One stammerer explains his difficulty as follows: "I find I am unable to talk and do something else at the same time. For instance, I have difficulty in talking while dancing, while at the table or while listening to music. If, for instance, I wish to talk to any one while the Victrola is being played, I unconsciously cut it off." This is a case where the stammerer finds that all of his faculties must be concentrated upon a supreme effort to speak before this becomes possible. In other words, he has not yet learned to control sufficiently the different parts of his body so that they may act independently. This might be termed a lack of independent co-ordination.

In the case of another young man, he found himself unable to control the movements of his muscles. In describing his trouble, he said: "At one time, when I was talking particularly bad, I was out with some other fellows driving our car. I started to talk, found it almost impossible and noticed a sharp twitching of the muscles of face, arms and limbs. Try as I might, I found I could not control these movements and in another minute I had steered the car into the ditch and wrecked it. And now," adds the young man, "although father has a new car, I am never allowed to drive it!"

Here was a case where the spasmodic action of the muscles had gotten so far beyond control as to make the ordinary pursuits of life dangerous to the young man who stammered. These spasmodic movements were always present—he told of one occasion when he was in a barber's chair being shaved. He attempted to say a word or two while the barber was at work upon him, with the result that he lost control of the muscles of face and neck, causing the barber to cut a long gash in his neck.

This was, of course, an abnormal case of spasmodic stammering, evidencing extraordinary muscular contractions of the worst type. In practically every case of stammering some such peculiarity is evident, resulting from the inability of the stammerer's brain to control physical actions.



CHAPTER IV

THE INTERMITTENT TENDENCY

Paradoxical as the statement may seem, it is nevertheless true that one of the symptoms of least seeming importance marks one of the most dangerous aspects of both stuttering and stammering.

This is the alternating good-and-bad condition known as the Intermittent Tendency or the tendency of the stutterer or stammerer to show marked improvement at times.

This seeming improvement brings about a feeling of relief, the unreasoning fear of failure seems for the time to have left almost entirely; the mental strain under which the sufferer ordinarily labors seems to be no longer present; there is but little worry about either present condition or future prospects; the nervous condition seems to have very materially improved, self-confidence returns quickly and with it the hope that the trouble is gone forever or is at least rapidly disappearing. With these manifestations of improvement come also a greater ease in concentration, a greater and more facile power-of-will and an ambition that shows signs of rekindling, with worth-while accomplishments in prospect.

Hope now burns high in the breast of the stutterer or stammerer. They go about smiling inwardly if not outwardly, happy as the proud father of a new boy, at peace with the world. The sun shines brighter than it has for months or years. Every one seems much more pleasant and agreeable. Things which the day before seemed totally impossible seem now to come within their range of accomplishment. Such is the feeling of the confirmed stutterer or stammerer during the time of this pseudo-freedom from his speech disorder.

In his own mind, the sufferer is quite sure that his malady has disappeared over-night, like a bad dream and that freedom of speech has been bestowed upon him as a gift from the gods on high.

The higher the hopes of the sufferer and the greater the assurance with which he pursues the activities of his day, the greater is his disappointment and despair when the inevitable relapse overtakes him.

For disappointment and despair are sure to come—just as sure as the sun is to rise in the heavens in the morning. The condition of relief is but temporary, and will soon pass away to be followed by a return of his old trouble in a form more aggravated than ever before.

Fate seems to play with the stammerer's affliction as a cat plays with a mouse, allowing him to be free for a few hours, a few days or a few weeks as the case may be, only to drag the dejected sufferer back to his former condition—or, as is true in many cases, worse than before.

THE RECURRENCE: With the return of the trouble, the bodily and mental reaction are almost too great for the human mechanism to withstand. Hope seems to be a word which has been lost from the life of the stammerer. The fear of failure returns with an overwhelming force mocking the sufferer with the thought of "Oh, how I deceived you!!"; the mental strain is exceedingly great—so great, in fact, that it seems as if the breaking point has almost been reached. The nervous condition is alarming, the sufferer noting in himself an inability to work, to play, to study or even to sit still. An observer would note the stammerer or stutterer in this condition fingering his coat lapels, putting his hands in his pockets and removing them again, biting his finger nails, constantly shifting eyes, head, arms and feet about. If at home, the sufferer in this condition would probably be seen walking about the house, unable to read, to play or listen to music or to follow any of the accustomed activities of his life. If in business or in the shop, he would be noticed making frequent trips to the wash room, to the drinking fountain, to the foreman, picking up and laying down his tools, looking out the window, shifting from one foot to another, all of which symptoms indicate an acute nervous condition, brought about by the return of his trouble.

At this stage, the stammerer's confidence is hopelessly gone, so it seems, and this feeling is accompanied by one of depression which finds an outlet in the expression of the firm belief and conviction on the part of the stutterer or stammerer that the disorder can NEVER be cured, by any method, although just the day before the same sufferer would have insisted that his stuttering or stammering had CURED ITSELF and left of its own accord.

These conditions, both at the time of the so-called improvement and at the time of the recurrence of the trouble, will appear in greater or less degree in the case of every stutterer or stammerer whose trouble is of the intermittent type.

THE DANGERS OF THIS TENDENCY: This period of recurrence is accompanied by almost total loss of the power-of-will, a marked weakening in the ability to concentrate, and if it does not result in insomnia (inability to sleep) puts the mind in such a state as to make sleep of little value in building up the body, replacing worn-out tissue cells and restoring vital energy.

The chief danger, however, resulting from these periods of temporary improvement, is the belief that it instills into the mind of the sufferer and more frequently into the minds of the parents of stuttering or stammering children, that the trouble will cure itself—a fallacy greater than which there is none.

Stuttering and stammering are destructive maladies. They tear down both body and mind but they have not the slightest power to build up. And until a strong mental and physical structure has been built up in place of the weakened structure (which results in stammering and stuttering) a cure is out of the question.



CHAPTER V

THE PROGRESSIVE TENDENCY

The spell of intense recurrence of either stammering or stuttering which follows a period of improvement, often marks the period of transition from one stage of the disorder into the next and more serious stage. This transition, however, may not be a conscious process—that is, the sufferer may not in any way be informed of the fact that he is passing into a more serious stage of his trouble save that after the transition has taken place, he may find himself a chronic or constant stammerer and in a nervous and mental condition much more acute than ever before.

Dr. Alexander Melville Bell (father of Alexander Graham Bell, inventor of the telephone), who, before his death, was a speech expert of unquestioned repute, discovered this condition many years ago and in his work PRINCIPLES OF SPEECH speaks of it as follows (page 234):

"Often the transition from simple to more complicated forms of difficulty is so rapid, that it cannot be traced or anticipated. Perhaps some slight ailment may imperceptibly introduce the higher impediment or some evil example may draw the ill-mastered utterance at once into the vortex of the difficulty."

This Progressive Tendency, which we shall hereafter call the Progressive Character of the trouble in order to distinguish it from the Intermittent Tendency, is present in more than 98 per cent, of the cases of stammering and stuttering which I have examined and diagnosed.

True, there are many cases, the apparent or manifest tendencies of which do not indicate that the disorder is becoming more serious, but nevertheless this condition is no indication that the trouble is not busily at work tearing out the foundation of mental and bodily perfection.

SUCCESSIVE STAGES: Stuttering may be conveniently divided into four stages, by which its progress may be measured. These may be designated in their order as:

1—Simple Phase 2—Advanced Phase 3—Mental Phase 4—Compound Phase

The progress of the disorder is sure. Take the case of a child eight years of age who has a case of simple stuttering. Permit the child to go without attention for some time and the trouble will have progressed into the Advanced Phase, usually without the knowledge of the child or his parents or without any especially noticeable surface change in his condition.

Stuttering in its first phase—Simple Stuttering—can justly be called a physical and not a mental trouble. In this stage, the disorder should be easily eradicated. The duration of cases of Simple Stuttering is very slight, for the reason that Simple Stuttering soon passes into the Advanced Phase, which is of a physical-mental nature, exhibiting the symptoms of a mental disturbance as well as of a physical difficulty.

From the Advanced Phase stuttering then passes into the Mental Phase, where the mental strain is found to be greatly intensified and the disorder a distinct mental type instead of a physical or physical-mental trouble.

When stuttering in this stage is permitted to continue its hold upon the sufferer, the continued strain, worry and fear bring about a condition of extraordinary malignancy, in which the trouble develops into the Chronic Mental Stage. This is a condition bordering upon mental breakdown and even though the complete breakdown never occurs, the one afflicted finds himself a chronic stutterer, without surcease from his trouble. He further finds that he has increasing difficulty in thinking of the things which he wishes to say. He seems to know, but his mind refuses to frame the thought. In other words, he is unable to recall the mental image of the word in mind, and is therefore unable to speak the word. This is a condition known as Aphasia or Thought Lapse and represents a most serious stage of the difficulty, in many cases totally beyond the possibility of relief—a condition in which no stutterer should allow himself to get.

