A Normative Study Of Oral Sensation And Perception: Two-Point Discrimination, Form Identification, Tactile Pattern Recognition, And Mandibular Kinesthesia

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Content 71- 12,410
PUFALL, Harold Edward, 1924-
A NORMATIVE STUDY OF ORAL SENSATION AND
PERCEPTION: TWO-POINT DISCRIMINATION, FORM
IDENTIFICATION, TACTILE PATTERN RECOGNITION,
AND MANDIBULAR KINESTHESIA.
University of Southern California, Ph.D.,
1970 ---*
Speech Pathology
University Microfilms, A XER O X Company, Ann Arbor, Michigan
ac nppFTvrn
A NORMATIVE STUDY OP ORAL SENSATION AND PERCEPTION!
TWO-POINT DISCRIMINATION, FORM IDENTIFICATION,
TACTILE PATTERN RECOGNITION, AND
MANDIBULAR KINESTHESIA
by
Harold Edward Pufall
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(Communicative Disorders)
August 1970
UNIVERSITY OF S O U TH E R N CA LIFO R NIA
THE G RADUATE SCHO O L
U N IV E R S IT Y PARK
LOS ANGELES. C A L IF O R N IA 9 0 0 0 7
This dissertation, w ritten by
___________
under the direction o f h%. ?. Dissertation C om
m ittee, and approved by a ll its members, has
been presented to and accepted by T h e G rad u
ate School, in p a rtia l fu lfillm e n t o f require
ments of the degree of
D O C T O R O F P H IL O S O P H Y
....
n Dtan
D a ^ . . . . A u £ u s . t . l 2 . 7 . 0 .
ACKNOWLEDGMENTS
The writer wishes to acknowledge the contributions
of Dr. William Perkins, University of Southern California,
whose long-standing encouragement and personal commitment
made completing the requirements for the degree possible;
of Dr. Frederic Darley, Mayo Clinic, whose steady guidance
and direction and infectious enthusiasm made this disser
tation possible; of Dr. Robert Ringel, Purdue University,
!
jfor the loan of the oral esthesiometer, the design of the
I
(modified caliper, and the suggestions for handling the
|
! geometric forms; and of his wife and sons who were without
i
i
|husband and father while he collected the data in Rochester,
Minnesota and returned to write the dissertation in his
(study in Minot, North Dakota.
i
! A special acknowledgment is due the staff, the pre
land post-doctoral Fellows, and the office personnel of the
|Speech Pathology Section, Mayo Clinic, for their continued
i
expressions of interest and encouragement during that
period in which the writer was researching the literature,
writing the prospectus, and collecting the data.
11
TABLE OP CONTENTS
ACKNOWLEDGMENTS ....................
Page
ii
LIST OP TABLES.................................... vi
LIST OP ILLUSTRATIONS.............................. xi
! Chapter
I
I INTRODUCTION ................................ 1
j
! II REVIEW OF THE LITERATURE.................... 5
I Section A. Related Studies . 5
Oral Anesthetization
Electrical Stimulation
Texture Discrimination
Weight Discrimination
One-Point Tactile Recognition
Tactile Acuity
Tactile Localization Recognition
Kinesthetic Pattern Recognition
Oral Form Identification
Summary.................................. 21
Section B. Background Studies ............ 23
Two-Point Discrimination
Oral Form Identification
(NIDR 20's series)
Lingual Tactile Pattern Recognition
Mandibular Kinesthesia
Summary.................................. **2
III PROBLEM, DEFINITIONS, AND PROCEDURE ........ 44
Problem .................................. 44
Definitions.............................. 44
Stereognosls
Klnesthesls
TABLE OF CONTENTS (Cont.)
Chapter Page
Procedure .................... 46
Sample
Criteria for Selection of Test
Measurements
General Procedure
Oral Two-Point Discrimination
Oral Form Identification
Lingual Tactile Pattern Recognition
Mandibular Kinesthesia
Treatment of the Data
IV RESULTS OF THE INVESTIGATION................ 67
Sample.............. 67
Oral Two-Point Discrimination............ 70
Regression Line Values
Percentiles
Two-Point Llmen Values
Summary
Oral Form Identification................ 84
Statistical Analysis
Error Scores for Wlthln-Class and
Between-Class Groups
Retest Scores for Reliability
Error Scores for Within-Class
Stimulus Pairs
Error Scores for Between-Class
Stimulus Pairs
Summary
Lingual Tactile Pattern Recognition .... 107
Statistical Analysis
Error Scores for Stimulus Numbers
Error Response Numbers
Group Distribution of Error
Response Numbers
Summary
lv
TABLE OF CONTENTS (Cont.)
Chapter Page
Mandibular Kinesthesia .................. 117
Statistical Analysis
Error Scores for "Standard" Mouth
Openings
Error Scores for "Variable" Mouth
Openings
Error Scores for Same, Less, More
Variable-Standard Pairs
Error Scores for "same," "less,"
and "more" Judgments
Difference Llmen (DL) Values
Summary
V DISCUSSION.................................. 133
Oral Two-Point Discrimination ............ 133
Oral Form Identification................ lUO
Lingual Tactile Pattern Recognition .... 1^9
Mandibular Kinesthesia .................. 157
VI SUMMARY.................................... 162
Introduction
Review of the Literature
Procedure
Results
Conclusions
APPENDIXES........................................ 172
LIST OF REFERENCES................................ 193
v
LIST OP TABLES
Table Page
1. Age Range and Mean Age of the Seven Age
Groups and the Male and Female Subgroups
of the Sample................................ 68
2. Education Level of Sample.................... 69
3. Occupations of Sample........................ 71
4. Regression Line Values and Standard Error
of Variance for Midllne Sites of Three
Oral Structures for Male and Female Sub
groups on a Test of Oral Two-Point
Discrimination.............................. 72
5. Observed Percentiles for Midllne Sites of
Three Oral Structures for Sample on a
Test of Oral Two-Point Discrimination........ 81
6. Mean and Standard Deviation Two-Point
Llmen Values, in mm, for Midllne Sites of
Three Oral Structures for Age Groups,
Male and Female Subgroups, and Sample on
a Test of Oral Two-Point Discrimination .... 82
7. Results of Chi Square Tests applied to
Error Scores In judging 15 Wlthln-Class
Stimulus Pairs of the Seven Age Groups,
the Male Subgroup, and the Female Sub
group on a Test of Oral Foim Identifica
tion ........................................ 86
8. Results of Chi Square Tests applied to
Error Scores in judging 21 Between-Class
Stimulus Pairs of the Seven Age Groups,
the Male Subgroup, and the Female Sub
group on a Test of Oral Form Identifica
tion ........................................ 87
9. Error Scores In judging Foim Pairs In
Wlthln-Class and In Between-Class Groups
of the Seven Age Groups, the Male Sub
group, and the Female Subgroup on a Test
of Oral Form Identification ................ 89
vl
LIST OP TABLES (Cont.)
Table
10.
11.
; 1 2 •
j
|
!
! 13.
15.
16.
Page
Per Cent Values for Error Scores of the
Seven Age Groups, the Male Subgroup, and
the Female Subgroup Compared to Total
Error Scores of Wlthln-Class and of
Between-Class Groups on a Test of Oral
Form Identification........................ . 93
Per cent Values for Error Scores Compared
to Number of Responses of the Seven Age
Groups, the Male Subgroup, and the Female
Subgroup In Judging Wlthln-Class and
Between-Class Groups on a Test of Oral
Foxm Identification.......................... 96
Retest (Reliability) Scores for Judging
Six Wlthln-Class Form Pairs as MSameM or
"Different" of the Seven Age Groups, the
Male Subgroup, and the Female Subgroup on
a test of Oral Form Identification.......... 98
Results of Chi Square Tests Applied to
Reliability Scores of the Seven Age
Groups, the Male Subgroup, and the Female
Subgroup In Judging Six Wlthln-Class
Stimulus Pairs on a Test of Oral Form
Identification.............................. 100
Error Scores In Judging Wlthln-Class
Stimulus Pairs as "Same" or "Different"
of the Seven Age Groups, the Male Sub
group, the Female Subgroup, and the Sample
on a Test of Oral Form Identification........ 101
Error Scores In Judging Between-Class
Stimulus Pairs as "Same" or "Different"
of the Seven Age Groups, the Male Sub
group, the Female Subroup, and the Sample
on a Test of Oral Form Identification........ 102
Per Cent Values for Error Scores of Four
Wlthln-Class and Three Between-Class Form
Pairs Compared to Total Error Scores of
Wlthln-Class and Between-Class Groups of
the Seven Age Groups, the Male Subgroup,
and the Female Subgroup on a Test of Oral
Form Identification.......................... 105
vll
LIST OF TABLES (Cont.)
Table
17.
18.
19.
20.
j
I
I
! 21.
| 22.
|
I
j
23.
24.
Page
Results of Chi Square Tests Applied to
Error Scores in Identifying Stimulus
Numbers of the Seven Age Groups* the
Male Subgroup* and the Female Subgroup
on a Test of Lingual Tactile Pattern
Recognition.................................. 108
Error Scores in Identifying Stimulus
Numbers of the Seven Age Groups* the
Male Subgroup* the Female Subgroup* and
the Sample on a Test of Lingual Tactile
Pattern Recognition .......................... 110
Distribution and Error Frequency of
Error Response Numbers for Stimulus
Numbers of Sample on a Test of Lingual
Tactile Pattern Recognition .................. 113
Distribution and Error Frequency of
Error Response Numbers of the Seven Age
Groups, the Male Subgroup, the Female
Subgroup, and the Sample on a Test of
Lingual Tactile Pattern Recognition .......... 115
Results of Chi Square Tests Applied to
Error Scores in Judging Variable and
Standard Mouth Opening Stimulus Pairs
of the Seven Age Groups, the Male Sub
group* and the Female Subgroup on a
Test of Mandibular Kinesthesia.............. 118
Error Scores of the Seven Standard
Mouth Openings of the Seven Age Groups*
the Male Subgroup, the Female Subgroup,
and the Sample on a Test of Mandibular
Kinesthesia . .............................. 120
Error Scores of the Seven Variable
Mouth Openings of the Seven Age Groups*
the Male Subgroup* the Female Subgroup,
and the Sample on a Test of Mandibular
Kinesthesia.............. 123
Error Scores and Per Cent Values of
Error Scores Compared to Number of Re
sponses of Each Age Group* the Male Sub-
viii
LIST OP TABLES (Cont.)
Table Page
group* the Female Subgroup, and the
Sample In Judging Same. Less, and More
Variable-Standard Groups on a Test o i l *
Mandibular Kinesthesia ...................... 126
25. Error Scores of Error Judgment when
Making "same," "less," or "more" Judg
ment of Each Age Group, the Male Sub
group, the Female Subgroup, and the
Sample In Judging Same, Less, and More
Variable-Standard Mouth Opening Pairs
on a Test of Mandibular Kinesthesia.......... 128
26. Difference Llmen (DL) Values, In
Millimeters, of Seven Standard Mouth
Openings of Each Age Group, the Male
Subgroup, the Female Subgroup, and the
Sample on a Test of Mandibular
Kinesthesia.......................... 130
27. Error Scores In Judging 15 Wlthln-
Class and 21 Between-Class Form Pairs
and Error Scores In Judging 11 Wlthln-
Class and 18 Between-Class Form Pairs
of the Seven Age Groups, the Male Sub
group, and the Female Subgroup on a
Test of Oral Foxm Identification ....... 142
28. Per Cent Values for Error Scores of 15
Wlthln-Class and 21 Between-Class Form
Pair8 Compared to Number of Responses
and Per Cent Values for Error Scores
of 11 Wlthln-Class and 18 Between-Class
Form Pairs Compared to Number of Re
sponses of the Seven Age Groups, the
Male Subgroup, and the Female Subgroup
on a Test of Oral Form Identification........ 144
29* Error Scores In Judging 11 Wlthln-Class
and 18 Between-Class Form Pairs of the
Seven Age Groups, the Male Subgroup,
and the Female Subgroup on a Test of
Oral Form Identification.................... 146
lx
LIST OP TABLES (Cont.)
Table
30.
Summary Table of Mean Two-Point Llmen
Values for Test of Oral Two-Point
Discrimination, Error Scores of Wlthln-
Class and Between-Class Form Pairs for
Test of Oral Foim Identification, Error
Scores for Test of Lingual Tactile
Pattern Recognition, and Mean DL Values
for Test of Mandibular Kinesthesia of
the Seven Age Groups, the Male Subgroup,
the Female Subgroup, and the Sample . .
Page
170
x
LIST OF ILLUSTRATIONS
Figure Page
1. Oral estheslometer used for testing
two-point discrimination .................... 52
2. Eight plastic geometric forms* selected
from NIDB series of 20, used for "between-
class" and Hwlthln-classH comparisons for
| oral form Identification............ . , . * 55
3* Three plastic geometric forms, selected
from NIDR series of 20, used as practice
forms prior to testing oral form Identi
fication ................................. 57
4. Stainless steel stylus used for tracing
numbers on the dorsum of the tongue for
lingual tactile pattern recognition .......... 59
5* Numbers used as test stimulus Items In
test of lingual tactile pattern recog
nition ...................................... 60!
6. Numbers used as practice stimulus Items
in test of lingual tactile pattern
recognition.................................. 60
7. Modified vernier caliper with micrometer
used to determine "variable" and "stan
dard" mouth opening gap-sets for testing
mandibular kinesthesia ...................... 62
8. Regression line and clinical range
values, In mm, for oral two-point dis
crimination ability for male subgroup
(Ns*70) at the midllne site of the tongue
tip.......................................... 73
9* Regression line and clinical range
values, In mm, for oral two-point dis
crimination ability for male subgroup
(N=70) at the midllne site of the tongue
blade........................................ 7* +
xl
LIST OP ILLUSTRATIONS (Cont.)
Figure Page
10. Regression line and clinical range
values* In mm* for oral two-point dis
crimination ability for male subgroup
(!fc=70) at the midllne site of the upper
lip.......................................... 75
11. Regression line and clinical range
values, In mm, for oral two-point dis
crimination ability for female subgroup
(N=70) at the midllne site of the tongue
tip.................... 76
12. Regression line and clinical range
values, In mm, for oral two-point dis
crimination ability for female subgroup
(N=70) at the midllne site of the tongue
blade........................................ 77
13* Regression line and clinical range
values, In mm, for oral two-point dis
crimination ability for female subgroup
(N=69) at the midllne site of the upper
lip.......................................... 78
14. Per cent value for error score of each
age group, the male subgroup, and the
female subgroup compared to the total
error score of the "Wlthln-Class" group
and of the "Between-Class" group............. 9^
15. Per cent value for error score compared
to total number of error responses of
each age group, the male subgroup, and
the female subgroup for the "Wlthln-
Class" group and for the "Between-Class"
group........................................ 97
16. Per cent values of error scores of seven
age groups, the male subgroup, and the
female subgroup In Identifying stimulus
numbers . ................ 112
17. Per cent value of error score of each
age group, the male subgroup, and the
female subgroup compared to total error
score in judging seven standard mouth
openings ..... ............................. 122
xli
CHAPTER I
INTRODUCTION
The role of the oral sensory Input system as a
feedback system critical to the act of speaking was pro
posed by Fairbanks (195*0 when he applied the servosystem
concept to the speech mechanism. The term servosystem* In
troduced by Weiner (19^8), describes any self-regulating
mechanism capable of maintaining or altering the manner of
Its output according to an error feedback signal. Two of
the processes required for such self-regulation are (1) a
feedback process and (2) an error-detecting center.
If an Intact oral sensory Input system capable of
sending accurate signals to an error-detecting center Is
requisite for normal speech* then It does not seem unlikely
that some abnormal speech might be the reflection of dis
rupted sensory channels producing distorted feedback sig
nals. While this has long been accepted as fact for per
sons having gross neuro-sensory Involvements In which the
speech disorder Is one of a group of symptoms* It is only
within recent years that the question has been raised re
garding persons with other types of speech Involvements. Do
Individuals with speech disorders now described as "func
tional" or believed to be symptomatic of emotional or psy-
1
chological conflicts or identified with anatomical anoma-
j
;lies have defective oral sensory perception systems? Do
they differ from normal individuals? If the answer to
;these questions is "yes," the implications for speech
i
itherapy are obvious and the need for objective diagnostic
! i
measurements is paramount. j
' j
The task has been to develop and standardize such I
| |
'measurements. It is in this direction that the efforts of |
speech pathologists, neurologists, neurophysiologists, and
specialists in dentistry have been encouraged. During the j
! years 1952 through 1963 explorations of oral sensation and
perception were pioneered in the departments of speech at
three universities. In 1962 the National Institute of
Dental Research (NIDR) became interested in persons having
i
conspicuous disabilities of oral sensation and perception i
with associated incapacity of speech articulation, biting,
and chewing. Conferences held in February, May, and Octo
ber of 196* 1 - permitted a collaborative review of progress in |
test design and instrumentation, of clinical observations |
of obtained data, and led to additional research at other J
iunlverslty centers (Bosma, 1967).
Tests of mandibular kinesthesia and of oral sensa
tion, perception, and stereognosis are used to assess the
subject's ability to identify, by means of his oral sensory
input system, a movement or a stimulus object— its shape,
pattern, texture, weight, or the manner of its application.
3
The measure of the subject's response* or lack of response*
Is then Interpreted to represent the degree of "lntactness"
of that system. This has its analogue In neurology» neuro
logists have traditionally used extra-oral tests of one-
and two-point discrimination, tactile localization recogni
tion and manual stereognosis* to name a few* to provide in
formation that contributes to the assessment of the pa
tient's somesthetlc perception system. It seems safe to
assume* then* that a test or battery of tests which can
provide information relative to a subject's intra-oral sen
sory functioning would have value for the researcher* diag
nostician* and clinician in speech pathology.
A review of the literature reveals the extent to
which this has been explored. Tests of texture and weight
discrimination* one- and two-point tactile discrimination*
kinesthetic and tactile pattern recognition* mandibular
kinesthesia* and oral form identification and tests in which
oral structures were anesthetized or subjected to electri
cal and vlbro-tactlle stimulation have been designed and
administered to select samples of normal and abnormal popu
lations. The wide variety of purposes, designs, and proce
dures of these exploratory measurements is testimony to the
Interest and resourcefulness of the researchers.1
1McCall (1969), in an article based on a paper pre
sented at the 1968 National Convention of the American Cleft
Palate Association, reviewed five methods for the assess
ment of lingual sensation and perception.___________________
4
The results obtained to date( while contributing In
formation of acknowledged value, have been In many Instan
ces either contradictory or Inconclusive. No fine line can
yet be comfortably drawn between response patterns clearly
Indicative of a normal sensory Input system and those In
dicative of sensory deficit. The abilities of the normal
and the abnormal, particularly the marginal population,
cannot yet be consistently profiled or dichotomized. It is
possible that more must be known about the normal If the
abnormal Is to be more readily Identified.
This Investigation studied the oral sensation and
perception abilities of a sample of a normal population,
made up of an equal number of males and females represent
ing a wide age range, as determined by their responses to
four test measurements of oral sensation, oral stereogno-
sis, and mandibular kinesthesia.
Six studies with similar design and Instrumentation
are reported In the literature. These investigations, de
signed for the purpose of developing Instrumentation and
procedures, studied small samples of normal and abnormal
populations with discrete age ranges. A study for the pur
pose of obtaining normative data on a large sample repre
senting a wide age range, which might be used In future in
vestigations of both normal and abnormal subjects, has not
yet been reported.
CHAPTER II
REVIEW OP THE LITERATURE
The review of literature is presented in two sec
tions. Section A is a review of studies of oral anestheti
zation* electrical stimulation* texture and weight discri
mination* one-point tactile recognition* tactile acuity,
sensitivity, and localization recognition* kinesthetic pat
tern recognition* and oral form identification (wherein
forms other than the NIDR 20's series were used). Section
B is a review of studies of two-point discrimination, oral
form identification (incorporating or exclusively using the
geometric forms of the NIDR 20's series), lingual tactile
pattern recognition, and mandibular kinesthesia which pro
vided direction for the design, methodology, and instrumen
tation of this study.
SECTION A. RELATED STUDIES
Oral Anesthetization.
Guttman (195*0 used oral anesthesia in three of six
experimental conditions and found that fewer words were ar
ticulated correctly under anesthesia.
McCroskey (1956) investigated the effect of bila
teral mandibular block anesthesia on the articulators. Six
5
6
subjects read word lists under four condltionsi normal side-
tone, delayed auditory side-tone, anesthetizing of articu
lators , and delayed side-tone plus anesthesia. Articula
tion breakdown was greater during anesthesia than during
nomal and delayed auditory feedback.
Weber (1961) investigated the relative effect of
high level masking and bilateral mandibular block anesthe
tization of oral structures upon articulatory proficiency
and certain voice characteristics of normal speakers. Eight
subjects read a word list and a passage under four condi
tions! normal, air and bone conduction masking, anesthetiz
ing of articulators, and combined masking and anesthetiza
tion. More articulation errors occurred during the two
anesthesia conditions than during normal and masked condi
tions, while pitch and loudness were only slightly affected,
Klein (1963) evaluated the speech behavior of nor
mal speakers with respect to articulation, phonatlon, nasal
resonance, and overall speech effectiveness under normal
conditions and three experimental conditions! disrupted
auditory feedback (white noise masking), disrupted tactile
feedback (topical anesthesia), and combined disrupted
auditory-tactile feedback. Thirty male graduate and under
graduate students were randomly assigned to one of three
groups, with each group participating in one of the experi
mental conditions. Except for nasal resonance, combined
auditory-tactile interference caused more disturbance in
7
the features of speech Investigated than either auditory or
tactile Interference alone.
Ringel and Steer (1963) studied articulation profi
ciency, duration (syllable duration and overall word-per-
minute rate), average intensity peak level, and fundamental
frequency of speech under six conditionsi control, binaural
masking noise, topical anesthesia, local nerve block anes
thesia, binaural masking and topical anesthesia, and bi
naural masking and local nerve block anesthesia. Under
conditions of nerve block anesthesia, speech was character
ized by significant Increments of amplitude of performance,
lack of rate variability, and articulatory inaccuracy.
Mason (1967) conducted a study to identify areas
and mechanisms Involved in oral stereognosis discrimination.
Thirty subjects were tested in three experimental condi
tionsi absence of anesthesia, right after unilateral mandi
bular block, and after bilateral mandibular block. In the
(absence of anesthesia most oral perception of three-dimen
sional objects was carried out in the area of the anterior
portion of the tongue. Unilateral mandibular block anes
thesia appeared to have little effect on oral perception.
Bilateral mandibular block anesthesia produced a loss of
perception in some subjects and brought more structures in
to active Involvement with vigorous manipulations of the
objects by the tongue, lips, teeth, and palate. The pos
terior portion of the tongue, not anesthetized during bi
8
lateral anesthesia, appeared to be sensitive to perception.
Deep pressure sensation In the oral area did not appear to
be lost with block anesthesia.
Electrical Stimulation.
Pilot studies were reported by Grossman (1967) on a
few normal subjects and on three teenage patients with dis
turbance of motor coordination. Monopolar and bipolar
probe tips were used as electrodes. Inconsistent results
were reported for the neurologieally Involved patients.
For the normal subjects, the rugae and anterior palate, the
labial mucosa, and the tongue tip were more sensitive to
electrical stimuli than the posterior palate, buccal mucous
membrane, and posterior of the tongue dorsum.
Studies employing vlbro-tactile stimulation of the
oral mucosae have been reported In progress elsewhere.
Texture Discrimination.
Solomon (1965) used three one-inch white plastic
discs to measure ability to differentiate texture. The
discs were presented successively in pairs* the subject in
dicated which member of the pair appeared to be rougher.
The subjects, 45 athetoid children and adults, aged 7 to 43
years, with normal hearing and an IQ of 80 or above, were
placed in one of four categories based on ratings of chewing:
and drinking ability* normal, mildly defective, moderately
defective, or grossly defective. A measure of their articu
9
latory ability was also obtained. The normal and mildly
defective chewing subjects made no errors in texture dis
crimination! 46 per cent of the moderately defective and 33
per cent of the grossly defective chewers made errors on
the test. No errors in texture discrimination were made by
subjects in the normal drinking group and only one subject
in the mildly defective drinking group made an error.
Eighty per cent of the moderately defective and 75 per cent
of the grossly defective drinking groups made errors. A
slight tendency was also noted for subjects who had diffi
culty with texture discrimination to have low scores on the
test of articulatory ability.
McDonald and Solomon (196?)* In a 19^2 pilot study
with smooth-surfaced buttons scored to give different sur
face textures, found that normal children as young as five
years of age could orally diJ texture.
Ringel and Fletcher 3ix swatches of
emery cloth to study the o. .auic ^scriminatory ability
of 24 female university stude The results showed the
lingual structures were genert more accurate evaluators
