The Training of a Case of Infantile Stammer.
- Author:
Claea IIaeeison Town, Ph.D.
The Psychological Clinic for March, 1907, contained the report of a case of infantile stammer in a boy of twelve years.’ This present article describes a similar case in a boy of thirteen years.
On April 5, 1909, E. R. was brought by his father to the Psychological Clinic for examination by Professor Witmer. The boy’s speech was quite unintelligible, and this defect combined with an inability to spell, threatened to prevent his entrance to the high school at the usual age. The father hoped that Professor Witmer would be able to discover the cause of the defects and recommend some measure by which they could be overcome. After tests in articulation similar to those described in the former article, Professor Witmer decided that the boy’s defect was due to a long established speech habit, an infantile stammer. Apparently, the stammer had originally developed as the result of abnormal physical conditions. Adenoids had made mouth breathing habitual, and, possibly as a result of this, the teeth were badly set in the mouth. They were crowded and the lower |j aw was placed so much further back than the upper j aw that the front teeth could be brought together only with difficulty. The boy was well developed physically, was in fact quite athletic, a member of a football team, and had an alert, manly bearing.
The examination showed that in the initial position he habitually pronounced p = b, b ? p, b = Tc, d = t, g ? d or ~k, 1c ? t, v = f, th = f, and dh = f, that m and n were confused, that for the sounds of s, z, sh, zh, h, ch, j, and I nothing was substituted? they were simply omitted?and that the sounds th, dh, and g had never been pronounced. As with the first case reported, the defects in spelling were closely associated with the defects in speech,?the words were spelled as they were pronounced by the boy himself.
Training in articulation was recommended and was at once begun. He was given two lessons a week, beginning April 5th and continuing, with two weeks intermission, until July 1st. The work was wonderfully facilitated by the boy’s unusual power of
application. I have never seen more concentrated effort than he put into that articulation drill.
The method pursued was similar to that described in the earlier article with the exception that instead of giving the preliminary drill on all the consonants in the initial, middle, and final position in a word, he was drilled in one consonant in all the positions in conjunction with every vowel and diphthong before passing on to the next consonant. The drill on these words and on the many practice sentences, which we formed as we progressed of the words which needed most repetition, lasted until June 10th. Each lesson was devoted to one and sometimes two new sounds and their combinations, together with a review of the preceding lessons. A frequent repetition was found necessary. The first sound attempted was k on April 5th and not until May 24th was it possible for R. to pronounce every word on the sheet. The k sound presented a peculiar difficulty. It was only with great effort that he learned to produce it after me as an isolated sound though he used it habitually as a substitute for initial t (take = cate). . This conversion of an habitual articulation to a voluntary one was extremely difficult. Kin and ken were difficult, not on account of initial k but the termination, their first rendering Icing and keng persisting for many lessons. Chalk and rock were, on account of their initial sounds, impossible until the end of May.
For the second lesson t was attempted. The ending un in tun was at first impossible to produce, the word being rendered tung. It was finally achieved by circuitous paths. It was easy for !R. to say under; he was led to prefix at ? tunder, which was successfully done, then to pronounce the word tunder whispering the last syllable der, next to pronounce the tun and only think the der, and at last he thus succeeded in producing a good clear tun. This method of utilizing some combination which had become habitual, in developing his power to articulate voluntarily some new combination was very useful in his training and was resorted to again and again. By May 3d, the ninth lesson, all the words on the t list1 were well pronounced at sight.
The third sound g had to be worked over for seven lessons. The boy’s ear was not at all sharp in detecting slight differences of sound, and it was most important- to show him just how to hold his tongue, teeth, and lips in order to produce the various sounds. For instance g was pronounced d, and when, after he had learned to produce the guttural and found that he could do so quite easily, I asked him why he had not used his throat before, he answered, 1 By ‘ list * is meant here a list of words containing a given sound element. “I did not know about it, no one ever told me.” Gun gave trouble as tun had done, it was rendered gung, and dropped, a word in a sentence, was pronounced dwopped. The sound of r was especially difficult for the boy and was not mastered until the sixteenth lesson, although he was given some little practice on it during every lesson for fear its difficulty might prevent its mastery by the end of the term. Not until the latter part of May could he pronounce rock, which occurred in the first lesson, as one syllable, and then the effort used was so intense that it made me feel tense to watch him. The sound of ch was second in difficulty and was treated in the same way.
The fourth sound d required seven lessons before all the words in the list were correctly pronounced. The initial d was made t, and to dawn and done a final g was added?dawng and dung. Awed was turned into wored, code into cote and goat, and birthday (a word in a sentence) into birfday. The process of changing dung to done was, however, not so long as had been that of changing tung to tun, but not until April 22d was R. able to feel the differences in tongue pressure used in done and dung. The fifth list b was not read correctly until the sixteenth lesson, May 27th. B was often pronounced p, bottle was pollow, bollow, boltel, bun was boon, bite was bit, and bauble was bibble. Burr was persistently called purr, superficially it would seem because the word purr with its meaning was more familiar, but the rendering of ball by Paul and pari cannot be so readily explained from the vocabulary of a football player. P, h, and ing were commenced in the sixth lesson, the p list not being correctly read until the fourteenth lesson, May 20th. Both initial and final p were pronounced b. Fop was fob until May 20th. H and ing did not require so much time; they were conquered by the twelfth lesson.
