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This is to certify that the

thesis entitled

 

AERODYNAMIC EVALUATION OF THE CONNECTED DISCOURSE

Date

OF NORMAL-HEARING AND SEVERELY TO PROFOUNDLY

HEARING—IMPAIRED ADULTS

presented by

Peter Feudo, Jr.

has been accepted towards fulfillment
of the requirements for

M.A.

 

August 11, 1978

 

 

degree in Andi°108Y & Speech

LIBRARY

Michigan State
University '

Sciences

5 gég. s—‘k

Major professor

 

AERODYNAMIC EVALUATION OF THE CONNECTED DISCOURSE
OF NORMAL-HEARING AND SEVERELY TO PROFOUNDLY

HEARING-IMPAIRED ADULTS

BY

Peter Feudo, Jr.

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements

for the degree of
MASTER OF ARTS

Department of Audiology and Speech Sciences

1977

Accepted by the faculty of the Department of Audiology
and Speech Sciences, College of Communication Arts,

Michigan State University, East Lansing, Michigan.

September 26, 1977

\"‘\—-———cg~c \— i ‘ \.\\

 

Linda L. Smith, Ph.D.
Chairperson

\L [/ givq

 

Leo V. Deal. Ph.D.

Paul A. Cooke, M.S.

ABSTRACT

AERODYNAMIC EVALUATION OF THE CONNECTED DISCOURSE
OF NORMAL-HEARING AND SEVERELY TO PROFOUNDLY
HEARING-IMPAIRED ADULTS

by
Peter Feudo, Jr.

The purpose of this study was to investigate
aerodynamic characteristics of connected discourse produced
by normal-hearing and severely to profoundly hearing-
impaired adults. Eight normal-hearing and eight orally
trained hearing4impairedadults participated. Each subject
read a total of eighteen sentences. Six sentences were
five syllables in length; six sentences were ten syllables
in length, and six sentences were fifteen syllables in
length. For a spontaneous speech sample, each subject des-
cribed the activities depicted in a picture of a pet shop
scene. All utterances were sensed by a pneumotachograph
and recorded by an Optical oscillograph. A simultaneous
audborecording was made. Inspiratory and expiratory vol-
'umes and expiratory time were measured. Three judges
assessed the word intelligibility of the hearing-impaired
speakers' utterances.

The results indicated that the hearing-impaired

subjects displayed greater ranges of inspiratory air

volumes and spontaneous expiratory air volumes and

greater expiratory time than the normal hearing subjects.
Additionally, in going from contrived to spontaneous
utterances, the hearing—impaired subjects varied expiratory
air volumes with a systematic change in speech intelligi—
bility. The therapeutic importance of these results was
discussed in support of increasing emphasis on aerodynamic

controls for developing the speech of the hearing-impaired.

LIST OF

TABLES .

LIST OF FIGURES

Chapter

I.

II.

III.

IV.

V.

TABLE OF CONTENTS

INTRODUCTION . . . .

Statement of the Problem . .

EXPERIMENTAL PROCEDURES . . .

Subjects.
Stimuli .

Instrumentation . .

Method .
Analysis 0

RESULTS .

Speech Intelligibility

f the Data

Inspiratory Data . .

Expiratory Volume Data

Expiratory
DISCUSSION

SUMMARY .

Time Data

LIST OF REFERENCES . . . . .

APPENDI

A.
B.

CES . . .

Auditory Thresholds for Pure Tone Averages

Results of Individual

Subject
Subject
Subject
Subject
Subject
Subject
Subject
Subject

#l(male) .
#2(male) .
#3(female)
#4(female)
#5(female)
#6(female)
#7(female)
#8(female)

ii

Hearing

Evaluations .

Page
iv

vi

10

ll
13

l4
l7

l7
19
24

26
3O
39
41
45

46
48

49
50
51
52
53
54
55
56

C.
D.
E.

Case Histor and Release Form .
Sentence Stimuli . . . . . . .
Instructions. . . . . . . . . .

iii

LIST OF TABLES

Table Page

1. The number of errors in word intelligibility
scored by three judges and the mean percent
correct word intelligibility for hearing-
impaired subjects . . . . . . . . . . . . . 18

2. The mean number of inspirations taken by
hearing-impaired subjects for each of
three sentence lengths. . . . . . . . . . . 19

3. The mean inspiratory air volume and stan-
dard deviation (SD) (in cc) for each of
three sentence lengths for normal-hearing
subjects and hearing—impaired subjects. . . 22

4. The mean overall per syllable inspiratory air
volume and standard deviation (SD) (in cc),
expiratory air volume (in cc), and expira-
tory time (in sec) for normal-hearing sub-
jects and hearing-impaired subjects . . . . 23

5. The mean expiratory air volume and standard
deviation (SD) (in cc) for each of three
sentence lengths for normal—hearing sub-
jects and hearing-impaired subjects . . . . 25

6. The mean expiratory time and standard deviation
(SD) (in sec) for each of three sentence

lengths for normal-hearing subjects and hear-
ing-impaired subjects . . . . . . . . . . . 27

7. The mean and standard deviation (SD) of data
for hearing-impaired subject #8 (female). . 28

8. The percent correct word intelligibility and
the mean number of inspirations for the poor
intelligibility hearing-impaired subjects
during the sentence condition . . . . . . . 30

iv

9. The change in intelligibility and expiratory
air volume (in percentage) for six hearing-

impaired subjects. . . . . . . . . . . . . . . . 35

LIST OF FIGURES
Figure Page

1. Schematic representation of instrumental
array 0 O Q Q . C C C Q C ' C O C O O Q C O O 12

2. Schematic representation of the production of
a lS-syllable sentence by normal—hearing
subject #7(female) and by hearing-impaired
subject #4(fema1e) . . . . . . . . . . . . . 32

vi

CHAPTER I

INTRODUCTION

The speech production of hearing-impaired indi-
viduals has been a tOpic reported in the literature for
many years. The majority of the literature which has
described the speech production of the hearing-impaired
has utilized perceptual bases for such descriptions. Per-
ceptual comparisons have been made of the speech of hear-
ing-impaired speakers and normal-hearing speakers rather
than judgments.<xf comparisons of objective measures of
speech production. By their nature, the perceptual com-
parisons have been unable to describe on-line dynamics of
speech production. Thus, perceptual descriptions of the
speech of the hearing-impaired have served to establish
the characteristics of the end-product of speech while
inferring physiologic occurrences in speech production.

The study by Hudgins and Numbers (1942) was an
example of perceptually-based descriptions of the speech
of the hearing-impaired. Errors such as (1) failure to
produce accurate voiced-voiceless distinctions, (2) final
consonant omissions, (3) excessive nasality, (4) vowel
prolongations, and (5) abnormal prosodic patterns were

established as common in the speech of the hearing-impaired.

l

2

Hypernasality (Colton and Cooker, 1968; DiCarlo, 1968),
abnormally high pitch and decreased control of loudness
(Angelocci, et al., 1964), and decreased rate of speech
(Colton and Cooker, 1968; DiCarlo, 1968) were noted per-
ceptually and in acoustic measures of hearing-impaired
speakers. Discussions of these descriptions inferred
physiologic disturbances. They lacked substantiation by
direct measurement of physiologic occurrences in speech
production.

In an attempt to document physiologic distur-
bances in the speech of the hearing-impaired, Hudgins
(1934) recorded "air flow rate" as a relative measure.
The instrumentation available for his experimentation
utilized tracing deflections of the chest wall and stomach
wall. The amplitudes of these deflections per second for
each syllable provided "air flow rate" or the movement of
body walls. This relative measure was coupled with re-
cords measured for phrase time and with his own visual
analysis. From this, Hudgins qualified a unique set of
"speech coordinations of deaf subjects." He noted (1)
prolonged vowels, (2) addition of syllables at points
where two consonants separate syllables, (3) slow rate of
utterance, (4) no distinction between voiced and voiceless
stop consonants, and (5) hypernasality. The degree of
abnormality was more extensive for prelingually hearing-
impaired subjects, and this abnormality increased with

increases in degree of hearing loss. Rawlings (1935, 1936)

replicated Hudgins' experiment utilizing a 50 syllable
paragraph for the speech stimuli as opposed to Hudgins'
use of phrases of various lengths. Rawlings' conclusions
were similar to those of Hudgins, but he additionally noted
that the hearing-impaired sujbects were pausing for
breaths more often than normal-hearing subjects and at
places other than sentence boundaries. In addition, the
time factors of rate of utterance, sentence duration.
phonation duration, and interphonation interval were
confirmed to be significantly increased in hearing-
impaired children (Voelker, 1935; 1938).