of texture than the labial structures; the finger tip proved
similar to the oral structures in its mode of response! and
in general all structures evaluated were capable of making
relatively accurate textural discrimination.
In a second investigation Ringel (1969b) used seven
sandpaper discs to study the oral-texture discrimination
10
ability of 20 female university students. The data showed
that progression from maximal to minimal oral perceptivity
Involved the labial, lingual, and palatal regions in that
order. The finger tip response was most similar to that
obtained from the tongue tip. The alveolar ridge and tonguo
blade regions were clearly different from the labial,
tongue tip, and finger tip regions. The relatively more
mobile structures, those capable of more refined movement
patterns, were "better" discriminators than the other
structures tested.
Weight Piscrlmlnatlon.
Solomon (1965) used five containers made of one-
half inch clear plastic tubing filled with varying amounts
of lead pellets and cotton to measure the subject's ability
to differentiate between weights placed on the tongue.
Those subjects classified as grossly defective in chewing
ability were significantly less able to recognize the
heavier of two weights than were normal and mildly defec
tive chewers. Significant differences in weight discrimi
nation ability were also found between those subjects clas
sified as grossly defective in drinking ability and those
with normal or mildly defective drinking ability. However,
the correlations between the chewing and drinking abilities
and the ability to differentiate weights indicated that the
relationship of these measures was not strong. Only a
11
slight positive relationship was found between articulatory
ability and the ability to differentiate between weights.
McDonald and Solomon (1967), in their 1962 pilot
study, found that normal children as young as five years of
age could differentiate weights placed in the mouth. The
test items, Imbedded with different numbers of lead shot,
had the same volume but differed In mass.
One-Point Tactile Recognition.
Grossman et al. (1965) reported a two-part investi
gation of one-point tactile recognition. In the first part,
with six adults and using a Semmes-Weinsteln nylon filament
estheslometer, tactile sensitivity of four midline oral
sites and two extra-oral sites was Investigated. In the
second part, with six normal adults and using a low-range
force transducer employing electrical resistance strain
gages, tactile thresholds for three midline oral sites were
determined. The estheslometer study revealed the upper lip
to be significantly more sensitive than any of the other
sites. The tongue and lower lip were not significantly dif
ferent from each other but were significantly more sensi
tive than the incisive papilla, finger, and palm. The in
cisive papilla was significantly more sensitive than the
finger and palm, which were not significantly different
from each other. The second part of the study, the deter
mination of tactile thresholds, revealed that the vermilion
12
border site of the upper lip was three times more sensitive
than the muco-cutaneous Junction which, in turn, was three
times more sensitive than the Incisive papilla.
Henkln and Banks (196?), using a modification of
the Semmes-Weinstein technique, obtained thresholds for
light touch in the oral area and on the hand with a gradu
ated series of nine nylon filaments. The subjects were 25
normal adults and 12 children. Sensitivity of the tongue
tip and hard palate for all subjects was significantly
greater than for the other areas tested. The tongue blade
was not significantly different from the hand areas tested
in sensitivity. No significant differences were found be
tween males and females nor between children and adults,
although the mean values for light touch in all three oral
areas tested were significantly higher in the children than
in the adults.
Tactile Acuity.
McCall (1964) prepared eleven plastic plates, all
but one containing an engraved groove, to measure lingual
tactile acuity. The plates were passed in random order
over the tongue tip and finger tip. Test samples Included
11 normal children, aged 12 and 13$ and 17 cerebral palsied
subjects. The athetoid and spastic subjects did not differ
appreciably in tactile acuity measured on the tongue tip,
but both groups were poorer than the normal control sub-
Jects.
i
Three additional studies have been reported In
j
which McCall's eleven plastic plates were used to measure
lingual tactile acuityi Olroyd, 19^51 Ashby, 19661 and
I
jKnlght, 1966,
Olroyd (1965) compared the tactile acuity ability
of eighteen 9-year-old and eighteen 11-year-old children
and found no statistically significant difference between
jthe two groups.
Ashby (1966) Investigated the "effect of expert-
jmentally Induced drying on the lingual surfaces on measure
ments of certain lingual somesthetlc sensibilities."
jTwenty-four normal young adults were tested. Pour proce
dures were used to accomplish drylngi cotton swabs were
placed under the subject's tongue, Just behind the lower
Incisor teetht cotton pads were used to dry the tip and
dorsum of the tongue) when needed, the tongues of some sub
jects were areated with an air Jet) and Inhibition of sali
vary secretions was accomplished through the use of a drug,
ihematroplne. The results of the Investigation revealed a
|consistent change In measurements on the test of tactile
)
acuity with every subject experiencing a poorer performance
under the experimentally dried condition as compared to the
normal condition.
Knight (1966) evaluated the Influence of Intellec
tual functioning upon subject performance. Thirty slow
I Ik
, learners, with an intelligence range of 60 to 85, and 30
i
normal subjects, all of Junior high school age, were test-
i
i
; ed. No significant difference was found in the performance
of the slow learning and the normal control groups.
j
Tactile Sensitivity.
I
Ashby (1966), in his investigation of the effect ofi
I experimentally Induced drying of the lingual surfaces,
tested tactile sensitivity by touching the subjects with a
wisp of cotton on the tip and on either side of the tongue
!
under the experimental and normal conditions. The results j
i
of the investigation revealed no change in subject perform-|
i
ance under the condition in which the lingual surfaces were;
dried as compared to the normal condition.
Knight (1966), using tufts of sterile cotton twist-i
i
ed into a strand applied to the tongue tip and lateral mar-;
|
gins, found no significant difference in the performance ofj
30 slow learning and 30 normal subjects of Junior high age.j
McCall and Kirkley (196?) conducted a pilot study j
j
consisting of six neurologically normal and two neurolog- |
jically abnormal subjects for the purpose of evaluating a
tactometer, developed by the experimenters, in an "effort
to obtain improved methods for the measurement of thres
holds of tactile sensitivity." The tactometer Incorporated
an electro-hydraulic transport system into its design. For
this preliminary investigation, tactile sensitivity thres-
15
holds were obtained at seven sites on the vermilion border
of the lower lip. Four test sessions were scheduled for
two of the normal subjects; two sessions were scheduled for
all other subjects. A minimum of twenty threshold measure
ments were made at each site during each test session.
Retests were done on all subjects.
I
I
The experimenters reported that the findings sug
gested that the tactometer "makes available a reliable and
i
valid approach to the measurement of relative thresholds of
tactile sensitivity" with several aspects of the design of
the equipment, however, imposing limitations on Its appli
cation.
Tactile Localization Recognition.
I
| McCall (1964) measured tactile localization by
i
touching the subject twice in rapid succession and asking
whether he was touched on the same point or on different
jpoints. No group differences were revealed between cere
bral palsied subjects and normal subjects with, in most in
stances, the median thresholds of the spastic and athetoid
i
subjects being virtually the same.
Olroyd (1965) compared the tactile localization
ability of eighteen 9-year-old and eighteen 11-year-old
normal children and found no statistically significant
difference between the two groups.
Solomon (1965) tested localization by touching the
subjects at four oral sites with a wisp of cotton and with
16
the end of an applicator stick. Sometimes the subjects
were not touched. None of the subjects had confusion about
being touched or not being touched. The subjects In the
normal chewing category responded correctly to all of the
items. Approximately one half of the moderately and gross
ly defective chewers exhibited some difficulty with locali
zation; the latter group tended to experience difficulty
with both light and heavy touch. A tetrachoric correlation
of .50 suggested a moderate relationship between chewing
ability and localization. A similar relationship was found
between drinking ability and localization. Those subjects
who exhibited some difficulty with localization also re
ceived lower scores on the articulation test.
Knight (1966) tested the tip, lateral margins, and
midline of the tongue to compare tactile localization abi
lity of 30 slow learners and 30 normal subjects. A signi
ficant difference was found 1 the mean percentage of correct
responses of the slow learning group was 7^.6; the mean
percentage of correct responses of the normal control group
was 93.0.
Kinesthetic Pattern Recognition.
McCall (196^) measured kinesthetic pattern recogni
tion by having subjects trace with their tongues a pattern
cut Into a plastic plate. Ten test patterns were used,
with three alternates for each pattern. The subject lndl-
17
cated which pattern he thought his tongue had traced from a
display of the test stimulus and the three alternates. The
spastlcs were significantly poorer than the athetolds and
control subjects, the latter two groups not differing
systematically.
Oral Form Identification.
One of the earliest reported Investigations of form
Identification and lingual acuity was a study by Larson
(1955) designed for the purpose of discovering If "func
tional articulatory subjects tend to have different kines
thetic and tactile ability from normal subjects as shown by
testing bodily extremities (fingers) and an oral mldllne
area (tongue)." Two groups of 30 children, In grades 3
through 9, matched on the basis of sex, age, Intelligence
scores, economic level, and general similarity of sibling
pattern In the home, were subjects. A knob test, consist
ing of one standard and 10 variable solid plastic cylinders
one Inch long, was used to evaluate manual stereognosls.
Marble and hole tests were used to study lingual stereog-
nostlc ability. The former consisted of one standard (half
Inch diameter) and 10 variable sized solid plastic spheres}
the latter included 10 plastic disks, each bored with a
standard and a variable sized hole. No differences were
found In the manual stereognostic ability between the two
groups. While the results from the marble test showed no
I significant difference between the two groups, the results
I i
from the hole test afforded the control group a marked
i
superiority, significant beyond the ,01 per cent level,
over the experimental group, I
Class (1956), Investigating tactual-kinesthetlc
perception of forms with the tongue, compared the perform-
jance of normal speakers, cerebral palsied speakers, stut-
| ;
|terers, and speakers with articulatory difficulties. The
|test Items consisted of six geometric forms (circle, half
oval, square, rhombus, Isosceles triangle, and right isos
celes triangle) In seven sizes mounted on uniform strips of
^plexiglass. Statistically significant differences were
found among groups and among sizes of stimuli. Cerebral
palsied speakers were Inferior to the other groups. Stut
terers and speakers with articulatory difficulties were in
ferior to normal speakers, with the first two groups not
being significantly different from each other. Cerebral
palsied speakers required more time to Identify the forms
than the other groups, while the differences between the
stutterers, normal speakers, and articulatory-defective
|speakers were not significant. j
i i
Woodford (196*0 used three discriminatory tests on j
8 * 4 - subjects In five clinical groupings for an evaluation of
oral sensory ability and digital proficiency In the ldentl-j
flcatIon of plastic objects of varying size, thickness, and
shape and the perception of spatial orientation of two
! 19
I holes In a disk. Three spheres were used for the size test,
three disks for the thickness test, and three symmetrical
|
and three asymmetrical forms of unfamiliar geometric design
|
for the shape test. Oral perception of objects of varying
|
|shape was found to be less accurate than that for size,
that for thickness, and for the spatial orientation of two
iholes. Manual discrimination in all samples, except for
I two-hole spatial differences, was slightly better than oral
jdlscrlminatlon. The wearing of dentures by edentulous sub
jects did not affect oral perception of size, thickness, or
shape or the spatial orientation of two holes. In contrast,
the dentulous subjects were superior, both orally and dlgl-
i
tally, in their shape and two-hole discrimination ability.
No significant difference was found between children with
i
normal occlusion and those with malocclusion for two-hole
I
oral perception and for objects of differing size and shape.
The neurologlcally normal children performed all tests more
skillfully than the neurologlcally impaired. Woodford con
cluded that oral shape discrimination (oral stereognosis)
was the most discriminating test for oral sensory function.
i
! Solomon (1965) investigated the relationship be-
\
tween several measures of oral sensation and perception
(five one-half inch three-dimensional plastic forms were
used for the oral stereognostlc test) and ratings of chew
ing and drinking ability and a measure of articulatory
skills. Oral stereognosis scores correlated .81 with rat
20
ings of chewing ability, .75 with ratings of drinking abi
lity, and ,70 with articulatory skill. These results were
interpreted as indicating a marked association between oral
motor abilities in chewing and drinking and the ability to
identify forms in the mouth.
Houck (1966) studied the orientation of a form in
the mouth. The subjects, all college students, were 157
normal speakers, aged 17 through ^1 years, and 39 articula
tory-defective speakers, aged 18 through 23 years, Pour
arrangements of three raised dots (labeled as "specifically
haptic form elements") were used representing mirror images
and 180-degree rotation of the same symbol and correspond
ing to the braille characters for the letters d, f, h, and
The stimuli were produced on plastic paper with a
braille-writer, each single arrangement centered at the end
of a tongue blade. Each of the subjects explored the
arrangement with his tongue and recorded his identification
of the stimulus on a form offering a six-arrangement choice.
Age, sex, and preferred hand and eye were also recorded.
Individual responses ranged from consistent mirroring to
consistent inversion of the stimulus item with the majority
of the subjects showing "confusions" in their responses.
The lingual orientation of the normal and articulatory-
defective speakers differed significantly with the defec
tive speakers making more inverted and fewer usual respon
ses than the normal speakers. The identification (16 per
21
cent) of more dots than were presented suggested that the
standard spacing of braille and/or the size of the elevated
dots may be too small for normal speakers to Identify with
the tongue.
McDonald and Solomon (1967)* In their 19^2 pilot
study, found that nonnal children as young as five years of
age could differentiate three-dimensional forms placed In
their mouths.
SUMMARY
To summarize the studies reviewed In this section
Is to describe their differences. The studies may be di
vided Into two groupsi (1) those Investigating the effects
of oral sensory deprivation and (2) those measuring kines
thetic and tactile sensitivity. No two investigations. In
either group, employed identical procedure. Instrumentation,
or methodology with similar subjects. Some studies were
designed to develop and evaluate procedure and instrumenta
tion* others were concerned with defining tactile sensiti
vity thresholds* still others compared samples of like or
unlike populations of different sizes representing varying
age ranges.
Small samples of normal children and adults were
tested in a number of studies. Six adults were subjects in
one study and 25 adults and 12 children in another study of
one-point tactile recognition. Eleven children, aged 12
22
and 13, served as control subjects In a study of tactile
acuity, tactile localization, and kinesthetic pattern recog
nition. Three studies, all with similar test measurements,
had 36 nine- and eleven-year-old children, 2b young adults,
and 30 junior high age children, respectively, as subjects.
Thirty children In grades 3 through 9 were subjects for one
study of oral form identification* 36 children, age 7 to 1^
years, and 36 adults with an average age of ^9 years were
subjects for another study* while a third study tested 20
adults, age 16 to 36 years.
Negative findings, conflicting results, and instru
mentation requiring excessive subjective Judgment would
seem to preclude the use of some test measurements for col
lecting normative data. Anesthetization did not signifi
cantly affect oral form perception. Different texture
stimuli and procedures in two studies with similar adult
samples resulted in different oral structure orders for sen
sitivity. The hand-held Semmes-Welnsteln estheslometer,
used for one-point tactile recognition, requires a "Just
noticeable bend" of the nylon filament after skln-surface
contact. The degree of deflection, thus the force of the
pressure, is subject to the experimenter's skill and Judg
ment. The fatigue factor of nylon filaments has also been
questioned. Three-dimensional forms used in one study with
athetoid subjects were found to be too easy for speech-
involved children in another study. The pilot electrical
23
stimulus study reported inconsistent results for three
teenage neurologlcally Involved subjects.
SECTION B. BACKGROUND STUDIES
Two-Point Pi sorlmlnatlon.
McCall (196*0 postulated that there are at least
three monitoring systems— auditory feedback, tactile feed
back, kinesthetic feedback— which "provide the information
required to learn and then to maintain adequate speech."
Five tests, to explore the latter two monitoring systems
and based upon the hypothesis "that they would be measuring
different types of sensation and levels of integration or
use of sensation," were selected for the study. Four of
the tests assessed tactile sensibilities! the fifth test
was assumed to require a normal kinesthetic feedback mecha
nism for adequate performance. The sensory skills assessed
Included tactile acuity (see page 12), tactile localization
(see page 15), kinesthetic pattern recognition (see page
16), two-point discrimination, and tactile pattern recog
nition (see page 39).
An adapted Mltutoyo caliper was used to evaluate
two-point discrimination on the finger tips, upper lip, and
tongue of 8 spastic, 9 athetold, and 11 normal subjects.
An analysis of the results yielded no group differences be
tween the spastic, athetold, and control subjects for mea
surements on the tongue tip, the better and poorer sides of
w
the upper lip, and the better side of the tongue. The
spastic and control subjects could be differentiated only
on the poorer lateral margin of the tongue.
Five studies have been reported in which an adapted
Mitutoyo caliper, modeled after McCall's, was used to ob
tain measurements of two-point discriminations Olroyd,
1965» Ashby, 1966s Knight, 1966s Morgan, 1966s and Ellen-
der, 1968.
Olroyd (1965)» in an investigation with a test-
retest design to study measurement reliability, compared
the two-point discrimination ability of eighteen 9-year-old
and eighteen 11-year-old children. No statistically signif
icant difference was found between the two groups. Statis
tical analyses of the sensory abilities of the tip and
!lateral margins of the tongue yielded significant differ
ences) tongue tip two-point limen values were significantly
smaller than those for either of the tongue margins, with
no statistically significant difference for the latter.
t
! Ashby (1966) investigated the "effect of experi
mentally Induced drying of lingual surfaces on two-point
discrimination." Twenty-four subjects, 15 males and 9
females, aged 18 to 36 years, were tested. The results of
the investigation revealed a consistent change in measure
ments, with every subject experiencing a poorer performance
under the experimentally dried condition as compared to the
normal condition.
, Knight (1966), In a study designed to evaluate the
Influence of intellectual functioning upon subject perform
ance, compared the performances of 30 slow learners and 30
normal subjects, aged 12 to 15 years. The slow learners,
with an intelligence range of 60 to 85* were enrolled in a
day school for exceptional childrens the control subjects
were enrolled in a regular Junior high school. The results
of the investigation showed no significant difference in
the performance of the two groups.
| Morgan (1966) designed a study to investigate
1
"variability in two-point discrimination on measurements on
the tongue." Twenty-five normal young adults, aged 18 to
30 years, were the subjects. One hundred measurements were
I taken on the tip and each lateral margin of the tongue.
Test time extended over a period of five days for all sub
jects, with two test sessions held each day and a minimal
period of 30 minutes between tests. Five ascending and
j
five descending measures were recorded for each area at
jeach test session,
1 The results of the study yielded the following con
clusions! a real lack of homogeneity of variance among the
25 subjects for measurements obtained on the tip and both
margins of the tongue* the relative measurement variability
of the 25 subjects tended to be smaller on the tongue tip
as compared to both tongue margins* and there was no sig
nificant difference in the relative magnitudes of variances
2S
for the left tongue margins as compared to the right tongue
margins for the 25 subjects.
Ellender (1968) explored five perceptual categor
ies, suggested from data obtained In a pilot study, In the
"transition from one to two point perception" on the later
al margin of the tongue. Twenty-four normal females, aged
19 to 27 years, were selected as subjects. Data were col
lected from two test sesslonsi In the first session, an
alternating ascending-descending approach was usedi In the
second session, separated from the first by not more than a
week, identical procedures were used for 12 subjects and a
random schedule was used for 12 subjects. After each
stimulus trial, the subject chose from among the five per
ceptual categories the one which best described her percep
tual experience.
No significant difference was found in the fre
quency with which each perceptual category was reported,
although some were reported more frequently than others.
Each category was identifiable in the transition from one
to two point perception. A systematic difference in the
amount of two-point separation required to elicit the five
categories was evident. The random method of stimulation
yielded significantly higher thresholds for the five cate
gories than the alternating ascending-descending approach.
Two manuscripts of a study by McCall and Morgan
(1969a, 1969b) not yet published were made available to the
writer. The study was designed to observe average Ilmen
values and "to Investigate measurement variability and bi- j
j i
lateral asymmetry in two-point limens on the tongue." |
Twenty-five young adults, aged 18 to 30 years, were select-!
! i
jed as subjects. Ten two-point limen values were estab- j
11shed on the tongue tip and on the right and left margins
I of the tongue.
I i
Analysis of the data provided evidence of smaller
limen values and less measurement variability on the tongue
tip than on the tongue margins, with an apparent relation
ship between measurement variability and two-point discrim
inatory capacity. Asymmetry was noted in two-point dis
criminatory capacity on the tongue margins of more than
half of the subjects. There was a lack of homogeneity of
variance among the subjects for the two-point limens ob
tained on the three areas of the tongue.
In the second manuscript the authors discussed in
greater detail the asymmetry noted in tongue margin two-
point discriminatory capacity. Fourteen of the 25 subjects
presented statistical evidence of asymmetry. Of these 1*4>,
nine individuals exhibited superior two-point discrimina
tory ability on the left side of the tongue and five ex
hibited superior ability on the right side of the tongue.
All but one of the 14 were right-handed. The authors con
cluded that the finding might be interpreted as evidence
that "sensory sidedness" in the tactile sensory system may
28
be a normal neurological phenomenon.
Ringel and Ewanowski (1965) designed a study for
the purpose of establishing procedures and collecting norma
tive data "as are applicable In evaluating the two-point
discriminatory capacities of selected oral structures," An
oral esthesiometer was used to approach four oral and two
extra-oral sltesi the midline, right and left sides of the
upper lip, tongue tip, alveolar ridge, and soft palate, and
the thenar eminence of the right hand and the tip of the
right middle finger. Twenty female and five male univer
sity students, aged 18 to 29 years, were subjects.
The results, reported to be consistent with pre
viously reported neuro-physiologic and histologic data and
theory, showed the tongue tip to be the maximal discrimina
tory structure, followed in order by the finger tip, upper
lip, soft palate, alveolar ridge, and the thenar regions.
The midline sites of the structures consistently yielded
smaller limen values than either lateral site. The experi
menters felt that the instrumentation and procedures devel
oped for use in this study were appropriate for the inves
tigation.
Solomon (1965), using a lead divider with paper
clips bent so that both points touched the tongue tip
simultaneously, found that 20 of her ^5 athetold children
and adults were not testable because of the degree of in
voluntary activity. All of the normal chewers, most of the
29
mildly defective chewing group, one third of the moderately
defective chewing group, and only one in the grossly defec
tive group could be tested.
Henkin and Banks (1967) evaluated two-point dis
crimination thresholds on the tongue and hand. A Weinstein