S and f were presented in the seventh lesson. There was a tendency to pronounce the s as sh which did not entirely disappear until the fifteenth lesson. St was especially difficult, still = seel. F required seven practice lessons. The x in fox was difficult; serf was called self, whiff = waff and roof = woof. The eighth list v was troublesome on account of the tendency to substitute the sound of f both for initial and final v. It was difficult for R. to learn to make the voiced sound,?vile was file, vow = fow, leave = leaf, save = safe, prove = proof, etc. A peculiar mistake was berry for bevy, the r sound coming quite naturally. Nine lessons were required for this list.
L was introduced in the ninth lesson. There was difficulty in pronouncing the I and further difficulty in combining it with short i and u, as in fill and lull. The list was read through correctly on May 27th after eight lessons. M and n were both presented in the tenth lesson and required five lessons for mastery. They had been habitually confused, moist was noist, am = an, noose = moose, etc. Nail was pronounced nile, nook = nock, boon = boom and can = tan. I cite the last example to show how the habit of changing initial k to t persisted in a new word after ten lessons. In the sentences gone was gong and with = wif. M gave little trouble. Makes was mates and makts before it was makes (k changed to t), fume was foom and am = an.
Drill was begun on w and wh in the eleventh lesson and continued through succeeding lessons until the sixteenth. The trouble lay in the vowel combinations. Win had to be learned through winter, want was went, waft = wauft and warf = wlierf. Sh was begun in the same lesson and the whole list, including the very difficult rush, read correctly in the fifteenth lesson. Tlv was presented in the twelfth lesson. This was a particularly difficult sound for R. to produce even after he had learned the correct position of the tongue. There was a tendency after properly placing the tongue to draw in the breath and the tongue with it. In addition to the difficulty of articulation, the habit of always substituting an f for th complicated the process. By the sixteenth lesson, however, every word on the sheet was pronounced correctly.
The thirteenth lesson was devoted to r. There had been much preliminary drill leading to this lesson and it bore good fruit. R. put forth tremendous effort and by the next lesson had practically conquered, though up to the last the sound was made consciously and with effort. Hour gave great trouble,?he would say arrow,?and fire was far. Ch, the second most difficult sound which had also received preliminary practice, was attempted in the fourteenth lesson. Again a great effort was made with equal success. The tendency to substitute sh was very great. J occupied the fifteenth lesson. It was difficult as a final sound, sh being substituted. Z and zh completed the lists in the sixteenth lesson. They gave little trouble. Of course the sounds taught in the final lessons had occurred more or less in the earlier lists and had thus received some practice before their particular sheets were reached.
The remaining six lessons were devoted partially to further drill on the lists of words, but principally to the task of developing the habit of practical application of the newly acquired command of articulation. The boy read aloud, attempting all the pronunciations without help. If he failed in a word he was given some clue which led him aright. The result of these lessons was most gratifying. It showed that he had not merely memorized certain words, but that he had learned to associate written symbols with their auditory and articulatory equivalents. He could now judge from the appearance of a word how it should be spoken.
At intervals during the term the effect of the articulation drill on R’s spelling was tested. During the lessons the printed words were always before him, thus the visual, auditory and articulatory experiences were constantly associated. As the lessons progressed the written symbols more and more surely called up their equivalents in sound and speech. The spelling test would determine whether the drill had also developed the reverse of the process, whether the sound of the word would call up the correct visual picture, in spite of the fact that no formal spelling drill had been attempted.
On April 19th out of sixty-three dictated words only six were misspelled; on April 22d, thirty-eight words and four sentences were dictated and the number of mistakes was seven. Some of these errors were the direct result of his old speech habits; for instance, cake was kate (t for k) duke was dut (t for k). One was a transposition of letters, gril for girl; this persisted for some time.
On June 15th in sixty words and three sentences the errors were eleven. Kite was tike, showing a transposition of k and t. On June 17th only nine words of ninety-one were misspelled. Such results clearly indicate that It’s defective spelling was a direct result of his speech defect, that the speech stammer was accompanied by a corresponding writing stammer. More drill would have been desirable, but the summer vacation made it impossible. Much, however, had been accomplished in the twenty-two lessons,?much more than would have been possible had not the boy thrown himself into the work with a will and a determination to succeed.
Disclaimer
The historical material in this project falls into one of three categories for clearances and permissions:
Material currently under copyright, made available with a Creative Commons license chosen by the publisher.
Material that is in the public domain
Material identified by the Welcome Trust as an Orphan Work, made available with a Creative Commons Attribution-NonCommercial 4.0 International License.
While we are in the process of adding metadata to the articles, please check the article at its original source for specific copyrights.