YOUR STAMMER AND HOW TO CORRECT IT

YOUR STAMMER

AND HOW TO

CORRECT IT

1

By the same author

YOUR SPEAKING VOICE AND

ITS POSSIBILITEIS

YOUR STAMMERAND HOW TO CORRECT IT

by

H. ST. JOHN RUMSEYM.A. Cantab.

Late Choral Scholar of King’s Coll.,Cambridge

Speech Therapist and Lecturer in Speech Therapy

at Guy’s Hospital

With a Foreword by

W. M. MOLLISON C.E.B., M.A., M.Ch., Cantab., F.R.C.S. Eng.,

Surgeon-in-charge Ear, Nose and Throat Dept.,

Guy’s Hospital

LONDON

FREDERICK MULLER LTD.29 Great James Street, W.C.I

3

FIRST PUBLISHED BY FREDERICK MULLER LTD.

IN 1937

PRINTED IN GREAT BRITAIN

BY BUTLER & TANNER LTD.

FROME & LONDON

FOREWORD

Many jokes have been founded on stammering, but to be a stammerer is far from a joking matter.

In this small book Mr. St. John Rumsey has set forth very clearly and in simple language the factors which conduce to stammering, and shows that there is not one cause but several; he explodes the myth that fear is the cause and suggests instead that stammering is the fearful thing; on the other hand, he points out the importance of the psychology of the stammerer and how friends and relations can help or hinder the sufferer in his efforts to overcome the stammering “habit”.

Mr. Rumsey holds out a sure hope of recovery to stammerers through well directed instructions on control of the vocal mechanism and deliberation in speech; but finally he impresses on the patients the great importance of their will to correct themselves.

A sensible exposition of an important physical drawback by one who has corrected himself of stammering must carry great weight and help many victims of stammering.

W.M. MOLLISON23 Devonshire Place,W.I.

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AUTHOR’S PREFACE

During the last few years we, in this country, have given much more thought to the correction of stammering; it has been a period of collecting facts and forming theories. At the moment there is a risk that some of us “cannot see the wood for the trees”.

This is my reason for writing another little book on the habit of stammering after another fourteen years of hospital and private experience. My aim is to clear the atmosphere by explaining to my readers how respiration, the vocal tone produced in the larynx and the articulatory movements of the tongue, lips and jaws are coordinated into speech in the normal speaker, and how, and why, in the case of the stammerer this coordination breads down.

My grateful thanks are due to Mr. ...

H. ST. JOHN RUMSEY153 Clatence Gate Gardens, N.W.I.

CONTENTS

Foreword

Author’s Preface

I Introductory.............................................................. 1

II A General Survey..................................................... 4

III Respiration............................................................... 8

IV The Larynx...............................................................12

V Vowels and Consonants..........................................16

VI The Stammerer’s Speech..........................................19

VII

Causation..................................................................25

VIII

Definition..................................................................31

IX

Treatment..................................................................32

X Example and Precept................................................39

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XI The

Stammerer..........................................................42

XII Cleft Palate Speech ..................................................46

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Chapter I

INTRODUCTORY

HE misery caused by a stammer can only be fully realized by those who have themselves suffered from the habit. Even parents of stammering children seem to be unable to

appreciate what their children suffer, the additional strain, the fact that occurrence which to the normal person call for no special effort, in the case of a stammerer assume terrifying proportions, and the ever-present fear that the occasion will arise when the stammerer will find himself in a floodlight of publicity or be confronted with what seems to him to be a dire calamity either to himself or an acquaintances.

T

Those who have personal knowledge of hundreds of cases and get to know their patients well are better able to realize fully how fear dominates their lives, fear of asking for a ticket, fear of being asked a simple question in the street, until fear becomes the constant companion of the sufferer. To the normal person, asking for a railway ticket hardly breaks into conversation with a companion, but for the stammerer it is an alarming crisis necessitating special practice beforehand and an event which has been dreaded for many hours. The sudden question is even worse because there is no clue, no chance to dodge the difficult word and no chance of practicing beforehand; yet to the normal person it means less than the striking of a match.

The outward sign of this incessant strain may be a marked diffidence of manner or a bombastic insistence to occupy the center of the stage and to be in the limelight all the time; again, it may be reflected by an abrupt manner or the habit of putting the other person in the wrong. Many stammerers develop into athletic fanatics in their endeavor to prove that although they may be unable to compete with other people in speech, they can excel in

games. There was a case of a stammerer who took up motor racing and flying to convince himself and others that he was not afraid, yet all the time he was shadowed by the fear of speech. Numberless instances could be given to show the effects and repercussions of this habit, but the important fact to be realized is that life is distorted and unhappy until the habit is corrected. There are cases in which the disability does not appear to worry the patient, but it is doubtful if this is really the case; it is far more probable that the indifference is assumed because he lacks the confidence to make a determined effort to correct it. There are a few cases of the stammer being used as a protection against work or additional responsibility, but it is probable that in most of such apparent cases fear is the real trouble and the patient distrusts his own ability to compete with the normal parson.

It is no exaggeration to say that stammering in very many cases amounts to a tragedy and yet, until the last few years, the only medical advice frequently given to the parents of a stammering child was, to do nothing because the child would probably grow out of it. It is quite true that many stammerers get better as they get older and that by the age of fifty have very little trouble left, but even if the average case did correct itself by the age of twenty-five, think of all the unnecessary misery of the years-from seven; eighteen years during which character is formed, clouded by fear, with confidence being undermined by failure day by day and year after year.

During the last few years much has been learned about the habit of stammering and it is realized by the medical profession that the average case of stammering can be corrected. Medical books of reference contain informative articles on the subject. At most of the larger hospitals speech clinics have been opened, but the general public is still under the impression that little if anything can be done for the stammerer. This erroneous idea is partly accounted for by the number of charlatans who appear from time to time and widely advertise sure and permanent cures in a given time for a definite and generally substantial sum of money. How can it be possible to say that anyone else can and

will break a bad habit? How can it be possible to say how long it will take?

The confidence shown by the medical profession by the institution of speech clinics at some of the larger hospitals is an assurance to the public that good work can be done and is being done, but the public should be guided by this medical confidence. To seek help from an instructor who has not got medical recommendation is to court disaster; it can only be compared with seeking medical advice from the local grocer.

As will be shown in more detail in the following chapters there are two distinct aspects from which stammering may be viewed; it is a definite bad habit and may be viewed and treated as such; there is also a strong element of fear, but whether the fear is the cause of the stammer or the result of it is a question which must engage the attention of every student of speech disabilities. If the fear is the primary cause of the stammer the help of the psychotherapist should be sought, but if the habit of stammering has caused the fear it is obviously the concern of the expert in voice production.

Chapter II

A GENERAL SURVEY

N order to evolve an effective method for the correction of the stammering habit and reducing the risk of a relapse to a minimum, it is necessary to take careful notice of the actual

differences between the speech of the stammerer and that of the normal speaker; this will help us to form an opinion with regard to the primary cause of the intermittent breakdown in the complicated mechanism of human speech which is called stammering.

I

We are apt to take for granted the wonders of nature; to take an instance, in the choice of our food, most of us are guided by likes and dislikes rather than by the study of food values and a balanced diet, but we are astonished at the occasional rebellion of the digestive system, nature’s warning to us to be guided in future by common sense, knowledge and experience. In a similar way we take speech for granted, although it is surely one of the greatest wonders of nature. We are astonished at partial speech failure (stammering) in one percent of the population, whereas the real wonder is the speech control of the ninety-nine per cent. We share many of our activities, mode of living and even the faculty of reasoning with the animal kingdom, but whereas all the animals with the exception of one or two can make a vocal noise, ability to mould that vocal noise into speech belongs only to human beings. Note carefully what you have just read, the moulding of vocal noise into words and sentences constitutes what we call speech, i.e. vocal noise is the primary essential. This is an important link in the chain of evidence which we are trying to form; its importance will be made clear presently.

Vocal noise is made in the larynx by the vibration of the vocal cords; the cords are vibrated by the breath from the lungs passing

between them. For vocal noise, then, there are two essentials, the vocal cords and the breath which causes them to vibrate. To make vocal noise into speech a third factor must be added, the movements of the lips, jaws, soft palate and the tongue, the last-mentioned being the most important. As the stammerer knows to his cost, the tongue has been well named “the unruly member”. The ventriloquist’s art consists in having his tongue under such perfect control that he can make it do the work of the lips and jaws and thus speak distinctly and audibly without the normal mouth movements. In the case of the stammerer he tries to make the tongue do the work of the larynx, a physical impossibility! Whistling is the only way in which the tongue can in any sense do work comparable with the work done by the larynx.