two-point esthesiometer was used to approach the tongue
tip, tongue blade, and three sites on the left hand; a
steel compass with points of equal shape and bluntness was
used to approach the hard palate. The subjects were 25
normal adults and 12 children.
The results obtained clearly demonstrated that two-
point discrimination thresholds in the oral areas were sig
nificantly lower than hypothenar eminence thresholds. The
order for sensitivity for the oral areas tested wast tongue
tip, hard palate, and tongue blade. No significant differ
ence was found between thresholds of males and females nor
between thresholds of children and adults; however, the
children's thresholds in all areas tested were consistently
higher than those of the adult sample.
Ringel (1969a) tested 27 patients, aged 17 to 4l
years, being seen in an outpatient muscular dystrophy clin
ic. The patients demonstrated articulation and/or voice
disorders and each had exhibited dystrophic symptomatology
for a minimum of three years prior to the date of the study.
The findings, consistent with research cited earlier
(Ringel and Ewanowski, 1965)* revealed the tongue tip and
30
lip mldline regions to be more discriminatory than the
lateral sites. The two-point discrimination order was vir
tually the same for the muscular dystrophy group as that
obtained for the normal subjects. Some significant differ
ences were noted which suggested the "need to consider sen
sory alterations as part of the complex symptomatology of
muscular dystrophy."
Oral Form Identification (NIDR 20*s series).
Smith (1967) in a 1964 study designed to "explore
oral stereognostic testing procedures," administered a 15-
item test to 25 speech-involved children, 14 with clefts
and 11 with hearing losses, enrolled in a summer residen
tial therapy program. The test consisted of five three-
dimensional forms and ten plastic forms provided by the
National Institute of Dental Research (NIDR). The results
led to the conclusion that the test was weighted with easy
items and that there was an Insufficient number of diffi
cult items to make the test discriminating. Ten additional
forms from NIDR were added to Smith's test, making a 25-
item test which was used in subsequent studies by Aungst,
1965j Hollingsworth, 19671 Mihacs, 1967» and McDonald and
Aungst, 1967.
Aungst (1965) investigated the relationship between
oral stereognosis and articulation proficiency with 40 kin
dergarten and 40 first grade children. Three measures were
31
used to sample oral stereognostlc and speech abilities of
the childrem (1) the 25-ltem test of oral stereognosis*
(2) Deep Tests of Articulation for the s, r, 1, and £
sounds, and (3) a "global" rating of articulation profi
ciency obtained from the average of four Judges' ratings of
a recorded sample of the child's speech. Results of the
study suggested only a slight association between articula
tion proficiency and stereognosis ability. The correct
production of the r and £ sounds appears to be more closely
related with oral stereognosis ability than does the cor
rect production of the s and 1 sounds.
Hollingsworth (1967) compared form Identification
on the tongue with form identification on the lips of 20
subjects with normal speech and dentition selected from an
undergraduate public speaking class. Half the subjects
were tested first on the tongue and half were tested first
on the lips. No significant difference was found between
the two order conditions on either tongue or lips. Those
items which were difficult to identify on the lips were
generally the same as those which were difficult to Identi
fy on the tongue.
Mihacs (1967) studied the effect of covering the
hard palate on the identification of the 25 forms. Twenty
subjects with normal speech and dentition selected from un
dergraduate public speaking classes were tested, palatal
covers were Individually molded from base wax. Each sub-
I 32
i
,Ject was tested twice, once with the palate covered and
|once with the palate uncovered. No significant differences
were found for any of the conditions. The mean number of
I forms correctly identified with the palate covered (21,25)
| I
was identical with the mean number identified with the j
! i
palate uncovered, ;
j
McDonald and Aungst (1967) studied the relationship
between age level and ability to identify forms in the oral
i
cavity. The test population included approximately 30 j
children in grades one through eight and in the 11th and
12th grades, 40 college students, and 29 geriatric subjects^
: I
A statistical summary of the scores by age suggested a ;
growth curve showing improvement in mean scores as a func
tion of age until the midteens and a marked decrease in
mean scores in the geriatric group. The experimenters
pointed out that the leveling of the growth curve in the j
midteens parallels the completion of the oral and facial
j
structures, and that the decrease of mean scores in the
]
geriatric group may reflect decreased perceptual ability or ;
,be an artifact of the data, which were obtained on a group i
I ;
jof subjects who, except for two, were residents of a county
home for the aged.
The National Institute of Dental Research standard
set of 20 geometric plastic forms (NIDR 20's series) was
used as the test instrument in investigations of Hetherlng-
ton, 1965i Levin, 1965i Carpe et al., 1967j Mason, 19671
33
Moser et al., 1967* and Shelton et al., 1967.
Hetherington (1965) used modifications of drawings
of the alternatives In the Shelton et al. (1967) study to
develop a test of oral form perception. Fifty subjects In
each of three age groups— 1st grade, 3rd grade, and col
lege— were tested. The test proved to be too difficult,
particularly for the younger children, to make an Identifi
cation of persons with oral sensory deficits.
Levin (1965) studied tactile agnosia or astereog-
nosls in aphasic patients by comparing the abilities of 27
adult aphasics with 66 normal adults in the areas of man
ual and oral stereognosis. A set of 20 plexiglass forms of
the same thickness but twice as large as the oral forms was
used for manual stereognosis testing. Significant differ
ences were revealed between the aphasic and normal subjects
for both oral and manual stereognosisi the aphasic subjects
were inferior to the normals in all scores. The errors of
the aphasics were not unlike those of the normals but
occurred with far greater frequency. Significant confu
sions were found between a number of forms for both the a-
phaslc and the normal subjects in both tests of oral and
manual sterognosis.
Carpe et al. (1967) investigated the effect of
teaching on oral form identification with 30 children
selected from 1st and 2nd grades. After completion of the
first test, 15 children were randomly selected to receive
15 minutes of teaching (those not selected spent the time
i
looking at and naming pictures). Pour experimental groups,
j
|Identified by the teaching modality, were formedi verbal,
visual, manual-tactile, and proprioceptive. After the
period of training (or of naming pictures), each child was
I
I again tested with the 20 Items. The mean scores of the
jpre-experimental and post-experimental tests of the taught
j
and the untaught children led to the conclusion that visual,
jtactlie, and proprioceptive stimulation had no significant
effect on Identification of forms by 1st and 2nd grade j
|children.
Mason (1967) reported an on-golng study at a cleft
palate center and training program with a cleft palate j
population to "determine whether oral perception deficits
iexist In this population and, If so, whether such deficits |
could be related to cleft type." Forty-two subjects,
selected at random from a two-month period of out-patient
appointments, were accepted into the study on the basis of
the examiner's Judgment of their ability to understand the
testing Instructions. Most of the cleft palate types were
represented, In Isolation and In combination with clefts of
the lip. Some of the subjects were postsurgical. Subjects
wearing prosthetic speech appliances were tested both with
and without the prosthesis.
No perceptual deficits for oral stereognostlc abili
ty of the ^2 subjects were revealed. No perceptual dlf-
| 35
ferences were found between cleft types. The results sug-
|
gested that this congenital anomaly Is not accompanied by
"congenital sensory Impairment of the oral area and that
there is no overall sensory deficit following tissue manip
ulation In cleft palate and lip surgery."
|
Moser et al. (1967) described Investigations of
|Kile, Kile and Class, and LaGourgue. Kile, in a test-
i i
j !
; retest study, compared oral stereognostlc abilities of
eight normal and eight articulatory-defective speakers. No
significant difference was found between the two groups,
jnor was a significant difference found between the test- !
|retest conditions for either group.
In a second experiment with the same general pro
cedure as the first, Kile and Class used three groups of
I ;
normal speaking college students and three sizes of the 20 j
forms1 standard, two-thirds standard, and one-half standard;
l i
size. Groups and form sizes were paired. Three questions
were posedi (1) Is there a difference in test-retest scores;
for the three form sizes? (2) Is there a difference in the:
pattern of confusions for the three form sizes? (3) Do the|
20 geometric forms differ In difficulty? An analysis of j
variance of three sizes versus trials revealed significant !
differences among the sizes but not between the trials)
there was, however, significant Interaction between the
trials and sizes. There were critical differences between
the standard size and the two-thirds standard size and be-
36
tween the standard size and the one-half standard size of
the first trial. Significant confusions* at the .01 level,
were revealed between a number of the forms for each of the
three form sizes.
LaGourgue, in the third Investigation, studied form
perceptive ability in 53 subjects with defective vision and
6l subjects with defective hearing (51 oral deaf and 10
manual deaf) with a minimum age of 12 years selected from
state schools for the blind and for the deaf. In the first
part of the study subjects matched the 20 forms using only
one (non-oral) sense modality. The blind subjects explored
and matched the forms manually (tactile sense)j the deaf
subjects explored and matched the forms visually. Those
unable to attain a score of 18 correct (or 90 per cent) on
the test of unisensory matching were not considered valid
subjects for the second part of the study— the test of oral
form perception. Twenty-seven blind, **8 oral deaf, and 10
manual deaf students formed the final experimental samples.
All explored the forms orally. The blind matched the forms
manuallyi the deaf matched the forms visually. Data was
taken from Levin's (1965) study for comparisons with a nor
mal sample's performance. On the basis of the samples used
in the two studies and considering only mean scores, it was
concluded that there is probably no significant difference
between blind, deaf, and normal populations in oral stereog
nosis ability.
| 37
j Shelton et al. (1967) In four pilot studies under
took the task of developing a test of oral form perception
which "would accurately assess an Individual's stereognos-
itlc ability."' The test form In Pilot Study IV, based on
i i
| ,
|information and experience from the first three pilot j
studies, was administered on different occasions to 26 1st j
i |
igrade children, 63 3rd grade children, and ten graduate |
S 1
! 1
students. The low scores for all groups led to the conclu-|
sion that the test was too difficult. j
1
Research has been recently reported in which
selected items from the NIDR 20’s series were used to con- j
struct a test for investigating oral stereognosls. Ringel !
et al. (1968) selected ten formsi two isosceles triangles, j
a square, two rectangles, three ovals, and two biconcaves.
The forms were subdivided into four geometric classes1 j
triangular, rectangular, oval, and biconcave. Pairing of |
j
the forms made possible "within-class" (triangle with tri
angle) and "between-class" (triangle with rectangle) stimu-j
1
lus pairs. The subjects were 20 normal-speaking, aged 19 |
;to 25 years, and 27 articulatory-defective, aged 18 to 25 |
I !
years, university students. The latter group was divided
jinto mild articulation (12 subjects) and moderate articula
tion (15 subjects) groups.
In a second investigation, Ringel et al. (1969) ad
ministered the 10-ltem test to 60 normal children and 60
children with "functional" articulation disorders enrolled
38
In grades 1-5 In local public schools. Selection of the
articulatory-defective children was such that three groups
of children, representing mild, moderate, and severe de
grees of articulation problems, were formed. The data ob
tained from the 120 children were compared with the data
contributed by the ^6 university students tested in the
earlier study.
An analysis of the combined data revealed that sub
jects with articulatory disorders made more errors in the
discrimination tasks than did subjects with normal speech}
that there was a clear tendency for discrimination errors
to increase as a function of the severity of articulation
defect; the children had more difficulty than the adults
with the discrimination task} and the magnitude of the vari
ability data followed the trend established by the average
scores.
A study of the reliability items used supported the
interpretation that the task was meaningful to and well
within the performance capabilities of the subjects. The
data suggested that the items permitted a satisfactory
level of response reliability since the major differences
were between age groups, the children's responses were less
reliable than those of the adults, but the level of articu
lation proficiency did not appear to be a factor in the
test-retest performance. The data also suggested that a
measurement of the ability to discriminate form in the
39
mouth can differentiate between degrees of articulatory
proficiency that have been independently established by
other means.
The "within-class" errors for both the children and
the adults did not identify levels of speech proficiency.
The proportion of "between-class" errors, however, for both
the children and the adults, increased "monotonically as a
function of severity of articulation defects." The ratio
between "within-class" and "between-class" errors of sub
jects with normal speech differed significantly from a
similar ratio of subjects with articulatory defects.
It was proposed that the "within-class" and
"between-class" comparison tasks appeared to be evaluating
performances at different levels of discriminatory activity.
The "within-class" task, which did not distinguish between
experimental groups, might be measuring "acuity" at some
level of the nervous system that is independent of speech
function while the "between-class" task appeared to test
discrimination processes whose integrity correlates posi
tively with articulation proficiency. The experimenters
suggested that future oral form discrimination testing me
thods eliminate comparisons of the "within-class" category.
Lingual Tactile Pattern Recognition.
McCall (1964) assessed tactile pattern recognition
by tracing a series of geometric designs, letters, and ab
stract forms on the dorsum of the tongue. The test had two
forms» each with ten stimulus patterns. Practice trials
were given with a third set of patterns. A group of 17
cerebral palsied subjects, age 12 to 20 years, and a group
of 11 normal children, aged 12 and 13 years, were studied.
The test results, while leading the experimenters
to conclude that this task was not difficult for the three
groups as a whole, yielded some differences. Only on this
task both the cerebral palsied subjects and the control
group improved by a statistically significant amount on the
retest, with the amount of improvement being essentially
the same for both groups. The performance of the athetoid
subjects was superior to that of the spastic subjects as
well as to that of the normal subjects. Mental age (not a
controlled variable in this study) differences between the
two groups was cited as a possible factor.
The study indicated that each test could be under
stood by children as young as six years of age and could be
performed satisfactorily by persons with all but the most
severe neuromotor involvement. Sensory defects were found
with surprising frequency, with deficiencies in oro-facial
sensation and perception not necessarily accompanied by
similar hand defects. It was concluded that there was a
satisfactory degree of Independence among the measurements.
Olroyd (1965), in an investigation with a test-
retest design to study measurement reliability, used the
41
test patterns to compare the tactile pattern recognition
ability of eighteen 9-year-old and eighteen 11-year-old nor
mal children. Of the four test measurements In this study,
on this test only were the 11-year-old children found to
perform superiorly to the 9-year-old children.
Ashby (1966) used McCall's test patterns with 24
normal adults, 15 males and 9 females, aged 18 to 36 years,
to study the effect of experimentally induced drying of the
lingual surfaces on tactile pattern recognition. The re
sults revealed a consistent change in response measurements
with every subject experiencing a poorer performance under
the experimentally dried condition as compared to the nor
mal condition.
Mandibular Kinesthesia.
Mandibular kinesthesia was investigated by Ringel
et al. (1967) In a study designed to "develop instrumenta
tion and procedures, and to collect basic data upon which
the direct study of oral kinesthetic sensibility and speech
production can be based," A modified vernier-type caliper,
the measuring tips extended by stainless steel plates, was
used to detemine mandibular kinesthesia difference limens
(DL). Twenty-five female and five male university students,
aged 18 to 26 years, were tested. The subjects compared
the magnitude of a standard mouth opening to the magnitudes
of a series of variable mouth openings and made Judgments
42
regarding their relationship as equal, greater, or smaller.
Nine values (rangei 9.6 - 26.8 mm) were selected as the
"standard" mouth openings! each standard was compared to
four smaller and to four larger mouth openings and to a
mouth opening equal to Itself.
An analysis of the data showed that the absolute DL
appeared to be fairly constant for the various mouth open
ings. The three smallest and the largest standard mouth
openings had absolute difference limens of 2.0 mm. The in
tervening mouth openings had absolute difference limens
ranging from 2.2 to 1.4 mm. It was concluded that the ab
solute DL for mandibular kinesthesia, for the oral range
studied, was relatively independent of the degree of mouth
opening.
When the relative DL values were determined, a dif
ference was notedi as the size of the mouth opening In
creased, proportionately smaller changes In the mouth open
ings were required for the judgment of a difference.
SUMMARY
Studies of four measurements of oral sensory func
tioning were reviewed in this section. In general, sensory
perception differences were found In noxmal subjects for
age groups and for lntra- and extra-oral sites tested and
between normal subjects, defective speakers, and persons
with organic pathologies. Perhaps the consistency of the
. 2 ^ 3
reported results reflects the instrumentation methodology,
or the unisensory nature of the stimulus-response mode of
these investigations.
While the validity of the results obtained is not
in question, the small number of studies reported designed
to explore and obtain nonnative data as well as the limited
number and discrete age ranges of the subjects tested in
these studies obviates a generalization of the results to
the general population. Single studies of two-point dis
crimination (using the oral esthesiometer), lingual tactile
pattern recognition (comparing normal and cerebral palsied
subjects), and mandibular kinesthesia have been reported.
Twenty-five normal adults, aged 18 to 29 years, were sub
jects for the first studyj 11 normal children, aged 12 and
13 years, were normal subjects for the second studyj and
thirty normal adults, aged 18 to 26 years, were subjects
for the third study. Two investigations of oral form dis
crimination (using selected NIDB 20's series forms) have
been reported. Twenty normal adults, age 19 to 25 years,
were subjects for the first study and 60 normal children
in grades 1-5 were control subjects for the second study.
CHAPTER III
PROBLEM, DEFINITIONS, AND PROCEDURE
PROBLEM
This study was concerned with investigating oral
sensation and perception in a sample of 140 normal sub
jects, composed of an equal number of males and females,
jwith an age range from six through 64 years.
|
It was the purpose of this study to establish nor
mative values for two measures of oral sensation, one
measure of oral stereognosls, and one measure of mandibular
jkinesthesia by age and by sex.
DEFINITIONS
Stereognosls.
Crltchley (1954) discusses stereognosls as followsi
Some authors, e.g., Delay (1939)* would
describe not two but three separate steps In the
tactile recognition of an object. Thus, the ac
tual physical properties may be broken down Into
two categories! first, the recognition of size,
shape and weight; and secondly, the recognition
of the consistency, thermal properties and struc
ture of the object In question. Some may argue
that these two groupings are a little artificial.
If, however, they are accepted for the time being,
then one can assume three separate activities in
recognizing, say, a lump of sugar placed In the
hand. Thus, it may be realized that the object
is a cubical structure, small in size and llght-
44
45
weight. Delay would then Isolate a further pro
cess. whereby the article was found to be hard,
with a rough surface, and made up of granula
tions. Lastly, there Is the stage whereby this
article Is Identified as a lump of sugar.
Neurologists frequently use a composite
term to cover all three of these operations,
namely, stereognosls ....
DeJong (1958) defines stereognosls as the "faculty
of perceiving and understanding the form and nature of ob
jects by touch, and of Identifying and recognizing them."
He adds that "when this ability Is lost, the patient has
astereognosis, or tactile agnosia." Blckerstaff's (1963)
definition Is "the ability to recognize an object purely
from the feel of Its shape and size. Mason (1967) defines
oral stereognosls as the "act of Identifying objects of
varying size and shape within the oral cavity."
The definition which might be identified with this
study (and which Is also quoted by Shelton et al., 1967) Is
that by Woodford (1964)t oral stereognosls Is "the faculty
of perceiving three dimensional qualities (shape) of ob
jects examined orally and of identifying them. ..."
Woodford continues with the statement that any "Inability
to perform this task represents astereognosis regardless of
whether It Is organic or functional."
Kinesthesia.
Two medical dictionaries have the following defini
tions! "The sense by which muscular motion, weight, posi-
k6
tlon, etc., are perceived" (Dorland's, 2^th ed., 1965)» and
"The sense perception of movementj the muscular sense"
(Stedman's, 21st ed., 1966).
Gibson (1967) describes klnesthesis as followsi
In this chapter klnesthesis will be used
to mean what It literally denotes— the pickup of
movements. It is not a clear concept in exist
ing textbooks because, to be logical, the term
would have to be supplemented with another term,
statesthesls. or the pickup of non-movement. It
cuts across the functional perceptual system.
The discrimination of bodily movement from non
movement is too important for the organism for
it to have been wholly entrusted to any single
group of receptors. . . . Klnesthesis is per
ceptual without being sensory1 it is one of the
best examples of sensatlonless perception.
PROCEDURE
Sample.
One hundred forty noxmal subjects (see Appendix A)
were used for this study, 70 males and 70 females. The age
range was 6 years, 1 month to 6k years, 10 months.
Seven groups, determined by age, were established.
Each group consisted of 20 subjects, ten males and ten fe
males. The age range of the groups was as followsi Group I,
6—91 Group II, 10-19i Group III, 20-29i Group IV, 30-39»
Group V, 40-^9j Group VI, 50-59i and Group VII, 60-6*1-.
Thus, Group I had a four-year age range» Group VII had a
five-year age rangei and the remaining five groups each had
a ten-year age range.
The initial design of the study included five-year-
*7
old children to provide a five-year age range for Group I.
Preliminary testing with the five-year-old children avail
able to the writer negated their Inclusion In the study.
Some were not proficient with numbers (for Lingual Tactile
Pattern Recognition)* others evidenced confusion while com
paring "variable'* and "standard" mouth openings (for Man
dibular Kinesthesia)* still others experienced difficulty
recalling and following Instructions. The lower age limit
of the sample, therefore, was set at six years while the
upper limit was held at sixty-four years.
i
While a number of the subjects were not native to
Minnesota, all were residents of Rochester or the surround-
jing metropolitan area. Subjects in Groups I and II who were
I at elementary and secondary grade levels were made avail
able to the writer by parents and school administrators.
Adult subjects (17 years of age and older) were volunteers.
Subject selection was determined by the require-
i
ments of the study designs age, sex, and physical fitness.
i
A medical history was taken for screening purposes (see
iAppendlx B). No subject reported a history of chronic dis
ease or sensory or motor disturbances. The writer sub
jectively evaluated the subjects' speech and hearing while
taking the medical history and during the discussion of the
test equipment and response procedures. All subjects were
free of speech Involvements. No subject reported a hearing
loss, had a history of chronic ear conditions requiring
| ^8
medical or surgical treatment, or gave evidence of behavior
or speech qualities characteristic of diminished hearing*
!Criteria for Selection of Test Measurements* i
!
The criteria which served as guidelines for the j
!selection, design, and Instrumentation of the tests em
ployed in this study were based on the results and experi-
1 i
! I
jences of experimenters whose research In the areas of oral j
sensation, oral stereognosls, and mandibular kinesthesia
were reported in Section B of the review of literature.
The criteria for the test Items were that they
1(1) be relatively - easy to handle, (2) be available to all
investigators, and (3) make it possible to obtain measur
able, reproduceable data.
The criteria for the individual test measurement
were that it (1) not be a test of intelligence, (2) be ap
plicable to subjects representing a wide range of ages and ;
