CEPHALGMETRIC ANAwsns or- mucua posruae
AND STRUCTURAL 905nm»
DURING ACCEPTABLE AND UNACCEPTABLE
pkooucmn or THE [s 1 SOUND

Thesis for the Dog!” of M. A.
MICHIGAN STATE UNEVERSlTY

Eleanor Harger Burgess
1961

 

LIBRARY

Michigan State
University

 

 

 

ABSTRACT

CEPHALOMETRIC ANALYSIS OF TONGUE POSTURE
AND STRUCTURAL POSITION DURING
ACCEPTABLE AND UNACCEPTABLE
PRODUCTION OF THE [s] SOUND

By Eleanor Harger Burgess

There is still much to be known about the pro-

duction of consonants. Much has been written concern-

ing the apparent physiological production of consonant
sounds, but this information generally has been deter-
mined from casual inspection rather than precise meas-
The [Ts_7'sound is one of the most frequent-

urement.
1y employed and misarticulated consonant sounds in

American English. It has been described phonetically

as a surd, lingua—alveolar continuant fricative, but
there are considerable variations in the physiologic
descriptions of acceptable Zfs_7’sound production.

Investigation of [Ts‘7'sound production as related to

tongue posture and dental occlusion has been indicated.
This study proposed to determine objectively the dif-
ferences in tongue posture and structural position
during the acceptable and the unacceptable production

of the Zfs_7'sound by means of cephalometric analysis.

Eleanor Harger Burgess

The study was conducted in the Department of

Orthodontia, Eastman Dental Dispensary, Rochester,

New York, and was supported in part by a United States

Public Health Service Grant (# D-lO7l). A group of

thirty adult and adolescent speakers having acceptable

zfs_7'sound production and normal occlusion and a group
of thirty adolescent speakers having unacceptable zfs_7'

sound production were examined. Cephalometric roent—

genograms were taken of each subject during the pro-

duction of the [3] sound.
as a radio-opaque media in order to define the ante—

Tracings of these roent-

Tantalum powder was used

rior regions of the tongue.

genograms were made by a qualified orthodontist. Meas-

urements designed to specify the exact posture of the
tongue in relation to the anterior structures were made.
A statistical test was employed with these measurements

to determine if there were significant differences be-

tween the two groups.
Statistically significant differences were found

between the anterior structural position and the antarc-
posterior tongue posture during the production of the

Zfs_7'sound by subjects who produced the sound accept-

ably and subjects who produced the sound unacceptably.

The physiologic differences were described, and implica-
tions for the correction of defective [Ts_7’sound pro—

duction were discussed.

CEPHALOMETRIC ANALYSIS OF TONGUE POSTURE
AND STRUCTURAL POSITION DURING
ACCEPTABLE AND UNACCEPTABLE
PRODUCTION OF THE [‘3] SOUND

By

Eleanor Harger Burgess

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS
Department of Speech

1961

0 J

 

4.1.5.25?

0/2 0/6.. ,

ACKNOWLEDGMENTS

The writer wishes to acknowledge the following

for their cooperation and invaluable assistance in this

study:

Dr. J. Daniel Subtelny, Head

Department of Orthodontia

Eastman Dental Dispensary 3
Rochester, New York A

Dr. Joanne D. Subtelny, Research Assoc

Department of Orthodontia
Eastman Dental Dispensary
Rochester, New York

late

The Members of the Department of Orthodontia

Eastman Dental Dispensary
Rochester, New York

Mr. Calvin Lauder, Consultant in Special Education

City School District
Rochester, New York

Mr. Ralph Boyink, Principal
Edison Technical and Industrial High School

Rochester, New York

Mr. Charles Clark, Principal

East High School
Rochester, New York

Mr. Willard Sabin, Principal
Benjamin Franklin High School

Rochester, New York

Dr. Herbert J. Oyer, Director
Speech and Hearing Clinic
Michigan State University
East Lansing, Michigan

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TABLE OF CONTENTS

ACKNOWLEDGMENTS . . . o o o 0
LIST OF TABLES. . . . o o o . . . . .
LIST OF ILLUSTRATIONS . . . . . o o . 0

Chapter
I. STATEMENT OF THE PROBLEM . . . .

Introduction
Statement of the Problem and

Purpose of the Study

Null Hypotheses
Importance of the Study

Definition of Terms
Organization of the Thesis

II. SURVEY OF THE LITERATURE . o . .

III. SUBJECTS, EQUIPMENT, AND PROCEDURES

Iv. ANALYSIS AND DISCUSSION. . . . .
V. SUMMARY AND CONCLUSIONS. . . . .

APPENDIX C O O O O O O O O O I O

BIBLIOGRAPHY . o o . o . o o

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Page

111

15
31
39
71

77
94

Table
1.

3.

5.

LIST OF TABLES
Page

The Difference in the Distance between
the Maxillary and Mandibular Incisal
Edges during the Production of the [3]
Sound by Subjects who Produce the

SE7'Sound Acceptably and the Sub—
ec s who Produce the s_7 Sound

unacceptably c o o o o o o

The Difference in the Shortest Distance
between the Maxillary Permanent First
Molar and the Mandibular Permanent First
Molar during the Production Of the [Ts
Sound by Subjects who Produce the
[£547 Sound Acceptabl and the Subjects
w 0 Produce the 175 Sound Unaccept- A
7

ably O O O O C O O O O O O O O O O O O

. “5

The Difference in the D

the Tongue and the An

Incisal Edge
y Subjects who Produce

the 5 Sound b
the 3 Sound Acceptably and the Sub-

ects who Produce the [Ts_7'Sound Un-
acceptably. o o o o o o o o o o “9

The Difference in the Distance between the
e Line and the Anterior

Lingual Referenc

Mandibular Incisal Edge during the Pro-
duction of the s_7 Sound by Subjects who
Produce the [Ts Sound Acceptably and Sub-
jects who Produce the [fs‘7'Sound Unaccept-

ably . . . . . . . . . .

The Difference in the Distance between the

Anterior, Inferior Point of the Tip of
the Tongue and the Palatal Plane during
the Production of the 5 Sound by
Subjects who Produce t e egg sound
Acce tably and Subjects w o oduce the

17s Sound Unacceptably . . . . . . .

The Difference in the Distance between the
Highest Portion of the Tongue and the
Palatal Plane during the Production of

-111-

55

 

LIST OF TABLES
Table Page

the [Ts_7'Sound by Subjects who Pro-
and

duce the [Ts_7 Sound Acceptabl
Subjects who Produce the [is Sound

unacceptably o o o o o o o o o o 57

7. The Difference in the Distance between

the Highest Portion of the Tongue and
the Pterygo-Maxillar Line during the
s_7 Sound by Sub-

Production of the
jects who Produce e 3 Sound

Acceptabl and Subjects who Produce
the [Ts_7ySOund Unacceptably. . . . . 60
8. The Difference in the Distance between
the Posterior Aspect of the Tongue and
the Pharyngeal Wall during the Pro-
ubjects

duction of the [Ts Sound by S
who Produce the 8‘7'Sound Acceptably

and Subjects who Produce the 3
Sound Unacceptably. . . . . . . . . . . 6l

9. The Difference in the Size of the Angle
Formed at Sella Turcica by the Sella-
d the Sella-Pogonian '47

Line during the Production of the [7:
Sound by Subjects who Produce the

z;s_7 Sound Acceptabl and Subjects
w 0 Produce the s_7ySound Unaccept-

ably. o o o o o o o o o

10. The Difference in the Size of the Angle
Formed at Nasion by the Sella-Nasion
Line and the Nasion~Pogonian Line
during the Production of the s
Sound by Subjects who Produce the
s_7'Sound Acceptably and by Sub-
jects who Produce the Zfs_7'Sound

Unacceptably. . . . . . . . . . . .

Nasion Line an

64

. . 66

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LIST OF ILLUSTRATIONS
Figure Page

1. Master Tracing of Acceptableil-s;7
Sound Production Showing Reference
Points and Location of Measurements. . 40

2. Master Tracing of Unacceptable [7347

Sound Production Showing Reference
Points and Location of Measurements. . 41

-v-

CHAPTER I
STATEMENT OF THE PROBLEM
I. INTRODUCTION x

There is still much to be known about the pro-
duction of consonants. Consonant sounds comprise the
majority of sounds in American English. Among all
speech problems, the misarticulations of consonant
sounds are the most prevalent. Much has been written
concerning the apparent physiological production of
consonant sounds, but this information generally has
been determined from casual inspection rather than pre-
cise measurement. Exactly what occurs in the production
of some consonants is not fully known. It is vital to the
field of Speech Therapy that finer measures be made in the
area of consonant sound production. This is indicated by
Peterson1 in his statement:

The physiOIOgical articulations of the consonants
have long been described in terms of organic position
and manner of production. In general, however, these
descriptions are at the level of casual observation
and personal opinion. The concept of speech pro-

duction as a combined mechanical and acoustical pro-
cess, in which there is a balance between articulatory

 

16. E. Peterson, ”Speech and Hearing Researché;
’

Journal of Speech and Hearing Research, I (March, 195
Do 9. ‘—-

-1-

 

-2-

(muscle) tension and driving breath pressure, needs
much further emphasis . . . . Devices are available
which can be applied to the study of many aspects of
the articulatory processes, but at present this area
of research is essentially undeveloped.

Although the [ng7 is but one sound, it is one of the most
frequently employed and misarticulated consonant sounds

in American English. The [rs_7’sound has been described

.-_.._...

phonetically as a surd, lingua-alveolar continuant frica-
tive,2 but there are considerable variations in the

descriptions of correct [Ts_7'sound production. Judson
3

and Weaver state:

The velar-pharyngeal closure is complete. The air
coming from the lungs under pressure is forced by
the tongue to pass through a relatively constricted
aperture to be released over the cutting edge of
one or more of the teeth. (Usually the air follows
a narrow groove along the mid-line of the dorsum of
the tongue and is directed against the sharp edge
of the lower incisors. However, the sound may be
made in numerous positions between the tongue and
the hard palate.) This produces a high frequency
friction sound.

Berry and Eisensonu seem to concur with this description.

They conclude their statements concerning [Ts_7'sound

production with the comment that a good [Ts_7'sound "can

vary from the stated position. Some have their tongues

 

2L. S. Judson and A. T. Weaver, Voice Science (New
York: Appleton-Century-Crofts, Inc., 1952), p. 377.

31b1d.

“M. Berry and J. Eisenson, Speech Disorders Prin-

."__ New or : pp e on-
$$2l§§.and Practices of There (
Century-CrOIEs, Inc.,—IQEES, p. 164.

-3-
close to the lower gum ridge. Others have a fairly flat
tongue . . . . , the phonetic descriptions are suggestive
and not prescriptive." Bloomer5 supports this rationale

concerning zrs_7'sound production. He adds:

The phoneme [Ts_7'is ordinarily produced with the
tongue grooved and in contact with the alveolar
ridge of the maxilla as far forward as the incisors.
It is possible to produce an acoustically acceptable

s47 in other ways. One variant form is to bring

e tongue tip in contact with the lingual surface
of the lower incisors and the grooved blade into
contact with the maxillary alveolar ridge (Kanter
and West, 1941; Froeschels, 1933) . . . . It is
quite possible, of course, that every speaker uses
each method to some extent depending on the sound
which immediately precedes or follows the [7347
sound. Individual preference may also be related
to general tongue posture and dental occlusion, but
this has not yet been determined objectively.

It should be noted that each of the forementioned de-
scriptions state that it is possible to produce an
acoustically acceptable [Tsd7'sound in a variety of ways.
Exactly which kind of variation can be made in acceptable
[Tsu7'sound production needs extensive investigation. It
also should be noted that further investigation of ZISJ?
sound production as related to gongue posture and dental
occlusion has been recommended. It is hoped that this
study will contribute toward a more objective explana-
tion of the differences between acceptable and defective

[Th_7'sound production, and that in so doing, it will aid

h

5H. H. Bloomer, "Speech Defects Associated with
Dental Abnormalities and.Malocclusions,“ Handbook of

Speech Patholo ed. L. Travis éNew York: AppIetEHL
entury-Croffs, Inc., 1957), p. 12. ,

-li...

therapists in correcting the most frequently misarticu-

lated consonant sound in American English.
II. STATEMENT OF THE PROBLEM AND PURPOSE OF THE STUDY

The purpose of this study was to compare the oral
structural positions and tongue posture of two groups of
speakers during the production of the'lfs47 sound. One
group of speakers was judged to have made the [Ts_7'
sound acceptably, whereas the other group was judged to
have made the [Ts_7'sound unacceptably. The following
question was proposed: 1. What differences are there be-
tween the two groups as regards relationship Of oral
structures of the subjects during the production of an

acceptable and an unacceptable [Th_7'sound?
III. NULL HYPOTHESES

In view of the question proposed, the following
null hypotheses were developed:

1. There is no significant difference in the distance
between the maxillary and mandibular incisal edges
during the production of the [Ts_7’sound as evi-
denced on the cephalometric roentgenograms of the
subjects who produce the Z?E_7'sound acceptably and
the subjects who produce the [Ts_7'sound unacceptably.

2. There is no significant difference in the distance
between the maxillary permanent first molar and the

mandibular permanent first molar during the pro-

3.

5.

-5...

duction of the zrs_7'sound as evidenced on the cepha-
lometric roentgenograms of the subjects who produce
the z7eg7 sound acceptably and the subjects who pro»
duce the Zfs_7’sound unacceptably.

There is no significant difference in the distance
between the anterior, inferior portion of the tip of
the tongue and the anterior mandibular incisal edge
during the production of the [Te_7 sound as evidenced
on the cephalometric roentgenograms of the subjects
who produce the [3] sound acceptably and the sub-
jects who produce the [TE_7'sound unacceptably.
There is no significant difference in the distance
between the lingual reference line and the anterior
mandibular incisal edge during the production of the
[rs_7'sound as evidenced on the cephalometric roent-
genograms of the subjects who produce the [Ts_7'
sound acceptably and the subjects who produce the
[fs_7'sound unacceptably.

There is no significant difference in the distance
between the anterior, inferior portion of the tip of
the tongue and the palatal plane during the production
of the~zrs_7'sound as evidenced on the cephalometric
roentgenograms of the subjects who produce the (ESQ?
sound acceptably and the subjects who produce the
[Ts_7'sound unacceptably.

There is no significant difference in the shortest

distance between the highest point of the tongue and

7.

9.

10.

-6-

i

palatal plane during the production of the [Ts_7'sound
as evidenced on the cephalometric roentgenograms

of the subjects who produce the Zfs_7'sound acceptably
and the subjects who produce the [Th_7'sound unac-
ceptably.

There is no significant difference in the distance
between the highest point of the tongue and the
pterygo-maxillary fissure line during the production
of the‘17s47 sound as evidenced on the cephalometric
roentgenograms of the subjects who produce the [Ts_7'
sound acceptably and the subjects who produce the
[a] sound unacceptably.

There is no significant difference in the distance
between the posterior aspect of the tongue and the
pharyngeal wall during the production of the [7347
sound as evidenced on the cephalometric roentgeno-
grams of the subjects who produce the Z?E_7'sound
acceptably and the subjects who produce the [I547
sound unacceptably.

There is no difference in the velar-pharyngeal closure
during the production of the [Th_7‘sound as evidenced
on the cephalometric roentgenograms of the subjects
who produce the (Ts_7‘sound acceptably and the sub-
jects who produce the [Ts_7’sound unacceptably.

