What Causes Hypernasal Speech (Hypernasality)?
Hypernasal Speech, also called hypernasality, is a speech resonance condition that occurs when sound escapes through the nose during speech production. This results in the voice sounding nasally, affecting speech clarity.
What causes hypernasality in speech?
Hypernasality in speech can be caused by a physical difference as well as learned misarticulation. It is usually due to a form of velopharyngeal dysfunction. Velopharyngeal Dysfunction (VPD) occurs when there is inadequate separation of the oral and nasal cavities during swallowing and/or speech.
Several factors can contribute to VPD. Some of these factors include:
- Cleft Palate (gap in the roof of the mouth)
- Neurological conditions such as Parkinson’s disease, stroke, or cerebral palsy
- Adenoidectomy or tonsillectomy
- Cancer of the soft palate (palatal tumors)
- Hearing Impairment
How is Speech Produced?
To produce speech, several structures need to work together. The respiratory system provides the airflow required for speech, with the lungs pushing air through the trachea. As the air moves upward, the larynx (voice box) vibrates to create sound. The muscles controlling the soft palate, tongue, and lips form the sound into words.
What are the symptoms of hypernasality?
The primary symptom of hypernasality is a distinctive nasally sounding speech. While the severity differs between individuals, the most common symptoms include:
- Nasal Voice Sound - A nasally sounding voice is the most noticeable symptom. Due to the excessive resonance through the nose, the speech may sound muffled.
- Articulation Difficulties - Due to the excess air flowing through the nasal cavity, speech articulation may not be accurate. This is especially true for sounds that rely on proper oral resonance.
- Distorted Speech Sounds - Consonants, such as p, b, d, and t, which require oral resonance, may be distorted. The sound of these consonants can become unclear because of the excess air escaping through the nose.
- Mouth Breathing - People with hyper-nasal speech may primarily breathe from their mouth, particularly those with a structural difference such as a cleft palate. This can make it more difficult to breathe and speak naturally. The extra effort used to breathe can also lead to speech fatigue.
How is hypernasality diagnosed?
Hypernasality is typically diagnosed through a combination of medical and speech assessments. Evaluating the individual’s medical history for physical differences such as a cleft palate or palatal tumors, neurological conditions, as well as previous adenoid or tonsil surgery can be helpful. An otolaryngologist (ENT - Ear Nose Throat Specialist) may complete a nasal endoscopy to check the anatomy of the nose and throat during speech. A speech therapist can diagnose by listening to the individual’s speech. They will pay particular attention to the resonance - Does the speech sound nasally or stuffy? The speech therapist will also listen to the overall quality/clarity of the individual's voice as well as their articulation.
What is Speech Resonance?
When referring to speech, resonance is the voice quality that results from sound vibrations in the pharynx (throat), oral cavity (mouth), and nasal cavity (nose). Having proper resonance is essential for producing a rich and full voice.
Examples of resonance disorders include:
- Hypernasality
- Hyponasality
- Cul De Sac Resonance Disorder
- Mixed Resonance
What is the difference between hyponasal and hypernasal speech?
Both hyponasal and hypernasal speech are conditions that affect speech resonance.
Hyponasal speech occurs when there is insufficient airflow through the nasal cavity. It is typically the result of nasal congestion and results in stuffy/blocked-sounding speech.
Hypernasal speech occurs when there is too much airflow through the nasal cavity. This often occurs when the velopharyngeal mechanism fails to close properly, allowing air to escape through the nose, resulting in nasally sounding speech.
Can speech therapy fix hypernasality?
Speech therapy is beneficial for treating hypernasality. The treatment plan will be dependent on the condition causing the hypernasal speech and will be determined by the speech therapist after a thorough evaluation.
Exercises to work on breath control may be included in the treatment plan. Since hypernasality involves incorrect tongue placement, working on awareness for proper placement will be a big part of treatment. Correcting the incorrect tongue placement can fix the airflow and reduce the nasally sounding voice.
If a physical structural abnormality (such as a cleft palate) is the cause of the hypernasal speech, surgery may be needed in combination with speech therapy. This should be discussed with your doctor.
The goal of speech therapy is for the individual to gain confidence while also improving their speech clarity. At Great Speech, we pride ourselves on being experts in online speech therapy. Getting started is easy! Schedule your free introductory call today.