physical conditions, (3) be a unlsensory measurement,
(4) have demonstrated a degree of reliability, (5) could be
completed in a relatively short period of time, (6) not re-
jquire a great amount of preparation on the part of the ex
perimenter, and (7) be relevant to speech activity.
I
The criteria for the battery of tests were that it
(1) could be completed in one sitting and (2) provide data
of a multi-sensory nature.
The four test measurements selected werei
^9
1. Oral Two-Point Discrimination! subject
Identifies one- and two-point skin surface contact
by probe tips on an oral estheslometer.
2. Oral Form Identification! subject Judges
pairs of plastic geometric forms, selected from
NIDR 20's series, as "same" or "different,"
3. Lingual Tactile Pattern Recognition!
subject Identifies a series of one-digit numbers
traced on the dorsum of the tongue with a stylus.
* » - . Mandibular Klnestheslai subject compares
a “variable" to a "standard" mouth opening, deter
mined by a gap-opening set between probe tips of a
modified vernier caliper, and Judges it as "same,"
"less," or "more."
General Procedure.
The tests of oral two-point discrimination, oral
form identification, lingual tactile pattern recognition,
and mandibular kinesthesia were Individually administered
to each of the 1^0 subjects.
The testing was done at five locations. Each test
room was well-lighted, adequately ventilated, free from en
vironmental noise, and Isolated from the traffic pattern of
the building. The subject was seated In a comfortable, up
holstered chair In basically a face-to-face relationship
with the examiner! the exact position of the subject varied
50
slightly from test to test as dictated by the mechanics of
test Item presentation. Record sheets (see Appendix C)
were on a table Immediately to the examiner's right. The
test Items, and those used for orientation, were arranged
to the right of the record sheets, covered, and sterilized.
The four tests were presented In a counterbalance
order. For example, subject 1 was tested first for oral
two-point discrimination, followed by oral form Identifica
tion, lingual tactile pattern recognition, and mandibular
kinesthesiai subject 2 was tested first for oral form Iden
tification, followed by lingual tactile pattern recogni
tion, mandibular kinesthesia, and oral two-point discrimi
nation; subject 3t therefore, was tested first for lingual
tactile pattern recognition, followed by mandibular kines
thesia, oral two-point discrimination, and oral form Iden
tification. The subject's responses were recorded at the
time they were given. Each test was completed before the
next one was started.
An orientation to the test Item, procedure, and
desired response preceded each test. The equipment was
presented for Inspection, the test procedure explained, and
a trial practice was done. This was considered necessary
to minimize subject confusion, reduce anxiety, and give the
examiner an opportunity to observe the subject's response
pattern.
51
Rest periods of three to five minutes were observed
between testsj rest periods during a test were at the re
quest of the subject or at the discretion of the examiner.
All questions were answered. The four tests were completed
in one sitting.
Oral Two-Point D1scrlmlnation.
An oral estheslometer (Figure 1.), developed and
described (see Appendix D) by Ringel and Ewanowskl (1965).
was used for this task. Three midline oral sites were ex
plored! the vermilion border of the upper lip, approxi
mately 1.5 mm from the marginj the dorsal surface of the
tongue tip, approximately 5*0 mm from the lingual apex; and
the dorsal surface of the tongue blade, approximately 3*0
cm from the lingual apex. All sites were marked to insure
location consistency for repeated stimuli presentation.
Three ascending and three descending patterns were
presented at each test site, starting with an ascending
pattern (0.0, 0.5, 1*0, 1.5, • • • mm) and alternating with
a descending pattern (. . . 1.5, 1*0, 0.5, 0.0 mm) until
the six patterns had been completed. The change In the
gap-opening between the probe tips was In discrete steps of
0.5 mm. The ascending pattern was started at 0.0 mm and
continued until the subject reported two two-point contacts!
the descending pattern was started at this last gap-opening
set and continued until the subject reported two one-point
Fig. 1. Oral esthesiometer used for testing two-point
discrimination.
53
contacts. The probe tips were held to the test site for
approximately two seconds. The subject was Instructed to
report a "two-point" contact, during both the ascending and
descending patterns, only when this was clearly recognized.
The following instructions were given as the esthe
siometer was presented for inspection and demonstration!
I am going to touch you lightly with these
tips at three placest your upper lip, tongue
tip, and near the middle of your tongue. As you
can see (demonstration), the tips can be moved
apart or brought together. You are to tell me,
after I've touched you, if you felt one or two
tips. Be absolutely sure that you felt two
tips before stating so.
We'll have a short practice session first.
I'll use the tip of the middle finger of your
preferred hand (the hand you write with).
Following the practice session, which usually con
sisted of one ascending pattern until the subject reported
a two-point contact and one descending pattern until the
subject reported a one-point contact, the following addi
tional instructions were givem
It will be necessary for you to have your
eyes closed. I'll tell you when you may open
them. Bemember, report two points only when you
are sure that you felt two points. Are there
any questions? Are you ready? Close your eyes
and we'll begin.
The median values for the three ascending and three
descending pattern series were determined for each site.
These values were then converted into mean scores which
represented the subject's two-point limen scores for the
three midline oral sites.
54
Oral Form Identification.
Eight plastic geometric forms (Figure 2.), selected
from the NIDR 20's series (see Appendix E), were used for
this task. The eight forms represented three geometric
classesi triangles (1, 2), rectangles (3* 4, 5)* and ovals
(6, 7. 8). All were used without stems. For ease of hand
ling, each form was drilled with a hole approximately 0.2
mm in diameter, 1 mm from an edge, and tied to a thread 12
Inches long.
The forms were presented as stimulus pairs for
"within-class" (e.g., pairs 1-2, 6-7) and "between-class"
(e.g., pairs 2-3» 5-6) comparisons. Each form was paired
with Itself and/or with every other form in the class with
each stimulus pair used only oncej that Is, pair 1-3 was
not repeated as pair 3-1• The 21 "between-class" pairs
were presented first, followed by the 15 "within-class"
pairs, in the order In which they appear on the record
sheets (see Appendix C) for a total of 38 stimulus pairs.
To serve as a reliability check, six of the
"within-class" pairs were presented a second time after
completion of the original test stimuli. These six pairs
consisted of the pairs the subject Incorrectly Judged the
first time plus the remaining number necessary to total six
randomly selected from each of the three geometric classes.
Thus, the total number of stimulus pairs presented to each
subject was 42.
■
Sa&SaSS?
Fig. 2. Eight plastic geometric forms, selected from NIUR
series of 20, used for "between-class" and "with-class"
comparisons for oral form identification.
56
The response required of the subject was that of
stating whether two successively presented forms— a stimu
lus pair— were the same or different. The examiner placed
each form In the subject's mouth and Instructed him to
manipulate It thoroughly. When the subject had completed
inspecting the first form, it was removed and the second
form was placed in his mouth. Immediately after removal of
the second form, the subject responded with "same" or "dif
ferent, " The subject's eyes were closed throughout the
presentation of all stimulus pairs of each class. A rest
period was observed between "between-class" and "within-
class" testing, during which time the forms were covered
and the subject permitted to open his eyes.
An orientation period preceded the test to familiar^
lze the subject with the items and procedure. Three addi
tional forms (Figure 3.), selected from the NIDR 20's
series, were used for this purpose1 a circle, a cross, and
a biconcave free-form. These were available to the subject
for inspection.
The following instructions were givem
I am going to place some small plastic
forms like these in your mouth. They will be
presented in pairs, one at a time. Some of the
pairs will have two forms which are the samei
other pairs will have two forms which are dif
ferent. After you've examined the second form
of the pair, you are to tell me whether the
two were the same or different. You may move
each one around in your mouth in any manner
and as much as you wish.
Fig. 3* Three plastic geometric forms, selected from imIDR series
of 20, used as practice forms prior to testing oral form identi
fication.
581
!
These three forms are for practicej they
will not be used again. It will be necessary
for you to have your eyes closed. I will tell
you when you may open them. Are there any ques
tions? Are you ready for the practice session?
Close your eyes and we’ll begin.
The data treated in this test were the errors the
subject made in identifying the "sameness" or "difference"
of the paired stimulus foxms.
!
i
! Lingual Tactile Pattern Recognition. j
A series of one-digit numbers traced on the dorsum j
1 !
of the tongue with a blunt, stainless steel stylus (Figure
4.) was used for this task. The numbers selected were 1, |
3. 6, 7, 9 (Figure 5.). Number presentation was in a
counterbalance order.
A practice session preceded the experimental task.
The numbers 2, * * • , 8 (Figure 6.) were used. Two of these
numbers, randomly selected, were traced on the palm of the
preferred handj two of these numbers, randomly selected,
were then traced on the dorsal surface of the tongue.
To Insure knowledge of and recognition for both the
test and practice numbers, each of the younger children was
asked to identify— to point to and name— numbers 1 through
20 printed on a standard sheet of typing paper. Those chil
dren who could not do so were not included in the 1^0 sub
jects of this study.
The following instructions were given prior to the
practice sessioni
Fig. 4* Stainless steel stylus used for tracing numbers on the
dorsum of the tongue for lingual tactile pattern recognition.
60
Fig. 5* Ntunbers used as test stimu
lus Items In test of lingual tactile
pattern recognition.
Fig. 6. Numbers used as practice
stimulus Items In test of lingual
tactile pattern recognition.
61
I am going to trace some numbers on your
tongue with this stylus. After I've traced a
number, you are to tell me what you think that
number is.
We'll have a short practice session first.
I'll trace two numbers on the palm of your pre
ferred hand (the hand you write with) and then
trace two numbers on your tongue. It will be
necessary for you to have your eyes closed while
I'm tracing the numbers on your hand. Are there
any questions? Are you ready? Close your eyes
and we'll begin.
The data treated in this test were the errors the
subject made in identifying the test stimuli.
Mandibular Kinesthesia.
A modified, chromium steel vernier caliper with
micrometer (Figure 7.) was used for this task. The dial of
the micrometer registered 0.1 mm increments and graduated
to 14 cm. The tapered jaws of the caliper were extended by
stainless steel plates, with a combined thickness of 2.5
mm, to permit their placement between the biting surfaces
of the upper- and lower-incisor teeth.
This task required the subject to compare a series
of "variable" mouth openings, determined by discrete milli
meter gap-set changes of the measuring tips, to a "stan
dard" mouth opening, determined by the millimeter set of
the measuring tips. The response of the subject to each
stimulus pair, a "variable" compared to the "standard"
mouth opening, was "same," "less," or "more."
The standard mouth openings, seven in number, were
Fig. 7. modified vernier caliper with micrometer used to deter
mine "variable” and "standard" mouth opening gap-sets for test
ing mandibular kinesthesia.
& 0s
10
63
12.0, 14.4, 16.8, 19.2, 21.6, 24.0, and 26.4 mm. The vari
able mouth openings, seven In number, were three set-
changes greater than the standard (standard plus 1.6, 3*2,
if,8 mm), three set-changes less than the standard (standard
minus 1.6, 3.2, 4.8 mm), and the standard mouth opening
compared with Itself. Thus, the subject was required to
make seven comparisons for each standard mouth opening, for
a total of 49 Judgments.
The standard mouth openings were presented In the
order In which they appear on the record sheet (see Appen
dix C); that Is, the 12.0 mm standard was presented first,
followed by the 14.4, 16.8, 19.2, 21.6, 24.0, and 26.4 mm
standard mouth openings. The three set-changes for the
standard plus and for the standard minus variable mouth
openings were also presented In the order in which they
appear on the record sheet. However, the three types of
variable mouth openings (same as standard, less than stan
dard, more than standard) were presented in counterbalance
order. For examplei for subject 1 the variable order for
the 12.0 mm standard mouth opening was same, less, moret
for the 14.4 mmi less, more, same; for the 16.8 mmt more,
same, less; for the 19.2 mmt same, less, morei for the
21.6 mmt less, more, same; for the 24.0 mmt more, same,
less; and for the 26.4 mmt same, less, more. The variable
order, then, for subject 2 for the 12.0 mm standard mouth
opening was less, more, same. Thus, no two consecutive
64
subjects* or two consecutive standard mouth openings* had
the same Initial and final variable mouth openings. For
all 49 judgments* the standard mouth opening preceded the
variable mouth opening.
A practice session preceded the test. The standard
mouth opening for this was 28.8 mmt the variable mouth
openings were plus and minus 3.2 mm.
The following instructions were given prior to the
practice sesslom
I am going to place these two bars
between your front teeth and ask you to touch
down lightly on them. I will do this two
times in succession. The space between the
bars* as you can see (demonstration)* can be
made bigger or smaller. The second time I
place the bars between your teeth the space
might be the same* it might be smaller* or it
might be bigger than it was the first time.
You are to tell me, after you’ve touched down
lightly on the bars the second time, if the
space between them was the same* less, or
more than it was the first time. You will
make this judgment for all the pairs which
will be presented.
We'll have a short practice session
first. It will be necessary for you to have
your eyes closed. I'll tell you when you
may open them. Are there any questions?
Are you ready? Close your eyes and we'll
begin.
The data treated in this test were the errors the
subject made in Judging a "variable" and a "standard" mouth
opening stimulus pair as same, less, or more. Difference
Ilmen values were also obtained for each of the seven stan
dard mouth openings for each subject.
. — gy
Treatment of the Data.
A chi square test of homogeneity (test of common
error rate), a method of comparing two characteristics to
determine whether or not they are Independent, was employed
to study group performance by age and by sex. Four group
ings, three for age and one for sex, were established for
comparison purposesi for age, the seven age groups, the 70
males (male subgroup, ten from each age group), and the 70
females (female subgroup, ten from each age group)j for
sex, the male and the female subgroups. The .05 level of
confidence was used In these tests. A statistically sig
nificant finding indicates that performance Is related to
age or sex, while a finding that Is not significant indl-
!
cates that performance Is Independent of age or sex. The
data treated were the error scores of the Oral Form Identi
fication, Lingual Tactile Pattern Recognition, and Man
dibular Kinesthesia measurements.
Since there were no error scores for the Oral Two-
Point Discrimination measurement, the data were treated as
i
a regression problem, which considers the frequency dis
tribution of one variable while another is held fixed at
each of several levels. Regression line curves were drawn
and clinical range limits were determined for each of the
three mldllne oral sites tested for the male and the female
subgroups to study performance by age and by sex.
In addition, two-point Ilmen values. In mm, were
66
obtained for each age group, the male subgroup, the female
subgroup, and the sample for each of the three midline oral
sites for the Oral Two-Point Discrimination measurement,
and difference limen values, in mm, were obtained for each
age group, the male subgroup, the female subgroup, and the
sample for each of the seven standard mouth openings for
the Mandibular Kinesthesia measurement.
CHAPTER IV
RESULTS OP THE INVESTIGATION
This study was concerned with investigating oral
sensation and perception. The purpose of the study was to
establish normative values for two measures of oral sensa
tion, one measure of oral stereognosls, and one measure of
mandibular kinesthesia by age and by sex. The discussion
in this chapter will be relative to the sample and to the
data obtained from the responses to four test measurementsi
(1) Oral Two-Point Discrimination, (2) Oral Form Identifi
cation, (3) Lingual Tactile Pattern Recognition, and (4)
Mandibular Kinesthesia.
SAMPLE
The sample consisted of 140 normal subjects ranging
in age from 6 years, 1 month to 6b years, 10 months. Seven
groups, determined by age, were established. The age range
and mean age of each of the seven groups and the male and
female subgroups are reported in Table 1.
While education and occupation were not criteria
for subject selection, this background is presented to in
dicate the extent to which the sample represented the gen
eral population. Education is reported in Table 2. Occu-
67
TABLE 1. AGE RANGE AND MEAN AGE OP THE SEVEN AGE GROUPS AND THE MALE AND FE
MALE SUBGROUPS OP THE SAMPLE.
Group
Males
Range Mean
Females
Range Mean
Combined
Range Mean
I 6-1 to 9-4 7.76 6-7 to 9-11
7.76 6-1 to 9-11
7.76
II 10-3
to 19-2 13.93 10-7
to 19-6 14.28
10-3
to 19-6 14.12
III 21-3
to
29-H
25.26 20-0 to 27-11 23.70 20-0 to
29-11
24.48
IV 30-2 to 38-6 33.98 30-6 to 39-10 35.67 30-2 to 39-10 34.82
V
40-7
to 48-9
44.50
41.5
to 49-10 46.16
40-7
to 49-10
45.33
VI 50-10 to 59-10 54.27
50-11 to
59-5 55.95
50-11 to 59-10 55.11
VII 60-0 to 64-10 62.12 60-0 to 64-3
61.95
60-6 to 64-10 62.03
C T \
00
TABLE 2. EDUCATION LEVEL OP SAMPLE.
Education N
Grade Level Int
Elementary grades
25
Secondary grades 10
Freshman year 2
Sophomore year
3
Grade Level Completed!
6th grade 1
8th grade 11
9th grade
5
10th grade
5
11th grade 2
12th grade 30
Freshman year ” 3
Sophomore year k
Junior year 2
Degrees Earnedt
♦Bachelor degrees 12
#Master degrees 11
Ph.D. degrees 6
Registered Nurse 6
M.D. degrees 2
*1 subject held two bachelor degrees
*1 subject was a Ph.D. candidate
#4* subjects held two master degrees
70
pation is reported in Table 3s classification headings* and
occupations assigned to them, were arbitrarily determined
by the writer to facilitate reading the table rather than
to designate occupation status or order.
ORAL TWO-POINT DISCRIMINATION
This test measurement required the subject to re
port one- and two-point skin surface contacts by the probe
jtlps of an oral estheslometer. Three mldllne oral sites
(upper lip, tongue tip, and tongue blade) were tested. Six
two-point thresholds, from three ascending and three de
scending trials, were obtained and converted into a mean
l
jtwo-point limen value, in mm, for each test site. This
procedure was repeated for each subject,
s
Regression Line Values.
The obtained data were treated as a regression
jproblemt the frequency distribution of the mean two-point
Ilmen values, with age being the fixed variable, was deter
mined. Scatter diagrams were plotted and regression lines
drawn for each of the three mldllne oral sites for the male
and the female subgroups to study the effect of age and sex
on performance. The results are reported in Table 4. The
regression line (y) values are also shown graphically in
Figures 8-13. Two-point limen values are shown on the ab
scissa with age shown on the ordinate.
TABLE 3. OCCUPATIONS OP SAMPLE.
Occupation N
General* 52
Fireman 18
Domestic
13
Custodial Service 7
General Service 5
Security Service 2
Nurses Aid 2
Housewife 2
Hospital Orderly 1
Parking Attendant 1
Pood Management 1
Studentsi
**0
Elementary 25
Secondary 10
Undergraduate 5
Business/Officei 13
Desk Attendant 4 -
Personnel 2
Business 2
Claims Adjuster 1
General Office 1
Public Relations 1
Salesman 1
Secretary 1
Educationi 12
Teacher 8
Principal
3
Activities Director 1
Medicinei 12
Nurse 6
Doctor 2
Lab Technician 2
Occupational Therapist 1
Veterinarian 1
Professlonali 11
Speech Pathologist
5
Librarian 2
Ac cotint ant 1
Admini strator 1
Artist 1
Banker 1
TABLE 1*. REGRESSION LINE VALUES AND STANDARD ERROR OP VAR
IANCE FOR MIDLINE SITES OP THREE ORAL STRUCTURES FOR MALE
AND FEMALE SUBGROUPS ON A TEST OF ORAL TWO-POINT DISCRIMI
NATION.
X
y
Slope b Intercept
SEb s7.x
Males 3^.60
1.09
Tongue Tip
0.002 1.006 0.002
0.29
Females 35.01*
1.15
0.001 1.123 0.002
0.31
Males 3^.60 1.87
Tongue Blade
0.005 1.716 0.003 0.55
Females 35.01* 1.89 o.ooi* 1 . 71*2
0.003
0.56
Males 3 1 *. 60 1.10
Upper Lip.
0.006 0.911 0.002
0.33
Females ♦35.01* 1.10 0.002 1.01*5 0.002 0.1*2
#35.26
1.07 0.003 0.977 0.002
0.31*
♦Values for N of 70 j not used to establish upper lip re
gression line and nonnal clinical range.
#Values for N of 69; used to establish upper lip regres
sion line and normal clinical range.
-Point Limen Values (In mm)
y+2sy.x
y-2sy.x
Age
Pig. 8, Regression line and clinical range values, in mm, for oral two-
point discrimination ability for male subgroup (N=70) at the mldllne
site of the tongue tip.
Two-Point Limen Values (in mm)
y+2sy.x
3.0
2.5
2.0
1.5
1.0
y-2sy.x
10 20
Age
Pig. 9. Regression line and clinical range values, in mm. for oral two-
point discrimination ability for male subgroup (Jfa70) at the midline
site of the tongue blade.
■ p -
-Point Limen Values (In mm)
3.0
2.5
2.0
■y+2sy.x
1.5
1.0
o
15
10 20
Age
Fig. 10. Regression line and clinical range values* In mm* for oral two-
point discrimination ability for male subgroup (N=70) at the mldllne
site of the upper lip.
Vn
-Point Limen Values (In mm)
o
£
3.0
2.5
2.0
1.5
1.0
.5
.0
-y+2sy.x
y
.y-2sy.x
10 20 30 ^0
Age
50 60 70
Pig. 11. Regression line and clinical range values, In mm, for oral two-
point discrimination ability for female subgroup (Ife70) at the mldllne
site of the tongue tip.
^3
O N
-Point Limen Values (In mm)
y+2sy.x
3.0
2.5
2.0
1.5
1.0
y-2sy.x
10 20
Age
Fig. 12. Regression line and clinical range values* In mm, for oral two-
point discrimination ability for female subgroup (Ifc70) at the mldllne
site of the tongue blade.
- > a
- V >
-Point Limen Values (in mm)
3.0
2.5
2.0
1.5
1.0
10 20
Age
Pig. 13. Regression line and clinical range values, in mm, for oral two-
point discrimination ability for female subgroup (N=69) at the midline
site of the upper lip.
0 0
79
The clinical limits1 for each of the six regression
lines were obtained by plotting points above and below the
regression line equal to twice the variance value ($i2sy.x).
These limits, encompassing 95% of the frequency, designate
the 2.5 and 97.5 percentile points of the distribution in
normal subjects. (One 20-year-old female obtained a 3*0 mm
two-point limen value for the upper lip, with a standard
deviation of 5«5» This value was eliminated in establish
ing the upper lip regression line and clinical range which,
therefore, represent 98.6 per cent of the females tested.)
The data were also subjected to analysis of variance and
standard errors for the regression lines were obtained (see
Table 4.).
Sex differences were not observed in the slopes and
means of the regression lines of the three oral sites while,
for age, only the increase of the means for the tongue tip
for the males was significant (±0| p<.01). Millimeter in
crease in two-point limen values per decade for the males
wast tongue tip, .025) tongue blade, .0^6; and upper lip,
.056. Millimeter Increase in two-point limen values per
decade for the females wasi tongue tip, ,0061 tongue blade,
.0^2) and upper lip, .027.
^he phrase "clinical limits" has been suggested by
Elveback et al., (1970). "We propose that the misleading
phrase 'normal limits' be dropped, and that the phrase
•clinical limits' be used to refer to the 2& and 97i per
centage points of the distribution in healthy persons." p.
________________________________________________________________
80
Differences between the clinical ranges of the
three oral sites may be noted. The normal clinical ranges
for the males and the females for the tongue tip were
y+0.58 and y+0.62, respectivelyi for the tongue blade,
ytl.10 and $+1.12, respectively* and for the upper lip,
y+0.66 and y+0.68, respectively. Three males had tongue
tip and three males had upper lip limen values greater than
the normal clinical range upper limits* two males had
tongue blade limen values less than the normal clinical
range lower limit. Three females had tongue tip limen val
ues and four females (including the 20-year-old female pre
viously mentioned) had upper lip limen values greater than
the normal clinical range upper limit.
Percentiles.
Sample percentiles for the three mldllne oral sites
are reported in Table 5»
Two-Point Limen Values.
The primary objective of this measurement was to
obtain mean two-point limen values for the three mldllne
oral sites for each age group, the male and the female sub
groups, and the sample. The mean and standard deviation
two-point limen values are presented in Table 6. The val
ues show the tongue blade, for all groups, to be less dis
criminatory than the tongue tip and the upper lip, with no
consistent discriminatory order maintained by the latter
TABLE 5. OBSERVED PERCENTILES FOR
MIDLINE SITES OP THREE ORAL STRUC
TURES FOR SAMPLE ON A TEST OP ORAL
TWO-POINT DISCRIMINATION.
Percentiles
Tongue
Tip
Tongue
Blade
Upper
Lip
25 .9^ 1.52 .76
50 1.11 1.92 1.06
75
1.32 2.20 1.34
97.5
1.84
2.95
1.98
oo
M
TABLE 6. MEAN AND STANDARD DEVIATION TWO-POINT LIMEN
VALUES, IN MM, FOR MIDLINE SITES OP THREE ORAL STRUC
TURES FOR AGE GROUPS, MALE AND FEMALE SUBGROUPS, AND
SAMPLE ON A TEST OF ORAL TWO-POINT DISCRIMINATION.
Group
Tongue Tip
Mean S.D.
Tongue Blade
Mean S.D.
Upper Lip
Mean S.D.
I
1.19 0.29
1.72 0.41
0.97 0.23
II 0.98 0.28 1.61 0.45 0.94 0.27
III 1.08
0.33
2.12
0.51 1.29
0.52
IV 1.11 0.31
1.86
0.59 1.03 0.31
V
1.17 0.33
2.02 0.74 1.06 0.34
