What is Nasal Emission?

Nasal emission is a type of speech error where air is forced through the nose while producing sounds that don’t normally require nasal air flow.  When we say words with the /m/, /n/, or “ng” sounds, air comes through our nose. If a word does not contain those sounds, air is not supposed to flow through the nose.

Nasal emission may sound like snorting or like there is a rattling sound in the nose.  You also may notice a blowing sound through the nose.  The term “hypernasality” is also used to describe too much air flow going through the nose.

What are the Types of Nasal Emission?

There are two types of nasal emission: learned and obligatory.

  • Obligatory Nasal Emission: Air flow is forced through the nose due to structural problems that make it difficult or impossible for the person to block off the nasal passages.  This may happen if someone has a cleft palate, a fistula (hole) in the palate, or their if their soft palate is too short or doesn’t work properly.
  • Learned Nasal Emission: Learned nasal emission occurs when the oral structures and functions are adequate but the person has learned to produce the sounds with incorrect air flow anyway.  This may just be a quirk of how a child learned to say a specific sound.  Or, it may be because a physical problem was present before when the child was learning to say those sounds, even though it has since been fixed.  This can be the case with repaired cleft palates.

Source: ASHA

Hypernasality/Nasal Emission Therapy Kit

Hypernasality Therapy Kit

Worksheets for Reducing Nasal Emission and Hypernasality

What is Phoneme-Specific Nasal Emission?

Phoneme-Specific Nasal Emission is when nasal emission occurs on one or more specific sounds.  This is often seen on fricatives (like /s/, /z/, /f/, /v) and affricates (“ch”, “sh”).  When no structural problems are found, this can be treated through speech therapy.

What is an Active Nasal Fricative?

Active nasal fricative is another term for nasal emission on fricative sounds.  In this type of speech error, air is forced through the nose when saying oral fricatives (like /s/, /z/, /f/, /v/), generating turbulent airflow in the nose instead of making the fricative sound in the mouth.  Active nasal fricatives can be due to a structural problem in the mouth.  Or, they can simply be the result of the child learning to say the sounds incorrectly when he/she was younger.  Speech therapy can help for children with active nasal fricatives.

Source: Kjellmer 2021

Refer to ENT

When nasal emission is found, a referral should be made to an ENT or a regional craniofacial or cleft palate team (even if there is no history of cleft) for further assessment and management.

Who is Appropriate for Speech Therapy After ENT Clearance: 

  • Phoneme-specific nasality or nasal emission due to faulty articulation
  • Children who use compensatory articulation productions due to a history of velopharyngeal dysfunction
  • After surgical management of velopharyngeal dysfunction to help the child to learn to make the best use of the new structures

Source: Kjellmer 2021

How to Do Nasal Emission Speech Therapy:

Non-Speech Oral Motor Exercises for Nasal Emission Speech Therapy:

ASHA advises against use of non-speech oral motor exercises like blowing and sucking for improving velopharyngeal function.  The parts of the brain that control blowing and sucking are not the same as those that control speech production so benefits will not carry over to speech.

Strategies for Nasal Emission Speech Therapy:

Nasal emission speech therapy
  • If there is nasal emission on sibilants only, have the child produce a /t/ sound with the teeth closed. Next, have the child prolong that sound. If the child has a normal velopharyngeal valve, this should result in a normal /s/ without nasal emission. This skill can then be transferred to the other sibilant sounds.
  • If the child co-articulates /ng/ for /l/ or /r/, or if the child has a high tongue position for vowels, it is often helpful to have the child co-articulate a yawn with the sounds. With a yawn, the back of the tongue goes down and the velum goes up.

What if it’s Not Working?

If the child continues to demonstrate hypernasality or nasal emission after a few months of treatment, that child should be referred to a specialist for further assessment and consideration of physical management.

Source: Kummer 2006

Additional Resources for Nasal Emission:

Hypernasality/Nasal Emission Therapy Kit

Hypernasality Therapy Kit

Worksheets for Reducing Nasal Emission and Hypernasality

Speech Therapy for Cleft Palate Cheat Sheet

Speech Therapy for Cleft Palate

Cheat Sheet

Carrie Clark, Speech-Language Pathologist

About the Author: Carrie Clark, MA CCC-SLP

Hi, I’m Carrie! I’m a speech-language pathologist from Columbia, Missouri, USA. I’ve worked with children and teenagers of all ages in schools, preschools, and even my own private practice. I love digging through the research on speech and language topics and breaking it down into step-by-step plans for my followers.

Fun Fact: I just asked my 9-year-old to tell me a fun fact to add to this page. He said, “you’re a really good mom!  I hope they like that fact!”.

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