How to Diagnose Hypernasality

Unlike many speech disorders, hypernasality does not usually result from congenital factors or brain damage, but from a deficiency in the speech organs. The soft palate does not close the pharynx properly--a condition called velopharyngeal incompetence. It takes a doctor and some complex equipment to diagnose. The main treatment for the condition is surgery.

Instructions

Difficulty: Moderate

Things You’ll Need:

• Information on the symptoms and causes of hypernasality

Diagnose Hypernasality

1. Arrange surgery for a child whose hypernasality of speech is caused by cleft palate as quickly as possible. Ask your pediatrician to refer you to a specialist who does this surgery often.
2. Listen carefully to a child who has not had an expert diagnose his hypernasality. Notice which sounds are most difficult to understand, often consonants like "p," "t" and "k."
3. Observe any extraneous sounds in speech, such as air escaping through the nose, excessive glottal stops (the sound you hear when you say "Uh-oh") or snorting as a substitute for the "s" or "ch" sound.
4. Look at how the facial muscles, head, neck and jaw move. See if the muscles look weak or over-tense or if there is unusual movement or lack or movement. See if there is trouble swallowing. Hypernasality can be caused by paralysis of certain muscles.
5. Watch for signs of hearing loss: failure to respond when called by name, inability to follow oral directions, general inattentiveness and others.
6. Read up on the latest technological tools used to diagnose hypernasality including radiography, endoscopy and various computer and visualization instruments. For more information go to the symptoms and causes listed at Resonance Disorders (see Resources below).
7. Find out if anyone close to the child, such as a parent or sibling speaks with hypernasality. She may not have a physical defect, but simply be imitating what she hears.
8. Consult an expert as soon as possible. Defects in the palate and the pharynx can be hard to diagnose and may require repeated testing.

Tips & Warnings

• While cleft palate is a major cause of hypernasality, the speech impairment sometimes remains after cleft palate surgery. Another, minor surgery may be needed to close the fistulae (holes) in the palate.
• Occasionally a child will develop hypernasality after having his adenoids removed.
• If the child has been diagnosed with a speech problem, but is not responding well to therapy, she may have been misdiagnosed. Take her to an otolaryngologist (ear, nose and throat specialist) to be sure that the problem is not physiological.