We have seen that there are three essentials without which even rudimentary speech is impossible, exhalation (breathing out), the vibration of the vocal cords and movements of the lips, jaws, soft palate and tongue. These are the essential factors which are coordinated into speech; the stammerer fails to coordinate them.

This failure to coordinate is all the more remarkable when we remind ourselves that the average stammerer can sing without any difficulty, in other words, failure to coordinate does not hinder song although it prevents fluent speech. This point cannot be too strongly emphasized, because we are not bi-vocal, we use the same organs for speech and song. The late Harry Plunket Greene did valuable service to the art of singing both by his own singing and his teaching by insisting on the “essential similarities between speech and song”. The only differences which should exist are that in song the pitch of the voice and the time values of the notes and syllables are decided by the composer whereas in speech these are left to the discretion and literary instinct of the speaker. With these exceptions it is to the advantage of both speaker and singer to remember that what is right in song is also right in speech, and that what is right in speech is also right in song. If I may be allowed to borrow the words of a great singer and teacher of singing, I would say:— “What can be sung, can equally easily be spoken as long as the speaker realizes and

abides by the essential similarities between speech and song”. The next step will be to show what factors should be included among essential similarities.

All who have studied singing will agree that, whatever methods may be employed by different teachers, they all aim at definite and universally appreciated characteristics.

1. A full, firm and resonant vocal tone under full control throughout the singer’s vocal range.

2. An open production with no muscular tenseness in the neck and face.

3. Controlled breathing.Since we have only one larynx apiece it is obvious that there

is only one way to use it correctly. Having mastered the art of producing full tone from it for singing, we ought to use a similar tone in speaking. How can the singer expect to produce a perfect tone when singing for a couple of hours per day at most, if he is content to use an incorrect tone while speaking for several hours per day? How can a singer expect to sing with an open production if the muscles of his throat and neck are constricted during his speech? If breath control is necessary during song it must also be necessary for speech.

Although the essential similarities between speech and song should exist, it is obvious that much more time is required for the training of the voice for song than for speech, because for the latter the range of pitch is very much more limited than in the case of song, when the trained singer reckons on a range of two octaves or slightly more. Whereas the middle notes can be produced with a full, resonant and open tone comparatively easily, it generally takes a great many months of hard work to carry the tone to the top notes. For speech, only middle of the singing range is used, so the correction of the tone production is not a very difficult matter.

Much the same may be said about breathing; control of breath is essential for the production of the high notes, whereas for the middle notes which require very much less breath pressure, a lower standard of breath control will be sufficient.

Now in the average speaker there is too little similarity between speech and song; very few people make the most of their voices in speech. In the case of stammerers, not only is there no similarity, but it is no exaggeration to say that speech and song are in the strongest possible contrast.

Whatever clearness of tone the stammerer achieved during song has gone and in its place is a thin, feeble voice that is very little more than a whisper; so feeble is it that frequently there is no vocal sound at all.

Any freedom of tone and absence of muscular tenseness that was present during song has gone and so great is the tenseness that the stammerer is making grimaces in his efforts to produce his words.

Any control of breath during song is entirely absent during speech.

The greater the contrast between speech and song, the greater will be the difficulties of the stammerer: the more he can ally speech to song, the less he will stammer and the better he will be speaking. The better the speaker, the more closely does his speech resemble song.

This matter will be discussed in detail in the following chapters and an endeavor will be made to explain the exact nature of the speech breakdown which we call stammering; whether or not we can succeed in finding the primary cause of the breakdown must be left to the judgment of the reader. Meanwhile we must go back to the first undeniable fact that the stammerer fails to coordinate the functions of the lungs, the larynx and the articulatory organs, which will now be described.

Chapter III

RESPIRATION

ESPIRATION requires careful consideration and some explanation, because it provides the power which causes the vocal cords to vibrate, thus producing the sound

which we call vocal tone or voice; we have an additional interest because many and widely divergent theories are held with regard to the connection between respiration and the stammering habit.

RFrom the time we are born until the moment of death

respiration is continuous and automatic. During sleep it is reduced to the minimum and during violent exercise it is increased to the maximum; it is of the utmost importance that we should realize that when speaking, very little in excess of minimum respiration is required. Since, however, a slight increase above minimum respiration is required for speech, and because speech is closely allied to song for which the maximum expansion may be required (for instance in grand opera when the singer may be accompanied by a full orchestra), we must understand the elementary facts about respiration and how it can be consciously increased and controlled, but we ought to realize that breathing is naturally automatic and that conscious control is advantageous only under special circumstances. Violent exercise will automatically compel maximum respiration; this fact will be thoroughly appreciated by anyone who has had to run a considerable distance to catch a train!

Deep breathing has a definite health value, especially in the early morning, so that the lungs may be fully aerated after the hours of sleep during which respiration is reduced to the minimum, but for our purpose we are concerned rather with respiration in so far as it is a factor of speech.

The entrance to the air passage is at the back of the throat and continuous with it is the larynx which will be described in the next chapter. Again, below the larynx and continuous with it is the trachea or wind-pipe which goes down into the chest where it divides into two main tubes, called the bronchi; these divide and sub-divide again and again till they reach all parts of the lungs; but for our purposes we are concerned, however, more with the bony cage which encloses the lungs and the expansion of that cage, than with the lungs themselves.

The cage containing the lungs is called the thorax which must be enlarged by expansion; to allow the lungs to be filled to capacity. The boundaries of the thorax are—the breastbone in front, the ribs at the sides, the spinal column at the back and the diaphragm below; the last-mentioned is a large dome-shaped muscle which divides the thorax from the lower part of the body.

The thorax is expanded laterally by raising the lower ribs with the intercostal muscles and at the same time the breastbone moves forwards. A further word of explanation is needed here because it is not easy to understand how the ribs, which are attached to the breastbone in front and the spinal column at the back, can be moved in such a way that the space which they enclose may be enlarged. If you join the tips of your first fingers together and also join your thumbs so that your hands form a rough circle lying in a horizontal plane, you will get some idea of the position of your ribs after they have been raised. Now, still keeping the tips of your first fingers and thumbs respectively joined, drop your wrists slightly; the circle formed no longer lies in one plane, but it gives you an idea of the position of your ribs before they are raised to expand the thorax.

Vertical expansion is accomplished by lowering the diaphragm so that the front wall of the abdomen is pushed slightly forward; as the diaphragm is raised again, the front wall of the abdomen will be drawn inwards. Any attempt to expand the thorax by raising the shoulders is valueless because the narrowest part of the lungs is at the top and the widest below, therefore to expand the upper part of the thorax at the expense of the lower will hinder rather than help respiration.

Having described the principle of inhaling air we must now turn our attention to its exhalation, the most important part of respiration for us; because it is the breath coming from the lungs which passes between the vocal cords, thereby causing them to vibrate and thus produce vocal tone.

Breathing out or exhalation is mostly governed by a natural recoil of the lungs which tend to contract after inflation. This recoil of the lungs is further accelerated by the recoil of the thorax, the bones of which tend to return to their relative positions before expansion. Unless this recoil of the thorax is controlled, the breath may flow between the vocal cords too quickly, in which case vocal tone will be diminished instead of being increased.

It is essential that the reader should realize that an increase of breath will not necessarily produce an increase of tone volume. Control of the breath is far more important than volume of breath. The most difficult problem in voice production is to preserve the balance between vocal cord control and breath control. The reader is once more reminded that very little breath is required for speech in excess of what is required when sleeping or sitting still.

The amount of breath required when at ease is called tidal air; that extra amount of air—which can be forcibly inhaled is called complemental air; that which can be forcibly exhaled is called supplemental air. Complemental air will be needed for singing, more especially in a large hall with a full orchestra; for public speaking very much less will be required, while for ordinary conversation the amount of complemental air necessary is almost negligible.

For singing the lateral expansion should be maintained all the time, while inspiration and expiration will be automatically controlled by the action of the diaphragm. By this method we are able to breath with an enlarged lung capacity, although respiration is controlled by the normal action of the diaphragm which is automatic. For lecturing it should be sufficient to stand very erect; this will slightly enlarge the breathing capacity and

should provide ample breath; it is not necessary consciously to maintain the lateral expansion.