Stammering, being a kindred condition to stuttering, progresses from bad to worse in a manner very similar. The progress of stammering may be classified into successive stages as follows:

1—Elementary Stage 2—Spasmodic Stage 3—Primary Mental Stage 4—Chronic Mental Stage 5—Compound Stage

Stammering in the Elementary Stage, like Stuttering, is a Physical Trouble. The Stammerer has often been known to remain in the Elementary Stage only a few days or a few weeks, passing almost immediately into either the Spasmodic or the Primary Mental Stage. Not all stammerers pass into the Spasmodic Stage of the disorder, however, some passing directly into Primary Mental Stage.

The Spasmodic Stage, however, is a form of difficulty somewhat akin to the Advanced Phase of Stuttering, for in this stage the trouble can be said to be of Physical-Mental nature instead of the purely physical disorder found in Elementary Stammering.

Stammering, in the Primary Mental Stage, takes on a distinct Mental form as differentiated from the Mental-Physical form and becomes therefore more difficult to eradicate. If allowed to continue, this form of Stammering (like Stuttering) passes into the Chronic Mental Stage, in which case the Stammerer usually exhibits pronounced signs of Thought Lapse and finds himself a Chronic or Constant Stammerer, often unable to utter a sound-and further at times unable to THINK of what he wishes to say.

The progress of both Stuttering and Stammering from one stage to another is very certain. These speech disorders do not differ materially from other human afflictions in this respect—they do not remain constant. There is an axiom in Nature, that "Nothing is static," which, being interpreted, means, that nothing stands still. And this applies with full force to the stutterer or stammerer. If no steps are taken to remedy the malady, he may be very sure that the disorder is getting worse—not standing still or remaining the same.



CHAPTER VI

CAN STAMMERING AND STUTTERING BE OUTGROWN?

Probably the most harmful and oft-repeated bit of advice ever given to a stammerer or stutterer is that which says, "Oh, don't bother about it—you will soon outgrow the trouble!" It is the most harmful because it is palpably untrue. It is so oft-repeated because the person giving the advice knows nothing whatever about the cause of stammering and just as little about its progress or treatment.

The fact that we hear of no cases of stuttering or stammering which have been outgrown does not seem to alter the popular and totally unfounded belief that stammering and stuttering can be readily outgrown.

If the reader has not read the chapter on the causes of stuttering and stammering and the two preceding chapters on the Intermittent Tendency and the Progressive Character of these speech disorders, then these chapters should be read carefully before going further with this one, because it is essential to know the cause of the trouble before it is possible to answer intelligently the question, "Can Stammering be Outgrown?"

To any one who understands the nature of the difficulty and the progress it is liable to make, the question is almost as absurd as asking whether or not the desire to sleep can be outgrown by staying awake. But aside from its scientific aspect—aside from the absurdity of the question—let us examine the facts as revealed by actual records of cases. Let us dispense with all theory on the subject and take experience gained in a wide range of cases as the correct guide in finding the answer.

FACTS FROM STATISTICS: An examination of the records of several thousand cases of stuttering and stammering of all types and in all stages of development reveals the fact that after passing the age of six, only one-fifth of one per cent, ever outgrow stammering. This means that out of every five hundred people who stammer, only one ever outgrows it. Between the ages of three and six, the indications are more favorable, the records in these cases showing that slightly less than one per cent, outgrow the difficulty. That means that one out of every hundred children affected has a chance, at least, of outgrowing the difficulty between the ages of three and six, and after that time, only one chance in five hundred.

Suppose you were handed a rifle, given five hundred cartridges and told to hit a bull's eye at a hundred yards, 499 times out of 500. Suppose you were told that if you missed once you would have to suffer the rest of your life as a stammerer.

Would you take the offer? Certainly not!!!

And yet that is exactly the opportunity that a stammerer over six years of age has to outgrow his trouble.

Dr. Leonard Keene Hirschberg, the medical writer, whose suggestions appear daily in a large list of newspapers, has this to say about the possibility of outgrowing stammering:

"Often when the attention of careless and reckless fatalistic relatives is attracted to a child's stammering, they labor under the mistaken illusion that the child 'will outgrow it.' A more harmful doctrine has never been perpetuated than the one contained in that stock phrase. As a matter of experience, speech troubles are not 'outgrown.' They become 'ingrown.' If not corrected at first they go from bad to worse. So firmly rooted and ingrained into the child's habits does stuttering become that with every hour's growth the chance for a cure becomes farther and farther removed."

This statement from Dr. Hirschberg is a straight-forward, practical and common-sense view of the subject.

The belief that the child will outgrow the malady often springs out of the tendency of the stammerer to be better and worse by turns, a condition which is fully described and explained in the chapter on the Intermittent Tendency. There is always present in any case of stammering the opportunity for a cessation of the trouble for a short period of time. The visible condition is changeable and it is this particular aspect of the disorder that renders it deceptive and dangerous, for many, who find themselves talking fairly well for a short period, believe that they are on the road to relief, whereas they are simply in a position where their trouble is about to return upon them in greater force than ever.

From the nature of the impediment—lack of co-ordination between the brain and the organs of speech—stammering cannot be outgrown—no more so than the desire to eat or to talk or to sleep.

Back of that statement, there is a very sound scientific reason that explains why stammering cannot be outgrown. Stammering is destructive. It tears down but cannot build up. Every time the stammerer attempts to speak and fails, the failure tears out a certain amount of his power-of-will. And since it is impossible for him to speak fluently except on rare occasions, this loss of will-power and confidence takes place every time he attempts to speak, so that with each successive failure, his power to speak correctly becomes steadily lessened. The case of a stammerer might be compared to a road in which a deep rut has been worn. Each time a wagon passes through this rut, it becomes deeper. The stammerer has no more chance of outgrowing his trouble than the road has of outgrowing the rut.

Dr. Alexander Melville Bell recognizes the absolute certainty of the progress of stammering and the impossibility of outgrowing the difficulty, when he states in his work, PRINCIPLES OF SPEECH (page 234):

"If the stammerer or stutterer were brought under treatment before the spasmodic habit became established, his cure would be much easier than after the malady has become rooted in his muscular and nervous system."

To the stammerer or stutterer or the parents of a stammering child, experience brings no truer lesson than this: Stammering cannot be outgrown; danger lurks behind delay.



CHAPTER VII

THE EFFECT ON THE MIND

It is hardly necessary to describe to the stammerer who has passed beyond the first stage of his trouble the effect of stammering on the mind. Most any sufferer in the second or third stages of the malady has experienced for very brief periods the sensation of thoughts slipping away from him and of pursuing or attempting to pursue those thoughts for some seconds without success, finally to find them returning like a flash.

The stammerer who recalls such an incident will remember the feelings of lassitude or momentary physical exhaustion, as well as the feeling of weakness which followed the lapse-of-thought. This mental flurry is but an indication of a mental condition known as Thought-Lapse, which may result from long-continued stammering, especially a case which has been allowed to progress into the Chronic or Advanced Stage.

A CASE OF APHASIA: One writer, in citing instances of thought-lapse, or aphasia, tells of the case of a man unable to recall the name of any object until it was repeated for him. A knife, for instance, placed on the table before him, brought no mental image of the word representing the object, yet if the word "knife" were spoken for him, he would immediately say, "Oh, yes, it is a knife."

A chapter could be filled with instances of this sort, but I shall not attempt to quote further any of the symptoms of aphasia in a stammerer, for in cases that become so far advanced, there is considerable question as to the possibility of bringing about a cure. I say this, notwithstanding the fact that my experience with students having this tendency has been very satisfactory indeed.

Cases of unreasoning despondency, which result in the stammerer's desire to take his own life, are so numerous as hardly to require comment. Very frequently you see in some of the large metropolitan papers an account of a suicide resulting from a nervous and mental condition brought on by stuttering and stammering. This condition seems to be very marked in the cases of stammerers between the ages of twelve and twenty, records showing that most of the suicides of stammerers are persons between those ages.

The intense mental strain, the extreme nervous condition, the continual worry and fear cannot fail, sooner or later, to have its effect upon the mind. This is clear to any stammerer, who is familiar with the mental condition brought about by the first few hours of one of his periods of recurrence. Another case where the mental strain is extremely great is that of the synonym stammerer—the mentally alert individual who, in order to prevent the outward appearance of stammering, is continually searching for synonyms or less difficult words to take the place of those which he cannot speak. This continual searching for synonyms results in a nervous tension that is sure to tell on the mental faculties sooner or later, and I have found, in examining many thousands of cases, that the synonym stammerer is usually in a more highly nervous state than any other type.

MENTAL STRAIN EVENTUALLY TELLS: The effect of stuttering or stammering on the sufferer's concentration is very marked. The sufferer notes an inability to concentrate his mind on any subject for any length of time, finds it impossible to pursue an education with any degree of success or to follow any business which requires close attention and careful work.

The power-of-will is also affected and the stammerer notes an inability to put through the things which he starts and which require the exercise of will power to bring to a successful conclusion.

A diagnosis of insanity is sometimes made in the case of a stammerer in the advanced stages of his malady, while in other instances the mental aberration takes the form of a hallucination of some sort, as in the case of the boy who was of the belief that he was continually being followed.

But regardless of what form is taken by the mental disorder resulting from stammering, such cases are almost invariably found to have long since passed into the incurable stage, although positive statements as to the individual's condition should not be made, as a rule, without a thorough diagnosis having first been made.



