Management of Speech and Resonance Disorders due to Velopharyngeal Insufficiency (VPI)


Course Type: Video – 1 1/2 hours

ASHA Course Code: Cleft Lip/Palate, Velopharyngeal Dysfunction (VPD), and Related Craniofacial Anomalies – 1080

Most SLPs work with VPI far less often than other speech disorders, and infrequently enough to make us scratch our heads and think, “What am I supposed to do here?” Dr. Ann Kummer, Professor Emeritus, University of Cincinnati College of Medicine, has answers for you!

Children with speech and resonance disorders due to velopharyngeal insufficiency (VPI) present challenges for speech-language pathologists (SLPs) in all settings. This presentation is designed to provide current and practical information to SLPs who frequently or occasionally see children with hypernasality, nasal emission and/or speech disorders secondary to velopharyngeal insufficiency (VPI).


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Additional Information


Adult, Early Childhood, School Age


1.5 hours


.15 Continuing Education Units


Articulation/Phonology, Evaluations



FINANCIAL: Dr. Ann Kummer is receiving an honorarium from Bilinguistics. Further, she receives royalties for the following textbook: Kummer AW. (2020). Cleft Palate and Craniofacial Conditions: A Comprehensive Guide to Clinical Management, 4th Edition, Burlington, MA: Jones & Bartlett Learning, and royalties for the following device: Oral & Nasal Listener, Super Duper Publications.

NON-FINANCIAL DISCLOSURE: Dr. Ann Kummer serves as a consultant for Smile Train.

Dr. Kummer will begin with a discussion of the factors that affect resonance for speech, using the source-filter theory as a basis. There will then be a description of the velopharyngeal valve and a description of normal velopharyngeal function. This will be followed by a discussion of the three types of velopharyngeal dysfunction. She will then focus on velopharyngeal insufficiency (VPI), which is the result of abnormal structure and therefore, is common in children with cleft palate. The effect of VPI on both speech production and resonance will be explained and demonstrated. Many short videos will be used for illustration.

Dr. Kummer will then describe and demonstrate simple low-tech and “no-tech” procedures that can be used for assessment of speech and resonance in either a clinical or school setting. Various treatment options (i.e., surgery, prosthetic devices, and speech therapy) will be discussed and guidelines for appropriate recommendations for treatment will be given.

Participants will:

Describe the characteristics of normal resonance and normal velopharyngeal function
Describe the characteristics of velopharyngeal insufficiency and its effect on speech and resonance
Select appropriate tools and effective procedures for the assessment of speech and resonance
Make appropriate recommendations for treatment (i.e., surgical intervention, prosthetic device, and/or speech therapy) based on the assessment results
Time-Ordered Agenda:

20 minutes: Normal resonance and normal velopharyngeal function

20 minutes: Velopharyngeal insufficiency (VPI) and effects on speech

20 minutes: Evaluation of speech, resonance, and VPI

15 minutes: Treatment of speech, resonance, and VPI

15 minutes: Questions and answers

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