Eliminate Nasalization

Do you have students who have nasal emissions? I go through some information regarding how to eliminate nasalization in this video.

People with nasalization and nasal emissions often do not realize that their words sound muffled or incorrect. However, there are steps that can be taken to reduce the amount of air going through the nose so that clients can be more understandable.

Define Nasalization

Nasalization refers to when an oral phoneme (like “s”) is produced with some air coming out of the nose, instead of the mouth. There can be a range of emission from a small amount of air to a large amount. This depends on the client’s diagnosis. Whenever a client nasalizes an oral phoneme, it muffles the crispness of the articulation of the sound. Nasalizing can be tricky to treat because some clients have minimal awareness of the air going through their noses.

Keep in mind that to nasalize a phoneme, it means that the velum or soft palate has lowered allowing air to be released through the velopharyngeal port. This could be caused by a weak or incompetent velum. One thing I think about when this happens is a submucosal cleft. That means that there is a cleft in the bone that is not apparent during an oral motor exam because it is covered with mucosal tissue. Another issue not as frequently seen is weakness of the pharyngeal muscles. I usually am curious about swallowing deficits when this happens as well. That’s because the velum has to make a seal by closing off the nasal passages when a bolus is propelled backwards into the pharynx to be swallowed. If the velum is weak, then there could be swallowing difficulties due to the lack of pressure and possible nasal regurgitation.

Gathering a through medical history with these clients is important. Does the client have a repaired cleft? If possible, consider referring the client to an ear, nose, and throat doctor (ENT) for a thorough medical assessment for the velopharyngeal insufficiency.

Body Posture and Tongue Resting Position

I don’t discuss this in the video, but it’s not a bad idea to check and make sure your client thinks about posture. They should keep their head up. Head positioning is a good place to chart. How is their airflow? Have clients sit up straight to help breathe in deeply. Make sure clients practice good breathing techniques such as diaphragmatic breathing to ensure a deep breath every time.

Consider reminding clients of the resting position of the tongue at rest. The tongue should be up on the alveolar ridge. That means that we breathe through our noses at rest. Does your client have an open mouth at rest? If so, we need to think about if they are getting enough air when they are breathing or talking. Could their tonsils be enlarged?

Start Slow

Have clients pay attention to the speed of their speech. If they’re rushing through sentences, it’s easy to misarticulate and let some air escape through the nose. Remind clients to speak slowly and deliberately to prevent this from happening. During speech therapy focused on the elimination of nasalization, start slow.

The video talks about way more than this, but proper posture, tongue placement and speaking speed, are the building blocks before you go into therapy techniques to eliminate nasalization and nasal emission issues.