There is no significant difference in the size of the
angle formed at sella turcica by the sella-nasion

line and the selmhpogonian line during the production

-7-

of the [TE_7'sound as evidenced on the cephalometric
roentgenOgrams of the subjects who produce the [TE_7'
sound acceptably and the subjects who produce the
[rs_7'sound unacceptably.

11. There is no significant difference in the size of the
angle formed at nasion by the sella-nasion line and
the nasiaepogonian line during the production of the
[rh_7'sound as evidenced on the cephalometric roent-
genograms of the subjects who produce the Z?E_7'sound
acceptably and the subjects who produce the [fs_7’sound

unacceptably.
IV. IMPORTANCE OF THE STUDY

The zrs_7'sound is one of the most frequently em-
ployed and misarticulated consonant sounds in the English
language. Fairbanks6 states that the [Ts_7'sound ranks
sixth in frequency of use among the consonants Of English.
Travis7 found the [TE_7'sound fourth in frequency of
occurrence in the conversational speech of children.

West, Kennedy,_and Carr8 suggest, ”Since the sound Occurs

frequently in our speech (comprising about seven per cent

 

6G. Fairbanks, Voice and Articulation Drillbook

(New York: Harper and BroEEers, PublIShers, 1§HO), p. 85.

7L. E. Travis S each Patholo (New York: D.
Appleton-Century and Company, 1931), p. 223.

R. West, L. Kennedy, and A. Carr, The Rehabi-
litation8 of S eech (New York: Harper and Brthers,
s era, , p. 209.

-8-

of our spoken sounds) its importance is further apparent."
In eight years of experience as a public high school ' ‘
speech therapist, the investigator found that approxi-
mately two-thirds of the speech cases had difficulty in
articulating the [rs_7'sound. Many investigators in the
field of Speech Therapy have noted that the [Ts_7'sound
ranks high in frequency of error. Powers,9 in a discussion
of functional articulatory disorders, states, ”The [Te_7'
and [Th_7'sounds are among the most frequently misarticu-
lated of all speech sounds." She supports this statement
by citing a number of studies directed toward this prob-
lem. Roe and Milisen10 studied the articulation of
children in grades one through six in 1941. They found
the [a] and the [a] sounds most frequently in error.

Sayler11

studied the articulation of children in grades
seven through twelve in 1949. In this study the [it 7 and
the‘17s47 sounds were also the most frequently mispro-

l2
nounced. Van Riper observed that the most frequently

 

ti 9M. H. Powers, "Functional Disorders of Articula~
on-Symptomatology and.Etiology Handbook 92 Speech
Patholo , ed. L. Travis (New York: AppIeEon-Cen ury-
Crofts, Inc., 1957), p. 718.

10V. Roe and R. Milisen, "The Effect of Maturation
upon Defective Articulation in Elementary Grades,” Journal
2£_Speech Disorders, VII (1942), pp. 37-50. .

11H. K. Sayler, ”The Effect of Maturation upon De-
fective Articulation in Grades Seven through Twelve,”
Journal 2; Speech and Hearing Disorders, CIV (1949),.pp.

120. Van Riper, 8 each Correction Princi lea and
Methods, (New York: PrenEIce-HEJI, Inc., I937), p. 15?.

 

-9-
mispronounced sounds were the [a], [a], ['0], [at],
[r], and [I] in a study in 1947. In a study of school
children and college freshmen made by Hall13 in 1938, she
found that the Zfs_7'and [fe47 sounds were the most fre-
quently misarticulated. Fairbanks and Spriestersbach14
made the same observation in their study of college stu-
dents in 1950. Esirhanks15 further states that 90% of all
clinical articulatory cases have difficulty with ZEB_7L He
says that it is much more frequently misarticulated by
both children and adults than any other sound. West,

16

Kennedy, and Carr agree that the 17347 sound is the
most frequently misarticulated consonant sound by stating
that, "From one-third to one-half of the cases in a school
speech clinic lisp." Since the [Ts47 sound seems to be
the consonant sound most frequently misarticulated, there
appears to be adequate justification in exploring its

normal production as well as its production when it is

judged to be defective. It is hoped that the information

 

13M. E. Hall, ”Auditory Factors in Functional
Articulatory Speech Defects," Journal p§_Exceptional
Education, VII, (1938), pp. 115-138.

1&6. Fairbanks and D. Spriestersbach, ”A Study of
Minor Organic Deviation in 'Functional' Disorders of Arti-
culation: 1. Rate of Movement of Oral Structures " Journal

of S each and Hearin Disorders, XV (January 1950) .
66. S. E a .9 DD

15Fairbanks, loc. cit.

16West, Kennedy, and Carr, loc. it.

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derived from this investigation will be more specific and
more objective due to the employment of cephalometric

roentgenography.
V. DEFINITION OF TERMS

l. Unacceptable A?E_7'sound production: in the context
of this study, [TE_7'sound production which is not
acoustically acceptable as judged by three trained
listeners.

2. Oral structures: lips, teeth, tongue, maxilla, man-
dible, hard palate, soft palate, and pharyngeal wall.

3. Tongue position: the posture of the tongue.

4. Occlusion: the natural and normal fitting together
of the teeth.

5. Normal occlusion: the dental arches are arranged in
concentric, parabolic curves in which the outline of the
maxillary arch is slightly larger than the mandibular
arch. The mesio-buccal cusp of the maxillary perma-
nent first molar occludes in the buccal groove of the
mandibular permanent first molar. The teeth of the maxil-
lary arch overhang the teeth in the mandibular arch
labially and buccally. The incisal ridges of the maxil-
lary incisors extend below the incisal ridges of the
mandibular incisors by one-third of the mandibular in-
cisal crowns.1

5. Malocclusion: failure of the teeth to assume a normal

M

17Bloomer, 22, cit., pp. 626-627.

-11-
antero-posterior relationship.

7. Angle Classification: class of malocclusion of molars
as defined by Edward H. Angle.18 The following is a
description of the classes.

(1) Class I (Neutrocclusion)--normal anterO-pos-
terior relationship of the molars, but anterior
malocclusions of various types are present.

(2) Class II (Distocclusion)--the mesio-buccal cusp
of the maxillary permanent first molar articu-
lates anterior to the buccal groove of the
mandibular permanent first molar.

(a) Division I--distocclusion accompanied by
extreme protrusion of the maxillary in-
cisors.

(b) Division II--distocclusion accompanied by
retrusion of the maxillary central in-
cisors and tipping of the maxillary
lateral incisors labially and mesially.

(c) Subdivisions--distocclusion occurs on
only one side Of the dental arch.

(3) Class III (Mesiocclusion)--the mesio-buccal
cusp of the maxillary permanent first molar
articulates posterior to the buccal groove of

the mandibular permanent first molar, the lower

lBEdward H. Angle, Malocclusion at; the Teeth (7th
ed.; Philadel hia: S. S. WHIEe DenEaI ManufacturIng

Conlpany. 1907 .

-12-
incisors protruding.
8. Overjet: the overhanging of the maxillary teeth over
the mandibular teeth labially and buccally.
9. Linguaversion: toward the tongue.
10. Labially: toward the lips.
11. Buccally: toward the cheek.
12. Distally: posterior to the normal position.
13. Mesially: anterior to the normal position.
1A. Lingual reference line: a line drawn from the ante-
rior, inferior point of the tip of the tongue through the
pharyngeal wall that is parallel to the palatal plane and
perpendicular to the pterygo-maxillary fissure line.
15. Palatal plane: a line drawn from the anterior nasal
spine through the posterior nasal spine which bisects both.
16. Pterygo-maxillary fissure line: a line drawn per-
pendicular to the palatal plane which bisects the pterygo-
maxillary fissure.
17. Posterior aspect of the tongue: point on the lingual
reference line where the lingual reference line crosses
the posterior portion of the tongue.
18. Velar-pharyngeal closure: the closing of the velum

against the pharyngeal wall.

19. Sella-nasion line: a line drawn from the center of

sella turcica to the juncture of the nasal bone and the

frontal bone.
a line drawn from the center

kelatal

20. Sella-pogonian line:

or sella turcica to the anterior most point on the a

chin.

-13-

21. Nasion-paganian line: a line drawn from the juncture
of the nasal bone and the frontal bone to the anterior
most point on the skeletal chin.

22. Cephalometric roentgenogram: x-ray photograph of
the head from which exact measurements of the structures
of the head can be made.

23. Sweep check: an audiometric method of screening out
possible hearing-loss cases by testing for auditory
response°to the following frequencies presented at a con-
stant intensity level of fifteen decibels of sound: 500
cps, 1000 cps, 2000 cps, 3000 cps, 4000 cps, 6000 cps,

and 8000 cps.19

VI. ORGANIZATION OF THESIS

Chapter I has contained a discussion of the prob-
lem under study, the purpose of the study, the null hypo-
theses that will be tested, the importance of the study,
the definition of terms, and the organization of the
thesis.

Chapter II will contain a survey of the litera-
ture on the use of roentgenography in the study of conso-
nant sound production and defective zrs_7'sound production
and occlusion.

Chapter III will describe the subjects, equipment,

and testing procedures used in this study.

 

19K. S. Wood, "Terminology and Nomenclature,”
Handbook of S each Patholo , ed. L. Travis (New York:
DD 9 on-CEn um roffs, Inc., 1957), p. 54.

-14-
Chapter IV will discuss the analysis and results

of the study.
Chapter V will contain the summary of the study

and the conclusions.

CHAPTER II
SURVEY OF THE LITERATURE

Speech scientists have been concerned for many
years with the production of speech sounds. In 1922,
Barclay and Nelson1 made an x-ray analysis of the sounds
of speech. This was a radiographic study of two dif-
ferent speakers saying eighteen different sounds. For
a clearer picture of tongue position, a paste of bismuth
carbonate and vaseline was applied to the mid-line of
the tongue and frenum. The two sets of radiOgraphs were
compared for each sound, and there was practically no
difference in the positions of the oral structures. The
study gave a description of how an [I547 sound was prO~
duced. No information was given concerning the occlu-
sion of the subjects. The study was limited in the
number of subjects photographed, and specific measure-
ments were taken from the x-rays. In 1934, Russellz
examined the production of speech sounds with an x-ray

study of selected consonant sounds. He determined that

1A. Barclay and W. Nelson, "x-Ray Analyses of the
Sounds of Speech," Journal p£_§pggpggpppy, III (July, 1922),
pp. 277-280. .

20. Russell, ”First Preliminary X-Ray Consonant
Study,” Journal 2; the Acoustical Society 2; America, V
(April. Wm. 57-31-
-15-

-15-

the position of the tongue for the Z?E_7'sound changed
depending upon the changing of the sounds on either side
of it. A significant finding was that the diameter of
the aperture between the tongue and the alveolar ridge
remained fairly constant. However, no specific measure-
ments of the diameter or of the oral structures were
‘made. This study was done with x~ray motion pictures, but
there was no information concerning the selection of sub-
jects, the speech of the subjects, or the occlusion of

the subjects. X-ray was employed by Holbrook3 in a study
of speech articulations in the early 1930's. Unfortunately,
he died before a thorough analysis of the study was made.
Carmody completed the analyses. This study investigated
the differences in the articulatiOns of vowels and some
consonants of English, French, Spanish, and Russian.
Holbrook primarily studied the movement of the hyoid bone,
the length of the vocal cords, and the pharynx, but meas~
urements in millimeters were taken of the distance be-
tween the jaws, the lips, the projection of the lower

lip, the diameter of the pharynx (top, mid., base), the
distance from the molars to the cords, and the distance
from the vertebra to the base of the pharynx. These
measurements were taken for each sound studied.l The study

was made with ten speakers and did not include defective

*—

3R. Holbrook and F. Carmody, 'X—Ray Studies of
Speech Articulations,“ Modern Philology, XX.(December,
1937): pp. 187‘2380 .

-17-

production. No mention was made of the occlusion of the
subjects, and no definite conclusions were drawn con—
cerning the [3] sound.

During the 1930's, speech scientists and dentists
became interested in the relationship of dentition and
speech. Several studies were published on this problem.
From the Spring of 1935 to June of 1937, Frowine and
Maseru studied seven cases with severe malocclusions to
determine the influence of dentition on speech. They
studied the following areas: (1) dental case his-
tories, (2) dental casts, (3) intra-oral photographs,
(4) facial photographs, (5) speech case histories,

(6) phonographic recordings of speech, (7) speech
analyses. Of the cases studied, there was only one who
had unsatisfactory speech. The other cases had excellent
or satisfactory speech. Each tended to compensate for
his dentofacial anomaly. No specific conclusions were
drawn. A definite outcome of the study was that the
psychological factor was prominent in each case. The
investigators recommended that a separate study be made
of the psychological factor.‘

Fymbo5 made a contribution to the knowledge of

MV. Frowine and H. Moser, "Relationship of Denti-
tion and Speech," Journal of the American Dental Associa-

ELOIL XXXI (July. IDEA), PDT 1581:1090.

5L. H. Fymbo, "The Relation of Malocclusion of the
Teeth to Defects of Speech," Archives g£_§22222; 1 (June,

1936). Pp. eon-216.
. ,. [I -. / ‘ 5‘? {:31

-18-

the relationship of malocclusion to defects Of speech in
his study of 410 male and female university students in
1936. Evaluations of the subjects' speech were made by
the members of the Department of Speech, State University
of Iowa. Each subject's speech was classified as supe-
rior, average, or defective. The following results were
determined by Fymbo: (1) 70% of the cases with normal
occlusion had satisfactory speech. Going from defective
to superior speakers, there was a decrease of dental
anomalies and facial deformities. Of the defective
speakers, 87.3% had malocclusions, 62% of the average
speakers had malocclusions, and 35% of the superior
speakers had malocclusions, (2) females were more able
to produce good speech in the face of handicaps than
were males, '(3) intelligence became higher going from de-

fective speakers to superior speakers, (4) malocclusion

cases had more difficulty with [s], [z], [a], [‘3],
[I]: [5], [ff J, [(15 :7, (5) with normal vertical

relationships, 58% had satisfactory speech, with closed-
bite only 29% had satisfactory speech, and with open-
bite 21% had satisfactory speech,' (6) of the total num-
ber of anterior teeth missing from the subjects' mouths,
52% were missing from defective speakers, 38% were miss-
ing from average speakers, and 10% were missing from supe-
rior speakers. The absence of posterior is not as impor-
tant as absence of any of the upper eight anterior teeth,

(7) defective speakers had more spaces between their

-19-

teeth, (8) unusually high or low palates operated to
produce faulty sounds, particularly the zrs_7’and [TE_7,
(9) there was a progressive increase in the size of the
palate in the cuspid region going from defective to
superior male and female speakers.

Fymbo concluded that there was a definite rela-
tionship between malocclusion and speech defects. In the

6 reported a high percentage of lisp-

same year, Van Thal
ers among orthodontic patients of the Royal Dental Hos-
pital in London; although she modified this with the
statement that many of them exhibited faulty tongue con-
trol. Wolf7 tended to support this statement in his
study of malocclusion and its relation to sigmatism. He
stated that there were two forms of sigmatism: (1) posi-
tion of the tongue normal, and (2) position of the tongue
faulty. When the position of the tongue was normal, the
sigmatism was due to mechanical defects of the organs

of speech such as missing teeth, open-bite or cleft palate.
When the tongue position was faulty, the sigmatism was due
to motor ineptness, congenital word deafness, impaired

hearing, mental retardation, or some defect of the organs

of speech. Although he gave no means of selection of the

 

6J. Van Thal, "The Relationship between Faults of
Dentition and Defects Of Speech, " Proceedings of the Second
International Congress of Phonetic Sciences, London,
pp. EBE-ESSO

1
71. J. Wolf, ”Relation of Malocclusion to Sigmatism, "

American Journal of Diseases of Children, LIV (September
a pp. 526‘ 528— ’

(If. «43"

-20-

subjects, no methods of execution of the study, no norms

established for comparison, and no specific measurements,

he did state that 74% of the lispers had malocclusions.