Since that time, aerodynamic measurement has been
established as one method of directly evaluating physiolo-
gic occurrences in speech production. Several aerodynamic
parameters have been determined sensitive to certain
physiologic occurrences in speech production. One parame-
ter is air flow rate. Air flow rate has been established
as a function of expiratory effort and airway resistance.
Flow rate events associated with speech are the direct
result of structural size and movements beginning with the
expiratory forces utilized in generating an air volume as
a sound source and occurring at any point of oropharyngeal
musculoskeletal valving (VanHattum, 1974). Air flow rates
during speech have fluctuated in correspondence to changes
in vocal intensity and to selective changes in pitch
(Isshiki, 1965; Subtelny, et al., 1966; McGlone, 1967;

1970). Characteristic patterns of air flow rate, in terms

of volume velocity, have been observed in speech in associa-
tion with (1) the presence or absence of voicing, (2) the
articulatory gesture produced, and (3) phonetic position of
a consonant within a speech segment (Isshiki and Ringel,
1964).

The establishment of air flow rate as a viable
measure of aerodynamic functioning in normal speakers is
particularly applicable to research with hearing-impaired
speakers. Recently, Hutchinson and Smith (1974) investi-
gated three aerodynamic measures in prelingually hearing-
impaired young adults. The hearing loss of each subject
was poorer than 65 dB HTL (P. T. A.). Four subjects
communicated primarily manually. Hutchinson and Smith
measured air flow rate, intraoral air pressure, and intra-
oral air pressure duration. The speech stimuli consisted
of 12 monosyllabic words beginning with cognate pairs of
stOps and fricatives. The hearing-impaired adults produced
higher mean intraoral air pressures and greater pressure
durations for all consonant classes when compared to pre-
vious normative data. While mean air flow rate values
did not reveal quantitative differences for any consonant
class, the authors noted *considerable inter-and intra-
subject variability (page 5) in the hearing-impaired.

This variability was apparent also in the intraoral air
pressure and air pressure duration data. From visual

inspection of the data and the aerodynamic recordings

three qualitative patterns, specific to the hearing—
impaired, were revealed as follows:

Pattern #1--Consonant cognate pairs were produced
similarly both quantitatively and qualitatively, resulting
in blurred voiced-voiceless distinctions.

Pattern #2--Changes in manner of articulation
were evidenced in the use of stOps in place of fricatives,
a result of the absence of air flow during build—up of
intraoral air pressure. These changes occurred less
frequently in the substitution of fricatives for stops, a
result of the continuation of air flow throughout the dura-
tion of the pressure build-up for an initial stop phoneme.

Pattern #3--Inefficient air stream valving was
characterized by the presence of high flow rates where
low flow rates were expected and, conversely, by the
presence of low flow rates where high flow rates were
expected.

Gilbert and Dixon (1974) investigated oral and
nasal air flows of hearing-impaired subjects during their
production of stop consonants in pre-, inter-, and post-
vocalic positions. They reported characteristic nasal
profiles and ranges of mean peak nasal values falling be-
tween mean peak nasal flow rates for normal-hearing and
cleft palate speakers established in previous studies.
Gilbert and Dixon refer to the cinefluorographic data of

McClumpha (1966) to substantiate their results. McClumpha

found considerable variation in five hearing—impaired
speakers in extent and in duration of velopharyngeal open—
ing during the production of VC syllables. Moll (1960)
demonstrated that velopharyngeal valving is affected by
phonetic environment and is different for sustained sounds
than for valving in connected speech. Bzoch (1965) has
indicated that normal speakers tend to break their velo-
pharyngeal seal when their rate of speech is reduced. In
their study of perceived nasality in the hearing-impaired,
Colton and Cooker (1968) reported that judges declared 5
of 7 speech samples of normal hearing subjects to be
hypernasal when uttered in a word-by-word fashion. This
further established rate of utterance as a variable con-
tributing to changes in nasality.

Rate of utterance, vowel duration, and phrasing
appear critical to physiologic measures of speech produc-
tion supporting the speculations of Hudgins and others of
his time. VanHattum and Worth (1967) found duration of
air flow to vary in relationship to voicing and phonetic
position in the same manner reported previously for air
flow rate. To utilize more information in a single mea-
sure, VanHattum and Worth manually integrated air flow
records to obtain expelled volumes. The majority of pre-
vious data was peak data gathered from syllabic stimuli.
VanHattum and.Worth(1967) noted that voiceless consonants

displayed considerably more expelled air volume than

voiced consonants. Manner of articulation appeared to
display results similar to those of Isshiki and Ringel
(1964). Initial consonants were more variable than final
consonants, although they were longer in duration and
utilized larger expelled air volumes. The expelled air
volumes for individual sounds tended to be less during
sentnece production than during the production of

single syllables. Duration was generally shorter for the
sounds in sentences. Warren and Wood (1969) confirmed
the results of VanHattum and Worth with regard to expelled
air volumes and their relationshiOp to voicing and manner
of articulation; they also establiShed significant male-
female volume differences.

Thus, aerodynamic measurement has been proven to
be a viable quantitative and qualitative gauge of the
physiologic dynamics of speech production in normal-
hearing and hearing-impaired subjects. Many variables have
not been tested in hearing-impaired subjects. Measurement
of volume data, accomplished by integrating air flow rate
and time, would utilize a combination of sensitive informa-
tion represented as a single parameter. This single para-
meter would integrate two variables previously suggested
as varying between normal-hearing and hearing-impaired
populations. Volume data appear sensitive to voicing and
manner of articulation as well as to utterance length and

duration. Again, research has suggested inter- and

intra-subject group variability related to these factors,

although this has not yet been documented in on-line

experimentation.

Statement of the Problem

 

Because aerodynamic measurement has not occurred

under varied lengths of utterances and because inspiratory

and expiratory air volumes have not been measured in the

hearing-impaired, this thesis investigated the following

questions:

(1)

(2)

(3)

(4)

(6)

What volume of air is inspired by normal-
hearing and hearing-impaired speakers for
utterances of various lengths?

What volume of air is expired by normal-
hearing and hearing-impaired speakers for
utterances of various lengths?

What is the relationship between inspira-
tory and expiratory air volumes during the
contrived and spontaneous speech of normal-
hearing and hearing-impaired speakers?

What is the expiratory time utilized by
normal-hearing and hearing-impaired speakers
for utterances of various lengths?

What change in speech intelligibility occurs
for hearing-impaired speakers going from
contrived speech to spontaneous speech?

CHAPTER II

EXPERIMENTAL PROCEDURES

Subjects

Sixteen young adults (four male, twelve female)
between the ages of 18 and 30 years comprised two subject
groups. The experimental group consisted of two males
and six females with bilateral, sensorineural hearing
losses (P. T. A. poorer than or equal to 75 dB HTL, re:
ANSI, 1969) with onset of loss prior to two years of age
(See Appendix A). See Appendix B for individual hearing
evaluation results. Middle ear pathology was ruled out
by impedance audiometry. Only hearing-impaired individuals
who reported oral communication as their primary mode of
communication (greater than 50% of expressive communica-
tion) comprised the experimental group (See Appendix C).
The reports of use of oral communication were verified
by persons familiar with the education and training of
each hearing-impaired subject. The experimental group
also reported no history of acute respiratory disorders.
Available clinical records concurred with the subjects'
reports.

The control group consisted of two males and six
females whose hearing was within normal limits as deter-

mined by a pure tone screening test delivered at 20 dB HTL

9

10

(re: ANSI, 1969) at 500, 1000, 2000, and 4000 Hz. The
control subjects had no history of communicative disorders

or acute respiratory disorders.

