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. .h.i.t 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 a.s.sociation 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 Ch.o.r.ea (St. Vitus Dance) is frequently the cause of stuttering of a type known as Ch.o.r.eatic 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 ill.u.s.tration--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 a.s.signable for this ability to talk in connection with others. The baffling element has been this--that the investigator has a.s.sumed 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 G.o.ds on high.
The higher the hopes of the sufferer and the greater the a.s.surance 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 pa.s.s 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.