The Remedial Treatment of a Case of Defective Speech due to Deafness
- Author:
LaVinia Warner, Pn.D.
State Bureau of Juvenile Research, Columbus, Ohio 5”” At the age of twelve a boy, whom we shall call Karl, was brought to the James Whitccmb Riley Hospital for Children, Indianapolis, by his sister, with the complaint that he had defective speech. The sister mentioned casually that the boy was hard-ofhearing. She did not consider this of great importance. The physical and psychological examinations made at the Hospital showed that Karl was in good health and of bright intelligence. The medical history gave nothing significant. However, the physicians concluded that he had defective neurological hearing due to middle ear involvement, but with some residual hearing. The psychologist concluded that Karl’s defective speech was due to deafness. It was recommended that he be given lessons in speech either in a school for the deaf or in the Psychological Clinic of Indiana University.
The parents chose to place Karl under the direction of the Psychological Clinic where his condition could be further analyzed and where he could be given individual instruction, both in speech and in academic school work.
Karl was a very good looking boy of fair complexion. His personality was pleasing and he was well poised. He had entered the first grade of the regular grade school when he was six years of age and had been promoted into the next higher grade every year. At the time that he came to the Indiana University Hospital, he was in the seventh grade. The teachers at school recognized his defect in oral speech and also his inability to express himself in written language, but, perhaps because of his eagerness and willingness to cooperate, they did not recognize that he was totally deaf and that he was in need of any special instruction.
Because Karl presented a striking problem in the psychology of learning and in clinical psychology, he was accepted by the writer for special study and treatment. He remained at the Psychological Clinic for nine months. At least an hour a day and sometimes two or three hours a day were spent in individual work. The remaining time “was spent in the public schools in a room with sixth grade children where he participated in group activities, such as art, shop, arithmetic-computation, gymnasium and auditorium work.
Various hearing tests given in the Clinic proved Karl to be totally deaf. There was found practically no residual hearing. Several standardized educational and intelligence tests were given to Karl at the beginning of this study in order, first, to compare him with hearing children according to the standards and norms for these particular tests; second, to serve as aids in analyzing his abilities and disabilities; third, to discover how much he had learned up to the present time; and fourth, to determine what he had not learned and why he had not learned what others of his ability and age usually learn. These tests and other individual tests which were especially devised to meet Karl’s particular needs were used to aid in determining what techniques he employed and which ones could be used as foundations upon which to build others. The tests used were chosen because of their national popularity at that time; because the standards and norms were well worked out for each test, thus enabling Karl to be compared with other children on these tests; and because it was believed that the tests would lend themselves fairly well to the conditions in this study. These tests were not standardized for deaf children, however.
The tests used were the Stanford Revision of the Binet-Simon Test; Otis Self-Administering Tests of Mental Ability, Intermediate Examination, Form A; Stanford Achievement Test, Advanced Examination, Form B; Haggerty Reading Examination, Sigma 1; National Intelligence Tests, Scale A, Form 1 and Form 2; ” Gettysburg Edition” of the Ayres’ Measuring Scale for Handwriting; and other individual tests.
The same tests were given again at the close of the nine months of instruction. This was done in order to compare the results obtained after he had received the special help with those obtained before he had received any special instruction, and thus to determine whether he had improved during his nine months of special work. The tests revealed the fact that Karl could do only first and second grade work in the different academic subjects at the beginning of this study, although he had been in the regular public schools for six years and had at this time been promoted to the seventh grade.
Language was Karl’s greatest difficulty. He could not interpret the simple sentences in the tests and he understood but very little of the vocabulary of the tests. His highest score on any educational test was in “arithmetic-computation.” Language was not involved in this. In “arithmetic-reasoning” tests, his scores averaged the same as those in any other test involving language. On non-verbal tests, Karl ranked between the eightieth and eighty-fifth percentile. He received a perfect score 011 the non-verbal sections of the National Intelligence Test. It was evident that his ability was not lower than the eightieth percentile.
