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5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 1
Rethinking Nasalance and Nasal Emission
By Martin Rothenberg, for Glottal Enterprises
For distribution at the 12th
International Congress on Cleft Lip /Palate and Related Craniofacial Anomalies, Orlando,
May 6-9, 2013.
There are two distinctly different problems in nasal speech (speech associated with Velopharyngeal
Insufficiency or VPI), namely, Nasal Emission problems in pressure consonants and Nasal Resonance
problems, or hypernasality, in vowels and vowel-like consonants. The latter is also commonly referred to as
nasalization.
Nasal Emission
Baken and Orlikoff accept the definition of Nasal Emission as the escape of air through the nasal passages when
the speaker is attempting to produce a speech sound requiring significant intraoral breath pressure, such as
plosives or fricatives. We will refer to such speech sounds as the pressure consonants. According to Baken
and Orlikoff, and we agree, “nasal emission is a fairly straightforward concept, not subject to much debate.
Nasal Emission can be readily measured and displayed by means of a Pneumotachograph at the nose.
Nasalance
Nasal Resonance or hypernasality is more difficult to measure and quantify, but is commonly believed to be
somewhat quantified by the objective measurement called Nasalance.
Nasalance is defined as a ratio of nasally emitted acoustic energy (N) in vowels to the sum of Nasal and orally
emitted energy (O), expressed as a percentage 100x (N/N+O).
In summary, Nasalance measures the effect of VPI on vowels and vowel-like consonants (such as the sonorants,
/l/ or /r/). Since nasalance is measured from acoustic energy associated with vowels, it is not relevant to
quantifying the nasal escape of air in pressure consonants. On the other hand, Nasal Emission measures the
effect of VPI on pressure consonants. It is not associated with vowels.
The Nasality Visualization System from Glottal Enterprises (and an associated product Dualview) measures
both of these aspects of nasality. Systems that measure only Nasalance, such as the Kay-Pentax version of the
Nasometer, measure only hypernasality in vowels. That system tells the user nothing about Nasal Emission.
Measurement of Average Nasalance
Testing for an average level of Nasalance is commonly performed using one or more of the following
types of test material:
1. Sentences or phrases that are rich in nasal consonants. For example the “Nasally biased” sentences
proposed by Fletcher, (see Baken and Orlikoff Table 11.2) and the sentences suggested in the user
manual for the Kay-Pentax version of the Nasometer.
2. Sentences or phrases that are rich in pressure consonants but have no nasal consonants. For example,
the Zoo Passage described by Baken and Orlikoff and elsewhere.
3. Sentences or phrases that have no nasal consonants or pressure consonants, as Hello, how are you? or
We were away. or Where are we? or Here we are. or I hear her. (Examples in this category may be
difficult to come by.)
4. Sentences or phrases that are phonetically balanced as far as frequency of occurrence in English. For
example, the well-known Rainbow Passage.
5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 2
It is suggested by many in the literature and in the manual for the Kay-Pentax version of the Nasometer that by
establishing norms in some of these categories, it is possible to identify nasality problems objectively and
separate normal from abnormal speech. Let us examine each category after first defining coarticulation.
Understanding Coarticulation
To understand the use of Nasalance in estimating VPI, one must appreciate the role of coarticulation in speech,
especially in determining nasality. The velar and pharyngeal movements that determine nasalization are not
rapid (except maybe in highly trained voice users). As a result, the state of the velum and pharynx in a
particular speech sound, whether it be a pressure consonant or nasal consonant, can strongly influence the state
of the velum and pharynx in an adjoining vowel. This is termed coarticulation.
Category 1. Sentences or phrases that are rich in nasal consonants
Nasalance in a sentences or phrase that is rich in nasal consonants is illustrated in Figure 1, obtained using a
Glottal Enterprises Separator Handle. (A similar result could be expected using a Mask Handle.) Since the
computer operating system was Windows XP, the ‘Win7 Separator’ box was not checked.
FIGURE 1. Nasalance for the phrase /ma ma na na ma ma/, illustrating the effect of nasal consonants in
computing average nasalance and the effect of excluding nasal consonants when averaging.
The nasalance display in Figure 1 illustrates the advantage in estimating the average vowel nasalance of the
feature available in the Glottal Enterprises NVS system for excluding nasal consonants when averaging.