Stimuli

The stimuli consisted of three pairs of syntac-
tically correct active, affirmative, declarative senten-
ces totaling six different sentences (See Appendix D).
Two sentences were five syllables in length. Two sentenc-
ces were ten syllables in length. Two sentences were fif-
teen syllables in length. The syllabification of the vo-
cabulary in the sentences was obtained from fifty college
students who were presented the stimuli randomized within
a pool of fifteen sentences. Each word within the sen-
tences was one or two syllables in length. The sentences
were from the Harper and Row Basic Reading Program, All

Through the Year (O'Donnell, 1967). All Through the Year

 

 

was a basic second reader, strand one. The sentences were
seleCted to be within the comprehension of all subjects.
Vocabulary Norms for Deaf Children (Silverman-Dresner and
Guilfoyle, 1972) has indicated that the vocabulary

in the sentence stimuli were within the comprehension of
16 year old hearing-impaired persons. Additionally,

a randomized list of the vocabulary which comprised the
sentences was given to each subject before the experi-
mentation. The subjects were asked to indicate any

words which they did not understand. All subjects claimed

11

to understand the vocabulary.

An additional stimulus item was the "I Wonder"
Card W-l from the Peabody Language Development Kit (Level
#2) (1966). This card illustrated children visiting a pet
shop. The card was utilized to obtain a spontaneous
speech sample for aerodynamic and speech intelligibility

analyses.

Instrumentation

 

The instrumentation utilized in this experiment
was similar to the instrumentation utilized by Hutchinson
and Ringel (1973) (See Figure 1). The aerodynamic data
were obtained using a tightly fitting mask coupled to a
pneumotachograph (Hewlett-Packard, custom-made). The
pressure drop across the mesh screen of the pneumotacho-
graph was sensed by a Statham PMls differential pressure
transducer. This pressure drop has been assumed to be
linearly related to the volume velocity from the mouth
(Isshiki and Ringel, 1964). The pressure drop was ampli-
fied by a Honeywell Accudata 113 Amplifier and recorded on
a Honeywell 1508B visicorder oscillograph.

The audio signal was sensed by an Electrovoice
635A microphone placed two inches from the end of the
pneumotachograph. This signal was recorded simultaneously
on a second channel of the optical oscillograph and on an

Ampex 601 tape recorder.

12

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umamaadss

umuwfiosm>amo

 

 

 

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museum

mconmouoflz

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OHSmmmHm

Hmaucmummmao

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adamaamam A. nmmumonomu085mcm

13

The system was calibrated prior to each subject
by directing a constant source of air with a known velocity
through a precision bore flowrator glass tube (Fischer and
Porter Co., #FP—l/2—27-G—10/27) connected to the pneumo-
tachograph and differential pressure transduction system.
The rate of air flow was measured on the flowrator and
equated with specific galvanometric deflections. Subjects
were run on various days. Recording time was minimal.
Normal-hearing subjects utilized up to 93 seconds. Hear-
ing-impiared subjects utilized up to 162 seconds. Repeated
calibration and balancing of the recording system were used
in order to prepare the equipment to be sensitive to the

large range of values which were recorded.

Method

The subjects received written and oral instruc-
tions in the experimental procedures (See Appendix E).
Each subject completed a case history, indicated his com—
prehension of the vocabulary which comprised the sentence
stimuli, and received a hearing evaluation. At the con-
clusion of these tasks, the subject proceeded to the
recording room for aerodynamic evaluation. The experimen-
ter explained the test procedures and demonstrated the use
of the facemask. Prior to the sentence stimuli, the sub—
jects were given three practice sentences corresponding
to each pair of test sentences. Prior to the picture

stimulus, the subject was given a practice picture. The

l4

practice items were used for adjustment to speaking into
the facemask. When the subject had practiced and had
indicated willingness to proceed, the test items were
presented. The presentations of the sentence and picture
stimuli were counterbalanced. The six sentences had been
typed on individual cards and were presented three times
each for a total of eighteen stimulus cards. Sentence

order was randomized for each subject.

Analysis of the Data

 

For each sentence and sentence length mean
values and ranges for three dependent variables were cal-
culated from the oscillographic recordings. Those de-
pendent variables were (1) inspiratory air volume, (2)
expratory air volume, and (3) time of expiratory air flow.
An Ott Compensating Polar Planimeter was utilized for cal-
culating the volume measurements.

By manually circumstracing the recorded deflec—
tions and the baseline, the planimeter displayed a dimen-
sionless value for the traced areas. The planimeter
measurements were varified by carrying out two tracings
beginning in different but symmetrically opposed positions
along the perimeter of the area. The mean value of these
two measurements was correct because of the automa-
tic compensation of the planimeter utilized. By reversing
the direction of the trace, the planimeter value returned

to zero proving its accuracy. The verified planimeter

15

measurement was entered into the following forumla (L2)
yielding the air volume within a particular inspiratory or

expiratory deflection.

AV = (L2)(K2)<L1)

 

K1
Where AV = the air volume within a particular segment,
L1 = the arbitrary value for time,

L2 = the arbitrary value for air flow rate
measured on the planimeter

K = %ngg, the time calibration value of the
paper,

the air flow rate calibration

 

K2 = chm3/sec,
1 cm

value,

L1 and L2 were multiplied by 1 cm to bring
dimension to their values, as the recording
paper is ruled in centimeters.
Thus, the volume value was an integrated function of air
flow rate and time, both having been recorded on the
oscillograph.

Time of expiratory flow was calculated by measur-
ing the width of an expiration at its baseline and dividing
the resultant value by the speed of the recording paper.

Speech intelligibility was judged by three normal-
hearing adults who listened in random order to tape record—
ings of the contrived and spontaneous speech of each sub-

ject. The judges had no previous exposure to the hearing-

impaired. The judges separately listened to the stimuli

16

from the AMPEX tape recorder via TDH-39 headphones in an
IAC booth. The judges adjusted the volume of the record—
ings and relistened to the recordings as many times as
necessary to make a decision. Intelligibility was re-
corded as the percentage of words correctly identified
out of the total word sample. The utilization of word
intelligibility was established by John and Howarth (1956)

and by Smith (1973).

CHAPTER III

RESULTS

Speech inteeligibility and aerodynamic data indi—
cate substantial quantitative differences between normal—
hearing and hearing-impaired subjects. In addition, there
are large intersubject differences among hearing-impaired
subjects. Separate presentations of these data are in four
sections: speech intelligibility, inspiratory data (includ-
ing number of inspirations and volume), expiratory data,

and expiratory time data.

Speech Intelligibility

 

Table 1 presents the speech intelligibility of the
hearing-impaired subjects in mean percentage of words cor-
rect in sentence and spontaneous samples. Intelligibility
among the sentence samples ranges from 3% (Subject #4) to
100% (Subjects #5, #6, #7, and #8). Mean sentence sample
intelligibility for the hearing-impaired subjects is 81%.
Intelligibility among the spontaneous samples ranges from
0% (Subject #4) to 100% (Subject #8). The word intelligi-
bility of Subject #2 (50%) is an inflated score in that
data could only be collected from four of six sentences
because two sentences were entirely unintelligible. An
accurate syllable count could not be made. The inclusion

of the inflated score also inflates the group mean

17

18

TABLE l.-~The number of errors in word intelligibility
scored by three judges and the mean percent cor—
rect word intelligibility for hearing—impaired

 

subjects.
SENTENCE SPONTANEOUS
mean % mean %
subject words errors correct words errors correct
16 18
1(male) 53 5 86 40 14 58
6 18
13 18
2(male) 53 18 71 * 31 13 50
15 15
2 8
3(female) 53 6 90 36 12 72
8
51
4(female) 53 51 3 ** 0
51
2
5(female) 53 0 100 55 2 96
2
2
6(female) 53 0 100 60 2 96
4
25
7(fema1e) 53 0 100 60 18 64
22
8(female) 53 0 100 56 0 100
group mean 81 67

 

 

 

 

 

 

 

 

*Data collected from 4 of 6 sentences. Two sentences
entirely unintelligible.

**Spontaneous sample entirely unintelligible.

l9

spontaneous sample intelligibility of 67%. Still, seven
subjects and the subject group mean decrease in speech
intelligibility from the sentence samples to the spontan-
eous samples. The remaining subject (#8) remains 100%

intelligible in both speech samples.

