ABSTRACT
Increasingly, speech scientists and surgeons have converted to using the term VPD in place of the older and more entrenched term, VPI (1,2). In common parlance, VPI generally means that there is incomplete sphincteric closure during production of oral sounds of speech. Use of the latter term, VPI, is confusing because various authors use it to connote “insufficiency,” “incompetence,” “inadequacy,” or “incorrect learning.” While such descriptors are used synonymously, they are not necessarily equivalent. In contrast, the term VPD does not assume or exclude any possible origin of speech symptoms. Anatomic, myoneural, behavioral, or combinations of disorders are all possible causes of the dysfunction. VPD occurs in approximately 20% of children who undergo palatoplasty (3). In depth evaluation of symptoms, causes, and treatment outcomes are critical aspects of managing patients with VPD.