VI 1.14 0.28 2.02 0.63 1.19 0.39
VII
1.17
0.26 1.84 0.41 1.24 0.41
Male 8 1.09 0.29 1.87 0.56 1.10 0.34
Females
1.15 0.31 1.89 0.57 1.10 0.41
Sample 1.12 0.30 1.88 0.56 1.10 0.38
oo
PO
83
two structures. The range of the mean limen values for the
tongue blade was 1.61-2.12 mm, a range of 0.51 mm, with a
mean two-point limen value of 1.88 mm.
The tongue tip was more discriminatory than the up
per lip for Groups III, VI, VII, and the male subgroup.
The range of the mean limen values for the tongue tip was
0.98-1.19 mm, a range of 0.21 mm, with a mean limen value
of 1.12 mm.
The upper lip was more discriminatory than the
tongue tip for Groups I, II, IV, V, and the female subgroup.
The range of the mean limen values for the upper lip was
0.9^-1*29 mm, a range of 0.35 mm, with a mean limen value
of 1,10 mm.
Thus, greater mean limen values and measurement
variability were obtained for the tongue blade than for
either the tongue tip or the upper lip. Measurement vari
ability was smaller for the tongue tip than for the upper
lip, whereas lower mean limen values were obtained for the
upper lip than for the tongue tip.
It might be noted that Group II obtained the lowest
mean limen values for the tongue tip, tongue blade, and up
per lip, followed by Group III for the tongue tip and Group
I for the tongue blade and upper lip. No relationship was
observed between the remaining groups and the mean limen
values.
84
Summary,
No significant sex difference for oral two-point
discrimination ability was indicated for each of the three
oral sites tested by the slopes and mean values of the re
gression lines while, for age, only the increase in the
means for the tongue tip for the males was significant.
Mean two-point limen values for all groups showed
the tongue blade to be less discriminatory than the tongue
tip and upper lip, with no discriminatory order established
for the latter two. The tongue tip was more discriminatory
for Groups III, VI,VII, and the male subgroup* the upper
lip was more discriminatory for Groups I, II, IV, V, and
the female subgroup.
It might be concluded, based on the results obtained
in this investigation, that the ability to perceive two-
point stimuli applied to the midline sites of the tongue
tip, tongue blade, and upper lip is not related to sex, and
only the ability to discriminate two-point stimuli applied
to the midline site of the tongue tip for the males is re
lated to age.
ORAL FORM IDENTIFICATION
This test measurement required the subject to ex
plore orally pairs of plastic geometric forms and to judge
whether they were "same" or "different." Fifteen stimulus
pairs formed the "within-class" group* six pairs from this
65
group were presented a second time for a reliability check.
Twenty-one stimulus pairs formed the "between-class" group.
Thus, a total of kZ Judgments were obtained from each sub
ject.
Statistical Analysis.
The data treated to study group performance by age
and by sex were the error scores obtained in Judging the 15
wlthin-class stimulus pairs and the 21 between-class stimu
lus pairs.
The results of the statistical analysis of the data
obtained in Judging the wlthin-class pairs are shown in
Table ?. Comparisons of the distributions of the error
scores of the seven age groups, the 70 males, and the 70
females yielded a statistically significant difference for
age for each group. The ability to Judge the 15 within-
class form pairs appears to be related to age. Comparison
of the error score totals of the male and the female sub
groups yielded no statistically significant difference for
sex; males and females were not different in ability to
Judge the 15 wlthin-class form pairs.
The results of the statistical analysis of the data
obtained in Judging the between-class pairs are shown in
Table 8, Comparisons of the distributions of the error
scores of the seven age groups, the 70 males, and the 70
females yielded contradictory results; a significant dif-
TABLE 7. RESULTS OF CHI SQUABE TESTS APPLIED TO
ERROR SCORES IN JUDGING 15 WITHIN-CLASS STIMULUS
PAIRS OF THE SEVEN AGE GROUPS, THE MALE SUBGROUP,
AND THE FEMALE SUBGROUP ON A TEST OF ORAL FORM
IDENTIFICATION.
Group X2 df
Age Groups I-VII
23.05
6 significant
Males 13.50 6 significant
Females 14.69
6 significant
Males vs Females .06 1 not significant
o o
ON
TABLE 8. RESULTS OF CHI SQUARE TESTS APPLIED TO
EBBOR SCORES IN JUDGING 21 BETWEEN-CLASS STIMULUS
PAIRS OF THE SEVEN AGE GROUPS, THE MALE SUBGROUP,
AND THE FEMALE SUBGROUP ON A TEST OF ORAL FORM
IDENTIFICATION.
Group X2 df
Age Groups I-VII
13.93
6 significant
Males 10.8^ 6 not significant
Females 7.8^ 6 not significant
Males vs Females 5.08 1 significant
oo
^3
88
ference for age was found in the performances of the seven
age groups when the sexes were pooled, whereas no signifi
cant difference was found for age in the performance of
either the 70 males or the 70 females when their scores
were treated separately. Considering these findings, a
conclusion that the ability to judge the 21 between-class
form pairs is related to age must be made with caution
since the age range of this sample is represented by the 70
males and the 70 females as well as by the seven age groups,
Comparison of the error score totals of the male
and the female subgroups yielded a statistically signifi
cant difference for sex, with the female subgroup making a
larger number of errorsi males and females were different
in ability to Judge the 21 between-class form pairs.
Error Scores for Wlthln-Class and Between-Class Groups,
Error scores of the seven age groups, the male sub
group, and the female subgroup in Judging the withln-class
and the between-class form pairs are presented in Table 9»
Wlthln-Class Group, Differences in ability to
judge within-class form pairs may be noted for Groups I and
VI, with error scores of 69 and 27* respectively. The er
ror scores of the other five groups ranged from 40-50, with
no observed relationship between age and error frequency.
The 10-polnt difference between the extremes of this range
is in contrast to the 19-point difference between the score
TABLE 9. ERROR SCORES IN JUDGING FORM PAIRS IN
WITHIN-CLASS GROUP AND IN BETWEEN-CLASS GROUP
OP THE SEVEN AGE GROUPS, THE MALE SUBGROUP, AND
THE FEMALE SUBGROUP ON A TEST OF ORAL FORM
IDENTIFICATION.
♦Within-Class
(15 pairs)
#Between-Class
(21 pairs)
Group M F Total M F Total
I 34
35 69
20 20 40
II 18 27 45 14
17 31
III
25 25
50 8 12 20
IV 26 20 46
13
14
27
V
19
21 40 11 24
35
VI 14
13 27
6 12 18
VII 21 20 4l 14 18 32
Total
157
161 318 86
117 203
♦Age groups« 300 responses, each.
♦Male, Female groupst 1,050 responses, each.
#Age groupsi 420 responses, each.
#Male, Female groupst 1,470 responses, each.
00
vo
90
of Group I and that of the next highest group, and the 13-
point difference between the score of Group VI and that of
the next lowest group.
Inspection of the error scores of the males and
females in each age group reveals the variant performances
of those in Groups I and VI. Group I males and females
made the greatest number of errors* Group VI males and fe-
! males made the least number of errors. Error rank order of
IGroups I and VI, therefore, was established by age, not by
sex,
1
The error score range of the 70 males was 14-3^# a
irange of 20* that of the females was 13-35# a range of 22,
The bias imposed by the performances of the males and fe
males of Groups I and VI may be observed when their error
scores are excluded* the male error score range is 18-26,
a range of 8* the female error score range is 20-27# a
range of 7. j
The statistically significant age differences ob
tained for the seven age groups, the 70 males, and the 70
females can be attributed to the subjects of Group I and,
to a lesser extent, the subjects of Group VI. Group I per
formance might be attributed to age* the performance of
Group VI cannot be accounted for.
! The total error scores of the male subgroup, 157#
(and of the female subgroup, l6l, when treated statistically,
i
|did not suggest a sex difference in ability to judge within-
91
class form pairs.
Between-Class Group. Differences in ability to
judge between-class form pairs may be noted for Groups I*
III, and VI, with error scores of 40, 20, and 18, respec
tively, The error scores of the other four groups ranged
from 27-35» with no observed relationship between age and
error frequency.
Inspection of the error scores of the males and fe
males in each age group reveals that the males (except for
those in Group I) made fewer errors than the females. The
males of Groups I and VI repeated the Judging pattern ob
served for the wlthin-class groupi Group I males made the
greatest number of errorsi Group VI males made the least
number of errors, followed closely by the males of Group
III, A similar consistency is not apparent for Group I fe
males, whereas Group VI females (and those in Group III)
again made the least number of errors. The error rank
order of Groups I and VI was the same as that noted for
judging the wlthin-class group.
The error score range of the 70 males was 6-20, a
range of l4j that of the 70 females was 12-24, a range of
12. Age difference for ability to Judge between-class form
pairs was not demonstrated by either the 70 males or the 70
females.
Total error scores of the male subgroup, 86, and of
the female subgroup, 117, when treated statistically,
92
yielded results which suggest a sex difference in ability
to Judge between-class form pairs.
While it might be concluded that the ability to
Judge between-class form pairs is related to age and sex,
such generalization must be guarded. Both age and sex dif
ferences obtained in this study might be attributed to the
variant performances of the males in Groups I, III, and VI.
Per Cent Scores. Per cent values were computed for
(1) error scores of each age group and sex subgroup com
pared to the total error score and for (2) error score com
pared to the total number of responses of each age group
and sex subgroup.
The extent to which each age group, the male sub
group, and the female subgroup contributed to the obtained
total error score in Judging the 15 within-class and the 21
between-class form pairs may be seen in Table 10. The per
cent values are shown graphically in Figure 14. Rank order
stability is noted in the cases of three groupsi Groups I,
II, and VI ranked first, fourth, and seventh, respectively,
for both within-class and between-class per cent of errors.
An inexplicable inverse rank order behavior is observed for
the remaining four groups. Groups III and IV, ranking
second and third for per cent of within-class errors, ranked
sixth and fifth for per cent of between-class errors, while
Groups VII and V, ranking fifth and sixth for per cent of
wlthin-class errors, ranked third and second for per cent
TABLE 10. PER CENT VALUES FOR ERROR SCORES
OF THE SEVEN AGE GROUPS, THE MALE SUBGROUP,
AND THE FEMALE SUBGROUP COMPARED TO TOTAL
ERROR SCORES OF WITHIN-CLASS AND OF BETWEEN-
CLASS GROUPS ON A TEST OF ORAL FORM IDENTI
FICATION.
Group
Wlthln-Class
(15 pairs)
Between-Class
(21 pairs)
I 21.7 19.7
II 14.1
15.3
III 15.7
9.8
IV
14.5 13.3
V 12.6 17.2
VI
8.5 8.9
VII
12.9
15.8
Males 49.4 42.4
Females 50.6 57.6
vO
V jJ
C O
u
o
w
V.
o
-p
c
©
o
u
©
p«
60r
50
^0
30
20
10
0
•Wlthln-Class*
Group
•Between-Class’
Group
J]
M M M £ M M M >
Pig. 1^. Per cent value for error score of each age group,
the male subgroup, and the female subgroup compared to the
total error score of the "Wlthln-Class** group and of the
"Between-Class" group.
vo
■ p -
95
of between-class errors.
Per cent values computed for error score compared
to total number of responses of each age group and sex sub
group are presented In Table 11 and shown graphically in
Figure 15* It may be noted that, proportionately, a great
er number of wlthin-class than between-class errors were
made by all groups.
Retest Scores for Reliability.
Six within-class stimulus pairs were presented a
second time for a reliability check. Thus, 120 responses,
60 from the males and 60 from the females, were obtained
from each of the seven age groups, and 420 responses were
obtained from the male subgroup and from the female sub
group, The retest scores are reported in Table 12. Scores
for same response (retest judgment same as test judgment)
of the seven age groups ranged from 93-108, a range of 15I
the scores of the 70 males ranged from 46-55* a range of 9i
the scores of the 70 females ranged from 45-56, a range of
11. The male subgroup obtained a same response score of
343* the female subgroup obtained a same response score of
355* a difference of 12 between the two scores.
Statistical Analysis. Chi square tests of homoge
neity (constant response over age, constant response over
sex) were applied to the same scores of the seven age
groups, the male subgroup, and the female subgroup (see
TABLE 11. PER CENT VALUES FOR ERROR SCORES
COMPARED TO NUMBER OF RESPONSES OF THE
SEVEN AGE GROUPS, THE MALE SUBGROUP, AND
THE FEMALE SUBGROUP IN JUDGING WITHIN-CLASS
AND BETWEEN-CLASS GROUPS ON A TEST OF ORAL
FORM IDENTIFICATION.
Group
Wlthln-Class
(15 pairs)
Between-Class
(21 pairs)
I 23.0 9.5
II 15.0 7.4
III 16.7
4.8
IV
15.3
6.4
V
13.3 8.3
VI 9.0
4.3
VII 13.7
7.6
Males 14.9 5.8
Females
15.3 7.9
VO
Ov
Per Cent of Errors
60
50
1*0
30
20
10
'Wlthln-Class*
Group
"Between-Class*
Group
J]
HnnOnflrr
M M M > > M H £
* £
Fig. 15. Per cent value for error score compared to total
number of error responses of each age group, the male sub
group, and the female subgroup for the "Wlthln-Class"
group and for the "Between-Class" group.
NO
■>3
TABLE 12. RETEST (RELIABILITY) SCORES FOR
JUDGING SIX WITHIN-CLASS FORM FAIRS AS
"SAME" OR "DIFFERENT" OF THE SEVEN AGE
GROUPS, THE MALE SUBGROUP, AND THE FEMALE
SUBGROUP ON A TEST OF ORAL FORM IDENTIFI
CATION.
Group
♦Same
Response
M F Total
#Opposite
Response
M F Total
I 50 52 102 10 8 18
II 48
45 93
12
15 27
III 49 50 99
11 10 21
IV 47 47
94
13 13
26
V 48 56 104 12 4 16
VI
55 53
108
5 7 12
VII 46 52 98
s
14 8 22
Total 343 355
698 77 55
142
*Retest judgment same as test judgment.
#Retest judgment opposite to that of test
judgment.
vo
GO
99
Table 13#). Comparisons of the distribution of the error
scores yielded no significant differences! the seven age
groups and the male and female subgroups were not different
In retest ability In judging within-class form pairs.
Error Scores for Wlthln-Class Stimulus Pairs.
Errors were tabulated for each of the 15 wlthin-
class stimulus pairs (see Table 1^.). Pour of the 15 pairs
yielded a strikingly greater number of error responses.
Pair 1-2 (triangles) had an error score of 88i pair 3-^
(rectangles)( 43» and pairs 6-7 and 7-8 (ovals), ^1 and 68,
respectively. The number of errors of the remaining eleven
pairs ranged from 1 (pair 3-5* rectangles) to 16 (pair 6-8,
ovals).
Generally, marked differences In group performances
were not evident) each age group and both the male and fe
male subgroups made a greater number of errors, in each
geometric class, on the stimulus pairs described in the
preceding paragraph. With the exception of Group I, no re
lationship was observed between age and error frequency.
Fewer errors were made by the male subgroup than by the fe
male subgroup.
Error Scores for Between-Class Stimulus Pairs.
Errors were tabulated for each of the 21 between-
class stimulus pairs (see Table 15.)• Three of the 21
pairs yielded a greater number of error responses. Pair
TABLE 13. HESULTS OP CHI SQUARE TESTS APPLIED TO
RELIABILITY SCORES OP THE SEVEN AGE GROUPS, THE
MALE SUBGROUP, AND THE FEMALE SUBGROUP IN JUDG
ING SIX WITHIN-CLASS STIMULUS PAIRS ON A TEST OF
ORAL FORM IDENTIFICATION.
Group X2 df
Age Groups I-VII
10.29 6
not significant
Males vs Females 1.22 1 not significant
100
TABLE 14. ERHOR SCORES IN JUDGING WITHIN-CLASS STIMULUS PAIRS AS "SAME" OR
"DIFFERENT" OF THE SEVEN AGE GROUPS, THE MALE SUBGROUP, THE FEMALE SUBGROUP,
AND THE SAMPLE ON A TEST OF ORAL FORM IDENTIFICATION.
Triangles Rectangles Ovals
Group 1-1 1-2 2-2 3-3 3-4 3-5 4-4 4-5 5-5
6-6
6-7
6-8 7-7 7-8 8-8 Total
I 0 16 0 0
9
0 1
3
1 2 11 8 1
15
2
69
II 1 16 1 0
5
0 1 2 0 1 4
3
1 10 0
45
III 1 16 0 2
5
0 2 0 0
3 5
0 4
9 3 50
IV 2 12 0 1 6 0 2 0 1 0 4 2
3
11 2 46
V 0 14 2 1 6 0 1 1 0 0
5
2 0 7 1 40
VI 0 7 1 0 2 0 0 0 1 0 6 0 1
9
0 27
VII 1 7 0 2 10 1 0 1 0 1 6 1 1 7 2 41
Male 8
3
42
3
4 20 1 4
3
2 6 18 6
7 30 8
157
Females 2 46 1 2
23
0
3 5
1 1
23
10 4 38 2 161
Sample
5
88 4 6
43
1
7
8
3 7
41 16 11 68 10 318
Notei Form pair numbers keyed to Oral Form Identification Record sheet, Appen-
dix C.
o
M
TABLE 15. ERROR SCORES IN JUDGING BETWEEN-CLASS STIMULUS PAIRS AS
"SAME" OR "DIFFERENT" OF THE SEVEN AGE GROUPS, THE MALE SUBGROUP,
THE FEMALE SUBGROUP, AND THE SAMPLE ON A TEST OF ORAL FORM IDENTI-
CATION.
Group
1-3
1-1*
1-5
1-6
1-7
1-8
2-3
2-4
2-5
2-6
2-7
2-8
I 0 1 2 0 1 0 0 4 6
5
2 0
II 0 1 1 0 1 0 0 2
5
1 1 0
III 0 1 1 0 0 0 1 1 1 1 1 1
IV 0 2 1 0 0 0 0 1 4 0 1 0
V 0 2
3
2 1 0 1 1 4 1 1 0
VI 0 1 0 0 1 1 0 0 2 1 1 0
VII 0 1 2
3
1 0 0 0
3
1 0 0
Males 0 4 2
3
1 0 1
5
11 4 2 0
Females 0
5
8 2 1* 1 1 4 14 6
5 1
Sample 0
9
10
5 5
1 2
9 25
10 7 1
Notes Form pair numbers keyed to Oral Form Identification Record
Sheet, Appendix C.
o
I N )
TABLE 15. (cont.) ERROR SCORES IN JUDGING BETWEEN-CLASS STIMU
LUS PAIRS AS "SAME" OR "DIFFERENT" OF THE SEVEN AGE GROUPS,
THE MALE SUBGROUP, THE FEMALE SUBGROUP, AND THE SAMPLE ON A
TEST OF ORAL FORM IDENTIFICATION.
Group 3-6
3-7
3-8 4-6 4-7 4-8 5-6 5-7 5-8 Total
I 0 0 0 1 0 0 2
9 7 40
II 0 0 0 0 1 2 1
9
6
31
III 0 0 0 0 1 1 0 8 2 20
IV 0 0 0 0 0 0 1 11 6
27
V 0 0 1 0 1 0
3
8 6
35
VI 0 0 0 0 0 2 0
7 2 18
VII 0 0 0 0 1 2
3 13
2 32
Males 0 0 0 0 0
3 5
28
17
86
Females 0 0 1 1 4 4
5 37
14
117
Sample 0 0 1 1 4
7 10
65 31 203
Notei Foim pair numbers keyed to Oral Form Identification
Record Sheet, Appendix C.
o
10^
2-5 (triangle-rectangle) had an error score of 25» pair 5-7
(rectangle-oval), 65* and pair 5-8 (rectangle-oval), 31,
The number of errors of the remaining eighteen pairs ranged
from 0-10.
Group performance in Judging the three between-
class stimulus pairs was similar to that noted in Judging
the four within-class pairs. All groups tended to make
more errors on each of the three pairs than on any of the
other eighteen pairs. With the exception of Group I, no
relationship was observed between age and error frequency.
Per Cent Scores. The extent to which the error
scores of the four wlthin-class and the three between-class
form pairs contributed to the error score totals of the
respective wlthin-class and between-class groups may be
seen in Table 16.
Some observations may be made. All groups— the
seven age groups, the male subgroup, and the female sub
group— found these seven form pairs difficult to Judge cor
rectly. The seven pairs contributed disproportionately to
the error score totals of the respective within-class and
between-class groups. The four within-class form pairs
were more difficult to Judge than the three between-class
form pairs.
Summary.
Wlthln-Class Group. No significant sex difference
TABLE 16. PER CENT VALUES FOR ERROR SCORES OF FOUR WITHIN-
CLASS AND THREE BETWEEN-CLASS FORM PAIRS COMPARED TO
TOTAL ERROR SCORES OF WITHIN-CLASS AND BETWEEN-CLASS
GROUPS OF THE SEVEN AGE GROUPS, THE MALE SUBGROUP, AND THE
FEMALE SUBGROUP ON A TEST OF ORAL FORM IDENTIFICATION.
Wlthln-Class Between-Class
Group *TES #SES
%
•TES #SES
%
I 69 51 73.9
40 22 55.0
II 45 35 77.7 31
20 64.5
III 50 35
70.0 20 11 55.0
IV 46
33 71.7 27 21 77.7
V 40 32 80.0
35
18 51.4
VI 27
24 88.8 18 11 61.1
VII 41 30 73.2 32 18
55.9
Males 157 110 70.0 86 56 65.1
Females 161 130 80.7 117 65 55.5
Wlthln-Classi
•Total Error Scores 15 form pairs judged.
#Selected Error Scores pairs 1-2, 3-4, 6-7, 7-8 Judged.
Between-Classs
•Total Error Scores 21 form pairs Judged.
#Selected Error Scores pairs 2-5, 5-7, 5-8 judged. g
Vj\
jwas found for ability to judge the 15 within-class form
pairs* Significant age differences* however, were found in
ithe performances of the seven age groups, the 70 males, and
I the 70 females* Both the males and females of Group I made
the greatest number of errors, while both the males and
females of Group VI made the least number of errors. The
error rank order of Groups I and VI, therefore, was estab
lished by age, not by sex. The significant age difference
found in this study might be attributed to these two groups
Between-Class Group. A significant sex difference
was found for ability to judge the 21 between-class for®
jpairs, with the females making a greater number of errors
i
'than the males. Contradictory findings for age were ob
tained from the analyses of the performances of the seven
age groups, the 70 males, and the 70 femalesi a significant
difference was found in the performances of the seven age
groups when the sexes were pooled, whereas no significant
'age difference was found in the performance of either the
|
!70 males or the 70 females when their error scores were
treated separately. Both age and sex differences obtained
in this study might be attributed to the variant perform
ances of the males in Groups I, III, end VI.
Wlthln-Class and Between-Class Stimulus Pairs. The
15 wlthin-class and the 21 between-class form pairs were
not of equal difficulty in their respective groups. Pour
form pairs accounted for 70.0-88.8 per cent of the errors
107
in the wlthin-class group, and three form pairs accounted
for 55.9-77.7 per cent of the errors In the between-class
group,
LINGUAL TACTILE PATTERN RECOGNITION
This test measurement required the subject to Iden
tify a series of one-dlglt numbers (1, 3* 6, 7# 9) traced
on the dorsum of the tongue with a stylus. Five responses,
therefore, were obtained from each subject.
Statistical Analysls.
The data treated to study group performance by age
and by sex were the error scores obtained In Identifying
the stimulus numbers.
The results of the statistical analysis are shown
In Table 17. Comparisons of the distributions of the error
soores of the seven age groups, the 70 males, and the 70 fe
males yielded contradictory results! no significant age
difference was found In the performances of the seven age
groups when the sexes were pooled, whereas significant age
differences were found In the performances of both the 70
males and the 70 females when their error scores were
treated separately. Comparison of the error score totals
of the male and the female subgroups yielded a statisti
cally significant sex difference, with the male subgroup
making the larger number of errors.
TABLE 17. RESULTS OP CHI SQUARE TESTS APPLIED TO
ERROR SCORES IN IDENTIFYING STIMULUS NUMBERS OP
THE SEVEN AGE GROUPS, THE MALE SUBGROUP, AND THE
FEMALE SUBGROUP ON A TEST OP LINGUAL TACTILE
PATTERN RECOGNITION.
Group X2 df
Age Groups I-VII 6.61 6 not significant
Males
13.3^
6 significant
Females 29.97
6 significant
Males vs Females 10.4-3 1 significant
108
109
Error Scores for Stimulus Numbers.
Total error scores of the sample reveal the numbers
most difficult to Identify to be 7 and 6, with 56 and 55
errors, respectively, followed by 3 and 9, with 36 and 28
errors, respectively. The stimulus number 1 was correctly
Identified by every subject (see Table 18.)•
Age and sex differences were reflected In the error
scores of the seven age groups and the male and female sub
groups. Group I made 45 errors whereas the errors made by
Groups II-VII ranged from 18-26. The error score total of
the male subgroup was 106 In contrast to the 69 error score
of the female subgroup.
The error response patterns of the age groups, with
the exception of Group I, did not repeat the sample pattern
for stimulus number order difficulty (7, 6, 3, 9). Numbers
6 and 3 were most difficult for Groups II, III, and Vj num
bers 7 and 9 were second for Groups III, V, VIt these num
bers— 7 and 9— were third for Groups II, IV, and Vi and
numbers 6 and 3 were least difficult for Groups IV, V,
and VI.
The error response pattern of the female subgroup
also differed from that of the sample» the stimulus number
order difficulty was 6, 7, 9, 3. The pattern of the male
subgroup was the same as that of the sample.
It would seem that the order difficulty for Iden
tifying stimulus numbers observed for the sample can be
TABLE 18. ERROR SCORES IN IDENTIFYING STIMULUS NUM
BERS OF THE SEVEN AGE GROUPS, THE MALE SUBGROUP,
THE FEMALE SUBGROUP, AND THE SAMPLE ON A TEST OF
LINGUAL TACTILE PATTERN RECOGNITION.
Group 1
3
6
7 9 M F M+F
I 0 10 14
15
6
23
22
45
II 0
9 7
2 0 16 2 18
III 0 4 10
9 3
18 8 26
IV 0
3
6
7 5
14
7 21
V 0 4
9
6
5
11
13
24
VI 0
3
2 7
6 8 10 18
VII 0
3 7
10
3
16
7 23
Males 0 26 30 36
14 106
Females 0 10
25
20 14
69
Sample 0 36 55 56 28
175
Age groupst 100 responses, each.
Male, Female groupst 350 responses, each.
110
attributed to the performance of the male subgroup and, to
j
a lesser extent, the performance of Group I.
Per Cent Scores. Differences between the perform
ances of Group I and Groups II-VII and between the male
and the female subgroups are more sharply focused when the
error scores are assigned per cent values (see Figure 16.),
Group I made 25.7 per cent of the total error score, with
Groups II-VII ranging from 10.3-1^.9 per cent. The male
subgroup made 60.6 per cent of the errorsj the female sub
group made 39.^ per cent of the errors.
Error Response Numbers. |
! All error responses were one-digit numbers (see j
Table 19.). The number most frequently used was 8, follow-j
! :
jed by, in frequency order, 2, 0 and 9, 5. 6, 7, *f, and 3.
|No subject used the number 1 for an error response.
i A cluster relationship may be noted for certain er-
iror response and stimulus numberst 8 with stimulus number J
3i 0 and 8 with 6; 2 and 9 with 7t and 4, 6, and 7 with 9. I
1
! A similar relationship for error numbers 3 and 5 is not evi*
dent, though the latter was fifth in error frequency order. !
i The cluster pattern would suggest a similarity be-
i i
tween certain pairs of error response and stimulus numbers
close enough to confuse the subject, making correct identi
fication difficult. The more obvious "pairs" (error re
sponse number given first) were 2-7. 9-7. 0-6, 8-6, and 8-3.
70r
t o
u
o
h
fe
w
Vi
O
C
®
O
«
Pi
60
50
1*0
30
20
10
M M M > > M M 5J Pi
M M M > |H
Pig. 16. Per cent values of error
scores of seven age groups, the
male subgroup, and the female
subgroup In Identifying stimulus
numbers.
M
ro
TABLE 19. DISTRIBUTION AND ERROR FREQUENCY OF ERROR RE
SPONSE NUMBERS FOR STIMULUS NUMBERS OF SAMPLE ON A TEST
OF LINGUAL TACTILE PATTERN RECOGNITION.
Stimulus
Number 0 1
Error
2 3
Response
k 5
Numbers
6 7
j
8
9
Total
1 0 0 0 0 0 0 0 0 0 0 0
3
2 0 0 0
3
2 0
25
0 36
6 22 0 7 1 0
3
0 0 18 k
55
7 1 0 26 1 0 i f 0 0
3
21 56
9
0 0 1 2 5 3
6 6
5
0 28
Total
25
0 38 1 *
5 13
8 6
51 25 175
114
It might also reflect the problem of maintaining consistent
pressure and skin surface contact to ensure an even, unin
terrupted tracing of the stimulus number.
Group Distribution of Error Response Numbers.
Distribution and error frequency of error response
numbers for the seven age groups, the male subgroup, the