InspiratorygData

 

While each normal-hearing subject could produce
each sentence stimulus after one inspiration, hearing-
impaired subjects utilize a greater number of inspirations.
Table 2 indicates that hearing—impaired subjects required
a range of 0.2 to 1.83 inspirations to produce the five
syllable sentence stimulus, a range of 0.5 to 4.50 inspira—
tions to produce the ten syllable sentence stimulus, and
a range of 0.5 to 6.00 inspirations to produce the fifteen

syllable sentence stimulus.

TABLE 2.--The mean number of inspirations taken by hearing-
impaired subjects for each of three sentence

 

lengths.
5-syllable lO-syllable lS-syllable

subject sentence sentence sentence
1(male) 1 2.16 2.16
2(male) l 2.16 1.66
3(female) l 1 1.33
4(female) 1.83 4.5 6
5(female) 0.83 l 0.83
6(female) 0.83 1 1
7(fema1e) l l l
8(fema1e) 0.2 0.5 0.5
group mean 0.96 1.67 1.81

20

Three hearing-impaired subjects (#5, #6, and #8)
inspired less than once for each sentence production.

Each of these subjects (and subject #7, who inspired once
per sentence) is 100% intelligible in the sentence condi-
tion. Subject #5 omits two inspirations, the inspiration
prior to the lst stimulus and the inspiration between the
3rd and 4th stimuli. The 3rd and 4th stimuli are 5-sylla-
ble stimuli. Subject #6 omits only the inspiration prior
to the lst stimulus. Review of the tracings of subject #8
reveals only 7 inspirations throughout the production of
the 18 sentence stimuli. An absence of turbulence over
time in the tracings of subjects #5 and #6 indicates that
each was holding her- breath prior to her initial utterance.
Further, subject #5 runs together the production of her
3rd and 4th stimuli without any pause or evidence of

held breath.

However, subject #8 inspires for her lst stimulus
and, apparently, randomly thereafter. Additionally, trac-
ings reveal cessation of respiratory activity between each
stimulus which is not preceded by an inspiration. Each
cessation consists of 0.8 seconds to 1.5 seconds. There is
no apparent relationship between the measured inspirations
and any other recorded parameter. Expiratory air volumes,
length of utterances, expiratory time, and overall time
(including interstimulus cessations) vary in relation to
the inspirations. Two inspirations occur during the first

eleven stimuli, whereas five inspirations occur during the

21

remaining seven stimuli. Because of the uniqueness of the
sentence data of subject #8, these data have been excluded
from Tables 3 through 6. These data fall well beyond pre-
dictions based upon the group mean and standard deviation.
The data for subject #8 are presented in Table #7.

The mean inspiratory air volumes (IAV in cc) and
their standard deviations for normal-hearing and hearing-
impaired subjects are presented in Table 3. The mean val-
ues for the normal-hearing subjects range from 100 cc to
916 cc for the five syllable sentence stimuli, 65 cc to 966
cc for the ten syllable sentence stimuli, and 178 cc to 1116
cc for the fifteen syllable sentence stimuli. Mean IAV for
the hearing-impaired subjects range from 102 cc to 1318 cc
for the five syllable sentence stimuli, 155 cc to 1784 cc
for the ten syllable sentence stimuli, and 261 cc to 1489 cc
for the fifteen syllable sentence stimuli. Ranges for each
sentence stimulus are greater for the hearing-impaired sub-
jects.

The mean overall IAV and their standard deviations
for all subjects are presented within Table 4. For normal-
hearing subjects in the sentence task inspiratory air vol-
umes per syllable based on 180 total syllables present
mean volumes ranging from 11 cc/syllable to 100 cc/syllable
with a group mean of 57 cc/syllable. For normal-hearing
subjects in the spontaneous task based on a mean of 73 syl-
lable with a mean of 20 cc/syllable. The mean overall

IAV of the hearing-impaired subjects range from 17

22

TABLE 3.-—The mean inspiratory air volume and standard
deviation (SD) (in cc) for each of three sen—

tence lengths for normal—hearing subjects and
hearingnimpaired subjects.

normal-hearing 5—syllab1e lO-syllable 15-sy11able

 

subjects sentence sentence sentence
mean SD mean SD mean SD

1(male) 916 157 966 137 1116 157
2(male) 783 177 883 227 1083 203
3(female) 366 234 699 183 616 313
4(female) 316 184 558 331 666 189
5(female) 258 110 291 146 233 118
6(female) 533 262 347 161 488 103
7(fema1e) 702 097 828 134 733 082
8(fema1e) 100 053 065 071 178 094
group mean 497 266 580 291 639 323

hearing-impaired S-syllable lO-syllable lS-syllable

 

subjects sentence sentence sentence
mean SD mean SD mean SD

1(male) 275 137 339 136 334 025
2(male) 1318 233 1784 273 1291 384
3(female) 327 072 347 126 374 157
4(female) 669 212 1296 150 1489 256
5(female) 526 321 533 215 931 569
6(female) 249 115 196 125 439 286
7(fema1e) 102 122 155 059 261 179

group mean 495 370 664 580 731 466

23

TABLE 4.--The mean overall per syllable inspiratory air
volume and standard deviation (SD) (in cc),
expiratory air volume (in cc), and expiratory
time (in sec) for normal-hearing subjects and
hearing-impaired subjects.

SENTENCE SPONTANEOUS

normal-hearing
subjects IAV EAV ET IAV EAV ET

mean SD mean SD mean SD mean mean mean

 

 

1(ma1e) 100 54 177 82 .27 .07 35 43 .24
2(male) 91 54 86 37 .28 .08 27 26 .23
3(female) 60 35 47 17 .30 .08 03 12 .25
4(female) 51 31 37 15 .28 .06 17 07 .23
5(female) 26 23 31 ll .26 .05 10 14 .28
6(female) 45 49 29 19 .27 .08 17 20 .27
7(fema1e) 75 43 80 31 .26 .06 37 47 .21
8(fema1e) 11 10 10 08 .23 .06 13 05 .18
group mean 57 29 62 50 .27 .02 20 22 .24
(SD)11(SD)13 (SD).03
SENTENCE SPONTANEOUS
hearing-
impaired
subjects IAV EAV ET IAV EAV ET
mean SD mean SD mean SD mean mean mean
1(ma1e) 31 23 22 11 .41 .10 101 46 .46
2(male) 146 83 135 56 .50 .10 *130 128 .49
3(female) 35 22 23 18 .54 .14 29 29 .47
4(female) 115 32 128 57 .43 .07
5(female) 66 51 81 29 .35 .10 31 43 .30
6(female) 30 23 32 32 .34 .09 20 19 .30
7(fema1e) 17 16 12 04 .29 .07 56 37 .33
group mean 63 ‘46 62 49 .41 .08 **61 so .39

(SD)41(SD)36 (SD).08

 

*Data collected from 4 of 6 sentences.

**Mean data for group excludes subject 4 who was entirely
unintelligible spontaneously and for whom the number of
syllables uttered could not be determined.

24

cc/syllable to 146 cc/syllable with a mean of 63
cc/syllable in the sentence task and from 20 cc/syllable
to 130 cc/syllable with a mean of 61 cc/syllable in the
spontaneous task based on a mean of 60 syllables. Spon—
taneous data for Subject #4 is not included because unin-
telligibility prevented the experimenter from securing a
more accurate syllable count.

Mean overall IAV ranges are greater for the
hearing-impaired groups in each direction. While the mean
values for the two groups are only slightly different in
the sentence data (6 cc/syllable), the difference in mean
values for the spontaneous data is 41 cc/syllable. Norma}-
hearing subjects decreased their inspiratory air volumes
in an average of 65% from sentence to spontaneous speech
stimuli, whereas hearing-impaired subjects decreased their

inspiratory air volumes an average of 03%.

Expiratory Volume Data

 

Table 5 presents the mean expiratory air volumes
(EAV in cc) and their standard deviation for normal-
hearing and hearing-impaired subjects. For the normal—
hearing subjects, the mean volumes range from 91 cc to
700 cc for the five syllable sentence stimuli, 127 cc to
1033 cc for the ten syllable stimuli, and 129 cc to 1033cx:
for the fifteen syllable stimuli. For the hearing-impaired
subjects these volumes range from 81 cc to 925 cc for the

five syllable sentence stimuli, 148 cc to 1845 cc for the

25

TABLE 5.-—The mean expiratory air volume and standard
deviation (SD) (in cc) for each of three sen—
tence lengths for normal-hearing subjects and
hearing—impaired subjects.

normal—hearing 5—syllable lO-syllable 15—sy11able

 

subjects sentence sentence sentence
mean SD mean SD mean SD
1(ma1e) 675 080 1033 149 950 126
2(male) 700 129 833 113 1033 199
3(female) 333 055 500 168 583 069
4(female) 225 080 408 151 483 107
5(female) 175 046 383 024 358 117
6(female) 268 077 308 102 300 064
7(fema1e) 628 089 861 060 933 085
8(fema1e) 091 054 127 037 129 034
group mean 387 228 557 152 596 317

hearing-impaired 5-syllab1e 10-sy11ab1e lS-syllable

 

subjects sentence sentence sentence
mean SD mean SD mean SD

1(ma1e) 130 055 290 079 250 115
2(male) 810 267 1845 404 1400 178
3(female) 243 067 211 061 245 092
4(female) 925 357 1425 087 1497 289
5(female) 573 114 758 177 1013 286
6(female) 368 165 325 033 299 053
7(fema1e) 081 018 148 032 152 046

group mean 447 307 715 620 694 547

26

ten syllable sentence stimuli, and 152 cc to 1497 cc for
the fifteen syllable stimuli.

Syllabic data (Table 4) for normal-hearing sub-
jects indicate mean overall EAV ranging from 10 cc/syllable
to 177 cc/syllable in the sentence task with a group mean
of 62 cc/syllable and from 5 cc/syllable to 47 cc/syllable
with a group mean of 22 cc/syllable in the spontaneous
task. Hearing-impaired subjects' data range from 12
cc/syllable to 135 cc/syllable in the sentence task (group
mean equals 62 cc/syllable) and from 19 cc/syllable to
128 cc/syllable in the spontaneous task (group mean equals
50 cc/syllable). As previously noted, spontaneous speech
data omit data from two of six utterances from hearing-
impaired subject #2 and the entire spontaneous sample of
hearing-impaired subject #4.

EAV decreased 65% from sentence to spontaneous
speech for the normal-hearing subject group and 19% from
sentence to spontaneous speech for the hearing-impaired

subject group.

ExpiratoryiTime Data

 

As viewed in Table 6, for normal-hearing subjects
the mean expiratory times (ET in sec.) range from 1.55 sec
to 2.19 sec for the five syllable sentence stimuli, 2.28
sec to 3.13 sec for ten syllable sentence stimuli, and

3.15 sec to 3.92 sec for the fifteen syllable

27

TABLE 6.--The mean expiratory time and standard deviation

(SD)

(in sec) for each of three sentence lengths

for normal—hearing subjects and hearing—impaired
subjects.

 

 

normal-hearing 5—sy11able lO-syllable lS—syllable
subjects sentence sentence sentence
mean SD mean SD mean SD
1(ma1e) 1.78 0.29 2.94 0.31 3.43 0.24
2(male) 1.99 0.22 2.84 0.36 3.81 0.52
3(female) 2.19 0.30 3.13 0.46 3.92 0.36
4(female) 1.82 0.17 2.91 0.21 3.67 0.15
5(female) 1.65 0.15 2.88 0.17 3.41 0.26
6(female) 1.86 0.37 2.83 0.27 3.50 0.15
7(fema1e) 1.75 0.17 2.89 0.15 3.36 0.19
8(fema1e) 1.55 0.17 2.28 0.22 3.15 0.19
group mean 1.82 0.19 2.84 0.23 3.53 0.24
hearing-impaired 5—sy11able lO-syllable 15-syllab1e
subjects sentence sentence sentence
mean SD mean SD mean SD
1(ma1e) 2.25 0.51 4.89 0.84 5.36 0.63
2(male) 3.11 0.32 5.58 0.30 6.40 0.69
3(female) 3.43 0.55 6.18 0.98 7.02 0.65
4(female) 2.38 0.42 4.79 0.22 5.81 0.37
5(female) 2.34 0.45 3.70 0.37 4.68 0.75
6(female) 2.11 0.38 3.77 0.77 4.38 0.29
7(fema1e) 1.75 0.27 3.27 0.54 3.84 0.83
group mean 2.48 0.54 4.60 0.99 5.36 1.05

28

 

om. mo. om. mm.o om.v m~.o mv.m mm.o om.a
mzHB Mmoa<mmem
mo mo mo mvo moa mmo oma mmo mvH
mzono> mHm wmoammmem
mo mo Ho moo moo nvo wmo NHo moo
some am some ow some 0m some am smmE
mHanHMm mom mannaawm mom mosmusmm wosmuswm mosmusmm

sump msomsmusomm pump mosmucmm oHanHMmimH oHanHmmloH mannaammlm

MEDAO> MH¢ MMOB<MHmmZH

.AmHmemv
m¢ womMQSm pmuammfifilmcflnmmn you dump mo Ammo cofluma>oc unopsmum can some wnall.h mamas

29

sentence stimuli. For the hearing-impaired subjects,
these ranges are 1.75 sec to 3.43 sec, 3.27 sec to 6.18
sec, and 3.84 sec to 7.02 sec, respectively.

The mean overall ET and their standard deviatflxm;
appear in Table 4. For the normal-hearing subject group,
these range from .23 sec/syllable to .30 sec/syllable in
sentence speech and .18 sec/syllable to .28 sec/syllable
in spontaneous speech. Group means are .27 sec/syllable
and .24 sec/syllable for sentence and spontaneous speech.
For the hearing—impaired subject group, mean overall ET
ranges from .29 sec/syllable to .54 sec/syllable in sen-
tence speech and from .30 sec/syllable to .49 sec/syllable
in spontaneous speech. Respective group means are .41
sec/syllable and .39 sec/syllable.

Mean expiratory time ranges are increasingly
greater for hearing-impaired subjects. Rank order of all
normal-hearing and hearing-impaired subjects indicates
that hearing-impaired subjects rank 1, 2, 3, 4, 5, 7, 8,
12 in ET utilized for producing the five syllable sentence
stimuli, 1 through 8 for the ten syllable sentence stim-
uli, and l, 2, 3, 4, 5, 6, 7, 9 for the fifteen syllable
sentence stimuli. For the hearing-impaired subjects,
increased expiratory time was significant to the 1.0%
level in the 5 syllable sentence task and significant to
th 0.2% level in the 10 syllable and 15 syllable tasks, and
in the overall per syllable sentence and spontaneous data

(Wilcoxon Sum of Ranks Test).

CHAPTER IV
DISCUSSION

This experiment documents air stream mismanage-
ment during the connected speech of the hearing-impaired.
Mismanagement occurs during inspiratory and expiratory
events. The hearing-impaired speakers with poor intelli-
gibility in the sentence condition inspire more frequently
than the hearing-impaired speakers with 100% intelligi-
bility and the normal-hearing speakers. Table 8 indicates
Table 8.--The percent correct word intelligibility and the

mean number of inspirations for the poor intelli-

gibility hearing-impaired subjects during the
sentence condition.

mean number of inspirations

 

subject % intelligible 5-sy11. 10-syll. 15-syll.
3(female) 90 1 1 1.33
2(male) 86 1 2.16 1.66
1(ma1e) 71 1 2.16 2.16
4(female) 03 1.83 4.5 6

 

that as intelligibility decreases the number of inspira-
tions increases. These inspirations occur randomly
throughout sentence productions. The inspirations do not
occur simultaneously with the initiation of noun or verb
phrases. The inspirations occur within phrases and within
words. In addition to decreasing word intelligibility,

30

31

random inspirations decrease the listeners‘ abilities to
recognize syntactic patterns within utterances (John and
Howarth, 1965).

This mismanagement is ammenable to therapy.