5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 3
With the nasals excluded, the average nasalance is calculated as 36%, which pretty much agrees with nasalance
in the vowel segments (in green). If the exclusion feature is turned off, to simulate the calculation performed by
the Kay/Pentax version of the Nasometer, the average is calculated to be 63%.
Figure 2 below shows a display of Nasalance from a Nasality Visualization System as recorded using a
separator handle from a normal-speaking phonetically trained adult male subject saying /ma ma ma ma ma ma/
with the first three syllables pronounced with an attempt to produce a minimal nasalization of the vowels, while
the final three syllables were pronounced with an attempt to produce a maximum nasalization of the vowels.
The object was to see if the NVS feature of excluding the nasal consonants from the computation of average
nasalance could bring a greater separation between the nasalance values for the minimally nasalized and
maximally nasalized vowels.
FIGURE 2. Minimally nasalized and highly nasalized vowels in a nasal consonant context. Testing the effect
of excluding the nasal consonants in the averaging.
From the average nasalance values noted at the right, when including nasal consonants in the average, the ratio
of average nasalance values for the highly nasalized to minimally nasalized vowels is 60/44 = 1.36. When the
nasal consonants are omitted from the average calculation, the ratio is 30/18 = 1.67. Thus the differentiation
between the highly nasalized and minimally nasalized changed from changed from 1.36 to 1.67. The
differentiation ratio increased by 0.31 for an improvement of 0.31/1.36, or 23%.
A caveat for singers: Some singers would like to keep vowels denasalized, even in a nasal consonant
environment. With concentration and practice, such singers may be able to produce low nasalance values in a
sentence with lots of nasal consonants. Some examples from a non-singer attempting to emulate the nasalance
pattern of a singer are in Figure 3.
5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 4
FIGURE 3. Reducing coarticulation effects from nasal consonants.
In Figure 3 one can see in the vowel nasalance variations (green areas) the effort made by this speaker to close
the velum in the intervals between the nasal consonants. The nasalance values during the nasal consonants of
close to 90% indicate that the velum was lowered and the oral pathway closed during the consonants, though
maybe not completely in some instances, as the second /m/ in the top sample. This display shows how the
feedback from this display may be useful in the training of singers.
5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 5
Category 2. Sentences or phrases that are rich in pressure consonants but have no nasal
consonants.
If pressure consonants in a sentence are produced with a good velopharyngeal closure (no nasal emission),
coarticulation effects will result in a good velopharyngeal closure in the neighboring vowels and a
correspondingly low vowel nasalance. Thus sentences in Category 2 will have the lowest nasalance. This is
illustrated in Figure 4
FIGURE 4. Vowels between the pressure consonants /p/, /b/, and /s/, showing a minimum of nasalance (2%
average for the vowel /a/). The yellow bars mark intervals during which the voiced energy in the oral and nasal
channels was below a preset threshold and no nasalance measurement was possible.
Nasalance will also vary with the nature of the vowel being pronounced, as is well documented in the literature
cited by Baken and Orlikoff (Table 11-3). The vowel /a/ in English is an example of a vowel that has a lower
value of nasalance for a given degree of nasalization. The vowel /i/ (as in “peat”) has a high level of nasalance
for a given degree of nasalization, at least in its English pronunciation. Though other vowels may exhibit more
nasalance than the /a/ vowel in Figure 4, the pressure consonant environment will invariably result in the
minimum for that vowel (again see Table 11-3 in Baken and Orlikoff).
The variation of nasalance with the vowel being spoken can also result in variations between languages and
between dialects of English. For example, an English speaker from a Spanish-speaking country will tend to
speak the /i/ vowel with less oral constriction and thus produce lower values of nasalance for the same degree of
nasalization.
Important: Phrases or sentences in Category 2 can advantageously be used to test the physiological ability of a
subject to close the velum in a vowel or as the first step in training velar closure during vowels.
5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 6
Category 3. Sentences or phrases that have no nasal consonants or pressure consonants
A low nasalance in Category 2 sentences will not necessarily mean that speech without pressure consonants will
not be nasal. The ultimate test of a speaker’s ability to speak or sing without nasalization of the vowels is the
ability to produce low nasalance in sentences in which there are no nasal consonants or pressure consonants,
such as the sentences “How are you? “ or Where are we? in English (Category 3).
In Figure 5, a category 3 sentence is shown spoken with three degrees of nasalization, as produced by a
phonetically trained normal speaking male adult speaker.
