A Case of Lack of Speech Due to Negativism
- Author:
Madella Rigby,
Recorder, The Psychological Clinic, University of Pennsylvania
There have come to the attention of the speech clinics of the Department of Psychology an increasing number of cases wherein no speech has developed. The acquisition of speech, like teething and learning the technique of maintaining equilibrium in the hazardous adventure of walking, is generally considered a basis for judging the normal development of young children. Nurses and parents wait for and carefully record the day of the first word and the day of the first step. One child in the family is casually compared with another in these achievements and thus an informal basis of comparison is developed in nearly every family. On the other hand we have physicians and hospitals devoted to the scientific observation of mental and physical growth of infants for the purpose of improving the methods of care as well as for growing the best possible children. From these statistical studies and from common practice we know that when a child reaches three and one-half years of age without speech, he is slow but the case is not by that fact alone, hopeless. Parents who are alert in these matters and aware of what constitutes normal development are coming in greater numbers to solicit the advice of experts in the case of retardation, and it is the wise mother who early seeks the reason for delayed development. Dr Twitmyer, who is the authority on speech defects in the Department of Psychology at the University of Pennsylvania, has studied the problem of lack of speech from the point of view of its possible causes. From his practical clinical experience, he has differentiated four reasons why a child might not talk, namely, amentia, deafness, anatomical anamoly, and negativism. To this list must also be added hysterical aphasia, although this term is properly meant to signify loss of speech that had been acquired. This paper is an attempt to illustrate by means of a case studied in our clinic the dispositional disturbance called negativism. In the words of Kraepelin it is “the instinctive resistance against every outer influence of the will.’’ Negativism varies greatly in degree of severity from the normal display of every child as it reaches the point of asserting its independence of parental care in the development of its individual personality on the one hand, to the point of hopeLACK OF SPEECH 157 less insanity as seen in cases of schizophrenic negativism. To one who has not had the opportunity to see extreme cases of negativism it may seem fantastic to suppose that a distorted disposition could be the cause for the failure of a human child to develop one of the faculties which set man apart from the apes and lower animals. Yet in dementia praecox this negativism may be seen to drive a patient to such extremes of resistance that he will not only refuse to talk but will starve rather than accept food brought for him to eat. Such is common enough in a pathological state. How much of this active non-conformity of otherwise mentally normal children can be blamed on training?or the lack of it, and how much is due to a predisposition in the matter of excessive will power has not been definitely determined. It is certainly true, however, that this clinic has been receiving more and more cases of negativism so strong as to interfere with the child’s proper development because it leads to social non-conformity.
There came to the Clinic during the summer session a case demonstrating pure negativism with otherwise normal mentality. It was a little boy, an attractive child with very blond hair and blue eyes. His name was Rex. He was brought to the Clinic by his father and mother because now, at the age of three and one-half years, he has no speech. He said “Daddy” a year ago but has dropped it. He has said, “Bye-bye” this year. Rex’s baby sister, one and a half years old, is already using words and phrases. In desperation the parents have taken the boy to hospitals in the city for physical examinations. He is under the care of the family physician who sent him to us at the suggestion of a former member of the Clinic staff. There seems to be no significant medical history in the case, although the laboratory tests were not all completed because of the inconvenience of bringing the child to the city from his home in the suburbs. His eyes and ears were both examined. The mother did not receive any written report of the findings because the tests were not completed; and she was not very clear as to the meaning of the terms used. She told us, however, that one doctor had hinted that the case was that of imbecility.