CHAPTER VIII

THE EFFECTS ON THE BODY

The effect of stammering or stuttering upon the physical structure is problematical. In some cases examined, a noticeable lack of vitality has been found, together with an almost total loss of active appetite, a marked inclination toward insomnia and a generally debilitated condition resulting from the nervous strain and continued fear brought on by the speech disorder.

In other cases, it has been found that the health was but little affected and that there was no marked departure from normal.

The physical condition of the stammerer is the result of many factors. If plenty of fresh air and exercise is supplied, and the mind is well-employed so that the worry over the trouble does not disturb the stammerer, then the chances for being in a normal physical condition are good.

On the other hand, the boy of studious disposition, who is somewhat of a bookworm, keeps close to the house and does not play with other children of his age, will probably find time for much introspection, and on this account, as well as on account of the lack of fresh air and exercise, will probably be in a physical condition that of itself demands careful attention.

It has been found in examinations of stammerers and stutterers, however, that they are usually of below normal chest expansion and that the health, while not particularly bad, is subject to a great improvement as a result of the proper treatment for stammering.

Charles Kingsley, the noted English divine and writer, and himself a stammerer many years ago, has the following to say regarding the effect of stammering on the body: "Continual depression of spirit wears out body as well as mind. The lungs never act rightly, never oxygenate the blood sufficiently. The vital energy continually directed to the organs of speech and there used up in the miserable spasm of mis-articulation cannot feed the rest of the body; and the man too often becomes thin, pale, flaccid, with contracted chest, loose ribs and bad digestion. I have seen a boy of twelve stunted, thin as a ghost and with every sign of approaching consumption. I have seen that boy a few months after being cured, upright, ruddy, stout, eating heartily and beginning to grow faster than he had ever grown in his life. I never knew a single case in which the health did not begin to improve then and there."



CHAPTER IX

DEFECTIVE SPEECH IN CHILDREN

(1) THE PRE-SPEAKING PERIOD

From the standpoint of speech development, the life of any person between the time of birth and the age of twenty-one years, may be divided into four periods as follows:

From Birth to Age 2—PRE-SPEAKING PERIOD. Age 2 to Age 6—FORMATIVE-SETTING PERIOD Age 6 to Age 11—SPEECH-SETTING PERIOD Age 11 to Age 20—ADOLESCENT PERIOD

This chapter will deal only with the first period of the child's speech-development, beginning with birth and taking the child up to his second year. The speech disorders of the later periods will be taken up in the three following chapters.

THE PRE-SPEAKING PERIOD: This is the period between the time of birth and the age of 2, and takes the child up to the time of the first spoken word. This does not mean, of course, that no child speaks before the age of 2, for many children have made their first trials at speaking at as early an age as 15 months, and many begin to talk by the time they are a year and a half old. At the age of two, however, not only the precocious child but the child of slower-than-average development should be able to talk in at least brief, disjointed monosyllables.

Before taking up the possibility of a child exhibiting symptoms of defective speech with the first utterance, let us familiarize ourselves with the fundamentals underlying the production of the first spoken words.

The mother, who for months, perhaps, has been listening with eager interest and fond anticipation for her child's first word to be spoken, has little comprehension of the vast amount of education and training which the infant has absorbed in order to perfect this first small utterance. Months have been spent in listening to others, in taking in sounds and recalling them, in impressing them upon the memory by constant repetition, until finally after a year and a half, or more, perhaps, the circuit is completed and the first word is put down as history.

ASSOCIATION OF IDEAS: It must be remembered that perfect co-ordination of speech is the result of many mental images, not of one. In saying the word "salt," for instance, you have a graphic mental picture of what salt looks like; a second picture of what the word sounds like; a "motor-memory" picture of the successive muscle movements necessary to the formation of the word; another picture that recalls the taste of salt, and still another that recalls the movements of the hand necessary to write the word.

These pictures all hinging upon the word "salt" were gradually acquired from the time you began to observe. You tasted salt. You saw it at the same time you tasted it. There you see was an association of two ideas. Thereafter, when you saw salt, you not only recognized it by sight, but your brain recalled the taste of salt, without the necessity of your really tasting it. Or, on the other hand, if you had shut your eyes and someone had put salt on your tongue, the taste in that case would have recalled to your mind the graphic picture of the appearance of salt.

As you grew older and learned to speak, your vocal organs imitated the sound of the word "salt" as you heard it expressed by others and thus you learned to speak that word. At that stage, your brain was capable of calling up three mental pictures—an auditory picture, or a picture of the sound of the word; a graphic or visual picture, or a picture of the appearance of salt and a third, which we have called a motor-memory picture, which represents the muscular movements necessary to speak the word. A little later on, after you had gone to school and learned to write, you added to these pictures a fourth, the movements of the hand necessary to write the word "salt."

At the sight of the mother, a child may, for instance, be heard to say the word "Mom" while at the sight of the pet dog whose name is "Dot," be heard to say "Dot" in his childish way.

Here we have the first example in this child of the association of ideas. The child has heard, repeatedly, the word "Mama" used in conjunction with the appearance of the smiling face of his mother. Thus has the child acquired the habit of associating the word "Mama" with that face—and the sight of the countenance after a time recalls the sound of the associated word. Thus a visual image of the mother transmitted to the child through the medium of the eye, links up a train of thought that finally results in the child's attempt to say "Mama."

To take another example of the association of ideas or the co-ordination of mental images necessary to the production of speech, let us suppose, for instance, that the child has been in the habit of petting the dog and hearing him called by name "Dot" at the same time. Now, if the dog be placed out of the child's sight and yet in a position where the hand of the child can reach and pet him in a familiar way, this sense of touch, like the sense of sight, will set up a train of thought that results in the child making his childish attempt to speak the name of the dog "Dot."

In other words the excitation of any sensory organs sets up a series of sensory impulses which are transmitted along the sensory nerve fibres to the brain, where they are referred to the cerebellum or filing case, locating a set of associated impulses which travel outward from the motor area of the brain and result in the actions, or series of actions, which are necessary to produce a word.

It will make the action of the brain clearer if the reader will remember the sensory nerve fibres as those carrying messages only TO the brain, while the motor nerve fibres carry messages only FROM the brain.

To make still clearer this association of ideas so necessary to the production of speech, suppose this same child hears the word "Dot" spoken in his presence. He will, in all probability, begin to repeat the word, and to search diligently for his pet dog. Thus it will be seen that in this case the sound of the dog's name has stirred up a train of mental images, one of these being a visual image of the dog himself, causing the child to look about in search for him.

HOW WE LEARN TO TALK: We learn to talk, therefore, purely by observation and imitation. Observation is here used in a broad sense and means not only SEEING but SENSING, such as sensing by smelling, touching or tasting. The child imitates the sounds he hears and if these sounds emanate from those afflicted with defective utterance, then it follows that the initial utterance of the child will be likewise defective.

SOURCE OF THE FIRST WORD: The first spoken word of the child usually finds its source in some name or word repeatedly spoken in the child's presence. It is not usual that this first word is marked by a defective utterance and if such should be the case, then it is safe to say that this faulty utterance can be traced back to the imitation of some member of the family, or some child who has been permitted to talk to the child in his pre-speaking period. There is little to be gained by tracing the first word back, for no very profound conclusion can safely be registered with such a basis, for no matter what the word be and no matter whether it be correctly or imperfectly enunciated, it is the result of imitation.

There may be two exceptions to this, however, one being the case of a child with a physical defect in the organs of speech and the other that of a child who has inherited from the parents a predisposition to stammer or stutter. These exceptions, however, are so rare as to hardly require consideration. In the first (that of a physical defect) it is hardly probable that an organic defect would manifest itself in the form of stuttering or stammering, but rather in some other form of defective utterance. In the case of the inherited predisposition to stutter or stammer, there is always the question which has contributed more largely to the defective utterance—the inherited predisposition or the association with others who speak in a faulty manner.

ADVICE TO PARENTS: It is very essential that from the very beginning of the period of the recording of suggestion, the child is shown the correct and customary utterance with the best method of its accomplishment. The child should not be subjected to constant repetitions of phonetic defects, imperfect utterance or speech disorders of any sort. The child who hears none but perfect speech is not liable to speak imperfectly, or at least not so liable as the child who hears wrong methods of talking in use at all times, for this last cannot escape the effects of his environment.



CHAPTER X

DEFECTIVE SPEECH IN CHILDREN

(2) THE FORMATIVE PERIOD

The period in a child's speech development dating from the second year and up to the sixth, is called the Formative Period, for the reason that this is the time when the child is busy learning new words, acquiring new habits of speech, co-ordinating and learning properly to associate the flood of ideas which overwhelm the child-mind in this period.

The child-vocabulary at this time is but an echo of the vocabulary of the home. The words that have been used most frequently there are most strongly impressed upon the child-mind. The names he has heard, the objects he has seen, the applications of speech-ideas—these alone are now in his mind. This condition is inevitable since the child must learn to speak by imitation—and, since he has had no source of word—pictures other than the home, he must have acquired facility in the use of only those words he has had an opportunity to hear.

Former President Wilson, whose faultless diction, remarkable fluency of expression and discriminating choice of words, made him a master speaker and writer, attributed his facility to the training he received in the home of his father, a minister, where the children were constantly encouraged in the use of correct English and in the broadening and enrichment of their store of words.

