CHAPTER I

SPEECH DISORDERS DEFINED

In the diagnosis of speech disorders, there are almost as many different forms of defective utterance as there are cases, all of which forms, however, divide themselves into a few basic types. These various disorders might be broadly classified into three classes:

(1)—Those resulting from carelessness in learning to speak;
(2)—Those which are of distinct mental form; and
(3)—Those caused by a physical deformity in the organs of speech themselves.

Regardless of under which of these three heads a speech disorder may come, it is commonly spoken of by the laymen as a "speech impediment" or "a stoppage in speech" notwithstanding the fact that the characteristics of the various disorders are quite dissimilar. In certain of the disorders,

(a)—There is an inability to release a word; in others,
(b)—A tendency to repeat a syllable several times before the following syllable can be uttered; in others,
(c)—The tendency to substitute an incorrect sound for the correct one; while in others,
(d)—The utterance is defective merely in the imperfect enunciation of sounds and syllables due to some organic defect, or to carelessness in learning to speak.

While this volume has but little to do with speech disorders other than stammering and stuttering, the characteristics of the more common forms of speech impediment—lisping, cluttering and hesitation, as well as stuttering and stammering—will be discussed in this first chapter, in order that the reader may be able, in a general way at least, to differentiate between the various disorders.

LISPING

This is a very common form of speech disorder and one which manifests itself early in the life of the child. Lisping may be divided into three forms:

(1)—Negligent Lisping
(2)—Neurotic Lisping
(3)—Organic Lisping

NEGLIGENT LISPING: This is a form of defective enunciation caused in most cases by parental neglect or the carelessness of the child himself in the pronunciation of words during the first few months of talking. This defective pronunciation in Negligent Lisping is caused either by a FAILURE or an INABILITY to observe others who speak correctly. We learn to speak by imitation, and failing to observe the correct method of speaking in others, we naturally fail to speak correctly ourselves. In Negligent Lisping, this inability properly to imitate correct speech processes, results in the substitution of an incorrect sound for the correct one with consequent faulty formation of words.

ORGANIC LISPING: This results from an organic or physical defect in the vocal organs, such as hare-lip, feeble lip, malformation of the tongue, defective teeth, overshot or undershot jaw, high palatal arch, cleft palate, defective palate, relaxed palate following an operation for adenoids, obstructed nasal passages or defective hearing.

NEUROTIC LISPING: This is a form of speech marked by short, rapid muscular contractions instead of the smooth and easy action used in producing normal sounds. Neurotic Lisping is often found to be combined with stammering or stuttering, which is quite logical, since it is similar, both as to CAUSE and as to the presence of a MENTAL DISTURBANCE. In Neurotic Lisping, the muscular movements are less spasmodic than in cases of stuttering, partaking more of the cramped sticking movement, common in stammering.

STUTTERING

Stuttering may be generally defined as the repetition—rapid in some cases, slow in others—of a word or a syllable, before the following word or syllable can be uttered. Stuttering may take several forms, any one of which will fall into one of four phases:

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

Simple stuttering can be said to be a purely physical form of the difficulty. The Advanced Phase marks the stage of further progress where the trouble passes from the purely physical state into a condition that may be known as Mental-Physical. The distinctly Mental Phase is marked by symptoms indicating a mental cause for the trouble, the disorder usually having passed into this form from the simple or advanced stages of the malady. Stuttering may be combined with stammering in which case the condition represents the Compound Phase of the trouble.

CHOREATIC STUTTERING: This originates in an attack of Acute Chorea or St. Vitus Dance, which leaves the sufferer in a condition where involuntary and spasmodic muscular contractions, especially of the face, have become an established habit. This breaks up the speech in a manner somewhat similar to ordinary stuttering. Also known as "Tic Speech."

SPASTIC SPEECH: This is often the result of infantile cerebral palsy, the characteristic symptom of the trouble being intense over-exertion, continued throughout a sentence, the syllables being equal in length and very laboriously enunciated. In spastic speech, there is present a noticeable hyper-tonicity of the nerve fibers actuating the muscles used in speaking as well as marked contractions of the facial muscles.

UNCONSCIOUS STUTTERING: This is a misnomer because there can be no such thing as unconscious stuttering. It appears that the person afflicted is not conscious of his difficulty for he insists that he does not s-s-s-s-tut-tut-tut-ter. Unconscious Stuttering is but a name for the disorder of a stutterer who is too stubborn to admit his own difficulty.