female subgroup, and the sample are presented in Table 20.
The numbers 2, 8, and 9 were used by all groups» 0 and 5
by six groupsi 4 and 6 by five groupsi and 3 and 4 by four
groups. Eight, the most frequently used error number by
Groups I, II, III, and VI, accounted for 44 per cent of the
error responses of Groups I and IIi 30 per cent for Group
III» and 22 per cent for Group VI. Two, the most frequent
ly used error response number by Groups IV, V, and VII,
accounted for 43 per cent of the error responses of Group
IVi 25 per cent for Group Vj and 34 per cent for Group VII.
The most evenly distributed error number was 9.
An inverse relationship between age and error fre
quency may be noted for error numbers 0 and 8j in both in
stances, as age Increased error frequency decreased. Gen
erally, it appears that while age is not a factor in error
number selection, it did influence the frequency with which
given error numbers were selected.
Error score totals of the male and the female sub
groups reveal error frequency differences for the numbers
TABLE 20. DISTRIBUTION AND ERROR FREQUENCY OF ERROR RE
SPONSE NUMBERS OF THE SEVEN AGE GROUPS, THE MALE SUB
GROUP, THE FEMALE SUBGROUP, AND THE SAMPLE ON A TEST OF
LINGUAL TACTILE PATTERN RECOGNITION.
Group 0 1 2
3
4
5
6
7
8
9
Total
I 6 0 8 1 1 2 0 2 20
5 45
II 5
0 1 0 0 0 1 0 8
3
18
III 5
0 4 0 1 1 1 1 8
5
26
IV 0 0
9
0 0 2 0 2
5 3
21
V
5
0 6 1 1 2
3
0
3 3
24
VI
3
0 2 1 1
3
1 1 4 2 18
VII 1 0 8 1 1
3
2 0
3
4
23
Males
13
0 22 1 2 4
5
4 34 21 106
Females 12 0 16
3 3 9 3
2
17
4
69
Sample
25
0 38
4
5 13
8 6
51 25 175
115
116
2, 8, and 9. The males made six more error responses with
2, twice as many with 8, and slightly over five times as
many with 9.
Summary.
A significant sex difference was found for ability
to identify numbers traced on the tongue, with the greater
number of errors made by the males Contradictory findings
for age were obtainedi a significant difference was not
found in the performances of the seven age groups when the
sexes were pooled, whereas significant differences were
found in the performances of both the 70 males and the 70
females when their error scores were treated separately.
The stimulus numbers most difficult to identify, in
frequency order based on sample error scores, were 7 and
6, followed by 3 and 9. The stimulus number 1 was correct
ly identified by every subject.
All error responses were one-digit numbers. Error
number 8 obtained the greatest frequency, followed, in fre
quency order, by 2, 0 and 9* 5. 6, 7i **. and 3, The number
1 did not appear as an error response number.
A tendency for certain error response and stimulus
numbers to "pair" suggests a configuration similarity for
the paired numbers close enough to confuse the subject.
The more obvious pairs (error number given first) were 2-7.
9-7. 0-6, 8-6, and 8-3.
117
Age and sex did not appear to be factors determin
ing error number selection but did seem to be related to
the frequency with which a given number was selected,
MANDIBULAR KINESTHESIA
This test measurement required the subject to com
pare a series of seven "variable" mouth openings to each of
seven "standard" mouth openings and make a judgment as to
whether the variable was the "same," "less," or "more" than
the standard. (Three variables were less than, three were
more than, and one was the same as the standard.) Thus, 49
responses were obtained from each subject.
Statistical Analysis.
The data treated to study group performance by age
and by sex were the error scores obtained for the seven
standard mouth openings.
The results of the statistical analysis are shown
In Table 21. Comparisons of the distributions of the error
scores of the seven age groups, the 70 males, and the 70
females yielded no statistically significant difference for
age. Comparison of the error score totals of the male and
the female subgroups yielded no statistically significant
difference for sex. The ability to Judge variable-standard
mouth opening pairs does not seem to be related to age or
sex.
TABLE 21. RESULTS OF CHI SQUARE TESTS APPLIED TO
ERROR SCORES IN JUDGING VARIABLE AND STANDARD
MOUTH OPENING STIMULUS PAIRS OF THE SEVEN AGE
GROUPS, THE MALE SUBGROUP, AND THE FEMALE SUB
GROUP ON A TEST OF MANDIBULAR KINESTHESIA.
Group X2 df
Age Groups I-VII 7.57
6 not significant
Males 6.44 6 not significant
Females 8.77
6 not significant
Males vs Females
0.75
1 not significant
H
M
00
119
Error Scores for "Standard" Mouth Openings.
Seven Judgments were required for each of the seven
standard mouth openings. Thus, for each standard mouth
opening, 1^0 responses were obtained from each age group
and 490 responses were obtained from the male subgroup and
the female subgroup. The error scores of the seven stan
dard mouth openings are presented in Table 22.
Inspection of the error score totals of the sample
shows, with one exception, a consistent relationship be
tween millimeter gap-set and error frequency* the greater
the gap-set dimension of the standard mouth opening, the
greater the number of error responses.
While the gap-set/error frequency relationship was
not as consistent along the standard mouth opening con
tinuum for the seven age groups, the trend was evident par
ticularly at both ends. Groups IV, VI, and VII had lowest
error scores for the 12.0 mm mouth opening, and Groups I and
II had lowest error scores for the 1^.^ mm mouth opening*.
Groups II and V differed1 each had lowest error scores for
two of the three middle mouth openings— 16,8 and 21.6 mm.
Six of the seven age groups had highest error scores for
the 2 6 mm mouth openings. (Two of the six groups also
had these scores for one other mouth opening each* Group II,
12.0 mm; Group VII, 2^.0 mm.) The remaining Group, III,
had its highest error score for the 2^.0 mm mouth opening.
The gap-set/error frequency relationship noted for
TABLE 22. ERBOR SCORES OF THE SEVEN STANDARD MOUTH OPENINGS OF
THE SEVEN AGE GROUPS, THE MALE SUBGROUP, THE FEMALE SUBGROUP,
AND THE SAMPLE ON A TEST OF MANDIBULAR KINESTHESIA.
Group 12.0 14.4 16.8 19.8 21.6 24.0 26.4 M F M+F
I 20
19 29 25 27 21
33 75 99
174
II 22 21 18 20 18 21 22 71 71 142
III 15 12 23 15
20
29
26 68 72 140
IV
15
16 24
19
22 2b 28 72 76 148
V
19
22 17
24
17 23 27 73
76 149
VI
17 19
22 22 30 21 32 91
72
163
VII
15
21 20 21 18
23 23
66 76 142
Males 56 58 72 72 76 80 102 516
Females 67 72 81 7b 76 82 90 542
Sample
123 130
153
lb 6 152 162 192 1058
Age groupsi 980 responses, each.
Male, Female groupsi 3,^30 responses,each.
PO
o
| 121
the sample was more consistently maintained by both the
male and the female subgroups for the seven standard mouth
openings than It was by the seven age groups.
It might be concluded that error frequency for
Judging standard mouth openings* while not related to age
or sex* Is related to the millimeter gap-set dimension of
the standard mouth opening.
Per Cent Scores. The extent to which each age
group, the male subgroup, and the female subgroup contrlb-
i
uted to the total error score In Judging the seven stan
dard mouth openings may be seen In Figure 17. A rank orderj
listing of the per cent values, from lowest to highest,
does not support a relationship between age and sex and
error frequency. Group III made 13.2 per cent of the er
rors* Groups II and VII, 13.^ per cent* Group IV, 1^.0 per
centj Group VI, 15.^ per cent* and Group I, 16.4 per cent.
The male subgroup made 51.2 per cent of the errors* the
i
female subgroup made 4-8.8 per cent of the errors.
Error Scores for HVarlablew Mouth Openings.
The variable mouth openings consisted of three set-
changes less than the standard, three set-changes greater
than the standard, and the standard mouth opening compared
with Itself. The error scores of each of the seven vari
able mouth openings are presented in Table 23*
Inspection of the error score totals of the sample
Pig. 17. Per cent value of error
score of each age group, the
male subgroup, and the female
subgroup compared to total error
score in judging seven standard
mouth openings. M
w
TABLE 23. ERROR SCORES OP THE SEVEN VARIABLE MOUTH OPENINGS OP
THE SEVEN AGE GROUPS. THE MALE SUBGROUP. THE FEMALE SUBGROUP,
AND THE SAMPLE ON A TEST OF MANDIBULAR KINESTHESIA.
Group -4.8 -3.2 -1.6 Std. +1.6 +3.2 +4.8 M F M+F
I 0 2 71
16 7b 10 1
75 99
174
II 0
9
60 8
59
6 0 71 71
142
III 1 7 57
24
43
6 2 68 72 140
IV 0 4 58 2b 52 7 3
72 76 148
V 0
5
49 3 6 52 6 1
73
76 149
VI 0
9 47
2b 74
9
0
91
72
163
VII 0
3 38 52 47 2 0 66 76 142
Males 0
19
181 76 210 26 4 516
Females 1 20
199
108
191
20
3
542
Sample 1
39
380 184 401 46
7
1058
Age groupst 980 responses, each.
Male, Female groups1 3*430 responses, each.
H
w
V j t )
124
reveals an Inverse relationship between millimeter gap-set
and error frequency* the greater the gap-set dimension of
the variable mouth opening, the fewer the number of error
responses. The error scores of variables -4,8 and +4.8 mm
were 1 and 7, respectively* for variables -3.2 and +3.2 mm,
39 and 46, respectively; for variables -1.6 and +1.6 mm,
380 and 401, respectively. The error score for the stan
dard variable was 184.
The inverse gap-set/error frequency relationship
noted for the sample was maintained by each of the seven
age groups and by the male and female subgroups. Only
Group III had an error response for the -4.8 mm variable
while Groups I, III, IV, and V had error responses for the
+4,8 mm variable. All seven age groups had error responses
for each of the remaining five variable mouth openings,
with error frequency increasing as the millimeter gap-set
decreased.
The error score ranges of the variable mouth open
ings further demonstrate the inverse relationship. Error
ranges of variables -4.8 and +4.8 mm were 0-1 and 0-3»
respectively; for variables -3.2 and +3.2 mm, 2-9 and 2-10,
respectively; for variables -1.6 and +1.6 mm, 38-71 and
43-74, respectively; and for the standard variable, 8-52,
Error Scores for Same, Less. More Variable-Standard Pairs.
Pairing the "variable" and the "standard" mouth
125
openings resulted in three variable-standard groupsi Same—
one variable same as standard; Less— three variables less
than standard; and More— three variables more than standard.
The error scores and per cent values of the error scores
compared to the number of Judgment responses of each age
group, the male subgroup, the female subgroup, and the
sample are presented in Table 24.
The per cent values of the sample show that more
error Judgments were made, proportionately, for the Same
variable-standard group, 18,8 per cent, than were made for
the Less, 14,4 per cent, and the More, 15.4 per cent,
variable-standard groups.
The error patterns of the age groups, with the ex
ception of Groups V and VII, and of the male and the female
subgroups did not repeat the error Judgment pattern of the
sample (Same. More. Less). The order difficulty for Group
III and the female subgroup was Same. Less. More; for Group
It More. Less. Same; for Groups IV and VI and the male sub
groups More. Same. Less; and for Group lit Less, More. Same.
Thus, four groups (III, V, VII, female subgroup) made more
errors, proportionately, for the Same variable-standard
group; four groups (I, IV, VI, male subgroup) made more
errors, proportionately, for the More variable-standard
group; and only Group I made more errors, proportionately,
for the Less variable-standard group.
TABLE 24. ERROR SCORES AND PER CENT VALUES OP ERROR SCORES COMPARED TO NUMBER
OP RESPONSES OP EACH AGE GROUP, THE MALE SUBGROUP, THE FEMALE SUBGROUP, AND
THE SAMPLE IN JUDGING SAME. LESS. AND MORE VARIABLE-STANDARD GROUPS ON A TEST
OF MANDIBULAR KINESTHESIA.
♦Same #Less #More Total
Group
Error
Score
% of
Response
Error
Score
% of
Response
Error
Score
% of
Response
Error
Score
% of
Response
I 16 11.4
73
17.4
85
20.2 174
17.7
II 8
5.7 69 16.3 65 15.5
142 14.5
III 24
17.1 65 15.5 51
12.1 140
14.3
IV 26
18.5
60 14.3 62 18.8 148
15.1
V
35
26.4
55
13.0 59 16.5 149 15.2
VI 21 15.0
59
14.0
83
19.8
163
16.6
VII 54
38.5 39 9.3 49 11.7
142
14.5
Males
75 15.3
201
13.7
240
16.3 516 15.0
Females
109 22.2 219 14.9
214
14.5 542 15.8
Sample 184 18.8 420 14.4 454 15.4 1068 15.4
wage groupsi responses, eacn.
♦Male, Female groupst 490 responses, each.
#Age groupsi 420 responses, each.
#Male, Female groupst 1,4?0 responses, each.
N >
o\
127
Error Scores for "same," "less," and "more" Judgments,
Each subject had three responses— "same," "less,"
"more"— from which to select one in judging a variable-
standard mouth opening pair. One was the correct response;
the other two were incorrect responses. For example, for a
Same variable-standard stimulus pair the oorrect response
was "same"; the incorrect responses were "less" and "more,"
Error scores for type of error Judgment were tabu
lated for each of the three variable-standard groups for
the seven age groups, the male subgroup, the female sub
group and the sample and are presented in Table 25*
Total error scores of the sample show a consistency
in type of error made in Judging a variable-standard pair.
For Same variable-standard pairs, there were 126 "less" and
58 "more" error Judgments; for Less variable-standard pairs,
413 "same" and 7 "more" error Judgments; for More variable-
standard pairs, 445 "same" and 9 "less" error Judgments.
This error type Judgment pattern was maintained by
five of the seven age groups and by the male and the fe
male subgroups. Only age groups I and III differed in one
Judgment— the Same variable-standard group. Group I had an
equal number of "less" and "more" error judgments, while
Group III reversed the order with 9 "less" and 15 "more"
error judgments.
It might be concluded that a subject is likely to
err in the direction of "less" when judging a Same variable-
TABLE 25. ERROR SCORES OP TYPE OF ERROR JUDGMENT WHEN MAKING "same,”
"less," OR "more" JUDGMENT OP EACH AGE GROUP, THE MALE SUBGROUP, THE
FEMALE SUBGROUP, AND THE SAMPLE IN JUDGING SAME. LESS. AND MORE
VARIABLE-STANDARD MOUTH OPENING PAIRS ON A TEST OPUXnDIBULAR
KINESTHESIA.
Group
Same
"less" "more"
Less
"same" "more"
More
"same" "less" Total
I 8 8 70
3 83
2 174
II
5 3 69
0 64 1 142
III 9 15
6b 1 48
3
140
IV 20 6 58 2
59 3
148
V 26
9 55
0
59
0 149
VI 11 10 58 1
83
0
163
VII
47 7 39
0 49 0 142
MAles 52
23 195
6
231 9
516
Females 74
35
218 1 214 0 542
Sample 126 58 413
7
445
9
1058
r o
00
| 129
standard mouth opening stimulus pair, and In the direction
of "same" when judging Less and More variable-standard
mouth opening stimulus pairs.
Difference Llmen (DL) Values.
The primary objective of this measurement was to
obtain difference llmen values* In mm* for each of the ,
seven standard mouth openings for each age group* the male
subgroup, the female subgroup, and the sample.
! The method used to obtain the DL values was that j
' j
; l
|suggested by Osgood (1956, p.^8) and reported In a study |
i
jby Rlngel et al. (1967). Curves representing the frequen
cies of the three judgments (same* less, more) were plotted
!
!
for each of the seven standard mouth openings. The point
where the "less" curve crosses the 50# line represents the j
; 1
|lower llmen and that where the "more" curve crosses the 50# J
line represents the upper llmen (I.e., those variable j
stimuli which would be Judged "less" or "more" than the
standard 50# of the time). The DL value Is assumed to be
lequal to half the Interval of uncertainty lying between the
|
upper and lower limitst DL = (Lu-Ll)/2. This procedure was
repeated for each of the standard mouth openings for each
age group and for the male and the female subgroups. The
obtained DL's are presented In Table 26.
The mean DL's of the sample suggest a relationship
between standard mouth opening millimeter gap-set and DL
TABLE 26. DIFFERENCE LIMEN (DL) VALUES, IN MILLIMETERS, OF SEVEN
STANDARD MOUTH OPENINGS OF EACH AGE GROUP, THE MALE SUBGROUP,
THE FEMALE SUBGROUP, AND THE SAMPLE ON A TEST OF MANDIBULAR
KINESTHESIA.
Group 12.0 14.4 16.8 19.2 21.6 24.0 26.4 Mean
I
1.35 1.30 1.80 1.50 1.65 1.60 2.05
1.61
II 1.50 1.50 1.35 1.25
1.20 1.40 1.50 1.38
III
0.95
1.00 1.30 1.00 1.45 1.75 1.25
1.24
IV 1.05 1.05 1.55 1.05 1.30 1.45 1.75 1.31
V 1.05 1.25 0.95 1.35
1.00
1.35 1.65 1.23
VI
1.15 1.25 1.50 1.45 1.40
1.35 1.65 1.39
VII 0.70
0.55
0.70
0.95 0.95
1.20 1.40 0.92
Males 1.10 1.10 1.25 1.30 1.30 1.50 1.75 1.33
Females 1.10
1.15 1.35 1.15 1.25
1.40 1.50 1.27
Sample 1.10 1.12 1.30 1.22
1.27 1.45 1.62 1.30
V j J
o
131
millimeter value; the greater the gap-set millimeter dimen
sion, the greater the DL millimeter value. This relation
ship, with one exception, can be observed across the seven
standard mouth openings.
The DL's of the seven age groups, the male subgroup,
and the female subgroup also show this relationship but with
less consistency than that demonstrated by the sample. Six
of the seven age groups and both the male and the female
subgroups obtained lower DL's for the 12.0 and 14.4 mm
standard mouth openings than for the 24,0 and 26.4 mm stan
dard. mouth openings. The relationship was less consistent
for the three middle standard mouth openings~l6.8, 19.2,
21.6 mm— for the seven age groups than for the male and the
female subgroups.
Summary.
No significant differences were found for age or
for sex for ability to Judge variable-standard mouth open
ing stimulus pairs.
Error scores were analyzed for the seven standard
mouth openings, the seven variable mouth openings, the
three variable-standard groups, and the three types of
Judgments.
A relationship was observed between standard mouth
opening millimeter gap-set and error frequency* the greater
the gap-set dimension, the greater the number of error re-
j 132
jsponses.
1
An Inverse relationship was observed between vari
able mouth opening millimeter gap-set and error frequency*
the greater the gap-set dlmension( the fewer the number of
error responses.
More error Judgments were made, proportionately,
for Same variable-standard mouth opening pairs than for
Less and More variable-standard mouth opening pairs.
For type of Judgment response, the subjects tended
to err In the direction of "less" when Judging a Same
variable-standard pair and In the direction of "same" when
Judging Less and More pairs.
Difference llmen (DL) values were obtained for the
seven standard mouth openings for each age group, the male
subgroup, the female subgroup, and the sample. A relatlon-
!
|ship was observed between standard mouth opening millimeter
gap-set and difference llmen millimeter value* an Increase
'In the standard mouth opening gap-set dimension was re-
j
i fleeted by an increase in the difference llmen millimeter
value.
CHAPTER V
DISCUSSION
The data obtained from the responses of a sample
consisting of 1^0 normal subjects to four measurements of
oral sensation and perception were presented In Chapter IV.
The data were analyzed by age and by sex to establish nor
mative values for oral two-point discrimination, oral form
Identification, lingual tactile pattern recognition, and
mandibular kinesthesia. This chapter will discuss the
findings and their Implications.
ORAL TWO-POINT DISCRIMINATION
Regression lines were drawn and clinical limits
plotted for each of the three mldllne oral sites tested for
the male and the female subgroups to study performance by
age and by sex. Sex differences were not observed In the
means and slopes of the regression lines of the three oral
sites. For age, the Increase In the means for only the
tongue tip for the males was significant; as age Increased,
an Increase In the gap opening was required for two-point
discrimination.
For both the male and the female subgroups, the
normal clinical range for the tongue blade was greater than
133
13^
that for the upper lip, and the normal clinical range for
the upper lip was greater than that for the tongue tip.
Mean two-point limen values were obtained for each
of the three midline oral sites for each age group, the
male subgroup, the female subgroup, and the sample. The
mean two-point llmen values of all groups show the tongue
blade to be less discriminatory than the tongue tip and
upper lip, with no consistent discriminatory order estab
lished for the latter two. The tongue tip was more dis
criminatory for Groups III, VI, VII, and the male subgroup*
the upper lip was more discriminatory for Groups I, II, IV,
V, and the female subgroup.
One study was reported in the literature in which
the oral esthesiometer was used to obtain two-point limen
values and to determine discriminatory capacity (Ringel and
Ewanowski, 1965), The discriminatory capacity of the two
oral structures common to the two studies (tongue tip and
upper lip) was the same for those subjects in this inves
tigation with an age range similar to that of the subjects
in the previous study. The two-point limen values obtained
in this investigation for the two oral sites, however, were
lower than those reported in the Ringel and Ewanowski study.
The limen values reported in their study for the tongue tip
and upper lip were 1.70 and 2.31 mm, respectively. The
limen values obtained by the sample in this Investigation
for the tongue tip and upper lip were 1.12 and 1,10 mm,
jrespectively, while the subjects with an age range similar
to that of the Ringel and Ewanowski study obtained limen
values of 1,08 and 1,29 m®, respectively.
While the variable, or variables, contributing to
the differences can only be conjectured, several possibili
ties are suggested by the results of a study reported by
Ellender (1966). She investigated five perceptual cate
gories involved in the transition from one- to two-point
i * !
perception on the lingual surfaces of normal subjects, and
compared threshold measures obtained by a random order
i
method with those obtained by an alternating ascending- j
j
descending approach. The five perceptual categories were
1
1(1) one distinct, polnt-llke stimulus, (2) one distinct !
I stimulus, not point-like in quality, (3) two stimuli not
i i
j j
itotally separate and distinct, (^) two separate, distinct |
! \
jstimuli, not point-like in quality, and (5) two separate, j
distinct, point-like stimuli. j
' The results revealed that the five perceptual cate- |
| j
jgories were identifiable in the transition from one- to i
!
jtwo-polnt perception, and that the random order method j
yielded significantly higher thresholds than the alternat
ing ascending-descending approach. She concluded that the
i
higher thresholds provided evidence that "perceptual ex
periences were not directly and absolutely related to the
distance between two points, but were methodologically
dependent."
136
The first variable proposed is that of instructional
variation. It is possible that subtle differences, unique
to the verbal instructions and not apparent in the written
texts, introduced by the researchers prompted the subjects
of this investigation to identify “two points" more fre
quently at Ellender's category levels 3 and 4, and the sub
jects of the Ringel and Ewanowski study to identify "two
points" more frequently at levels 4 and 5.
The second variable proposed is that of method of
stimulation. Ringel and Ewanowski reported that "both
ascending and descending procedures were followed three
times in accordance with a random order." The random order
method was not used in the present study. The three ascend
ing and the three descending patterns were presented at
each test site starting with an ascending pattern and al
ternating with a descending pattern until the six patterns
had been completed.
The third variable proposed is that of test loca
tion. It seems apparent that a relationship exists between
the discrete site selected for stimulation and the degree
of sensitivity (described in terms of thresholds or llmen
values) reported for that region, or in some Instances for
the oral structure. Labial sensitivity appears to vary
progressively from the muco-cutaneous Junction to the ver
milion border* lingual sensitivity appears to vary pro
gressively from the apex posteriorly along the mldllne of
137
the blade, and from the midline laterally to the margins.
It Is not unlikely, therefore, that the location selected
for stimulation to represent the anatomical region or struc
ture being investigated influences the findings. It Is not
surprising that independent investigations have obtained
varying Ilmen values and, when the obtained results from
two or more oral structures are compared, that varying dis
criminatory capacity orders have been noted.
That different anatomical regions of an oral struc
ture, as well as the different oral structures, vary in
sensitivity has been documented in the literature. Studies
of one-point tactile recognition and two-point discrimina
tion show the tongue tip to be more sensitive than the
tongue blade (Henkln and Banks, 1957)» to be more sensitive
than the lateral margins of the tongue (Such, 1951I Gross
man, 196^1 McCall, 196^1 Olroyd, 1965» Ringel and Ewanowskl,
1965)1 and to have less measurement variability than the
lateral margins (Morgan, 19661 McCall and Morgan, 1969a).
Ringel and Ewanowskl (1965) reported the three tongue loca
tions— midline, right and left sides— to be significantly
more discriminatory than similar sites of other oral struc
tures.
The labial mucosa and the tongue tip were found to
be more sensitive to electrical stimulation than the pos
terior tongue dorsum (Grossman, 1967)*
Inconsistent and contradictory findings have also
138
been obtained. In a study of one-point tactile recognition
(Grossman, et al., 1965), the upper lip was found to be the
most sensitive of four midllne oral sites tested} the
tongue tip and lower lip were not significantly different
from each other; and the vermilion border of the upper lip
was three times more sensitive than the muco-cutaneous
Junction. Ringel and Ewanowskl (1965) found the midllne
region of the upper lip to be more discriminatory than both
the right and left sides, whereas McCall and Kirkley (1967)
found no evidence to suggest a difference in the tactile
sensitivity for the midline and six lateral sites of the
vermilion border of the lower lip. Morgan (1966) obtained
no significant differences in the relative magnitude of
variances for the right and left tongue margins, while
asymmetry in two-point capacity on the tongue margins of
more than half the subjects tested was reported by McCall
and Morgan (1969b).
The varying difference limen values reported in the
literature reflect the findings reported for discriminatory
capacity. Limen values of 1-2 mm and approximately 4 mm
for the tongue tip and upper lip, respectively, were re
ported by Ruch (1951). Silverman (1961) obtained a differ
ence limen of 1.4 mm for the tongue tip; Grossman (196*0
reported limen values of 2-3 nun for the tongue tip. McCall
(1964) obtained two-point measurements of .0671 and .1035
inches for the tongue tip and poorer tongue margin, respec-
139
tively, for his normal subjects.
These variations might be attributed to differences
in subjectsi procedures, methodology, and instrumentation.
Studies, for example, have been reported in which an
adapted Mitutoyo caliper was used to investigate two-point