From the form of simple child-speech, made up often of monosyllables or of a few brief and easy sentences, the child must now evolve a more complicated form of thought-expression, with the use of connectives, descriptions and a finer gradation of color than heretofore.

This process may be materially aided by the parent by the repetition of the child's own utterances, proving to the child that these are correct, that he is being understood and giving him confidence to venture further out in his attempts at speech amplification. This encouragement of the child-mind in its attempts to speak is so important that it is worth while to give some simple examples of what is meant, in order that the point may be clearly understood. Let us take, first, the example of a mother who, from some cause, allows herself to be of a nervous and irritable disposition. The small child may say, "Mam—ma, I want a tooky." The mother, either through indifference or through habit, says, "You want WHAT?" This, first of all, is like a dash of cold water to the child in his uncertain state of mind as to the correctness of his utterance. The child repeats, "I want a tooky," and in all probability gets the further inquiry, "You want a TOOKY—what's that?" which undermines the child's confidence in himself and in his ability to talk.

On the other hand, the mother who understands the needs of the child from a speech-forming standpoint will not insist on the child repeating the word time after time as if it was not understood. She will strive hard to understand the first time, even though the expression is imperfect and difficult of interpretation, and her nimble mind having figured out what it is that the child desires, will say, "Baby wants a cooky?" Here the child, in his comparatively new occupation of talking, finds a deal of delight in knowing that his words have been properly comprehended and feels a new confidence in his ability to express thoughts—which confidence, by the way, is essential to normal speech development in the child. It has the further effect of correcting the tendency of faulty utterance, and in time will result in the complete eradication of the natural tendency to "baby-talk" which is too often encouraged and aided by the habit of parents in REPEATING THE BABY-TALK. In no case, should defective utterances be repeated, no matter how "cute" the utterance may seem at the time. Many speak indistinctly throughout their entire life simply because of the habit of their parents in repeating baby-talk, thus confirming incorrect images of numerous words.

SPEECH DISORDERS IN THE FORMATIVE PERIOD: The Formative Period may mark the beginning of a speech disorder and in many instances chronic cases of stuttering and stammering may be traced to a simple disorder which first manifested itself in the ages between 2 and 6.

Speech disorders arising in this period may be traced to any one of a number of causes. In a child of five, for instance, the diagnostician would look for evidences of an inherited tendency to stammer or stutter; he would look also for circumstances which would show that the child had acquired defective utterance through mimicry of others similarly afflicted or through the unconscious imitation of the defective speech of those immediately about him.

Failing to find any hereditary tendency to a speech defect or any evidence that the disorder had been acquired by imitation or mimicry, the next step would be to determine whether or not the trouble had been caused by disease or injury.

As explained in Chapter III, the diseases of childhood, such as Whooping Cough, Scarlet Fever, Diphtheria, Acute Chorea, Infantile Cerebral Palsy and Infantile Paralysis are frequently the cause of stuttering or stammering, and a history showing a record of these diseases would result in a very careful examination for the purpose of determining if they had resulted in a form of defective utterance.

ADVICE TO PARENTS: But whatever the cause of the trouble, care should be taken to see that it grows no worse and every attempt should be made to eradicate it at this early stage. Like a fire, speech disorders in their early stages are insignificant compared to their future progress and can be much more readily eradicated then than later. Inasmuch as a child of less than eight years is hardly old enough to undertake institutional treatment successfully, it behooves the parent of the stammering or stuttering child to render what home assistance is possible, during this period. The old adage, tried and true, that "An ounce of prevention is worth a pound of cure" is never more correctly applied than here. A few simple suggestions may aid in preventing the trouble from progressing rapidly to a serious stage, even though these suggestions do not eradicate the disorder altogether.

First of all, the child should be kept in the very best possible physical condition. This means, too, plenty of fresh air and sunshine, without which any child is less than physically fit.

It is important that the child be not allowed to associate with others who stammer or stutter, or who have any form of speech disorder. Imitation or mimicry, as heretofore stated, is the most prolific cause of speech trouble and to place a child who stammers or stutters in the company of an older person similarly afflicted, is to invite a serious form of the disorder.

Nervousness, while not the cause of speech disorder, is an aggravant of the trouble and should be avoided. The child should not be allowed to engage in anything which has a tendency to make him nervous or highly excited. Such a condition will aggravate the speech trouble, make it worse and tend to fix it more firmly in the child.

Furthermore, parents should not scold or berate the child because he stammers or stutters. No child stammers or stutters because he wants to, but because he has not the power to control his speech organs. In other words, the child cannot help himself—and scolding and harsh words simply cause confusion and dejection which in turn react to make a more serious condition.

THE CHANCES FOR OUTGROWING: The author's examination and diagnosis of more than 20,000 cases of speech disorders has revealed the fact that at this period in the life of the child afflicted with stammering or stuttering, slightly less than 1 percent. outgrow the difficulty. With proper parental care it might be possible to increase this percentage, perhaps double it, but this should hardly be called "outgrowing." In the mind of the average person, the expression "outgrowing his stammering" means that the stammerer has been able to go ahead without giving the slightest heed to his trouble and that it has, by some magical process, ceased to exist. This is a fallacy. Stammering and stuttering are both destructive and progressive and no amount of indifference will result in relief—but on the other hand, will terminate in a more malignant type of the disorder. It IS true, however, that more care on the part of the parent in looking after the formation of speech habits in the Pre-Speaking and Formative Periods of the child's speech development, would result in fewer cases of chronic stammering and stuttering in later life.



CHAPTER XI

DEFECTIVE SPEECH IN CHILDREN

(3) THE SPEECH-SETTING PERIOD

The period from the age of 6 to the age of 11 (inclusive) is in truth the Speech-Setting Period, for it is at this time that the child's speech habits become more or less fixed, and his vocabulary, while constantly developing, manifests tendencies which may be traced through into the later life of the adult.

This Speech-Setting Period marks two very important events in the speech development of the child. First, it marks the period of second dentition or the time when the milk-teeth are "shed" and the new and permanent teeth take their place. This is a critical period and statistics show that there is a marked increase in speech disorders at this time. The second event of importance, both to child and to parents, is the beginning of the work in school. It must be remembered that heretofore the child has been under the watchful care of the parents during most of his hours, while now, with the beginning of his work in school, he is having his first small taste of facing the world alone—even if only for a little while each day.

Regardless of the attitude which the child takes toward his work in school, this work presents new problems and new possibilities of danger from a standpoint of speech development. A slight defect in utterance which at home is passed over from long familiarity, is the subject of ridicule and laughter at school. For the first time in the child-life, the stammering or stuttering youngster may experience the awful feeling of being laughed at and made fun of, without exactly knowing why. He will have to face the questions of his thoughtless companions who will attempt to make him talk merely for the sake of entertaining themselves. To the child who stutters or stammers, this is torture in its worst form. The humiliation and disgrace which the stammering child must undergo on the way to school, in the school-yard and on the way home again, is a tremendous force in the life of the youngster—a force which may seriously impede his mental development, his physical welfare and his progress in school. He finds himself unlike others, deficient in some respect and yet not realizing the exact nature of his deficiency or understanding why it should be a deficiency. He stands up to recite with a constantly increasing fear of failure in his heart and unless he is fortunate enough to have a teacher who understands, is apt to fare poorly at her hands, also. Even in the case of the teacher who does understand the child's difficulty and consequently permits written instead of oral recitations, there is a constant feeling of inability on the part of the child, a knowledge of being less-whole than those about him, which saps the self-confidence so necessary to proper mental development and normal progress. He furthermore misses much of the value of the studies that he pursues, for, as a noted educator has said, "In order for a child to remember and fix clearly in his own mind the things he studies, those things must be repeated in oral recitation." And this the stammering or stuttering child cannot do.

SENDING STAMMERING CHILDREN TO SCHOOL: With these facts in mind, the question arises as to whether it is ever policy to send a stammering or stuttering child to school, knowing that he is afflicted with a speech-disorder. In the first place the parents who send a stammering child to school exhibit a careless disregard for the rights of others and a further disregard for the many children who must, of a necessity, associate with this stammering child, with all the consequent dangers of infection by imitation or mimicry. Speech defects of a remediable nature among school children could be materially reduced by refusing to allow children so afflicted to play or in any way associate with the others who talk normally.

Aside, however, from the question of the parents' obligation to society and to the children of others (which should be, in the end, a means of protection for their own children, as well) there is the bigger and more selfish aspect of the question, viz.: the effect on the child himself.

No better suggestion can be given than that contained in "The Habit of Success" by Luther H. Gulick, who says: "If you take a child that is really mentally subnormal and put him in school with normal children, he cannot do well no matter how hard he tries. He tries again and again and fails. Then he is scolded and punished, kept after school and held up to the ridicule of the teacher and other students. When he goes out on the playground, he cannot play with the vigor and skill and force of other children. In the plays, he is not wanted on either side; he is always 'it' in tag. So he soon acquires the presentment that he is going to fail no matter what he does, that he cannot do as the others do and that there is no use in trying. So he gives up trying. He quits.