THOUGHT STUTTERING: This is an advanced form of stuttering which is also known as Aphasia and which is caused by the inability of the sufferer to recall the mental images necessary to the formation of a word. Stuttering in its simpler forms is usually connected with the period of childhood, while aphasia is often connected with old age or injury. The aphasic person is excessively nervous as is the stutterer; he undergoes the same anxiety to get his words out and the same fear of being ridiculous. In aphasia there is, however, no excessive muscular tension or cramp of the speech muscles. In these cases, the stutterer will sometimes repeat the first syllable ten or fifteen times with pauses between, being for a time unable to recall what the second syllable is. It is, in other words, a habitual, but nevertheless temporary, inability to recall to mind the mental images necessary to produce the word or syllable desired to be spoken. This condition is more commonly known as Thought Lapse or the inability to think of what you desire to say.

One investigator shows that the diagnosis of "insanity" with later commitment to an asylum occurred in the case of a bad stutterer. When excited he would go through the most extreme contortions and the wildest gesticulations in a vain attempt to finally get all of the word out, finally pacing up and down the room like one truly insane. This tendency to believe that the stutterer is insane because of the convulsive or spasmodic effort accompanying his efforts to speak, is a mistaken one, although there can be little doubt of the tendency of this condition finally to lead to insanity if not checked.

HESITATION

Hesitation is marked by a silent, choking effort, often accompanied by a fruitless opening and closing of the mouth. Hesitation is a stage through which the sufferer usually passes before he reaches the condition known as Elementary Stammering.

STAMMERING

Stammering is a condition in which the person afflicted is unable to begin a word or a sentence no matter how much effort may be directed toward the attempt to speak, or how well they may know what they wish to say. In stammering, there is the "sticking" as the stammerer terms it, or the inability to express a sound. The difference between stammering and stuttering lies in the fact that in stuttering, the disorder manifests itself in loose and hurried (or in some cases, slow) repetitions of sounds, syllables or words, while in the case of stammering, the manifestation takes the form of an inability to express a sound, or to begin a word or a sentence.

ELEMENTARY STAMMERING: This is the simplest form of this disorder. Here, the convulsive effort is not especially noticeable and the marked results of long-continued stammering are not apparent. Most cases pass quickly from the elementary stage unless checked in their incipiency.

SPASMODIC STAMMERING: This marks the stage of the disorder where the effort to speak brings about marked muscular contractions and pronounced spasmodic efforts, resulting in all sorts of facial contortions, grimaces and uncontrolled jerkings of the head, body and limbs.

THOUGHT STAMMERING: This, like Thought-Stuttering, is a form of Aphasia and manifests itself in the inability of the stammerer to think of what he wishes to say. In other words, the thought-stammerer, like the thought-stutterer, is unable to recall the mental images necessary to the production of a certain word or sound—and is, therefore, unable to produce sounds correctly. The manifestations described under Thought Stuttering are present in Thought Stammering also.

COMBINED STAMMERING AND STUTTERING: This is a compound form of difficulty in which the sufferer finds himself at times not only unable to utter a sound or begin a word or a sentence but also is found to repeat a sound or syllable several times before the following syllable can be uttered. Any case of stuttering or stammering in the Simple or Elementary Stages may pass into Combined Stammering and Stuttering without warning or without the knowledge, even, of the stammerer or stutterer.

CHAPTER II

THE CAUSES OF STUTTERING AND STAMMERING

One of the first questions asked by the stutterer or stammerer is, "What is the cause of my trouble?" In asking this question, the stammerer is getting at the very essence of the successful method of treatment of his malady, for there is no method of curing stuttering, stammering and kindred defects of speech that can bring real and permanent relief from the affliction unless it attacks the cause of the trouble and removes that cause.

Inasmuch as this book has to do almost entirely with the two defective forms of utterance known as stuttering and stammering, we will at this time drop all reference to the other forms of speech impediments and from this time forth refer only to stuttering and stammering.

These forms of defective speech are manifested by the inability to express words in the normal, natural manner—freely and fluently. In other words, there is a marked departure from the normal in the methods used by the stammerer in the production of speech. It is necessary, therefore, before taking up the discussion of the causes of stuttering and stammering, to determine the method by which voice is produced in the normal individual, so that we can compare this normal production of speech with the faulty method adopted by the stutterer or stammerer and learn where the fault is and what is the cause of it.

Let us now proceed to do this: In other words, let us ask the question: "How is speech produced in the normal person not afflicted with defective utterance?"

