Speech Impairment

As a person speaks the back the palate (soft palate) moves backwards and upwards during and blocks the nasal air passage from the oral air passage when certain sounds are produced. In case repaired cleft palate sometimes the movements of palate are less and its length can also be deficient, this leads to escape of air through the nose which adds a nasal tinge to the voice. This condition is called as Velopharyngeal Incompetence or simple VPI. When a small growing child faces this problem in his efforts to speak normally which beyond his physical ability he /she develops abnormal speaking habits , These are called articulation disorders develop, this refers to problems associated with the structuring of the words.

The earliest speech impairment is diagnosed is when the child starts forming complete sentences and is old enough to co-operate with the surgeon /speech therapist. This normally will be possible by the age of three to three and half years. Treatment involves surgery and speech therapy, the order in which it is required depends on the type of speech impairment.

Evaluation, Initial evaluation is done by the speech language pathologist. Further investigations include nasometery which is a device which measures nasal escape during speech and nasopharyngeal endoscopy which allows a surgeon to see palate movements during speech and make an assessment of the type of surgery that will help the patient.

Advanced, Broadly speaking surgery for speech impairment (VPI) is of two types.

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Dr. S.C.Sood

M.B.B.S., M.S., MCh. (Plastic Surgery) Senior Consultant Aesthetic & Reconstructive Surgery. ( Omit gen surgery)

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