"That is the largest element in the lives of the feeble-minded—that conviction that they cannot do like others, and is the first thing they must overcome if they are to be helped. There is no hope whatever of growth, as long as they foresee they are going to fail."

The futility of trying to "cram" an education into a subnormal child has never been better expressed than in the statement quoted above. There is nothing to be gained by insisting that a child who is ill, attend school—and it should be remembered that so far as school is concerned, the child who stutters or stammers is just as ill as the one with the measles, save that the illness of the stammering or stuttering child is chronic and persistent, while that of the other is temporary.

CHANCES FOR OUTGROWING AT THIS AGE: The opportunities for the stammering or stuttering child to outgrow his trouble are about five times as great in the Formative Period, between the ages of 2 and 6, as they are in the Speech-Setting Period, from 6 to 11. In the former, as previously explained, statistics show that about 1 per cent.—or one in a hundred—outgrow their trouble before the age of 6, while after this age the percentage drops to one-fifth of one per cent, or about one person in every five hundred, which is a very small chance indeed.

In speaking of the tendency of parents to wait in the hope that speech disorders will be outgrown, Walter B. Swift, A.B., S.B., M.D., has this to say:

"This suggestion may frequently be offered, even by the physician. Many people say, 'Let the case alone and it will outgrow its defect.' No treatment could be more foolish than this. No advice could be more ill-advised; no suggestion could show more ignorance of the problems of speech. Such advisers are ignorant of the harm they are doing and the amount of mental drill of which they are depriving the pupil. Nor do they know at all whether or not the case will ever 'outgrow' its defect. In brief, this advice is without foundation, without scientific backing, and should never be followed."

ADVICE TO PARENTS: Parents of children between the ages of 6 and 11 who stammer or stutter, should follow out the suggestions given in the previous chapter, with the idea of removing the difficulty in its incipiency if possible, or at least of preventing its progress. If by the time the child is eight years of age, the defective utterance remains, this fact is proof that the speech disorder is of a form that will not yield to the simple methods possible under parental treatment at home and the child should be immediately placed under the care of an expert whose previous knowledge and experience insures his ability to correct the defective utterance quickly and permanently.

In all cases after the age of 8, the matter should be taken firmly in hand. There should be no dilly-dallying, no foolish belief in the possibility of outgrowing the trouble, for whatever chances once existed are now past. First of all, the child's case should be diagnosed by an expert with the idea of ascertaining the exact nature of the speech disorder, the probable progress of the trouble, the present condition, the curability of the case and the possibilities for early relief. A personal diagnosis should be secured where possible, but when this cannot be brought about, a written description and history of the case should enable the capable diagnostician of speech defects to diagnose the case in a very thorough manner. The result of this diagnosis should be set down in the form of a report in order that the parent may have a permanent record of the child's condition and may be able to take the proper steps for the eradication of the speech disorder. With this information as to the child's case in hand, parents should be guided by the advice of Alexander Melville Bell, one of the greatest speech specialists of his age, who said:

"Stuttering and Hesitation are stages through which the stammerer generally passes before he reaches the climax of his difficulty, and if he were brought under treatment before the spasmodic habit became established, his cure would be much more easy than after the malady has become rooted in his muscular and nervous system."

Truly may it be said of the stammering child at this period, that "There is a tide in the affairs of men, which taken at the flood, leads on to fortune; omitted, all the voyage of their life is bound in shallows and in miseries."



CHAPTER XII

THE SPEECH DISORDERS OF YOUTH

Youth, as we shall define it from the standpoint of the development of speech disorders, is the period from the age of 12 to the age of 20. From the twelfth to the twentieth year is a very critical period in the life of both the boy and the girl who stammers—a period which should have the watchfulness and care of the parent at every step. This is known as the period of adolescence and may be said to mark the time of a new birth, when both mind and body undergo vital changes. New sensations, many of them intense, arise, and new associations in the sense sphere are formed.

To the boy or girl passing through this stage of life, it is a period of new and unknown forces, emotions and feelings. It is a time of uncertainty. The sure-footed confidence of childhood gives way to the unsure, hesitating, questioning attitude of a mind filled with new and strange thoughts and a body animated by new and strange sensations.

These are the symptoms of a fundamental change, the outward manifestations of the passing from childhood to manhood or womanhood. This is childhood's equinoctial storm, marking the beginning of the second season of life's year. In this storm, it is the paramount duty of the parent to be a safe and ever-present pilot through the sea that to the captain of this craft is as uncharted as the route to the Indies in Columbus' day.

The revolution now taking place in both the mental and bodily processes results hi a lack of stability—an "unsettledness" that manifests itself in restlessness, nervousness, self-consciousness or morbidness, taking perhaps the form of a persistent melancholia or desire to be alone.

At this time in the life of the boy or girl, the possibilities for stuttering or stammering to secure a firm hold on their muscular and nervous system are very great. Next to the age of second dentition, children at the age of puberty are most susceptible to stammering or stuttering.

During adolescence, the annual rate of growth in height, weight and strength is increased and often doubled or more. The power of the diseases peculiar to childhood abates and the liability to the far more numerous diseases of maturity begins, so that with the liability to both it is not strange that this period is marked at the same time by increased morbidity.

The significant fact about stuttering in children as far as it relates to the period of adolescence, is that this stage marks the most pronounced susceptibility to the malady as well as the time during which it may most quickly pass into the chronic stage. Examinations show that the largest percentage of stutterers among boys was at the ages of eight, thirteen and sixteen, while the largest percentage among girls was at the ages of seven, twelve and sixteen—the earlier age of severity in girls being explained by the fact that the girl reaches a given state of maturity more quickly than a boy.

Parents of stammering or stuttering children between the ages of twelve and twenty, may well note with alarm the increasing nervousness, the hyper-sensitive feelings, the overpowering self-consciousness and the morbid tendencies which mark a state of mental depression, brooding and worry over troubles both real and fancied.

PERIOD OF MOST FREQUENT SUICIDE: Statistics gathered over a period of years indicate that the cases of suicide of stammering children occur at this time with greater frequency than at any other. Rarely has a case been found where a child has attempted to take his life before the age of 12 and seldom after the age of 20.

At frequent intervals there can be found in any of the large papers, a very brief note of the suicide of a child who had found life too much of a burden for him to bear and who, as a consequence, fell to brooding over his troubles and as the easiest way out of them, took his own life. A Chicago boy attempted suicide by inhaling gas, although he was discovered before it was too late. Another took his own life by shooting himself with a revolver given him some years ago as a birthday present; still another took poison as the easiest way out of his humiliation, embarrassment and despair.

The average age of these boys was about 16 1/2 years, which marks a period of intense self-consciousness and extreme sensitiveness of the youth to ridicule and disgrace.

TENDENCY TO RAPID PROGRESS: The condition of the young person between the ages of 12 and 20 can hardly be considered to be normal in any way. The physical processes are un-normal and are undergoing a change, and the mental faculties, too, are un-normal, overwhelmed as they are with new emotions and sensations. The nervous condition is marked by a much higher nervous irritability, which contributes to a condition most favorable for the rapid progress of the speech disorder, always easily aggravated by a subnormal physical, mental or nervous condition. Cases where the Intermittent Tendency is a pronounced characteristic are liable at this period to find the alternate periods of relief and recurrence to be more frequent than ever before and to note a marked tendency of their trouble to recur with constantly increasing malignancy. Cases that at the age of 11 or 12, for instance, might have been said to have been in an incipient state, have commonly been known at this age to pass through the successive intermediate stages of the trouble and become of a deep-seated and chronic nature in a surprisingly short period of time.

In some cases where the transition from a simple to the complex form of the difficulty takes place at this age, it is found that the disorder has passed beyond the curable stage, in which case, of course, nothing is left to the unfortunate stammerer but the prospects of a life of untold misery and torture, deprived of companionship, ostracized from society and debarred from participation in either business or the professions.

CHANCES OF OUTGROWING: The chances for outgrowing a speech disorder at this age are considerably less than at any other time in the previous life of the individual. The unbalanced general condition tends to make the stammerer more susceptible instead of less so. As previously explained, this period marks the time when speech disorders progress rapidly from bad to worse and, as a consequence, the chances for outgrowing diminished from 1 per cent, before the age of 6 to practically zero after the age of 12. SUGGESTIONS: There is little that can be said for the good of the young person at these ages. The time for home treatment is past. The simple suggestions offered for the assistance of those in the Formative or Speech-Setting Periods would be of little value here because the growth of the individual has made the eradication of the trouble quite improbable without a complete re-education along correct speech lines—best obtained from an institution devoting its efforts to that work. Whatever steps are taken, however, should be taken before the disorder has become rooted in the muscular and nervous system and before it has passed into the Chronic Stage.



CHAPTER XIII

WHERE DOES STAMMERING LEAD?

In answering the question: "Where Does Stammering Lead?" nothing truer can be found than the words of a man who has stammered himself:

"What pen can depict the woefulness, the intensified suffering of the inveterate stammerer, confirmed, stereotyped in a malady seemingly worse than death? Are the afflictions, mental and physical, of the pelted, brow-beaten, down-trodden stutterer imaginary? Nonsense! There is not a word of truth in the idea. His sufferings all the time, day in and day out, at home and abroad, are real—intense—purgatorial. And none but those who have drunk the bitter cup to its dregs feel and know its death, death, double death! These afflicted ones die daily and the graves to them seem pleasant and delightful. The sufferings of the deaf and dumb are myths—but a drop in the ocean compared to what I endured! And who cared for me? Who? I wag the laughing stock, a subject of scoffing and ridicule, often. I could fill an octavo with the miseries I endured from early childhood till the elapsement of forty summers."

