If your child’s speech sounds as if air is escaping from the nose, they may have a condition called velopharyngeal incompetence (VPI).
When we talk, air moves from our lungs, up through the vocal cords and into the velopharynx (back of the throat). For clear speech, the air must go to the right place, which is sometimes our nose and other times our mouth. The soft palate (velum) directs the flow of air to the correct place. The lips, teeth and tongue then shape the air to make specific speech sounds. If the soft palate doesn’t work well, then your child’s speech may sound unusual with a nasal quality.
Most families have never heard of VPI until their child is diagnosed with it. Children’s Health℠ has a great deal of experience treating VPI with our expert speech-language pathologists, plastic surgeons and ear, nose and throat (ENT) physicians. Children with a cleft or submucous cleft palate will see a plastic surgeon. All other VPI conditions are treated by an ENT physician.
To limit the impact on your child's speech and social development, early detection and treatment are critical.
A trained speech-language pathologist and a plastic surgeon or ENT carry out tests to decide whether your child has VPI and whether it is a cleft or non-cleft type of VPI. These tests include a comprehensive speech and resonance assessment. Your child will need to imitate words and phrases during the evaluation.
If the doctor thinks your child has VPI, their speech is tested further with two techniques:
The results will be explained so you can make the most informed decision about your child’s care.
Following the diagnosis, treatment recommendations may include speech therapy combined with surgery or orthodontic appliances. In some cases, speech therapy is the only treatment needed.
Speech therapy may also be needed to teach the correct lip and tongue movements for speech.
The goal of surgery will be to fix your child’s soft palate so that less air escapes from the nose during speech.