How Does It Work?
Resonance is at the heart of voice quality. Resonance refers to vibrations shaping airflow as it passes through oral and nasal cavities during speech. If you or a loved one struggles with an overly nasal-sounding or muffled voice, speech therapy tailored toward improving resonance may provide invaluable assistance.
Resonance disorders can make your voice sound too nasal, quiet, or strained and reduce speech intelligibility and clarity. They may be due to an underlying medical condition like cleft palate or enlarged adenoids; or structural causes like deviated septum or weak soft palate/velum; whatever is at play here our experienced speech-language pathologists can provide help!
There are various kinds of resonance disorders, such as hypernasality, hyponasality, cul-de-sac resonance and mixed resonance. These conditions range from high-pitched nasally-sounding voices to muffled breathy or strain voices with symptoms including high pitch pitches or inability to produce certain sounds such as the English “t” and “d”.
Hypernasality may result from several conditions, including cleft palate or hole in the palate, enlarged tonsils, deviated septum or any physical difference that prevents normal movement of the velopharyngeal valve during speech. People who are hard of hearing may also have issues with resonance when learning how to speak without hearing themselves speak.
Speech therapy for resonance disorders focuses on teaching you or your child how to produce the appropriate sound while learning techniques to prevent nasal and mouth breathing during speech. You or your child will practice speaking in various environments and situations; speech therapy may improve symptoms without surgery but a physician may suggest surgery as part of an overall structural correction plan.
If your child is diagnosed with a resonance disorder, our speech therapists at CHOP will work in collaboration with other specialists to find the most appropriate treatments. Each plan depends on its cause and type; should a surgical correction be necessary, speech therapy services will be provided prior and post surgery so as to maximize progress for all involved parties.
How Can I Get Started?
When treating patients presenting with nasal sounding speech, you will want to assess for physical causes. This may involve conducting a comprehensive medical history and examination, as well as audiology testing that measures airflow over the soft palate and back and side walls of the throat (pharynx). When dealing with children, additional tests might include diagnosing for cleft lip or palate syndrome.
Once you understand your patient’s physical cause, the next step should be addressing their speech production problems that contribute to hypernasality or hyponasality. You must teach your patient to distinguish nasal and oral sounds by saying vowels such as “a” and “aw”, then noting how they feel or sound with each approach. You should then teach them how to use their full range of articulators when producing “a” and “aw”, which should reduce voice placement from nasal cavities into pharyngeal and oral cavities automatically.
Your child can learn to look into a mirror while they speak and observe how their uvula moves up and down during nasal and non-nasal speech, and they can practice gently touching different sides of their nose and mouth to gain feedback on how different modes feel while speaking.
If the root of their issue lies within their structures, otolaryngology specialists should be consulted for evaluation and treatment. You could also recommend behavioral resonance tips as a means of improving quality of life and comprehensibility; and our website contains several resources related to resonance disorders including assessment tools, step-by-step treatment ideas, and evidence-based handouts that may prove useful in providing assistance for resonance disorders.
