EVALUATING THE APPREHENSION REGARDING SPEECH INTERVENTIONS FOR VELOPHARYNGEAL DYSFUNCTION AMONG SPEECH AND LANGUAGE PATHOLOGISTS

Abstract

Background:
Velopharyngeal dysfunction (VPD) is a complex speech disorder that poses substantial challenges for speech-language pathologists, particularly in accurate assessment, treatment planning, and interdisciplinary coordination. Despite its reported occurrence in 10–40% of individuals following cleft palate repai, limited attention has been given to the professional confidence and apprehension of clinicians managing this condition. Understanding these factors is essential, as clinician uncertainty may influence decision-making, referral patterns, and overall quality of care for individuals with VPD.

Objective:
This study aimed to evaluate the level and specific domains of apprehension and perceived competence among speech-language pathologists regarding speech interventions for velopharyngeal dysfunction.

Methods:
A cross-sectional descriptive survey was conducted among 108 practicing speech-language pathologists working in hospitals, clinics, private practices, and rehabilitation centers in Pakistan. Data were collected using a structured, self-administered questionnaire comprising demographic variables and 17 closed-ended items assessing apprehension and competence across six domains: assessment and treatment planning, articulation therapy, voice and resonance therapy, prosthetic management, surgical collaboration, and compensatory strategies. Responses were recorded on a five-point Likert scale. Descriptive statistical analysis was performed using SPSS version 20.

Results:
The sample was predominantly female (89.8%), with most participants having 2–5 years of clinical experience (81.5%) and holding a bachelor’s degree (83.1%). Apprehension during VPD assessment was reported at least sometimes by 84.1% of participants, while 75.3% reported similar levels of concern during treatment planning. Concerns regarding intervention effectiveness were reported often or always by 74.1% of respondents, and 73.2% reported feeling overwhelmed by the complexity of VPD. In contrast, strong confidence was observed in articulation therapy, with 43.5% always targeting specific phonemes and 50.0% consistently applying correct placement techniques. Pre- and post-surgical speech assessment was performed often or always by 76.0% of participants. Prosthetic devices were frequently used by 36.1%, while only 61.2% reported consistent confidence in overall VPD intervention knowledge, despite 76.9% believing they could manage case complexity.

Conclusion:
Speech-language pathologists demonstrated solid technical competence in specific intervention domains but reported substantial uncertainty regarding comprehensive VPD management and treatment outcomes. These findings highlight the need for enhanced training, structured mentorship, and stronger interdisciplinary collaboration to improve clinical confidence and optimize care for individuals with velopharyngeal dysfunction.

Keywords:
Cleft Palate, Clinical Competence, Professional Practice, Speech Disorders, Speech-Language Pathology, Velopharyngeal Insufficiency, Velopharyngeal Dysfunction