discrimination (see Chapter II, pages 23-27). The probe
tips of this caliper are in an anterior-posterior relation
ship with each other, on a plane parallel with that of the
instrument shaft. Thus, the contact shift of the probe
tips, as the gap opening is increased or decreased, on a
test site such as the midline of the tongue tip would seem
to be in an anterior-posterior direction along the axis of
the median raphe. In contrast, the probe tips of the oral
esthesiometer used in the present study (and by Ringel and
Ewanowskl, 1965) are in a side-to-side relationship with
each other, on a plane at right angles to the instrument.
The contact shift of the probe tips, therefore, at the mid
line site of the tongue tip is in a bilateral direction at
right angles to the axis of the median raphe. It would
seem that different neural fields are stimulated by the
application of the probe tips of the two instruments.
The variables discussed in this section, particu
larly that of the methods of stimulation, the random order
method versus an alternating ascending-descending approach,
offer suggestions for further research.
1^0
ORAL FORM IDENTIFICATION
The error scores obtained in judging the within-
class and the between-class form pair groups were used to
study sample performance by age and by sex. The error
scores obtained for each of the 15 within-class and the 21
between-class form pairs were used to study the effect of
the stimulus pairs on group performance.
No statistically significant sex difference was
found for ability to Judge within-class form pairs, whereas
a significant difference was found for age, with the sub
jects of Group I making the greatest number of errors.
A statistically significant sex difference was
found for ability to judge between-class form pairs, with
the female subgroup making the greater number of errors.
Contradictory findings were obtained for agei no signifi
cant difference was found in the performance of either the
70 males or the 70 females, whereas a significant differ
ence was found when the sexes were pooled with the subjects
of Group I making the greatest number of errors.
The performance of Group I, with the greatest num
ber of errors in Judging both the within-class and the
between-class groups, might be attributed to age. The dif
ference in the performances of the male and the female sub
groups only in judging the between-class group, with the
females making the greater number of errors, cannot be
accounted for.
The validity of these results are open to question.
An inspection of the error scores tabulated for each of the
15 within-class and for each of the 21 between-class form
pairs revealed that they were all not of equal difficulty.
Pour of the within-class pairs (1-2, 3-^» 6-7, 7-8) ac
counted for 70.0-88.8 per cent of the errors made by the
seven age groups in judging the 15 within-class pairs, and
|three of the between-class pairs (2-5# 5-7# 5-8) accounted
I
for 55#9-77.7 per cent of the errors made by the seven age |
i i
jgroups in judging the 21 between-class pairs. j
| The bias Imposed by these seven form pairs on the J
; total error scores obtained by the seven age groups, the j
male subgroup, and the female subgroup may be seen when
j
their scores are excluded (see Table 27.). The error score
I
'range of the seven age groups for the 15 within-class form
: pairs was 27-69, a range of 42 j with the four within-class
j
form pair scores excluded, the error score range is 3-18,
a range of 15. For the 21 between-class form pairs, the
error score range of the seven age groups was 18-40, a
range of 221 with the three between-class form pair scores
excluded, the error score range is 6-18, a range of 12.
The error scores of the male and the female sub
groups for the 15 within-class form pairs were 157 and 161,
respectively, a difference of 4j with the four within-class
jfoim pair scores excluded, the error scores are 47 and 31#
TABLE 27. ERROR SCORES IN JUDGING 15 WITHIN-
CLASS AND 21 BETWEEN-CLASS FORM PAIRS AND
ERROR SCORES IN JUDGING 11 WITHIN-CLASS AND
18 BETWEEN-CLASS FORM PAIRS OF THE SEVEN AGE
GROUPS, THE MALE SUBGROUP, AND THE FEMALE
SUBGROUP
CATION.
ON A TEST OF ORAL FORM IDENTIFI-
Wlthin-Class Between-Class
Group
15
pairs
11
pairs
21
pairs
18
pairs
I 69 18 40 18
II
45
10 31
11
III 50 15
20 9
IV 46
13 27
6
V 4o 8
35 17
VI 27 3
18
7
VII 4l 11 32
14
Males 157 47
86 30
Females l6l
31 117 52
143
a difference of 16. For the 21 between-class form pairs,
the error scores of the male and the female subgroups were
86 and 117, respectively, a difference of 31» with the
three between-class form pair scores excluded, the error
scores are 30 and 52, respectively, a difference of 22.
The bias imposed by the seven form pairs is fur
ther demonstrated when the error scores of the 15 within-
class and the 21 between-class form pairs and the error
scores of the remaining 11 within-class and the 18 between-
class form pairs are assigned per cent values (see Table
28. ) .
The adjusted error scores would seem to indicate
that age was not a factor in ability to judge the remaining
11 within-class and the remaining 18 between-class form
pairs nor do the adjusted error scores seem to indicate a
judgment difficulty difference between the within-class and
the between-class groups.
The adjusted error scores reveal a different per
formance pattern for the male and the female subgroups. In
contrast to the results obtained for judging the 15 within-
class form pairs, the male subgroup made the greater number
of errors in Judging the remaining 11 within-class form
pairs, with the difference between the error scores of the
male and the female subgroups being greater— from 4 to 16.
While the female subgroup made the greater number of errors
in judging both the 21 between-class form pairs and the re-
TABLE 28. PEB CENT VALUES FOB EBBOB SCOBES OF
15 WITHIN-CLASS AND 21 BETWEEN-CLASS FOBM PAIBS
COMPARED TO NUMBEB OF BESPONSES AND PEB CENT
VALUES FOB EBBOB SCOBES OF 11 WITHIN-CLASS AND
18 BETWEEN-CLASS FORM PAIBS COMPABED TO NUMBEB
OF BESPONSES OF THE SEVEN AGE GHOUPS, THE MALE
SUBGROUP, AND THE FEMALE SUBGROUP ON A TEST OF
OBAL FORM IDENTIFICATION.
Group
Within
15
pairs
-Class
11
pairs
Between-Class
21 18
pairs pairs
I 23.0 8.2
9.5
2.2
II 15.0 4.6 7.4 3.0
III 16.7
6.8 4.8
2.5
IV
15.3 5.9
6.4
1.7
V
13.3
3.6
8.3 4.7
VI 9.0 1.4
^.3 1.9
VII
13.7 5.0 7.6
3.9
Males
Females
14.9
15.3
6.1
4.0
5.8
7.9
2.4
4.1
145
malning 18 between-class foxm pairs* the difference between
the error scores of the male and the female subgroups Is
less— from 31 to 22. The error scores of the males and
females In each age group are presented in Table 29*
Thus, while the males tended to make a greater num
ber of errors In judging the 11 within-class pairs and the
females tended to make a greater number of errors In judg
ing the 18 between-class pairs, the sex differences seem to
be less sharply defined for ablity to Judge within-class
and between-class groups.
It might be concluded that the error responses ob
tained from the sample reflect oral fox® identification
difficulty for judging four within-class and three between-
class form pairs rather than ability for judging the
within-class and the between-class fox® pair groups which
comprise the test stimuli of this measurement.
Attempts to develop a test of oral form identifi
cation with the standard set of 20 geometric forms develop
ed by the NIDR have generally been unsuccessful. Hether-
ington (1965), using modifications of drawings of the al
ternatives in the Shelton et al, (1967) study, found the
test to be too difficult, particularly for the younger
children, to make an identification of persons with oral
sensory deficits. Levin (1965) found significant confu
sions between a number of foxms for both her aphasic and
normal subjects in tests of oral and manual stereognosis.
TABLE 29. ERROR SCORES IN JUDGING 11 WITHIN-
CLASS AND 18 BETWEEN-CLASS FORM PAIRS OF THE
SEVEN AGE GROUPS, THE MALE SUBGROUP, AND THE
FEMALE SUBGROUP ON A TEST OF ORAL FORM IDEN
TIFICATION.
♦Within-Class
(11 pairs)
#Between-Class
(18 pairs)
Group M F Total M F Total
I 11 7
18 8 10 18
II
5 5
10
5
6 11
III 7
8
15 3
6
9
IV 11 2
13
2 6
V 2 6 8 2
15 17
VI 2 1
3
2
5 7
VII
9
2 11 6 8 1^
Total 47
31
78 30 52 82
♦Age groupst 220 responses, each,
♦Male, Female groups* 770 responses, each.
#Age groups* 360 responses, each.
#Male, Female groups* 1,260 responses, each.
M
■ P -
o\
147
Moser et al. (196?). reporting an investigation of Kile and
Class, stated that the experimenters found significant con
fusions, at the .01 level, between a number of forms for
each of the three form sizes used in the study,- Shelton
et al. (1967) administered a test of oral form perception,
developed from information and experience from three pre
vious pilot studies, to 1st and 3rd grade children and to
graduate students. The low scores of all groups led to
the conclusion that the test was too difficult.
Varying results have been reported in those studies
in which the standard set of 20 geometric forms was used
to compare the abilities of normal and abnormal subjects.
Levin (1965) found significant differences between the per
formances of aphasic and normal subjects for both oral and
manual stereognosis, with the aphasic subjects inferior to
the normals in all scores. Mason (1967), reporting an on
going study at a cleft palate center and training program,
found no perceptual deficits for oral stereognostic abili
ties for the 42 subjects tested. No significant difference
was found in the oral stereognostic abilities of eight nor
mal and eight articulatory-defective speakers by Kile, and
the results obtained by LaGourgue led to the conclusion
that there is probably no significant difference between
blind, deaf, and normal populations in oral stereognostic
ability (Moser et al., 1967).
More recently, two studies (Ringel et al., 1968*
Ringel et, al., 1969) have been reported in which signifi
cant differences in oral form discrimination ability were
obtained between a group of normal and a group of articula
tory-defective speakers. Ten forms (two triangles, a
square, two rectangles, three ovals, and two biconcaves)
were selected from the NIDR 20's series to construct the
test. An analysis of the data of the two studies led to a
number of conclusions two of which were that both the nor
mal and the articulatory-defective subjects made a greater
average number of within-class than between-class errors
and that the children had more difficulty than the adults .
with the discrimination task. A study of the reliability
items suggested that the major differences were between age
groups, with the children's responses being less reliable
than those of the adults. Data on performance by sex were
not reported in either of the two studies.
While the findings of the present investigation,
based on the data obtained in Judging the 15 within-class
and the 21 between-class form pairs, are similar to those
reported by Ringel and his associates, the observations
based on the adjusted error scores of the seven age groups,
the male subgroup, and the female subgroup do not support
their conclusion for age and reliability differences, nor
for the Judgment difficulty difference between the within-
class and the between-class groups. It might be conjec
tured that the within-class form pairs 1-2, 3-^t 6-7* and
V+9
7-8 and between-class form pairs 2-5» 5-7* an(* 5-8* which
were common to the three studies, affected the performances
of Ringel's subjects and the subjects In this investigation
In a like manner.
The value of an oral form identification measure
ment, constructed in the manner described and used by
Ringel and his associates, has been suggested by the re
sults obtained in their Investigations. The value of the
test measurement in its present foim has been questioned by
the results obtained from the performances of a normal sam
ple in the present investigation. The error scores of cer
tain form pairs suggest a similarity of size and/or shape
close enough to confuse the normal subject, making correct
Judgments of "same" or "different" difficult. It is pos
sible that these pairs would not differentiate the normal
and the sensory-deprived person. Further research is indi
cated following modification of these geometric forms.
LINGUAL TACTILE PATTERN RECOGNITION
The error scores obtained in identifying the stimu
lus numbers were used to study group performance by age and
by sex. Additional Information used to study the relation
ship between group performance and certain characteristics
of the test items and procedure was obtained from the error
scores of the stimulus and error response numbers, from the
group distribution of the error response numbers, and from
| 150
the observations of the writer.
i
A statistically significant sex difference was
I found in ability to identify one-digit numbers traced on
;the tongue dorsum, with the male subgroup making the great
er number of errors. Contradictory results were obtained
for agei no significant difference was found in the perform
ances of the seven age groups when the sexes were pooled,
whereas significant differences were found in the perform-
jances of both the 70 males and the 70 females when the er
ror scores of the two groups were treated separately.
The stimulus number most difficult to identify was
;7, followed in order by 6, 3* and 9. The error response
number most frequently used was 8, followed in order by 2,
0 and 9, 5» 6, 7* and 3. The stimulus number 1 was cor
rectly identified by all subjects and did not appear as an
error response number. Certain error response and stimulus
numbers were "paired" with greater frequency than others
(error response number given first)* 2-7» 9-7, 0-6, 8-6,
and 8-3.
From the analysis of the data, it might be con
cluded that while age and sex do not appear to be factors
determining error number selection, they do seem to be
related to the frequency with which a given number is
selected.
The error scores of the stimulus numbers suggest a
[relationship between ability to recognize a one-digit num
151
ber traced on the skin surface and the complexity of that
number's written pattern. The stimulus number 1, which has
the least complex pattern of the five stimuli, was correct
ly identified by all subjects. The stimulus numbers 7» 6,
3, and 9, which have more complex patterns, yielded error
scores of 56, 55* 36, and 28, respectively.
The "pairing'’ of certain error response and stimu
lus numbers suggests a relationship between ability to rec
ognize a one-digit number traced on the skin surface and
the distinctiveness of that number's written pattemi that
is, the less difference (distinctiveness) between the pat
terns of two numbers the more likely is the first number to
Ibe incorrectly identified and the second number to be given
; I
as an error response. This relationship may be seen when
! I
the stimulus and error response number pairings obtained
i
from the subjects are inspected.
i i
It is the opinion of the writer that the responses
obtained from the subjects on this test measurement do not
fully reflect their ability to identify numbers traced on
the tongue dorsum. Variables introduced by the writer, the ;
i i
subjects, the test site, and the test procedures might have,
individually or collectively, adversely affected subject j
performance.
The first variable, inadvertently introduced by the
writer, was not recognized until over half the subjects had
been tested. The stimulus numbers were traced on the
152
tongue dorsum In the writer's manner, or style, of writing.
I
The bias this presented for number recognition was only
recognized when a subject, after completing the test, ques
tioned the stimulus numbers. Comparison of samples of the
writer's and the subject's written numbers revealed a
marked difference in the styles, and prompted the subject
to state, "That's why I couldn't tell what that number was*
I don't make mine that way."
!
j It might be hypothesized that a relationship exists
between a subject's ability to recognize a stimulus number
| traced on the skin surface and the writing style used in
i
|the tracing of that number. Further, that stimulus number
recognition is facilitated when the writing style of the
researcher is similar to that of the subject and is Impeded
when the writing style is dissimilar to that of the subject,
A second variable, contributed to the testing pro-
i
cedure by both the writer and the subjects, is that of the
consistency with which the numbers were traced on the
tongue dorsum. A consistently even, uninterrupted tracing
of the stimulus pattern was difficult to maintain from num-
jber to number and from subject to subject. Pressure, skin
surface contact, rate of tracing, and size of each stimulus
number were dependent on the skill of the writer.
The subject's ability to control tongue movement
presented a third variable. The tongue appears to be a
structure behaviorally responsive to continuous uninter-
153
rupted tactile stimulation and not easily volitionally con
trolled, A number of the subjects were unable to hold the
tongue in a fixed position or to inhibit spontaneous ir
regular movements throughout the tracing of the stimulus
pattern. While this behavior was observed in both the
males and the females and in all age groups, it was par
ticularly evident in subjects in Group I, for whom the
tongue movements were generally larger, more random, occur
red with greater frequency, and were less successfully in
hibited.
Differences in lingual skin surface texture and in
tactness presented yet another variable. Some subjects had
tongues with relatively smooth intact surfaces; others had
tongues with more prominent papillae, hence less smooth
surfaces. The tongues of some subjects were irregularly
convoluted with clearly visible furrows; the tongues of
other subjects, while appearing intact on visual inspec
tion, proved to be finely fissured. For some subjects,
these furrows and fissures ran along the length of the
tongue parallel with the median sulcus; for others, they
tended to angle across the tongue laterally from the mid
line; for still others, the pattern was both longitudinal
and lateral. Although no record was made, it seems to the
writer, in retrospect, that the texture and intactness of
the lingual skin surface was related to both age and sex,
with surface Irregularities increasing with age and occur
15^
ring more frequently in males.
The stimuli, design, and procedure of the test
measurement introduced another set of variables. Only in
this measurement was it likely that the ability to Judge
the test stimuli was related to the subject's past experi
ence. If it can be assumed that experience with numbers is
determined by such factors as age, education, occupation,
need, etc., then it can also be assumed that the stimuli of
this measurement were not equally familiar to all subjects
tested. The advantage would be to those who were older,
who had more education, whose occupations required working
with numbers or, possibly, to those who were more number-
oriented.
The test design might also have given some subjects
an advantage. For the other three test measurements, prior
to the start of each test, the subject was told both the
number and types of responses available to him. The test
of Oral Form Identification, for example, had two responses
from which the subject was to select onei "same" and "dif
ferent"} the test of Oral Two-Point Discrimination had two
responses! "one" and "two" pointsi and the test of Mandibu
lar Kinesthesia had three responses! "same," "less," and
"more," In this test measurement, while the subject knew
the type of response (a number), he was not given a defined
group of numbers from which to select that response. It is
possible, then, that making a response to a stimulus in
- 155
this test was a more complex task; that the subject had a
three-level taski first, to determine those numbers which
were unlike the stimulus pattern; second, to detemine
those numbers which were like the stimulus pattern; and,
third, to select from this self-defined group the number
which identified the perceived stimulus pattern. The ad
vantage would be to the more number-experienced, number-
oriented subjects.
The test procedure of this measurement involved
tracing each stimulus number one time on the subject's
tongue, after which the subject was asked to identify that
number. The writer believes that the single tracing of the
stimulus number to be the more serious weakness of the test
design and the one which afforded the greatest advantage to
a proportionately smaller number of subjects. McCall
(1964), whose tactile patterns included abstract forms,
geometric designs, and letters, traced each test pattern
three times on the subject's tongue. After each tracing
I
the subject selected the pattern he perceived traced on his
tongue from a group of similar patterns arranged on a test
form. McCall stated that "upon the second tracing the sub
ject had a visual set of the pattern he thought was traced
on his tongue" and that the second tracing offered the sub
ject an "opportunity to make a Judgment relative to the
correctness of his original choice."
It is suggested that a procedure which involves two
156
tracings of the stimulus pattern, after which the subject
Identifies that pattern, is better suited to the purpose of
the test and the needs of the subject. It is basic that
the stimulus number pattern be traced on the tongue Intact
and complete. It would seem equally basic that the subject
have an opportunity to evaluate his perception of that pat
tern before committing himself to a response. It cannot be
assumed that a single tracing provides the subject with a
pattern sufficiently complete so as to make a correct re
sponse possible, and it is obvious that a single tracing
offers the subject no opportunity to evaluate the correct
ness of his initial Judgment,
It is the opinion of the writer that the test of
Lingual Tactile Pattern Recognition merits continued con
sideration as a potential measurement of oral sensory func
tion, The test measurement, in its present form, is not
entirely satisfactory. The variables detailed in the dis
cussion question the reliability of the procedure and,
thus, the validity of the results. Further research is
indicated, particularly in which the effect of various
stimulus number tracing styles, offering a defined group of
numbers from which the response number is selected, and a
single tracing versus multiple tracings on subject perfor
mance are studied.
157
MANDIBULAR KINESTHESIA
The error scores obtained for the seven standard
mouth openings were used to study group performance by age
and by sex. The data studied to explore the relationship
between group performance and certain characteristics of
the test measurement were the error scores of the seven
standard mouth openings, the seven variable mouth openings,
the three variable-standard, groups, and the types of Judg
ment response.
Finally, normative difference limen (DL) values
were obtained for each of the seven standard mouth openings
for each age group, the male subgroup, the female subgroup,
and the sample.
Comparisons of the error scores of the seven stan
dard mouth openings of the seven age groups, the 70 males,
and the 70 females and of the error scores of the male and
the female subgroups yielded no statistically significant
difference for age or sex for ability to Judge mouth open
ings.
An analysis of the error scores of the seven stan
dard mouth openings suggests a relationship between degree
of mouth opening and error frequency* the greater the di
mension of the standard mouth opening, the greater the num
ber of error Judgments, This relationship, with one excep
tion, was observed for the error scores of the standard
158
mouth openings of the sample, the male subgroup, the female
subgroup and, with less consistency for the three middle
standard mouth openings, for the error scores of the seven
age groups.
An analysis of the error scores of the seven vari
able mouth openings suggests an inverse relationship be
tween degree of mouth opening and error frequencyi the
greater the dimension of the variable mouth opening, the
fewer the number of error judgments. This relationship was
observed for the error scores of the seven variable mouth
openings of all groups.
Further evidence of a relationship between gap
opening size and ability to judge a difference was observed
when the error scores of the three variable-standard groups
were analyzed. Proportionately, more error Judgments were
made for the Same variable-standard group than were made
for the Less and More variable-standard groups. It was
more difficult to Judge correctly a mouth opening stimulus
pair when the variable and the standard were the same than
when the variable and the standard were different.
The error scores for the three types of Judgment
responses revealed an error judgment pattern common to all
groups. The subjects tended to err in the direction of a
"less" judgment for a Same variable-standard stimulus pair
and in the direction of a "same" judgment for Less and More
variable-standard stimulus pairs.
I 159
l
One study (Ringel et al., 1967) of mandibular kines
thesia was reported in the literature. The data collected
were used to determine difference limen values for each of
nine standard mouth openings.
The millimeter values and the range of the DL*s
obtained in the present investigation were not in accord
with those reported by Ringel and his associates, nor did
the findings support their conclusions that (1) the DL
value for mandibular kinesthesia is relatively independent
of the degree of mouth opening and that (2) as the size of
the mouth opening increases, proportionately smaller
changes in mouth opening are required for the Judgment of
a difference.
The DL values obtained in this Investigation, while
somewhat parallel to, were lower than those reported in the
previous study for six of the seven standard mouth openings
(12.0-20.4 mm) common to the two studies. The lower DL's
were obtained by all groups, including the 20-subject group
with an age range similar to that of the 30 subjects in the
Ringel study.
The range of the DL values in this investigation
was 1.10-1.62 mm, a range of 0.52 mm, with a mean DL value
of 1.30 mm. The range of the DL values reported by Ringel
and his associates was 1.4-2.4 mm, a range of 1.0 mm, with
a mean DL value of 2.04 mm.
Ringel*s conclusion that the DL value is relatively
160
Independent of the degree of mouth opening was not supported
by the results of this investigation. On the contrary, the
results suggest a relationship between degree of mouth
opening and DL valuej the greater the dimension of the
standard mouth opening, the greater the millimeter value of
the DL. This relationship, with one exception, was ob
served for the DL values of the standard mouth openings of
the sample and, with less consistency for the three middle
