Phoneme-Specific Nasal Air Emissions versus Hypernasality

Question

Answer

This is a key question for SLPs to be able to distinguish between. Treatment issues are different for both of these emission disorders. Using the book Cleft Palate and Craniofacial Anomalies: The effects on speech and resonance (2001). Ann W. Kummer. Singular, San Diego, CA., I will outline a few key points.

Hypernasality occurs throughout conversational speech and on individual words the client says. This indicates an abnormal coupling of the oral and nasal cavities during speech. This results in an abnormal resonance of sound. Hypernasality is always associated with speech sounds that are phonated and does not affect voiceless consonants. Hypernasality is very evident on vowels. Hypernasality is most commonly associated with velopharyngeal dysfunction - impaired movement, coordination, and timing of the velopharyngeal valve and by articulation or because of velopharyngeal insufficiency/incompetency.

Nasal Air Emission refers to the inappropriate release of air pressure through the nasal cavity during speech. NAE only occurs of consonants, especially pressure consonants. NAE affects articulation (not resonance). NAE can occur as the result of a leak in Velopharyngeal valve during build up of intra oral pressure - velopharyngeal insufficiency or incompetence, but could also be a result of faulty learning or from a fistula.

Phoneme Specific nasal air emission is the release of air pressure that occurs on certain phonemes only and does not occur on other oral sounds. It is a result of faulty articulation due to mis-learning, rather than velopharyngeal dysfunction. It occurs most frequently on sibilant sounds. Therapy needs to change articulation placement.

Therapy will need to take into consideration whether the system is faulty and needs further repair (surgery or an appliance) or if the errors are because of articulation errors. It would be important to be in touch with a professional who is most familiar with these differences and in diagnosis of the differences. A SLP with the local cleft lip and palate clinic would be an excellent resource to ensure that the most appropriate treatment protocol is implemented.

Lesley Magnus received her Bachelor of Science in Education from Minot State University in 1985. She completed her Master of Science in Speech-Language Pathology from Minot State University in 1986. After 15 years of clinical work in Pediatric SLP, Dr. Magnus returned to Wichita State University to complete her Doctor of Philosophy in Communication Disorders and Sciences in 2000. Her doctoral dissertation focused on phonological aspects of children born with Clefting anomalies. Magnus is a certified SLP in both Canada and the USA. In addition, she is past president of the Saskatchewan Association of Speech Language Pathologists and Audiologists. Magnus' professional interests and work lie in the areas of phonology, clefting, and language disorders in children.