[Joint treatment of patients with clefts by orthodontists and logopedists]

Close cooperation between speech pathologist and orthodontist in management of CLP cases is described. Preoperative treatment aims at maintenance of initially favorable maxillary relations and compensation for imbalance of the oral musculature. Knowledge of growth and speech development is decisive for timing of primary surgery (lip about 6 months, soft palate about 18 months, hard palate 5 to 7 years). Speech assessment starts at age 2-2 1/2, followed by team controls once or twice a year with proper coaching of parents. Actual speech therapy is not stared before age 5. The approach described, with particular consideration of growth and speech problems, has been followed for 5 years. With a view to speech as well as to cephalometric evaluation, temporary results excell those of former years for the same age group. As regards teamwork, assessment of velopharyngeal closure is mentioned since orthodontists may provide speech-pathologists with an additional diagnostic means, i.e. cephalometric headplates, taken during phonation.