John and Howarth (1965) substantiated treatment for rela-
tive time factors of syllable length, sentence length,

and non-linguistic pauses during connected discourse to

the exclusion of articulation emphasis. Repeated imitation
of a normal-hearing speaker's rate and rhythm yielded
increasing meassage comprehension by increasing word intel-
ligibility and syntactic intelligibility (by 56% and 203%,
respectively, in John and Howarth, 1965).

The significantly increased expiratory time
utilized by the hearing-impaired speakers is consistent
with the early literature (Hudgins, 1934; Rawlings, 1935,
1936; Voelker, 1935, 1938). The hearing-impaired speakers'
expiratory time was 52% and 63% greater than that of the
normal-hearing speakers in the sentence and spontaneous
conditions, respectively. These data coupled with expira-
tory air volumes similar to normal-hearing speakers
yielded decreased air flow rate peak magnitudes. Such
decreases are a parameter of blurred consonant production
(Hutchinson and Smith, 1974). Figure 2 represents the pro-
duction of a lS-syllable sentence by normal-hearing subject
#7 (female) and by hearing-impaired subject #4 (female).
The normal-hearing subject inspired 788 cc of air immedi-

ately prior to the intelligible production of the sentence

32

 

Figure 2.-—Schematic representation of the production of
a 15-sy11able sentence by (A) normal—hearing
subject #7 (female) and by (B) hearing-impaired
subject #4 (female). Pattern (A) illustrates
on inspiration of 788 cc and expiration of
1060 cc during 3.32 seconds. Pattern (B)
illustrates seven random inspirations of 1040 cc
and expiration of 1020 cc during 5.94 seconds
of expiratory time. Pattern (B) represents
completely unintelligible speech by the hearing—
impaired subject. The stimulus is, "You know
how to stick to things until you find out the
answers."

 

 

 

33

oo ovoa u ofisao> Had huoumuflmmcH

mpaoomm wo.m u mafia muoumuwmxm

 

{a E i>§>§§

oo omoa u mEsHo> Hflm muoumuflmxm Amy zmmaamm

 

00 wow u mESHo> Had whoumuwmmsH

mcsoomm mm.m n mafia muoumuflmxm

 

'

 

oo omoH u mEdHo> Had mnoumnflmxm Amv zmmaamm

34

and expired 1060 cc of air in 3.32 seconds. The hearing—
impaired subject inspired 1040 cc of air in 7 random
inspirations and expired 1020 cc of air in 5.94 seconds
throughout a production which was entirely unintelligible.
Visual analysis of the two air flow rate (AFR) traces notes
a lack of clear peaks in the AFR of the hearing-impaired
speaker. That trace denotes air flow turbulence with an
absence of clear consonant production. Although expiratory
air volumes are similar, the disturbance of time factors
and the manner in which the air flow was expired lead to
unintelligible speech.

This mismanagement also appears responsive to
therapy. Hutchinson and Smith (1974) demonstrated the
ability of hearing-impaired adults to condition aerodynamic
and concurrent intelligibility changes in monosyllabic
stimuli. Their subjects successively approximated Optic-
ally recorded information from equipment similar to that
used in this experiment.

Further research should attempt to increase the
length of stimuli practiced in therapy. Perhaps a two-
stage treatment program would be effective if based on
decreasing expiratory time prior to direct conditioning
of air flow. Control for the spontaneity of stimuli
should be continued.

The present experiment reveals the occurrence
of a distinct aerodynamic event effecting the decreased

word intelligibility of hearing-impaired speakers from

35

contrived sentence stimuli to spontaneous stimuli. The
group mean intelligibility decreases 14%, whereas indivi-
dual subjects exhibit a range from no change to -36% (see
Table 9). Table 9 was obtained from data presented in
Tables 1 and 4.

Table 9.--The change in intelligibility and expiratory air

volume (in percentage) for six hearing-impaired
subjects.

 

hearing-impaired intelligibility expiratory air
subject changes volume change
1(ma1e) -28% +209%
3(female) -18% +26%
5(female) —04% -47%
6(female) -04% -41%
7(female) -36% +208%
8(fema1e) 0% -44%

 

Excluding Subject #2 and Subject #4 because of incomplete
data, the six remaining subjects can be reviewed in two
groups regarding intelligibility change in the two stimuli
conditions. Subjects #7, #1, and #3 decrease their intel-
ligibility 36%, 28%, and 18%, respectively. Subjects #5
and #6 decrease their intelligibility only 4%, while
Subject #8 remains 100% intelligible. These changes in
intelligibility are consistent with changes in expiratory
air volumes. The group of Subjects #7, #1, and #3, while
markedly decreasing word intelligibility, increase their
EAV by 208%, 109%, and 26%, respectively. Subject #7,

who displays the greatest decrease in intelligibility and

36

the greatest increase in EAV, is 100% word intelligible
during the production of contrived sentences. During that
condition, Subject #7 inspires apprOpriately. Subject #7,
along with Subjects #1 and #3 appear to lose physiologic
control when required to speak spontaneously. In the spon—
taneous condition, these subjects produce 5, 9, and 9
syllables respectively per inspiration. The remaining
hearing-impaired subjects and the normal-hearing subjects
produce from 10 to 36 syllables per inspiration. Whether
the result of ineffective laryngeal or articulatory valving,
the changes in EAV are contrary to the performance of the
hearing-impaired subjects with highly intelligible spon-
taneous speech and to the performance of the normal-hearing
subjects.

Subjects #5, #6, and #8, with minimal or no de-
crease in intelligibility, decrease their EAV in the spon-
taneous condition by 47%, 41%, and 44%. This approaches
the 65% decrease (range of 31-81%) which the normal-hearing
subjects exhibit. For intelligible spontaneous speech,
such information illustrates the necessity to decrease and
retain expiratory air volumes from the amount utilized in
contrived sentences. We are concerned with the percentage
of EAV retained by each subject going from the contrived
conditions to the spontaneous condition as opposed to the
absolute value of EAV. The retention of EAV by intelli-
gible speakers indicates the recognition and use of a

valving adjustment for spontaneous speech. Further

37

research to account for this adjustment is warranted.

The data presented are consistent with other
research findings. Forner and Hixon (1977) assessed res-
piratory events of profoundly hearing-impaired speakers.
Their evaluation utilized the apparati for respiration
kinematics established by Hixon, Goldman, and Mead (1973).
Subjects (young adults) communicated predominantly by manual
or total (simultaneous oral and manual) communication and
were judged moderately to severely deviant in articulation,
rhythm, stress and linguistic phrasing. Data collected
during utterances of continuous discourse displayed frequent
deviancies in one or more of the following areas: (1) lin-
guistic programming, (2) respiratory adjustments, (3) laryn—
geal or upper airway adjustments. Similar to the present
thesis, Forner and Hixon noted that most of their subjects
inspired frequently during nonpunctuated word strings which
increased the amount of breaths per minute. Thus, the num-
ber of syllables supported per breath was decreased.

Forner and Hixon noted tracings which were not accmpanied
by vocalization and noted breath haltings which did not
involve inspiration. Many subjects expired volumes up to
250 cc during these haltings. This further decreased the
available volumes which, as seen in the present thesis,
were decreased initially by large volume expenditures.
Additionally, the breath haltings involved a phenomenon

similar to the cessation of measurable respiratory activity

38

by this thesis' Subject #8. Possibly, this subject
retained intelligibility by conserving necessary air
volumes.

The support of the Forner and Hixon data for the
data of the present thesis is clear. A range of respira-
tory behaviors is seen during the connected utterances of
severely to profoundly hearing-impaired adults. Relation-
ships to speech intelligibility are noted. These relation-
ships need to be expressed in therapeutic programs at the
levels of linguistic, respiratory, and laryngeal mechanics.
An appropriate component of such programming is the analy-
sis of the communicative behavior of the hearing-impaired
in terms of speech intelligibility and aerodynamic func-
tioning. This component, apparently unbiased by minimal
variations in extent of hearing loss, establishes initial
and continuous evaluation clearly representative of the

needs for effective expressive communication.

CHAPTER V

SUMMARY

The purpose Of the study was tO investigate
aerodynamic characteristics Of connected discourse pro—
duced by normal-hearing and severely-to-profoundly hearingh
impaired adults. The results added support for the use Of
aerodynamic evaluation in speech—disordered populations
while providing normative information from normal-hearing
and hearing-impaired populations. This is intended to
provide a basis for future investigations.