When Rex came into the Clinic he ran at once to the toys spread out on the table. He played well and demonstrated that he heard and understood speech by bringing toys to the examiner as they were called for. His gait and general movements were well coordinated. His behavior was purposive and he played sen sibly. He poured imaginary liquid from the coffee pot into the cup and drank it. He was particularly pleased with the toy automobile and the gaily colored whirligig. His immediate response to the cricket and the way he heeded directions given in an ordinary tone of voice when the examiner’s lips were hidden from his view was sufficient evidence that he hears. That he played well and was able to follow directions augured that his lack of speech was not due to amentia. This possibility was further explored by trying his ability to do formboards. He was successful with the ThreeBlock Seguin Formboard. He completed the Witmer Formboard with instructions, within the time limit. Even though his performance was inferior to ninety-nine per cent of boys at the six year level, his solutions showed good coordination, fair discrimination of form, and fair distribution of attention. He presented the typical infantile reaction, treating the test as a game and patting the blocks as he put them away. There was no anatomical defect apparent. So far he seemed to be a normal child.
At this point, with the possibility of negativism left to account for the lack of speech, Dr Twitmyer proposed to make the child say the words that he was reported to have said on previous occasions. This demonstration was left until the end for it was believed that it would not be possible to reestablish rapport once his confidence in the examiner was shaken. The mother’s consent to rough treatment was asked. Then Dr Twitmyer picked the boy up from the floor where he was sitting playing with the toys. He was carried to the table and sat upon it facing Dr Twitmyer. He was told to say, “Daddy.” This was the word, you remember, that he had said a year ago. Rex behaved very much like a balky horse. He sat and looked at the ogre that was confronting him with this absurd demand. He said nothing. The other word which was contained in his vocabulary at a more recent date was tried. Rex was told to say “Bye-bye.” There was no greater success. The command was repeated and emphasized by taking the boy by the arms and shaking him. The child began to yell. Tears did not come, there were no sobs, but there was an emission of noise that increased in volume as the command to say “Bye-bye” was repeated. Rex was held tightly by the arm, raised from the table and put down upon it again with some degree of violence. He stiffened his legs and made his body straight at the hips, yelling all the while. It is obvious that this stiffening is not part of the act of sitting down. Rex’s intention was to slide out of the clutches of his torLACK OF SPEECH 159 mentor. As long as Dr Twitmyer was going to hold him uncomfortably, it was the child’s intention to make it as difficult as possible. Again and again Dr Twitmyer had to raise the boy as he slid from the table, and the result was that he had to be held in mid air with his stiff little body pushed against the table. Rex was howling all this time. At last the unsuccess was so apparent, the noise so distressing and the effort of holding the child so inefficient that Dr Twitmyer released him. Rex went right back to his toys on the floor and began to play just where he was before being taken to the fray. He did not even go to his mother for sympathy. He had been disturbed by this stranger who had forced himself upon the child’s consciousness and had made unpleasant demands. The demands had not been yielded to. Rex had vanquished the offender, the affair was over, he went back to play, that was all there was to it.
It was then that his mother called him to her to wipe his face which was dirty from the tears that he had squeezed out in the course of his session with the enemy. In the bustle of leaving the Clinic the handkerchief was dropped on the floor. Dr Twitmyer caught sight of it and told Rex to pick it up. The boy paid no attention to the request, but Dr Twitmyer was not to be so lightly disregarded. Mere words, however, had no effect. The examiner had to take the child’s hand and make him stretch out to pick up the handkerchief. Then his fingers were held so that Rex had to grasp it and carry it to his mother who took it and put it away in her bag. This was the first encounter that Dr Twitmyer had won, but Rex was not through. While the doctors talked with his mother, he hung on her knees, he pulled at her skirts, he grasped her arms, he whined all the while and tried to catch hold of her handbag. At last Dr Twitmyer told her to let him have the bag. He took it in his hands, opened the clasp, and took out the handkerchief. Then he turned and threw the thing on the floor. A breeze happened to catch it and blow it on a chair. Rex went after it at once. He snatched the handkerchief off the chair, and threw it this time so that it floated to the floor, then he turned and glared his defiance at Dr Twitmyer. He had won again. This was a demonstration of purposive opposition to discipline that involved an intelligent and complicated plan. This was surely not the working of an ament. He had demonstrated abundantly his intelligence?that ability to solve