Are you worried about the nasality of your child’s speech?

How do we control airflow when we talk?

Typically when we speak, air comes up from the lungs and flows into our mouth or nose when we talk to make the different speech sounds. The muscles at the back of the mouth, including the ‘dangly bit’ called the soft palate, are very important in controlling how the air flows between the mouth and nose.

Mouth sounds

Most sounds are made by air flowing through the mouth, for example, b, t, k, s, v, and ch. To do this we close the nose off from the mouth. The soft palate moves up and back to help close the nose off from the mouth. Muscles in the throat can also help to close the nose off.

This allows the air to flow through into the mouth properly for these sounds.

Nose sounds

The sounds ‘m’, ‘n’ and ‘ng’ as in the word ‘ring’ are made by air flowing through the nose. To do this, the soft palate stays down and the nose is not closed off from the mouth.

This allows the air to flow through the nose properly for these sounds.

What is hyponasality?

Hyponasality happens when a child is trying to say a nose consonant sound, ‘m’, ‘n’ and ‘ng’ in English, but the nasal airway is blocked. This means the air cannot flow into the nose. So ‘mummy’ sounds like “bubby”, or ‘nanny’ might sound like “daddy”. It can also change how vowels such as a, e, i, o, and u sound. This means the speech sounds blocked or congested, or like they have a cold when they do not.

Hyponasality can be related to the accent you have and can be normal for that accent, for example, people in Birmingham use less air in their nose when they talk so can sound bunged up to people that are not from Birmingham.

If hyponasality is not linked to the child’s accent, it is often linked to:

• allergies, like hayfever
• a cold or flu
• enlarged tonsils or adenoids
• a deviated septum or other medical issues

Speech and language therapy cannot advise on the causes of hyponasality. You should speak to the child’s GP to discuss your concerns. The GP will explore options for treatment if needed.

If there are other concerns with the child’s speech, please refer to our specialist service referral criteria.

What is hypernasality?

Hypernasality happens when a child is trying to say a mouth consonant sound, for example, b, d, g, t, k, s, v, ch, but the soft palate is not closing the nose off fully, and or at the right time. This means air escapes into the nose when the child is talking.

When the child is trying to say mouth sounds you might hear any or all of the below:

• ‘baby’ sounds like “mamy”, or ‘daddy’ sounds like “nany”
• the speech has too much of a nasal tone on vowel sounds
• there is air escaping with a hiss or rustling through the nose
• the speech sounds weak, so it is harder to understand them in a noisy place with some background noise

Hypernasality requires a referral to speech and language therapy. Please refer to our specialist service referral criteria.

What is an active nasal fricative?

Some children push air out of their nose for specific sounds, for example, this is often when the child says the following sounds ‘s’, ‘sh’ or ‘z’, however it can be on other hissy sounds. This is how they have learned the sound, we call this an active nasal fricative.

It is often linked to a short term hearing problem when they were developing these sounds. The hearing problem might not have been identified at the time, and it does not always mean they have a hearing problem now. If you are worried about their hearing, please ask for a referral via a healthcare professional.

Active nasal fricatives require a referral to speech and language therapy. Please refer to our specialist service referral criteria.