For ordinary speech so little complemental air is needed that conscious control of the lateral expansion is likely to do more harm than good. As we have seen, our breathing is automatic and there should be a very good reason before an attempt is made consciously to control it.

“Little and often” is the golden rule for respiration during speech. By breaking sentences into short phrases, as is done by the normal speaker, we get an opportunity of taking a little more breath at the end of each phrase, that is to say, after every few words. Short phrasing is instinctive for the average speaker in ordinary conversation. By this means we have frequent opportunities for taking breath and therefore experience none of the discomfort and dryness of the throat experienced so often by public speakers, who use phrases which are too long, with the result that they have to use not only tidal air to reach the end of the phrase or sentence, but often find it necessary to draw on supplemental air. Short phrasing makes speech more comfortable for the speaker and far more intelligible to the audience.

The above remarks apply to normal speech, and explain the part played by respiration as the power which causes the vibrations in the larynx. The misuse of respiration by the stammerer will be considered in a later chapter, in which his failure to coordinate respiration, the larynx and the articulatory mechanism will be discussed in detail.

Chapter I V

THE LARYNX

S the intention of the following chapter is to explain the part played in the production of vocal tone by the vocal cords, no attempt will be made to give a detailed

description of the larynx; it would serve no useful purpose and would merely tend to distract the attention of the reader from the vocal cords themselves and the method of their control. Those who wish for further details are referred to my book, Your Speaking Voice and its Possibilities, while anyone who wants a full and detailed description in medical terms will find it in any textbook on anatomy.

A

To form some definite conception of what the vocal cords are like, think of the stage curtains at a theater; they are joined at the top even when fully drawn back to expose the stage, or they can be drawn together so that the edges meet and completely obscure the stage, shutting it off from the auditorium.

Think of the vocal cords as a pair of muscular curtains meeting at the front, being attached to the thyroid cartilage or Adam’s apple. These curtains can be opened widely for respiration so that the air passes into the lungs and is exhaled without any obstruction. Or for the production of vocal tone they can be drawn together so that their edges are approximated and they shut off the windpipe from the throat.

When the vocal cords are drawn together, the breath exhaled from the lungs is forced between them, causing their edges to vibrate: this vibration is called vocal tone.

Whereas the theater curtains are drawn back by cords fastened to their sides, the vocal cords are opened and closed by the arytaenoid cartilages to which their extremities are attached. These are like three-sided pyramids, which, moving freely on

their bases, by rotatory movements, not only open and close the vocal cords, but increase and decrease their tension, thereby changing the pitch of their vibration.

The vocal cords are controlled by a muscular system which, in turn, is controlled by the mental conception of the vocal tone required.

This is one of the most important facts in our chain of evidence and to make it clearer we will use another wording. The vocal cords are not under the control of the will, but are controlled by our mental perception of the sound they make.

In a later chapter the importance of this fact and the light it throws on the stammering habit will be discussed. Meanwhile there are other facts about the vocal cords which we ought to know.

In the case of musical instruments, of which the larynx is one, the power must be in proportion to the vibrator. As an illustration, think of the varying weights of the bows used respectively for a violin, a cello and a double bass. If the power (the breath) that drives the vibrator (the vocal cords) is too powerful and out of proportion, the vocal tone will suffer in quality. In the case of the human voice quality depends on the full use of the resonating cavities, to be explained later, which amplify the tone produced in the larynx and supply the harmonics or overtones, which make the voice-tone full and “round” instead of thin and reedy.

If the voice is perfectly produced, the whole of the thorax is converted into a musical instrument, inasmuch as all the bones of the thoracic cage will act as resonators supplementary to the vibration in the larynx. It is by this means that the voice is reinforced, gains in musical quality and carrying power, and gives an impression of power and personality. In addition to thoracic resonance, the top of the head, the forehead and the cavities round the nose all contribute to and help to “fill up” the original tone.

The valuable contribution of these auxiliary resonators can be hindered or even entirely frustrated by constriction of the throat above the vocal cords; it is therefore essential to learn what is called the open production, if full use is to be made of the voice.

Open production is impossible unless the pressure of the breath is so regulated that there is never a shortage or an excess over what is required to cause the laryngeal vibration.

If the breath is exhaled from the lungs too quickly by the natural recoil of the lungs and the thoracic cage, an instinctive effort will be made to assist the control of the breath by closing or partly closing the pharynx (the back of the throat) above the vocal cords. Any tendency to this closure must be overcome if we intend to make full use of our voices. We now see the importance of controlling the breath so that it reaches the vocal cords with the correct pressure to cause vibration. The larynx is a delicate machine, intended for the production of vocal tone; it must not be misused by allowing too great a force of breath to reach it.

Having stressed the fact that we are not bivocal, and having urged the application of the principles of singing to speech and vice versa, it is necessary to mention the need of breath control in connection with the function of larynx, even though our subject is the use and misuse of the voice in speech. It is obvious that breath control by the intercostal muscles is an absolute necessity if the larynx is to do its work perfectly and have the support of the auxiliary resonators for singing. We must not, however, lose sight of the fact that, whereas the utmost expansion and control will be necessary for singing in grand opera, for ordinary speech so little breath is required in excess of tidal air that conscious control cannot be required unless the circumstances are exceptional. In the case of stammerers circumstances very often are exceptional; many stammerers form the habit of breathing far too deeply in their attempts to speak. This is often the result of well-meaning but misguided advice. The greatest hindrance to the correction of a stammer is very frequently a deep-rooted habit of taking in enough breath for a long-sustained and high note in grand opera, whereas the amount of breath required is so little more than tidal air, that its inspiration should be automatic and conscious control is quite unnecessary. This will be discussed again fully in a later chapter.

It is impossible for people to judge the quality of their own voices; very often a constricted tone will sound better to the user

than the free open tone with all the resonators working perfectly. The reason of this is that we hear our own voices directly, the vibrations being carried by the bones of our heads; other people hear our voices only after the vibrations have traveled to them through the air. It is necessary to have the advice and guidance of a reliable voice producer who, by giving a criticism from time to time, will keep the student on the right road.

For those who cannot get advice and must rely on their own judgment, the best general test of correct tone is a feeling of absolute effortlessness in its production; it should be as easy and effortless as the emission of sigh. A first indication that the tone is being produced properly is the vibration of the breastbone, which should be clearly felt with the tips of the finger.

We have now considered correct breathing and the correct use of the larynx; the result of the combination of these will be correct vocal tone, resonant and clear with an open production. Our next chapter will describe the moulding of vocal tone into words.

Chapter V

VOWELS AND CONSONANTS

E are now going to consider the contribution of the mouth to what we call speech. Its work is twofold, as the first resonator, and as the machine that moulds

vocal tone into words and sentences. Its importance as a resonator cannot be overestimated, but since it is our object to explain the mechanism of normal speech with a view to helping the stammerer to break his habit, rather than to improve the average speaker, we must leave the consideration of the mouth as a resonator and pass on to its function as the articulatory mechanism.

W

The speech sounds are divided into twenty five vowel sounds and twenty-seven consonants; a full list of them is given on following pages. It will be seen that the vowels fall into three groups, monophthongs or single vowels, diphthongs or double vowels, and triphthongs in which there are three vowels linked together.

The consonants are divided into two groups, explosives and continuants; both these groups are divided again into two, aspirate and vocal. For instance, sound a prolonged “F” (a hissing sound made by the breath passing between the upper teeth and the lower lip) if, instead of sending air through this narrow aperture, vocal tone is emitted, the “F” will be changed into “V”.

We are not concerned with the details of sound formation, those who are so interested will find the matter discussed in the fullest details in my book, Your Speaking Voice and its Possibilities. It is our object to understand the general construction and mechanism of normal speech.

The vocal tone produced on the larynx is formed into vowels and consonants as it passes through and out of the mouth. By changing the shape of the cavity of the mouth, either by different positions of the tongue or by opening the jaws to varying extents, fourteen different vowel sounds can be made, these are combined together in a further eleven compound vowel sounds. The widest of the vowels is “AR” and the narrowest is “OO”, that is to say, the vocal tone has absolutely free exit in the former, whereas in the latter case, the emission of the tone is reduced to the proportion of a consonant “W”.

(List of English vowel and consonant sounds is not included here.)

For the pronunciation of the consonants, emission of the vocal tone is either very restricted, as in the case of M, N or V, or it is completely interrupted, as in the case of D, B or G. In the case of the aspirate consonants the emission of vocal tone is suspended so the consonant is sounded with breath which has not been vocalized in the larynx, that is, the breath has passed through the larynx with the vocal cords widely divided.