standard mouth openings, for the DL values of the seven age
groups, the male subgroup, and. the female subgroup.
To support Ringel's second conclusion~as the size
of the mouth opening increases, proportionately smaller
changes in mouth opening are required for the judgment of a
difference— one would expect to find a systematic decrease
in error frequency along the standard mouth opening con
tinuum, reflecting an increase in the number of correct
judgments of those variable-standard mouth opening pairs in
which the millimeter gap-set of the variable approaches that
of the standard. Such systematic decrease in error fre
quency was not observed in this studyj on the contrary,
error frequency increased along the standard mouth opening
conti num.
The difference between the results reported by
Ringel et al. and those obtained in the present investiga
tion might be attributed to the procedures used for pre
senting the variable-standard mouth opening pairs. Ringel
l6l
reported "the presentation order of all stimuli was ran
domized." In this investigation, the seven standard mouth
openings were presented in sequential order of gap-set
increase and the three groups of variable mouth openings
(variable same as standard, variable less than standard,
variable more than standard) were presented in a counter
balance order.
Ellender (1968), in a study of oral two-point dis
crimination in which she compared the results obtained with
the random order method with those obtained with the alter
nating ascending-descending approach, reported the random
order method yielded significantly higher thresholds. She
concluded that the higher thresholds provided evidence that
the "perceptual experiences were not directly and abso
lutely related to the distance between the two points, but
were methodologically dependent."
It might be conjectured at this point that the ran
dom method of order presentation of variable-standard mouth
opening pairs might well Introduce confusion as a variable,
unrecognized very likely by both subject and researcher,
which adversely influences subject performance.
Further research is indicated, particularly in
which the effect of the random method and the sequential,
counterbalance order of test stimuli presentation on sub
ject performance is studied.
CHAPTER VI
SUMMARY
Introduction.
The role of the oral sensory Input system as a feed
back system critical to the act of speaking was proposed by
Fairbanks (195^) when he applied the servosystem concept to
the speech mechanism. The term servosystem describes any
self-regulating mechanism capable of maintaining or alter
ing the manner of Its output according to an error feedback
signal. Two processes required for such regulation are
(1) a feedback process and (2) an error detecting center.
If an Intact oral sensory Input system capable of
sending accurate signals to an error-detecting center Is
requisite for normal speech, then It does not seem unlikely
that abnormal speech might be a reflection of disrupted
sensory channels producing distorted feedback signals. It
Is only within recent years that such questions have been
raised as Do Individuals with speech disorders now des
cribed as "functional" or believed to be symptomatic of
emotional or psychological conflicts or Identified with
anatomical anomalies have defective oral sensory perceptive
systems? and Do they differ from normal Individuals?
The Initial task was to develop and standardize
162
objective diagnostic measurements. A review of the litera
ture reveals the extent to which this has been explored.
The results obtained to date, while contributing Informa
tion of acknowledged value, have been In many Instances
either contradictory or Inconclusive. The oral sensory
labilities of the normal and the abnormal cannot yet be con-
I
sistently profiled or dichotomized. There Is a need to
know more about the normal If the abnormal is to be more
readily identified.
This investigation studied the oral sensory and per
ception abilities of a sample of the normal population,
made up of an equal number of males and females represent
ing a wide age range, as determined by their responses to
two test measurements of oral sensation, one test measure
ment of oral stereognosls, and one test measurement of
mandibular kinesthesia.
Review of the Literature.
The review of literature is presented in two parts.
Section A Is a review of related studies with test measure
ments which were not Included In this investigation. Sec
tion B Is a review of background studies of two-point dis
crimination, oral form Identification, lingual tactile pat
tern recognition, and mandibular kinesthesia which provided
direction for the design, methodology, and Instrumentation
of this Investigation.
i s i r
In general, some studies have reported sensory per
ception differences in normal subjects for age groups and
for intra- and extra-oral sites tested and between normal
subjects, defective speakers, and persons with organic
pathologies. The small number of reported studies designed
*rn*« '
to explore and obtain normative values as well as the
limited number and discrete age ranges of the subjects
tested in these studies obviates a generalization of the
results to the general population.
The need for a normative study with a large sample
representing a wide age range seemed to be indicated.
Procedures.
A battery of four sensory tests was administered to
140 normal subjects, 70 males and 70 females, ranging in
age from 6 years, 1 month to 64 years, 10 months. Seven
groups, determined by age, were established. Each group
consisted of 20 subjects, ten males and ten females. The
age range of the groups was as followsi Group I, 6—9I
Group II, 10-19; Group III, 20-29; Group IV, 30-39; Group V,
40-49} Group VI, 50-59; and Group VII, 60-64.
The four test measurements selected for the inves
tigation were (1) Oral Two-Point Discrimination, (2) Oral
Form Identification, (3) Lingual Tactile Pattern Recogni
tion, and (4) Mandibular Kinesthesia. The four tests, com
pleted in one sitting, were presented in a counterbalance
order so that each test was administered first, second,
third, and fourth approximately the same number of times.
Group performance was studied by age and by sex.
For age, comparisons were made of the performances of the
seven age groups, of the 70 males, and of the 70 females*
for sex, comparison was made of the performances of the
male and the female subgroups,
Chi square tests of homogeneity were applied to the
obtained data. The data treated were the error scores In
judging the form pairs In the test of Oral Form Identifica
tion, the error scores In identifying one-digit numbers
traced on the tongue dorsum in the test of Lingual Tactile
Pattern Recognition, and the error scores in Judging the
variable-standard mouth opening pairs in the test of Man
dibular Kinesthesia. Since there were no error scores in
the test of Oral Two-Point Discrimination, regression line
values were established for each of the three midline sites
tested for age and for sex. In addition, two-point Ilmen
values, in mm, were obtained for Oral Two-Point Discrimina
tion and difference Ilmen (DL) values, in mm, were obtained
for Mandibular Kinesthesia.
Results.
Oral Two-Point Discrimination. Sex differences were
not observed in the means and slopes of the regression
lines of the three oral sites. For age, the Increase in
166
the means for only the tongue tip for the males was signi
ficant! as age increased, an increase in the gap-set dimen
sion was required for two-point discrimination.
The normal clinical ranges of both the males and
the females were greatest for the tongue blade followed by,
in order, those for the upper lip and for the tongue tip.
The mean two-point limen values obtained by all
groups showed the tongue blade to be less discriminatory
than the tongue tip and the upper lip, with no consistent
discriminatory order established for the latter two struc
tures.
Oral Form Identification. Based on the results
obtained in Judging the 15 wlthin-class and the 21 between-
class form pairs, no sex difference was found for ability
to judge wlthin-class form pairs, whereas an age difference
was found, with the subjects of Group I making the greatest
number of errors.
A sex d iffe re n c e was found fo r a b i l i t y to Judge
1
between-class form pairs, with the females making the
greater number of errors. Contradictory findings were ob
tained for agei no significant difference was found for
either the 70 males or the 70 females when their error
scores were treated separately, whereas a significant dif
ference was obtained when the sexes were pooled, with the
subjects of Group I making the greatest number of errors.
Proportionately, a greater number of within-class
167
than between-class errors were made by all groups.
The validity of these results were questioned when
the error scores of each of the 15 within-class and each of
the 21 between-class form pairs were inspected. Four of
the within-class pairs accounted for 70.0-88.8 per cent of
|
the error Judgments and three of the between-class pairs
accounted for 55.9-77.7 per cent of the error Judgments
made by the sample in Judging the wlthin-class and the
between-class groups.
When the error scores of these seven form pairs
were excluded, the adjusted error scores seemed to indicate
that age was not a factor in ability to Judge the remaining
11 wlthin-class and the remaining 18 between-class form
pairst nor did the adjusted error scores seem to indicate
a marked difference in Judgment difficulty between the
wlthin-class and the between-class groups. The sex differ
ences in ability to Judge the remaining 11 wlthin-class and
the remaining 18 between-class form pairs seemed less
sharply defined.
Lingual Tactile Pattern Recognition. A sSx differ
ence was found for ability to identify one-digit numbers
traced on the dorsum of the tongue, with the males making
the greater number of errors. Contradictory findings were
obtained for aget no significant difference was found when
the sexes were pooled, whereas a significant difference was
found for both the 70 males and the 70 females when their
_____
error scores were treated separately.
Prom the analysis of the data It was concluded that
while age and sex did not appear to be factors determining
error number selection, they did appear to be related to
the frequency with which a given number was selected.
The observations made by the writer led to the con
clusion that the obtained responses did not fully reflect
the subjects' ability to identify numbers traced on the
tongue. Variables introduced by the writer, the subjects,
the test site, and the test design and procedure might
have, individually or collectively, adversely affected sub
ject performance.
Mandibular Kinesthesia. No age or sex difference
was found for ability to Judge variable-standard mouth
opening pairs.
A relationship was found between degree of standard
mouth opening and DL millimeter valuei the greater the
dimension of the standard mouth opening, the greater the
DL millimeter value.
A relationship was observed between degree of stan
dard mouth opening and error frequencyi the greater the
dimension of the standard mouth opening, the greater the
number of error Judgments.
An Inverse relationship was observed between degree
of variable mouth opening and error frequencyi the greater
the dimension of the variable mouth opening, the fewer the
_ g _
number of error Judgments.
Proportionately, more error judgments were made for
Same variable-standard mouth opening pairs than were made
for Less and More variable-standard mouth opening pairs.
For type of Judgment response, the subjects tended
to err in the direction of a "less" judgment for Same
variable-standard pairs and in the direction of a "same"
Judgment for Less and More variable-standard pairs.
A summary of the results obtained from the respon
ses of the sample to the four test measurements is pre
sented in Table 30.
Conclusions.
The results of this investigation suggest the fol
lowing conclusions for the oral sensory and perception
abilities of the normal sample tested*
1. The ability to discriminate two-point stimuli
applied to the midline sites of the tongue tip,
tongue blade, and upper lip is not related to
sex, whereas only the ability to discriminate
two-point stimuli applied to the midline site
of the tongue tip for the males appears to be
related to age.
2. The ability to Judge within-class form pairs
placed in the mouth, based on group performance
in judging 11 wlthin-class form pairs, does not
TABLE 30. SUMMARY TABLE OP MEAN TWO-POINT LIMEN VALUES FOR TEST OF ORAL TWO-POINT
DISCRIMINATION, ERROR SCORES OF WITHIN-CLASS AND BETWEEN-CLASS FORM PAIRS FOR TEST
OF ORAL FORM IDENTIFICATION, ERROR SCORES FOR TEST OF LINGUAL TACTILE PATTERN RE
COGNITION, AND MEAN DL VALUES FOR TEST OF MANDIBULAR KINESTHESIA OF THE SEVEN AGE
GROUPS, THE MALE SUBGROUP, THE FEMALE SUBGROUP, AND THE SAMPLE.
Oral Two-Point
D1scrimination
Oral Form
Identification
Lingual Tac
tile Pattern
Mandibular
Kinesthesia
Mean Two-Point
Limen Values Error Scores Error Scores
Mean
DL Values
Group
Tongue Tongue Upper
Tip Blade Lip
Within-Class
(15) (11)
Between-Class
(21) (18)
I 1.19
1.72 0.97 69
18 40 18
45
1.61
II 0.98 1.61
0.94 45
10
31
11 18 1.38
III 1.08 2.12
1.29 50
15
20
9
26 1.24
IV 1.11 1.86
1.03 46
13 27
6 21
1.31
V 1.17 2.02 1.06 40 8
35 17
24
1.23
VI 1.1 4 2.02
1.19 27 3
18
7
18
1.39
VII
1.17 1.84 1.24 41 11 32
14
23 0.92
Males
1.09 1.87 1.10 157 47
86 30 106
1.33
Females
1.15 1.89 1.10 l6l
31 117 52 69 1.27
Sample 1.12 1.88 1.10 318 78 203
82
175 1.30 170
seem to be related to age but does appear to be
related to sex, with the males Inferior to the
females.
3. The ability to Judge between-class form pairs
placed in the mouth, based on group performance
in Judging 18 between-class form pairs, does
not seem to be related to age but does appear
to be related to sex, with the females inferior
to the males.
The ability to identify one-digit numbers
traced on the dorsum of the tongue appears to
be related to both age and sex, with the
youngest age group inferior to the other age
groups and the males inferior to the females.
5. The ability to Judge variable-standard mouth
opening pairs does not appear to be related to
age or sex.
i
APPENDIXES
i
172
APPENDIX A
SAMPLE
173
SAMPLE
Order Sex Age Education Occupation
Group I
3
F 7-2 2 Student
4 F 9-11 5
Student
5
M 8-3
3
Student
6 F
9-5
4 Student
9 F 8-1
3
Student
21 M 6-1 K Student
22 F 6-8 1 Student
25
M 6-9 1 Student
27
F 6-8 1 Student
29
F 7-5
2 Student
30 F 7-5
2 Student
31
F 8-8
3
Student
32 F 8-0
3
Student
33
M 7-10 2 Student
38 M 7-11 2 Student
1*2 M 7-2 2 Student
44 M 8-8
3
Student
45 M
9-4
4 Student
^7 M 8-2 3
Student
48 M 9-2 4 Student
17^
Order Sex
P
Age Education Occupation
175
Group I I
1 17-8 Freshman Student
8 F 15-1 10 Student
11 P 19-6 Sophomore Student
12 M
18-1 Freshman Student
15
F 18-2 12 Desk A ttendant
23
M 13-10 8 Student
24 P 13-2 7
Student
26 P lb-3 8 Student
28 M 13-3
8 Student
3b P 10-7 5
Student
35
P 11-5
6 Student
36 P 12-4 6 Student
37
F 12-5 7
Student
bo M 12-7 7
Student
bi M 12-2
7
Student
b3 M 11-8 6 Student
b9 M 10-3 5
Student
50 M 11-10
7
Student
131 M 16-10 11 Student
138 M 19-2 12 H o s p ita l O rd erly
Group I I I
10 P 20-0 Sophomore Student
13
P
20-3 12 S ecretary
lb M 26-2 Sophomore Student
176
Order Sex Age
20-8
Education Occupation
16 P 12 Desk Attendant
17 P 23-0 Sophomore Desk Attendant
20 F 20-2 Freshman Nurse's Aid
46 M 29-10 MS
Teacher, Elementary
52 M 28-0 MD
Fellow, Mayo Clinic
55
F
23-11
Junior Artist
64 M 24-1 12 Fireman
69
M
25-1
12 Fireman
72 M 29-11
12 Fireman
86 M 21-9
12 General Service
87
P
29-11
12 Ass't Personnel Dir.
102 P 27-11 12 General Office
11* * F
25-5
BS Food Service Management
115
M 21-3
Sophomore General Service
116 M 24-0 Junior General Service
117 M 22-7
Freshman General Service
119
P 27-2 12 Lab Technician
ip IV
7 M 34-1 MD Fellow, Mayo Clinic
19 M 33-10 PhD Fellow, Mayo Clinic
51
P 38-2 MS + MLS Librarian
5b P
3 6-5
12 Housewife
57 P 30-6 BA Librarian
58 P
31-3
BA Occupational Therapist
62 M 30-4 BA Fireman
Order Sex Age Education
177
Occupation
63
M 30-2 12 Fireman
65
M 38-3 12 Fireman
68 M 30-5
12 Fireman
70 M 32-0 12 Fireman
85
M 3^-7
BA Store Owner
92 F 37-7 12 Activities Director
96 F 36-7
Sophomore Nurse’s Aid
106 F 38-11 12 Domestic
110 F
35-11
RN Nurse
118 M 37-8 MS+30 hrs Speech Pathologist
120 M 38-6 8 Parking Attendant
125
F 32-0 MA Teacher, Secondary
126 F 39-10 MA + MS Teacher, Secondary
Group V
2 F 43-8 PhD Cand. Fellow, Mayo Clinic
39
M 44-3 MA Principal, Elementary
56 M 44-2 MA Music Teacher (Private)
60 M 41-1 PhD Speech Pathologist
61 M 48-9 11 Fireman
66 M 40-7 12 Fireman
67 M 45-8 10 Fireman
71 M 42-0 12 Fireman
73
M 48-6
9 Fireman
81 M 47-10 BS + BVM Veterinarian
84 M 42-3 PhD Principal, Junior High
Order Sex Age Education
178
Occupation
89
P 46-11 BA Housewife
103 P 48-5 MA + MBA Administrator
104 P 47-11 BS Accountant
107 F 49-4 PhD Teacher, College
108 F 49-11 MA Public Relations
111 F 43-1 RN Nurse
112 F 44-9 RN Nurse
113
F 46-5 Freshman Domestic
140 F 41-5 10 Domestic
Grout) VI
18 M 50-10 PhD Speech Pathologist
74 M
51-3
12 Fireman
75 M 51-4 12 Fireman
76 M 54-9
12 Fireman
77 M 52-7
10 Fire Prevention Bureau
78 M 55-3
10 Fireman
79 M 55-4 BA Salesman
80 M
53-9
PhD Principal, High School
90 F 58-0 Sophomore Claims Adjuster
91 F 57-2 12 Lab Technician
93
F 59-2 RN Nurse
97 F
55-9
8 Domestic
98 F 58-5
8 Domestic
99 F
58-3
BA Teacher, Secondary
109 F 54-2 MA Teacher, Secondary
Order Sex
M
Age
57-10
Education
179
Occupation
121
9
Custodial Service
122 M 59-6 8 Custodial Service
124 P 54-6 12 Desk Attendant
135
P 53-0 10 Domestic
136 P 50-11 8 Domestic
Group VII
53
P 60-10 12 Business
59
F 63-7
RN Nurse
82 M 61-3
12 General Service
83 M 60-4 BA Personnel Director
88 M 64-11 12 Banker
94 P 60-4 12 Domestic
95
M 63-IO 12 Maintenance
100 P 61-2
9
Domestic
101 F 64-3 6 Domestic
105
F 62-10 9
Domestic
123 M 61-7 11 Custodial Service
12? F
63-5
MA + MS Teacher, Secondary
128 M 63-7
8 Custodial Service
129 M 60-9
8 Custodial Service
130 P 61-6 8 Domestic
132 M 64-2 8 Maintenance
133
M 60-11 8 Security Service
134 M 60-0 8 Security Service
137
F 60-0 9
Domestic
Order
139
Ser Age Education Occupation
P 61-5 RN Nurse
APPENDIX B
EDUCATION/MEDICAL HISTORY
181
182
EDUCATION/MEDICAL HISTORY
Date I __________
Name I BDi Age_I_______Sex:
Address: Occ:
I. Education Grades School
Elementary: K 1 2 3 4 S 6 A B C D F
Secondary : 7 8 9 10 11 12 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
College : Fr So Jr Sr _ _ _ _ _ _____________________
Graduated : HS BA/BS MA/MS PhD/MD Other _ _ _ _ _ _ _ _ _ _ _ _ _
II. Medical Yes Mo Age
Birth Injury: ____ Svmo:
Carcinoma : Loc: Treat:
Concussion : Coma: Amnesic:
Hosd: Residual:
Convulsions : Number: Frea:
Diabetes : Treat:
Epilepsy : Treat:
Stroke : Treat:
Numbness* : Chronic: Recur:
Tingling* : Chronic: Recur:
Prickling* : Chronic: Recur:
Sharp pain* : Chronic: Recur:
Surgery# : Date: Hosp:
Injections# : Date: Hosd:
Medication Type Freaucncv
Antlconvul. :
Antlleptlc :
Sedative :
Tranquilizer:
Diaeases of brain or nerves:
* of face, tongue, throat
# to brain or nerves
APPENDIX C
RECORD SHEETS
183
184
ORAL TWO-POINT DISCRIMINATION RECORD SHEET
A|« Group i_
Gap Opan.
Subjecti _
Sexi
Tongue Tip
Ascending Descending
Tongue Blade
Ascending Descending
Upper Lin
Ascending Descending
.0 m b ______________________________ ____
.5 ~ ___
1.0 __
1.5_________________________ ___________ ____
2.0 _
2.5 —
3.0 ______________________________
3.3 ~
Meant Meant Meant_
Sublactt
.0 n ____________ _________________ ____
.5 ______________________________ _______
1.0 ________
1.3 ~
2.0 _ H _
2.5 __________________ ___________ __________ _____
3.0 __________________ ___________ ___
3.5 __________________ ___________ __________ ________
Meant Meant Meant_
SubJec11
.0 mm ___ _____
.5 ______________________________ __________ ________
1.0 _____
1.5 ; ___ ______________________ __________ ________
2.0 _____
2.5 ______________________________ __________ ________
3.0 ______________________________ __________ ________
3.5 __________________ ___________ __________ ________
Meant Meant Meant_
Sublactt
.0 tm ______ ___________________ ____ _____ ____
.3 ______________________________ __________ _________
1.0 _____
1.5 __________________ ___________ __________ ________
2.0 _____
2.5 __________________ ___________ __________ _________
3.0 __________________ ___________ __________ ________
3.5 __________________ ___________ __________ ________
Meant Meant Meant__
Sub Jec 11 _______
. O n __________________ ___________ __________ _________
.5 __________________ ___________ __________ ________
1.0 _____
1.5_______ __________________ ___________ __________ _________
2.0 _____
2.5 __________________ ___________ __________ _________
3.0 __________________ ___________ __________ _________
3.5 __________________ ___________ __________ _________
Meant______ Meant Meant
ORAL FORM IDENTIFICATION RECORD SHEET
Age Group :_
Subject !_
Sext
"Withln-Class" Same Diff
O O -
Q C O _
GD GD_
O © L_
QD C
G
DGDl. _
Same Dlff (Reliability)
Mo. of Errors:
Triangles :
Rectangles:
Ovals i
"Wlthln-Class":
"Betveen-Clasa":
Total No. Errors:
186
ORAL FORM IDENTIFICATION RECORD SHEET
Age Group
Subject !_
"Between-Class" Same Plff
© _
A C D
c
A
A
A ©
A G D _
A
_ I_
G_j _
Sex:
Same V I
© _
CD L.
G_3
©
C
\
© -
A
] CZ3
i_
Ho. of Errors:
187
LINGUAL TACTILE PATTERN RECOGNITION RECORD SHEET
Af« Croupi S*xt
0.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
N o w I 3 6 2 ! Wo. Wrong
Total t
S*xi
Totoll
Age Group Totalt
M M M M M N M
^ ^ ^ O' O' O' o
to to to to to to to
3 3 3 3 3 3 3
to to to to to to to
H t- H t* H H H
H H H H H H H
^ ^ ^ ^ ^ 3 3
H H H N H H H
O O' 3 O' 3 3 O'
H N H H H N H
3 3 3 3 3 3 3
H N H H H H H
to to N to B O to to
©
•
3* ^ 3- 3» 3* 3« 3* o © © © © o © O' ^ ^ O' ^ ^ O' to to to to to to to 0 B 0 B 0 B 0 B C D O B O B 3 3 3 3 3 3 3 o o o o o o o *
©
+ + + 1 1 1 P * + + + 1 1 IP * + + + a » IP * + + + 1 1 IP * + + + i a i p * + + + i a i p * + + + 1 1 1 p »
o
s
to
3 U N 3 W f - O'
to
3 U H 3 U H 3
to
3 W h « 3 U H H 3 U M 3 U H 3
**
3» U » 3* W ** O'
h-
3 W H 3 U t * 3 3 Ul K 3 U H N
9
M *
* «
O B to O' O B to O' 3* 00 to O' 0 B to O' o O B to O' 0 D to O' O' 0 B to O' 0 D to O' to © to O' O B to O' O B O B to <3 O B to 3 3 O B to O' O B to O' O 0 Q
m
U tO M N tO tO
H O 3 H W 3
tO IO M H tO N
t t O O 'O O M
to to to H H to
O' 3* W O' 0 B o
1 s t to M H K H
3 N 0 3 3 M
tO M H H H H
h O V n u o
H N H H N
«0 >) 3 o h ro
H H N H
3 O W O 0 O
1
to O' O O' to 0 B
w
00 to O' to O B 3 »
w w V V
3 0 B to 0 B 3 O
vy "W V V
0 3 3 3 0 3
v S i S J S
to O' O O' to at
W W W
0 B to O' to Q B
w w o w w w
S f
"7
1 1 1 II 1 h1 1 1 1 1 1 h1 1 1 1 1 1 h1 1 1 1 1 1 h1 1 1 1 1 1 h1 1 1 1 1 1 h
C /J
i
111 h r t i 111 r tti 1 1 1 M T I 111 m i 111 rtti 111 rtti 111 rtti
S’
•
»
rtti 1 1 1 rtti 111 rtti 111 rtti 111 rtti 111 rtti 111 rtti 111 * 1
O
? &
O * ©
• a
n
f t o
e
f
*
w
*
3
*
3 3 3
??g
s s 1
3 3 3
•i
s
* t
o
K> IO h> H H H M
(A
X
00
00
MANDIBULAR KINESTHESIA RECORD SHEET
APPENDIX D
DESCRIPTION OP
ORAL ESTHESIOMETER
189
ORAL ESTHESIOMETER
| This instrument facilitated the investigation of
itwo-point discrimination capacity at extra-oral and rela
tively inaccessible intra-oral sites. The esthesiometer !
also provided a means for calibrating and controlling the j
distance between the two stimulus points and the contactor-j
skin (mucosa) force. This latter factor was deemed impor- j
tant since it has been shown that tactile sensitivity j
varies with the force the transducer exerts against the
|skin surface (Barley, 1958). Specifically, a pair of j
; lights mounted on the instrument allows the experimenter
to monitor, and thereby control, the mount of force
exerted upon the skin surface by the stimulus points. j
When the instrument is 'unloaded,' that is, when ,
jless than one gram of force is exerted in a downward direc
tion on the probe points, the force of the tension spring
is great enough to pull the shaft downward and cause it to
contact the tip of the inferior adjustment screw. This
contact results in a 'closed circuit' and a subsequent
illumination of the posterior bulb. When a force greater
than one gram is exerted upon the probe points, as might
occur when the points are displaced through contact with
the skin surface, the shaft is lifted from its rest posi
tion and is balanced upon a fulcrum between the two screws
luntil the force exceeds three grams. At this point (>3
! grams) the shaft is lifted to the extent that it contacts
ithe superiorly inserted screw and thereby closes the cir
cuit associated with the anteriorly situated light bulb.
Both the probe shaft and the adjustment screw tips were
'silvered' to facilitate circuit closure. Hence the in- !
vestlgator was able to maintain a force >1<3 grams on the
probe tips by keeping both lights off (both circuits open).
Measurements of two-point Ilmen were taken only during such
periods. The distance between the stimulus probe points
(the gap) is adjusted by means of a calibration knob which I
is mounted on the horizontal aspect of the probe arms; this I
knob is calibrated in .5 mm Increments and allows for a
range of probe tip separation from 0-10 mm. i
Source* Ringel, Robert L., and Ewanowski, Stanley J.,
Oral Perception* 1. Two-Point Discrimination,
J. Speech Hear. Res., 8, 389-398 (1965).
190
APPENDIX E
GEOMETRIC FORMS
(NIDR 20's SERIES)
191
Drawing, actual size, of standard set of 20 plastic forms
developed by the National Institute of Dental Research,
plastic
Drawing
Bethesda, M aryland.
L I S T OF R E F E R E N C E S
193
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19^
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Elveback, Lila R., Guillier, Claude L., and Keating, F,
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196
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f
|
|
jMorgan
i
!
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i
l
i
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Asset Metadata

Creator Pufall, Harold Edward (author)

Core Title A Normative Study Of Oral Sensation And Perception: Two-Point Discrimination, Form Identification, Tactile Pattern Recognition, And Mandibular Kinesthesia

Contributor Digitized by ProQuest (provenance)

Degree Doctor of Philosophy

Degree Program Communicative Disorders

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag health sciences, speech pathology,OAI-PMH Harvest

Language English

Advisor Perkins, William H. (committee chair), Garwood, Victor P. (committee member), Harvey, Herman M. (committee member), LaDarley, Frederic (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c18-460672

Unique identifier UC11362054

Identifier 7112410.pdf (filename),usctheses-c18-460672 (legacy record id)

Legacy Identifier 7112410.pdf

Dmrecord 460672

Document Type Dissertation

Rights Pufall, Harold Edward

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA