Velopharyngeal Dysfunction Program
The Velopharyngeal Dysfunction Program at Children’s National Hospital provides comprehensive, family-centered care for children with velopharyngeal dysfunction (VPD)—a condition that makes it difficult to close the palate and throat when speaking and can affect speech clarity and strength. Through coordinated assessments and personalized treatment plans, we help children achieve improved communication and confidence.
Our Providers
Our pediatric specialists provide personalized care for your child’s physical, mental and emotional health needs.
Contact Information
For appointments, please call 1-888-884-BEAR (2327) and for information, call 202-476-6765.
What conditions does the Velopharyngeal Dysfunction Program treat?
Velopharyngeal dysfunction (VPD)
VPD happens when the velum (also known as the soft palate, the soft, flexible part at the back of the roof of your mouth) and the pharynx (the back of the throat) don’t come together effectively during speech. This can allow air to escape through the nose, making speech sound nasal or difficult to understand.
Velopharyngeal insufficiency (VPI)
Velopharyngeal insufficiency (VPI) is a type of VPD that happens when there is not enough tissue in the soft palate or surrounding structures to fully close the space between the mouth and nose during speech.
Speech and resonance issues
- Hypernasal speech or audible air escape when talking
- Unclear speech after adenoidectomy
- Reduced speech volume, articulation errors or nasal regurgitation (when food or liquid accidentally comes out through the nose instead of going down the throat)
How can we help your family with velopharyngeal dysfunction care?
- Thorough evaluation and treatment plan. In a single visit, your child will be seen by a pediatric otolaryngologist and a speech-language pathologist. Diego Preciado, MD, PhD, James Leonard, MD, and Vanessa Whyte, MA, CCC-SLP, perform a real-time team evaluation that allows our experts to observe speech, conduct targeted testing (including endoscopic or imaging assessments if needed), and provide families with a clear, coordinated plan before they leave the clinic. We also partner with craniofacial specialists, feeding therapists and developmental teams when needed to support all of your child’s needs. When you come in for your visit, our team will make sure you understand every step of the process:
- Speech and language check: We’ll listen carefully to how your child speaks, paying attention to resonance, articulation and airflow
- Seeing how things work: If needed, we’ll use a nasal endoscopy (a small flexible camera) to watch how the palate and throat move during speech—this helps us understand what’s happening inside
- Clear next steps: Before you leave, our team will sit down with you to explain therapy options, share recommendations and discuss whether surgery could help your child
- Specialized surgical procedures. Surgery is recommended only when speech evaluation and therapy suggest structural or movement changes that are unlikely to improve without an operation. Our surgeons and speech team discuss options with families so they choose the approach that best matches the child’s anatomy and speech needs. These procedures include:
- Furlow palatoplasty: Reorients and lengthens the soft palate muscles to improve closure
- Pharyngeal flap: Creates a tissue bridge that helps close the gap between the palate and throat during speech
- Sphincter pharyngoplasty: Repositions tissue to narrow the sides of the throat and improve closure for selected children
How are patients referred to the Velopharyngeal Dysfunction Program?
Families can schedule an appointment directly—no referral from a pediatrician or therapist is required, though referrals are always welcome. During the first visit, we’ll listen to your concerns, observe speech in real time and recommend individualized next steps, whether that’s targeted speech therapy, further testing or a surgical plan.
Location
Main Hospital
- Specialty Care
- Emergency Care