Speech, then, consists of the emission of vocal tone in varying degrees of freedom (the vowel sounds), and the further restriction of tone or its total suspension (the consonants). The problem is to keep the ideal balance between vowels and consonants, but since it is the vocal tone which has individuality, carrying power, musical quality and which carries the rhythmic swing of the sentence, some preference should always be given to the vowels. There is no doubt that the best speakers and the most pleasant to listen to and easiest to understand, are those who sound their vowels clearly and fully. On the other hand, speech with over-stressed consonants gives no pleasure and is difficult to hear. It is a fallacy to claim that audibility depends upon stressed consonants; to emphasize an unfamiliar word stressed consonants have some value, but there is a great difference between distinctness and audibility; the former depends on consonants, while the latter depends on the carrying power of the voice, the clear sounding of each vowel to bring out its individual character and the rhythmic swing of the sentence or phrase.

There are essential similarities between speech and song; for the latter, vowels (which carry the vocal tone) must predominate. If our aim is to speak musically and with rhythm the vowels will receive a certain amount of preference over the consonants.

Broadly speaking, the vocal tone has free exit from the mouth during the sounding of the vowels, while it is considerably restricted during the pronunciation of the consonants: another very important link in our chain of evidence. Remember, it is always in the consonants that the stammerer imagines that he finds his difficulties.

Any attempt to sing necessitates concentration on the production of vocal tone, which has free exit during the sounding of the vowels. The stammerer can sing without any difficulty.

So much then for normal speech in the average case and some hint of how it may be improved. The next chapter will describe the mannerisms of the typical stammerer.

Chapter VI

THE STAMMERER’S SPEECH

N the earlier chapters we have considered in some detail the factors which are combined in normal speech, the speech of the average person. The way is now clear for the most

interesting and important aspect of our subject, the consideration of the speech of the stammerer. First of all we must remember that the stammerer is not unable to speak, but that under certain conditions and for a few seconds at a time, his speech fails him. It is probably a fairly accurate estimate of the average case to say that his speech is at least ninety per cent efficient.

I

If a child is liable to faint, it is not necessary to wait for a fainting attack for the doctor’s examination; he examines the heart in its normal condition in order to account for its partial breakdown during a fainting attack. I am constantly asked to listen to detailed descriptions of what a boy does during a stammering attack; such details are of no importance, what does matter is how he speaks when he is at his best, for this will reveal the weaknesses in coordination that make speech failure in a stammering attack possible. We shall find that there are very definite characteristics which are common to very nearly all cases of stammering.

1. The Stammerer Speaks Too-FastAs we have seen, speech depends on the coordination of three

factors all of which are controlled by muscles—respiration, the approximation of the vocal cords and the movements of the tongue, jaws, lips and soft palate. In a similar way, walking and

running depend on the coordination of muscular movements, but this does not mean that two men of the same age, height and weight will be able to run a hundred yards in the same number of seconds. For each of us there is a limit to the speed at which we can control muscular movements, beyond this limit we cannot go without the risk of a breakdown. Typewriting and piano-playing offer good illustrations; to exceed the speed at which we have control, is to invite a breakdown—we shall begin to stumble with our fingers.

Some people can talk fast without losing a high standard of tone production, clearness and audibility, but they are above the average and must be reckoned as exceptional. Some of the announcers at Broadcasting House can, when necessary, speak fast, but we must remember that they are experts, they have a control of voice production and pronunciation of vowels and consonants that is far above the average. The stammerer whose safe speed is far below the average, attempts a speed far above it. The stammerer calls the speed of the announcer slow; it is slow compared with the speed, or rather the attempted speed, of the stammerer, but the fact remains that the announcer can not only speak but he can be heard and understood, while the stammerer’s intermittent speech failures make his opinion about speed of no value.

2. The stammerer uses a high pitch and a light vocal tone.We have noted in a previous chapter that it is easier to control

a low medium pitch than high one; the low pitch requires less tightening of the cords and consequently less breath pressure, and therefore less effort.

A light, breathy vocal tone is the result of failure to approximate the vocal cords correctly; it means that some of the breath, instead of causing the cords to vibrate, is merely escaping between them and is being wasted. As we have seen in a previous chapter, this is due to a loss of balance between breath pressure and vocal cord resistance. By this loss of balanced proportion the stammerer is using more than the average amount of breath, but is producing less than the average amount of vocal tone with it.

3. The Stammerer Breathes IrregularlyThe stammerer shows breathing irregularities in three different

ways. First, by a sudden exhalation, so violent that it is audible although it is producing no vibration of the vocal cords; the lungs are in a state of empty collapse with no breath supply with which to finish the sentence. It is this familiar habit of the stammerer that causes the well meaning schoolmaster wrongly to urge his pupil to take a deep breath before beginning a sentence.

Here again we have another aspect of lack of cord resistance, in this case so marked that the cords are wide apart when they should be approximated; it is a further development of failure to close the cords by the only control, that will close them, the mental picture of the tone required. The schoolmaster, with the best intentions, makes matters worse by insisting on such a supply of breath, without any attempt at intercostal control, that cord resistance is hardly possible, except for the production of a very high note in grand opera.

Secondly, the stammerer often holds the breath after inhalation and before exhalation. This forcible closing of the vocal cords is due to having taken too much breath; for speech there is no need for such a supply of breath that conscious control is necessary or advisable.

Both these breathing irregularities are really caused by taking in too much breath. It is essential to remember that we want a very little breath for speech, but we want an adequate cord resistance. Remembering this essential balance between cord resistance and breath supply, we see how breathing irregularities are linked up with use of breathy tone.

There is a third type of breathing fault—a sudden spasm of the diaphragm just before beginning to speak. This sudden “catch” can be distinctly felt if the hand is placed on the abdomen; a similar spasm is felt during an Attack of hiccups, and the same “catch” of breath is experienced if we are suddenly startled and frightened. The fear factor will be discussed presently, but there is little doubt that fear causes the spasm of the diaphragm.

4. The Stammerer Speaks Jerkily instead of Smoothly and Evenly

If you listen to a small child playing a tune on the piano and using only one finger, there will be no continuity of musical sound. The musical term for this is “staccato”, and it is in strong contrast with a smooth continuous flow of sound, the musical term for which is “legato”. It is convenient to use these terms—staccato and legato in describing speech rhythm. Normal speech is legato, but the speech of the stammerer is staccato to a marked degree, so much so that while speaking he gives the impression of frequently breaking into the vocal tone, frequently stopping and re-starting.

To understand this jerky speech even better, try this experiment. Make up a sentence and speak it with every consonant very much overstressed. You will notice that the more you exaggerate the consonants, the more will the continuity of vocal tone be lost; your sentence will have lost all its rhythm and tune and will have deteriorated into a sequence of ugly explosions. In other words, the stammerer over-stresses his consonants at the expense of his tune, which is carried in the vowels. By using a staccato rhythm he has lost the rhythmic swing of tone which carries on the tune of the sentence from each word to the next one. Over-stressed consonants rob speech of its natural legato rhythm and musical quality. This way of speaking is usually a form of affection; at best it is an indication that the speaker has taken a course of lessons from an inefficient teacher of elocution.

5. The Stammerer Shows Sign of Tenseness in his Face Muscles

This is a further development of overstressing the consonants. Test this for yourself by saying your sentence over again while you look at yourself in a glass; if you exaggerate enough you will see that you actually make grimaces. The truth of the matter is that a very slight movement of the face is sufficient to enable you to speak plainly. The ventriloquist proves that clear and audible speech is possible in a large theater without any visible movement of the face. Watch the average person speaking with a cigarette in his mouth; all the time he is speaking the cigarette is flapping about, yet the ventriloquist can sing a song with a

cigarette in his mouth and can keep it still all the time. So much then for the typical mannerisms of speech which can be noticed in nearly all stammerers; here they are once more.

1. Talking too fast.2. Using too light a tone on too high a pitch.3. Breathing irregularly.4. Speaking staccato instead of legato.5. Tightening of the face muscles.Numbers 2 and 3 can be taken together because they are

mostly cause and effect, while the same can be said of numbers 4 and 5. We, therefore, reduce our stammerers characteristics to these.