Of the 74%, only 28% had a definite relationship between

the [Ts_7'sound and the malocclusion. He concluded:
Although it is reasonable to assume that malocclusion
may interfere with the normal action of the tongue
so that sigmatism results, such correlation is often
difficult to establish. In this group, therefore,
that relationship between malocclusion and sigmatism
is obscure and controversial.

Green8 was more positive in the conclusions Of a
study he did in 1937 on speech defects and oral anomalies.
Although he observed that compensatory movements can be
made for the production of most sounds, he concluded:

. . . when teeth are out of alinement, they general-
ly impede the motion and formations of the tongue,

especially when there is a high palate. The sounds
of the second and third articulation sphere are more

or less strongly impeded, the Zfs_7'sound more so
than the other sounds.
The influence of the palate on lisping was the
object of a statistical investigation done by Herman9 in
1943. Palatopography was employed in this study. The

study resulted in the following conclusion:

 

8J. S. Green, "Speech Defects and Related Oral
Anomalies," Journal of.the American Dental Association

E22.£E£.2£2£sl.§2EEE§3 XXIV (DecemBGr. 1937). p. 1972.

9G. Herman, "A Study of Palate Shape and Its
Characteristics in Lispers, (unpublished Master's thesis,
University of Michigan, May, 1943), P. 55.

-21-

In general, no difference has been established be-
tween the palates of lispers and the palates of the

general population (as represented by the control
In almost every aspect of palate shape con-

group).
sidered, it was possible to demonstrate that no sig-

nificant difference existed between the two groups.
This does not indicate that palate shape never
Operates as an influence in the etiology of lisping;
but it suggests that, in general, palate shape is not
a factor which may be considered as responsible for

the development of the lisp. It certainly never
Operates as an independent cause Of lisping and pro-
bably not as a prime factor in a complex of causes.

10 studied the influence of dental anom-

Palmer
He stated, "While speech is

alias on speech in 1948.
primarily a function of the central nervous system, ab-

normalities in the peripheral speech organs, of course,
militate against the development of normal language."

He outlined normal Zfs_7'sound production and followed his

outline with a discussion of the influence of malocclu-

sions on normal [Ts_7'sound production. He found that the
movement of the mandible forward or backward from its

normal position made it difficult to hit the lower teeth

This impeded the ability of the

with a blast of air.
A medial

tongue to make proper contact with the alveolus.

open-bite contributed to tongue protrusion. Cross-bites

or lateral open-bites contributed to lateral zrs_7'sounds.
He reasoned that the process of learning a good [Ts_7'

sound was a chance system greatly aided by normal occlu-

sion. "The point is that malocclusions prevent normal

10J. F. Palmer, ”Orthodontics and the Disorders of
Speech,” American Journal 92.0rthodontics, XXXIV (July,

1948), P. 5790

-22-

movements from developing by the usual chance system."

The factor of chance was not considered by Gard-

nor11 in his study of dental, oral, and general causes

of articulatory defects in 1949.

Articulatory defects are those caused by dental
defects and cleft palate. Articulation includes the

movements during speech of the organs that modify the
stream of breath into meaningful sounds largely through
movements of the mandible, lips, tongue and the soft

palate.

He suggested five oral anomalies that caused defective

[Th_7'sound production. They were (1) retrusive mandible,

(2) prognathous mandible,
(5) high palatal arch.

(3) open-bite, (A) cleft

palate, and Concerning the fifth

cause he concluded:

Directly it interferes with the formation of a
lingual groove along the median raphe of the tongue

in the production of [TE and l7b_7'sounds. In order
to follow the anatomy of the hard palate of the mouth,

the dorsum of the tongue has to be so sharply arched
that the groove is impossible.

A cephalometric study was conducted at Lynn,

Massachusetts, by Murray Bernsteinle in 1954. This study

involved 437 children with defective speech and 446 chil-

dren with normal speech. The children with defective

_—_

11A. F. Gardner, "Dental, Oral, and General Causes

of Speech Pathology " Oral Sur er Oral Medicine, and Oral
_§atholpgy, II (June:.19397, p. 73%: ‘—

12M. Bernstein, "Relation of Speech Defects and Mal-
occlusion,” American Journal p£_0rthodontia,.XL (February,

19514), ppOl "' o

-23-

speech were divided into two groups, those having normal

occlusion and defective speech and those having mal-

occlusions and defective speech. The latter group was

investigated by lateral head x-rays with the Margolis
Cephalostat and speech recordings. The following conclu-

sions were drawn:
Children with speech defects did not have greater

1.
amounts of malocclusion than children with
normal speech.

2. Speech defects were not related to malocclusion
generally except in the case of open-bite.

3. The open~bite was strongly related to lisping.

4. In the case of open—bite, the severity of the

lisp did not vary with the amount the bite was

open or the amount of overJet or over-bite.

In a study of ten cases with marked speech prob-

lems and malocclusions, Rathbone and Snidecor13 found that

many defective dental sounds were corrected by orthodontia.

Only [3], [z], [a], [I], and [5] were not cor-

rected, but they improved. They stated that the follow-

ing dental anomalies were associated with defects of the

following sounds: (I) spaces-~all dental sounds except

[n] and [y]; (2) high palate-- [s], [z], [a],

13J. s. Rathbone and J. c. Snidecor, "Appraisal of

Speech in Dental Anomalies with Reference to Speech Im-
provement," The Angle Orthodontist, XXIX (January, 1959),

pp. 5h‘58.

-24-

[r], [1]; (3) width of arch-- [a], [z], and
[9.73 (‘0 Open-bite" [8] : [17: [5.7: [0.7:
[tU, and [(1.373 (5) degree of protrusion-- [s],
[z], [I], ['5]; (6) thickness of the alveolar

ridge-- [8], [z], [5‘]; (7) severity of rotated
teeth-~a11 dental sounds but [Th_7'and zfy_7; They con-

cluded that, "Improvement of speech can be predicted with
improved structural factors, and any residual errors can be
reduced or eliminated by the process of learning."1u
Bloomer15 found a limited and qualified relation-
ship between the form of oral structures and speech de-
fects in his investigations. He suggested that a func-
tional relationship might exist between speech articula-
tion and malocclusion in a particular individual. He listed
the following malocclusions that might contribute to de-
fective speech: (1) extreme distocclusion, (2) extreme
mesiocclusion, (3) Open-bite, (4) lingually malposed
teeth (especially in the maxillary anterior teeth), (5)
maxillary teeth in labioversion (especially when associ-
ated with distocclusion), (6) asymmetry of the dental
arches (especially of the maxillary teeth), (7) absence
of teeth, (8) extreme contraction of the maxillary arch.

In connection with palate height he stated:

1“Donal” p. 59.

15H. Bloomer, "Speech as Related to Dentistry,"
Journal 9; The Michi an State Dental Association, XL
ovem er, I958), p. §54.

-25-

Palate height probably has little effect on consonant

articulation. Its significance lies in the fact that

it usually accompanies a narrow maxillary arch and

palate height is usually associated with nasal con-

striction. A high maxillary vault should not inter-

fere with speech.
He concluded that malocclusions often contributed to but
were not the primary cause of speech defects.

A roentgenologic investigation was conducted with

246 patients, 143 male and 103 female, at the Orthodontic
Department of the Royal Dental College, Copenhagen, Den-
mark, by Benediktsson16 in 1958. The study examined the
relations of the tongue and Jaws during [Ts_7'sound
production in cases with normal and abnormal incisal occlu—
sion. The subjects were placed into nine groups according
to combinations of overJet and overbite. The group with
normal incisal occlusion was used as the control group.
The roentgenograms were identical profile exposures; they
were taken of the Jaws in occlusion, in rest position, and
in [Ts_7'sound position. Tantalum powder was used to
bring out the position of the tongue in occlusion and in
[3] sound production. For this study, a normal [8]
sound was either a tongue tip [Ts_7’sound or a tongue
blade [Ts_7'sound, the tongue blade [:s_7'sound being

more frequent in the Danish language. There was no

acoustical evaluation of the [Ts_7’sounds produced by

 

l6E. Benediktsson, "Variation in Tongue and Jaw
Position in a Sound Production in Relation to Front Teeth
Occlusion,“ Acta Odontologica Scandinavica, XV (January,

1958), pp..275:§97.

-26-

the subJects. The subJects were grouped in the following
classes: (1) normal overJet and normal overbite, (2)
mandibular overJet and deep bite, (3) normal overJet and
deep bite, (4) maxillary overJet and deep bite, (5)
mandibular overJet and normal overbite, (6) maxillary
overJet and normal overbite, (7) mandibular overJet and
open-bite, (8) normal overJet and open-bite, (9) maxil-
lary overJet and open-bite. Measurements in millimeters
were taken of the changes in Jaw position in occlusion, in
rest position and in [Ts_7'sound position. No exact meas-
urements were taken of the tongue in any position; how-
ever, descriptions were given of the tongue posture of
each of the positions. The investigator gave the follow-
ing results of her study:

The investigation demonstrates a certain relationship

between malocclusions and Jaw and tongue positions.

Abnormal overJet or overbite of the incisors or com-

binations of both cause deviation from the normal

function both as regards the position of the tongue

and that of the Jaw. The degree of this deviation

and its direction depend upon the type of malocclu-

sion.

Whether normal [7347 sound production is achieved

by means of these compensatory movements of tongue

and Jaw cannot be concluded from this investigation

as there has been no acoustical registration. The

distinct tendency to variation of the compensatory

movements according to the incisal occlusion, how-

ever, might indicate that these movements are necessary

for normal speech. It is concievable that certain

speech anomalies are caused by failure of functional

adaptation due to lack of ability of adaptation or to

too extreme deviation from normal incisal occlusion.
The investigator found a marked influence of incisal

occlusion on the movements and the position of the tongue

-27-

and the lower Jaw in [Ts_7'sound production. In cases
of malocclusion a compensatory tendency was found. The
main features of the compensatory movements were summa-

rized as follows:

Jaw position: In cases with extreme maxillary over-
Jet and normal or extreme overbite the general ten-
dency is towards a more pronounced frontal transla-
tion of the lower Jaw than in the normal group, where-
as in cases with mandibular overJet the translation
of the lower Jaw is less pronounced, in some cases
even dorsal. In cases with open bite however, the
translation of the lower Jaw during éfs_7'sound pro—
duction is generally very slight wit in all groups.
Regardless of the degree of overJet the lowering of
the mandible is pronounced in cases with extreme
overbite, whereas in cases with openbite the lower-
ing of the mandible is slighter than in the normal
group apart from cases which also have extreme maxil-
lary overJet. In such cases the lowering of the
mandible is the same as in the normal group.

Tongue position: Various movements of the tongue
from rest position to [Ts_7'sound position were
demonstrated, indicating various means of achieving
normal tongue position during‘l‘s47 sound production.
This appears especially obvious in the cases in which
the translation of the lower Jaw does not fully com-
pensate for the extreme overJet as in group 9. In
these cases a very marked protrusion of the tongue

is found. On the other hand, in cases with mandi-
bular overJet usually no protrusion of the tongue

is found. Such compensatory variations of the
tongue movements frequently result in a normal
tongue position in relation to the front teeth.17

The most recently published cephalometric study
was conducted in the Department of Orthodontia, Eastman

Dental Hospital, University of London, by Peter Blyth18

 

17Ibi9-. pp. 298-299.

18Peter Blyth, "The Relationship between Speech,
Tongue Behaviour, and Occlusal Abnormalities," Dental Prac-
titioner and Dental Record, X (September, 1959), pp. 11:55.
ns 1 ute of Dental Surgery, University of London, East—
man Dental Hospital).

-28-

in 1959. Two hundred children attending the orthodontia
clinic were examined for the relationship between speech,
tongue behavior and occlusal abnormalities. Conversion
tracings were prepared from lateral head plates, and
cephalometric measurements were made. The speech was
evaluated by a speech therapist; 52 of the children were
found to have interdental sigmatism and 10 were found to
have lateral sigmatism. In essence, the conclusions
were as follows:

1. Skeletal base discrepancy in an antero-posterior
direction does not produce an actual increase in
sigmatisms and compensations take place both by
the tongue and mandibular movements.

2. The cause and effect relationship between a high
maxillary-mandibular plane angle and an inter-
dental sigmatism cannot be assessed. There is
an association between high angles and Class II,
division 1 malocclusion. There is an association
between high angles and low tongue position. There
is also an association between Class II, division
1 malocclusion and interdental sigmatism.

3. The importance of the tongue in relation to the
occlusal plane cannot be resolved.

4. Some form of tongue thrusting behavior accom-
panies most of the interdental sigmatism. Where

there is a substitution of [e] for [a], there

is less likely to be atypical swallowing.

-29-

5. Tongue behavior improves when finger or thumb
sucking is brought under control.

6. Persistence of thumb-finger sucking habit may
serve to perpetuate the other disorders.

7. The cause of interdental sigmatism not accom-
panied by secondary sucking mechanisms is not
definite. Deafness and intelligence are also
important as well as other etiological factors.

8. Lateral sigmatism may or may not be associated
with tooth apart swallowing. When lateral sig-
matism is associated with Class II, division I
malocclusion, the cause of the incisor relation-
ship must be ascribed to some other factor than
forward tongue thrusting, unless the two co-
exist.

9. Lateral sigmatism is often associated with Class
II, division II malocclusion.

10. Cases should be subJect to a period of observa-
tion before beginning orthodontic treatment.

Many and varied investigations concerning the [7347

sound have been conducted. Each has contributed some new

information, and each has brought forth new questions

about [Ts_7'sound production. The relationship of mal-

occlusion, tongue posture, palate height, and Jaw position

to defective [Ts_7'sound production are Just a few prob-

lems which call for further study. Specific differences

between normal and defective er_7’sound production have

yet to be determined.

-30-

yet to be determined.

-30-

CHAPTER III

SUBJECTS, EQUIPMENT, AND PROCEDURES

I. SUBJECTS

Number and source of sungct population. Sixty

 

subJects participated in this study. Twenty of them were
students at the Eastman Dental Dispensary, Rochester, New
York. Forty were public high school students from Ben—
Jamin Franklin High School, Edison Technical and Indus-
trial High School, and East High School, Rochester, New
York. Participation in the study was voluntary. The
parents of each participating high school student were
contacted by letter (see Appendix, page‘78.) The letter
briefly explained the study and contained a form which
the parents were asked to sign if they approved of having
their child participate in the study. The signed form
was then returned to the investigator. No student under
eighteen years of age participated in this study without
the written permission of his parent or parents. The high
school students were from grades nine through twelve,
with ages ranging from thirteen years to nineteen years.
The Dental Dispensary students were dental hygienists
and interning dentists whose ages ranged from eighteen

years to twenty-five years.
-31-

-32-

Selection of SubJects. Thirty-seven male and
twenty-three female subJects participated in the study.
IThe primary criterion employed in the selection of all
subJects was the acceptability or unacceptability of the
production of the [Ts_7'sound. The group of thirty with
unacceptable [Ts_7'sound production were high school
students selected from the speech therapy classes of

the investigator. Each of these subJects was Judged

to have a moderately severe or severe distortion or
substitution of the [a] and [z] sounds. A second
criterion was employed in the selection of the group of
thirty with acceptable [Ts_7'sound production. Each
subJect in this group was required to have acceptable
[Ts_7'sound production and normal occlusion. The Judge-
ments on occlusion were made by a qualified orthodontist.
The Judgements of the acceptability or unacceptability of
the Zfs_7'sound production of each subJect were made by a
panel of three experienced, practicing speech therapists.
All of the subJects were tested with articulation-testing
sentences and words from Voice and Articulation Drillbook

(see Appendix, page 77’.)1
II. EQUIPMENT

The equipment employed in this study was:
1. A Sonotone audiometer. (Model 91)

 

1Fairbanks, 22, cit., PP. xii-xx.

