Impediments of Speech in Children-How to Overcome Them BY A. CHESTER TUCKER, FORMERLY INSTRUCTOR AT DANFORTH SCHOOL, FRAMINGHAM, MASSACHUSETTS. I ÷NVESTIGATIONS in ten graded grammar schools in different cities and towns in New England have thrown light on the following facts regarding the commonness of impediments of speech in children of from five to sixteen years of age. Taking the ten schools together, which represented an aggregate of 3010 pupils, the table be...........................low accurately shows the number of pupils by grades found to possess some defect of speech: First Grade 1 out of 13.8 pupils. Third Grade 1 out of 12.4 pupils. Eighth Grade 1 out of 15.4.pupils. The impediments of speech taken into account in these statistics were cases of stammering or stuttering, mouthing and lisping, some cases being inveterate while others were only slight. In none of these schools, although all were under excellent supervision, was any special account taken to correct the tendencies in the pupils that were ailing. It is the experience of every teacher to find a certain proportion of their students possessing speech defects, although we doubt if many teachers realize exactly how large a percentage of all their pupils are sufferers. How to treat these cases is oftentimes a puzzling problem; and it is for the guidance of teachers and parents confronted with such a difficulty that this article is being written. We will first consider the case of the stutterer. Stuttering is of two general kinds: nervous stuttering, directly caused by imperfect muscular control of the vocal areas and as the term signifies, effected by the nervous temperament of the sufferer; and physical stuttering, the result of deformity most often, of the voice organs. In considering the nervous stutterer, let us say at the outset never to allow him to hear himself mocked. He is sensitive to an extreme and becomes only the more nervous and unmanageable in his speech if ridiculed concerning his ailment. The ignorance of some parents on this score is lamentable. While making a special study of an insidious case of nervous stuttering, upon visiting the child's home, we discovered that his parents were accustomed to mock everything the boy said, "just to show him how badly it sounds", they explained. "We never ridicule Robert", another fond parent confided, "that is, except his uncle; and we can't seem to help his doing it." Our advice to the good mother of Robert was for her to suggest to the child's uncle that he find a new boarding place. Nervous stuttering is a functional disorder. Its correction is a work for the teacher, conversant with nervous psychopathy, and for the parent at home. It requires for treatment the teacher's persistent patience and deep-seeing tact. We have often wondered why there are not more teachers specialized in this field of work, which is an interesting and profitable one to exploit. The nervous stutterer is usually more mentally active than the normal child. He is often expressed as thinking faster than he can talk. As regards speech, he is filled with nervous impulses; it seems impossible for him to control them. But he must. No sooner does he think of a thing than the desire to ́ cry it out has obsessed his tongue. He is inclined to think and speak by the same impulse. His process of speech, therefore, is like nothing so much as a series of exclamations. The first step towards the control of his difficulty is drill in deliberation of thought and utterance. Exercise: Train the child that as soon as he feels actuated to say something, to look about him and let his eye pick out three objects containing some one particular color, before uttering what he is about to say. Such an exercise is not foolish. It engenders in the child deliberation between his conceived thought and his utterance of it, and will be found to overcome his tendency to stutter his words. Children that have been well-drilled in this exercise may come to perform it automatically. The teacher that merely admonishes the child to "think twice before speaking", will accomplish nothing, whereas an exercise embodying that principle is intelligible and may be acquired as a corrective habit. A stubborn case of nervous stuttering in a boy was remedied by the help of the following exercise: Every time the child started to stutter a syllable, he was taught, before trying to speak again, to count the buttons on the front of his jacket by touching each one four times, all the while thinking each word he was to say. It was almost a physical impossibility at first for the child to utter a complete sentence connectedly; this exercise, however, besides teaching him to deliberate, tended to transfer his nervous impulse from his speech to his hands which he used in counting his buttons. It was no difficult task later, when he had learned to control his speech somewhat, to break him of his button-counting habit. The teacher may adapt other exercises appealing to her ingenuity, so long as they have the purpose in view of serving as a lightning-arrester for the patient's confused speech impulses. It were better, we would suggest, that the exercise be not one in which the child counts up mentally to a certain number before making a new effort to speak, (an exercise we have seen adapted several times by others) which would embrace the associative centers of speech in the brain; for the purpose of the exercise is designed to shift the focus of his nervousness from his speech to some entirely different function, until