A Case of Chronic Bad Spelling? Amnesia Visualise Verbalis, Due to Arrest of Post-Natal Development
- Author:
Ligiitner Witmer.
In March, 1896, a boy, wliose identity I shall conceal under the name of Charles Gilman, was so fortunate as to attract to himself the personal attention and active interest of the grade teacher of a Philadelphia grammar school. Children in this boy’s class, then designated as the Ninth A Grade, are supposed to be in their fifth school year. The normal age for this grade is assumed by the school system to be eleven years. Charles Gilman, however, was fourteen years old. If his classmates were in the fifth school year, and it is assumed that he entered school at the normal age of six, he was then in his eighth school year. He had thus irretrievably lost three years in eight, more than one-third of his school life. He was seventeen when, in 1899, he had completed the work of the secondary school, having taken eleven years to accomplish the work of eight. If we measure intellectual development in terms of the school progress of the average child, as appears to be justifiable, Charles Gilman at seventeen years of age manifested a retardation that amounted to an actual loss at the end of his school career of three years in eleven.
As a matter of fact, Charles actually began his school career before he was six years of age. He was, moreover, endowed by nature with somewhat more than average mental ability, as will presently be shown. The public funds, the time and labor of the administrators of education, had been expended in his case with a return about one-third less than wo have a right to expect from the results of school instruction. My report will show that the retardation in school work and the relative ineffectiveness of the school system in the case of this boy were due to causes that could havo been removed early in his school life. It indicates the necessity for the assumption of new functions by the school authorities in order to meet cases presenting special difficulties. The bare fact of retardation, when once established, as in the case of Charles Gilman, should be sufficient to arouse the inquiring attention of the grade teacher and principal. It was not the general retardation, however, that attracted his teacher’s attention, but the specific inability to acquire the correct spelling ?f English words. To determine the causes of this persistent bad spelling and to obtain assistance in teaching him. to overcome his deficiency, his grade teacher, Miss Margaret T. Maguire, brought him at the age of fourteen to the laboratory of psychology.
In view of his teacher’s statement of this deficiency, my examination naturally had reference to his trouble in spelling. I asked him first to spell the word “crowd.” He spelled it c-r-o-u-d. Without telling him that this was wrong, I asked him to spell the word “loud”; he gave this correctly, l-o-u-d. If l-o-u-d spells “loud,” the boy who says c-r-o-u-d spells “crowd” is not deficient in intelligence, however insufficient may be his training in orthography. I then asked him to spell “crow.” He gave it correctly, c-r-o-w. I told him to put a d at the end of this word, and asked him what the letters c-r-o-w-d spelled. He told me they spelled ‘crowed.” Again he had made a perfectly logical inference from a combination of the phonetic elements of the English language. In this and many other tests, he showed himself to be a boy above, rather than below, the average in intelligence. Ho was able to reason; he understood questions and gave satisfactory answers to them, although the questions involved matters of fact that had probably never before been brought to his attention. His powers of expression through spoken language were good. His reading, however, was as deficient as his spelling. Indeed, in the accepted meaning of the term, he was absolutely incapable of reading a single sentence. The only words that he was able to pronounce without first spelling were “an,” “the,” and a few other monosyllables of not more than three letters. All other words were spelled letter by letter before he was able to comprehend what the symbols stood for; the hesitation was noticeable as he articulated, either to himself or aloud, the name of each literal symbol before he combined the sounds in the utterance of the words they represented. Even such a simple word as “house,” which he must frequently have met, he was unable to recognize on sight.
Thus we have to do with a boy of fair intelligence and general information commensurate with his age, whose progress in written language was not greater than that usually attained by children in the second school year, and whose reading was no better than that of a child at the very beginning of the acquirement of this function. He read not only with great slowness, but with many mistakes. He never read for pleasure, and never took up a newspaper to see the news. That ho got on as well as ho did in school work, despite this retardation in written language, was a tribute to his general intelligence.
