Coordination and monitoring of rehabilitative measures of dysglossia, resonance disorders and velopharyngeal insufficiency are explained by stressing the need of cooperation and presenting the challenges of the phoniatrician in the multidisciplinary team. Unusual misarticulations by a subset of children with cleft palate (CP) with or without cleft alveolus or cleft lip, or with congenital velopharyngeal dysfunction (VPD) are listed and described as errors of motor learning that occur early in the child’s phonological development. Therapeutic approaches are reviewed and discussed. After explaining the rationale of physiotherapy for velopharyngeal dysfunction, related methods are presented, and experiences in resistance therapy such as DoctorVox therapy and continuous positive airway pressure (CPAP) therapy are introduced. Preconditions for myofunctional therapy, goals and indications of orofacial myofunctional treatment are defined, and intervention programmes are presented. The effectiveness of nasopharyngoscopic biofeedback in treatment of cleft palate speech is discussed. Examples are provided for different kinds of velopharyngeal insufficiency. Intervention by augmentative and alternative communication (AAC) procedures is displayed for cases of severe communication disorder combined with dysglossia, resonance disorder or velopharyngeal insufficiency. An overview is given of oral motor devices in functional training of oral structures. The effectiveness of custom-made and prefabricated generic devices is discussed. Palatal prostheses are presented as a treatment option to achieve velopharyngeal closure and thus to prevent leakage of food and liquid into and out of the nose and to improve speech intelligibility. Options in computerised rehabilitation of inappropriate nasalisation are introduced, related to therapeutic approaches and the evaluation of therapy effects. General principles of drug treatment in case of sialorrhoea/hypersalivation are defined. After explaining the development of the neuro- and viscerocranium, principles of craniofacial surgery are introduced, classifying craniosynostoses and addressing the most typical skull deformities and their surgical correction. Principles of maxillofacial cleft surgery are introduced, covering pre-surgical orthodontics, primary surgical procedures, palatoplasty, alveolar ostoplasty, general principles of secondary corrections, lip (nose) revisions, fistula repair in the palate, correction of the cleft nose deformity, secondary rhinoplasty and orthognathic surgery. Indications, special diagnostic aspects, surgical methods and results, confounders and possible complications are presented concerning speech-improving surgery. Sequelae of lip/nose operations, palatoplasty, velopharyngoplasty and orthognathic surgery are highlighted. The prognosis of treatments for velopharyngeal insufficiency and hypernasality is elucidated by defining its application and meaning, discussing the validity of prognostic statements and considering different nosological backgrounds.