Reduction of hypernasal speakers’ nasalance scores with voice focus adjustments: Replication and expansion of findings

Speech therapy exercises are not considered effective to reduce hypernasality in the speech of children with cleft palate. Previous research studies have shown that nasalance scores of hypernasal speakers were lower in backward and higher in forward voice focus. Conversely, some individual speakers had lower nasalance scores in forward voice focus. The present study sought to replicate and further expand these findings. The study investigated how many hypernasal speakers in a small convenience sample could lower their nasalance using voice focus. For 6 hypernasal speakers (4 F, 2 M, ages 5-18) with repaired cleft palate, nasalance scores were recorded for a non-nasal sentence, a nasal sentence, 2 phonetically varied sentences and a short song at baseline, in backward voice focus, in forward voice focus and at a final baseline. For individual speakers, reductions in nasalance of -10% from baseline were considered meaningful. Mean nasalance scores for all stimuli combined changed significantly from 58.2% nasalance (SD 11.3) at baseline to 44.2% (SD 15.3) in backward voice focus, 60.8% (SD 17.6) in forward voice focus, and 53.0% (SD 11.9) at the final baseline. Nasalance scores in the backward voice focus were significantly lower than the initial baseline and forward voice focus conditions. Inspection of individual scores showed that 4 of the 6 participants showed pronounced reductions in nasalance scores of up to -44% in backward and up to -23% in forward voice focus. Further research about the potential effectiveness of this approach for speech therapy should be undertaken.