By questioning him and his teacher I learned that his spelling lesson was prepared at home with the help of his mother and sister. Although he spent hours in preparation, he would misspell more than half of the lesson when dictated to him the following day. When copying from the blackboard his teacher reported that he could never take down more than one syllable at a time, and his copy showed many blunders. Thus, he would write cone for “come,” and hone for “home,”?a blunder the significance of which I did not appreciate at that time.
It appeared to me that the retardation in spelling and reading might be due to some special disability of memory. It is well known that many children have no ear for music, and are incapable of remembering accurately the sequence of musical sounds. In other respects, the memory for sounds may be good. This boy was shown by appropriate tests to have no deficiency in remembering the sequence of the sounds of letters. He possessed also an adequate visual memory for simple geometrical figures and for colors. Thus he could shut his eyes and imagine a square, or the color blue. He could also visualize, according to his statement, the appearance of separate letters, but he could not visualize the appearance of words. It was only with the greatest difficulty that he could imagine even the short word “cat” as it looked when written or printed.
Excepting this difficulty in reading, writing and spelling, geography was the only school subject that gave him trouble, his teacher thinking that he lacked the visual memory necessary to locate places correctly on the map. But, as an offset to this apparent deficiency in visualization, ho was good at drawing, which would seem also to require a degree of visual imagination. In history, he was reported to be remarkably good, as he followed the logical sequence of events readily. He was apt in science work, being quick at finding causes for observed effects. My examination had, therefore, revealed,?
1. That he was equal to, if not above, the average boy in general intelligence. 2. That he was able to express his thoughts adequately in sP?ken language. 3. That he had a good memory for sounds. 4. That he had a good visual memory for color and simple geometrical figures and even for separate letters. 5. That he had no visual inemorv of words, and could not read. 6. That he spelled correctly only such words as ho could spell from the sound of the component letters. 56 TEE PSYCHOLOGICAL CLINIC. When I first saw Charles, he was a fine-looking boy, fairly strong and healthy, rather large for his age, for he came of a family in which the men averaged six feet. He was of German descent; his parents were educated and provided amply for the care and education of their children. The boy was well-mannered and respectful, evidencing satisfactory home training. There was no history of any physical disorder, disease, or accident, likely to account for his defect. His pedagogical history showed that he had been first sent to a public kindergarten, and from there he proceeded to the primary school. Here he did not get on well, and his mother, thinking this was on account of the teacher, placed him in the kindergarten for another year. From there he entered the public school system again, and passed on from grade to grade, until at the time I saw him he had reached the second half of the fifth school year, being in the Ninth A Grade, with a record of having failed of promotion three times. His teachers affirmed that he was serious and industrious in all the work of the school.
I first thought that inefficient school training was responsible for the deficiency in spelling and reading. This conclusion seemed to be evidenced by the report of his teacher, which showed that since the second school year he probably read on the average not more than one minute a day. He prepared no reading lesson at home, and had not taken a reading book home since he had left the primary school. He had never written a spelling exercise; he studied his spelling lesson orally. “When we undertook his training he was compelled for the first time to write his spelling lesson, and to copy over and over again words that he had misspelled. These considerations suggested the necessity of a special training of his visual memory to develop correct habits of spelling; in order to improve his reading, he was given exercises also in the rapid apprehension or perception of words. During tho spring of 1896, the effort was made to give him this training in connection with his school work. His grade teacher, however, was not able to devote sufficient time to this one boy to make an effectual attempt at overcoming his deficiency. In the fall of 1896, he began to come regularly to the psychological laboratory for instruction in spelling and reading. Pedagogical treatment had no sooner commenced than his absurd mistakes in reading (for example, he would read “was” as saw, “weather” as water), and his uncertainty in pointing rapidly to individual letters led me to suspect some ocular defect. I soon discovered that the steady fixation of a finger, especially when held within a distance of three feet, caused the finger to appear double. If I held up two or three fingers before him at an easily recognizable distance, he showed great difficulty and hesitation in distinguishing the number. Only after my discovery of this fact did he inform me that in trying to write, the letters of a word he was tracing would frequently double under his pen; in looking at a printed page, letters would often double and the page usually looked blurred and indistinct. He had never mentioned this trouble to his teachers or parents; he no doubt thought it was a natural phenomenon of vision. ITo one suspected an ocular defect, for his work in drawing at school had been good, and at home he exercised considerable skill in fine embroidery work. I did not myself inquire into the possible existence of an eye defect until I began to teach him to read and spell. Superficial tests of each eye separately had shown that his vision was not sufficiently below normal to account for his deficiency in spelling and reading. I appreciate at the present time what I may perhaps be pardoned for having been slow to recognize at the beginning of my work with these children, that the school record alone was sufficient to justify the recommendation of a visit to the oculist. In fact, I would venture this opinion to-day in the case of a boy who persistently drops a stroke in the writing of certain letters, as for example the m in “come,” especially if this occurs in writing from a copy before him.
