Velopharyngeal insufficiency (VI) is a condition where the soft palate (velum) does not completely close in the back of the mouth (oropharynx).  This results in either food or air escaping through the nose.  It can have a significant effect on your ability to understand child’s speech because of problems related to resonance and subsequent articulation patterns.  
Vl is often associated with cleft palate and Velocardiofacial Syndrome.


  • Hypernasality of the voice – too much air moving through the nose causes the voice to be high pitched and difficult to understand
  • Low pressure in the mouth when speaking affecting the way your child says consonants making speech difficult to understand
  • Food or liquid escaping from the nose


Velopharyngeal insufficiency must be evaluated  and diagnosed by directly viewing the movement of the velum, or soft palate.  This is done in conjunction with an ENT physician in a nasoendoscopy procedure, where a small camera is inserted through the nasal passage to watch the closing of the velum during speech activities.  It is often accompanied by an assessment of hypernasality using a nasometer.
During or after diagnosis your child will likely be evaluated by a Speech Language Pathologist (SLP).  The SLP will talk with you about your discuss your child’s medical history and your concerns. They will then talk with child, perform an examination of your child’s mouth and throat and perform a speech assessment with your child.


Medical treatment of velopharyngeal insufficiency may include orthodontic appliances to lift the palate or surgical interventions.
Speech Therapy will help your child improve the quality of their speech.
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