INTRAORAL PRESSURE AND VELOPHARYNGEAL FUNCTION

Objective: The objective of this study was to determine the influence of velopharyngeal (VP) inadequacy on respiratory speech compensations. Design: The pressure-flow technique was used to measure pressure, air flow, and timing variables associated with VP closure during the produ ction of the initial plosive consonant /p/ in a series of the utteranc e ''papa.'' Setting: The study was conducted in the speech and breathi ng laboratory of the UNC Craniofacial Center. Participants: Eighty-two subjects with cleft lip and/or palate were assessed. The subjects wer e divided into two groups, those with adequate VP closure (VP size <.0 10 cm(2)) and those with inadequate VP closure (VP size >0.10 cm(2)). The adequate group was comprised of 62 subjects, and 20 subjects were categorized as inadequate. Results: Peak intraoral pressure decreased in the inadequate group, but the difference was not significant. Nasal airflow increased (p < .01), but duration of the pressure pulse was t he same for both groups. The area under the pressure curve decreased f or the inadequate group (p = .04). Conclusion: These data contrast wit h previously reported published data using /p/ in the utterance ''hamp er.'' This suggests that phonetic context influences the compensatory response to velopharyngeal inadequacy. Additionally, while the finding s are somewhat similar to studies that involved noncleft subjects whos e oral airway was suddenly vented during the production of /p/, there is enough difference to suggest that learning also affects the compens atory outcome.