As soon as I discovered the condition of double vision, he was sent to Dr Posey, who found that the boy had practically normal vision in each eye, but that he saw double because he lacked the power to direct the two eyes co-ordinately upon the same point in space, e. g., a letter, the left eye looking lower than the right. This was due to a defect of the external muscles that control the movements of the eye-balls in their sockets. The muscular insufficiency was corrected, as nearly as was possible at the time, by the wearing of proper glasses. This improved his visual perception. He was now able not only to see clearly individual letters, but also to distribute his visual attention over several words. To see a word or a phrase requires a greater mental and physical effort than to see an individual letter. By making a great effort, he had been able to control the co-ordinate direction of the two eyes, so as to see a letter single, even though only for a moment. The least fatigue or relaxation of visual attention allowed the eyes to deviate and caused the letter to appear double. When he attempted to distribute his attention over an entire word or a group of words, he could no longer make the effort necessary to overcome the muscular weakness and preserve the co-ordinate direction of the two eyes. If the muscular defect had been greater, it would have been better for him; he would then have had a permanent squint and learned to overlook or suppress the images of one eye, as I believe he must have done when exercising his skill in embroidery and drawing. Visual perception was now approximately normal, but he could not yet read or spell any better than he had done before. Visual imagination was still in the same state of retardation. It is through the training of visual memory and imagination that we acquire facility in reading and spelling. Reading, for example, requires more than good eye-sight: the posterior lobes of the brain (the visual centers) must be stocked with the memories of words and trained to the ready apprehension (called technically apperception) of the literal symbols of language. The brain of this boy, so far as reading and spelling were concerned, had received practically no training during his entire school career. He was fourteen years of age, but the centers of the brain which are concerned with the function of spelling and reading were as undeveloped as those of a child of six or seven. It was as necessary as ever to teach him to read and spell, but this instruction could be undertaken with some hope of success. lie could now see words, and his brain could be trained to store and use the visual images of the words that he saw.
The special training, which had been interrupted during the examination and treatment of the eyes, was again undertaken through weekly visits to the psychological clinic, and almost daily instruction by Miss Maguire. For six months a persistent course of instruction was given in rapid reading, in order to induce him to “jump” at words without previously spelling them. Some attention, but not quite so much, was given to spelling. It seemed to me that the ability to read was more essential to continued progress in the school room than the ability to spell. A careful record was made of the work undertaken and accomplished from week to week and frequent tests were given to determine the amount and character of progress. Even after regular treatment under my direction had ceased, he continued to come to the laboratory at intervals for examination. I am able to present the following brief history of progressive improvement by selecting a few significant details from my recorded data. The reading lessons began in the latter part of November. At first the fourth reader was used. In two hours he had read only two pages. It was still necessary for him to spell every word before its recognition. The effort to get even a short word without spelling it was accompanied by great mental fatigue. In the second lesson an easier reader was employed in order to familiarize him with such words as could, may, would, should, have, etc. In this lesson, he recognized at sight had, am, spring and gave. Was, however, was frequently called saw, and for was read of. In the lesson of a week later, the tendency to spell phonetically was slightly less marked, although no decided improvement was to be observed. A trial of Hawthorne’s “Wonder-Book” proved this simple text to be too difficult for use as a reader. In copying from his note-book, he wrote soas-bubble instead of “soap-bubble.” lie took one minute to discover his mistake, although he wrote soap correctly when asked to write the word separately.