Voice is produced by the vocal organs much in the same manner as sounds are produced on a saxophone or clarinet, by forcing a current of air through an aperture over which is a reed which vibrates with the sounds. The low tones produced by the saxophone or clarinet result from the enlargement of the aperture, while the higher tones are produced by contracting the opening. Variations of pitch in the human voice are also effected by elongation and contraction of the vocal cords with comparative slackness or tension, as in the violin.

It would be of no value, and, in fact, would only serve to confuse the layman, to know the duties or functions of the various organs or parts entering into the production of speech. Suffice it to say that in the "manufacture" of words, there are concerned the glottis, the larynx, thorax, diaphragm, lungs, soft palate, tongue, teeth and lips. In the production of the sounds and the combination of sounds that we call words, each of these organs of speech has its own particular duty to perform and the failure of any one of these organs properly to perform that duty may result in defective utterance of some form.

BRAIN CONTROL: It must be borne in mind that for any one or all of the organs of speech to become operative or to manifest any action, they must be innervated or activated by impulses originating in the brain.

For instance, if it is necessary that the glottis be contracted to a point which we will call "half-open" for the production of a certain sound, the brain must first send a message to that organ before the necessary movement can take place. In saying the word "you," for instance, it would be necessary for the tongue to press tip against the base of the lower row of front teeth. But before the tongue can assume that position, it is necessary that the brain send to the tongue a message directing what is to be done.

When the number of different organs involved in the production of the simplest word of one syllable is considered (such as the word "you" just mentioned), and when it is further considered that separate brain messages must be sent to each of the organs, muscles or parts concerned in the production of that word, then it will be understood that the process of speaking is a most complicated one, involving not only numerous physical organs but also intricate mental processes.

When all of the organs concerned in the production of speech are working properly and when the brain sends prompt and correct brain impulses to them, the result is perfect speech, the free, fluent and easy conversation of the good talker. But when any or all of these organs fail to function properly, due to inco-ordination, the result is discord—and defective utterance.

CAUSE OF DEFECTIVE UTTERANCE: Now, let us consider the cause of defective utterance. What is it that causes the organ, muscle or parts to fail properly to function? The first and most obvious conclusion would be that there was some inherent defect in the organ, muscle or part which failed to function. But experience has proved that this is usually not the case. An examination of two thousand cases of defective utterance, including many others besides stuttering and stammering, revealed three-tenths of one per cent. with an organic defect—that is, a defect in the organs themselves. In other words, only three persons out of every thousand afflicted with defective utterance were found to have any physical shortcoming that was responsible for the affliction.

Take any of these two thousand cases—say those that stammered, for instance. What was the cause of their difficulty, if it did not lie in the organs used in the production of speech? This is the question that long puzzled investigators in the field of speech defects. Like Darwin, they said: "It must be this, for if it is not this, then what is it?" If stuttering and stammering are not caused by actual physical defects in the organs themselves, what then can be the cause?

DUE TO A LACK OF CO-ORDINATION: Cases of stammering and stuttering where no organic defect is present are due to a lack of co-ordination between the brain and the muscles of speech. In other words, the harmony between the brain and the speech organs which normally result in smooth working and perfect speech has been interrupted. The brain impulses are no longer properly transmitted to and executed by the muscles of speech.

This failure to transmit properly brain messages or this lack of co-ordination may take one of two forms: it may result in an UNDER-innervation of the organs of speech, which results in loose, uncontrolled repetitions of a word, sound or syllable, or it may take the form of an overinnervation of the vocal organ with the result that it is so intensely contracted as to be entirely closed, causing the "sticking" or inability to pronounce even a sound, so common to the stammerer.

Suppose that you try to say the word "tray." Do not articulate the sounds. Merely make the initial effort to say it. What happens? Simply this: The tip of the tongue comes in contact with the upper front teeth at their base and as you progress in your attempt to say "t," the tongue flattens itself against the roof of the mouth, moving from the tip of the tongue toward its base. If you are a stammerer, you will probably find in endeavoring to say this word, that your vocal organs fail to respond quickly and correctly to the set of brain messages which should result in the proper enunciation of the word "tray." Your tongue clings to the roof of your mouth, your mouth remains open, you suffer a rush of blood to the face, due to your powerful and unsuccessful effort to articulate, and the word refuses to be spoken.

Now, in order to dissociate "lack of co-ordination," from stammering and to get an idea of its real nature, let us imagine an experiment which can be conducted by any one, whether they stammer or not.

