Palate Investigation Clinic

What is palate investigation clinic?

Palate investigation clinic (PIC) is a four-stop clinic held at Addenbrooke’s Hospital in Cambridge, to assess the movement of the palate during speech.

• It is an all-day clinic where assessments are taken and you have the chance to discuss the findings on the day, ask any questions, and make a plan of action with the team.
• It is run by the members of the cleft lip and palate team, including a surgeon, specialist speech and language therapists and clinical psychologists.

• PIC looks at what the soft palate does during speech. It needs to lift to touch the back wall of the nose and throat during speech (and eating).
• If it does not reach, there may be a ’nasal’ quality to the voice and air may escape down the nose for some sounds in speech. In some cases, food and drink may come through the nose.
• A moving x-ray allows us to see where and how well the palate moves and whether it reaches the back wall of the nose and throat as it should.

What happens at PIC

There are four separate appointments with breaks between them.

1. A video recording of speech: conversation, counting and sentence repetition in Clinic 7. For younger children, this may be done through play.
2. A meeting with one of the Clinical Psychologists to talk about your expectations for the day. They can support you to think about any questions or concerns you may have about the clinic, or possible outcomes, and help you to think about any decision that you might have to make in the future.
3. A visit to the x-ray department on Level 3 for a short video x-ray of speech. We take the x-ray while doing some more talking together. You/your child will have to sit very still.
4. Later, there will be a discussion in Clinic 7 with the team about the findings from the day, and if there is any way the surgeon can help.

Please note: The timetable is tight and our X-ray slots are limited, so please try to arrive promptly.

• If driving, please allow plenty of time to park.
• We can have up to six families going through this process on the day, so there is some time to wait between each appointment.
• We try our hardest to run to time in discussions, but sometimes they take longer than expected – please bring entertainment with you!
• If you take your clinic letter to the main hospital reception at the end of the day, you will be given a discounted parking ticket.

What might happen after PIC?

At PIC there may be a variety of outcomes.

1. Watchful waiting - We may decide to use the investigation as a baseline and monitor progress to see if growth and maturation have any effect over time.
2. Speech and Language Therapy - We may offer speech and language therapy to see if changes can be made to speech with therapy input.
3. Surgery - An operation to the palate or throat may be offered to help improve speech.
4. Prosthetics – In some cases there may be a non surgical option available to improve speech.
5. A combination of the above.

Contacts / Further information

Cleft.NET.East

Box 46
Addenbrooke’s Hospital Cambridge

University Hospitals NHS Foundation Trust

Cambridge Biomedical Campus

Hills Road Cambridge

CB2 0QQ

Tel: 01223 596272

Cleft Net East