COPING STRATEGIES OF PARENTS AND CLEFT LIP PALATE PATIENTS

Based on the study entitled Coping strategies and social support in the family impact of
cleft lip and palate and parents' adjustment and psychological distress (Baker et al, 2008) , while
there were many impacts of a child’s cleft lip palate, results showed that parents have higher
levels of positive adjustment and stress-related growth as a result of their child’s condition. They
have also shown high levels of social support and relied more on approaching rather than
avoiding the impacts as their coping strategy. Having more support coming from family and
friends was associated with less negative family impact, lower psychological distress and better
adjustment for the child. The use of approach coping was associated with more positive
outcomes for the patient with cleft lip palate as well as for the patient’s parents.

Baker, S.R., Owens, J., Stern, M., Willmot, D. (2008, August 20). Coping strategies and social
support in the family impact of cleft lip and palate and parents' adjustment and
psychological distress. Retrieved January 20, 2018 from
http://www.academia.edu/19403022/Coping_Strategies_and_Social_Support_in_the_Fa
mily_Impact_of_Cleft_Lip_and_Palate_and_Parents_Adjustment_and_Psychological_Di
stress.

According to Kids Health Organization (n.d), Genetic counseling is done by first

performing a genetic test by analyzing small samples of blood or body tissues which can
determine whether a parent or the baby carry genes for certain inherited disorders. Genetic
counseling is the process of evaluating the results of this investigation and helping the parents
understand and reach decisions about what to do next. Through the help of a genetic counselor,
the parents will be able to understand any potential problem areas in their family or medical
history that can possibly cause a disorder. The counselor can also help the parents to understand
the inheritance patterns of any potential disorders and help assess their chances of having a child
with those disorders. Aside from that, genetic counseling can help parents understand their next
options and adjust to any uncertainties that they will face. Through this counseling, the parents
can be prepared for whatever the results of the genetic test will be and it can also help them in
coping and dealing with the possible challenges that comes along with having a child that has a
disorder. Genetic counselors can, however, also refer the parents with specialists for further help.
Genetic counselors can also refer parents to social workers, support groups, or mental health
professionals which can help them adjust to and prepare for their future.

Prenatal Genetic Counseling. (n.d). Retrieved January 20, 2018 from

http://kidshealth.org/en/parents/genetic-counseling.html?WT.ac=p-ra#
 According to Fletcher, Hunt, Channon and Hammond (2012), social support has
been emphasized as the most useful in the process of coping with having a child with a
cleft lip and palate as well as the perceived support from professionals that are involved
with the child’s health care. The support given by the patient’s friends and family were
shown to have resulted to lower distress, better adjustment and less negative impact on
the family. In terms of coping strategies by parents, the use of approach coping or
seeking of support, problem solving and positive appraisal was associated with more
positive results compared to avoidant coping. Social support was also identified as one of
the coping strategies used by parents. The significance of support from other parents has
also been highlighted in the study.

Fletcher, A.J., Hunt, J., Channon, S., & Hammond, V. (2012, August 15). Psychological Impact

of Repair Surgery in Cleft Lip and Palate. International Journal of Clinical Pediatrics,

1(4-5), 93-96. doi: http://dx.doi.org/10.4021/ijcp39w.

Based on an article created by the Kids Health Organization (2013), Many kids with a
cleft lip and palate experience occasional teasing and can be easy targets because their
differences are visible. Kids who get tease many times can have a difficulty in handling it and
may need help in knowing how to respond. The parents can help their child cope with these
scenarios by encouraging them to say if they get tease and by calmly listening and showing them
that you understand their feelings. Another thing to do is to teach them some ways on how they
can deal with it like using a confident voice to tell the child who is teasing to stop, ignore or
calmly walk away from the teasing, avoid acting too upset, thinking of a short phrase or joke to
say in response and telling an adult or a teacher about it. The parents can also help their children
by being a role-model and teaching them to become resilient by offering support, encouraging
activities and friendships that will develop their strength and confidence. Many schools
nowadays already have programs that deals with problems of teasing and bullying and promotes
positive relationship between kids. The parents can ask a school staff and cooperate with them to
make sure that an adult in charge will respond to such situations. If the teasing doesn’t stop and
the parents start to notice sudden changes with their child’s behaviour, they can talk with a
counsellor or mental health professor for additional support.
How Can Parents Help Kids Handle Teasing?. (2013). Retrieved January 20, 2018 from
http://kidshealth.org/en/parents/lip-tease.html?WT.ac=p-ra.