FIGURE 5. The sentence How are you?, in Category 3, spoken with 3 degrees of nasalization. Sentences
spoken separately and compiled graphically.
Nasalance can be expected to correlate most highly with the perception of nasality for sentences in Category 3
and therefore they may make the best test of a speaker’s ability to control the velum without the help of pressure
consonants to aid in the closure. The criterion level of 15% is a suggestion for separating vowel segments that
do not sound nasal (colored green) from those that exhibit significant nasality (colored red). It would be
interesting and informative to test this level suggestion experimentally.
Category 4. Sentences or phrases that are phonetically balanced.
Such phrases and sentences contain segments during which the vowel nasalance is being increased by
coarticulation from nasal consonants, a factor not related to VPI, as well as segments during which coarticulation
from pressure consonants is reducing the nasalance. In addition, if the program used does not have the capacity
5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 7
to exclude nasalance values from the nasal consonants themselves, as does the Glottal Enterprises program, the
average nasalance will be further increased by this extraneous factor. These conflicting and confounding factors
may make average nasalance measurements for Category 4 sentences difficult to interpret.
Some cautions for the interpretation of measurements of nasal emission and nasalance.
1. Nasal Emission does not directly reflect the area of the velopharyngeal opening. Systems for
estimating opening area more closely also record the oral pressure and compute area from a combination of
airflow and pressure. However such systems tend to be complex and expensive. For most clinical situations,
airflow alone may suffice, since the breath pressure does not vary much at a given voice effort.
2. Nasalance does not directly reflect the subjective level of nasal resonance. There are a number of
reasons for this. One is that nasalance varies with the vowel. Nasalance also is strongly affected by nasal
consonant coarticulation, whereas nasal resonance is not. It is as if the listener’s perception expects the
increased velopharyngeal opening near a nasal consonant and ignores it when judging nasality. Nasal resonance
is also affected by the acoustics of the anterior nasal passages. Nasalance is not similarly affected. In fact,
partially blocking the nares will increase the perception of nasality and for this reason is commonly used as a test
for VPI. However, blocking the anterior nares will tend to decrease measured Nasalance, since it reduces the
passage of acoustic energy through the nose.
There are other mechanical and procedural problems that affect measured levels of nasalance that will not be
reflected in perceived nasal resonance. For example, a separation partition resting on the upper lip will register
different values of nasalance depending on the positioning and orientation of the separator plate and
microphones. This is true for all makes of Nasometer. (The mask handle separator available from Glottal
Enterprises shows much less of this effect and therefore may be preferable for research.) Also, perceived nasal
resonance depends somewhat on voice level and quality. Nasalance values in general do not vary with voice
level and quality, though the acoustic filtering of the nasal passageways could conceivably cause the spectral
qualities of the voice to interact with nasalance measurements.
Norms for Nasal Emission and Nasalance
Nasal Emission – Values for nasal emission that separate normal productions and those with VPI are easy to
determine from the literature cited by Baken and Orlikoff (Tables 11-4 and 11-5). In a normal production of a
pressure consonant, there is little or no nasal emission. Taking into account the possibility of measurement
errors, we could say that values below approximately 30 ml/s can be considered normal for adults for typical
levels of voice effort (and subglottal pressure). Peak airflows above about 150ml/s during the consonant appear
to indicate a moderate to severe impairment (Table 11-5)..
Nasalance – It is much more difficult to establish normal values for Nasalance, given the various factors that
can affect the readings, especially the coarticulatory effects described above and variations with the vowel being
spoken. Clinicians are well-advised to keep these effects in mind when treating patients, and not look for a
magic procedure that will use nasalance measurements to separate a normal voice from one with VPI. On the
other hand, Nasalance can be quite valuable clinically in measuring and displaying intrasubject variations, since
in intrasubject measurements most of the confounding variables are not present. For example, nasalance can be
used to measuring the effect of surgery or therapy. Also, nasalance displays can be useful for biofeedback for
patients learning to hear their own nasality or to reduce their nasality. When using nasalance in intrasubject
measurements, a guiding principle is that for a given linguistic context, voice level, etc. the nasalance will
invariably increase when the area of the velopharyngeal passageway increases, and vice-versa.
References
Baken, RJ and Orlikoff, RF, Clinical Measurement of Speech and Voice 2e, Singular Thompson, San Diego.
