Pediatric Hypernasality & Hyponasality in Children
What is pediatric hypernasality and hyponasality?
When your child speaks, you may notice that their voice sounds unusually “nasal” or “stuffy.” While many people associate this with having a cold, persistent changes in how air moves through the nose during speech may be a sign of hypernasality or hyponasality. These are resonance disorders that can affect speech clarity, communication, and confidence.
At Therapy Smarts, our pediatric speech-language pathologists (SLPs) evaluate and treat children with resonance disorders to help them communicate more clearly and effectively.
What Is Hypernasality?
Hypernasality occurs when too much air escapes through the nose during speech. This happens when the soft palate (also called the velum) does not close properly against the back of the throat during speech, allowing excessive airflow into the nasal cavity.
Hypernasality is most noticeable when speaking sounds that should be produced through the mouth, such as:
- B
- P
- D
- T
- G
- K
- S
- Z
- SH
- CH
Children with hypernasality may sound as though they are “talking through their nose.”
What Is Hyponasality?
Hyponasality is the opposite. It occurs when too little air passes through the nose during speech because the nasal passages are blocked or restricted. A child with hyponasality often sounds like they have a constant stuffy nose, even when they are not sick.
This is especially noticeable on sounds like:
- M
- N
- NG
Instead of “mom,” a child may sound more like “bob.”
Pediatric Hyponasality and Hypernasality Signs & Symptoms
Signs and Symptoms of Hyponasality
Children with hyponasality may have:
- Speech that sounds “stuffy” or “blocked”
- Difficulty producing M, N, and NG sounds
- Frequent mouth breathing
- Chronic nasal congestion
- Snoring
- Enlarged tonsils or adenoids
- Chronic allergies
- Frequent sinus infections
- Reduced speech clarity
What Causes Hypernasality?
Hypernasality can result from several conditions, including:
- Cleft palate or repaired cleft palate
- Velopharyngeal insufficiency (VPI)
- Velopharyngeal dysfunction (VPD)
- Submucous cleft palate
- Neurological disorders
- Muscular weakness
- Craniofacial differences
- Certain genetic conditions
- Trauma or surgery affecting the palate
What Causes Hyponasality?
Hyponasality is often caused by an obstruction that prevents normal airflow through the nose.
Common causes include:
- Enlarged adenoids
- Enlarged tonsils
- Seasonal allergies
- Chronic nasal congestion
- Sinus infections
- Nasal polyps
- Deviated septum
- Upper respiratory infections
How Are Resonance Disorders Diagnosed?
A pediatric speech-language pathologist performs a comprehensive evaluation that may include:
- Speech sound assessment
- Oral mechanism examination
- Resonance assessment
- Listening for nasal airflow
- Evaluating speech intelligibility
- Reviewing developmental history
- Collaboration with pediatricians and ENT specialists when appropriate
If structural differences are suspected, your child may also be referred to an ear, nose, and throat (ENT) physician or craniofacial team for additional evaluation.
How Therapy Smarts Supports Children with Facial Weakness?
At Therapy Smarts, our multidisciplinary team develops individualized treatment plans based on your child’s diagnosis, age, strengths, and goals.
Our speech-language pathologists help children improve:
- Oral motor coordination
- Lip strength and control
- Speech clarity
- Articulation
- Breath support for speech
- Oral awareness
- Safe swallowing when appropriate
- Feeding skills
Therapy focuses on functional communication while supporting facial muscle coordination needed for speech production.
Occupational therapists help children improve the daily skills impacted by facial weakness, including:
- Self-feeding
- Drinking from cups and straws
- Oral sensory awareness
- Facial muscle coordination during eating
- Adaptive strategies for everyday activities
- Fine motor skills if additional neurological concerns are present
Many children with facial weakness benefit from specialized feeding therapy to address:
- Weak lip closure
- Chewing efficiency
- Food pocketing
- Drinking skills
- Safe swallowing strategies
- Oral motor coordination during meals
If facial weakness is part of a larger neurological condition affecting balance, posture, or movement, pediatric physical therapists can help improve:
- Gross motor development
- Strength
- Balance
- Coordination
- Mobility
- Overall physical function
What Does Therapy Look Like?
Every child receives an individualized evaluation before treatment begins. Therapy may include:
- Play-based oral motor activities
- Speech sound practice
- Feeding exercises
- Facial movement activities
- Strengthening exercises (when clinically appropriate)
- Coordination activities
- Parent education
- Home exercise programs to reinforce skills between visits
Our therapists collaborate with your child’s physicians and other specialists to ensure coordinated care.
Why Early Intervention Matters
Children’s brains are highly adaptable, especially during early development. Early therapy can help improve:
- Speech intelligibility
- Feeding success
- Oral motor coordination
- Facial symmetry during movement (when possible)
- Confidence in social interactions
- Independence with daily activities
Beginning therapy early often leads to better long-term functional outcomes.
Why Families Choose Therapy Smarts
At Therapy Smarts, we understand that facial weakness affects much more than appearance—it can influence communication, nutrition, confidence, and participation in everyday life.
Our experienced pediatric team provides compassionate, evidence-based care through:
- Speech Therapy
- Occupational Therapy
- Physical Therapy
- Feeding Therapy
- Psychological Services
- Applied Behavior Analysis (ABA), when appropriate for co-occurring needs
With clinics in Durham and Chapel Hill, our therapists work together to help children build the skills they need to communicate, eat safely, participate confidently, and thrive.
Wondering About Developmental Milestones?
Have questions about your child’s development, or wondering if a certain diagnosis may be a fit? Try out our developmental screening tool— it’s a fast, free way to get a snapshot of your child’s progress on his or her developmental milestones.
Ready to Help Your Child Reach Their Full Potential?
At Therapy Smarts, we don’t believe in a “wait and see” approach. We believe in early, expert intervention that gives your child the tools they need to thrive. Whether you are looking for specialized Cerebral Palsy support or a comprehensive developmental evaluation, our award-winning team in Durham and Chapel Hill is ready to partner with your family.
Two Easy Ways to Begin:
Contact Us Directly: Ready to schedule? Call us at 919-378-1340.
Fill out our Online Inquiry Form to speak with a member of our intake team.
Don’t navigate this journey alone—let’s unlock your child’s possibilities together