You see on the table before you a pencil. You want to write and consequently you want to pick up the pencil. Therefore, your brain sends a message to your thumb and forefinger, saying, "Pick up the pencil." Your brain does not, of course, express that command in words, but sends a brain impulse based upon the kinaesthetic or motor image of the muscular action necessary to accomplish that act. But for our purpose in this experiment, we can assume that the brain sends the message in terms which, if interpreted in words, would be "pick up the pencil." Suppose that when that brain message reaches your thumb and forefinger, instead of reaching for the pencil, they immediately close and clap or stick, refusing to act. Your hand is unable to pick up the pencil. That, then, is similar to stammering. The hand is doing practically what the vocal organs do when the stammerer attempts to speak and fails. But, on the other hand, if, when the message was received by your thumb and finger, it made short, successive attempts to pick up the pencil, but failed to accomplish it, then you could compare that failure to the uncontrolled repetitions of stuttering. This inability to control the action of the thumb and forefinger would be the result of a lack of co-ordination between the brain and the muscles of the hand, while stuttering or stammering is the result of a lack of co-ordination between the brain and the muscles of speech.

WHAT CAUSES LACK OF CO-ORDINATION: But even after it is known that stuttering and stammering are caused by a lack of co-ordination between the brain and the organs of speech, still, the mind of scientific and inquiring trend must ask, "What causes the lack of co-ordination?" And that question is quite in order. It is plain that the lack of co-ordination does not exist without a cause. What, then, is this cause?

An inquiry into the cause of the inco-ordination between brain and speech-organs leads us to an examination of the original or basic causes of stammering. These original or basic causes in their various ramifications are almost as numerous as the cases of speech disorders themselves, but they fall into a comparatively few well-defined classes.

These original causes in many cases do not appear to have been the direct and immediate cause of the trouble, but rather a predisposing cause or a cause which brought about a condition that later developed into stuttering or stammering.

Let us set down a list of the more common of these causes, not with the expectation of having the list complete but rather of giving facts about the representative or more common Basic Predisposing Causes of Stuttering and Stammering.

A little more than 96 per cent. of the causes of stammering which the author has examined can be traced back to one of the five causes shown below:

1—Mimicry or Imitation
2—Fright or severe nerve shock
3—Fall or injury of some sort
4—Heredity
5—Disease

Let us take up these familiar causes of stuttering or stammering in the order in which we have set them down and learn something more of them.

The first and one of the most common causes is Mimicry, or, as it is probably more often called, Imitation. Mimicry or Imitation is almost wholly confined to children. After reaching the age of discretion, the adult is usually of sufficient intelligence to refrain from mimicking or imitating a person who stutters or stammers.

The average small boy, however, (or girl, for that matter) seems to find delight in mocking and imitating a playmate who stutters or stammers, and so keen is this delight that he persists in this practice day after day until (as its own punishment) the practice of mockery or mimicry brings upon the boy himself the affliction in which he found his fun.

It may be noted, however, that Imitation is not always conscious, but often unconscious. The small child begins to imitate the stuttering companion without knowing that he engages in imitation. This practice, notwithstanding the fact that it is unconscious, soon develops into stuttering, without any cause being assignable by the parent until investigation develops that unconscious and even unnoticed imitation is the basic cause of the defective utterance.

It has been definitely determined that stuttering may be communicable through contagious impressions, especially among children of tender age whose minds are subject to the slightest impressions.

For this reason, it is not advisable for parents to allow children to play with others who stutter or stammer, nor is it charitable to allow a child who stutters or stammers to play with other children who are not so afflicted.

So far-reaching are the effects of Imitation or Mimicry that in certain cases, children have been known to contract stuttering from associating with a deaf-mute whose expressions were made chiefly in the form of grunts and inarticulate sounds.

FRIGHT OR SEVERE NERVE SHOCK: Another common cause of stammering is fright or nervous shock, which may have been brought about in countless ways. One boy who came to me some time ago stated that he had swallowed a nail when about six years of age and that this was the cause of his stammering. The logical conclusion in a case like this would be that the nail had injured the vocal organs, but an examination proved that there was no organic defect and that the stammering was caused, not by injury directly to the vocal organs but by the nervous shock occasioned by swallowing the nail.

Another case was that of a stammerer who reported that he had been given carbolic acid, by mistake, when a child and that he had stammered ever since. This, like the case of the boy who swallowed the nail, might be expected to prove a case of absolute physical injury or impairment of the vocal chords, but once again, it was clear that such was not the case and that the stammering was brought about solely from the nervous shock which came as a result of taking carbolic acid.

