Nasal speech is one of those concerns adults often notice right away, but may not know how to describe. A child might sound like they are “talking through their nose,” “too nasally,” or like they have a constant stuffy nose even when they seem healthy. Sometimes it’s temporary and harmless. Other times, it can signal a structural, medical, or speech-related issue that deserves a closer look.
In schools, nasal speech can affect more than how a child sounds. It can impact how well others understand them, how confident they feel speaking in class, and how willing they are to participate socially. The good news is that nasal speech can often be evaluated clearly and supported effectively with the right team and the right plan.
What is “nasal speech,” really?
Nasal speech refers to how much sound and airflow resonate through the nose during speech. Nasal resonance is normal for certain sounds, especially:
- Nasal sounds: /m/, /n/, and “ng” (as in “sing”)
For most other speech sounds, the soft palate (also called the velum) lifts and closes off the nasal cavity so that sound resonates mainly in the mouth. When that system isn’t working as expected—or when the nose is blocked—speech can sound noticeably different.
Two common types: hypernasality vs. hyponasality
Hypernasality: “Too much” nasal sound
Hypernasality happens when there is too much resonance through the nose during sounds that should be primarily oral (like vowels and most consonants). People may describe it as:
- “Nasally” speech
- A “nasal twang”
- Speech that sounds like air is escaping through the nose
Hypernasality is often linked to difficulty achieving a tight seal between the soft palate and the throat during speech. This is commonly discussed under the umbrella of velopharyngeal dysfunction (VPD), which includes different reasons the velopharyngeal mechanism may not close as it should.
Hyponasality: “Not enough” nasal sound
Hyponasality is the opposite: there is too little nasal resonance, usually because the nasal passages are blocked. It can sound like the child is congested. Adults may say:
- “They sound stuffed up all the time.”
- “It sounds like they have a cold.”
Hyponasality can make nasal sounds like /m/ and /n/ sound “off” (for example, /m/ might sound closer to /b/).
What can cause nasal speech in children?
Nasal speech is not one single diagnosis. It’s a symptom, and the cause matters because it determines what kind of help will actually work.
Common causes of hypernasality
- Cleft palate or submucous cleft palate: Sometimes a cleft is obvious, and sometimes it’s hidden under the tissue (submucous). Either can affect closure for speech.
- History of cleft palate repair: Some children still have velopharyngeal closure difficulties after surgery and may need specialized follow-up.
- Velopharyngeal insufficiency: The soft palate may be too short or not move enough to close the space.
- Velopharyngeal incompetence: The structure may be adequate, but movement/coordination is reduced (sometimes associated with neurological differences).
- Hearing loss: Some children with reduced hearing may develop resonance differences and articulation patterns that resemble nasal speech concerns.
- Learned speech patterns (mislearning): Occasionally, a child may produce sounds in a way that creates nasal airflow even though the structure is adequate (this is important because it changes treatment).
Common causes of hyponasality
- Enlarged adenoids or tonsils: These can block airflow through the nose.
- Chronic allergies or sinus congestion: Persistent swelling can change resonance.
- Deviated septum or nasal polyps: Less common in young children, but possible.
- Temporary colds: Short-term hyponasality is very common and usually resolves.
Why “just do speech therapy” isn’t always the right first step
This is one of the most important messages for families and educators: not all nasal speech can be fixed with traditional articulation practice. If the underlying issue is structural (for example, a velopharyngeal closure problem), practicing sounds harder and harder may frustrate the child without changing the resonance.
That’s why a careful evaluation matters. A speech-language pathologist (SLP) looks at:
- Whether the child is hypernasal, hyponasal, or mixed
- Whether there is audible nasal air emission (air leaking through the nose on certain sounds)
- Whether speech errors are compensatory (the child has learned “workarounds” that affect clarity)
- Overall intelligibility (how well others can understand them)
- Patterns across sounds (for example, are pressure sounds like /p/, /t/, /k/, /s/ especially affected?)
When needed, the SLP may recommend medical follow-up with an ENT (ear, nose, and throat specialist), a craniofacial team, or other specialists. In some cases, instrumental assessment (such as nasoendoscopy or videofluoroscopy) is used to see how the velopharyngeal mechanism functions during speech.
How nasal speech can show up at school
Even when academics are strong, nasal speech can create barriers in the school environment. You may notice:
- Peers asking the child to repeat themselves
- The child speaking less in group discussions
- Teachers misunderstanding responses (especially in noisy classrooms)
- Reduced confidence during presentations or reading aloud
- Social teasing or unwanted attention
For children receiving special education services, nasal speech can also overlap with other needs (language, articulation, fluency, or social communication). A school-based approach should consider the whole child, not just the sound of their voice.
What treatment and support can look like
Support depends on the cause. A strong plan is individualized and may include collaboration between school teams and medical providers.
If the issue is hyponasality (blockage)
- Referral to medical providers when congestion is chronic or unexplained
- Monitoring speech as medical issues resolve
- Speech therapy may still be helpful if the child developed articulation habits during long-term congestion
If the issue is hypernasality due to structural or physiological factors
- Medical evaluation (often ENT or cleft/craniofacial team)
- Possible surgical or prosthetic management when indicated
- Speech therapy focused on correct placement and reducing compensatory errors (when the structure can support improved resonance)
If the issue is learned resonance patterns (mislearning)
- Direct speech therapy targeting oral airflow and accurate sound production
- Biofeedback strategies when appropriate (helping the child “feel” or “hear” the difference)
- Home practice that is short, consistent, and success-based
In all cases, the best outcomes come from early identification, clear diagnosis, and coordinated support.
How online school-based therapy can help
For many school teams, getting timely speech-language support can be challenging—especially when specialized experience is needed or staffing is tight. Online therapy can help schools provide consistent services, reduce gaps, and connect students with qualified clinicians.
At TinyEYE, online therapy is designed to fit within the school setting while supporting collaboration. That can include:
- Structured evaluations and progress monitoring
- Individualized therapy goals aligned with educational impact
- Support for carryover with educators and caregivers
- Practical strategies to improve intelligibility and classroom participation
When should you seek an evaluation?
Consider referring a child for an SLP evaluation (and possibly medical follow-up) if:
- Nasal-sounding speech lasts beyond a typical cold
- The child is hard to understand, especially on pressure sounds (/p/, /t/, /k/, /s/)
- You hear air escaping through the nose during speech
- The child has a history of cleft palate, craniofacial differences, or frequent ear infections
- Teachers report participation concerns due to speech intelligibility
Most importantly: trust patterns over one-off moments. A child who sounds nasal only when sick likely needs time. A child who sounds nasal consistently deserves a closer look.
For more information, please follow this link.