1. Talking too fast.2. Failing to use a firm tone of voice.3. Speaking in jerks instead of smoothly.Think now of the speech of a small Child when learning to

talk; they all try to talk too fast and they all talk with a staccato jerk. It is easy to account for this. The small Child’s idea of words is limited to “Papa”, “Mamma”, “Nana”, “Baba”, “Dada”, etc. A firm open vowel “AR” and a single consonant. From this we build up the complicated system of sounds which we call speech; this is done mainly by adding more and more consonants, thus making the child concentrate more and more on consonants, whereas good speech depends on a balance in favour of the vowels. It is not to be wondered at that the child grows up with a quick, jerky, staccato rhythm. Try the experiment of asking a child to say “splash”; the child will try two or three times, probably make a grimace and finally jerk the word out with a violent movement of the head. It is easy to see why; the only vowel is a short “a” as in “cat”. Before this vowel is a triple consonant and it is followed by another consonant—“SH”.

The efforts of that small child will be identical with those of a stammerer, the repeated attempts, the jerky movement of the head, and the resultant word will sound like that of a stammerer with a “clipped” vowel and all the weight of the word on the consonants. In spite of all these difficulties which have to be overcome before normal speech is mastered, only one per cent

develops a stammer; all the others muddle through somehow and settle gradually down into a normal standard of speech.

The above remarks apply to the typical stammerer, but there are occasional cases of very much more complicated stammering, cases in which there does not seem to be a single factor of speech which is under control nor one which can readily be brought under conscious control. Such cases will most probably defy all efforts to correct them in a reasonable time.

Chapter VII

CAUSATION

E have described in some detail the three factors which are combined in speech, and we have noted some typical mannerisms of the stammerer; we realize

that what may be described as imperfections of speech in the average speaker, have assumed the proportions of definite faults and failure to coordinate in the case of the stammerer. We must now try to find the cause of the habit of stammering; how can we account for it?

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Even though imperfections have grown into faults sufficiently serious to make a stammer possible, these faults do not wholly account for it. There are many people who talk as fast as the stammerer, but they do not stammer. There are thousands of children who hold diplomas for elocution, most of them have little or no musical tone or speech rhythm, they over-stress their consonants at the expense of their vowels, but they do not stammer.

There is one factor in stammering upon which we have not yet touched—the fear factor. That fear plays a very big part in the stammer habit is proved by the fact that however bad the stammerer may be, he can always speak fluently when alone, it is the presence of other people that defeats him. Further indications of fear are found in the speed of the stammerer’s speech; he wants to reach his goal, he gets started and is filled with the idea of getting to the end of the sentence. As has been already stated, fear will account for the irregular breathing, that spasm of the diaphragm with which we are all more or less familiar. Years ago it used to be described as your heart coming into your mouth!

Whether fear causes the stammer or the stammer causes the fear, is a frequently debated question, but whichever is the true

answer, no one will deny that a vicious circle is established—the stammer increases the fear, which in turn increases the stammer. There are those who believe that shock or fright in early childhood is the primary cause of the stammering habit, and that when the fear has been explained away, the stammerer will speak normally. It is, however, difficult to imagine any childhood that is so sheltered that there have been no shocks, no moments of fear. Those who believe that fear is the primary cause of stammering will find it an easy matter to “dig out” an episode to account for it, but the life of a normal child is so full of what appear to be calamities and catastrophies, that it might be difficult to select the one particular episode to be held responsible.

Turning to the alternative theory that the fear is caused by the stammer, I can think of nothing more calculated to set up a fear complex than to find that speech, over which ninety-nine per cent of the population find no difficulty, is liable to break down at any time. What could be more devastating than to realize that one’s particular disability had been made the subject of ridicule again and again in stories and on the stage. That this alternative theory is the right one is indicated by the fact that as the stammer is corrected so the signs of fear and anxiety disappear. Furthermore, there are quite a large number of first-class athletes who have stammered; those whom I have encountered personally have never seemed to be of the nervous type; any signs of fear or anxiety which they betray being connected only with their speech. That there are a few cases in which fear seems to be the primary cause of the stammer is undeniable, but such cases are probably very much rarer than is generally supposed.

There is a widely held theory that the stammerer needs deeper breathing, that his cords will not vibrate because there is not enough breath to cause a vibration. In actual fact, although it is possible that such cases exist, we have seen that the cords do not vibrate because they have not been approximated. It is obviously improbable that the same person who has enough breath to sing (and singing needs quite a lot of breath) will find himself short of a breath supply for speech (which needs very little more than tidal air). As the reader will realize, it is the cord resistance that is

insufficient; many more stammerers are over-supplied with breath than under-supplied. About eighty per cent, or even more, of public school-boys whom I see, have been told to take a very deep breath before beginning to speak. Unfortunately, this seems to be the one correction which the average stammerer learns easily and puts into practice consistently; it often takes a few weeks for the patient to unlearn this acquired habit which, with his weak cord resistance, makes it almost impossible for him to speak without violent efforts and facial contortions.

The theory that unnecessary tension is responsible for stammering is pretty widely held and has led to a regular system of exercises to overcome it. Those who have read the earlier part of this book will realize that tension is present in every normal pupil who is learning to sing or speak, and that it can only be corrected by keeping the balance between cord resistance and breath supply and between the sounding of vowels and the pronunciation of the consonants. As the reader will realize, nothing will contribute to tension of muscles more than having more breath than is needed to vibrate the cords.

Parents often say that their child stammers because he thinks more quickly than he can speak. The fallacy of this theory is very easily shown; read a page of a book to yourself and see how long it takes you; now read the same page again, but aloud this time and compare the times taken reading to yourself and reading aloud. It is obvious that your brain will work at least as fast as your silent reading, but your silent reading is very much quicker than your pace of reading aloud, which is probably about the same pace as that at which you speak. Whenever I am met with this erroneous idea, I suggest that the boy would not be at large if he could not think at least ten times as fast as he can speak. Incidentally, my chief argument in favour of slow speaking is that it gives the speaker so much more time to think.

Connection between Stammering and left handedness. The facts are as follows:—For skilled actions of the hand the control is diagonal, if the child is right-handed, his skilled actions such as writing and drawing will be controlled from the left side of his brain. It is also stated that speech in the case of a righthanded

child is controlled from the left side of the brain. It was thought at one time that to compel a child, naturally left-handed, to write with his right hand, disturbed the control of his speech. It is now thought by most people who have studied the question that there is no proved risk to the speech control. My own experience during the last twenty years tells me that the use of the right or left hand is such a small factor that it will not make the difference between a successful treatment and a failure.

The risk from imitation. There is no doubt that many cases of stammering have developed from the imitation of another stammerer, intentionally for the purpose of ridicule, in which case the development of a stammer is indeed a Gilbertian punishment! In other cases the imitation has been subconscious, but the result equally disastrous. There is a definite risk in permitting association with another stammerer, and for this reason remedial treatment in classes is not to be recommended.

Is Stammering Hereditary? This is a question that is very often asked by young people who contemplate marriage and are themselves stammerers. To answer it, I would remind you how the average child learns to speak; he is not taught by experts, but he picks up speech from those immediately round him. He will naturally learn chiefly by imitation, and if his mother, with whom he is likely to spend a good deal of his time, happens to be a rapid speaker with a staccato rhythm, the child will grow up with the type of speech liable to break down into a stammer. In many families there is a great similarity of speech among the various members. To quote two or three instances, in one family both parents stammered slightly and all the six children stammered. In another case, the father stammered and two sons out of six children required correction. In a family of eight children both sons stammered, one of them very badly indeed; the father had stammered in youth and the whole family, without exception, spoke at excessive speed, so fast indeed that it was almost impossible to understand what they were trying to say. This unfortunate propensity among children to imitate the speech of those around them, whether it happens to be desirable or not,

brings us to the consideration of the most probable cause of stammering in the average case.

How the stammer develops in the majority of cases. We have carefully noted the characteristics of speech which are audible in nearly all cases of stammering.

1. Speaking too fast.2. Failure to use a firm vocal tone.3. Speaking with a jerky, staccato rhythm.We noticed too, that all small children while learning to speak

have similar speech characteristics, and that very nearly all of them stumble over double and triple consonants.

What is it that turns one per cent of these stumbling children into a stammerer? They have all stumbled, all talked too fast, all used the typical breathy vocal tone and all talked jerkily. Ninety-nine per cent find their way to normal speech, but the luckless one per cent, instead of growing out of the stumbling stage, continues to speak with visible effort. Suddenly comes the realization that he has been left behind, that he cannot get his words out; this leads to fear and anticipation of more failure. In this way the vicious circle is formed and the stumbling child begins to be a nervous stammerer. The conscious effort to speak and the determination not to stammer makes matters worse; speech should be without effort and a determination not to fail is in itself a suggestion of more failures to come.