(2000)

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Rethinking nasalance and nasal emission9

  • 1. 5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 1 Rethinking Nasalance and Nasal Emission By Martin Rothenberg, for Glottal Enterprises For distribution at the 12th International Congress on Cleft Lip /Palate and Related Craniofacial Anomalies, Orlando, May 6-9, 2013. There are two distinctly different problems in nasal speech (speech associated with Velopharyngeal Insufficiency or VPI), namely, Nasal Emission problems in pressure consonants and Nasal Resonance problems, or hypernasality, in vowels and vowel-like consonants. The latter is also commonly referred to as nasalization. Nasal Emission Baken and Orlikoff accept the definition of Nasal Emission as the escape of air through the nasal passages when the speaker is attempting to produce a speech sound requiring significant intraoral breath pressure, such as plosives or fricatives. We will refer to such speech sounds as the pressure consonants. According to Baken and Orlikoff, and we agree, “nasal emission is a fairly straightforward concept, not subject to much debate. Nasal Emission can be readily measured and displayed by means of a Pneumotachograph at the nose. Nasalance Nasal Resonance or hypernasality is more difficult to measure and quantify, but is commonly believed to be somewhat quantified by the objective measurement called Nasalance. Nasalance is defined as a ratio of nasally emitted acoustic energy (N) in vowels to the sum of Nasal and orally emitted energy (O), expressed as a percentage 100x (N/N+O). In summary, Nasalance measures the effect of VPI on vowels and vowel-like consonants (such as the sonorants, /l/ or /r/). Since nasalance is measured from acoustic energy associated with vowels, it is not relevant to quantifying the nasal escape of air in pressure consonants. On the other hand, Nasal Emission measures the effect of VPI on pressure consonants. It is not associated with vowels. The Nasality Visualization System from Glottal Enterprises (and an associated product Dualview) measures both of these aspects of nasality. Systems that measure only Nasalance, such as the Kay-Pentax version of the Nasometer, measure only hypernasality in vowels. That system tells the user nothing about Nasal Emission. Measurement of Average Nasalance Testing for an average level of Nasalance is commonly performed using one or more of the following types of test material: 1. Sentences or phrases that are rich in nasal consonants. For example the “Nasally biased” sentences proposed by Fletcher, (see Baken and Orlikoff Table 11.2) and the sentences suggested in the user manual for the Kay-Pentax version of the Nasometer. 2. Sentences or phrases that are rich in pressure consonants but have no nasal consonants. For example, the Zoo Passage described by Baken and Orlikoff and elsewhere. 3. Sentences or phrases that have no nasal consonants or pressure consonants, as Hello, how are you? or We were away. or Where are we? or Here we are. or I hear her. (Examples in this category may be difficult to come by.) 4. Sentences or phrases that are phonetically balanced as far as frequency of occurrence in English. For example, the well-known Rainbow Passage.
  • 2. 5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 2 It is suggested by many in the literature and in the manual for the Kay-Pentax version of the Nasometer that by establishing norms in some of these categories, it is possible to identify nasality problems objectively and separate normal from abnormal speech. Let us examine each category after first defining coarticulation. Understanding Coarticulation To understand the use of Nasalance in estimating VPI, one must appreciate the role of coarticulation in speech, especially in determining nasality. The velar and pharyngeal movements that determine nasalization are not rapid (except maybe in highly trained voice users). As a result, the state of the velum and pharynx in a particular speech sound, whether it be a pressure consonant or nasal consonant, can strongly influence the state of the velum and pharynx in an adjoining vowel. This is termed coarticulation. Category 1. Sentences or phrases that are rich in nasal consonants Nasalance in a sentences or phrase that is rich in nasal consonants is illustrated in Figure 1, obtained using a Glottal Enterprises Separator Handle. (A similar result could be expected using a Mask Handle.) Since the computer operating system was Windows XP, the ‘Win7 Separator’ box was not checked. FIGURE 1. Nasalance for the phrase /ma ma na na ma ma/, illustrating the effect of nasal consonants in computing average nasalance and the effect of excluding nasal consonants when averaging. The nasalance display in Figure 1 illustrates the advantage in estimating the average vowel nasalance of the feature available in the Glottal Enterprises NVS system for excluding nasal consonants when averaging.