-33-

2. A Margolis cephalostat.
3. A Broadbent Bolton cephalostat.

III. PROCEDURES

 

Hearing examinations. In order to determine
whether any subJect with defective zrs_7'sound production
had a hearing loss, each subJect with defective [Ts_7 sound
production was given an individual audiometric examina-
tion by the investigator. These examinations were ad-
ministered in the speech therapy rooms in BenJamin Frank-
lin High School and Edison Technical and Industrial High
School. The speech therapy rooms were not sound treated.
A puretone audiometer, (Sonotone, model 91), was employed
in the administration of the hearing examinations. Each
subJect with defective [Ts_7’sound production was given
a sweep check at fifteen decibels in each ear at the fol-
lowing frequencies: 500 cps, 1000 cps, 2000 cps, 3000 cps,
4000 cps, 6000 cps, and 8000 cps. Two of the subJects had
losses at 4000 cps in the left ear only. One of those two
subJects had a loss of forty decibels at 4000 cps in the
left ear, and the other subJectrad a loss of thirty deci-
bels at 4000 cps in the left ear.

Evaluation of occlusion. An evaluation of the
occlusion of each subJect was made by an orthodontist.
This evaluation was made in the Department of Orthodontia,
Eastman Dental Dispensary. The orthodontist completed an

examination sheet on each subJect (see Appendix, page 79 ).

-34-

The occlusion was evaluated to determine the Angle classi-
fication, open-bite, closed—bite, overJet, spacing, crowd-
ing, teeth in linguaversion, rotations, missing teeth,
palate contour, ability to elevate and groove the tongue,
the appearance and function of the lips during swallow-
ing, and the pattern of swallowing. These evaluations
were later analyzed and compared.

Cephalometric roentgenography. The cephalometric

 

roentgenOgrams were made at the Eastman Dental Dispensary,
Rochester, New York, Department of Orthodontia, under the
direction of Dr. J. Daniel Subtelny. An orthodontist and
an x-ray technician were responsible for taking and de-
veloping the roentgenograms. A set of three cephalo-
metric roentgenograms per subJect was taken. The in-
vestigator was present each time to evaluate [Ts_7'sound
production when the roentgenogram was taken. The first
forty-three sets of cephalometric roentgenograms were made
with a Margolis cephalostat, and the last seventeen sets
were made with a Broadbent Bolton cephalostat. The reason
two different cephalostats were employed was due to the
fact that a new Broadbent Bolton cephalostat was purchased
by the Dental Dispensary as a replacement for the Margolis
unit during the investigation. The x-ray head of both
cephalostats was positioned four feet, ten inches from
the mid-line of the skull of the subJect being x-rayed.
Only lateral cephalometric roentgenograms were taken.

The amount of enlargement and distortion was the same for

-35-
all of the roentgenograms. Each subJect was seated in
the stationary chair which was adJustable in height. The
chair was then raised so that the subJect's head was
directly anterior to the cassette holder. The head was
stabilized and positioned by ear rods and a nose piece.
The ear rods and nose piece were graduated and adJustable.
Because of this the head of each subJect was positioned
identically anterior to the cassette. Immediately prior
to taking the first roentgenogram, the orthodontist painted
the mid-line and tip of the subJect's tongue with tantalum
powder paste. This paste was composed of tantalum powder,
gum Arabic, and water. Tantalum was used as a radio-opaque
media to assure a clear outline of the tongue posture dur-
ing the production of the [Ts_7’sound in the roentgenogram.
The first roentgenogram was taken as the subJect produced
a sustained [Ts_7'sound. The roentgenogram was actually
taken one to two seconds after the subJect initiated the
[Ts_7'sound. This was done to allow the investigator time
to make a Judgment as to whether the [fs_7'sound was either
acceptable or unacceptable at the moment the roentgenogram
was taken. The second roentgenogram was taken of the sub-
Ject's mandible at rest. This was the position assumed by
the mandible when it was relaxed. The third roentgeno-
gram was taken of the subJect's teeth occluded. All three
roentgenograms were lateral head—plates and limited to
two planes. Tracings of the roentgenograms showing oral

structures during sustained [rs_7’sound production were

-36-

made by a qualified orthodontist. Structures traced were

as follows:

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.

nose

lips

chin

nasal bone

nasion

anterior portion of the maxilla
maxillary central incisor
anterior portion of the mandible
mandibular central incisor
alveolar ridge

anterior and posterior nasal spines
hard palate

soft palate

velar-pharyngeal closure
maxillary permanent first molar
mandibular permanent first molar
tongue posture at midline aspect of the tongue
hyoid bone

epiglottis

pterygo-maxillary fissure

sella turcica

pharyngeal wall

Cephalometric measurements of these structures were made

from the tracings. The following measurements were made

for this study:

-37-

l. the distance between the incisal edge of the maxillary
central incisor and the anterior incisal edge of the
mandibular central incisor during the production of the
[8] sound.

2. the distance between the maxillary permanent first
molar and the mandibular permanent first molar during
the production of the (fs_7'sound.

3. the distance between the anterior, inferior portion
of the tip of the tongue and the anterior mandibular
incisal edge during the production of the [Ts_7’sound.
4. the distance between the lingual reference line and
the anterior mandibular incisal edge during the pro-
duction of the [Ts_7'sound.

5. the distance between the anterior, inferior portion
of the tip of the tongue and the palatal plane during
the production of the gfsg7 sound.

6. the distance between the highest point of the tongue
and the palatal plane during the production of the th_7'
sound.

7. the distance between the highest point of the tongue
and the pterygo-maxillary fissure line during the pro-
duction of the [Ts_7'sound.

8. the distance between the posterior aspect of the
tongue and the pharyngeal wall during the production of
the [s] sound.

9. the velar-pharyngeal closure during the production
of the [8] sound.

-38—

10. the size of the angle formed at sella turcica by
the sella-nasion line and the sella-pogonian line dur-
ing the production of the [Ts_7 sound.
11. the size of the angle formed at nasion by the sella-
nasion line and the nasion-pogonian line during the pro-
duction of the [Ts_7'sound.

The portion of the study which was conducted at
Eastman Dental Dispensary was supported in part by a

United States Public Health Service Grant (#D-107l).

CHAPTER IV
ANALYSIS AND DISCUSSION

An analysis was made of the data obtained from
the tracings of the cephalometric roentgenograms taken
during the production of the [Ts_7'sound. See Figure l
for drawing of a tracing of a cephalometric roentgeno-
gram taken during the production of an acceptable 17347
sound. See Figure 2 for drawing of a tracing of a
cephalometric roentgenogram taken during the production
of an unacceptable [Ts_7'sound. On each tracing base
lines were drawn on the structures of the head. By
using the same points on the skeletal structure of
each subJect's tracing, comparable angular and linear
measurements could be made with the elimination of the
factors of distortion from the x-ray and differences in
head size. The first line drawn was the sella-nasion
line. Using a transparent plastic ruler, this line was
drawn from the center of the sella turcica to the Juncture
of the nasal bone and the frontal bone. The second line
drawn was the nasion-pogonian line. This line was drawn
from the Juncture of the nasal bone and the frontal bone
to the anterior most portion of the skeletal chin. The

third line drawn was the sella-pogonian line. This line

-39-

 

-MO-

N NASION
S SELLA

 

 

 

 

 

 

 

 

 

 

' O f O O -_ Ph
POG‘ I ARYNGEAL
F WALL

FIGURE I. NASTEN TNACINO OF ACCEPTABLE [S] SOUNO PRODUCTION
SHOWING REFERENCE POINT AND LOCATION OF MEASUREMENTS.

S - N SELLA-NASION LINE

S-POO SELLA-POOONION LINE

N-POO NASION‘POOONION LINE

P-P PALATAL PLANE

PI-N-F PTENYOO-NAXLLANY PISSUNE LINE
L-N°L LINOUAL REFERENCE LINE

PIC-N PNARYNOEAL -NYOIO LINE

P’P-N PALATAL PLANE-NYOIO LINE

-41—

 

 

 

 

 

 

 

 

/ s SELLA
I
" l '4 P u... \
ll ' \ 0
It! >4 .. \\ L
N
POOONDN IF "U V! fin.

 

FIGURE 2. nuns "acme or uwaccunu: (a) souwo

PROWCTION SNOVINO REFERENCE POINTS AND LOCATION OF
NEASURENENTS.

S-N SELLA°NASION LINE

S-POO SELLA°POOONION LINE
N-POO NASION-POOONION LII‘

P-P PALATAL PLANE
PI-N-P PTERVOO'NAXILLARY PISSURE LINE

L-R-L LINOUAL REFERENCE LINE

N-PI NYOIO PNARYNOEAL WALL LINE
P-P-N PALATAL PLME'NYGO LINE

 

-42-
was drawn from the same center point of the sella turcica
to a point on the nasion-pogonian line where that line
contacted the anterior most portion of the skeletal chin.
The sella-pogonian line also bisected that anterior most
portion of the skeletal chin. The next line drawn was
the palatal plane. This line was drawn from the anterior
nasal spine through the posterior nasal spine and bisected
both spines. All of the above lines were drawn with a
transparent plastic ruler whereas all other lines were
drawn with a transparent plastic protractor. The pterygo-
maxillary line was drawn perpendicular to the palatal
plane and bisected the pterygo-maxillary fissure. The
lingual reference line was drawn from the anterior, in-
ferior portion of the tip of the tongue through the
pharyngeal wall. This line was parallel to the palatal
plane and perpendicular to the pterygo-maxillary fissure
line. A line was drawn from the anterior, superior most
point of the hyoid to the palatal plane. This line was
parallel to the pterygo—maxillary fissure line and per-
pendicular to the palatal plane. A line was drawn from
that same anterior, superior point of the hyoid through
the pharyngeal wall. This line was parallel to the
lingual reference line and perpendicular to the hyoid-
palatal plane line. Upon completion of the base lines,
the cephalometric measurements were made and recorded.
With the completion of all of the cephalometric measure-

ments, 2 tests were employed to determine the significance

-43-

of the differences in the variances between the two small
sample groups.1 The following symbolizatinn was used in
the employment of the t_test:

X1 —- each score of the population with acceptable
[Ts_7’sound production

X2 -- each score of the population with unacceptable
zrs_7'sound production

X1 -- the mean of the scores of the population with
acceptable [Ts_7'sound production

X2 -- the mean of the scores of the population with
unacceptable [Ts_7'sound production

N -- the number in each sample
S -- the variances estimated from sample data
2 -- the sign for the process of adding.
The mean for each particular measurement for each group

was calculated by the following formula:
-X': XX
N

 

The variance for each particular measurement was calcu-

lated by the following formula: 2 2
2 (“1) (5X2)

2 +
$2 = 2. X1 + ZXQ - N N
N1 + N2 - 2

 

 

To obtain the value of t for each particular measurement,

the following formula was used:
361 " X2
2

S (_1_ + .1.)

t :

 

.————

1Quinn McNemar, Ps cholo ical Statistics (New York:
John Wiley and Sons, Inc::1I949U§—ET—2§H.

-uu-

By using a .01 and a .05 level of confidence, it was pos-
sible to determine which measurements showed a significant
difference.

The measurements made and tested for this study
were:

1. 'Lhe distance between the maxillary and mandibular

 

incisal edges during the production g£_the [Ts_7'sound

 

g§.evidenced gg_the tracings Q;_the cephalometric

roentgenograms Q£_the subJects who produce the Z7547

 

sound acceptably_and the subJects who pgoduce the

 

[Ts_7'§ound unacceptably. To determine the distance

 

between the maxillary and mandibular incisal edges
during the production of the [Ts_7’sound, one point
of the compass was placed on the anterior point of
the mandibular incisal edge and the other point of
the compass was placed'on the anterior point of the
maxillary incisal edge. This distance was then trans-
posed from the compass to‘a metric ruler and the exact
measurement of the distance in millimeters was recorded
on the data sheet. When the measurements for all
subJects were complete, the t test was employed.
Results of the statistical test are presented in
Table 1.

-u5-

TABLE 1.--The Difference in the Distance between the

Maxillary and Mandibular Incisal Edges during the Pro-

duction of the zrs_7'Sound by SubJects who Produce

the 17s_7'80und Acce tably and the SubJects who Produce
the (be Sound Unacceptably

 

Xi Ié t* degrees of freedom

 

1.72 mm. 4.77 mm. 6.17 58

 

*at .01 level of confidence t
at .05 level of confidence E

II II
M
e
O
C

There is a significant difference at the .01 level

of confidence in the distance between the maxillary
and mandibular incisal edges during the production of
the [8] sound by subJects who produce the [s] sound
acceptably and subJects who produce the [7947 sound
unacceptably. SubJects who produce the [7s47 sound
acceptably have a much closer antero-posterior rela-
tionship of the incisal edges during the production
of the [Ts_7'sound than do subJects who produce the
[Ts_7'sound unacceptably. In general, subJects who
produced the [Ts_7'sound acceptably had the mandi-
bular incisal edge slightly above and posterior to
the maxillary incisal edge. Of this group, three

had an edge to edge anterior incisal relationship.
The greatest antero—posterior distance between
incisal edges was 4.0 mm. while the mean for this

group was 1.72 mm. 0f the subJects who produced

-46-

the er_7'sound unacceptably, only one had an edge to
edge anterior incisal relationship. In this group
the greatest antero-posterior distance between in-
cisal edges during the production of the [7347

sound was 10.5 mm. while the mean for the group was
4.77 mm. Because there is a significant difference
in the distance between the maxillary and mandibular
incisal edges during the production of the [I547
sound, it can be concluded that the antero-posterior
relationship of the maxillary and mandibular incisal
edges is a significant factor in the production of
an acceptable Zfs_7’sound.

2. the shortest distance between the maxillary per-
manent first molar and the mandibular permanent first

molar during the production g§_the [Ts_7'sound.