The results established aerodynamic mismanagement
during the speech Of the hearing-impaired evidenced by
increased frequency Of inspirations for hearing-impaired
subjects with poor speech, increased ranges Of inspiratory
and expiratory air volumes, and greatly increased expira-
tory time. The general result of these characteristics
was a blurring Of aerodynamic peaks necessary for intel-
ligible speech. Further mismanagement was noted in
proceeding from contrived to spontaneous stimuli. Hearing-
impaired subjects who suffered minimal change in speech
intelligibility executed aerodynamic adjustments Opposed
tO those Of the normal-hearing and minimal change hearing-

impaired subjects.

39

40

Previous therapeutic investigations were des-
cribed and, in conjunction with this study, are supportive
Of therapeutic emphasis on aerodynamic management. Con-
nected discourse has been seen as an appropriate and relia-
ble stimulus for use in future investigations.

Further investigations should consider the ex—
tent Of hearing—impairment and the status of respiratory
physiology. In this study,speech intelligibility and aero-
dynamic measures did not vary in relation to hearing loss.
For example, hearing—impaired Subject #6 (female) had the
poorest pure tone average while exhibiting 100% intelligi—
ble speech in the contrived condition and 96% intelligible
Speech in the spontaneous condition. The status Of the
subjects' respiratory physiology was not evaluated beyond
screening for gross abnormalities. Perhaps further evalua-
tion would explain the lack Of respiratory control exhibited
by the hearing—impaired subjects Of the present investi-

gation.

LIST OF REFERENCES

41

42

LIST OF REFERENCES

Angelocci, A., Kopp, G., and Holbrook, A., The vowel for-
mants Of deaf and normal-hearing eleven to fourteen
year Old boys. Journal of Speech and Hearing
Disorders, 29, 156-170 (1964).

 

Bzoch, K. R., Variations in velopharyngeal valving as a
function Of syllabic change in repeated CV syllables.
Paper presented at the Annual Convention Of the Ameri-
can Speech and Hearing Association, Chicago (1965).

Colton, R. H. and Cooker, H. S., Perceived nasality in the

speech Of the deaf. Journal of Speech and Hearing
Research, 11, 553-559 (1968).

DiCarlo, L. M., Speech, language, and cognitive abilities
of the hard-of—hearing. Proceedings of the Institute
on Aural Rehabilitation, 45-66 (1968).

 

Forner, L. L. and Hixon, T. J., Respiratory kinematics in
profoundly hearing-impaired speakers. Journal Of
Speech and Hearing Research, 20, 323-408 (1977).

 

 

Gilbert, H. R. and Dixon, H. P., Simultaneous oral and nasal
airflows during production of stop consonants by hard
Of hearing subjects. Paper presented at the Annual
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Hixon, T. J., Goldman, M., and Mead, J., Kinematics Of the
chest wall during speech production: Volume displace-
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Speech and Hearing Research, 16, 70-115 (1973).

 

Hudgins, C. V., A comparative study Of the speech coordina—
tions Of deaf and normal subjects. Journal of Genetic
Psychology, 44, 3-48 (1934).

 

 

and Numbers, F. C., An investigation of the
intelligibility Of the speech of the deaf. Genetic
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Hutchinson, J. M. and Ringel, R. L., Aerodynamic patterns of
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and Smith, L. L., An aerodynamic evaluation of

consonant production in the adult deaf. Paper presented
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Hearing Association, Las Vegas (1974).

 

43

Isshiki, N., Vocal intensity and air flow rate. Folia
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Isshiki, N. and Ringel, R., Air flow during the production

Of selected consonants. Journal Of Speech and Hearing
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John, J. E. J. and Howarth, J. N., the effect Of time dis-
tortions on the intelligibility Of deaf children's
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McClumpha, S. L., Cinefluorographic investigation Of velo-
pharyngeal function in selected deaf speakers. Master's
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M011, K. L., Cinefluorographic techniques in speech research.
Journal Of Speech and Hearing Research, 3, 227—241.(1960L

 

McGlone, R. E., Air flow during vocal fry phonation. Jour-
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, Air flow in the upper register. FOlia Phonia-
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O'Donnell, M., All Through the Year: Harper and Row Basic
Reading Program. New York: Harper and Row (1967).

 

 

Rawlings, C. G., A comparative study Of the movements of the
breathing muscles in speech and quiet breathing of deaf
and normal subjects. American Annals Of the Deaf, 80,
147-156 (1935).

 

, 81, 136-150 (1936).

 

Silverman-Dresner, T. and Guilfoyle, G. R., Vocabulary Norms
for Deaf Children. Washington, D. C.: Alexander
Graham Bell Association for the Deaf (1972).

 

 

Smith, C. R., Residual hearing and speech production in deaf
children. CSL Research Report, 4 (1973).

 

Subtelny, J. D., Worth, J. H., and Sakuda, M., Intraoral
pressure and rate of flow during speech. Journal Of
Speech and Hearing Research, 9, 498-518 (1966).

 

VanHattum, R. J., Communication therapy for problems asso-
ciated with cleft palate; in Dickson, Communication
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44

and Worth, J. H., Air flow rate in normal
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Voelker, C. H., A preliminary strobophotoscopic study Of the
speech Of the deaf. American Annals Of the Deaf, 80,
243-259 (1935).

 

, An experimental study of the comparative rate
Of utterance Of deaf and normal hearing speakers.
American Annals Of the Deaf, 83, 274-284 (1938).

 

 

Warren, D. W. and Wood, M. T., Respiratory volumes in speech:
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APPENDICES

45

APPENDIX A

AUDITORY THRESHOLDS FOR PURE TONE AVERAGES

46

47

 

 

 

 

om moa mm om mm mos mm

moa mos mos mos ms me me

mos cos moa mos mm mm mm

om om mm mm mm mm mm

moa mz moa mz mm mz mos

on ma om m» cm ms mm

Em mz mm om om mz mm

mm moa cos mm mm moa cos

.<.ar.m um ooom um oooa as com .a .9 .m as ooom um coca

.mmMImmmm umm usmmm

.moma

.Hmza "mu .aem mo as we ooom can .Nm OOH .Nm com um muomnnsm

 

 

 

mm
mm
OOH
on
mm
om
mm

mm

Nm oom

Amamfimmvm
AmHmEmmoo
Amamfimmvm
AmHmEmmvm
Adamsmmoe
AmHmEmmvm

Amamsom

Aoamsoa

pomflnsm

UOHHMQEHImsflHmmn How mommuo>m msou muse can mpaonmmunu sofluospsoo Hfl¢1|.¢ xflpsommm

APPENDIX B

RESULTS OF INDIVIDUAL HEARING EVALUATIONS

48

49

SUBJECT #1(MALE)

Frequency in Hertz (Hz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

m mxnmmmfifle spasm:
0 fl“ 306wppnk nausea Hwawnn manna: an
a o / / A
mm _ A _ _ _ _
HO X MR 0. 0. a... 5.. h. 9.. 1.
SO
c / //
r
a R Tu
E
o ooapwwmsom Om onnnnca
W O 2 h 6 8 m
8
o
m
o
m m
m m
o m
m
0
a

125

c m" m m m. a“ w
3me .325 no 5 ~33

o 0
7 9

   
 

caozmwune magnum:

mob

f
8..
.1
t
S

o

 

air pressure in mm of water

50

SUBJECT # 2 (MALE)

Frequency in Hertz (Hz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M A mxomomwflm twnSws .
O HM Bovwwwnw sonamw Hwawnu naunmsmum
n.
_ E
u o x mm m n" a... L «L 3.4 1..
.3 / // /
no

r

a R L

as
o ooappwssom Om shamans
W 0 2 k 6 8 Wu. 0
a
o
0
w
o
m
z m
m m
o m
a
o
a

 

125

ommmwmwm ”Rm

3..