Karl’s vocabulary was very limited. This was due to the fact that he had never heard language and that it had never been properly taught to him. He had to depend almost wholly upon lipreading for his verbal language impressions. His lip-reading, according to tests devised by the clinician and given to him at the beginning of this clinical study, was inadequate to serve him as a satisfactory basis upon which to build a useful language. He had not been taught to read from books; consequently he could not increase his vocabulary through reading. Before Karl was given the special instruction, it was almost impossible for him to make himself understood through oral language. His written and oral language was in ” parts-of-sentences,” that is, he either expressed himself in the key words or by partly describing what he wanted to say. He did not know how to use conjunctions, articles, etc., which help to make sentences complete. He would have the main idea in his mind but could not put the parts of speech together which would form complete sentences about it. Consequently, he spoke in fragments of sentences, stressing the names of the main objects 01* the words describing them or the words expressing the main actions. Karl seemed to think and to learn things as pictures only, having meaning but no names. This made it impossible for him to write or speak what was actually in his mind. He had more visual images than he had speaking ability. If this is true of all deaf people, then it is not necessary to wait for speech in teaching them to read. Karl realized many facts which he could not express. He knew that cats, dogs, ponies, etc., were pets, but he had no idea of what the word ‘’ animal’’ meant.
Karl did not know many things which would be learned naturally by the young hearing child. This was due to the fact that he did not hear the language spoken by those around him. Hearing is essential in learning most things unless special methods of education are provided. Karl was almost entirely dependent upon visual, kinaesthetic, and tactile senses for material for perceptions. Because of this he could give the use of objects, but could not name them. He thought in terms of use, form, structure, position, and location.
It was Karl’s mother who had taught him to talk as well as he did before he came to the Psychological Clinic. She had never recognized him as a totally deaf child, yet she could not help seeing his difficulty in language and pronunciation. She worked with him until she had succeeded in getting him to respond orally. Much credit is due the mother for her untiring efforts in getting this much accomplished with him. It was a result of her teaching that Karl could pronounce some few words so that they could be understood. These served as a basis for his teaching.
What could Karl do in the regular grade school ? He could play actively on the playground and on the gymnasium floor; he could take a part in the drawing lessons; he could copy, in a very good handwriting, written work from the blackboard or from a book; he could solve simple problems in arithmetic if they did not involve language; and he could make a noise as though reading orally in a defective speech when confronted with a book for oral reading. Karl would take his turn in “reading” orally from books in school whenever asked to do so by the teachers. He was not reading, but was simply making a noise as though reading. This oral noise which he produced was interpreted by the teachers at school and by his family at home as real reading. His pronunciation of the words in the reading was not understandable, but they believed it due to defective speech which was beyond their power to correct and they did not know but that he understood what he was apparently reading. The noise was simply the result of the operation of a recitation organization which had been built up partly through his observation of the other children when they read from books at school. He had learned to try to pronounce symbols and words which conveyed no thought to him. He had learned to pronounce the names of the letters of the alphabet fairly well. When confronted with a selection for oral reading in school or at home, he simply pronounced the names of the letters in the alphabet and in some cases single words and syllables which he had learned to pronounce. This resembled oral reading, although he was only producing a noise. The reading material had no more thought content for him than did the alphabet when he tried to pronounce it. When the clinician handed Karl a French book he “read” it orally as freely and with as much assurance as he did the English books she had previously handed him. In the same way he “read” books printed in Spanish, Russian, Greek, Hebrew and Chinese. Karl was not trying to deceive the clinician in his “reading” of these books. He had been “reading” all his school life and not getting much thought from it. In his apparent reading of these foreign language books, he was simply continuing to respond to a printed book as he had been in the habit of doing. When he observed others reading from a book he did not realize that they were getting thought from their reading.
Karl had been taught to react to a printed page by making oral sounds. When he was confronted with the foreign languages, he did exactly as he had been taught. To him reading was to look at a Printed page and make enough noises to satisfy people about him. How could he be expected to know otherwise when this kind of performance had been accepted during his entire school life? In all correct learning there must be a stimulus which will bring out the desired reaction. The stimulus in the regular grade school situation had not been the correct one for him as a deaf person in learning to read. The teachers understood to some extent his handicap, yet apparently not knowing what to do for it, they did the best they could and passed him to the next higher grade.
According to the results of standardized educational tests, Karl was retarded at least five years in reading and language ability when the clinician began the diagnostic study of him, and he was retarded three years in arithmetic-computation and four years in arithmetic-reasoning. According to the results of the StanfordAchievement Test, he was retarded three years and seven months in educational age.