There is still another case of a boy who felt that he was continually being followed. This was of course merely a hallucination, but the fright that this boy's state of mind brought on soon caused him to stutter and stammer in a very pronounced manner.

Fright is a prolific cause of stuttering in small children and may be traced in a great many cases to parents or nurses who persist in telling children stories of a frightful nature, or who, as a means of discipline, scare them by locking them up in the cellar, the closet or the garret. To these scare-tales told to children should be added the misguided practice of telling children that "the bogey-man will get you" or "the policeman is after you" or some such tale to enforce parental commands. An instance is recalled of a woman who created out of a morbid imagination a phantom of terrible mien, who abode in the garret and was constantly lying in wait for the small children of the household with the professed intention of "eating them alive."

Such disciplinary methods of parents savor much of the Inquisition and the Dark Ages and should, for the good of the children and the future generation they represent, be totally abolished. While these methods do not, in every case, result in stuttering or stammering, they make the child of a nervous disposition and lay him liable in later years to the afflictions which accompany nervous disorders. In some cases "tickling" a child has caused stammering or stuttering. Care should be exercised here as well, for prolonged tickling brings about intense muscular contraction especially of the diaphragmatic muscles, which contraction is accompanied by an agitated mental condition as well as extreme nervousness, all of which approaches very closely to the combination of abnormal conditions which are found to be present in stammering or stuttering.

FALL OR INJURY AS A CAUSE: Step into any gathering of average American parents for a half-hour and if the subject of the children should come up, you are sure to hear one or more dramatic recitals of the falls and injuries suffered by the junior members of the household, from the first time that Johnny fell out of bed and frightened his mother nearly to death, to the day that he was in an automobile crash at the age of 23. And these tales are always closed with the profound bit of confided information that these falls are of no consequence—"nothing ever comes of them."

While in a great measure this is true, there are many falls and injuries suffered in childhood which are responsible for the ills of later life, although it is seldom indeed that they are blamed for the results which they bring about.

Injuries and falls are a frequent cause of stuttering and stammering. Usually, however, an injury results in stuttering or stammering, not because of any change in the physical structure brought about by the injury but rather by the nervous shock attending it. In other words, cases of stammering and stuttering caused apparently by injury might, if desired, be traced still further back, showing as the initial cause an injury but as a direct cause the fright or nervous shock resulting from that injury.

A good example of this is found in a case of a young man who came to me some years ago. He said: "When I was about five years old, my brother and I were playing in the cellar and I wanted to jump off the top step. When I jumped, I hit my head on the cross-piece and it knocked me back on the steps and I slid down on my back, and ever since, for ten years, I have stammered."

Here is a case where the blow on the head, or the succession of blows on the spinal column as the boy slid down the stairs, might have been the cause of the trouble. More probably, it was the combined injury, undoubtedly resulting in a severe nervous shock from which the boy probably did not recover for many days.

Another man said, in describing his case during an examination: "At the age of 16, I was hit on the head with a ball. I lost my memory for one week and when I regained it, I was a stammerer." This is a plain case of injury resulting in immediate stammering.

Still another case is that of a boy who, at the age of three, was shot in the neck by a rifle, the bullet coming out of his chin, which resulted in his becoming an immediate stammerer. Here, as in the case of the boy who swallowed the nail, it might be expected that the cause was a defect in the organs of speech, but I found stammering was brought on by the nervous shock.

From these few cases of actual occurrences, it will be seen that practically all cases of stammering caused by injury can be traced to the NERVOUS SHOCK brought about by the injury.

HEREDITY AS A CAUSE: There is little that need be said on the subject of heredity as a cause of stuttering and stammering, save that heredity is a common cause and that children of stuttering or stammering parents usually stammer. In this, as in the case of any malady hereditarily transmitted, it is difficult to say whether the trouble is caused by inheritance or by constant and intimate association of the child with his parents during the period of early speech development.

THE RESULT OF DISEASE: Many cases of both stammering and stuttering may be traced back to disease as the basic or predisposing cause. Acute Chorea (St. Vitus Dance) is frequently the cause of stuttering of a type known as Choreatic Stuttering or "Tic Speech." Infantile Cerebral Palsy sometimes brings about a condition known as "Spastic Speech," while whooping cough, scarlet fever, measles, meningitis, infantile paralysis, scrofula and rickets are sometimes responsible for the disorder.

