Coming to terms with VPI: a response to Loney and Bloem.

This report agrees with Loney and Bloem (1987) that there is no consistency in the use of terminology for velopharyngeal function disorders. It extends the recommendations of those authors, however, by proposing a taxonomy for velopharyngeal disorders based on etiology. In this classification, velopharyngeal inadequacy is the genetic term used to denote any type of abnormal velopharyngeal function. Within the broad category of inadequacies, three subgroups are specified, as follows: velopharyngeal insufficiency, which includes structural etiologies; velopharyngeal incompetence, which includes neurogenic etiologies; and velopharyngeal mislearning, which includes functional etiologies. The classification uses diagnostic categories that are clinically meaningful and offer professionals an etiologically based system that can be applied in research and treatment.