On December 7th, he recognized at sight happy and following. This was the first successful attempt to grasp at sight a word of more than one syllable and was considered an encouraging improvement. On December 15th he misspelled six of fifteen words, though they were all words that had occurred in his reading lesson of the previous days. This, however, was thought to be a very flattering tribute to the methods employed, in view of the number of words he had previously been accustomed to misspell after careful preparation. On December 19th he was tried without his glasses. He was compelled to spell over a large number of words and seemed unable to phrase at all. The word “leaves” he called heaves three times, and was surprised when he found that the first letter “was I instead of h.
On January 19th he read in three minutes 203 words with bis glasses and 120 without them.
On February 4tli he read a page and a half in eight minutes. In reading the last half page a second time he stopped only four times to spell words, reading otherwise in a natural and easy, though slow, manner. On this day he recognized at a glance and Pronounced correctly all of the following words: observe, depends, discoveries, qualities, progress, creature, knowledge, house, success, products, beautiful. On February 9th he was tested by exposing single words for one second only. The words service, poor, never, master, notice, anywhere, scarlet, again, he recognized on a single exposure. The words interested, busied, warming, reflect, leaned, require, were recognized in two exposures, and the word applaud required three. In March his improvement in spelling was very marked and his ability to read underStandingly greatly advanced. He reported with elation that he had even read to members of his family something of interest from the newspapers. In April his special training ceased, because other interests occupied the time of his instructors.
He was given exercises for home practice, and was directed to read aloud, either to himself or to others, provided he could persuade them to listen to him. He came to the laboratory after this only at infrequent intervals. When I saw him in May, he told me that he could get his lessons much more easily than he used to. He reported that he was beginning to read at times for pleasure, and his grade teacher, of whom I inquired, said that liis spelling was somewhat improved. I noticed that in reading ho often hesitated when he thought he did not know some long word, but if I insisted on his making the attempt to pronounce it without spelling, he would be surprised to find that he could read the word perfectly. He still showed at this time some of the curious confusions and transpositions that I have observed in many cases of this kind. Thus he would read “especially” as particularly, or vice versa. In spelling the word “that” he would write litat. When seen on October 20, 1897, he complained that his eyes were not much better than when he first put on glasses. Examination revealed the continued presence of rather severe ocular symptoms, and he was again sent to the oculist, who found it necessary to perform an operation.
On December 31, 1897, he showed a little, but not much, improvement over the stage of development that he had reached the preceding April, when the special training ceased. He required five minutes to read 2G8 words of an editorial in a newspaper printed in not very clear type. He was able, however, to read instantaneously many difficult words, as resolutions, opposite, etc. Boylike, he had neglected to follow out my instructions to read aloud daily and write out his spelling. As a spelling test, he wrote a paragraph of an editorial, which is reproduced with the spelling of each word as he wrote it down from dictation.
