Although cleft-palate speech, like foreign dialect, is characterized by articulatory and voice defects and hence could be classified under both disorders, the consonantal substitutions, omissions, and distortions and the qualities of the various vowels are so peculiar that they demand separate treatment. The disorder may vary from a very slight nasal lisp to a form of speech in which the consonants and vowels are so distorted that even the parents of the child can seldom understand him. Profound disturbances of personality also often occur.
Causes. Cleft-palate speech may be the result of any one of three causes: imitation; a soft palate that is paralyzed or sluggish or too short; a cleft or opening along the midline of the soft or hard palate or of both palates. The latter condition is frequently accompanied by cleft or harelip. Cleft palate seems to have some hereditary factor, and since the speech accompanying it is usually strikingly different, young children who associate intimately with a parent, sibling, or playmate who possesses a cleft palate tend to acquire some of the defective sounds, particularly the nasal snort which is used for the sibilant sounds. Shortness, sluggishness, or paralysis of the soft palate may be due to injury, to the effect of diphtheria or some other infection, to adenoidal cushions which prevented normal palatal movement, or to congenital influences. When the speech dis