 

To determine the distance between the maxillary per-
manent first molar and the mandibular permanent first
molar, one point of the compass was placed on the point
of the mandibular molar that appeared to be nearest
to the maxillary permanent first molar. The other
point of the compass was placed on the nearest point
of the maxillary permanent first molar. This dis-
tance was then transposed from the compass to the
metric ruler, and the exact distance in millimeters
was recorded on the data sheet. Other distances
between the permanent first molars were measured

in the same manner to assure that the shortest

-u7-

distance was the one measured and recorded. If the
molars were completely occluded, the distance was
recorded as zero. When all of the measurements for
all subJects were complete, the §_test was employed.
Table 2 presents the statistical results of the t
test.
TABLE 2.--The Difference in the Shortest Distance be-
tween the Maxillary Permanent First Molar and the Man-
dibular Permanent First Molar during the Production of
the s_7’Sound by SubJects who Produce the [7547

Soun Acceptably and the SubJects who Produce the [7347
Sound Unacceptably

 

X1 X2 3? degrees of freedom

 

1.03 mm. 1.08 mm. .1765 58

*at .01 level of confidence t - 2.75
at .05 level of confidence §:- 2.00

There is no significant difference in the shortest
distance between the maxillary permanent first molar
and the mandibular permanent first molar during the
production of the‘ZTs47 sound by subJects who produce
the zrs_7'sound acceptably and subJects who produce
the zrs_7'sound unacceptably. Both groups had
practically the same molar relationship during the
production of the [Ts_7'sound. Of the subJects who
produced the [Ts_7’sound acceptably, seven had the

permanent first molars occluded during the production

-48-

of the [rs_7'sound. In this group the greatest dis-
tance between the permanent first molars was 3.5 mm.
while the mean was 1.03 mm. 0f the subJects who
produced the [rs:7"sound unacceptably, twelve had

the molars occluded during the production of the
[Ts_7'sound. In this group the greatest distance be-
tween the permanent first molars was 4.0 mm. while the
mean was 1.08 mm. Because there is no significant
difference in the distance between mandibular and
maxillary permanent first molars during the production
of the [Ts_7'sound, it can be concluded that this
posterior molar relationship is not a significant
factor during the production of an acceptable [I347
sound.

3. the distance between the anterior, inferior point
2£_thg tip 2; the tongue and the anterior mandibular
incisal edge during the production 92.223.175—7’33323!

 

To determine the distance between the anterior, in-
ferior point of the tip of the tongue and the anterior
mandibular incisal edge, one point of the compass was
placed on the anterior mandibular incisal edge, The
other point of the compass was placed on the point

of the tip of the tongue where the lingual reference
line crossed the tip of the tongue. This distance

was then transposed from the compass to the metric
ruler, and the exact distance in millimeters was

recorded on the data sheet. If the anterior,

-hg-

inferior point of the tip of the tongue was anterior
to the anterior mandibular incisal edge, the dis-
tance was recorded as plus millimeters. If the
anterior, inferior point of the tip of the tongue
was neither anterior nor posterior to the anterior
mandibular incisal edge but exactly perpendicular

to the anterior mandibular incisal edge, the distance
was recorded as zero millimeters. If the anterior,
inferior point of the tip of the tongue was pos-
terior to the anterior mandibular incisal edge, the
distance was recorded as minus millimeters. When
all of the measurements were complete, the scores
were transposed to eliminate the pluses and minuses.
The raw and transposed scores can be found in the
Appendix, page 84 . The t_test was employed with
the transposed scores. Table 3 presents the results

of the statistical test.

TABLE 3.--The Difference in the Distance between the
Anterior, Inferior Point of the Tip of the Tongue and
the Anterior Mandibular Incisal Edge during the Pro-
duction of the Zfs_7'Sound by Subdects who Produce the

[Ts_7’Sound Acce tably and SubJects who Produce the
[T§_7'Sound Unacceptably

 

X1 Kg t* degrees of freedom

5.47 9.28 4.28 58

 

*at .01 level of confidence t - 2.75
at .05 level of confidence §:;_2.00

-50-

There is a significant difference at the .01 level
of confidence in the distance between the anterior,
inferior point of the tip of the tongue and the
anterior mandibular incisal edge during the production
of the [8] sound by subJects who produce the [s]
sound acceptably and subJects who produce the 17547
sound unacceptably. All the subJects who produced
the [fs_7'sound acceptably had the tip of the tongue
posterior to the anterior mandibular incisal edge.
The distances ranged from 2.0 mm. to 9.0 mm. pos-
terior to the anterior mandibular incisal edge while
the mean distance for the group was 4.5 mm. pos-
terior to the anterior mandibular incisal edge. or
the subJects who produced the Zfs_7'sound unacceptably,
the tip of the tongue was placed anywhere from 7.0
mm. anterior to the anterior mandibular incisal edge
to 8.5 mm. posterior to the anterior mandibular in-
cisal edge. The mean for this group was .7 mm. pos-
terior to the anterior mandibular incisal edge. It
is interesting to note that the subJects who produced
the [7347 sound unacceptably had an antero-posterior
tongue tip position that was considerably farther
forward than that of the subJects who produced the
[Tsn7'sound acceptably. Because there is a signi-
ficant difference in the distance between the ante-

rior, inferior point of the tip of the tongue and

-51-

the anterior mandibular incisal edge during the pro-
duction of the [Ts_7'sound by subJects who produce

the [Ts_7'sound acceptably and subJects who produce

the zrs_7'sound unacceptably, it can be concluded

that the antero-posterior distance of the tongue tip
from the anterior mandibular incisal edge is a sig-
nificant factor during the production.of the [7347
sound.

4. the distance between the lingual reference line

and the anterior mandibular incisal edge during the pro-

duction o£_the Z7s_7'sound. To determine the distance

 

between the lingual reference line and the anterior
mandibular incisal edge, one point of the compass

was placed on the anterior point of the mandibular in-
cisal edge. The other point of the compass was placed
perpendicular to the anterior mandibular incisal edge
on the lingual reference line. This distance was

then transposed from the compass to the metric ruler,
and the exact distance in millimeters was recorded on
the data sheet. If the lingual reference line was be-
low the anterior mandibular incisal edge, the dis-
tance was recorded as minus millimeters. If the lingual
reference line exactly crossed the anterior mandibular
incisal edge, the distance was recorded as zero milli-
meters because the lingual reference line was neither
above nor below the anterior mandibular incisal edge.

If the lingual reference line was above the anterior

-52-

mandibular incisal edge, the distance was recorded

as plus millimeters. When all of the measurements

were complete, the scores were transposed to elimi-

nate the pluses and minuses. These scores and trans-

posed figures are found in the Appendix, page 86.

A E_test was employed with the transposed scores.

Table 4 gives the results of the statistical test.
TABLE 4.--The Difference in the Distance between the
Lingual Reference Line and the Anterior Mandibular Incisal
Edge during the Production of the [7s47'Sound by SubJects

who Produce the [Ts_7’Sound Acceptably and SubJects who
Produce the [Ts_7'Sound Unacceptably

 

 

 

 

X1 X5 .3? degrees of freedom
4.73 5.93 2.83 58
*at .01 level of confidence 2.. 2.75
at .05 level of confidence t_= 2.00

There is a significant difference at the .01 level of
confidence in the distance between the lingual refer-
ence line and the anterior mandibular incisal edge
during the production of the [Ts_7'sound by subJects
who produce the [Ts_7'sound acceptably and subJects
who produce the [Ts_7’sound unacceptably. 0f the
subJects who produced the Zfs_7'sound acceptably,

the distances of the lingual reference line from the

anterior mandibular incisal edge ranged from 1.0 mm.

-53-

below the anterior mandibular incisal edge to 2.5 mm.
above the anterior mandibular incisal edge. The mean
for this group was .73 mm. above the mandibular in-
cisal edge. or the subJects who produced the [Ts_7'
sound unacceptably, the distances of the lingual
reference line from the anterior mandibular incisal
edge ranged from 3.0 mm. below the anterior mandi-
bular incisal edge to 5.0 mm. above the anterior
mandibular incisal edge. The mean for this group

was 1.93 mm. above the anterior mandibular incisal
edge. The subJects who produced the [Ts_7'sound un-
acceptably did not relate the tip of the tongue to

the anterior mandibular incisal edge in either the
vertical or antero-posterior aspects of tongue tip
position. All of the subJects who produced the [7347
sound acceptably related the tip of the tongue to

the mandibular incisal edge rather than the alveolar
ridge. This was true in both the antero-posterior
and vertical aspects of tongue tip position. It must
be reiterated that the subJects who produced the [7347
sound acceptably also had normal occlusion. It is
quite possible that the tip of the tongue relates
with the mandibular incisal edge during the pro-
duction of the [Ts_7’sound when the subJects producing
the [Ts_7'sound acceptably have normal occlusion. It
may be that the much discussed tongue tip-alveolar

ridge relationship during the production of an

-54-

acceptable [Ts_7'sound is an adaptive movement rather
than a normal movement depending on normalcy of the
occlusion. Since all of the subJects who produced
the [Ts_7’sound acceptably had the same tongue tip—
mandibular incisal edge relationship, this investi-
gation would support the idea that the lower tongue
tip position during the production of an acceptable
[rs_7'sound is normal for subJects who have normal
occlusion. At any rate, because there is a signi-
ficant difference in the distance between the lingual
reference line and the anterior mandibular incisal
edge during the production of the Zfs_7'sound by
subJects who produce the [Ts_7'sound acceptably and
subJects who produce the [Ts_7'sound unacceptably, it
can be concluded that the vertical distance of the
tongue tip from the mandibular incisal edge is a
significant factor during the production of an accept-
able [s] sound.

5. the distance between the anterior, inferior paint

2£_the tip 93 the tongue and the pglatal plane during

 

the ppoduction pf the [Ts_7'sound. To determine the

 

distance between the anterior, inferior point of the
tip of the tongue and the palatal plane during the
production of the [Ts_7'sound, one point of the com~
pass was placed on the point of the tip of the tongue
where the lingual reference line crossed the tip of

the tongue. The other point of the compass was placed

-55-

perpendicular to the anterior, inferior point of the
tip of the tongue on the palatal plane. This dis-
tance was then transposed from the compass to the
metric ruler, and the exact measurement in milli-
meters was recorded on the data sheet. When all of
the measurements were complete, a‘g test was em-
ployed. Table 5 gives the results of this test.

TABLE 5.--The Difference in the Distance between the

Anterior, Inferior Point of the Tip of the Tongue and

the Palatal Plane during the Production of the [I347

Sound by SubJects who Produce the s_7 Sound Acceptably
and SubJects who Produce the (is Sound Unacceptably

 

 

X1 X2 tf degrees of freedom

 

30.4 mm. 28.83 mm. 1.38 58

 

*at .01 level of confidence t - 2.75
at .05 level of confidence §:- 2.00

There is no significant difference in the distance
between the anterior, inferior point of the tip of
the tongue and the palatal plane during the pro-
duction of the [Ts_7'sound by subJects who produce
the Z7s_7'sound acceptably and subJects who produce
the zrs_7'sound unacceptably. 0f the subJects who
produced the [Ts_7'sound acceptably, the distances
between the anterior, inferior point of the tip of

the tongue and the palatal plane ranged from 23.0 mm.

-55-

to 41.5 mm. The mean for this group was 30.48 mm.
or the subJects who produced the er_7'sound un-
acceptably, the distances between the anterior,
inferior point of the tip of the tongue and the
palatal plane ranged from 21.0 mm. to 38.0 mm.

The mean for this group was 28.83 mm. The relation-
ship of the tongue tip to the palatal plane was
approximately the same for both groups. Because
there is no significant difference in the distance
between the anterior, inferior pointcf the tip of
the tongue and the palatal plane during the pro-
duction of the Zfs_7'sound by subJects who produce
the [Ts_7'sound acceptably and subJects who produce
the [Ts_7'sound unacceptably, it can be concluded
that the distance of the tongue tip from the palatal
plane is not a significant factor in the production
of an acceptable [Ts_7'sound.

6. the distance between the highest portigp'9£.E§§.
tongue and the palatal plane. To determine the dis-
tance between the highest portion of the tongue and
the palatal plane, it was first necessary to deter-
mine which was the highest portion of the tongue. To
do this, the transparent ruler was placed on the
tracing with the first line superimposed upon the
palatal plane. The ruler was then moved along the
palatal plane. The distance between the palatal

plane and the tongue was continuously noted. When

-57...

it was determined what portion of the tongue was
closest to the palatal plane, the length of this
portion was marked and measured in millimeters. This
distance was then bisected 0n the tracing. One point
of the compass was placed on the point of bisection.
The other point of the compass was placed on the
palatal plane perpendicular to the point of bisection.
This distance was then transposed from the compass to
a metric ruler, and the exact measurement in milli-
meters was recorded on the data sheet. When all of

the measurements were complete, a §_test was employed.

TABLE 6.--The Difference in the Distance between the
Highest Portion of the Tongue and the Palatal Plane
during the Production of the [Te_7’Sound by SubJects
who Produce the [rs_7’Sound Acceptably and SubJects who

Produce the Zfs_7’Sound Unacceptably

 

 

X1 X2 pf degrees of freedom

 

15.16 mm. 12.97 mm. 2.02 58

 

*at .01 level of confidence t - 2.75
at .05 level of confidence §:- 2.00

There is no significant difference at the one per
cent level of confidence, but there is a significant
difference at the five per cent level of confidence
in the distance between the highest portion of
the tongue and the palatal plane during the pro-
duction of the [fs_7'sound by subJects who produce

-58-

the [Ts_7'sound acceptably and subJects who produce
the Zfs_7'sound unacceptably. 0f the subJects who
produced the [Ts_7'sound acceptably, the distances
between the highest portion of the tongue and the
palatal plane ranged from 26.0 mm. to 10.0 mm. The
mean for this group was 15.16 mm. 0f the subJects
who produced the [rs_7'sound unacceptably, the dis-
tances between the highest portion of the tongue

and the palatal plane ranged from 19.5 mm. to 6.5 mm.
The mean for this group was 12.97 mm. There was a
greater distance between the highest portion of the
tongue and the palatal plane during the production of
the [s] sound by subJects who produced the [8]
sound acceptably. This supports the previous find-
ing that generally the tongue posture during the
production of the [Ts_7'sound is lower in the oral
cavity for subJects who produce the [fe_7 sound
acceptably. Because there is a significant dif-
ference at the five per cent level in the distance
between the highest portion of the tongue and the
palatal plane during the production of the [Is47
sound by subJects who produce the [Ts_7'sound accept-
ably and subJects who produce the [Te_7 sound un-
acceptably, it can be concluded that the distance

of the highest portion of the tongue from the palatal
plane is a somewhat significant factor in the pro-

duction of an acceptable [7947 sound.

-59..

7. Egg distance between 222 highest portion pf £22.
tongue and the pperygo-maxillary fissure line. To
determine the distance between the highest portion

of the tongue and the pterygo-maxillary fissure line
during the production of the [Ts_7'sound, one point
of the compass was placed on the bisected point of
the highest portion of the tongue which was dis-
cussed in the previous measurement. The other point
of the compass was placed on the pterygo-maxillary
fissure line perpendicular to the point of bisection.
This distance was then transposed from the compass to
a metric ruler, and the exact distance in millimeters
was recorded on the data sheet. When all of the
measurements for all subJects had been completed,

a £_test was employed. Table 7 gives the results

of this test. There is no significant difference

in the distance between the highest portion of the
tongue and the pterygo-maxillary fissure line dur-
ing the production of the [Ts_7'sound by subJects
who produce the [feg7 sound acceptably and subJects
who produce the [rs_7'sound unacceptably. 0f the
subJects who produced the Zfs_7'sound acceptably,
the distances between the highest portion of the
tongue and the pterygo-maxillary fissure line ranged
from 40.0 mm. to 0.0 mm. The mean for this group
was 8.72 mm. 0f the subJects who produced the [TSE7

sound unacceptably, the distances between the highest

-60-

portion of the tongue and the pterygo-maxillary
fissure line ranged from 52.5 mm. to 1.0 mm. The
mean for this group was 13.6 mm. Both groups had a
large variation in the distances of the highest por-
tion of the tongue from the pterygo-maxillary fissure
line. Because there is no significant difference in
the distance between the highest portion of the
tongue and the pterygo-maxillary fissure line during
the production of the Zfs_7'sound by subJects who
produce the [Ts_7'sound acceptably and subJects who
produce the [rsg7'sound unacceptably, it can be con-
cluded that the distance of the highest portion of
the tongue from the pterygo-maxillary fissure line
is not a significant factor in the production of an
acceptable Zfs_7'sound.

