Resonance Speech Therapy works to mold how air and sound flow through your child’s mouth, nose and throat for easy phonation. This form of treatment addresses issues that affect how sounds are produced such as Hypernasality, Hyponasality, Cul-de-sac Resonance or Mixed Resonance – four distinct resonance disorders which could interfere with how sounds are created.
Hyponasal Resonance
Balance between sound vibrations in the pharynx (throat), oral cavity and nasal cavity during speech production is what determines its quality; when someone has a resonance disorder, that balance shifts, leading to reduced speech quality and voice quality. Hypernasality, cul-de-sac resonance and mixed resonance are common disorders; an evaluation including connected speech should help identify them accurately.
Hypernasal speech, often known as VPI (velopharyngeal incompetence), is characterized by excessive nasal emission on vowels and voiced oral consonants. This condition occurs when the soft palate doesn’t close correctly during speech allowing air leakage from the nose into the pharynx during speaking – this may be caused by physical abnormalities or learned behaviors like cleft lip/palate.
Hypernasal speech in children typically manifests itself in an inaudible voice that appears “stuffed up.” This condition is most frequently the result of nasal blockages such as deviated septum or nasal polyps, although it could also be tied to congestion or a nose cold.
To identify whether a child suffers from hypernasality, place a bendable straw into their nostril and have them repeat syllables containing pressure-sensitive oral consonants and nasal sounds such as plophrettes, fricatives and affricates. If they can hear any sound through this straw then hypernasality is present.
Contrast this with cul-de-sac speech, which is characterized by poor nasal resonance on nasal consonants and sounds like mumbling or not speaking up. This condition is most frequently due to obstruction or blockage within the nasal cavity – such as polyps, deviated septum or enlarged tonsils – leading to reduced nasal resonance on these sounds and sounds like mumbling or not speaking up.
Speech therapy cannot address cul-de-sac resonance problems without first treating their root cause, typically an ENT specialist. Medication or surgery may be needed to decrease airflow through the nasal cavity during speech; while speech therapy can improve resonance by increasing how quickly soft palate closes.
Hypernasal Resonance
Normal voices typically possess an appropriate balance of oral and nasal sound energy based on their intended speech sounds, such as vowels and vocalic consonants across languages and dialects, and depending on each person’s unique anatomy and physiology. Hypernasal resonance is an abnormal deviation from this ideal, often caused by obstruction in either throat or nasal passages (Kummer, 2020). This distortion may manifest either hypernasality where too much nasal airflow enters through mouth; or hyponasality where not enough nasal air flow through nose.
Diagnosing and rating severity of resonance disorders is challenging due to factors like fluctuating size of velopharyngeal openings during speech utterances of differing length and phonemic complexity, and uneven nasal emission from vowels or voiced oral consonants accompanied by excessive nasal emission; conversely hyponasal resonance often features reduced nasal emission on nasal consonants like m, n and ng and muffled or low intensity tones; listening closely is usually useful in determining treatment recommendations. Identifying type of nasal resonance will allow best treatment recommendations; listening can reveal treatment recommendations most effectively; listening closely is useful when listening for connected speech is heard through connected speech: Hypernasal resonance is distinguished by excessive nasal emission on vowels and voiced oral consonants which causes breathiness; conversely hyponasal resonance typically features insufficient nasal emission or vowels or voiced oral consonants which often causes breathiness while listening connected speech exposes related speech: it typically results in breathiness while hyponasal resonance is distinguished by insufficient nasal emission on consonants such as m, n and ng consonant consonants which often manifest themselves through muffled toned spoken words: hypernasal emission during vowels while voiced oral consonant voiced oral consonants which typically leads to breathiness when spoken aloud; while hyponasal resonance is typically accompanied by muffled low intensity tone as in speech (typically due to excessive emits intonairy speech while hyponasal resonance often present when spoken alaudited speech with muffled or low intensity tone, usually muffled or low tone being voiced consonants emitting emits/ng which emitting at all this yearn/ng sounding from oral consonants emitting due to insufficient emits when spoken ald ng are vocalized but still heard/ng conson pronounced normally emits innal resonance is typically muffled which tone is produced or lacks voiced for instance).