a new problem. His behavior was the result of scheming of a high order for a four year old. His efficiency in carrying through his plot against the disciplining force was good. In the first instance his noise was so distressing and his rigid little body was so difficult to hold that Dr Twitmyer had had to give up and acknowledge defeat. He learned quickly the most efficient way of not doing what he did not like to do. Later his mother was so annoyed and harrassed by his clinging to her that she could not talk to the professors with any comfort or peace until she had given him his own way and allowed him to open her handbag. In considering this case in relation to Dr Witmer’s Universal Categories of Human Competency, we can say there is a decided deficiency in conformity to the generally accepted pattern of behavior of boys three and a half years of age. His outstanding nonconformity?his lack of speech?was the reason for his being brought to the Clinic. Right through the attempt to discipline in simple and reasonable demands, Rex showed himself to be entirely out of control. Furthermore, the purpose motivating his conduct was not of the sort that is acceptable to society. In fact, it was purely in defiance of social observance. He did not do as he was told, because he was told. This is Negativism. It has been said that every child shows more or less negativism in the normal growth and unfolding of individual personality. But when this tendency to oppose is so strong that it is an impediment in the acquisition of language?? which is onej of the abilities that distinguishes the genus Homo Sapiens?there is manifestly something so far wrong in the line of motivation and direction of energies and abilities that the individual may come to be looked upon as non-social, abnormal?an idiot in the sense of living a life apart. He got what he wanted but the trouble was that what he wanted was not the acceptable thing to society. This child’s mother had been told at the hospital that he was a kind of imbecile. Yet his behavior could not be called either feeble or lacking efficiency. He demonstrated the will to see a thing through to the finish. He did not give up until he had successfully defied authority. The mother had to be told again that if this child is not brought to terms, is not trained to respond to discipline, he will amount to a case for institutional placement. He will grow so far out of hand that he cannot be allowed the freedom of the city. On the other hand with this boy’s intelligence, efficiency, energy, concentration, determination, and discrimination, if he could be given the proper motivation he might be able to make a real contribution to the world’s work.
A study of this child’s home throws more light on the situation. It seems that the father met with an accident which has made him blind in one eye. As a result he cannot earn enough money now to support his family and the mother of the boy has taken a job in order to keep up the family income. With both parents working all day, the child is sent to live with his grandmother. He sees his parents only for the week-ends. The mother explains rather pathetically that she does not want to be correcting and disciplining her son all the short time he is with her, lest he come to dislike her. So she lets him do pretty much as he pleases. She admits that it is difficult for her to manage him. At his grandmother’s he is terribly spoiled by a grandfather and an unmarried uncle about twenty-one years old. The grandmother alone tries to control him. The picture is easy to imagine. The grandmother tries to make Rex obey her in some little thing. He raises a protest. The call for help reaches the ears of grandfather or uncle, both of whom are very fond of the boy. They interfere in the disciplining, and Rex is saved the necessity of submitting to anyone’s orders. It is obvious that this vicious home situation just aggravates the naturally strong opposition to discipline. It is easy to see that the lack of speech is only one phase of the problem. Up to this time, age three and a half, Rex has not felt the necessity for spoken language. He gets immediate attention and his desires are gratified whenever he sets up a howl.
Articulation would not only be unnecessary but difficult.
The next consideration in such a case is the problem of treatment. At present he is not feebleminded. His retardation in talking is within the range of normality. But he must be brought under control effectively and immediately. He must not be given his way in a single thing. He must be brought to the state where he does as he is told because he is told to do it. The method Dr Twitmyer recommends for achieving this end is “protoplasmic discomfort.” Soft words and coaxing may seem to work but they are not the essence of discipline. This boy is too shrewd to be allowed to get away with anything more. Before long, at the rate he is going now, he will run the family out of the house. Spanking is as poor a method as compromise or coaxing. Military discipline is the quickest way to bring him around. He may exhaust the disciplinarian in a few hours but he must be attacked at the moment when he himself is worn out and there must be 110 relaxing of the rule. It will be a long task and a hard one, but only when this boy is obedient will he be rescued from imbecility.
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