Dr. Shirley has many years of experience in treating children with speech abnormalities. Most speech abnormalities are functional problems of enunciation that can be corrected with correct therapy with a good speech pathologist. Most enunciation errors are not due to an anatomic problem that needs correction. However, if it is determined that your child is potentially having signs of hypernasality then an evaluation by an ENT with experience in diagnosing and treating this disorder is warranted. Dr. Shirley was for many years the director of the VPI clinic at Childrens of Alabama, where he evaluated, diagnosed and performed successful surgical correction of this problem for many children. Hypernasality means that with certain sounds the child is not able to attain full closure of the nasopharynx and therefore air escapes through the nose when it should not. This is more prominent with sounds such as P, B, C, CK, and S’s. If this is happening it may be due to an underlying abnormality of the soft palate that is keeping the palate from moving correctly. Dr. Shirley has many years experience in diagnosing and treating such abnormalities. Sometimes the hypernasality is not due to an abnormality but is just an incorrect speech pattern that needs to be corrected. It is important to make this distinction and Dr. Shirley will often work closely with a speech therapist to help make this diagnosis and to begin initiation of correct speech therapy. All avenues of corrective therapy will be pursued but if surgery is indicated there are multiple options, depending on what exactly is the problem and Dr. Shirley will go over all of these in detail with the family.