"Have you been for a walk?" there is a decided rise of pitch. If you utter
the sentence "Who are you?" there is a very definite rise of pitch on
'are.'




PATHOLOGICAL DEGENERATIVE CHANGES PRODUCING SPEECH DEFECTS
AND WHAT THEY TEACH


As I have before remarked, children utter vowel sounds before consonants,
and I used this as an argument that phonation preceded articulation; but
there is another reason for supposing that articulate sounds are of later
development phylogenetically, as well as ontogenetically. Not only are they
more dependent for their proper production on intelligence, but in those
disorders of speech which occur as a result of degenerative processes of
the central nervous system the difficulty of articulate speech precedes
that of phonation. Take, for example, bulbar paralysis, a form of
progressive muscular atrophy, a disease due to a progressive decay and
destruction of the motor nerve cells presiding over the movements of the
tongue, lips, and larynx, hence often called glosso-labial-laryngeal palsy.
In this disease the lips, tongue, throat, and often the larynx are
paralysed on both sides. "The symptoms are, so to speak, grouped about the
tongue as a centre, and it is in this organ that the earliest symptoms are
usually manifested." (Gowers). Imperfect articulation of those sounds in
which the tongue is chiefly concerned, viz. the lingual consonants l, r, n,
and t, causing indistinctness of speech, is the first symptom; the lips
then become affected and there is difficulty in the pronunciation of sounds
in which the lips are concerned, viz. u, o, p, b, and m. Eventually