Q: In your book, Successful R Therapy (pg 62), I read about how to help a client with hypernasality on R. That helped a lot. But I need help with the actual teaching part. How do I get the student to say the R without the nasal sound?

Your client first needs to discover that sound comes out his nose and mouth differentially, and he needs to control this as he makes R. Use a flexible tube about 18 inches long and 1/2-inch in diameter. Try the following:

1. Place one end of the tube at his NOSE and the other at his ear. Have him listen to himself produce “M” and “N” and “Ng.” Talk about the fact that sound can come out the nose. Help him understand that only three sounds come out the nose – “M” and “N” and “Ng.”
2. Place one end of the tube at his MOUTH and the other at his ear. Have him say a vowel, like “Ah.” Help him hear his oral sound. Discuss how all other sounds come out the mouth.
3. Tell him that he is saying his “R” sound out the nose when he should not be. I tell kids, “Your nose cannot say the sound. Your mouth must say the sound.”
4. Have him say “Ah” while listening with the tube at his NOSE. Then have him continue to prolong “Ah” and transition to “R” while the tube is still at the NOSE. He will hear that at some point in the transition, his voice stream switches from oral to nasal. As soon as he allows his voice to go through the nose when he switches to “R,” the voice will boom through the tube. Congratulate him for discovering this.
5. Continue to practice transitioning to “R” from the vowel. Tell him NOT to allow the sound to switch to his nose. Practice a variety of vowels if necessary to find one that will work.
6. If he is already getting his tongue into correct position for “R” and the problem is only on the nasality, then this technique should work for him. However, the nasality element may be only one part of the problem. Once oral, you then may have to add other techniques to actually get the tongue into position.