Goal: Reduce Nasal Emission During Speech

Long Term-Ultimate Goal:

The client will independently have no nasal emissions/hypernasality during unstructured conversation in all settings 85% of the time.

If there is nasal emission on sibilants only, have the child produce a /t/ sound with the teeth closed. Next, have the child prolong that sound. If the child has a normal velopharyngeal valve, this should result in a normal /s/ without nasal emission. This skill can then be transferred to the other sibilant sounds.

If the child co-articulates /ng/ for /l/ or /r/, or if the child has a high tongue position for vowels, it is often helpful to have the child co-articulate a yawn with the sounds. With a yawn, the back of the tongue goes down and the velum goes up.

If the child continues to demonstrate hypernasality or nasal emission after a few month or treatment, that child should be referred to a specialist for further assessment and consideration of physical management (source: Resonance Disorders and Nasal Emissions – Evaluation and Treatment using “Low Tech” and “No Tech” Procedures)

Download the No-Prep Therapy Kit:

We have a start-to-finish therapy kit that will give you everything you need to practice this skill in therapy and send home homework.  Click the packet below to open it.  Then, print it out and place it in the child’s notebook or binder.

Therapy Kit Coming Soon!

Therapy Phases:

  1. Refer to ENT: All clients who come to us for voice issues should be referred to an ENT first to check the structures and functions and be cleared for therapy.
  2.  Attempt Direct Therapy to Facilitate Appropriate Oral Air Flow: The SLP will use a variety of tools to attempt to establish correct, oral air flow. 
  3. Generalize Oral Air Flow to Other Environments: Student will use correct oral airflow in a variety of situations and environments.
  4. Discontinue Therapy if Not Making Progress: If no progress is made after 6 weeks, client should be re-evaluated by ENT.

Supplemental Materials

Here are some other resources that may help you when working on this skill:

Word List for Lisps

It can be helpful to run your client through a list of /s/ and /z/ words to see if there are any contexts in which the child does not lisp.  Try these word lists (no pictures).

No-Prep Kit Worksheet

Have the child practice saying the /s/ sound in isolation (by itself, not in a word) in the following activities. Place the page in a plastic page protector and use a dry erase marker. Or, just have the child trace each item with his/her finger.

/s/ Articulation Worksheet

Additional worksheets with photos to target this sound in therapy or for homework.

Training Videos:

Need some extra help on treating this skill?  Check out these related training videos:

Webinar Recordings:

If you need some in-depth information related to this skill, check out our related webinar recording(s):

Resources, Tools, and Training for Speech-Language Professionals

*** The SLP Solution is for informational and educational purposes only and does not provide medical or psychological advice.  We provide general resources but cannot tell you exactly what should be done for a specific client.  Every client is different and your clinical judgement should be used when making decisions about specific individuals.


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