Thus does the Rev. David F. Newton, himself a stammerer for forty years, speak of stammering and stuttering and its effects. And Charles Kingsley, a noted English divine and author who stammered, paints the stammerer's future in words of experience that no stammerer should ever forget:

"The stammerer's life is a life of misery, growing with his growth and deepening as his knowledge of life and his aspirations deepen. One comfort he has, truly, that his life will not be a long one. Some may smile at this assertion; let them think for themselves. How many old people have they ever heard stammer! I have known but two. One is a very slight ease, the other a very severe one. He, a man of fortune, dragged on a very painful and pitiful existence—nervous, decrepit, asthmatic—kept alive by continual nursing. Had he been a laboring man, he would have died thirty years sooner than he did."

To the man who has never been through the suffering that results from stammering or who has never been privileged to watch the careers of stammerers and stutterers over a period of years, these final results of stammering seem impossible. The inexperienced observer can only ask in wonder: "How can stammering or stuttering bring a man or woman to these depths of despair?"

To the stammerer who has but begun to taste the sorrows of a stammerer's life these effects of stammering appear to be the ultimate result of an UNUSUAL case—never the inevitable result of his own trouble.

Doubtless if Charles Kingsley were with us today, he could look back and tell us of the day when he, too, was sure that stammering was but a trifle. He, too, could point out the tune when he felt that sometime, somehow, his stammering would magically depart and leave him free to talk as others talked. And yet, having gone down the road through a long life of usefulness, Kingsley's is the voice of a mature experience which says to every stammerer: "Beware—there are pitfalls ahead!" And this man is right.

RESULTS OF STAMMERING: Experience proves that the results of continued stammering or stuttering are definite and positive, and that they are inevitable. Stammering is known to be at the root of many troubles. It causes nervousness, self-consciousness and sometimes brings about a mental condition bordering on complete mental breakdown. It causes mental sluggishness, dissipates the power-of-concentration, weakens the power of will, destroys ambition and stands between the sufferer and an education.

There is no affliction more annoying or embarrassing to its victim than stammering. No matter how bright the intellect may be, if the tongue is unable easily and quickly to formulate the words expressing thought, the individual is held back in business and is debarred from the pleasures of social and home life.

Stammering is a drawback to children in school. To be unable to recite means failure. It means humiliation. It means disgrace in the eyes of the other pupils. And finally, it means valuable time wasted—not in getting an education—but in suffering untold misery in TRYING to get one—and failing.

A boy fourteen years of age, who has failed to advance in school, and who finds stammering a handicap of serious proportions, tells me:

"I am fourteen years old and only in the fifth grade. I am afraid to recite because of my stuttering, and because of my not reciting when my teachers call on me, I am getting low marks in school and do not know if I will ever get through."

One mother writes:

"My little girl will not go to Sunday School because she does not like the other children to look at her so straight when she stammers."

A boy says:

"I am thirteen years old and in school. I am afraid to recite because of my stuttering; and because of my not reciting I get low average in studies."

Another boy told me:

"I am now in the third year of my high school course. On the first day of the term I went to school, I made such a miserable thing of myself that I quit. The school superintendent and principal saw me when I came back the second day as I was carrying my books out. Of course they stopped me and I made an explanation. I couldn't tell any of the new teachers my name. It was impossible to make any kind of a recitation. I was introduced to all of my teachers and have been STUMBLING ALONG ever since with grades anywhere from 0 to 60."

A SOCIAL DRAWBACK: No stammerer but knows that his malady marks him for the half-suppressed smiles of thoughtless people and the unkind remarks of those who really know nothing of the suffering which these unkind remarks occasion. It is true, but unfortunate, that the stammerer is not wanted in any social gathering, he can provide no entertainment, save at his own expense, and of all people he is most ill at ease when out among others.

A young lady writes:

"Mr. Bogue, I would give one of my eyes to get rid of stammering. That is all I am after. Please excuse this awful writing. I AM SO NERVOUS I CAN HARDLY GET THE PEN INTO THE INK BOTTLE."

Here is a letter from one man:

"I am 36 years old, and have stammered for 28 years. I don't stammer so bad, but just bad enough to spoil my life. I always have to take a back seat in company. I belong to three lodges, but I do not take part in any of them because I am afraid they will ask me to take part in the order. It would make me feel cheap. I have often felt like committing suicide, but I would pull my nerves together and make the best of it again. I am now a janitor at a school."

HOPELESS IN BUSINESS: There is not a young man stammerer in this whole country who would not work night and day to be cured of stammering if he realized the hopelessness of trying to be a success in a business way, handicapped by stammering, unable to talk fluently, clearly and intelligently.

A man says:

"I am 33 years old and single. I have stammered ever since I was a child. It has made me nervous. At my age it is very embarrassing to me to stutter. I kept getting more nervous from year to year, and finally I have had to give up my position. I was a long-hand biller for ten years, but I am now troubled with writer's cramp and unable to do much. I can't get a clerk's job because of my stuttering."

And here is another—a man grown, who too late realized the futility of trying to get an education while yet handicapped by stammering. He said, a while back:

"I must say my stammering has spoiled my life and robbed me of a successful career. I would give much if my parents had sent me to be cured of stammering when a boy, instead of trying as they did to educate me."

STAMMERER APPEARS ILLITERATE: No matter how great the stammerer's knowledge may be, he often appears to be illiterate simply because he is unable to express himself in words. His knowledge is locked up by his infirmity, the same as though he had a steel band drawn over his mouth and fastened with a padlock which he is unable to unlock for want of a proper key. The man with the locked-up knowledge is under as great a handicap as the man without knowledge.

A man who had a chance to be a big success in business, had he not stammered, says:

"Stammering is the cause of all my trouble. My earlier associates have shunned me for several years, and I have sought the worst class of dives and the lowest kind of companions, where I was reasonably certain that I would not come in contact with those with whom I had associated in earlier years. My eyes are wet with tears—tears of remorse and regret—because I see no chance in life for me now."

The stammerer who thinks that success comes to the man who stammers—who believes that the business world is willing to put up with anything less than fluent speech, should read this heart-broken letter from a young man:

"I am a bookkeeper, and dearly love my work, but am afraid that I am going to have to give it up because my speech is getting worse, and I have noticed that the boss has mentioned it to me a couple of times now, and it almost breaks my heart to know that my position is going to get away from me. No one realizes how much one suffers, and I'm afraid I'm going to break down with nervous prostration soon. When one day is over with me, I wonder how I am going to get through with the next one."

What are the results of stammering? Should anyone ask that question, I could point to instances in my own experience that would prove that almost every undesirable condition of human existence may be the result of stammering. I have seen young men who are business failures, dejected, hopeless, drifting along, men who in early years were intellectual giants, and who before their death were mere children in mental power, because they allowed stammering to destroy every valuable faculty they possessed.

I could point to children whom stammering had held back almost from the time they began to talk—give cases of young men depressed, embarrassed, unsuccessful, because they stammer—cite instances of all the worth-while things in life turned from the path of a young woman because she stammered.

Yet in the past, not one of these knew what was coming. Not one realized where the trail was leading. No stammerer can of himself see into the future. But he can, at least, look into the future of others, who, like himself, are stammerers, and avoid the pitfalls into which they have fallen and save himself the mistakes they have made.



PART III

THE CURE OF STAMMERING AND STUTTERING



CHAPTER I

CAN STAMMERING REALLY BE CURED?

It has only been a few years since the impression was abroad that stammering was incurable. Not a particle of hope was held out to the afflicted individual that any semblance of a cure was possible by any method. This erroneous idea that stammering could not be cured grew up in the mind of the average person as a result of one or all of the following conditions:

1st—The inability of the stammerer to cure himself and his further inability to outgrow the trouble, (although he was repeatedly told that he would outgrow it) was the first reason that led to the foolish and totally unfounded belief that stammering could not be cured.

2nd—The principles of speech and the un-normal condition known as stammering have been surrounded with a great deal of mystery in the years gone by. The idea has been widely prevalent that the affliction was one sent by Providence as a punishment for some act committed by the sufferer or his forbears. This and many other ideas bordering upon superstition, are responsible, too, to a great degree for the belief that stammering is incurable.

3rd—Even if an attempt to cure stammering was made, this attempt was based upon the "supposition" that stammering was a physical trouble, due to some defect in the organs of speech. It followed that since no one was ever able to discover any physical defect, no one knew the true cause of the disorder, nor how to treat it successfully.

4th—Unfortunately there have been in the field a number of irresponsible charlatans, preying upon the stammerer with claims to cure, while in fact they knew little or nothing of the disorder, had never stammered themselves, nor had the slightest knowledge of the correct methods of procedure in the core of stammering. The failure of such as these to do any good led to a widespread belief that there was no successful method for the eradication of speech disorders.