Children may experience hypernasality due to neurogenic causes such as traumatic brain injury, cerebral palsy or apraxia. Children may develop compensatory behaviors which include producing nasal sounds because it’s easier than trying to articulate more complex sounds needed for verbal communication.
Resonance speech therapy aims to correct any underlying dysfunction and restore optimal velopharyngeal function. If hypernasal resonance occurs, therapy sessions may include eliminating certain foods and beverages from diet, increasing air pressure in nasal passages or both of these. Another effective strategy includes teaching children to press their tongue against the roof of their mouth when saying target sounds for more posterior movement and producing stronger posterior resonance patterns when saying them; biofeedback may be utilized to demonstrate changes in resonance pattern of target sounds and provide feedback regarding progress made during therapy sessions.
Cul-de-sac Resonance
As the sound from vocal folds travels through different parts of the vocal tract – including the pharynx, oral cavity and nasal cavity – it can be altered and enhanced depending on their shapes, sizes and locations. But these structures can also become obstructions to sound transmission causing resonance disorders that produce altered voices with muffled or low volumes due to blockages at one or more cavities exits.
An individual with cul-de-sac resonance typically has an unusually small mouth opening that causes their speech to sound as though they’re mumbling. Another possible cause could be having large tonsils which prevent sound from passing through to oropharynx during speech. As it can be hard to differentiate this disorder from hypernasality or hyponasality, therapists must conduct an exhaustive intraoral evaluation in order to accurately diagnose their clients with this issue.
One way of recognizing resonance disorders is through an evaluation of nasometer data with perceptual assessment tools. Nasometer can help evaluate if resonance energy is released as speech sound is produced at each vertical focus of resonance; this evaluation tool can also determine if any such disorders exist.
Normal individuals demonstrate excellent coordination between velopharyngeal function and the voicing process, creating effective resonance patterns for all consonants and vowels. Nasometer data for individuals suffering from Hyperionic (HI) disorders shows inappropriate coordination that creates deviant resonance patterns in both head and throaty foci of resonance.
Normal adult phonation occurs through a series of movements to the glottal flaps, adduction and lateralization of vocal cords that results in vocal fold vibration and release of energy through the glottal cavity. When vibrated vocal folds create resonance it can then reflect off walls within the pharynx, oral cavity or nasal cavity and be released again through their resonance waves; in case of cul-de-sac resonance disorders this energy remains trapped somewhere among these three areas.
Velopharyngeal Incompetence
Resonance refers to the balance of sound vibrations within your child’s mouth, throat and nose. For most speech sounds to come through properly during phonation, your child’s soft palate (velum) must rise and touch against the back wall of their pharynx (throat). This process is known as Velopharyngeal Closure; when this process goes awry or incompletely it’s known as Resonance Disorder.
VPD may result from several sources, including craniofacial anomalies, short soft palates, irregularly shaped or enlarged adenoids, muscle weakness, velar paralysis or neurological conditions; they all can result in abnormal or incomplete velopharyngeal movement during phonation; this condition may also arise following an adenotomy or sphincter pharyngoplasty surgery to decrease snoring.
VPD treatment depends on its cause and nature of dysfunction. If mislearning is to blame, speech therapy will likely correct abnormal speech. If structural anomalies exist however, surgery will likely be required; options include tonsillectomy, Furlow Z-plasty, palatal flap surgery and posterior pharyngeal wall implant placement as possible solutions.
Whenever a child exhibits symptoms of VPD, our team recommends seeking evaluation from both an ENT (ears, nose and throat doctor) and speech-language pathologist. Speech-language pathologists possess the training and skills required to assess velopharyngeal movements as well as factors which may impede speech production such as articulation deficits or motor planning problems.
Our speech and language therapists can provide your child with strategies to enhance the articulation and quality of voice production, including exercises targeted at treating conditions like cleft palate or other conditions that inhibit sound production in an effective manner. Articulation-based therapy techniques can assist your child in producing more accurate speech sounds at an increased speed, as well as commit to therapy activities over an extended period to experience improvements. While it can be challenging, such commitment is essential for learning correct pronunciation. Our therapists will discuss individual plans with you that best suit the needs of each child receiving speech-language therapy services from us.
