By Pam Marshalla
Q: My client produces some vowels with nasality. Do you know how to get rid of this problem? Old-fashioned articulation texts (pre-phonology) used to contain large sections, even whole chapters, on how to do this. Let me give you one method to get you started. This one is central to all the rest because it uses a simple biofeedback procedure. Getting rid of nasalization is mostly a matter of ear training. The following represents the way that therapists like Alexander…
By Pam Marshalla
Q: My client sounds hypernasal on certain phonemes. How do I work on this? This question is a regular one that comes into my office. It used to be that textbooks on articulation from Van Riper’s era dealt with this topic quite succinctly, but now with our over-focus on phonology and out downplay on all things phonetic, we seem to be forgetting these basic old-time procedures. I will have a chapter of methods on this in my next book, The Marshalla…
By Pam Marshalla
Several questions have come in recently about how to get rid of hypernasality on a specific phoneme, particularly the hypernasal R and the nasal snort on one or more of the sibilants. I’d like to address these questions together… We are talking about clients who produce nasal emission on one or more specific phonemes in the absence of more generalized hypernasality. These clients sniff, snort, or allow some nasal sound to escape during production of their error phoneme(s). Peterson-Falzone and…
By Pam Marshalla
Q: My adolescent client speaks while holding his tongue tensed against the roof of his mouth in an “ing” position all the time. He has had years of therapy due to hearing impairment but can not produce a T, D or N at all. Most all of my oral motor experience has been to increase strength/tone. Any suggestions are greatly appreciated. Ahhhhhh…. You have discovered that “oral motor” needs to be much more than simply “strengthening” the mechanism. In fact,…
By Pam Marshalla
Q: My 4th grade client substitutes a nasal snort for his sibilants. Have you written about this? The escape of nasal sound on the sibilants is fairly common and has been called by various terms in the traditional literature––nasal lisp, nasal snort, recessive s-lisp, and nasal stigmatism. Peterson-Falzone and Graham (1990) used the phrases phoneme-specific nasal emission and posterior nasal frication to describe nasalized sibilants. I have written a whole chapter about how to work with resonance problems like this…
By Pam Marshalla
Q: My client had a tonsillectomy and adenoidectomy but she still sounds stuffy and nasal. Mom says she has always sounded this way. Suggestions? Voice is a very difficult topic for those of us who do not specialize in it. Many clients do not change their voice and resonance patterns after surgery because the “old voice” is just what they are used to. It’s the way they always have sounded. It’s them. Therapy intends to change that vocal quality. Unfortunately…
By Pam Marshalla
Q: I am working with a child 2;6 who substitutes /n/ or /m/ for many other consonants. We have worked with words she says often, and she can make the correct sounds in words with a model, but talking on her own she just sounds like she is whining. Two-year-olds can be so variable, and what looks like something very severe can turn out to be nothing. She simply may be jargoning, and her jargon happens to sound like whining. …
By Pam Marshalla
Q: Your Vowel Tracks program was great and the child I am writing about now has all his vowels. His language is improving but most staff cannot understand him because his prosody is drawling, singsong-ish, and inflection is always up at the end of each statement like a question. Any thoughts about how to approach this? The interesting thing about this rising intonation pattern used on statements is that I hear many young people use this today. They say things…
By Pam Marshalla
Q: My 5-year-old client substitutes N for L. I cannot seem to help him make the sound oral and not nasal. These are the types of things I would try… Use a Vowel Have her open her mouth wide and say “Ah.” Then have her prolong “Ah” for 5 seconds or more. Then have her continue to say “Ah” while she lifts and lowers her tongue-tip up to the alveolar ridge about 5 times. Tell her, “Don’t try to say…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in mid- 2011. Download the original PDF here. *** How to Teach Proper Oral-Nasal Resonance Balance I receive weekly questions from therapists struggling with how to decrease hypernasality in clients who have adequate velo-pharyngeal structure. I am not an expert in this area, but I would like to share what I do to help clients become less nasal. These clients generally can achieve oral sound, but they…
