A survey of speech pathologists: current trends in the diagnosis and management of velopharyngeal insufficiency.

A questionnaire designed to survey methods of diagnosis and management of velopharyngeal insufficiency associated with cleft palate was distributed to over 1,000 speech pathologists in the United States and Canada. There was a 60% response, and 65% of those responding were associated with cleft palate teams. Findings included: (1) 90% of responding cleft palate team members primarily rely on listener judgment, oral examination, and articulation testing in the diagnosis of velopharyngeal insufficiency (VPI) and for the recommendation of pharyngoplasty. (2) Only 11% indicated that their team had a radiologist. (3) More than half of those responding said that they would prefer palatal repair to be completed after the age of two. (4) 60% of those responding regarded VPI as a voice disorder, yet 84% treated the symptoms of VPI with articulation therapy rather than voice therapy.