What is it that steps in and prevents the natural mastery of speech in that unfortunate one per cent?

I believe the primary factor in the typical stammer is SPEED.In the last chapter we discussed speed limitations as they

apply to typewriting, piano playing or athletic exercises like running. Some people are capable of speed, while others are not capable of it and to attempt normal speed is to court disaster.

The stammering child fails to grow out of the stumbling stage because he happens to have definite speed limitations. Not only does he attempt the normal, average speed, but as he becomes conscious of his stammer, he tends to hurry still more in his anxiety.

I have never met a former stammerer, who, having successfully corrected his disability, is not slow speaker.

I have never met a stammerer who has not been brought up in daily contact with a very rapid speaker.

I am convinced that speed is the determining cause of the stammer; therefore fear is the result and not the cause.

Chapter VIII

DEFINITION

T is a matter of the utmost importance that we should arrive at a true definition of a stammer, in order to decide by which method it should be corrected, a method that will prove

effective and permanent if properly carried out.I

Stammering is not a disease that can be cured by a physician; it is not a defect, like cleft-palate and hare-lip, which need the work of surgeon or dental surgeon or the combined skill of both to be followed up by speech training. It is bad habit which must be corrected by the stammerer himself by the formation of a correct habit to take its place. The speech therapist will advise and guide him, but he must make the personal effort.

Stammering is the result of a combination of three bad habits in speech.

1. Excessive speed which shortens the vowels and prevents consistent coordination of the muscular movements which are combined in speech.

2. The use of an incorrect vocal tone which upsets the normal balance between breath pressure and vocal cord resistance.

3. Speaking jerkily instead of smoothly; this upsets the normal balance between the production of vocal tone in the larynx, and the formation of consonants by movements of the mouth.

This habit is further complicated by fear and anxiety, the natural consequences of frequent failure.

Chapter IX

TREATMENT

HERE are four definite and widely employed systems of treatment. T

1. Voice Production and Speech Training.It must be clearly understood that identical instruction and

advice are given to an actor, a public speaker and a stammerer. The imperfections in the speech of the actor and public speaker have merely assumed greater proportions in the case of the stammerer, whose lack of balance has been so intensified that it has led to intermittent breakdown, and his speech has become unreliable. In every case the aim of the instructor should be to teach a perfectly balanced speech which secures the maximum result with the minimum effort.

Learning to use a firm, open and resonant tone necessarily increases cord resistance and thus corrects breathing irregularities, it will also go a long way towards building up self-confidence.

Speaking smoothly will bring the vowels into prominence and will soften the consonants, the over-stressing of which have caused so much difficulty. Smooth speech is more easily heard and is more musical and it necessitates continuity of vocal tone. Remember, it is the sudden stopping and breaking off of the vocal tone which is a regular characteristic of the stammerer.

Speaking slowly will further develop the vowels and thus increase the essential similarity between speech and song; in addition to this it assists correct coordination of the factors of speech. It is impossible for anyone to stammer if he will speak on the lines indicated above.

The outstanding characteristic of a stammer is failure to produce the vocal tone at the right moment: the shape of the

sound is made with the mouth, but the vocal tone to be directed into that shape is not produced.

We have seen that the larynx is controlled by the mental picture of the tone required.

By concentrating his mind on a continuous “tune” the stammerer will be able to keep his vocal cords together.

While singing, vocal tone is continuous, and as the speech of the stammerer resembles song more and more, the failure to produce vocal tone will be mastered.

Allowing the vocal tone to stop is a bad habit which can be corrected only by learning to keep the vocal tone continuous.

That it can be done is proved by the stammerer’s ability to sing fluently.

With such a simple and logical method of correction, the reader will naturally ask whether the results are a hundred per cent cure. In the cases where the patient will cooperate with the instructor and is willing to follow his advice, the stammer is quickly and permanently corrected; in a few weeks the trouble is mastered. There is, however, a tendency for the patient to hesitate about making the change of voice tone, speed and rhythm. He is accustomed to his own speech, he does not notice its excessive speed, its breathy tone and staccato rhythm. He feels self-conscious and reluctant to change.

To the normal speaker, and still more, to the expert, this reluctance to adopt a new way of speaking seems merely foolish and obstinate but it really is a very natural result of stammering. When we remember that the normal speaker will feel nervous if he is asked to make a speech lasting for a few minutes, is it to be wondered at that the stammerer (whose unfortunate habit has made him particularly self-conscious with regard to speech) will be reluctant to make a change which necessitates speaking more loudly and slowly? The natural instinct of the stammerer must be to escape notice as far as possible and get his talking over as quickly as possible. To escape notice he speaks in a breathy undertone and rushes through his words at express speed. Unfortunately, both these efforts to escape notice are doomed to failure; not only do they fail in their object, but, by actually

increasing the stammer, more attention than ever is drawn to the unfortunate victim. The patient must be brought to realize that the new voice is the right voice for every speaker: It is not a trick to cure a trick, it is the best way to use the voice, it is more musical, more persuasive and gives an impression of personality and sound knowledge. If he will listen with an open mind to other speakers, he will soon realize that theirs is the better way and that his way is not only inefficient, but is unconvincing and unmusical to hear.

The mental attitude of the stammerer to this treatment is of the utmost importance; to change a long established habit is not easy and requires courage, determination and a genuine wish to accomplish the change; if there is a mental reservation, a wish to compromise or to procrastinate, to delay the change or to keep it for special occasions, the patient had much better be honest with himself and his instructor and postpone his treatment until he is able to appreciate the obvious advantages to be gained by following out the advice of an expert who has made a special study of speech from every angle.

Sometimes school-boys imagine that if they change their voices they will bring upon themselves the ridicule of the other boys; this is contrary to my experience. Many boys have made the change without any comments; anticipation of ridicule is caused by over-sensitiveness and self-consciousness. Even if a few remarks were made, the benefit gained would surely be ample compensation. For his comfort the stammerer may remember that changing the voice is a gradual process and that he and his teacher will probably be the only people who are aware that a change is being made. In any case, surely the conquest of the stammering habit outweighs every other consideration including anticipated remarks which will probably never be made!

The choice is a very simple one:—Keep your old voice and keep your stammer, or change your voice for a better one and lose your stammer: a few weeks of hard work can rid you of your stammer and change your whole life.

2. Relaxation.This method is used very widely, both in London and in the

newly formed provincial speech clinics. For many years the teaching of relaxation was combined with breathing exercises, the assumption being that incorrect breathing was the cause of stammering. During the last few years it has been realized that the teachers of voice production were right after all and that—

Stammering is the cause of incorrect breathing.It is important that the reader should remember what has been

explained in a previous chapter, that the balance between vocal cord resistance and breath supply should be kept. With a view to establishing this balance, attention must be directed towards the control of the vocal cords and the breath supply. With regard to the latter the best advice is to take very little; it is better to take the small amount needed for the vibration of the cords which needs no conscious control, than to take more than is required and have to learn how to hold it back until it is wanted.

The more the vocal cords are controlled, the less breath will be necessary, and it is obviously easier to train the vocal tone which we can hear, imitate and judge than to change our method of breathing which is, as we know, automatic.

We now come to the question of relaxation to correct the habit of stammering. We have seen in the previous chapters that stammering is due to lack of control, which is evident in three ways.

The stammerer lacks1. Control of speed.2. Control of quality of vocal tone.3. Control of continuity of vocal tone.How can Control be Established through Complete

Relaxation?No one will dispute that general relaxation may be beneficial,

but from the stammerer we want effort, effort in the right direction, in which case speech will appear to be effortless.

Stammerers are “tense in body and mind” we are told by users of this system. This is probably true and should cause no surprise if we remember that the stammerer is trying to do everything in

the most difficult way possible. He is trying to produce tone without having approximated his vocal cords; when he succeeds in approximating his cords, he is inhaling far more breath than is required to vibrate them, or he closes them so tightly that no breath or tone can escape.

The stammerer needs training and exercises, so intense that he may need relaxation after his exercises, but it is difficult to see how relaxation can be expected to take the place of training. It is admitted that muscles are being used which should be relaxed, but the first step must surely be to tell the patient what to do and how to do it; we may summarize the position thus—

Correction by relaxation is entirely negative.Correction by voice training is entirely positive.The use of wrong muscles and the tightening up of the body is

well known to every golfer, but the bad golfer needs instruction in what is right, not complete relaxation.

