Nasal resonance and airflow can also be impacted by cleft lip and/or palate. The abnormal nasal resonance and airflow cause hypernasal and hyponasal speech. Hypernasal speech occurs when there is too much airflow coming through the nasal cavity making sounds more breathy. Hyponasal speech occurs when too little airflow comes through the nasal cavity making the sounds sound as if the child has a plugged nose (Nagarajan, Savitha, & Subramaniyan, 2009). Velopharyngeal dysfunction is the dysfunction of the valve located between the oral and nasal cavities. Velopharyngeal dysfunction can cause speech production difficulties in children that have cleft lip and/or palate. The velopharyngeal valve includes the soft palate, and the lateral and posterior
