The diagnosis of velopharyngeal inadequacy

At present, there are a number of instrumental devices that can be used to supplement information obtained by the experienced clinician. Although each has its proponents, there continue to be distinct disadvantages associated with all of them. From a clinician's standpoint, the most frustrating limitation is that instruments with demonstrated reliability and validity typically cannot be used comfortably with pre-school children (Table 1). This is extremely unfortunate because those teams wishing to normalize a youngster's velopharyngeal mechanism prior to school enrollment still must rely almost exclusively upon the ear of the clinician for assessment. It is hoped that future research will address this important issue.