Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232

(615) 936-1000

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Velopharyngeal Insufficiency (VPI)


What is velopharyngeal insufficiency

Velopharyngeal insufficiency, or VPI, is the improper closing of the soft  palate against the back or the throat during speech. This causes too much air to pass through the nose, rather than the mouth. Children with the condition often have difficulty pronouncing strong consonants including "p," "b," "d," "g," and "t." This condition makes it difficult for children to make themselves understood and can contribute to difficulties in developing age-appropriate language skills and cause social frustration.  Learn more about velopharyngeal insufficiency

Diagnosing and treating velopharyngeal insufficiency (VPI) requires a close partnership among parents, referring physicians, speech pathologists and doctors specializing in this area and. Our team coordinator serves as the single point of contact between parents and our team to ensure your child has the best plan to improve speech problems associated with VPI. Unlike many other speech problems, VPI often involves a structural problem in the palate or throat that can’t be managed with speech therapy alone. Together the team develops an individualized plan for each patient, which may include speech therapy and surgery.


A referral from a healthcare provider is required for an appointment. For appointments and information, contact Crystal McKissack at (615) 875-0134.

Your child's clinic visit

You and your child will typically meet with a doctor specializing in ear nose and throat disorders (otolaryngologist) and a speech pathologist. They will evaluate your child's speech and resonance. The team may examine the speech structures in your child's nose and throat using a child-sized endoscope, a thin, flexible tube attached to a bright light and a camera.

Related services

Last Edited: February 1, 2016
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