Understanding Velopharyngeal Dysfunction: What Parents Need to Know 

If your speech-language pathologist or another professional has mentioned the term “velopharyngeal dysfunction” (VPD), there are often a lot of questions about what this means and what the next steps are. VPD can happen for different reasons, including structural differences, muscle weakness, or learned speech patterns. Understanding the type of VPD your child has is key to finding the right treatment, whether that’s speech therapy, surgery, or a combination of both.

There are three main types of VPD: velopharyngeal incompetence, velopharyngeal insufficiency, and velopharyngeal mislearning. While they sound similar, they have different causes and treatment options.

1. Velopharyngeal Incompetence

Velopharyngeal incompetence happens when the muscles of the soft palate and throat don’t work properly, even though all the structures are there. This is often due to a neurologic or genetic condition that impacts muscle tone, or it can be caused by weakness from surgery or injury.

Treatment: Specialized devices (like a speech prosthesis) are usually recommended, as speech therapy alone won’t improve the muscle function. Surgery is also considered depending on the underlying reason for the velopharyngeal incompetence.

2. Velopharyngeal Insufficiency

Velopharyngeal insufficiency occurs when there isn’t enough tissue in the soft palate to fully close off airflow into the nose. It’s often seen in children born with a cleft palate, even after surgical repair, or in those with certain genetic conditions affecting facial structure.

Treatment: Like incompetence, surgery is typically required to add or reposition tissue. Speech therapy alone won’t correct it, but it can help children learn to use their repaired structures correctly after surgery.

3. Velopharyngeal Mislearning

Velopharyngeal mislearning happens when a child’s speech patterns are incorrect, even though their anatomy and muscle function are normal. Instead of using the right tongue and lip movements for sounds, they may develop habits like making sounds in their throat or out their nose, making their speech harder to understand.

Treatment: This is the only type of VPD that speech therapy can fully correct! A speech-language pathologist (SLP) can teach your child new speech patterns and help them produce sounds correctly.

What Can Parents Do?

If you notice your child’s speech sounds unusually nasal or unclear, consult a speech therapist. They can determine whether speech therapy will help or if a referral to other medical specialists is needed. Early intervention can make a big difference in your child’s communication skills and confidence!