This chapter explores the impact of cleft palate and congenital VPD on early speech sound and lexical development and describes the early speech-language profiles seen in this population. Investigations conducted throughout the past 30 years have demonstrated that toddlers with cleft palate and VPD demonstrate delays in early speech sound development, and these delays influence the phonetic make-up, frequency, and rate of early word development. Four different speech-language profiles of toddlers after palate repair will be described. Considerations for assessment and early intervention will be addressed.