Children begin practicing for speech during the first year of life. Speech begins with sounds that are easy to make (vowels such as a, e, i, o and u) and progresses to sounds that are harder, such as "th," "st" and "str." For children, learning speech happens like this:
- First they make general sounds, such as cooing and vowel sounds
- Then they make sounds that are like speech sounds, such as babbling and consonant sounds
- Then they make real speech sounds and words
- After putting some speech sounds together to form words, they begin to make sentences
For a child with a cleft lip and palate, it may be hard to move through these steps because of an opening into the nose, missing teeth or teeth that are out of line.