TABLE 7.--The Difference in the Distance between the

Highest Portion of the Tongue and the Ptery o-Maxillary

Fissure Line during the Production of the {Sc Sound by

SubJects who Produce the [Te Sound Accep ab y and
SubJects who Produce the s:7'Sound Unacceptably

 

 

W w-E— I l
Xi Xi 3f degrees of freedom
8.72 mm. 13.6 mm. 1.79 58

*at .01 level of confidence t =.2.38
at .05 level of confidence §:- 2.

8. the distance between the posterior agpect g: the

tongue and the pharyngeal wall. To determine the

-61-

distance between the posterior aspect of the tongue
and the pharyngeal during the production of the [Ts_7’
sound, one point of the compass was placed on the
point of the tongue where the lingual reference line
crossed the posterior aspect of the tongue. The
other point of the compass was placed on the point
of the pharyngeal wall where the lingual reference
line crossed the pharyngeal wall. This distance was
then transposed from the compass to a metric ruler,
and the exact distance in millimeters was recorded
on the data sheet. When all of the measurements for
all subJects were complete, a 3 test was employed.
Table 8 gives the results of this statistical test.
TABLE 8.--The Difference in the Distance between the Pos-
terior Aspect of the Tongue and the Pharyngeal Wall dur-
ing the Production of the [Te Sound by SubJects who

Produce the [Ts Sound Accep ably and SubJects who Pro-
duce e zrs_7'Sound Unacceptably

 

 

 

* j M 1
ii X2 3} degrees of freedom
14.27 mm. 200514 me 3073 58

 

*at .01 level of confidence t - 2.75
at .05 level of confidence §:- 2.00
There is a significant difference at the .01 level
of confidence in the distance between the posterior
aspect of the tongue and the pharyngeal wall during
the production of the 17a47 sound by subJects who

-62-
produce the Zfs_7'sound acceptably and subJects who

produce the [Ts_7'sound unacceptably. 0f the sub—
Jects who produced the Ars_7'sound acceptably, the

distances between the posterior aspect of the tongue

and the pharyngeal ranged from 28.0 mm. to 5.0 mm.

The mean for this group was 14.27 mm. 0f the sub-

Jects who produced the [Ts_7'sound unacceptably, the

distances between the posterior aspect of the tongue

and the pharyngeal wall ranged from 32.5 mm. to 8.0 mm.

The mean for this group was 20.54 mm. The fact that

the distance between the posterior aspect of the

tongue and the pharyngeal wall is much less for sub-

Jects who produce the [Ts_7'sound acceptably gives

further support to the previous findings of this

study regarding the antero-posterior aspects of

tongue posture. All subJects who produced the [I347

sound acceptably retracted the whole tongue in the

oral cavity further than did subJects who produced

the zrs_7'sound unacceptably. It would appear that

the antero—posterior tongue posture is extremely im-

portant in acceptable Zfs_7’sound production. Be-

cause there is a significant difference in the dis-

tance between the posterior aspect of the tongue

and the pharyngeal wall during the production of the
[8] sound by subJects who produce the [s] sound
acceptably and subJects who produce the zrs_7’sound

unacceptably, it can be concluded that the relation-

-63-

ship and thecflstance of the posterior aspect of the
tongue to the pharyngeal wall is a significant factor

in the production of an acceptable [rs_7'sound.

9. the velar-pharyngeal closure. No statistical

measurement was made of the velar-pharyngeal closure
because the velar-pharyngeal closure was complete

for all subJects regardless of the type of [Is47

sound production. There is no difference in the

velar-pharyngeal closure for both groups of subJects.
This can be seen very clearly on all of the tracings.
Because there is no difference in the velar-pharyngeal

closure during the production of the [Ts_7’sound by

subJects who produce the [Ts_7's0und acceptably and

subJects who produce the [Ts_7'sound unacceptably,
it can be concluded that the velar-pharyngeal closure

is not a factor in the production of an acceptable [Ts_7'

sound.
the_size g: the angle formed g§_sella turcica pg

 

10.
the sella-nasion line and the sella-pogonian line.

 

To determine the size of the angle formed at sella

turcica by the sella—nasion line and the sella-

pogonian line during the production of the [fag7

sound, a protractor was employed to measure the
number of degrees in the angle. After measuring the

angle, the exact number of degrees was recorded on

the data sheet. When all of the measurements for

all subJects were complete, a E_test was employed.

-54-

Table 9 gives the results of this test.

TABLE 9.--The Difference in the Size of the Angle Formed

at Sella Turcica by the Sella-Nasion Line and the Sella-

Pogonian Line during the Production of the [TS_7 Sound
Z11;;77sound Acceptably and
S

by SubJects who Produce the
SubJects who Produce the ound Unacceptably

 

64.51° 65.57° 1.12

- 2.75

*at .01 level of confidencet
2.00

at .05 level of confidence E'a2

There is no significant difference in the size of
the angle formed at sella turcica by the sella-nasion
line and the sella-pogonian line during the production

of the [s] sound by subJects who produce the [3]

sound acceptably and subJects who produce the [Ts_7'

sound unacceptably. 0f the subJects who produced the

[Ts_7'sound acceptably, the size of the angle formed
at sella turcica varied from 57.0 degrees to 69 5

degrees. The mean for this group was 64.51 degrees.

Of the subJects who produced the zrs_7’sound unac-

ceptably, the size of the angle formed at sella tur-
cica varied from 57.5 degrees to 74.0 degrees. The
mean for this group was 65.57 degrees. The fact that

there is no significant difference in the size of the

angle formed at sella turcica during the production

-65-

of the [a] sound by both groups indicates that the
downward movement of the mandible during the pro-

duction of the [Ts_7'sound is approximately the

same for both groups. Because there is no signi-

ficant difference in the size of the angle formed at

sella turcica during the production of the Zfs_7'
sound by subJects who produce the [Ts_7'sound accept-
ably and subJects who produce the [Ts‘7’sound unac-
ceptably, it can be concluded that the size of the

angle formed at sella turcica is not a significant

factor in the production of an acceptable [7347 sound.

11. the size g£_the angle formed g§_nasion 21 the

sella-nasion line and the nasiongpogonian line.
To determine the size of the angle formed at nasion

by the sella-nasion line and the nasion-pogonian

line during the production of the [Ts_7'sound, a

protractor again was employed to measure the number

of degrees in the angle. After measuring the angle,

the exact number of degrees in the angle was re-

corded on the data sheet. When all of the measure-

ments for all subJects were complete, a §_test was

employed. Table 10 gives the results of this test.

-66-

TABLE lO.--The Difference in the Size of the Angle formed

at Nasion by the Sella-Nasion Line and the Nasion-Pogonian

Line during the Production of the s_7 Sound by SubJects

who Produce the {gt Sound Acceptably and SubJects who
sg7'Sound Unacceptably

 

 

 

Produce e
X1 i5 3? degrees of freedom
81.95“ 80.28° 1.56 58

 

*at .01 level of confidence §_- 2
at .05 level of confidence E.- 2

There is no significant difference in the size of the

angle formed at nasion by the sella-nasion line and

the nasion-pogonian line during the production of the
[Ts_7'sound by subJects who produce the 17e_7 sound

acceptably and subJects who produce the Zfs_7'sound

unacceptably. 0f the subJects who produced the [Ts_7'

sound acceptably, the size of the angle formed at

nasion varied from 89.0 degrees to 76.0 degrees.
The mean for this group was 81.95 degrees. Of the

subJects who produced the [Ts_7'sound unacceptably,

the size of the angle formed at nasion varied from

88.0 degrees to 72.0 degrees. The fact that there

is no significant difference in the size of the angle

formed at nasion during the production of thell‘s47

sound by both groups indicates that the forward move-

ment of the mandible during the production of the 47e_7'

sound is approximately the same for both groups.

-67-

Because there is no significant difference in the
size of the angle formed at nasion by the sella-
nasion line and the nasion-pogonian line during the
production of the (Ts_7’sound by subJects who pro-
duce the [fs_7'sound acceptably and subJects who pro-
duce the Zfs_7'sound unacceptably, it can be con-
cluded that the size of the angle formed at nasion
is not a significant factor in acceptable z7e_7'
sound production.
0f the total measurements made for this study,
only five proved to be statistically different between
subJects who produce the [Ts_7'sound acceptably and
subJects who produce the [rs_7'sound unacceptably. These
were:

1. the distance between the maxillary and mandibular
incisal edges during the production of the [Ts_7'
sound.

2. the distance between the anterior, inferior point
of the tip of the tongue and the anterior mandi-
bular incisal edge during the prdduction of the
[Ts_7’sound.

3. the distance between the lingual reference line
and the anterior mandibular incisal edge during

the production of the [Ts_7’sound.

4. the distance between the highest portion of the

tongue and the palatal plane during the production

of the [fsg7'sound.

-68-

5. the distance between the posterior aspect of the
tongue and the pharyngeal wall during the pro-
duction of the [Ts_7’sound.

The statistical significance of these differences sug-
gests certain clinical implications.

The relationship of the mandibular incisal edge
to the maxillary incisal edge of the subJects who pro-
duced the [Ts_7'sound acceptably was slightly posterior
to and slightly above the maxillary incisal edge. Clin-
ically this would suggest that it would be necessary to
obtain a comparable antero-posterior maxillary and man-
dibular incisal relationship for acceptable [Ts_7'sound
production. In order to obtain this closer antero-
posterior relationship of the maxillary and mandibular
incisal edges for acceptable zfe_7 sound production, the
group with unacceptable [Ts_7'sound production probably
would have to have greater mandibular movement. It is
doubtful that this increased mandibular movement would
greatly affect the size of the angles at sella turcica
or at nasion. It would appear that clinically a closer
antero-posterior relationship of the maxillary and man-
dibular incisal edges should be effected for acceptable
[s] sound production.

The relationship of the anterior, inferior point
of the tip of the tongue to the anterior mandibular
incisal edge of the subJects who produced the [ng7'

sound acceptably was posterior to and slightly above

-59-

the mandibular incisal edge. The relationship of the
highest portion of the tongue to the palatal plane of
the subJects who produced the [Ts_7'sound acceptably was
lower than that of the subJects who produced the [Ts_7'
sound unacceptably. The relationship of the posterior
aspect of the tongue to the pharyngeal wall of the sub-
Jects who produced the 17e_7 sound acceptably was con-
siderably narrower than that of the subJects who pro-
duced the Zfs_7'sound unacceptably. Clinically these
relationships must be considered together because they
all are concerned with tongue posture. All of these re-
lationships indicate that the tongue should be farther
back in the mouth for acceptable z7s_7'sound production.
This would indicate that, if the proper incisal rela-
tionship is effected, it would be plausable to relate
the tip of the tongue to the mandibular incisal edge
for acceptable Zfs_7'sound production. It would appear
that a more retracted antero-posterior tongue posture
should be effected for acceptable [Ts_7 sound production.
The other aspects of tongue posture and struc-
tural positions investigated in this study proved to be
comparable for both groups of subJects. It would appear
that the relationship of the permanent first molars, the
relationship of the anterior, inferior point of the tip
of the tongue to the palatal plane, the relationship of
the highest portion of the tongue to the pterygo-

maxillary fissure line, the velar-pharyngeal closure,

-70-

the angle formed at sella turcica indicating the ver-
tical movement of the mandible, and the angle formed
at nasion indicating the horizontal movement of the
mandible would not be significant factors in the pro-
duction of an acceptable [Ts_7'sound because these re-
lationships were approximately the same for both groups

of speakers.

CHAPTER V
SUMMARY AND CONCLUSIONS
I. SUMMARY

The [Ts_7'sound is one of the most frequently
misarticulated consonant sounds in American English. In
public school speech therapy programs, approximately
two-thirds of the speech cases have difficulty articu-
lating the [Ts_7'sound. Much has been written concern-
ing the apparent physiological production of the [7547
sound, but this information generally has been determined
from casual observation. Exactly what occurs in the pro-
duction of the [Ts_7'sound is not fully known. The pur-
pose of this study was to determine obJectively the dif-
ferences in tongue posture and structural position
during the acceptable and the unacceptable production
of the Zfs_7'sound through cephalometric analysis. The
study was conducted in the Department of Orthodontia,
Eastman Dental Dispensary, Rochester, New York, and was
supported in part by a United States Public Health
Service Grant (# D-107l.) A group of thirty adult and
adolescent speakers having acceptable [rs_7'sound pro-
duction and normal occlusion and a group of thirty

adolescent speakers having unacceptable [Ts_7'sound
-71-

-72-
production were examined. Cephalometric roentgeno-
grams were takna of each subJect during the production
of the [3] sound. Tantalum powder was used as a
radio-opaque media in order to define the anterior re-
gions of the tongue. Tracings of these roentgenograms
were made by a qualified orthodontist. Measurements
designed to specify the exact posture of the tongue in
relation to the anterior structures were made. Statis-
tically significant differences in the measurements of
tongue posture and structural position of speakers who
produce the [Ts_7'sound acceptably and speakers who pro-
duce the [Ts_7'sound unacceptably were found. The
physiologic differences were described, and clinical
implications for the correction of defective [Ts_7'

sound production were discussed.

II. CONCLUSIONS

This study has investigated obJectively the
differences in tongue posture and structural position
between speakers who were Judged as producing the [ISJ7
sound acceptably and other speakers with unacceptable
[Ts_7'sound production. A method of cephalometric
analysis was employed. The results of this investiga-
tion lead to the following conclusions:

1. There is a significant difference in the rela-
tionship between the maxillary and mandibular

incisal edges during acceptable and unacceptable

3.

-73-

production of the [Ts_7'sound. During acceptable
[Ts_7’sound production, the mandibular incisal
edge is placed posterior to and slightly above
the maxillary incisal edge. These two incisal
edges relate very closely. During unacceptable
[5;7'sound production, there are wide discre-
pancies from the forementioned anterior struc-
tural position. In many cases, the maxillary
and mandibular incisal edges do not relate at
all.

There is a significant difference in the hori-
zontal relationship of the tip of the tongue

to the mandibular incisal edge during the
acceptable and unacceptable production of the
[3] sound. During the acceptable [3] sound
production, the tip of the tongue was constantly
posterior to the mandibular incisal edge. Dur-
ing the unacceptable [Ts_7’sound production,

the tip of the tongue was considerably farther
forward in the mouth. In many cases, the tip

of the tongue was anterior to the mandibular
incisal edge.

There is a significant difference in the ver-
tical relationship of the tip of the tongue to
the mandibular incisal edge during the acceptable
and unacceptable production of the [Ts_7'sound.
During acceptable Zfs_7'sound production, the

5.

~74-

height of the tip of the tongue was closely
related to the mandibular incisal edge. In
every case, the tip of the tongue was related
to the mandibular incisal edge. During un-
acceptable [Ts_7'sound production, the tip of
the tongue was higher in the mouth. In most
cases, the tip of the tongue was related to
anterior structures other than the mandibular
incisal edge.