Again we readily admit that tenseness of muscles is the result of speaking in jerks with emphasis on all the consonants; instead of smoothly, with the vocal tone carried through the vowels, but we again remind the reader that the words are uttered smoothly in song and that the stammerer can sing. Why go the long way round and try to teach a legato (smooth) rhythm in speech by learning to relax the arms and legs? There is a definite value in learning general relaxation; it is the best correction of insomnia, but it is very hard to teach or learn, even in the case of people with highly educated and trained minds.

The weakest part of this system is the grouping of stammerers in classes. All stammerers can read in chorus without any difficulty, so to allow them to do so suggests to me “taking the line of least resistance”. As soon as a stammerer has been shown how to speak, he is capable of doing it, and the sooner he makes himself do what he knows he can do, the sooner he will be a normal person with normal control of his speech.

3. Psycho-therapy.As we have already seen, in every case of stammering there is

an undeniable element of fear; this is conclusively proved by the fact that the stammerer can read aloud or speak as long as he is

alone. The Psycho-therapist sets himself to overcome the fear factor, and if he is successful, the stammer will cease. This method is the quickest of all and is complete as long as the fear factor is kept under, but with the faulty speech of the average stammerer left uncorrected, there is an obvious danger of relapse if mental poise should again become upset. To guard against this it should be combined with speech correction so that, not only is the fear eliminated but the door is closed against the stammer for all time.

A great number of stammerers have been cured by this method, but it is not always successful, and if used by itself there is a very considerable chance of a relapse.

4. Elocution.The derivation of this word suggests that elocution teaches the

art of speech delivery, but in actual fact, most of the teachers of elocution are engaged in training children for the stage. With this end in view far more attention is given to the study of gesture and expression than to the basic principles of speech, in fact there is little done in this direction except to teach pupils to emphasize all the consonants. There are very few teachers of elocution who ever mention voice production or who teach the correct formation of the vowel sounds of what we may call Southern Educated English.

With the enormous expansion of elocution as a business there has come into being an examination system whereby pupils can gradually progress from diploma (in various grades) to medals (in three grades) and finally to a teacher’s diploma. This diploma generally contains a statement to the effect that the holder is qualified to undertake the correction of speech defects and disabilities, but as far as can be ascertained, among the various schools of elocution which organize public examinations and grant diplomas to teachers, there is only one in which instruction in speech therapy is given by a specialist in that work and who holds a public appointment.

Since speech training in most of the schools of elocution consists of teaching over-stressed consonants while voice production is entirely ignored, it is obvious that the stammerer

who already over-stresses his consonants and has faulty voice production cannot look for a cure in that direction. There are of course, a few teachers of elocution who are speech trainers and whose help would be of definite value.

The German opinion of the English methods will be interesting, all the more because the percentage of stammering has always been very high in Germany, with the natural consequence that they, as a nation, have given much more careful thought to its correction than we have.

The view held by the Germans is that the essential corrections are in vocal tone, speed and rhythm. With this they couple some psychological treatment, chiefly with the object of persuading the stammerer to make the necessary changes in tone, speed and rhythm; thus, this side of the treatment does not aim so much at the conquest of the fear of the stammer, as at the fear of changing to a better and more reliable way of speaking. They maintain that, even if the fear is overcome, if the speech is left uncorrected, the stammer is still there—below the surface, and that it will come back again.

They emphasize the need for a quick correction and maintain that a slow method is psychologically bad, inasmuch as it suggests to the patient that he has a chronic illness which needs a very long time to cure it. They say that a few weeks should correct a stammerer and that any treatment which necessitates years to effect a result, is unsound.

Chapter X

EXAMPLE AND PRECEPT

HEN a decision has been reached with regard to the type of treatment, much can be done by the parents and other members of the family to expedite the

correction of the stammer; there are many things which the immediate family ought to be able to find out more easily than the speech therapist, who has only just begun making the acquaintance of his patient. For instance, some boys make use of a stammer as a protection against work; many young men have told me quite frankly that, when they were small boys, they found a stammer a very useful screen to cover insufficiently prepared work. Parents should know whether their boys are lazy or industrious; school reports are very often misleading. A bad report often leads to a lot of correspondence, and for this reason bad reports are never sent out from a number of schools. If a boy loafs about during the holidays and can show nothing at the end of the time, it is a pretty sure indication that he does not work at school; if he is always busy with some new idea, learning something or making something, he is likely to be a steady worker at school.

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If there is even a suspicion that the stammer is being used as a defence against work, treatment should be delayed until the patient is genuinely anxious to get rid of his disability. Any unsuccessful treatment is worse than no treatment at all, since it leaves the patient with less confidence in the possibility of correction.

Athletic sons of rich fathers sometimes use their disability to delay the dreaded day when work begins in earnest and there are no long holidays at frequent intervals, and no leisure for daily

rounds of golf. In such a case a few weeks in London for treatment is a pleasant alternative to settling down to an office routine, but it is much better to delay the treatment and get the plunge into work safely over; so that the boy knows the worst; later on, he can be given a few weeks leave from his work so that he may go through a course of instruction. The more the parents can tell the speech therapist about the patient, the better are the latter’s chances of success.

When the treatment actually begins, sympathetic help from the other members of the family may be the deciding factor between failure and success. While it is true that the effort must be made by the stammerer and the correction must be his, it makes all the difference if he is in a sympathetic atmosphere. If he wants to be reminded about his voice, it is very unkind of the family to show complete apathy, yet I have known many cases in which such simple help was withheld because the family were too busy with their amusements to take trouble on behalf of the unfortunate stammerer. Again, there are other cases in which the stammerer is better left alone, he prefers to worry through his correction by himself. It is surely the business of the members of the family to know what is wanted and to do all in their power to help, whether by leaving the stammerer alone or by reminding him of his voice without nagging at him.

The most valuable help of all in every type of case will be for the other members of the family to talk slowly and firmly and evenly. While they are helping the stammerer they will be improving their own speech.

We have seen how large a part is played by imitation; the child learns speech in the first instance by conscious imitation; we see how grown up people unconsciously imitate an American accent or an Australian one. Subconsciously the stammerer will tend to talk like the people around him and apart from this he will appreciate the sympathy that is felt for him in his efforts to correct his faults. I have personal knowledge of many cases in which a stammer has been averted at its first onset, by the efforts made by the parents; no mention of stammering has been made, but the parents have spoken slowly with the happiest results. I

have also personal knowledge of cases under treatment which have been made successful by the patient efforts of parents. I know of actual cases in which failure was the direct result of the gabbling speech of the rest of the family; it is not too easy to speak slowly, but it is made ten times more difficult if brothers and sisters display complete apathy by continuing to speak rapidly although they know that the stammerer is making a great effort to speak slowly.

There are still people who advise parents to leave a stammerer alone, they say that the boy will grow out of it. First of all, there is no reason why he should grow out of it, but if he did it would probably not be until he was over thirty; meanwhile think of the half wasted school years, with constant interference with work and comparative certainty of being passed over instead of being appointed to the office of prefect. The most valuable time during the years at a public school is the year or so during which boy is a prefect; a neglected stammer makes such promotion out of the question except in special circumstances.

It is useless to send a boy for treatment unless he has a real and personal wish to speak properly, it is unfair to the boy and to the instructor, who gets blamed if the treatment is unsuccessful, but it is even more unfair to withhold treatment if the patient is genuinely keen and prepared to do his best.

Chapter XI

THE STAMMERER

HE stammerer must realize from the first that his stammer is a bad habit, nothing more and nothing less; he has got into it and he has got to get out of it. It is not a disease for

which he must seek a cure; it is not a defect to be remedied by a surgeon, it is a bad habit into which he has drifted and the only way out of it is to cultivate a new, correct habit to take its place.

TThe speech therapist can explain the facts of the case and he

can advise the patient how to make the necessary change, but the work has got to be done by the stammerer himself; it means work and lots of it, but the time it takes and the completeness of the correction depend on the courage and energy of the patient.

The task is to change—from fast to slow—from feeble tone to firm tone—from staccato rhythm to legato.

Scores of stammerers have already made this change, some have done it in a couple of weeks, others have failed to do it in as many years. Boys of seven and men of fifty have broken this habit, others of all ages have lacked the moral courage to win, for it is a test of courage. The stammerer must decide whether he is going to change or not; half-measures are useless, the old habit will win every time if there is a hint of compromise. If you mean to keep your old voice, be honest about it and say “No” straight away. Keep your voice and don’t grumble at the price—the possession of a stammer. If you want to get rid of the stammer, pay the price, change a poor voice for a good one, a gabble for audibility, a voice that does justice to your personality, but don’t grumble at some hard work; it is worth it.

