Have you ever gotten a student who nasalized a phoneme or two? When I’ve seen it with my Spanish-speaking students, improper nasalization has normally occurred on the /s/ sound. When you have a student who nasalizing, the best practice is to refer the student to an ENT to make sure that there isn’t a concern. But most of the students I work with aren’t able to follow through with that doctor visit because it’s too costly for the family to see a specialist or they simply don’t have time.
When an ENT has ruled out velopharyngeal insufficiency or other problems, I approach therapy as a placement error. So I think of it as the student is not putting the articulators in the right place to make the sound. To treat nasalization as a placement error, here are the ways I’ve been successful:
- Teach the Correct Nasal Phonemes – In English the phonemes are /m/ /n/ and “ng” and in Spanish they have all of the above, plus an alveolar-palatal that is spelled “ñ” in Spanish. I just was reading up on it! Practice words with these sounds so the student becomes aware of what he/she is doing to produce the nasal quality.
- Demonstrate Nasal Vibration – Put your hand on your nose and have the student put his/her hand on the nose to feel the difference between a nasalized phoneme and another phoneme. I would chose a voiceless phoneme like /t/ or /f/ because the contrast is great (compared to a voiced phoneme because he/she might get confused about the vocal vibration happening).
- Plug Your Nose – By closing off the air from their nostrils and then producing a word with the erroneous nasalized phoneme in it, the student will feel the air getting forced back into the back of the mouth. It’s an uncomfortable feeling!
- The Best Cue – I’ve found that once I’ve completed steps 1 through 3 that simply telling the student, “Air through the mouth” after they nasalize a phoneme and then having the student repeat the word again, they can do it correctly. This is not always the case, but it has worked for me.
- Articulation Drill – When working with articulation, drill is the best way to work through a sound error. Make it fun and keep those productions up. If you can involve parents, either by talking to them over the phone or sending home simple homework, that’s the best way to make sure carryover occurs.
Keep in mind that involving an ENT is the best course of action, but sometimes it’s just not possible. I’ve worked with three early elementary-age students like this (in 11 years) and all three were able to learn how to correctly produce the /s/ sound without nasalizing it. It took at least a year for these students — just so you know how long to expect.
I’d love to hear how you’ve been able to have success treating nasalized phonemes! Feel free to comment below!