The soft palate is a muscle in your mouth that moves up and down, touching the back of your throat during normal speech.
In order to produce oral consonants like the letters p, w, and x, the soft palate must firmly close against the back of your throat.
With the soft palate closed, air does not come out through your nose while making those sounds.
Velopharyngeal insufficiency is when your soft palate is unable to close tightly against the back of your throat, most commonly caused by cleft palate.
It’s what’s known as a resonance disorder.
To treat velopharyngeal insufficiency, you’ll often need surgery to correct it, because of the physical gap between the back of the throat and soft palate.
Afterwards though, it’s a good idea to work with a speech therapist.
Now, let’s find out more about velopharyngeal insufficiency and how a speech therapist can help.
What Is Velopharyngeal Insufficiency?
Velopharyngeal insufficiency is when your soft palate does not close tightly against the back of your throat.
This leads to air escaping out of the nose during speech, which can create speech that is difficult to understand and nasal in quality.
What Causes Velopharyngeal Insufficiency?
The most common cause of velopharyngeal insufficiency is a cleft palate or a submucous cleft palate.
Roughly 20% of children who have had their cleft palates repaired will have persistent velopharyngeal insufficiency.
Rarely, having an adenoidectomy can result in velopharyngeal insufficiency.
An adenoidectomy is a procedure to remove your adenoid glands, located in the back of your throat just behind your uvula.
It usually happens because of chronic infection.
As a result of the procedure, it can create more space between your soft palate and the back of your throat, which causes velopharyngeal insufficiency.
This is often temporary and typically improves after a few weeks, though.
Other causes include traumatic brain injuries and neurological disorders due to muscle weakness or difficulty with muscle coordination of the palate.
Sometimes, the cause remains unknown.
What Are The Symptoms Of Velopharyngeal Insufficiency?
The symptoms or effects of velopharyngeal insufficiency on resonance and articulation differ from child to child.
One common symptom is the presence of hypernasality in speech, which is too much sound resonating in the naval cavity.
This typically manifests on vowels and voiced oral consonants during speech.
Pressure consonants may be weak due to reduced oral pressure and breath support during speech may be compromised due to nasal escape, which reduces the length of your utterance.
An audible nasal emission of air typically accompanies this.
Another symptom known as poor articulatory placement can occur as a side effect of velopharyngeal insufficiency, which is the result of your child compensating for this insufficiency and creating laryngeal tension as a result.
Some examples include poor lip approximations, poor tongue tip elevation, and aberrant tongue posturing.
How Is Velopharyngeal Insufficiency Diagnosed?
A speech language pathologist can determine if your child’s speech deficit is caused by velopharyngeal insufficiency or something else.
We’ll use a nasoendoscopy to explore the size and shape of your or your child’s velopharyngeal gap.
With the image it makes, we can confirm velopharyngeal insufficiency or if there’s another issue at work.
How Does A Speech Therapist Treat Velopharyngeal Insufficiency?
As mentioned above, the first step in correcting velopharyngeal insufficiency is surgery.
You should speak to a speech therapist around six weeks post surgery to see if you’ll need their services.
Children with velopharyngeal insufficiency often produce sounds incorrectly post surgery.
If you or your child is experiencing that, speech therapy can help.
There are a number of different ways a speech therapist can do this.
First, you’ll need to unlearn the ways you compensated for your
Primarily, it’s by focusing on correcting any articulation errors and eliminating velopharyngeal mislearned patterns.
To correct articulation errors, your speech therapist will work to teach you or your child to eliminate compensatory errors with the goal of reducing the perception of hypernasality.
This is often focused on voiceless sounds like w, h, p, and t before moving on to voiced sounds.
You may have developed velopharyngeal mislearning as a result of their previous velopharyngeal insufficiency.
Velopharyngeal mislearning is when you or your child learned to produce sounds like‘s’ and ‘pr’ through the nose instead of through the mouth.
When corrected by a speech therapist, their resonance improves and eliminates any nasal emission.
Some strategies your speech therapist might use for this include:
- Tactile feedback (feeling the nose during oral and nasal speech)
- Visual feedback
- Auditory feedback
- Increased articulatory effort: increasing their loudness level
- Increase general awareness of oral and nasal airflow
- Description exercises
Book An Appointment With District Speech
As you can see, speech therapy is a great resource to help your child recover from velopharyngeal insufficiency.
Although surgery is typically required, the valuable skill set of a speech therapist is still required in order to correct your child’s speech patterns going forward.
As always, the earlier your child is able to start speech therapy, the greater the chances for success.
This is because there has been less of an opportunity for their bad habits to get ingrained.
It is important to address velopharyngeal insufficiency quickly in order to set your child up for success later in life.
Book an appointment today with District Speech to get started and schedule an evaluation.
We look forward to working with you.
1300 I St NW, #400E,
Washington, DC 20005
District Speech and Language Therapy specializes in speech therapy, physical therapy, and occupational therapy solutions, for both children and adults, in the Washington D.C and the Arlington Virginia areas.