What could the schools have done for Karl 1 The regular grade teacher, trained to teach the regular academic subjects to hearing children, is not prepared to teach a deaf child such as Karl. If there had been a special class for deaf children, taught by a teacher trained especially to teach deaf children, and if Karl had been placed in it as soon as he was of school age, he could have been taught to read lips so that he could understand what others were saying; he could have learned to speak so that he could have been, at least, fairly well understood; and he could have learned to express himself in complete sentences. His advancement might not have been quite as rapid as the hearing child’s in the regular grades. Much of his time would have had to be spent in learning to lip-read, to pronounce correctly, and to learn the language which the hearing child naturally learns through hearing language spoken. Therefore, he probably would have been one or two grades retarded in the regular school subjects. If he could have had the advantage of a special class for deaf children, no doubt by the age of twelve lie would have been efficient enough in language, speaking, and in reading lips to enter the regular high school, and to compete in the school work with the hearing children.
According to the results of the Stanford-Achievement Test given at the close of the nine months of special instruction, Karl advanced at least eleven months in all academic subjects and as much as four grades in one. If he had enough ability to learn so rapidly at the age of twelve, he would have been able to conquer a grade a year from the moment he entered school had he been properly instructed. It is usually advised that deaf children enter the course of training at an earlier age than the hearing children because of the special speech and lip-reading training which they require. If this could have been done for Karl, he would have advanced more rapidly than the average deaf child because he rated above the average mentality. The deafness did not make Karl as he was, but it was the kind of training and the lack of appropriate training which he had received, plus his deafness. He had not had appropriate instructions to meet his needs as a deaf child. His reaction organizations were perfectly normal for the type of instruction which he had received.
In the nine months of special instruction, Karl learned to talk so that any one could understand him. He learned to speak and write in simple complete sentences. He learned to say readily practically all the sounds in the English language. He had learned the use of the diacritical marks and the dictionary. He could pronounce diacritically any English word from the dictionary himself, so that he was almost independent in the pronunciation of new words.
He advanced not less than one school grade in all, and as much as four school grades in some academic subjects during the nine months of special instruction. Thus Karl advanced during one school year of special individual instruction as much as he had in six school years in regular grade school instruction and in some subjects more. This certainly proves that specialized instruction is needed for deaf children such as Karl. If they can actually learn as much as he did during the nine months of special instruction, and if they can use what they learn, it is certainly uneconomical for the public schools not to provide the training which children such as these require.
When Karl came to the Psychological Clinic he was twelve years of age; he was unable to talk or write so that he could be understood ; and he was retarded about five grades in school work achievement. What could yet be done for him by the schools ? He could be instructed individually by a trained teacher, or Placed in a special class with children of his own ability and of his own level of achievement, or in a special class where individual instruction and not group instruction is provided. Individual instruction is no doubt the best plan for a child of his age, ability and level of achievement. It is hardly likely that a group of children of his age and stage of development would be located closely enough together, except in a large city, so that they could be assembled for group instruction. Karl lived in a small city of eight thousand inhabitants. He enjoyed his own home life and his family and it was yery difficult for him, his neighbors, friends, and the members of his family to become reconciled to his going away for special instruction. If a special class for deaf children could be organized in his home city or county where he could be taught individually by a teacher trained to teach deaf children, his speech could be trained so that he could be well understood; he could be taught all the practieal school subjects; and in three or four years probably could compete on equal grounds with hearing persons. He should be able to complete the regular high school curriculum and enter a university Provided for hearing persons. He could be trained so that he could enter a desirable vocation in which total deafness does not interfere.
There is certainly a need for more and larger medical departments and psychological clinics connected with the public schools so that handicapped and problem children could be discovered, clinically studied, and proper provisions devised. Various types of special classes should be organized so that all types of exceptional children could be properly graded and instructed in the public schools of their own city. If a city is too small and does not contain a sufficient number of children suffering from the same handicap to make up a special class, the county could be used as a unit and all the children of the county brought together in a central location for a special class.
Karl was an undetected problem child when he was attending the public schools. He was a pseudo-successful child. He was recognized as having a speech defect but was not considered to be totally deaf. There are many other neglected children in our schools, and every effort should be made to establish Psychological and Educational Guidance Clinics to aid our teachers in discovering these children and to aid the schools in training them when they are discovered.
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.