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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

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