velopharyngeal insufficiency (VPI) - anybody have experience with this?

[Guest guest]

My 3yr has severe verbal apraxia. He had his videofluoroscopy

(because he isn't making progress on sounds like b,p, etc and talks

hypernasal and has an abnormal palate - probably submucous cleft

palate) and was immediately diagnosed with velopharyngeal

insufficiency (VPI).

Speech therapy alone, unfortunately, won't be able to overcome the

VPI due to the physical abnormality of his palate. It sounds like

surgery is inevitable. We're off to see consult with the pediatric

ENT / surgeon next.

Anybody with personal experience with VPI?

Anybody have a child with BOTH apraxia and VPI? Any recommendations

on the approach of speech therapy with both conditions (obviously,

it complicates matters).

Thanks for any help you can provide!

Tammy, mom to 3yo w/ severe verbal apraxia, mild DIS, VPI, abnormal

palate (probably submucous cleft palate), and possible hearing issue

[Guest guest]

What does his palate look like?

We go monday to rule this out hopefully!Lindsey doesnt have many air sound when

speaking so we are worried!

Jennie

[Guest guest]

Hello Tammy

My son has apraxia, oral & verbal & VPI. He will soon be 6 in April. We

had a velo study done a couple of years ago & it showed that his flap (can't

remember the medical name??) was very weak & would hit & fall off. Luckily

nothing was structurely wrong. When he speaks most of the air leaks from

his nose causing him to sound very hypernasal. The slp had been working

with him trying to teach him to control his air flow when he was in private

therapy. We recently had to stop his private therapy but hope to begin

again this summer. I am hoping with him being a bit older now he may get

what she is telling him & not have to have surgery. I feel he has

strenghened so many other muscles, why not those too in time???

Tammy I. in FL

From: " apraxiamom03 " <apraxiamom03@...>

Reply-

Subject: [ ] velopharyngeal insufficiency (VPI) - anybody

have experience with this?

Date: Thu, 26 Feb 2004 12:10:27 -0000

_________________________________________________________________

Get a FREE online computer virus scan from McAfee when you click here.

http://clinic.mcafee.com/clinic/ibuy/campaign.asp?cid=3963

[Guest guest]

What does his palate look like? ...

Well, the ped ENT said his palate is on the " spectrum of a submucous

cleft palate " . Basically, it's physically abnormal. The palate is

high and short, and the uvula is practically missing! The SLP who

did the videofluoroscopy (palate study) said that because it's too

short, there isn't anything that can be done via speech therapy to

help him (for this specific problem). It's just too short to make

the connection (from what I understand), so he can't stop the air

from escaping (which is why he talks hypernasal). As he grows, it

apparently will only get worse - since the gap will increase in size.

From what I've read and discussed with different SLPs, it seems that

surgery is inevitable. Have to discuss this with the ped ENT and

surgeon in more detail though.

I'm not sure if they'll even do surgery since my son is so young

(only 3). Apparently, it's more common to have this

diagnosed/surgery at 4 or 5?? I'm very concerned about surgery so

young (it's not an easy surgery/recovery from what I can tell), but

I'm also concerned about how this impacts his speech. We can work on

bs and ps forever - but if he can't physically do it because his

palate is too short, then we won't make any progress whatsoever

(which is exactly what we've been noticing with bs and ps the past

year)!

Personally, I think apraxia is complicated by itself... so adding

other issues really furthers the complication. Hard for me to know

what speech issue is caused by VPI, caused by apraxia, or a

combination of both (and now, a possible hearing issue thrown into

that, as well).

Tammy, mom to 3yo w/ severe verbal apraxia, mild DIS, VPI, abnormal

palate (probably submucous cleft palate), and possible hearing issue

[Guest guest]

Hi Tammy

The child can have both VPI and Apraxia. If sugery cannot be done now, then I

think that it would be better to concentrate on the apraxia more than on the

VPI. This is because the surgery at a later age will more or less take care of

the hypernasality. I would not rule out therapy towards VPI at all, but it

should not be the ONLY thing the SLP does.

Good luck

Vani

SLP, India

apraxiamom03 <apraxiamom03@...> wrote:

My 3yr has severe verbal apraxia. He had his videofluoroscopy

(because he isn't making progress on sounds like b,p, etc and talks

hypernasal and has an abnormal palate - probably submucous cleft

palate) and was immediately diagnosed with velopharyngeal

insufficiency (VPI).

Speech therapy alone, unfortunately, won't be able to overcome the

VPI due to the physical abnormality of his palate. It sounds like

surgery is inevitable. We're off to see consult with the pediatric

ENT / surgeon next.

Anybody with personal experience with VPI?

Anybody have a child with BOTH apraxia and VPI? Any recommendations

on the approach of speech therapy with both conditions (obviously,

it complicates matters).

Thanks for any help you can provide!

Tammy, mom to 3yo w/ severe verbal apraxia, mild DIS, VPI, abnormal

palate (probably submucous cleft palate), and possible hearing issue