Disease may cause stuttering or stammering as an immediate after effect or the speech trouble may not show up for considerable time, depending altogether upon the individual. But regardless of the length of time elapsing between the disease which predisposes the individual to the speech disorder and the time of the first evidence of its presence, diagnosis reveals but an insignificant percentage of organic defects in these cases resulting from disease, indicating that even here the predominant causative factor is a mental one.

CHAPTER III

THE PECULIARITIES OF STUTTERING AND STAMMERING

Each individual case of stuttering or stammering has its own peculiarities, already more or less developed—arising from structural differences (but not necessarily defects) in the organs of speech, as well as differences in temperament, health and nervousness; or peculiarities arising from habit—which is the result of previous training or neglect, as the case may be.

SING WITHOUT DIFFICULTY: Almost without exception, the stutterer or stammerer can sing without any difficulty, can talk to animals without stuttering or stammering, can talk when alone and in some cases can talk perfectly in a whisper. Some stammerers have less difficulty in talking to strangers than in talking to friends or relatives while in other cases, the condition is exactly reversed. A stutterer or stammerer almost always experiences difficulty in speaking over the telephone. One experimenter has shown, however, that a stammerer can talk perfectly over the telephone so long as the receiver hook is depressed and there is no connection with another person at the other end of the line. This experimenter shows that immediately the receiver hook is released and a connection is established, the halting, stumbling utterance begins.

These peculiarities of stuttering and stammering for many years puzzled investigators and were, in fact, finally responsible for arriving at the true cause of stammering.

Almost every stammerer seeks for an explanation of these peculiar manifestations. Why is it, for instance, that a stammerer can sing without difficulty, although he cannot talk? This is one of the best evidences that could be produced to show that stammering is the result of a lack of mental control. The stammerer who can sing without difficulty has no organic or inherent defect in the vocal organs, that is sure. If the stammerer can sing, and if this proves that he has no organic defect, then it follows logically that the cause of his trouble is mental and not physical.

TALK WHEN ALONE: The fact that a stammerer can talk without hesitation when alone and that he can talk to animals may be explained by a very simple illustration—any stammerer can try this experiment on one of his friends who does not stammer. He can prove that the reflex, or what might be termed subconscious movements of the bodily organs are more nearly normal than the same movements consciously controlled. Take, for instance, the regular beating of the pulse. Let anyone who does not stammer (it makes no difference in trying this experiment whether the person stammers or not, save that we are trying to prove that the condition may be brought about in one who is not a stammerer) feel his own pulse for sixty seconds. Let him be thoroughly conscious of this effort to learn the rapidity of its beating. If a disinterested observer could record the pulse as normally beating and the pulse under the conscious influence of the mind, it would be found that the pulse under the conscious effort is beating either more rapidly or more slowly or that it is not beating as regularly as in the case of unconscious or reflex action.

This same condition may be noticed in another unconscious or reflex action—breathing. The moment you become conscious of an attempt to breathe regularly, breathing becomes difficult, restricted, irregular, whereas this same action, when unconscious, is thoroughly regular and even.

In the average or normal person who has learned to talk correctly, speaking should be practically an unconscious process. It should not be necessary to make a conscious effort to form words, nor should a normal individual be conscious of the energy necessary to create a word or the muscular movements necessary to its formation and expression.

This will explain why the stutterer or stammerer can talk without difficulty to animals or when alone—there is no self-consciousness—no conscious effort—no thinking of what is being done.

Another of the peculiarities of stammering is that the stammerer in many cases seems to be able to talk perfectly in concert. This has long baffled the investigator in this field, no reason being assignable for this ability to talk in connection with others. The baffling element has been this—that the investigator has assumed that the stammerer talked well in concert, whereas a very careful scientist would have discovered the stammerer to be a fraction of a second or a part of a syllable behind the others.

You have doubtless been in church at some time when you were not entirely familiar with the hymn being sung, yet by lagging a note or two behind the rest, you could sing the song, to all appearances being right along with the others.

When you talk over the long-distance telephone, the voice seems instantly to reach the party at the other end of the line, yet we know that a period of time has had to elapse to allow the voice waves to move along the telephone wire and reach the other end. The elapse of time has been too slight to be noted by the average human mind and the transmission seems instantaneous. This is what happens in the case of the stammerer who seems able to talk in concert—he is merely a syllable or part of a syllable behind the rest, all the while giving the impression nevertheless, that he is talking just as they are.

There are many other individual peculiarities which can be described by almost every stammerer. These different peculiarities are more numerous than the cases of stammering and it would be useless to attempt to discuss them in detail. I will take up only two as being typical of dozens which have come under my observation in twenty-eight years' experience.

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.

(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.