We aften hear it said that such people have oncly themselves to blaim for the irksomness of their existance. Strong and encgoratic natures can scarcely fanin (fathom) weelcness and certainly find it hard to simpathise with or exchusc them. They lay the entire blame to the indervidual that suffers himself to be thus overcome and if they pity him it is with a pity largely minglicd with contempt. Now whilo it ia undoutaly true that much of such misery may be distinctly traced to suflfiness (selfishness) or shallowness or lethoge (lethargy) of the indevedual it is also true that others that have come into personal contract with him generally have a decide share in the responsibility. On January 15, 1899, he was seventeen years of age and in the Twelfth Grade, from which he expected to be promoted in vJune. He had not failed of promotion from the time when wo “undertook his training. He reported that he did not find reading very difficult, that he was fond of Cooper’s novels, and he spoke with enthusiasm of a poem which he had recently read. He, however, did not think that lie could read well enough to ask anyone to listen to him.
After graduating from the grammar school in June, 1899, Charles went to a school of industrial art, where his talent for drawing enabled him to do excellent work in one of the textile departments. He was compelled to leave the technical school owing to the fact that lie developed tuberculosis of the muscles and joints. When I saw him on July 9, 1903, his physical condition was pitiable. He was over six feet tall and weighed only 120 pounds. He was compelled to walk with a cane, and walking fatigued him greatly. In his disabled condition, he found a great deal of pleasure in his recently acquired ability to read. He said that he preferred to read a book himself to having someone read to him. He had read Dumas and Balzac, and claimed to have read a novel of about 250 pages in the course of an afternoon, lie no longer needed to spell any word letter by letter before lie could pronounce it; if he had difficulty, as sometimes happened with long words, lie could usually get them by combining the syllables. In reading a long and rather difficult passage, he failed completely with only one word, “unctuous,” and this he could not pronounce even after he had spelled it. His conversation was tliat of a very well-informed and entirely normal young *nan. A letter written to me about this time was well phrased, contained no mistakes in spelling, and the handwriting was good. In January of this year, he died of the malady from which he suffered during the last six years of his life. I think it well to consider a few points that present themselves in the study of this case and the conclusions that may he drawn from them.
It is not unusual to find a case of chronic bad spelling cited to instance the inefficient work of the school system, or to demonstrate the ineffectiveness of some special method of instruction. I cannot make too emphatic the statement that a single case of bad spelling, or even many cases, does not furnish a legitimate basis for the criticism of school systems and methods. For one boy who is backward in learning to spell, there are fifty boys sitting with him in the same class room who acquire this facility readily.
Although the grade teachers and school system cannot be held responsible, there are underlying causes which may be discovy ered and removed, and these causes are operative in a large number of cases. Thus, when this boy was in the Twelfth Grade, the grade teacher reported that there were five or six other boys in the class as deficient in spelling as Charles Gilman. Some satisfactory method must be devised for the discovery of these cases and for the study of the causes of retardation in each individual case. Until such a system is devised, the most effective means to discover and treat these cases is a rigid insistence upon the requirements of promotion. If these children are held in a given grade until they have performed the work of that grade, no matter how many times they fail of promotion, teachers, principals, superintendents and parents will awaken to a recognition of the problem that confronts the school authorities in certain cases and a realization of the possibility of its solution only through the study and special training of the individual child. This will lead necessarily to the formation of ungraded classes. In time it will be found that every school with an enrolment of one thousand children requires at least one ungraded class. These classes should be in the hands of especially expert teachers; the number of pupils to one teacher should be limited to not more than fifteen or twenty, and the object should be to study and train the children with reference to their special deficiencies. If Charles Gilman had been kept in the first or second grade until he had been taught to read as well as a boy in those grades should read, his ocular defect would have been discovered. If the mother or teacher had possessed the knowledge and experience that the study of cases like his will give, he would have been sent early in life to the oculist, his defect of vision could have been entirely corrected, and he would have made normal progress through the grades. Ilis history shows the presence of ocular deficiency from the first school year. Not having been then removed, by the time he had reached fourteen years of age it was too late for him to make up all that lie had lost. He never acquired normal facility in reading and spelling. He was in the position of the adult who endeavors to acquire a new language. Except in very unusual cases, no one can acquire, after adult age has been reached, the same facility and finish in a foreign language tliat he has attained in his native tongue or in a foreign language learned in early childhood.