CLEFT LIP/PALATE THERAPY

According to Kummer (2008), children who have a history of cleft palate are prone to
experiencing speech problems due to velopharyngeal dysfunction (VPD). These speech
problems may include hypernasality or the presence of too much sound in the nasal cavity, nasal
air emission or the leakage of air during consonant production and compensatory articulation
productions. Kummer (2008) also stated that speech therapy is not usually effective in treating
hypernasality and nasal emission due to abnormal physiology but rather, speech therapy can be
effective if the patient has compensatory articulation productions that cause nasal emission,
misarticulations that cause nasal air emission or hypernasality that is phoneme-specific,
hypernasality or variable resonance due to apraxia and hypernasality or nasal emission following
surgical correction. The following are some specific therapy that have been effective in the
study: Auditory Feedback through the Oral and Nasal Listener and Nasometry and speech
therapy for misarticulation such as glottal stops, compensatory productions, nasalized and
pharyngeal plosives and Palatal-Dorsal productions.

Kummer, A.W. (2008). Cleft Palate and Craniofacial Anomalies: The Effects on Speech and
Resonance, 2nd Edition. New Albany, NY: Delmar Cengage Learning.

According to the American Speech-Language-Hearing Association (n.d), children that

have cleft lip palate only often need speech intervention to treat any speech delays or errors that
they might develop. Some patient will require speech therapy while others will require a surgery.
If a patient’s speech problems are due to incorrect articulation, it will only require speech therapy
which can help the patient learn how to use his/her tongue or lips to make speech sounds
correctly. On the other hand, if a patient’s speech problems are related to VPI or other problems
related to oral structures, speech therapy may not be an appropriate treatment and would require
surgery as well as therapy to create normal sounding speech. It is also important to discuss the
treatment of the patient’s speech problems with the cleft palate/craniofacial team speech-
language pathologist who has the knowledge and skills to accurately diagnose and monitor the
treatment of speech problems.

Cleft Lip and Cleft Palate. (n.d). Retrieved January 20, 2018 from
http://www.asha.org/public/speech/disorders/CleftLip/
 According to an article created by Speech Buddies (2012, November 6), “Velopharyngeal
dysfunction or VPD occurs when the opening between the mouth and the nose cannot close
properly which results in hypernasality or the excessive airflow from the nose while the patient is
speaking. Although it can be treated with surgery, some patients will still experience
velopharyngeal dysfunction and would require speech therapy. Auditory feedback and
articulation practice are the crucial first steps in correcting a patient’s speech pattern. The patient
must learn to distinguish between normal and nasalized sounds which can be done using a
variety of techniques. Therapy for nasalized and pharyngeal plosives, a sound that is produced
when the vocal tract is obstructed by a speech structure such as the lips or the tongue, can also be
used. It can be done by having the patient yawn in order to push the back of the tongue down and
practice producing sounds while doing so. Another is the therapy for pharyngeal fricative which
is produced when the tongue is retracted but the base of the tongue doesn’t make any contact
with the pharyngeal wall. It can be done by having the patient make a loud “t” sound and then a
“ts” sound with his/her teeth closed. By rounding the lips, he/she can then practice the “ch” and
“sh” sounds. Lastly is the palatal-dorsal production which can be done by having the patient bite
down on a tongue blade that is positioned in a way that presses down on the middle of the
tongue. The patient will then practice producing “t”, “n”, “d”, “k”, “g” and “ng” sounds.

Top 4 Cleft Palate Speech Therapy Techniques. (2012, November 6). Retrieved January 20, 2018
from https://www.speechbuddy.com/blog/speech-therapy-techniques/top-4-cleft-palate-
speech-therapy-techniques/

Based from an article created by the Kids Health Organization (2015), speech disorders can also
occur for children experiencing cleft lip and palate even after surgeries which include
articulation, fluency and resonance disorders. Aside from that, cleft lip and palate patients can
also experience language disorders and oral feeding disorders. Speech-language pathologists or
often referred to as speech therapists, are professionals educated in the study of human
communication, its development, and its disorders. They are the ones who assess speech,
language, cognitive-communication, and oral or feeding/swallowing skills to identify the type of
communication problems and the best way to treat them. Some of the strategies that SLPs used
in their therapies include: language intervention activities that can stimulate language
development, articulation therapy which will teach the patient how to make certain sounds and
lastly is the oral-motor or feeding and swallowing therapy to strengthen the muscles of the mouth
for eating and drinking. There are a variety of reasons on why children might need a speech-
language therapy. Some of these are hearing impairments, cognitive or other developmental
delays, weak oral muscles as well as respiratory problems. Therapy are advised to begin at a
young age because children having therapies at an early age tend to have better outcomes but this
does not mean that older kids cannot make any progress in therapy but rather, they may progress
at a much slower rate. Speech therapies also agree that the involvement of the parents in these
activities is crucial for the child’s progress. The process of overcoming a speech or language
disorder can take some time and effort, so it's important that all family members be patient and
understanding with the child.

Speech-Language Therapy. (2015). Retrieved January 20, 2018 from

http://kidshealth.org/en/parents/speech-therapy.html?WT.ac=p-ra.