha Thi Kim Yen, former head of the Paediatrics Hospital No.1's rehabilitation ward, said that most parents think these children need only lip and palate repair surgery and are not aware of the need for speech therapy.

For instance, Dau and his colleagues performed repair surgery on 1,430 children with cleft lip and palate between September 2010 and September 2013, but only one per cent of them received speech therapy.

Yen said speech therapists should work with local health facilities in provinces to provide more information on speech therapy.

Patients also have limited access to speech therapy because of the low number of speech therapists and shortage of equipment for speech therapy, Yen said.

Hoang Van Quyen, speech therapist at Paediatrics Hospital No.1's rehabilitation ward, said that speech errors made with a repaired cleft palate were complex.

If a child with the defect receives early speech therapy, her speech could be clear and confident in communication, said Quyen.

The 22-year-old university graduate now has much better articulation and speech, having received instruction from Quyen.

"Now, I have a better job. There is no longer a speech barrier between me and my colleagues. Speech therapy right after the first cleft palate repair surgery is the only way to minimize the emotional pain for these children in the future," the woman said.

In another case, a seven-year-old girl from Binh Tan District received speech therapy for 30-40 minutes weekly for 16 months, beginning when she was four years old.

She is now in the first grade and her speech is clear, according to Quyen.

Since January, his ward has provided speech therapy to 40 children. Of those, 11 have clear articulation and are studying in primary school. The remaining are still under treatment.

To get the best results, children should be cared for by a multidisciplinary team including dentists, paediatricians, speech therapists, teachers and parents, Quyen said.

VNS/VNN