The 2 main speech symptoms of VPI are:
- Nasal speech (hypernasality)
- Nasal air escape
Both symptoms happen because the palate does not touch the back of the throat during speech.
In English, the sounds m, n and ng are the only sounds that should sound nasal. Nasal speech happens when other sounds resonate through the nose. This is called “hypernasality” or “hypernasal resonance.” It can be mild or severe.
You can hear nasal speech when a child is saying vowels or sounds such as w, y, l or r.
Nasal air escape
When air escapes through the nose as your child makes pressure consonants, this is called “nasal air escape” or “nasal air emission.”
In English, the pressure consonants are p, b, t, d, k, g, s, z, f, v, sh, zh, ch, dj and th.
They are called pressure consonants because pressure builds up in the mouth when the palate closes and seals off the mouth from the nose.
When a child has VPI, pressure cannot build up in the mouth. Air escaping through the nose can sound like puffs, squeaks or snorts. Your child’s speech may be very soft.
To learn more, see Early Sound Development in Children with a Cleft Palate (PDF) (Spanish).