30

CHAPTER

1 INTRODUCTION

constitute the locomotor system. The nervous and sensory systems form the neurosensory system, and the
nervous and endocrine systems constitute the neuroendocrine system. There are also systems within systems.
The limbic system as part of the nervous system is but
one example. Since the early 1980's, the immune or autoimmune system has received a great deal of attention.

The immune system functions

like a well-orchestrated team, with each successive
team member further weakening an incoming microbe. Initially, protein molecules called antibodies
immobilize the invading microbe, which then enables
a large macrophage to engulf the invader. The
macrophage then "signals" white blood cells known as
T cells that the immune system has been invaded. The
T cells, so named because they mature in the thymus
gland, finish off the infected cell either by killing the
cell directly or by stimulating B cells (another type of
white blood cell) to produce antibodies to kill the cell.
The process is known as antibody-related immunity.
The body contains as many as 100 million different
kinds ofantibodies and an equal variety of memory T
cells and memory B cells. The memory cells provide
long-term protection against a subsequent invasion by
the same bacteria or virus.
Another type of immunity called cell-mediated
immunity is particularly important in helping the body
combat fungi, parasites, viruses, and tuberculosis. Cellmediated immunity causes T cells to attack directly
without the help of antibodies. A dramatic example of
what can occur when the immune system fails is the autoimmune deficiency syndrome (AIDS). The human
immunodeficiency viruses HIV-l and HIV-2-in
particular HIV-l-are responsible for AIDS. Anyone
who comes into physical contact with other humans
should be aware that blood and body fluids containing
visible blood are vehicles of the HIV virus. This also
applies to semen and vaginal secretions. Blood and body
fluids containing visible blood from all clients should always be handled as though they were infectious.l'
CLINICAL

NOTE:

With just a moment of thought it becomes apparent that no one of these systems is independent of the
others. The speech mechanism draws heavily on some
systems and less heavily on others, but either directly or
indirectly it is dependent upon all the systems in the
body. We shall be directing our attention to a good
share of the skeletal, muscular; nenJOUS,and respiratory systems. Sometimes our approach will be 1'egional and
sometimes it will be systemic and, at times, a little of

9Hodine numbers: Center for Disease Control (CDC): 1-800342-AIDS; Public Health Service Hotline: J-800-447-AIDS.

AND

ORIENTATION

each, We shall be less concerned with the circulatory

and endocrine systems, and probably will mention the
reproductive and digestive systems only in passing.

SPEECH

PRODUCTION

The Need for an

Integrative Approach
Each of us, in our own minds, must generate a working
construct of me speech and hearing mechanisms. Constructs are me personal property of the individuals responsible for generating them, and a valuable component
in the battery of clinical and teaching tools we use in our
professional lives. We must realize mat constructs should
never become stereotyped and inflexible. They should be
constantly in a state of flux and subject to modification.
Stereotyped constructs lead to stereotyped and inflexible clinical
management.
In the pages that follow, we will become familiar
with the structures comprising the speech and hearing
mechanisms. We will also be faced with the responsibility of integrating these structures into a manageable
working construct.
Speech production is sometimes described as consisting of four phases: respiration, phonation, articulation, and resonance. This compartmentalization of
the speech act is very unfortunate. It is incomplete, for
one thing, because it completely neglects the role of the
hearing mechanism and other avenues of feedback.l"
This compartmentalization also tends to convey
the impression of an unrealistic, temporal sequence of
events leading to the production of speech. That is,
first we breathe, then we phonate, then we articulate,
finally the process of resonance takes place, and 10 and
behold! Out comes speech! It's like putting beads on a
string.
A model of speech production is shown in Figure
1-34. It illustrates the need for an integrative approach
in generating a construct of speech production. Here,
speech begins at the cortical level. The thought or response process leads to a sequence of neural impulses
that are transmitted to the musculature of the breathing mechanism, to the larynx, and to the articulators.
These neural impulses can be (but are not necessarily)
delivered to all the musculature simultaneously, or to
individual structures. This model recognizes both temporal overlap and the mutual influence the structures

IOIt is interesting to see how quickly speech deteriorates when a

person cannot monitor me speech signal being produced, Small
wonder that me speech of the deaf and severely hearing handicapped requires such long-term and patiently managed therapy.

31

SPEECH PRODUCTION

Conscious

-I
I
I

- -

muscles

feedback
-

.,_

from
-

- -

and tendons

-.

Auditory feedback
~----------Conscious feedback from

....

Cortical level
thought processes
lead to

:..------------muscles

and tendons

I
I

t
I
I
I
I

Unconscious
feedback
L ______
...._from
____
I
I
I

muscles

and tendons

Neural

I
I
I
I
I
I

Sequential
neural
commands to
muscles of
respiration, phonation
articulation

and tendons

I
I
I
I
I
I
I
I
I

overlap

I
I

Phonation

Respiration

from

- - - - - - -

t
Temporal

feedback

Neural commands

overlap

muscles

commands
Temporal

Unconscious

f4 - - - -_

I
I
I
I
I

Articulation
h

Mutual

influence

Mutual

influence

+
FIGURE

1-34

A model of speech production,

of the speech mechanism may have over one another.

For example, we phonate and at the same time the articulators are actively producing a meaningful sequence of
speech sounds. In addition, changes in air flow resistance that occur during phonation and articulation
influence the respiratory system, and the articulatory
process will, in many instances, influence the phonatory mechanism.
Specialized receptors in our joints, tendons, and
muscles provide the brain with information about how
well things are going. Some of this information never
reaches the conscious level. Without feedback, auditory and proprioceptive,
speech production
would
be as haphazard as throwing darts in the dark. We
should also recognize that this highly integrated and
incredibly complex chain of events can be interrupted
(by disease, for example) at virtually any stage to interfere with the normal processes of speech production
and reception.

