A small tongue is present and this limits movements of the soft palate causing nasal speech. Often there is a Y or an H fashioned skin dimpling over the chin.
In Case 1, deep-set eyes, epicanthus, blepharophimosis, right lid ptosis, strabismus, anti mongoloid slant, small mouth, mask-like face, high-arched palate, nasal speech,
The tongue may be small, and the limited movement of the soft palate may cause nasal speech. Often there is an H- or Y-shaped dimpling of the skin over the chin.