From an experience covering more than twenty-eight years, during which time the author has corresponded with 210,000 persons who stammer and has personally met and diagnosed about 22,000 cases, it has been proved that all of these beliefs are fallacies of the worst character. Given any person who stutters or stammers and who has no organic defect and is as intelligent as the average child of eight years, it has been found that the Unit Method of Restoring Speech will eradicate the trouble at its source and by removing the cause, entirely remove the defective utterance.

THE STAMMERER'S CASE NOT HOPELESS: Stammerers should fix this fact firmly in mind: Stammering can be cured! There is hope, positive, definite hope for every case—this fact is based on every imaginable form of stuttering or stammering. It is not, in other words, a mere idle statement based on theory or guess-work, but a mathematical truth, taken from experience.

I recall very well the case of a man of 32 who came to me for help after five of the so-called schools for stammerers had failed to afford him any relief. Quite naturally this man was a confirmed skeptic. He did not believe that there was any cure for him. Anyone who had been through the trials that he had experienced would have felt the same way. But he placed himself under treatment, nevertheless, and in a few weeks' time, the Unit Method had restored him to perfect speech. He left entirely convinced that stammering could be cured, because it had been done in his own case which had so long seemed beyond all hope.

Many years afterward, he wrote a letter which I take the liberty of reproducing here for the encouragement and inspiration of everyone who is similarly afflicted and who feels as this man felt—that he is incurable:

"I tried to be cured of stammering at five different times by five different men at a total cost of more than one thousand dollars. None of them cured me. Then I decided to try the Unit Method. Nine years ago I did so—a decision that I have never regretted. It was evident that this method was based on a comprehensive knowledge of the art of speech. I am now a piano salesman and talk by the hour all day long; talk over the telephone perfectly; and many tell me that I speak more distinctly than the majority of people who have never stammered. I believe this is because I was taught through the Unit Method the very fundamentals of speech."

This man's case is typical of the hundreds of failures-to-cure which are responsible for the belief that stammering cannot be cured. The fact that he had made five separate attempts to be cured would, in the mind of the average man, establish the fact that stammering cannot be cured and yet it is seen that even in this extreme case, under the application of the proper scientific methods, the stammerer found freedom of speech without unusual difficulty and in a comparatively short time.



CHAPTER II

CASES THAT "CURE THEMSELVES"

Not infrequently from some source will be heard a story, many times retold, to the effect that "So-and-so" who stammered for many years has been cured—that the trouble has magically disappeared and that he stammers no longer.

What is the cause of this? What brings about such a miraculous cure?

The answer depends upon the case. Usually, the story is much more a story than a fact. Few indeed have been the stammerers who have ever actually heard the man stammer before "his trouble cured itself" and then heard him talk perfectly afterwards. Like the stories of haunted houses, there is nothing to substantiate the truth of the statement, there is no evidence by which the story may be checked up.

In the rare cases where the facts would seem to indicate the truth of the statement, it will be found that the person in question never really stammered—that his trouble was something else—lalling, lisping, or some defect of speech that was mistaken for stammering or stuttering.

Another case of apparent miraculous cure is the case of the stammerer who, finding himself unable to say words beginning with certain letters, begins the practice of substituting easy sounds for those that are difficult and thus, provided he has only a slight case, leads many to believe that he talks almost perfectly. This fellow is known as the "Synonym Stammerer" and is usually a quick thinker and a ready "substituter-of-words." If he has stammered noticeably for some time until those in his vicinity have become acquainted with his affliction, and then discovers the plan of substituting easy sounds for hard ones, he may for a time conceal his impediment and lead certain of his friends to believe that he no longer stammers.

This "Synonym Stammerer" is storing up endless trouble for himself, however, for the mental strain of trying to remember and speak synonyms of hard words entails such a great drain upon his mind as to make it almost impossible to maintain the practice for any great length of tune. In this connection, let every stammerer be warned to avoid this practice of substitution of words. It is a seeming way out of difficulty sometimes, but you will find that you are only making your malady worse and laying up difficulties for yourself in the future.



CHAPTER III

CASES THAT CANNOT BE CURED

In an experience in meeting stammerers and in curing stammering it is only natural to assume that I have come across certain cases which could not be cured. It is only natural, too, to expect that in such a wide experience it would be possible to determine what cases are incurable and why.

Cases of incurable speech impediments may be divided into seven classes:

(1)—Those with organic defects; (2)—Those with diseased condition of the brain; (3)—Those who have postponed treatment until their malady has progressed so far into the chronic stage as to make treatment valueless; (4)—Those who refuse to obey instructions; (5)—Those who persist in dissipation, regardless of effects; (6)—Those of below normal intelligence; (7)—Those who will not make the effort to be cured.

Stutterers and stammerers whose trouble arises from an organic defect are so few as to be almost an exception, but where those cases exist, they must be regarded as incurable. The re-educational process used in the successful method of curing stuttering and stammering will not replace a defective organ of the body with a new one. It will not cure harelip or cleft palate, nor will it loosen the tongue of the child who has been hopelessly tongue-tied from birth.

A boy was brought to me some years ago by his parents in the hope that his speech trouble might be eradicated, but it was found upon examination that he had always been tongue-tied and that the deformity would not permit of the normal, natural movements of the tongue necessary to proper speaking. I immediately told the parents the unfortunate condition of their son and frankly stated that in his condition there was no possibility of my being able to help him.

DISEASED BRAIN: Taking up the second class—those who have a diseased condition of the brain—these cases, too, are very rare. I have met but a comparatively few. Where a lesion of the brain has occurred, and a distinct change has thus been brought about in the physical structure of that organ, an attempt to bring about a cure would be a waste of time—hopeless from the start.

THE PROCRASTINATORS: The third type of incurable cases is that of the stammerer or stutterer who, against all advice and experience, has persisted in the belief that his trouble would be outgrown and who has by this means allowed the disorder to progress so far into the chronic stage as to make treatment entirely without effect.

This type of incurable is very numerous. They usually start in childhood with a case of simple stuttering which, if treated then, could be eradicated quickly and easily. From this stage they usually pass into the trouble of a compound nature, known as combined stammering and stuttering. Here, also, their malady would yield readily to proper methods of treatment, but instead of giving it the attention so badly needed, they allow it to pass into a severe case of Spasmodic Stammering, and from this into the most chronic stage of that trouble. The malady becomes rooted in the muscular system. The nervous strain and continued fear tear down all semblance of mental control and in time the sufferer is in a condition that is hopeless indeed, a condition where he is subject for the pity and the sympathy of every one who stammers, and yet a condition brought on purely by his own neglect and wilfulness.

I recall the case of a father who brought his boy of 16 to see me some years ago. At that time, the boy represented one of the worst cases of stammering I ever saw. He could scarcely speak at all. He made awful contortions of the face and body when attempting to speak. When he succeeded in uttering sounds, these resembled the deep bark of a dog. These sounds were totally unintelligible, save upon rare occasions, when he would be able to speak clearly enough to make himself understood. I gave the boy the most searching personal diagnosis and very carefully inspected his condition both mental and physical, after which I was convinced that he could be cured, with time and persistent work. The father was given the result of my findings and told of the boy's condition. He decided to take the boy home, talk the matter over and place him under my care the next week. Ten days later he wrote me saying that the boy had secured a job in a garage at $6 a week and could not think about being cured of stammering at that time.

Two and a half years later—the boy was nearing twenty—I saw him again, and even after all my experience in meeting stammerers, could hardly believe that stammering could bring about such a terrible condition as this boy was in at that time. His mental faculties were entirely shattered. His concentration was gone. This poor boy was merely a blubbering, stumbling idiot, a sight to move the stoutest heart, a living example of the result of carelessness and parental neglect. Needless to say, I would not consider his treatment in such a condition. There was no longer any foundation to build on—no longer the slightest chance for benefiting the boy in the least.

THE WILFULLY DISOBEDIENT CASES: Taking up the fourth class of incurables, those who refuse to obey instructions—I can only say that such as these are not deserving of a cure. They are not sincere, they are not willing to hold themselves to the simplest program no matter how great might be the resultant good. They spend their own money or the money of their parents foolishly, get no results and disgust the instructor who spends his or her efforts in trying to bring about a cure, against obstacles that no one can overcome, viz.: unwillingness to do as told. The old saying that "You can lead a horse to water, but you can't make him drink" applies most forcefully to the case of the wilfully disobedient stammerer. You can instruct this individual in the methods to bring about a cure, but you can't make him follow them.

I well remember one case in point. A young man of 20 years came to me apparently with every desire in the world to be cured of stammering. The first day he followed instructions with great care, seemed to take a wonderful interest in his work and at the end of the day expressed to me his pleasure in finding himself improved even with one day's work. By the third day, the novelty had worn off and his "smart-aleck" tendencies began to come to the surface. He was impertinent. He was impudent. He was rude. He failed to come to his work promptly in the morning, was late at meals, stayed out at night beyond the time limit set by the dormitory rules and persisted in doing everything in an irregular and wilfully disobedient manner.

I was not inclined to dismiss him because of his misconduct, because it was evident that here was a boy of more than ordinary native intelligence, a fine-looking chap with untold opportunities ahead of him, if he were cured of stammering. So I put up with his misdeeds for many days, until one morning I decided that either he must come to time or return to his home—and he elected to take the latter course.

