When a child has a cold or stuffy nose, their speech can be affected and it can sound very “nasal-y.” Some parents experience this type of speech on a daily basis with their child.

Children suffering from a form of speech impairment known as VPI, or velopharyngeal insufficiency, speak with this nasal-like and muffled tone/hypernasality constantly. It occurs when there is not enough soft tissue in the palate, or throat, to allow the palate to properly close the communication between the nose and the mouth while talking. Loss of this function can affect not only how a child speaks, but also how they swallow and breathe. Our goal at Wellspring Craniofacial Group is to help assess your child and give them all the tools for normal speech development so that they can create a voice of their very own.

In common English, the only sounds with a true nasal tone involve the letters m, n, and ng. If you hear nasality with other sounds, especially vowels or when using the letters w, y, l, or r, it may be time for your child to be evaluated by a speech pathologist for VPI.

Most instances of VPI are caused by one of the following:

  • History of cleft palate, as approximately 25% of children with a cleft palate condition also suffer from VPI
  • Complications from adenoid surgery removal
  • Weak throat muscles
  • Genetic syndromes
  • Too much space between the palate and throat
  • A fine motor or developmental disorder

Sometimes the cause of VPI remains unknown.

If there is concern that your child may be suffering from VPI, your surgeon will suggest further diagnostic imaging and a thorough speech evaluation.

The vast majority of these cases are treated very successfully with surgery. Our surgical team proceeds with input from your speech pathologist, and sometimes an orthodontist as well.

The most common types of corrective surgery that we use are:

Pharyngeal Flap: bringing a segment of tissue from the back of the throat toward the soft palate so that the space between the nose and mouth can be closed during speech

Palatoplasty: bringing the muscles of the palate into a more normal position for an easier connection with the throat

Sphincter Pharyngoplasty: moving tissue from the side of the throat to fashion a tiny ‘speed bump’ structure at the back of the throat

Following your child’s surgery, speech therapy is often prescribed and highly encouraged to get them used to their new, non-nasal voices…which will be music to their ears, and yours too.

To schedule a consultation, contact our office at 512-600-2888. 


Children’s Hospital of Richmond at VCU 

Seattle Children’s Hospital