There is a significant difference in the rela-
tionship of the highest portion of the tongue
to the palatal plane during the production of
the acceptable and unacceptable [Ts_7'sound.
During acceptable Zfs_7'sound production, the
tongue is lower in the mouth. It is interest-
ing to note that the highest portion of the
tongue is generally in the area of the pterygo-
maxillary fissure line for both acceptable and
unacceptable [Ts_7'sound production. The
highest part of the tongue is the dorsum of
the tongue, not the tip.

There is a significant difference in the rela-
tionship of the posterior aspect of the tongue
to the pharyngeal wall during acceptable and
unacceptable Zfs_7'sound production. During
acceptable Zfsfi7'sound production, the posterior

aspect of the tongue is much closer to the

-75-
pharyngeal wall. This relationship gives further
proof that the whole tongue is drawn farther
back in the oral cavity during the production
of an acceptable [Ts_7'sound.

6. The following aspects of tongue posture and
structural position are approximately the same
for both acceptable and unacceptable [Ts_7’
sound production:

a. the relationship of the tip of the tongue
to the palatal plane.

b. the relationship of the maxillary and
mandibular permanent first molars to each
other.

c. the relationship of the highest portion of
the tongue to the pterygo-maxillary fissure
line.

d. the complete velar-pharyngeal closure.

e. the forward movement of the mandible.

f. the downward movement of the mandible.

The findings of this investigation indicate that

the antero-posterior tongue posture and the anterior

structural relationship are factors with which the

therapist must be primarily concerned in order to obtain

acceptable [Ts_7’sound production.

These findings indicate a need for greater

obJective research on this subJect. More obJective

information is needed concerning tongue posture and

-76-

structural position during acceptable Zfs_7'sound pro-
duction by subJects who have malocclusions. More ob-
Jective research is needed concerning tongue posture and
structural position during unacceptable [Ts_7'sound
production by subJects who have normal occlusion. More
obJective research is needed concerning tongue habits
and [Ts_7'sound production. This investigation in con-
Junction with correlated research could lead to new

methods for correction of defective [Ts_7'sound pro-

duction.

l.

2.

Sentences used for articulation testing.

APPENDIX

a. We hasten the boys off my garage path to show

which edge young owls could view.

b. Sister eats soup and ice-cream with a spoon.

She also likes to sew her dress.

c. The trees are thick on both sides of the path.

Do you think you can see anything?

d. Little girls like to play with dolls.

boys like to play ball.

e. Harry read a story about a rabbit.

Little

A bird

who had no feathers was in the same story.

f. The bees are always buzzing in my ears.

music makes me lazy.

Their

g. While she washed the dishes the men fished.

Then she looked for shells along the shore.

Words used for articulation testing.

race
lice
bus
fuss
Juice
sink
seal
zag
raise
lies

buzz
fuzz
Jews
zink
zeal
shag
sip

sign
save
seem

sin
sank
sing
fizz
ship
shine
shave
theme
thin
thank

-77..

thing
fish
some
truth
path
myth
lease
lass
zone
with

thumb
truce
pass
miss
leash
lash
shown
wish
sheaf
thief

-78-

3. Permission letter to parents.

Dear Mr. and Mrs. 3

I am doing a research study on why children
produce the "s" sound incorrectly. The results of
the study should give us increased knowledge of this
problem and should help us to meet the needs of our
children in an improved manner. I would like to have
your written permission to have your son, daughter
participate in this study with
me. This will inv01ve approximately one hour of class
time. If you have any questions or wish to talk with
me about this study, please call me at BenJamin Frank—
lin High School on Tuesdays, Thursdays, or Fridays or
at Edison Technical and Industrial High School on
Mondays and Wednesdays. Thank you so much for your

cooperation in this matter.

 

Very truly yours,

(Mrs.) Eleanor H. Burgess
Speech and Hearing Therapist

 

Please fill out the attached form and return it imme-

diately to:

Mrs. Eleanor H. Burgess
Speech and Hearing Therapist
BenJamin Franklin High School
950 Norton Street

Rochester 21, New York

I hereby freely give my permission for my son,

daughter to participate

 

in a study by Mrs. Eleanor H. Burgess on defective "s"

sound production.

Date

 

Signed

 

(Parent or Guardian)

-79...

4. Occlusal evaluation sheet.

 

 

 

 

 

Date
Name Age
Case Number R.O.
Angle Classification: Class I Class II Class III __
Open Bite: Present Absent
Approximate dimensIon between incisal edges in mm
Closed Bite: Present Absent
Mild Moderate Severe
Over-Jet: Present Absent
Approximate a-p aimension between incisors in mm
Spacing: Present Absent
Located between Upper Centrals Yes ____ No ___
Upper R. Central and Lateral Yes ____ No ____
Upper L. Central and Lateral Yes No

Located between Lower Centrals Yes ___. N0 ___

Lower R. Central and Lateral Yes --. N0 ___
Lower L. Central and Lateral Yes ____ N0 ___
Spacing in Buccal Segments Yes ____ N0 __-

Located in Upper __

Located in Lower

 

Crowdin in U er Anterior Region: Present Absent ___
Crogding IE Lower Anterior Region Presen ____Absent ___
Crowding in Upper Buccal Segments: Present ___Absen '___

One side Both sides ___ t
Crowding in Lower BuEEEl Segments: Present ___Absen __

One side ____ Both sides ___
Number of Teeth in Linguaversion in Upper Arch

Identif Upper Teeth in Linguaversion __fi
EstimatZd Degree of Linguaversion of upper teeth

in mms .
Number of TeeEE In Linguaversion in Lower Arch

Identif Lower Teeth in Linguaversion
Estimatgd Degree of Linguaversion of lower teeth

in mms

 

 

 

 

 

 

Rotations in Upper Anteriors: Present Absent
Identify Rotations in Upper Anteriors __ _1_

-80-

Rotation in Lower Anteriors: Present Absent
Identify Rotations in Lower Anteriors -"- '—_'
Number of Missing Teeth in Upper Arch
Identify Missing upper Teeth

Number of Missing Teeth in Lower Arch
Identify Missing Teeth in Lower Arch

 

 

 

 

 

 

Palate Contour: Normal Low and Broad7

High and Narrow Irregular in Contour
Tongue: Can elevate tip to touch outer margin of

upper lip Yes No

Can groove easi'l‘y' __ filth difficulty __ Not at all___
Lips: Normal in appearance ___ Do not approximate in

repose
Normal in Function Hypo tonic upper
Hypo tonic lower
Evidence of perverted swallow Yes No

Evidence of adverse habit patterns observed fies
o

-81-

5. Distance in millimeters between maxillary and
and mandibular incisal edges during the pro-
duction of the [Ts_7'sound.

 

 

Case Acce table Unacceptable
Number [8} sound [3] sound
1 1.0 mm. 2075 mme
2 ”.0 mm. 2.0 mm.
3 2.0 mm. 6.0 mm.
A 4.0 mm. 4.0 mm.
5 14.0 mm. 6075 mm.
6 0.0 mm. 0.0 mm.
7 2.0 mm. 5.5 mm.
8 2.0 mm. 6.0 mm.
9 1.0 mm. 4.0 mm.
10 2.0 mm. 1005 mm-
11 1.0 mm. 4.5 mm-
12 3.5 mm. 6.25 mm.
13 2.75 mm. 2-5 mm-
11!. 3.5 mm. 500 mm.
15 1.5 mm. 10.0 01111.
16 2.0 mm. 2’0 mm.
17 1.0 mm. “‘5 mm‘
18 3.0 mm. 2-0 mm:
19 0.0 mm. 6'5 mm:
20 0.75 mm. 6-0 mm:
21 1.0 mm. 14.0 mm.
22 1.0 mm. 1'75 mm:
23 0.5 mm. 25 mm:
24 1.0 mm. 8.5 mm-
25 0.5 mm. 5.0 mm.
26 2.5 mm. 2'5 “1"“
27 1.7 mm. 3-0 “““°
28 1.5 mm. 6.5 mm.
29 1.0 mm. 5'5 mm:
30 0.0 mm. 7'0 “m“

-82-

6. Distance in millimeters between the maxillary and
mandibular permanent first molars during the pro-
duction of the [Ts_7'sound.

Case Acce table Unacceptable
Number [fajg

sound [Ts_7'sound

 

1 2.0 mm. 0.0 mm.
2 1.0 mm. 3.0 mm.
3 1.0 m. 2.0 mm.
LI: 000 mm. 1.0 mm.
5 1.0 mm. 2.5 mm.
6 2.5 mm. 0.0 mm.
7 0.0 mm. 1.0 mm.
8 1.0 mm. 0.0 mm.
9 1.0 mm. 3.75 mm.
10 2.0 mm. 0.0 mm.
11 2.5 mm. 1.0 mm.
12 0.0 mm. 000 mm.
13 0.0 mm. 0.5 mm.
14 0.5 mm. 3.0 mm.
15 1.5 mm. 3.0 mm.
16 2.0 mm. 000 mm.
17 0.5 mm. 1.5 mm.
18 0.5 mm. 005 mm.
19 0.0 mm. 4.0 mm.
20 0.5 mm. ‘005 mm.
21 0.5 mm. 0.5 mm.
22 0.0 mm. 0.0 mm.
23 1.5 mm. 0.0 mm.
24 0.5 mm. 0-0 mm.
25 2.5 mm. 3.0 mm.
26 1.5 mm. 0.0 mm.
27 1.5 mm. 0.0 mm.
28 0.0 mm. 0-5 mm-
29 1.0 mm. 0.0 mm.
30 2.25 mm. 1-0 mm-

~83-

7. Distance in millimeters between the anterior,
inferior point of the tip of the tongue and the
anterior mandibular incisal edge during the pro-
duction of the [Ts_7'sound.

Unacceptable
sound (Tag? sound

Case Acce table
Number ZIP-5'

 

1 ~5.0 mm. +1.0 mm.
2 -3.5 mm. '500 mm.
3 -5.0 mm. +3.0 mm.
4 -5.0 mm. +3.5 mm.
5 -9.0 mm. +7.0 mm.
6 -11.5 mm. -)-|-.O mm.
7 -5.0 mm. +4.5 mm.
8 -500 mm. -5°5 mm.
9 ~5.5 mm. ”-5 mm:
10 ~3.0 mm. -4.0 mm.
11 -4.25 mm. 0.0 mm.
12 “5.75 mm. 0’0 mm'
13 -u.o m. 0-0 “1““
1,4 .2.0 mm. ”2.5 M.
15 44.5 mm. +2.5 mm:
16 -3.5 mm. ‘2-0 “1m“
17 4.5 mm. -56 ml"-
18 ‘500 mm. -1.5 mm.
19 ”8.0 mm. +6’5 mm.
20 -6.5 mm. '“°° mm'
21 -3.5 mm. ‘“'° "““°
22 -3.5 mm. '2-5 mm:
23 ~7.0 mm. -6.0 mm.
2a -3.0 mm. + '5 mm'
25 -3.0 mm. +fi'5 mm'
26 “305 mm. -8.0 mm.
27 “’200 mm. - .0 m.
28 ’600 mm. +3.5 mm.
29 -200 me - .3 mm.

-6.0 mm. 0' mm'

-84-

8. Transposed scores of the measurement of the distance
in millimeters between the anterior, inferior point
of the tip of the tongue and the anterior mandibular
incisal edge during the production of the [Ts_7 sound

Case Acce table Unacceptable
Number fa} sound [8] sound

 

HHHHHHHHHH
wmfimmtmeoomfimmszH

MN“)
POI-‘0

NNNMNMM
\OCO'N‘lChUl-P-‘UO

on
O

eeeeee
WU'I

O\CDJ='CDO\N~IUJ O\O\UO NU'IU'I GNU”! ODO‘I—TU'I'K'I -I-‘-'U1U1U" I-‘U'IU'I mm
0
OOOOU‘OOOU'IU'IU'IOOU'IUTU'IOONNOU'IOOU'IOOOUTO

I-'I-'I-‘ I-‘
:ONWWWH
e e e e e

H H

HHH

H H
OHWNONS'm-fi'kmmONCD-PODMNOOOONF:
0

HH
0.00....

H

OU‘OOOU'IU'IOU'IOOU'IU'IU'IOU'IUIOOOOUVU'IU'IOOUTOOO

I-'

-85-

9. Distance in millimeters between the lingual
reference line and the anterior mandibular edge
during the production of the Zfs_7'sound.

Case Acce table ' Unacceptable
Number [Ts_§'

sound [TS_7'sound

— -._» -_.— --. .-_-_._._ L....- W~.-,-__---— .._-_.—_ -_ M— _. _-..-.- ._- ———-——--- _._.-._..._ . - . - _ . _J_ _

   
 
    

1 +2.0 mm. +0.5 mm.
2 +1.0 mm. -O.5 mm.
3 +1.0 mm. +2.5 mm.
4 +1.0 mm. +2.0 mm.
5 0.0 mm. +4.0 mm.
6 +0.5 mm. -l.0 mm.
7 0.0 mm. +2.0 mm.
8 +1.0 mm. ’200 mm.
9 +2.0 mm. 0.0 mm.
10 0.0 mm. +2.0 mm.
11 +1.5 mm. +305 mm.
12 +2.0 mm. +4.25 mm.
13 -1.0 mm. +2.0 mm.
14 +1.0 mm. +2.5 mm.
15 +3.0 mm. +2.0 mm.
16 -2.0 mm. +0.5 mm.
17 0.0 mm. +4.0 mm.
18 -1.0 mm. +0.75 mm.
19 ~1.0 mm. +1.75 mm.
20 , +2.0 mm. -1.0 mm.
21. +1.5 mm. “300 mme
22 +2.0 mm. +3.0 mm.
23 +2.5 mm. +4.0 mm.
24 +1.0 mm. +5.0 mm.
25 +0.75 mm. +4.5 mm.
26 0.0 mm. +2.0 mm.
27 +1.0 mm. +2.8 mm.
28 0.0 mm. + . mm.
29 0.0 mm. +3°5 mm-
30 0.0 mm. +2-0 mm:

-86-

10. The transposed scores for the distance in milli-
meters between the lingual reference line and the
anterior mandibular incisal edge during the pro-
duction of the zfsd7 sound.

Case Acce table Unacceptable
Number ZTs_; sound zfs_7 sound

 

OOO00-4CUTOUWOOOOOOOOOU'IOOOOUTOOOOO

\OCDNO‘xW-SITWMH!

0
U1

omooomooooouqohomommooooooommm

0
m
can.