In looking up this boy's record later on, it was found that he was incorrigible, that his parents had never been successful in controlling him at any time and that he had been expelled from school twice.

There is no need for me to say that this boy was afflicted with something even worse than stammering—something that science was not able to help—i. e., a lack of sense. His case was incurable, just as much so as if an inch of his tongue had been sheared off. With such stammerers as this I have neither patience nor sympathy. They have no respect or consideration for others and are consequently entitled to none themselves.

THE CHRONIC DISSIPATOR: The fifth type of incurable might be called the "chronic dissipator" and his stammering is hopelessly incurable just as far as his habits are incurable. The person who persists in undermining his mental and physical being with dissipation and who, when he knows the results of his doings, will not cease, cannot hope to be cured of stammering. Cases such as these I do not attempt to treat. They are neither wanted nor accepted.

I recall the case of a man of 32, a big, stalwart fellow, who came to me about two years ago with a very severe case of combined stammering and stuttering. He made his plans to place himself under my care but before getting back, fell a victim to his inordinate appetite for drink and was laid up for a week. His wife wrote me the circumstances, told me it had been going on for nine years and that all efforts to eradicate the appetite had failed. I immediately advised her that I considered his case incurable and could not accept him for treatment. In such cases, a cure is built upon too shallow and uncertain a foundation to offer any hope of being permanent.

BELOW NORMAL INTELLIGENCE: There is another incurable case which must be included if we are to complete this list of the incurable forms of speech impediments. That is the case of the stammerer who is of below normal intelligence. These cases are very rare and I do not recall but four instances where a case has been diagnosed as incurable on account of the lack of intelligence. This is a direct refutation of the statement that stammerers are naturally below normal in mental ability. Out of more than twenty-six years' experience in meeting stammerers by the thousands, I can say most emphatically that stammerers as a class ARE NOT NATURALLY BELOW NORMAL INTELLIGENCE OR MENTAL POWER, SAVE AS THEIR TROUBLE MAY HAVE AFFECTED THEIR CONCENTRATION OR WILL-POWER.

THE LACKADAISICAL: The last and largest class of incurable cases of stammering are those who will not make the effort to be cured. These are the spineless, the unsure, the cowards, who are afraid to try anything for fear it will not be successful.

They are usually afflicted with a malady worse than stammering or stuttering—"indecision"—a malady for which science has found no remedy. Knowing the dire results of continued stammering, still they stammer. Reason fails to move them to the necessary effort. Common sense makes no appeal. Well, indeed, in such cases, may we paraphrase the words of Dr. Russell H. Conwell and say:

"There is nothing in the world that can prevent you from being cured of stammering but YOURSELF. Neither heredity, environment or any of the obstacles superimposed by man can keep you from marching straight through to a cure if you are guided by a firm, driving determination and have health and normal intelligence."

These seven classes of incurable cases complete the list. And the number of such cases, all taken together, is so small as to be almost out of consideration. For, out of a thousand cases of stuttering and stammering examined, I find but 2 per cent. with organic defects or of an incurable nature. In other words, 98 per cent. can be completely and permanently cured.



CHAPTER IV

CAN STAMMERING BE CURED BY MAIL?

In the years past there have been attempts from time to time to induce the stammerer to seek a cure for his impediment in mail order treatments. As has already been told, I was the victim of one of these so-called "correspondence-cures" and know something about them from personal experience.

In the first place, the sufferer usually takes up with the mail order specialist because this man retails his "profound" knowledge at a low rate, a rate so low that even a single thought on the subject would convince anyone that his money was buying a few sheets of paper but no professional knowledge or experience.

The very best correspondence course I have ever known anything about was not as good as a number of books on elocution that are available in any good library. Usually these courses are written by some charlatan who is in business as a mail-order-man selling trinkets and stammering cures or running a general correspondence school, teaching not only how to cure stammering by correspondence but giving courses in "Hair-Waving" and "How to Become a Detective." It is needless for me to say that such as these are in the business, not for the good of the stammerer nor even for the purpose of helping him, but simply for the money that can be extracted from the stammerer or stutterer.

THE DIFFERENCE: There are two main differences, however, between the books which the stammerer may read without cost and the correspondence course for which he pays out his good money—many dollars of it. The correspondence course has been written by a man who knew little or nothing of the subject, and who put out a course for stammerers only because he knew something of the number of stammerers in his territory and said to himself, "My, but I ought to be able to sell them a mail-order cure." Forthwith he sits down and writes a course—it isn't necessary to have anything in it at all. Often these men do not even take the trouble to consult reliable books on the subject. They do not profess to know anything about stammering or stuttering, their cause or their cure. They simply sit down and write—and when they have it written, they send it to the printer, have it printed and then split these printed sheets up into ten, or twenty, or fifty, or a hundred lessons—whatever their fancy may dictate, and begin to sell them. They have no thought of the results—results to them mean nothing save the number of courses that can be sold—and whether or not a single iota of good accrues to the stammerer from this expenditure of money is one of the things in which the correspondence school stammering specialist is not at all interested.

The most that can be expected from the very best mail course for the cure of stammering is that the subscriber will receive information worth as much as that which might be in a library book. He receives this in installments and for privilege of reading it piece-meal, pays from $50 to $100.

It is hopeless to try to cure stammering or stuttering by any method unless the instructor knows his business. And this knowledge comes not by chance but by long, hard study.

MAIL CURES A FAILURE: No stammerer should attempt to be cured by any correspondence method. When the decision has been made to have a speech defect removed, the sufferer should place himself under the care of a reputable institution, the past record of which entitles it to consideration. Correspondence cures are a waste of money, a waste of time and finally leave the stammerer with the firm-founded belief that his trouble is absolutely incurable, when, as a matter of fact, he may have a comparatively simple form of stuttering or stammering which could be quickly eradicated by the proper institutional treatment.

At no time should the stammerer resort to the use of any mechanical contrivance to aid him in speaking correctly. The cause of the trouble as previously explained, is inco-ordination. Mechanical contrivances to hold the tongue in a certain position, elevate the palate or for any other purpose may be positively harmful and should be strictly avoided—ALWAYS.



CHAPTER V

THE IMPORTANCE OF EXPERT DIAGNOSIS

A diagnosis is an examination or analysis to determine the identity of a disease and to reveal its cause and characteristics. A reputable medical man will not undertake the treatment of any malady without having first made a searching examination and a thorough diagnosis of the trouble.

In the case of the stammerer or stutterer, expert diagnosis is very important and should be undertaken only by a diagnostician who has had previous training and experience of sufficient duration to enable him to be classed as an expert on the subject. No stammerer or stutterer, however, should overlook the value of such diagnosis, for the reason that there are so many forms of speech disorders that it is totally impossible as well as unsafe for the sufferer himself to try to determine the exact nature of his trouble.

I recall the case of a certain young man who had depended upon his own knowledge to determine the identity of his speech defect and the nature of his trouble. When a boy, he had swallowed a small program pencil with a metal tip, injuring his vocal cords, so he said, and causing him to become a stammerer. An examination of his condition and a careful diagnosis of his case revealed the fact that his vocal organs were as normal as those of any person who had never stammered. The diagnosis also revealed the fact that his stammering was not originally caused by any organic defect or any injury to the vocal organs, but that, on the other hand, he had, in the first place, inherited a predisposition to stammer, his father and his grandfather both having been stammerers whose trouble had never been remedied. The diagnosis showed that the onset of the trouble immediately after swallowing the pencil was due chiefly to the nervous shock and fright caused by the accident, which, in conjunction, with the inherited predisposition toward stammering, was too much for the boy's mental control and he immediately developed into a stammerer. The young man had believed for many years that his defective utterance was totally incurable, that it was due to an organic defect which could not be remedied. The diagnosis quickly revealed, however, that a very different condition was responsible for his trouble and as a consequence, he found himself able to be cured where, without expert diagnosis, he had resigned himself to a life as a stammerer.

Another case which also shows the stammerer's inability to diagnose his own trouble accurately was that of a woman who persistently refused to allow her son to have his case diagnosed, because of her belief that he was incurable and that the diagnosis would be a waste of time and money.

After months of coaxing, however, he succeeded in getting her to consent and I gave him a thorough diagnosis and report on his condition. This mother had been unduly alarmed—the boy was still in a curable stage and in fact completed the necessary work in much less than the usual time. This is but another case that shows the loss which comes from not knowing the truth.

Written Report of Diagnosis Valuable: It is well to get a personal diagnosis of the case where possible, but if this cannot be done, a written history of the case, together with a statement of the symptoms and present condition, should enable the expert diagnostician of speech defects to make a thorough and reliable diagnosis of the trouble.

This diagnosis, to be of the most value to the stammerer or stutterer, should be made up in the form of a written report, so that the information may be in permanent form and so that the sufferer can study his own case in all its angles.

WHAT DIAGNOSIS SHOULD SHOW: First of all, of course, the diagnosis should identify and label your trouble. It should tell what form of speech defect is revealed by the symptoms; it should tell the cause of the trouble; the stage it is now in; should indicate whether or not there is any organic defect; should give information as to the possibilities of outgrowing the trouble; and, most important of all, should state whether or not the disorder is in a curable stage.