Respiratory kinematics in profoundly hearing-impaired speakers.

Anteroposterior diameters of the rib cage and abdomen were measured in profoundly hearing-impaired individuals in a standing position during respiratory maneuvers and utterance tasks. Data were charted in relative motion diagrams (rib cage vs abdomen) which enabled graphic solution for lung volume change, relative volume displacements of the rib cage and abdomen, and chest wall configuration. Function during resting tidal breathing was within normal limits. Function during utterance was frequently deviant in one or more of the following regards: (1) linguistic programming, (2) mechanical adjustments of respiratory origin, and (3) mechanical adjustments of the larynx and upper airway. Deviancies in mechanical adjustments of respiratory origin were confined mainly to lung volume events. Overall function is discussed with respect to the potential muscular mechanisms governing different respiratory behaviors. We conclude that both a lack of normal auditory sensation and inappropriate early speech skill instruction are responsible for the respiratory behaviors observed. Implications for clinical endeavors are detailed and data are presented to illustrate the power of biofeedback in managing speech disorders in the profoundly hearing impaired, when those disorders are partially respiratory based.