Hypernasality makes a person appear to speak through their nose, making their words hard to understand and making others uncomfortable.
Speech therapy may help improve how air moves through the mouth and nose during speech; however, surgery may be required in some instances to address structural causes of the condition.
Breathing and Relaxation
Resonance refers to how sound reverberates through your mouth or nose when spoken out loud. Resonance helps amplify and shape your voice to produce full, vibrant tones when speaking aloud, while hypernasality or hyponasality disorders, which make it hard for others to comprehend what you’re saying, may affect its quality and make communication harder than necessary. Resonance therapy can address such problems while improving communication abilities.
Resonant speech therapy uses various techniques and adaptive strategies to help improve vocal function, such as breath control and resonance placement. A speech-language pathologist may also teach warm-ups and relaxation exercises designed to alleviate tension in your throat which contribute to nasality.
Breath and relaxation are key components of resonance. A tense voice tends to sound nasal and less full due to reduced space for air in your mouth and lungs; it may even result in hard glottal attacks – an unpleasant noise produced when speaking aloud. Speech therapy exercises aim to teach you to breathe deeply with controlled diaphragmatic breaths to relieve tension in your neck, shoulders, larynx.
Speech therapy can also assist in training your soft palate to close properly. Velopharyngeal incompetence, also known as improper soft palate closure, may result in nasally sounding voices due to nasal regurgitation during eating or drinking, leading to nasally sounding voice quality and possibly regurgitated food or drink being regurgitated back into your throat. Sometimes this condition may be corrected with the aid of an in-mouth speech device; other times daily vocal exercises may be required for improvement.
Your speech therapist can also assist in training your throat to produce consonant sounds that are less nasal, such as M and Z. This technique can be especially helpful for children who have nasal resonance problems who sound similar to Fran Drescher or Steve Urkel, while it may reduce the risk of ataxia-related choking as a mistimed closure of the velum can result in mistimed swallowing of food and beverages.
Tongue Adjustment
At CHOP, our Speech and Language Pathologists specialize in treating resonance disorders to produce speech. A cleft palate can affect the size and motion of these structures during speech production, leading to different types of resonance disorders like hypernasality, hyponasality, cul-de-sac resonance and nasal emission which lead to poor sound quality and reduced intelligibility resulting in poor intelligibility of sounds produced at CHOP. Resonance disorders also impact intelligibility levels significantly.
Hypernasality occurs when your child produces oral fricative sounds such as /s/, /z/ and /f/ with air that must pass through their nose. Typically this is due to structural issues in their mouth like cleft palate or enlarged adenoids; it could also be an indicator of an underlying neurological issue such as Down syndrome.
A therapist can assist children suffering from hypernasality by employing various techniques that increase the strength of tongue movement, increase airflow through their nose, reduce or eliminate puffy cheeks and decrease/eliminate puffiness around cheeks. These may include breathing exercises, vocal warm-ups/exercises as well as positioning of the tongue within their mouths.
Resonance disorders also include nasal air emission, which occurs when your child produces oral fricative sounds by breathing through his nose instead of mouth. This condition could be the result of mislearning or due to cleft palate; therapy can assist children by using techniques for increasing or decreasing airflow into and through their nose and mouth – though correction of this disorder is more complex.
Resonance disorders among children typically have two primary treatment options: therapy and surgery. Speech therapy may help, while in cases caused by structural issues like an uncorrected cleft palate or malformed soft palate, surgery will likely be required to correct it. Otolaryngologists typically handle such procedures while CHOP SLPs offer support in improving speech.
Biofeedback
Voice disorders affect many individuals by restricting how air flows through their oral and nasal passages when speaking, often creating an “nasal” sound or “blocked” voice. Speech-language pathologists can help these individuals improve the flow of air during speech to reduce severity of voice disorder symptoms while increasing communication abilities overall.
Biofeedback therapy is one of the mainstays of nasal resonance speech therapy, serving as an operant conditioning technique that allows individuals to learn how to regulate certain physiological functions like their heart rate, blood pressure and muscle tension. Therapists will apply electrode patches on different parts of their bodies that track data on an electronic monitor that displays this data; once biofeedback signals increase significantly they’ll explain why and then guide clients through relaxation exercises to bring down those signals again.
Biofeedback treatments vary depending on the condition being addressed; electromyogram (EMG) sensors track changes in muscle tension while temperature biofeedback monitors skin surface temperature to detect sweat changes and detect changes in perspiration levels. Both approaches can help treat anxiety disorders that impact vocal quality or contribute to other communication difficulties like stuttering.
While these therapy methods can produce extremely successful outcomes, ongoing support may be required to achieve maximum effects. That is why many patients find value in working with an interprofessional healthcare team of physical therapists, neurologists, and psychiatric health nurses in order to optimize results while also encouraging open dialogue between clinicians.
An individual suffering from hypernasality will require referral to an ENT before proceeding with speech therapy for resonance, so they can inspect their mouth and nasal cavities for blockages that could be contributing to symptoms. After this step has been completed, SLPs can teach techniques for managing their symptoms effectively.
Mirror Work
Mirror work is a practice which involves gazing upon yourself in the mirror while repeating positive affirmations, with the purpose of increasing self-love and inner peace. It can also help treat emotional and mental health conditions. Sometimes coupled with other therapies like breathing exercises or biofeedback to provide comprehensive support.
Mirror work involves standing in front of a mirror and looking softly into your eyes while repeating positive affirmations to build inner confidence and love, and to support emotional well-being over time. Over time, these affirmations energise and rewire the brain for optimal emotional wellbeing.
Mirror work can do much more than enhance self-love; it can also assist with managing negative emotions such as anxiety and depression, improve self-image and foster healthy relationships with others. To maximize its effects, however, mirror work should be practiced regularly alongside working with an experienced mental health provider.
A therapist can help you identify the source of your hypernasality and create a treatment plan, whether that involves speech therapy alone or combined with nasal surgery. They’ll begin by assessing your condition and any associated symptoms; then take detailed records of how your voice travels through your nose when speaking.
They will then use the results of their assessment to create a personalized treatment plan tailored specifically to meet your needs and goals. This may involve techniques like mirror work, biofeedback and breathing exercises or cognitive behavioral therapy (CBT).
As you embark on your nasal resonance speech therapy journey, remember the importance of consistency is. Practice daily even if it means just for a few minutes each day to build muscle memory and create lasting changes to both confidence and self-perception. Writing down positive or negative self-affirmations depending on how your day unfolds can also be useful to track progress. Keeping a journal during this process can also provide a good way to record experiences and track progression – just add positive or negative affirmations whenever appropriate for you!
