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Early Intervention Speech Therapy

A Velopharyngeal Dysfunction Refresher

Published October 9, 2012 12:18 PM by Stephanie Bruno-Dowling
Today's post is a factual look at VPD or Velopharyngeal Dysfunction. I am currently working with a student who presents with a hypernasal quality to their speech and am researching on my own the best ways to treat them in therapy. Based on my research, here is some of the most helpful information I have found:

According to the Children's Hospitals and Clinics of Minnesota website, Velopharyngeal Dysfunction is defined as the following:

In order to produce most speech sounds, the nose must be closed off from the mouth by using the soft palate (velum) and the walls of the throat (pharyngeal walls). If a child is unable to adequately close off the nose during speech it is called velopharyngeal dysfunction. Velopharyngeal dysfunction (VPD) includes velopharyngeal insufficiency and velopharyngeal incompetence (VPI).

Children with velopharyngeal dysfunction may present with the following concerns:

  • Speech that sounds overly "nasal," as if the person is "talking through his/her nose." This is called hypernasality.
  • Speech that sounds "stuffed-up," like the child has a cold all of the time. This is called hyponasality
  • Articulation errors:
  • "P" and "B" sounds more like "M," "T" and "D" sounds more like "N"
  • Weak and deleted speech sounds due to air loss through the nose
  • Difficulty producing longer phrases because too much air is lost through the nose

The site goes on to state that "the most common causes of VPD are cleft palate and submucous cleft palate. However, "other causes include a short soft palate, craniofacial abnormalities, adenoidectomy, enlarged or irregular shaped adenoids, childhood apraxia of speech, muscle weakness, velar paralysis and/or neurological disorders".

According to the Cincinnati Children's Hospital Medical Center, the most common treatments of VPD is contingent upon the type and cause of the problem. For example:

If the problem is due to velopharyngeal mislearning, speech therapy alone will correct the abnormal speech. The treatment of velopharyngeal insufficiency or velopharyngeal incompetence usually requires a surgical procedure (tonsillectomy, pharyngeal flap, sphincter pharyngoplasty, or posterior pharyngeal wall implant). Prosthetic devices can also be used for VPI on a temporary or permanent basis in some cases.

Although surgery is usually needed for VPI, the surgery does not change the way the child has already learned to talk. Therefore, postoperative speech therapy is usually required to help the child learn how to use the corrected structure and produce sounds correctly.

The Cincinnati Children's website also includes links to other informative websites as well as helpful information for parents to know!

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About this Blog


    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
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