Velopharyngeal Insufficiency (VPI) Treatment Clinic

The VPI Clinic at Children’s Hospital Colorado provides multidisciplinary care for children who have a diagnosis of or suspicion of velopharyngeal insufficiency. Velopharyngeal insufficiency is a condition in which a child has trouble moving or closing the soft palate and surrounding structures during speech.

Children who have velopharyngeal insufficiency have speech that is not understood very well by others. They may have too much or too little sound coming through their nose, or they may have a quiet or hoarse voice.

The care team within the VPI clinic is made up of pediatric specialists from the otolaryngology, plastic surgery, and audiology, speech and learning departments.

To assess for velopharyngeal insufficiency, our multidisciplinary team evaluates the following:

• speech sound production
• oral and nasal resonance (sound energy traveling through the nose and mouth)
• velopharyngeal function (movement of the soft palate and structures around it during speech)

Why choose the VPI Clinic at Children’s Hospital Colorado?

Our multidisciplinary team works together to understand the cause of your child’s speech difficulties and provide recommendations to improve your child’s ability to communicate and be understood.

We use equipment that is child-sized, which makes testing more comfortable for your child. Team members understand how to use play, humor and child-friendly language to help your child participate as easily and comfortably as possible in the evaluation.

Services offered

At our VPI Clinic, we provide speech, resonance and voice evaluations to determine if your child has VPI. This is accomplished through:

• Caregiver interviews with a nurse and speech-language pathologist
• Speech and resonance evaluation by a speech-language pathologist, which includes the use of a nasometer (computer-based tool that measures sound energy coming from the nose and mouth)
• Direct visualization of the speech structures in the nose and throat using a pediatric endoscope

An evaluation at the VPI Clinic helps us identify the underlying issues that are causing your child’s speech, resonance and voice difficulties. The goal of the evaluation is to provide treatment recommendations that will help your child’s speech be more understandable. Treatment recommendations may include speech-language therapy, surgery or both.

Typically, children do not come to the VPI clinic before the age of 2 because the child needs to cooperate to a certain degree during evaluation. Once a child is referred to the VPI clinic, care team members will review the child’s records to determine if this is the most appropriate evaluation. If a VPI evaluation is recommended, the VPI clinic scheduler helps families with scheduling and preparing for the visit. A visit to the outpatient VPI clinic is typically about one hour long.

Additional resources:

• Velopharyngeal Insufficiency/Speech Management Surgery (.pdf)
• Cirugía para corregir la insuficiencia velofaríngea/tratamiento para el habla (.pdf)