Abstract

Hypernasality is a disorder where excess nasal resonance is perceived during speech, often as a result of abnormal coupling between the oral and nasal tracts known as velopharyngeal insufficiency (VPI). The most common cause of VPI is a cleft palate, which affects around 1 in 1650 babies, around ⅓ of whom have persistent speech problems after surgery. Current equipment-based assessment methods are invasive and require expert knowledge, and perceptual assessment methods are limited by the availability of expert listeners and differing interpretations of assessment scales. Spectral analysis of hypernasality within the academic community has resulted in potentially useful spectral indicators, but these are highly variable, vowel specific, and not commonly used within clinical practice.Previous works by others have developed noise excitation technologies for the measurement of oral tract transfer functions using resonance measurement devices (RMD). These techniques provide an opportunity to investigate the structural system abnormalities which lead to hypernasality, without the need for invasive measurement equipment. Thus, the work presented in this study adapts these techniques for the detection of hypernasality. These adaptations include augmentation of the hardware and development of the software, so as to be suitable for transfer function measurement at the nostrils rather than the mouth (nRMD). The new method was tested with a single participant trained in hypernasal production, producing ‘normal’ and hypernasal vowels, and the recordings validated through a listening test by an expert listener and calculation of nasalance values using a nasality microphone. These validation stages indicated the reliability of the captured data, and analysis of the nRMD measurements indicated the presence of a systematic difference in the frequency range 2 to 2.5 kHz between normal and hypernasal speech. Further investigation is warranted to determine the generalisability of these findings across speakers, and to investigate the origins of differences manifesting in the transfer functions between conditions. This will provide new insights into the effects of nasal tract coupling on voice acoustics, which could in turn lead to the development of useful new tools to support clinicians in their work with hypernasality.

Highlights

  • Hypernasality is a type of speech disorder, defined as the occurrence of excess nasal resonance perceived during speech production

  • This paper describes the development of a novel method employing the resonance measurement devices (RMD) for acoustic measurement at the nose to assess hypernasality, with a case study of a single participant producing normal2 and nasalised vowels

  • The main research question within this study can be addressed: whether any features of hypernasality are indicated in the results captured by the nRMD

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Summary

Introduction

Hypernasality is a type of speech disorder, defined as the occurrence of excess nasal resonance perceived during speech production. It can result from an abnormal coupling of the oral and nasal resonating cavities, due to incomplete closure of the velopharyngeal mechanism (soft palate and pharyngeal walls) [1] known as velopharyngeal insufficiency and/or incompetency (VPI). Velopharyngeal insufficiency is indicative of a lack of tissue, while velopharyngeal incompetency typically results from a neurological disorder [4]. Depending on the type of VPI, treatment may include: surgery, in the case of an anatomical/structural defect (velopharyngeal insufficiency); or a combination of the surgery and speech therapy, especially where poor closure is due to a neurological control problem (velopharyngeal insufficiency) [3]

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