.1 f

b .1
.33 .825 no 5 :33 30535. magnum: m a

air pressure in mm Of water

51

SUBJECT #3(FEMALE)

Frequency in Hertz (Hz)

 

 

 

fl“ mxomumwmo swarm:

Bone

 

socwwwnk sonanw Hwawnm/I z/I mhflwnsaun

 

a o . L

 

 

 

 

COMPLIANCE
_4

 

 

 

 

 

 

 

 

 

 

 

 

C
I
nox m m mas. .. a 1.
.. ////
a R .u
E
o ooapwwmsom On osnmnsa
m o 2 .Q 6 8
8
o
0
w
o
m
. m
o u
m
0
a

 

125

o m m m, w m m m m m m

.32 .325 no 5 «2.3 30:353. 333:

i f
b u
m u

m

o

 

air pressure in mm of water

552

SUBJECT #4(FEMALE)

Frequency in Hertz (Hz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

m L mxommmwcm that»:
O h” aocwwwnw sonaeH Huawnm unwnnsouu
B E
m _// 21%
m1 . 4_da) d _
uox mm .w a.._.....” .. a A
2 100 0 o o
A ”M _ ._. 7 w _
c //
r
aRL
E
o ooafiwwmsoo Om canonsa
W O 2 k 6 8 m
8
o
m
o
m
z m
G
m m
m an
o
a
5
u

  
  

,..m m m. w m w m m m m

Ammoa .Hm24o no :« Hm>oa Odonmmuna magnum:

.1
a
m

stiff

o

 

air pressure in mm of water

553

SUBJECT #5(FEMALE)

Frequency in Hertz (Hz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

$0 1000 200 0 '00 O 0 800 0
TYMPANOGRAM

2.50

   

125

O 0 000000
1 mmfihw6789mu

Amwma .Hm24o mp :« Hw>wA caonmmuns mcwummm

mobil

2

u 6 8

OOSOHMOSOO Om mononsa

stiff

m . mxommm+<m twnrws .
o h“ aoquwnk SOnamH HPBHnm mnwmmsmmm
B
m //////7
m: _ ._fi _ _
a... mm o. .11.. J ..
A m.M 2_ 1. o o. o 0_ oa
coo -
c /////
r i
a R ru
E

o
11

0
1

0

 

air pressure in mm of water

54

SUBJECT #6(FEMALE)

Frequency in Hertz-(Hz)

 

P

 

swarm:
sonamp Hwawn

 

 

.7

 

 

0.6

 

u
e
0

 

_

 

2

L, Wei

1

 

 

 

 

7

 

/._/ 4 /

 

 

 

 

 

 

 

$0 1000 2000 I000 0 8000
TYMPANOGRAM

80

 

125

ommmwww mmm

Amos“ .Hmzao no as ~m>mg oaosmmuns mcwummm

m mxomsmw<m
o soquwnk
B E
m

ml . A _
no x mm m 0. ...
r
a R rs
E

o

ooapwwmsom Om bonanza

mob

2

nw

6

8

f
f
.1
t
3

m

o

 

air pressure in mm of water

555

SUBJECT #7(FEMALE)

Frequency in Hertz (Hz)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

250 $0 1000 2000 I000 0 8000

125

 

0

  

 

     
   

O
H

o

TYMPANOGRAM,

loose .Hmzao mo ca Hw>oq oaocmmuns meadow:

m L mxommmm<m twnrwc .
O h“ BOUHHHHK sonamw Heapnm mnwmmsmmm
B
W //l .//r ./ /// ///
C
. _ _
no x mm .w 0. ... AH u a. L
A TM. 2. 1.0—0_ 0 0p 0b
50 -
C l// ///z ///r.
r
a R L
E

OOSOHMESOO Om bonanza

2

l
.1.
w
m

k

6 8

stiff

o
1

10

o

 

in mm of water

air pressure

56

SUBJECT #8(FEMALE)

Frequency in Hertz (Hz)

 

 

twnSMS

:onamp Hwawnu

unwmnsmum

 

 

7

 

1.0

_s__ -
.o.

 

0.15

—

0.8

 

 

/_/ E/

 

 

 

 

_/

 

./...//

 

 

 

 

 

 

 

  

m A mxnmomw<m
O acceppnw
B E
no
em _
II
n 0 Va me m
A TM 2.
coo
C
r
a R .u
E
o
m
8
o
o
o
u
o
w
2
o
$
0
3
s
u

0 m” m m w w mu m M %

Amoma .Hm24o up :w HO>OQ annmmuna magnum:

   

   

0
AJ

II.

    

    

0
H

   

ooapwwmsom Om mmnancs

O 2

TYMPANOGRAM

mObi

n4

6

8

f
8..
.1
t
3

m...

o

 

air pressure in mm of water

APPENDIX C

CASE HISTORY AND RELEASE FORM

57

58

Name Birthdate Age

 

 

 

Address Phone

 

 

PLEASE FILL IN ALL APPROPRIATE QUESTIONS.

Have you ever had facial surgery or surgery on your
ears

What kind

 

When and where

 

What medications do you take now

 

DO you have an acute allery (occurs suddenly)

 

Age Of onset of hearing loss

 

Cause Of hearing loss

 

How has your hearing changed

 

DO you wear a hearing aid

 

What kind

 

DO you know sign language

 

How Often do you sign

 

DO you know fingerspelling

 

How often do you fingerspell

 

How Often do you write messages in face to face communi-

cation

 

What percent Of your communication is oral as Opposed to

manual or written

 

59

TO what extent was your education oral

 

manual

 

or combined manual

 

What was the last school you attended

 

Where and when have you received speech theraphy

 

I attest tO the truth Of the above information and my

willingness tO participate in this experimentation.

 

 

Signature Witness

 

 

Date Date

APPENDIX D

SENTENCE STIMULI

60

61

Practice Sentence Items

We sat on the floor.

I want to wish you a happy birthday.

The two boys worked at the job Off and on but not all

the time.

Test Sentence Items

Dad went on a trip.

She made a picture.

The ice is too cold to hold in your hands.

That big tree will shade us from the hot sun.

You know how to stick tO things until you find out the
answers.

Now each person in the Office is talking about the dog.

APPENDIX E

INSTRUCTIONS

62

(l)

(2)

(3)
(4)

63

Please fill out the case history form. I will answer
any questions you have.
Read these words. If you do not understand a word,
please tell me.
Next, we will go to Room B-5 for a hearing evaluation.
Next, we will go to Room 209-C. You will be seated
at the equipment table.
a. Hold the rubber mask to your face, like this
(example given).
Make the mask tightly cover your mouth and nose.
DO not let air leak out the sides of the mask.
In front Of you is a stack Of cards.
Each card has one sentence typed on it.
You will read every sentence into the mask.
When you are ready, I will turn on the machine,
and you will begin reading the sentences.
Let's practice.
Read these three sentences. Read as you usually
do.

Are you ready to read the other sentences?

b. Hold the rubber mask to your face.
Make the mask tightly cover your mouth and nose.
DO not let air leak out the sides of the mask.
You will look at this picture and hold the mask to

your face.

64

I want you to tell what you see in the picture.
When you are ready, I will turn on the machine,
and you will begin talking about the picture.
Let's practice.

Tell me what you see in this picture. Talk as

you usually do.

Are you ready to tell me about another picture?

(l)

(2)

(3)
(4)

65

Please fill out the case history form. I will answer

any questions you have.

Read these words. If you do not understand a word,

please tell me.

Next, we will gO to Room B-5 for a hearing evaluation.

Next, we will gO tO Room 209-C. You will be seated

at the equipment table.

a.

Hold the rubber mask to your face, like this
(example given).

Make the mask tightly cover your mouth and nose.
DO not let air leak out the sides Of the mask.
You will look at this picture and hold the mask
to your face.

I want you to tell what you see in the picture.
When you are ready, I will turn on the machine,
and you will begin talking about the picture.
Let's practice.

Tell me what you see in this picture. Talk as
you usually do.

Are you ready to tell me about another picture?

Hold the rubber mask to your face.

Make the mask tightly cover your mouth and nose.
DO not let air leak out the sides of the mask.
In front of you is a stack Of cards.

Each card has one sentence typed on it.

66

You will read every sentence into the mask.

When you are ready, I will turn on the machine,
and you will begin reading the sentences.

Let's practice.

Read these three sentences. Read as you usually
do.

Are you ready tO read the other sentences?