The presentation will give an overview of historic and current approaches to a number of perennial problems in the assessment and treatment of oral-nasal balance and articulation disorders in children with cleft palate. The first part of the presentation will review techniques for the assessment of velopharyngeal dysfunction (VPD). The relationship between VPD and acoustic and auditory-perceptual measures of oral-nasal balance will be discussed with regards to effective treatment approaches. In the second part of the presentation, the complex relationship between structural differences in the vocal tract of patients with cleft palate and the resulting articulation disorders will be explored. The role of inter- and intraindividual variability in the symptoms of VPD and articulation disorders will be discussed. Speech assessments necessarily paint a static picture of a patient’s abilities. Spontaneous changes, adaptations and compensations in the patient’s speech over time are more difficult to capture. While such variability adds complexity, it may also offer new and sometimes unexpected perspectives for the effective interdisciplinary management of VPD and articulation disorders in patients with cleft palate.