• How is VPD Treated?

    The treatment of a resonance disorder or velopharyngeal dysfunction depends on the type and cause of the problem. 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, Furlow Z-plasty, 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 correctly produce sounds.

    If therapy is necessary, the speech pathologist on our team will advise your child’s current therapist on effective methods of treatment. Note: Contrary to previous beliefs, blowing, sucking and oral-motor exercises are NOT effective in improving velopharyngeal closure or the abnormal resonance.

    The treatment of a resonance disorder or VPD (velopharyngeal dysfunction) depends on the type and cause of the problem. The treatment for velopharyngeal mislearning requires speech therapy only. However, VPI (both velopharyngeal insufficiency and velopharyngeal incompetence) require physical management. A surgical procedure (i.e., a tonsillectomy, Furlow Z-plasty, pharyngeal flap, sphincter pharyngoplasty, or posterior pharyngeal wall implant) is usually required. In selected cases, a prosthetic device can be used on a temporary or permanent basis.

    When surgery is done to correct the structure, 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.

    If therapy is necessary, the speech-language pathologist on our team will advise the child’s current therapist on effective methods of treatment. Note: Contrary to previous beliefs, blowing, sucking and oral-motor exercises are NOT effective in improving velopharyngeal closure or the abnormal resonance.

    What can parents do to help?

    • Parents should be active members of the child’s treatment team. They can help in the following ways:
    • Follow-up on recommendations from the surgeon and speech-language pathologist.
    • If surgery has been performed, the child may need to learn how to use his or her new structure. This is done through speech therapy.
    • It is important that the parent and child work together in between therapy sessions on activities suggested by the speech-language pathologist.
    • Several short practice sessions each day are the most effective in helping the child at home.

    Additional Resources

    The Cleft Palate Foundation provides a variety of complimentary booklets and fact sheets for families and individuals with a history of cleft and/or velopharyngeal dysfunction.

    The following book provides more in-depth information about clefts, velopharyngeal dysfunction and team care:
    Kummer AW. (2008). Cleft Palate and Craniofacial Anomalies: Effects on Speech and Resonance, 2nd Edition. Clifton Park, NY. Learn more at Delmar Cengage Learning.

    Contact Information

    For more information about the VPI Clinic or to make a referral, call Angela Davis, 513-636-0336.

  • Assessment protocol

    Read about the assessment protocol in the VPI Clinic at Cincinnati Children’s.

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