Sound Production
Those parts of the body most closely associated with
speech production include the lungs, the trachea, the
larynx, the nasal cavities, and the oral cavity (mouth).

These structures, shown in Figure 1-35, form a versatile and intricate sound production system.
Two absolute requirements for the production of
sounds of any kind are a source of energy and a vibrating element. The primary source of energy for speech
production is air provided by the lower respiratory tract,
in particular the lungs. They supply the sound vibrators
(the vocal folds in the larynx) with power in me form of
a fairly smooth unmodulated flow of air. We should note,
however, that the conversion of a flow of air into sound
may take place almost anywhere along the vocal tract,
which is that portion of the speech mechanism lying
above (and including) the vocal folds.
Usually we think of the vibrating folds as the primary source of sound for speech production, but there
are others. By constricting the vocal tract somewhere
along its length, the air stream may become turbulent to
produce fricative noise. In addition, this turbulence
may be generated with or without vibration of the vocal
folds. Sounds may also be generated by momentarily
blocking the flow of air through the vocal tract. A sudden release of the pressurized air may produce a mild
explosion or a plosive sound. The vocal folds, the lips,
the tongue, or the soft palate may act as valves to block
the flow of air and to release it.

32

CHAPTER

1 INTRODUCTION

AND

ORIENTATION

BIBLIOGRAPHY

AND

READING

LIST

Alopour-Haghighi, F, 1. Titze, and P Durham, "Twitch Response

in the Canine Vocalis Muscle," J. Sp. H17lg, Res" 30, 1987,290-294.
ASHA, AIDSIHIV
Implications [or Speecb-Lrmgllage
Audiologists, December, 1990.
~

Hard palate

"L---

Soft palate

Pharyngeal cavity

Pathologists and

Basmajian, J. V, P1"i11l{/1YAl1at011lY, 7th ed. Baltimore: Williams

and Wilkins, 1976,
Bloom, W, and D, Fawcett, A Textbook of Histology,
Philadelphia: W. B, Saunders, 1968,

9m ed.

Cunningham, D, J, Textbook of Al1at01l1Y, 9th ed. New York: Oxford University Press, 1951.
DiDio, L
Trachea

J A, Synopsis ofAnatomy.

Dorland's Illustrated Medical

W B, Saunders, 1975,

St. Louis: C.V Mosby, 1970,

Dictionary,

25m ed. Philadelphia:

Freeman, A. A, R, Adult Articular Cartilage,

Medical, 1973,
Lung tissue

London: Pitman

Gray, H., Gray's Anatomy, 36th British ed. (P L Williams and R

Warwick, eds.). Philadelphia: W B, Saunders, 1980,
Gray, H" Gray's Annunuy, 38t11British ed, London: Churchill and
Livingstone, 1995.

Diaphragm

Guyton, A, c., Textbook of Medical Pbysiology, oth ed. Philadelphia:

W, B. Saunders, 1981.
Henderson, 1. F, and J H, Kenneth, A Dictionary of Scientific
Ter111s,7th ed. Princeton, NJ: D, Van Nostrand, 1960.

FIGURE

1-35

Schematic of the speech mechanism,

Hultkranz, W, "Uber die Spaltricbtungen del' Gelenleknorpel," Verhandlungen der Anarornischen Gesellschafr. Aus der Zwolfen
Vesammlung in Kiel, 14 (Suppl.) 1898,

J udson,

L Y., and A T Weaver, Voice Science. New York: AppletonCentury-Crofts, 1965,

The quality of many speech sounds may be greatly

modified by changes in the configuration and thus the
acoustical properties of the vocal tract, These changes
are brought about mainly by modifications in the shape
of the oral cavity.
A physical analog of the speech mechanism might
consist of a power supply, vibrating elements, a system of
valves, and a filte7'ing device. No matter how the speech
mechanism is represented, one of the first considerations is a power supply. Chapter 2 deals with the power
supply, or the breathing mechanism.
It will be difficult initially to incorporate the breathing mechanism into our model. The breatbing mecbanism is an air pump, capable of supplying a variable
air stream to the larynx and to the articulatory mecbanism, each of which constitutes a variable resistance to
me flow of air. Until we add these sources of resistance
to our model, the breathing mechanism must stand
alone.

Kuehn, D" M, Lemme, and J Baumgartner, Ne71TaI Bases of

Speech-Hearing and Language, Boston: College Hill Press, 1989.
Love, R, ],' and W, G. Webb, Neurology f01' tbe Speecb-Language
Pathologist. Boston: Butterworth-Heinemann,
1992,
McCall, J G" "Scanning Electron Microscopy of Articular Surfaces," Lancet, 1968,
Moore, c., The Correspondence of Vocal Tract Resonance with
Volumes Obtained from Magnetic Resonance Images," J. Sp.
H177g, Res, 35, 1992, 1009,
Moore, K. L, Clinicaliy Oriented Anatomy,
and Wilkins, 1985,
Patten, B, M" Human

Baltimore: Williams

Embryology, Philadelphia: Blakiston, 1946,

Perlman, A., 1. Titze, and D, Cooper, "Elasticity of Canine Vocal

Fold Tissue," J. Sp, Hrng. Res" 27,1984,212-219.
Perrier, P, L. J Boe, and R Sock, "Vocal Tract Area Function Estimation from Midsagittal Dimensions with CT Scans and a Vocal
Tract Cast: Modeling the Transition with Two Sets of Coefficients," J. Sp, Hrng. Res" 35, 1992,53-67,
Woodburne, R T, Essentials of HU11lan Anatomy,
ford University Press, 1973,

New York: Ox-