  • 3. 5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 3 With the nasals excluded, the average nasalance is calculated as 36%, which pretty much agrees with nasalance in the vowel segments (in green). If the exclusion feature is turned off, to simulate the calculation performed by the Kay/Pentax version of the Nasometer, the average is calculated to be 63%. Figure 2 below shows a display of Nasalance from a Nasality Visualization System as recorded using a separator handle from a normal-speaking phonetically trained adult male subject saying /ma ma ma ma ma ma/ with the first three syllables pronounced with an attempt to produce a minimal nasalization of the vowels, while the final three syllables were pronounced with an attempt to produce a maximum nasalization of the vowels. The object was to see if the NVS feature of excluding the nasal consonants from the computation of average nasalance could bring a greater separation between the nasalance values for the minimally nasalized and maximally nasalized vowels. FIGURE 2. Minimally nasalized and highly nasalized vowels in a nasal consonant context. Testing the effect of excluding the nasal consonants in the averaging. From the average nasalance values noted at the right, when including nasal consonants in the average, the ratio of average nasalance values for the highly nasalized to minimally nasalized vowels is 60/44 = 1.36. When the nasal consonants are omitted from the average calculation, the ratio is 30/18 = 1.67. Thus the differentiation between the highly nasalized and minimally nasalized changed from changed from 1.36 to 1.67. The differentiation ratio increased by 0.31 for an improvement of 0.31/1.36, or 23%. A caveat for singers: Some singers would like to keep vowels denasalized, even in a nasal consonant environment. With concentration and practice, such singers may be able to produce low nasalance values in a sentence with lots of nasal consonants. Some examples from a non-singer attempting to emulate the nasalance pattern of a singer are in Figure 3.
  • 4. 5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 4 FIGURE 3. Reducing coarticulation effects from nasal consonants. In Figure 3 one can see in the vowel nasalance variations (green areas) the effort made by this speaker to close the velum in the intervals between the nasal consonants. The nasalance values during the nasal consonants of close to 90% indicate that the velum was lowered and the oral pathway closed during the consonants, though maybe not completely in some instances, as the second /m/ in the top sample. This display shows how the feedback from this display may be useful in the training of singers.
  • 5. 5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 5 Category 2. Sentences or phrases that are rich in pressure consonants but have no nasal consonants. If pressure consonants in a sentence are produced with a good velopharyngeal closure (no nasal emission), coarticulation effects will result in a good velopharyngeal closure in the neighboring vowels and a correspondingly low vowel nasalance. Thus sentences in Category 2 will have the lowest nasalance. This is illustrated in Figure 4 FIGURE 4. Vowels between the pressure consonants /p/, /b/, and /s/, showing a minimum of nasalance (2% average for the vowel /a/). The yellow bars mark intervals during which the voiced energy in the oral and nasal channels was below a preset threshold and no nasalance measurement was possible. Nasalance will also vary with the nature of the vowel being pronounced, as is well documented in the literature cited by Baken and Orlikoff (Table 11-3). The vowel /a/ in English is an example of a vowel that has a lower value of nasalance for a given degree of nasalization. The vowel /i/ (as in “peat”) has a high level of nasalance for a given degree of nasalization, at least in its English pronunciation. Though other vowels may exhibit more nasalance than the /a/ vowel in Figure 4, the pressure consonant environment will invariably result in the minimum for that vowel (again see Table 11-3 in Baken and Orlikoff). The variation of nasalance with the vowel being spoken can also result in variations between languages and between dialects of English. For example, an English speaker from a Spanish-speaking country will tend to speak the /i/ vowel with less oral constriction and thus produce lower values of nasalance for the same degree of nasalization. Important: Phrases or sentences in Category 2 can advantageously be used to test the physiological ability of a subject to close the velum in a vowel or as the first step in training velar closure during vowels.