The case presents certain points of psychological and physiological interest. A boy of fourteen years is shown to be deficient in spelling, in reading, and, as appears from my record, in the intellectual apprehension of ideas obtained from reading. There were no symptoms, however, of other deficiencies of intellect. The study of injuries to the adult brain shows that if the injury affects a definitely restricted portion of the brain, the result may be a loss of the ability to read, with the preservation of other functions connected with the faculty of language. The patient who has lost the ability to read, a condition known as alexia, may be quite able to understand others when they speak or read, and to express his ideas through articulate language. This partial loss of the faculty of language is the result of the loss of the acquired memories of the visual symbols of language. Aphasia, as a loss of the faculty of speech is called, is in these cases a partial amnesia, or loss of memory. In some cases the amnesia may be limited to the loss of a few words only. In other cases it extends to all letters and words. This boy had not lost any of his memories of words. He had never acquired them, and seemed incapable of acquiring them in a large and sufficient measure. Ilis defect of language did not extend to the memories of words which lie heard or which he himself spoke. He understood perfectly spoken language and expressed his ideas in appropriate articulate speech. He manifested what I think we have a right to call a visual aphasia, dependent upon an arrest in the development of visual memory for words,?that is, he showed a visual verbal amnesia. His visual memory for other objects than “words, and even for letters, so long as the letters were not to be remembered in a given sequence, was good. The degree of visual aphasia from which this boy suffered at fourteen years of age and from which he had not entirely recovered at the time of his death, ls quite normal in a child of six or seven years. This condition in the normal child is overcome by training, an important feature of ^hich is the stocking of the brain with the visual memories of M’oiVls. The history of the case which I have recited presents a 30y whose brain did not acquire these visual memories, and could n^t receive the training necessary to a normal exercise of the Visual functions of language.
The cause of this failure to acquire the visual memories of ^ords I have already indicated. The clear visual image of the Word is essential for the storing of the brain with verbal mem64 TEE PSYCHOLOGICAL CLINIC. ories and for training in the visual functions of language. His ocular defect made the formation of clear visual images of words impossible. When this defect was removed at fourteen years of age, the formative period was past, the time when the brain most easily retains and elaborates its impressions. The arrest of visual development for a period of nine years could not be entirely overcome at this later period by even the best of training. Many physical defects, which are in no way directly related to cerebral deficiency, will make it difficult or impossible for the brain to pass through the various stages of normal development. Defects of hearing and naso-pharyngeal obstruction, especially when they lead to defects of articulation, frequently cause a retardation or arrest in the acquisition of the articulatory, auditory and even visual elements of language. I would characterize the condition of Charles Gilman as a case of visual aphasia, or visual verbal amnesia, due to an arrest of post-natal development, the result of a defect in the sensory visual process.
There is, however, another possible explanation which has been suggested in a number of cases that I have seen. The visual centers of a child of six years must not only be subjected to training in order to evoke normal development, they must also be susceptible of training. Some brains may be congenitally incapable of developing the normal visual functions of language. If such cases exist, the condition is exactly analogous to one that is frequently found with respect to the function of hearing called musical audition. There can be little doubt that many otherwise normal brains give evidence of lacking musical capacity. Those who possess such brains, we say, lack a musical ear. It may bo that perfectly normal children lack the spelling eye, as other children lack the musical ear, and that the former can be as little trained to spell correctly as the latter to play or sing; but if such children exist, I have yet to meet the first clear case. My experience leads me always to examine the eyesight of a bad speller who is otherwise free from mental or physical defect and who has enjoyed satisfactory school training, even though such examination appears to be unnecesary and a mere matter of form. I have found in such cases that the chronic bad spelling is invariably associated with some form of defective vision. I am not convinced, however, that the bad spelling is necessarily caused by the eye defect.
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