NOTE: For treatment options for resonance disorders in children due to cleft lip and palate or other craniofacial abnormalities, please contact the Cleft and Craniofacial Center at Golisano Children’s Hospital.
What are resonance disorders?
Resonance refers to the way airflow for speech is shaped as it passes through the oral (mouth) and nasal (nose) cavities. During speech, the soft palate (back part of the roof of the mouth) will move to open or close the velopharyngeal valve (the opening between the mouth and the nose) to direct airflow between the mouth and the nose, according to the speech sounds we make. A resonance disorder occurs when there is an opening, inconsistent movement, or obstruction that changes the way the air flows through the system.
When a resonance disorder is the result of incomplete or inconsistent closure of the opening between the mouth and nose, it is called Velopharyngeal Dysfunction (VPD). The three main types are:
- Incompetence: the velopharyngeal valve does not close completely due to a neurological problem, such as ALS or a stroke.
- Insufficiency (VPI): the velopharyngeal valve does not close completely due to a structural defect, for example, a short palate or a part of the soft palate removed due to cancer.
- Mislearning: in some cases, the velopharyngeal valve is able to work normally, but a person may not have learned how to make these sounds accurately, for example, due to hearing loss as a child, or they learned to make sounds differently to compensate for another problem which is now corrected.
Speech-Language Pathology Evaluation & Therapy
Our Speech-Language Pathologists have specialty training in evaluation of resonance disorders, and can help determine if therapy would improve the clarity and sound quality of speech. A laryngoscopic examination with a laryngologist at the UR Voice Center is required before SLP evaluation to determine if medical or surgical interventions are required prior to therapy.
Assessment may include:
- A detailed case history of speech, voice, and swallowing issues
- Oral motor examination of the face and mouth
- Voice quality testing using acoustic and aerodynamic testing, including equipment to specifically test for resonance disorders
- Collection of speech samples which are analyzed for patterns in speech sound errors which are affecting intelligibility
- Swallow testing to screen for problems related to velopharyngeal function, and recommendations for further instrumental swallow testing if needed
Treatment is tailored to individual needs and goals, and may include:
- Exercises to improve the precision and clarity of speech sounds
- Exercises to strengthen oral and facial muscles
- Exercises to improve clarity and efficiency of vocal quality
- Strategies to compensate for permanent changes
- Education for lifestyle changes which improve the health of the voice and support healthy vocal function
National Speech-Language Hearing Association (ASHA): https://www.asha.org/practice-portal/clinical-topics/resonance-disorders/
Golisano Children’s Hospital Cleft and Craniofacial Center: https://www.urmc.rochester.edu/childrens-hospital/craniofacial.aspx