he can recover his poise for speaking. To sum up briefly the matter thus far, the nervous stutterer's speech is impelled by flashes of incomplete mental perception to which he is heir; he must be trained at the outset in deliberation. His treatment to this extent, therefore, is only disciplinary of mental capacities that teach him to control speech impulses. Let us examine the nervous stutterer from the physical perspective. Loosen his collar and watch the movement of the mus-. cles of his throat as he undertakes to speak. A certain rigidity is evident, or spasmodic movement. The psychologist in studying the case in all probability, would locate the cause of ailment somewhere in the motor areas of the patient's brain. Well and good; but the psychologist has no practical method of treatment to suggest. The parents of the child suffering from nervous stuttering will almost invariably seek out the physician at first for a cure. Perhaps two or half a dozen physicians have been consulted; but experience soon shows the futility of seeking help in that direction. What divers troubles, withal, are brought to the physician, for which there is no panacea in the realm of medicine: a case of stuttering is not the measles, so why seek the same cure for each? One does not call in the doctor of medicine to prescribe for the child learning how to prattle, or hire a learned man of psychology to bring his theoretical intellect to bear upon the subject of infant perambulation. The stutterer needs instruction, not physic or theories. We will grant that the child has never learned how to talk correctly stuttering habits do not break out over night like the rash-but has been permitted through indifferent teaching to accumulate and become confirmed in evil habits of speech. It is high time, therefore, that he be given corrective instruction. The first step in the physical guidance of the child is to bring about a power to relax his throat muscles. His larynx muscles are internal, and their conscious manipulation can only be subjectively directed at first. The muscles controlling the movements of the tongue are perhaps as closely allied in sensation as any to the thoracic ligaments, so that in subjecting the tongue to conscious direction of the will, a lesson may be imparted indirectly to the vocal organs themselves. Exercise: Train the child to secure absolute relaxation of the tongue. The mouth is held loosely open, and the tongue, if relaxed, will lie evenly in its place in the lower jaw, tip against the walls of the lower teeth. A nerveless condition of the tongue is sought; to accomplish the feat perfectly will call for the exercise of the will and prove not an easy task. Stuttering consists, of course, in the inability of the sufferer to "let go" of his consonant sounds, since he has not the power of relaxing and tightening at will the muscles concerned in vocalization. Considered vocally, a consonant sound is a pure vowel sound clipped short; it has for its body the vocal content of the vowel sound, the even flow of which becomes arrested and shaped by the lips, tongue and teeth. The consonant sounds require the more energy to utter, while for the vowels only an open, sustained throat orifice and no muscular movement is needed to produce them. The stutterer finds all his difficulties in the consonants; any effort to overcome them must begin with a study of the vowel sounds. Exercise: Drill the student to secure an open condition of the throat orifice in vocalizing the simple vowel sounds: ă-ă-ă; ĕ-ě-ě; Ĭ-Ĭ-Ĭ; ŏ-õõ; ŭ-ŭ-ŭ; a-a-a; e-c-e; i-ii; 0-00; uuu. Join the consonants to the vowels: bă-ă-ă; ckě-ě-ě; dĭ-i-ĭ, etc. Persist in variations of this simple drill until the student shows no disposition to hesitate over it. Observation has shown that some stutterers are more troubled over one combination of consonants with vowel sounds than another. It will be well, therefore, to mark those sounds most difficult for him to effect, giving him drill in special exercises embodying them. We will only mention the case of the child whose stuttering arises from deformity of the larynx or adjacent regions. He stutters under all conditions and at all times, the cause of his weakness is something other than nervous stress. His ailment is often something more than stuttering; rather a thickness and unintelligibility of articulation. A partial paralysis of his vocal functions is very often accountable, which may have been the direct result of a severe illness or was with him at birth. Such a case is often given up as being without hope, but such many times is not the fact. Whereas a paralytic membrane cannot be restored to normality by anything less than a miracle, the powers of other membranes can be so developed and trained as to perform part of the function of the diseased member. The case of a young man was once brought to our attention for whom it was a physical impossibility to give utterance to j and soft g sounds. The disorder was a purely physical one, the result of severe illness. It became necessary to instruct the patient' over again in all the rudiments of speech production. Gymnastic exercises were prescribed for loosening the muscles of the throat; vocal exercises were made of use, incorporating the principles of vowel vocalization and combinations of syllables. That portion of his throat was affected that always prevented him from securing a good voice placement, but he did learn to produce combinations of j and soft g sounds which before were impossible for him to master. |