  • 6. 5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 6 Category 3. Sentences or phrases that have no nasal consonants or pressure consonants A low nasalance in Category 2 sentences will not necessarily mean that speech without pressure consonants will not be nasal. The ultimate test of a speaker’s ability to speak or sing without nasalization of the vowels is the ability to produce low nasalance in sentences in which there are no nasal consonants or pressure consonants, such as the sentences “How are you? “ or Where are we? in English (Category 3). In Figure 5, a category 3 sentence is shown spoken with three degrees of nasalization, as produced by a phonetically trained normal speaking male adult speaker. FIGURE 5. The sentence How are you?, in Category 3, spoken with 3 degrees of nasalization. Sentences spoken separately and compiled graphically. Nasalance can be expected to correlate most highly with the perception of nasality for sentences in Category 3 and therefore they may make the best test of a speaker’s ability to control the velum without the help of pressure consonants to aid in the closure. The criterion level of 15% is a suggestion for separating vowel segments that do not sound nasal (colored green) from those that exhibit significant nasality (colored red). It would be interesting and informative to test this level suggestion experimentally. Category 4. Sentences or phrases that are phonetically balanced. Such phrases and sentences contain segments during which the vowel nasalance is being increased by coarticulation from nasal consonants, a factor not related to VPI, as well as segments during which coarticulation from pressure consonants is reducing the nasalance. In addition, if the program used does not have the capacity
  • 7. 5/2/2013 Rethinking Nasalance and Nasal Emission Copyright 2013 Glottal Enterprises 7 to exclude nasalance values from the nasal consonants themselves, as does the Glottal Enterprises program, the average nasalance will be further increased by this extraneous factor. These conflicting and confounding factors may make average nasalance measurements for Category 4 sentences difficult to interpret. Some cautions for the interpretation of measurements of nasal emission and nasalance. 1. Nasal Emission does not directly reflect the area of the velopharyngeal opening. Systems for estimating opening area more closely also record the oral pressure and compute area from a combination of airflow and pressure. However such systems tend to be complex and expensive. For most clinical situations, airflow alone may suffice, since the breath pressure does not vary much at a given voice effort. 2. Nasalance does not directly reflect the subjective level of nasal resonance. There are a number of reasons for this. One is that nasalance varies with the vowel. Nasalance also is strongly affected by nasal consonant coarticulation, whereas nasal resonance is not. It is as if the listener’s perception expects the increased velopharyngeal opening near a nasal consonant and ignores it when judging nasality. Nasal resonance is also affected by the acoustics of the anterior nasal passages. Nasalance is not similarly affected. In fact, partially blocking the nares will increase the perception of nasality and for this reason is commonly used as a test for VPI. However, blocking the anterior nares will tend to decrease measured Nasalance, since it reduces the passage of acoustic energy through the nose. There are other mechanical and procedural problems that affect measured levels of nasalance that will not be reflected in perceived nasal resonance. For example, a separation partition resting on the upper lip will register different values of nasalance depending on the positioning and orientation of the separator plate and microphones. This is true for all makes of Nasometer. (The mask handle separator available from Glottal Enterprises shows much less of this effect and therefore may be preferable for research.) Also, perceived nasal resonance depends somewhat on voice level and quality. Nasalance values in general do not vary with voice level and quality, though the acoustic filtering of the nasal passageways could conceivably cause the spectral qualities of the voice to interact with nasalance measurements. Norms for Nasal Emission and Nasalance Nasal Emission – Values for nasal emission that separate normal productions and those with VPI are easy to determine from the literature cited by Baken and Orlikoff (Tables 11-4 and 11-5). In a normal production of a pressure consonant, there is little or no nasal emission. Taking into account the possibility of measurement errors, we could say that values below approximately 30 ml/s can be considered normal for adults for typical levels of voice effort (and subglottal pressure). Peak airflows above about 150ml/s during the consonant appear to indicate a moderate to severe impairment (Table 11-5).. Nasalance – It is much more difficult to establish normal values for Nasalance, given the various factors that can affect the readings, especially the coarticulatory effects described above and variations with the vowel being spoken. Clinicians are well-advised to keep these effects in mind when treating patients, and not look for a magic procedure that will use nasalance measurements to separate a normal voice from one with VPI. On the other hand, Nasalance can be quite valuable clinically in measuring and displaying intrasubject variations, since in intrasubject measurements most of the confounding variables are not present. For example, nasalance can be used to measuring the effect of surgery or therapy. Also, nasalance displays can be useful for biofeedback for patients learning to hear their own nasality or to reduce their nasality. When using nasalance in intrasubject measurements, a guiding principle is that for a given linguistic context, voice level, etc. the nasalance will invariably increase when the area of the velopharyngeal passageway increases, and vice-versa. References Baken, RJ and Orlikoff, RF, Clinical Measurement of Speech and Voice 2e, Singular Thompson, San Diego. (2000)