H
W

k-P-PUW «hf-Pm O\O\U1 mun» kip-40100 OUT 41'0“.” rttmmm C\
0

ON moo-4 CDKD CD4 n—awm #(D-F—‘OQOCDKI ON-P‘h) O\UJCDO\O\UO 12'
O

-87-

11. Measurements in millimeters of the anterior,
inferior point of the tip of the tongue to the
palatal plane during the production.of the [7947

 

sound.
Case Acce table Unacceptable
Number [6335 sound [fs47 sound
1 30.0 mm. 25.0 mm.
2 28.0 mm. 32.0 mm.
3 33.0 mm. 2400 mm.
4 24.0 mm. 27.75 mm.
5 30.0 mm. 30.5 mm.
6 32.5 mm. 2900 mm.
7 33. 0 mm. 28.75 mm.
8 23. 0 mm. 2505 mm.
9 31+. 0 mm. 3000 mm.
10 26. 0 mm. 21.0 mm.
11 31.0 mm. 30.0 mm.
12 37.0 mm. 25.0 mm.
13 33.5 mm. 30-5 mm
In 32.0 mm. 33.5 mm.
15 27.0 mm. 29.0 mm.
16 32.5 mm. 32-5 mm-
17 32.0 mm. 33°75 mm.
18 hl 5 mm. 31.0 mm.
19 36. 0 mm. 37.5 mm.
20 33.0 mm. 24.0 mm.
21 28.0 mm. 23: .0 mm.
22 2905 mm. 2L.- 5 mm.
23 32.0 mm. 2 .5 mm.
24 25.0 mm. 32' '5 mg.
25 31.5 mm. '5 mm'
26 27.0 mm. 33 ;5 3m
27 ' 23.0 mm. 38.0 mm.
29 29.0 mm. 34.0 mm.

30 28.0 mm.

-88-

12. Measurements in millimeters of the highest portion
of the tongue to the palatal plane during the pro-

duction of the [s] sound.

 

Case Acce table Unacceptable
Number [303$ sound [fs47 sound
1 12.2 mm. 9.0 mm.
2 13.7 mm. 18.5 mm.
3 13.5 mm. 18.5 mm.
4 10.0 mm. 15.0 mm.
5 16.2 mm. 8.75 mm.
6 15.0 mm. 12.0 mm.
7 21.0 mm. 16.0 mm.
8 13.0 mm. 12.5 mm.
9 18.0 mm. 14.5 mm.
10 10.5 mm. 905 mm.
11 12.0 mm. 8.5 mm.
12 17.7 mm. 13.5 mm.
13 17.0 mm. 13.0 mm.
14 15.0 mm. 13.75 mm.
15 13.5 mm. 19.5 mm.
16 11.0 mm. 11.5 mm.
17 10.8 mm. 8.5 mm.
18 111.0 mm. 18.2 mm.
19 21.0 mm. 14.5 mm.
20 21.5 mm. 9.0 mm.
21 11.5 mm. 15.0 mm-
22 16.0 mm. 16.5 mm.
23 26.0 mm. 12.5 mm-
2H 11.5 mm. 15-5 -mm'
25 10.0 mm. 17.0 mm-
26 23.0 mm.
27 16.0 mm. 5'5 mm-
28 15.0 mm. 11.0 mm.
29 16.0 mm. 14.0 mule
17.0 m.

30 1M.0 mm.

-89-

 

13. Measurements in millimeters of the distance
between the highest portion of the tongue and
the pterygo-maxillar fissure line during the
production of the Zf§_7 sound.
Case Acce table Unacceptable
Number [8} sound [5] sound
1 10.0 mm. 19.0 mm.
2 6.0 mm. 12.0 mm.
3 0.5 mm. 52.5 mm.
1‘» 6.5 mm. 1605 mm.
5 13.0 mm. 8.0 mm.
6 15.2 mm. 14.5 mm.
7 39.5 mm. 10.0 mm.
8 16.0 mm. 8.5 mm.
9 1.5 mm. 7.5 mm.
10 2.0 mm. 18.5 mm.
11 M.O mm. 1100 mm.
12 6.0 mm. 12.5 mm.
1 7.0 mm. 1.0 mm.
1 . 7.5 mm. 6.0 mm.
15 8.0 mm. 4.5 W“-
16 15.0 mm. 29-5 mm-
17 14.0 mm. 12.5 mm.
18 3.0 mm. 28.0 mm-
19 1.0 mm. lg-O mm-
20 0.75 mm. .0 mo
21 0.0 mm. 32.0 mm-
22 2.0 mm. '8 mm-
23 1.2 mm. 30 mm.
21 111.0 mm. ”-3 mm‘
25 2.0 mm. ' ““"°
10.0 mm.
3? no.0 mm. 130(5) :12
28 2'0 mm. 2h.5 mm.
29 “'00 mm. 3.0 mm.
10.0 mm. . .

-90-

14. Measurements in millimeters of the distance
between the posterior aspect of the tongue and
the phar ngeal wall during the production of
the [3} sound.

 

 

Case Acce table Unacceptable
Number zfs_5 sound [Ts_7 sound

1 14.5 mm. 32.0 mm.

2 13.5 mm. 21.0 mm.

3 10.0 mm. 32.0 mm.

4 19.0 mm. 2§.5 mm.

5 1905 mm. 26.8 mm.

6 19.0 mm. 18. mm.

7 26.5 mm. 1 .5 mm.

8 19.0 mm. 9.5 mm.

9 18.0 mm. 28.0 mm.
10 900 mm. 53.5 mm.
11 6.0 mm. 23.8 gm.
12 5.0 mm. 21.75 mm.
13 12.5 mm. 10.0 mm.
14 7'0 mm' 21.5 mm:
15 8.0 mm. 17-5 mm.
16 15.0 mm- 32.5 mm.
17 10.0 mm. 13-5 mm.
18 15.0 mm. 17:5 mm.
19 900 mm‘ 16.0 mm.
20 11.0 mm. 36.0 mm.
21 18'0 mm. 14.0 mm.
22 11.0 mm. 15.0 mm.
23 13.5 mm. 11.5 mm.
21‘ 1900 mm. 17.0 mm.
25 7.0 mm. 27.5 mm.
26 23.0 mm. 15.0 mm.
27 28'0 mm. 8.0 mm.
28 13'? 3% 24-5 mm.
29 1h.0 mm. 19.5 mm.

-91-

15. Scores for the completeness of the velar—
pharyngeal closure during the production
of the [Tsi7’sound. If the closure was
complete, t was recorded as zero.

 

Case ' Acce table Unacceptable
Number [Ts_$'sound [7947 sound
1 o 8
2 o
3 0 0
4 O 0
5 0 0
6 O 0
7 0 0
8 0 O
9 0 °
10 0 0
11 O 0
12 0 0
13 0 8
l4 0 O
15 0 o
16 O 0
17 0 o
18 0 o
19 0 o
20 0 o
21 0 o
22 8 o
33 o g
25 O o
26 O 0
27 0 o
28 g o
29 O o

-92-

16. Measurement in degrees of the size of the angle
formed at sella turcica during the production
of the Zfs‘7 sound.

Unacceptable

Case Acce table
_J; sound Zfs_7 sound

Number [is

I

 

 

fl

\omxloxmr-‘wmr—I

OOOOOOOOOOO

O\O\O\O\O\O\O\C\O\O\O\O\
ODNIUON [DU‘U'I (DODKI O\\O

O\O\O\
M04?
0 O

OUlU'i

ON

0

O
OO

63.

60.5
63.0
61.5
67.0
62.5
62.0
64.0
63.5
57.0
68.0
68.0
61.0

0\
U0

0
m
U1

OO'OOOOO00000000000000000000000

wmmpmmHmW‘me
00.000.000.000 0
WOOOOOOOOU‘U‘U‘OOOCONWOONOWOOOWNW

0vq~aowmcnowmaufiChovmmnowmvigyncnownovqChowmvwour
opzmmmqwommmmmmmo

U1

000000000000OOOOOOOOOOOOOOOOOO

-92-

16. Measurement in degrees of the size of the angle
formed at sella turcica during the production
of the [Ts_7'sound.

 

 

Case Acce table Unacceptable
Number [Ts_§'sound [Ts_7 sound
1 69.0 2 65.5 :
2 66.0 0 65.2 .
3 67.0 o 2705 o
n 68.0 . 62.0 .
5 68°0 ° 61.8 °
6 65.0 o . o
8 62'0 ° 64°25°
9 67'0 o 62.0 °
10 63.0 . 6 '0 .
11 67.0 . 63.5 .
12 68.250 64.75“
13 64.5 ° 59.0 °
14 6905 o 66.0 o
15 62.0 o 68.0 o
16 60.0 . 65.0 .
l7 63.0 O 65.0 o
18 63‘ o 68. o
19 60.5 O 65.5 o
20 63.0 o 58. a
21 61.5 .0 0
67.0 0 70. 0
22 o 6100
23 6205 O 67.0 0
24 62.0 o 65.0 o
25 64.0 o 68.0 °
26 6305 o 65.0 °
27 57.0 o 74.0 o
28 68.0 o 74.0 o
29 68°C . 69.5 °
30 61.0

Unacceptable

[Ts_7'sound

[Ts_7’sound

-93-
table
sound

.fi

angle formed at nasion during the acceptable and
Acce

Raw scores for the measurement of the size of the
unacceptable production of the

 

17.
Case
Number

OOOOOOOOO0.000000.00°.0,000000.0.000

5
5000000000000
assassssmmmemmmmwmaamaaamagmaa

1 0
W&%WWW&WW8W8878888888788888778

12314567890123“5678901234567890
111111111122222222223

BIBLIOGRAPHY
BOOKS

Angle, Edward H. Malocclusion 9£_the Teeth. Phila~
delphia: S. S. White Dental Manufacturing
Company, 1907.

 

 

Berry, Mildred F. and Eisenson, Jon. Speech Disorders
Principles and Practices g£_Therap%. New York:
Appleton-Century—Crofts, Inc., 95 .

 

 

“Bloomer, H. Harlan. "Speech Defects Associated with
Dental Abnormalities and Malocclusions,"
Handbook 9§_Speech Pathology. ed. Lee E.
Travis. New York: Appleton~Century-Crofts,
‘4 ~-/ Inc., 19570

 

Eisenson, Jon and Ogilvie, Mardel. Speech Correction
in_the Schools. New York: The MacMillan
Company,'1957.

 

 

g. Fairbanks, Grant. Voice and Articulation Drillbook.
New York: Harper and Brothers, 1940.

-/Judson, Lyman S. and Weaver, Andrew T. Voice Science.
New York: Appleton-Century-Crofts, Inc., 1942.

 

McNemar, Quinn. Psychological Statistics. New York:
John Wiley and Sons, Inc.;W1949.

 

Powers, Margaret H. "Functional Disorders of Articu-
lation-Symptomatology and Etiology," Handbook
9£_Speech Pathology. ed. Lee E. Travis. New
York: Appleton-Century—Crofts, Inc., 1957.

 

Travis, Lee E. Speech Pathology. New York: D.
Appleton-Century and Company, 1931.

 

Van Riper, Charles. Speech Correction Principles and .
Methods. New York: Prentice-Hall} lnc.,‘1§47.

 

West, Robert, Ansberry, Merle, and Carr, Anna. The
Rehabilitation 9; Speech. New York: Harper
and Brothers, Publishers, 1957.

-9u-

 

-95-

, Kennedy, Lou, and Carr, Anna. The Rehabili-
tation of S eech. New York: Harper and Brothers,
. I93 .

PublishEFs

Wood, K. S. "Terminology and Nomenclature, " Hand-
book of Speech Pathology. ed. L. Travis. New
York: ”Appleton-Century-Crofts, Inc., 1957.

ARTIC LES AND PERIODIC AIS

Barclay, A. E. and Nelson, W. "The X-ray Analyses of
the Sounds of Speech, " Journal of Radiography,
3 (July, 1922), 277- 280.

 

Benediktsson, Ellen. "Variation in Tongue and Jaw
Position in '8' Sound Production in Relation to

Front Teeth Occlusion," Acta Odontolo ica
Scandinavica, 15 (January, 19585, 275- 303.
Bernstein, M. "Relation of Speech Defects and Mal-

occlusion," American Journal of Orthodontia,
40 (February, 1954), 149-150.“

P/f/ “at

 

 

 

Bloomer, H. H. "Speech as Related to Dentistry,"
Journal of the Michi an State Dental Association,
November, “1958}, 2584267.

Blyth, Peter. "The Relationship between Speech, Tongue
Behaviour, and Occlusal Abnormalities,“
Dental Practitioner and Dental Record, 10
(September, ’1959), 11:22. (Institute of
Dental Surgery, University of London, Eastman
Dental Hospital).

 

 

' Fairbanks, Grant and Lintner, Mary Van Horn. "A Study
of Minor Organic Deviations in 'Functional'
Disorders of Articulation: 4. The Teeth and

Hard Palate, " Journal of S eech and Hearin
Disorders, 16 (September, I951), 273- 279.

, and Spriestersbach, D. "A Study of Minor
Organic Deviations in 'Functional' Disorders
of Articulation: 1. Rate of Movement of Oral

Structures," Journal of S eech and Hearing
Disorders, 15 (January, 1950}, 60-69.

Frowine, V. K. and Moser, H. "Relationship of Dentition
and Speech, Journal of the American Dental
Association, 31 (Jul , ”1944), 1081~ 1090.

 

 

 

 

-96-

Fymbo, L. H. "The Relation of Malocclusion of the
Teeth to Defects of Speech," Archives 9; Speech,
1 (June, 1936), 204-216. ,

Gardner, A. F. "Dental, Oral, and General Causes of
Speech Pathology," Oral Surgery, Oral Medicine,
and Oral Pathology, 2 (June, 1949), 742-751.

 

 

JGreen, J. S. "Anomalies of the Speech Mechanism and
Associated Voice and Speech Disorders," Neg
York State Journal g£_Medicine, 45 (March,
1915) , hos-H18. W

 

, "Speech Defects and Related Oral Anomalies,"
Journal 9£_the American Dental Association and
the Dental Cosmos, 24 (December,19377. 1969-1974.

 

 

 

Hall, Margaret E. "Auditory Factors in Functional
Articulatory Speech Defects " Journal g£_§§-
ceptional Education, 7 (1938),’IIE:138.

Holbrook, R. T. and Carmody, F. J. "X-ray Studies of
Speech Articulations," Modern Philology,
20 (1937). 187-273.

Palmer, Martin. "Orthodontics and Disorders of Speech "
American Journal 9£_0rthodontics, 34 (July, 1948L
579-5880

Peterson, Gordon. "Speech and Hearing Research,"
Journal of Speech and Hearing Research, 1

(March;'1§58), 3-11.

Rathbone, J. S. and Snidecor, J. C. "Appraisal of Speech
Defects in Dental Anomalies with Reference to
Speech Improvement," The Angle Orthodontist,
29 (January: 1959): 54-59.

Roe, V. and Milisen, R. "The Effect of Maturation u on
Defective Articulation in Elementary Grades,‘
Journal g£_§peech Disorders, 7 (1942), 37-50.

 

 

 

 

 

 

Russell, G. 0. "First Preliminary X-ray Study,"
Journal of the Acoustical Society 9§_America,

5 (April:~1934), 237—251.

Sayler, H. K. "The Effect of Maturation upon De-
fective Articulation in Grades Seven through
Twelve," Journal of Speech and Hearinngis-

orders,.1ofi'(1949)?"202-207.

Van Thal, J. "The Relationship between Faults of
Dentition and Defects of Speech," Proceedings

 

 

 

 

-97-

g: the Second International Congress of
Phonetic Sciences, London, (1936), 254:255.

Wolf, I. J. "Relation of Malocclusion to Sigmatism,"
American Journal 9f Diseases 9; Children,
54 (September, 1937), 520-528.

 

UNPUBLISHED MATERIAL

Herman, George. "A Study of Palate Shape and Its
Characteristics in Lispers," Unpublished Mas-
ter's thesis, University of Michigan, (May,
1943).

ROOM USE UM!

 

‘5 gm Y 1 " f '1
1"" l l 7"}K} w-‘I-.—W
w...

 

 

 

W- , my;

 

 

“7:717:77 1 71777111777177 {1111:1115

     

'li