Classification of Velopharyngeal Dysfunction

Figure adapted with permission from Trost-Cardamone (1989) and

Peterson-Falzone, Trost-Cardamone, Karnell, and Hardin-Jones (2006).

Velopharyngeal Dysfunction/VPD
(Velopharyngeal Inadequacy/VPI)

Cleft VPD Non-Cleft VPD

Velopharyngeal Velopharyngeal Velopharyngeal Velopharyngeal

Insufficiency Insufficiency Incompetency Mislearning
(Structural) (Structural) (Neurogenic)
• Phoneme-specific nasal
• Unrepaired cleft palate • Mechanical interference • Congenital or emission
(overt or submucous) (e.g., excessive tonsils acquired primary
or posterior pillar motor/neuromotor • Persisting postoperative
• Postsurgical insufficiencies webbing) control (dysarthria) nasal emission (with
(e.g., palatal length too adequate closure ability)
short post palate repair; • Palatopharyngeal • Motor association/
VPI postadenoidectomy) disproportion (deep motor programming • Compensatory
pharynx) (apraxia) misarticulations

• Ablative palatal lesions • Deafness/hearing

(e.g., cancer, traumatic impairment
injury

Trost-Cardamone, J. E. (1989). Coming to terms with VPI: A response to Loney and Bloem. Cleft Palate Journal, 26(1), 68–70.

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Peterson-Falzone, S. J., Trost-Cardamone, J. E., Karnell, M. P., & Hardin-Jones, M. A. (2006). The clinician’s guide to treating cleft palate speech. St. Louis, MO: Mosby.