1. By Jozlynne Taylor and Kersten Stelmach

2. WHAT IS A CLEFT PALATE? A congenital split in the roof of the mouth The two parts of the skull which form the hard palate are not fused together Soft palate had a gap Affects 1 in 700 babies annually

3. Cleft palates are more common in Caucasian and Asian babies In most cases, the cause is unknown Scientists believe it is a combination of genetic and environmental factors Appears to be greater chance if a relative has it May be related to a medication taken during pregnancy Medications possibly causing them: anti-seizure drugs, acne drugs containing Accutane, and methotrexate HOW DO YOU GET A CLEFT PALATE

4. Clearly visible when baby is born Can be unilateral or bilateral Prenatal ultrasounds can sometimes determine a cleft in an unborn child Symptoms of a cleft occurring in the muscles of the soft palate include difficulty swallowing, nasal speaking voice, and recurring ear infections A physical exam of the mouth, nose, and palate can confirm after birth Other symptoms: change in nose shape, poorly aligned teeth SIGNS AND SYMPTOMS

5. Dental problems Ear infections Feeding difficulties Hearing loss Speech problems Self confidence could go down Failure to gain weight Poor growth PROBLEMS

6. Surgery occurs when the child is 6 weeks to 9 months old Type and severity of cleft decides what treatment is recommended Sometimes the cleft palate is covered by a prosthetic device made to fit the roof of the mouth, covering the gap TREATMENT

7. Cleft palates affect feeding, hearing, speech, and teeth They will require several operations to repair the cleft More operations may be needed during childhood, adolescence, and early adulthood Hearing should be monitored closely during early childhood Child should be monitored regularly by a experienced dentist Many children now achieve excellent results with their apperance, speech, and teeth KEY POINTS TO REMEMBER

8. Cost may include: -Surgeon’s fee -Hospital or surgery facility fee -Anesthesia fee -Prescriptions -Post- surgery garments -Medical tests Estimated cost without health insurance is $5,000 to $10,000 With health insurance is estimated from several hundred to several thousand COST OF TREATMENT

9. Cleft palates and their corrections connects to The Kite Runner because in the novel, one of the characters Hassan has a cleft palate. It has affected him for his whole life and a correction was never really an option because him and his father are poor servants. But then, Baba the man that they are servants for pays for the operation to get Hassan’s cleft fixed. CONNECTION TO THE NOVEL

10. Department of Plastic and Maxillofacial Surgery and Speech Therapy at the RCH. "The Royal Children's Hospital Melbourne." Kids Health Info : Cleft Lip and Palate. October 2010. Accessed March 06, 2014. http://www.rch.org.au/kidsinfo/fact_sheets/Cleft_Lip_and_Palate_an_overview/. http://www.rch.org.au/kidsinfo/fact_sheets/Cleft_Lip_and_Palate_an_overview/ Parker SE. "Facts about Cleft Lip and Cleft Palate." Centers for Disease Control and Prevention. July 15, 2013. Accessed March 05, 2014. http://www.cdc.gov/ncbddd/birthdefects/cleftlip.html. http://www.cdc.gov/ncbddd/birthdefects/cleftlip.html Mayo Clinic. "Cleft Lip and Cleft Palate." Definition. February/March, 1998. Accessed March 04, 2014. http://www.mayoclinic.org/diseases-conditions/cleft- palate/basics/definition/con-20024619.http://www.mayoclinic.org/diseases-conditions/cleft- palate/basics/definition/con-20024619 SOURCES