In this episode of the Speech and Language Kids Podcast, speech-language pathologist Carrie Clark discusses how to do speech therapy with a child who has hypernasality (or too much resonance in the nasal cavity) when they speak.


***First, determine if there is a functional cause:

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  • Your school/state may require an assessment before you begin therapy
  • Speech therapy when there is velopharyngeal insufficiency not only doesn’t work but can damage self-concept and self-worth

Techniques for therapy:

  • Stimulability probe: Try to get the child to imitate oral resonance
  • Altering Tongue Position: Try for a lower, posterior tongue placement
  • Open Mouth: Have the child speak with his mouth more open
  • Change Volume: Try different volumes to see which has less nasality
  • Change Pitch: Try different pitches to see which has less nasality
  • Auditory Feedback: Teach the child to hear the difference between nasal and oral resonance in himself and others
  • Feedback: Tell the child if productions are oral or nasal so he can learn to feel the difference
  • Focus on the Facial Mask Area: Have the child draw his focus and attention to the eyes/nose area of his face
  • Bio-feedback: Give the child immediate feedback on if air is coming out of the nose like placing a mirror right below nose or using a See Scape

****Voice therapy for resonance should not be continued for very long without success

  • Bad for motivation and self-confidence
  • Could still be a structural problem
  • May need to try again when the child is older
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The Voice and Voice Therapy, Seventh Edition: By Boone, McFarlane, and Von Berg

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