From the moment the stammerer can say one sentence with correct speed, correct vocal tone and correct rhythm, he knows that—

he can correct his stammering habit.If he can speak one sentence correctly, he can speak the

others. Below is a sentence which has corrected scores of stammers. “He ordered his men to break down the bridge.”

H D D H S M N T BR K D N TH BR DG

EE OR ER I E OO EA OW E I

The upper line shows the stammerer’s version—all consonants.

The lower line shows what the singer has in mind—all vowels.

Make sounds instead of merely shapes of sounds. There is a pattern sentence; what I have done with that one,

you can and must do with all the others—bring out your vowels. Speak slowly, firmly and smoothly all the time. That is the motto for the stammerer who means to win. Keep at it constantly, try to practice for two minutes in every

half-hour of the day. By practice, I mean “tuning in” to your new voice so that you get used to its sound and the sensation of producing it. Stimulate consciousness, think about it; if you don’t hear your voice when you speak, listen until you do, then listen again! The object of tuning-in is that you may be able to speak the better for it for the next twenty-eight minutes, until it is time to tune-in again. Every time you tune in, focus your mind on the tune of the sentence rather than its words. Every conscious effort is practice, don’t wait until you can find an empty room in an empty house! Force your opportunities; keeping on a firm voice all the time, ask thirty different people the shortest way to your own house! If you want some matches, buy one box in each of twelve different shops, instead of buying a dozen boxes in one shop.

Don’t measure your progress by whether you stammer or not, but by whether you keep to the right speed, tone and rhythm. You did not always stammer before, so the presence or absence of a

stammer during one day tells you nothing, it is a change of voice which will correct your stammering habit.

The most valuable practice is with your family, especially if you are at your best with them, that is the time when you can concentrate on your voice and keep to it; they are the people who can remind you if you forget your voice.

If you are a cricketer and wish to improve your batting, you get someone to coach you and you practice your strokes in the nets; you don’t keep your new strokes for the most important matches; you get used to them in the nets, so that you have full confidence in them when you play in the match. Do the same with your voice, get used to it until you trust it and eventually it will come naturally, it will be your voice, the only way you can talk; by that time you will have lost your stammer, your muscles will work smoothly, the former jerky movements will have been lost and you will have forgotten how to stammer. Every day you keep on your new voice is a good day, do it every day, every week till you have formed a new muscle memory for the right way of speaking, instead of the old wrong way.

Some stammerers are anxious to learn things which may help them, they will suggest learning to sing because it may improve their speech. Don’t be content with parallel roads, the direct road is the one for you if you mean to win.

Above all things remember it is your voice, your speed and your rhythm you have to correct; when you have done this your stammer will have gone. The stammer is the result of second rate speech; it is the proof that you had much to learn about speech. Correct the faults and the stammer will disappear automatically.

Get interested in good speech for its own sake; you are interested in doing other things in the right way. Why be content with second rate speech, your chief way of expressing yourself and your thoughts to other people. Read Your Speaking Voice and its Possibilities, a book written to help the man who is above the average, and who has to address meetings and make speeches. He wants to do justice to his personality, you want to do the same.

When you have won, and you will win, you will have done far more than correct a bad habit of speech; you will have proved to yourself that you have courage and determination, that you can meet and surmount difficulties. You will then be a proved man, ready to undertake further tasks and more responsibility. When you have proved your power to control yourself, you will be equipped to control other people.

Remember you are following a certainty; correct your voice and your stammer will leave you.

Chapter XII

CLEFT PALATE SPEECH

T must frequently have been the experience of parents to find that, after a cleft palate has been completely closed by a surgeon or by a denture or by a combination of the two, the

dull muffled tone, that is generally associated with this defect, still persists. There are a few patients who are naturally adaptable and are able to find out for themselves how to readjust their speech and thus take full advantage of the skill of the surgeon, but the majority have no idea how to begin; many of them do not realize in what fundamentals their speech is abnormal and defective, and therefore have no idea what has to be corrected and how it is to be done.

I

There are two definite defects:The vocal tone is dull and muffled and the consonants are

indistinct, especially: P, B, T, D, K and G. In the normal speaker the speech function of the soft palate is

to open and close the nasopharynx (the passage upwards to the nose). To open it the soft palate is drawn downwards and forwards, and to shut it the soft palate is drawn upwards and backwards. In cases of cleft palate the soft palate is frequently too short to reach back to the back wall of the nasopharynx, while in cases in which the soft palate has been surgically joined, its movements are very often considerably restricted by the presence of scar tissue.

The first effect of this inability to close the nasopharynx is that the vocal tone passes more through the nose than through the mouth, and for this reason has an abnormal and ugly resonance. The second is that it is impossible to articulate some of the

consonants in a normal manner, more especially in the case of the explosives, P, B, T, D, K & G.

All consonants necessitate some degree of breath pressure in the mouth, more particularly the explosives, but any such pressure is impossible until the nasopharynx can be closed. Until this is done it is impossible to prevent an escape of breath through the nose before and during the release of breath through the mouth, which release is itself the consonant. To explain more fully, for P & B the breath is released by the lips; for T & D it is released by the tip of the tongue behind the upper front teeth; for K & G it is released by the back of the tongue and the soft palate. Now it is the different position of release of the above consonants which enables us to know one from the other, but if during such release there is in each case an audible escape of breath through the nose, it is obvious that all will sound alike.

The first essential then is to learn to close the nasopharynx; this can be done in two ways, first by increasing the movement of the soft palate and secondly, by hyper development of auxiliary movement of the back wall of the nasopharynx. In plain words we must make the soft palate move more freely backwards towards the back wall of the nasopharynx, and, if it is still unable to meet the back wall, we must make the back wall move forward to meet it; somehow or other we must contrive to make this closure before we can make a normal explosive consonant.

When the cheeks can be puffed out, normal speech is possible. If the cheeks can be puffed out, it is obvious that escape of breath through the nose has been prevented by closure of the nasopharynx. Blowing up toy balloons, blowing out candles at increasing distances and whistling all depend upon pressure of breath in the mouth. Nature is extremely resourceful and inventive and persistent efforts to do the above exercises will be rewarded with success. There are several other ways in which the escape of breath through the nose can be prevented, nature will find these ways in answer to the effort made to do the exercises and, most important of all, to puff out the cheeks.

Having learned how to close the nasopharynx the first essential has been mastered, but it is very important that the

patient should stimulate consciousness of what he is doing; he must make a mental note of the sensation of the closure in order to apply it to speech. He must link up exercises and actual formation of consonants.

Full details about the correct positions of all the English consonants will be found in my book, Your Speaking Voice and its Possibilities. The patient will have to work hard to learn the correct formation of each consonant, but he may be quite sure that it can be done and that success will be in exact proportion to the amount of work he does.

As we have seen in previous chapters the outflowing vocal tone is interrupted chiefly in the consonants, in other words, more breath pressure in the mouth is needed for the consonants than for the vowels; therefore the greatest test of skill for the cleft palate patient is the correct articulation of the consonants. If he is keen he will not be satisfied until he has learned to make every consonant perfectly. It is a lengthy task but it is worth while to get it right.

So far we have considered the greatest speech difficulty for a cleft palate patient, the articulation of the consonants; we must now turn our attention to the vowels, which although they present very much less difficulty are of far more importance. They present less difficulty because, as we have seen in a previous chapter, the vowel shapes are made by movements of the tongue and by opening the jaws to a greater or less degree. It is evident that the cleft palate will not affect the vowel formation itself. In most cases the vowels are suffering more from neglect than from faulty formation. It is only natural that the consonants which presented particular difficulties should have claimed the chief attention, but we must remember that audibility depends on the vowels far more than on the consonants; the aim of the patient being to speak audibly, he should now turn to an easier but more important task, the study of the vowels. Audibility depends chiefly on clear differentiation between the twenty five vowel sounds. The complete list is on tables given previously and it will repay careful thought and study.

The shortened soft palate will only affect the vowels inasmuch as it will impart an unusual quality of resonance; it is this point which will receive attention now that we are passing on to consider voice production in relation to cleft palate. If the consonants are correctly articulated as a result of learning to close the nasopharynx, there will be particular difficulty about getting normal mouth resonance for the vowels, and general vocal tone.

For tone production the first thing to be learnt is to open the throat to its fullest extent by raising the soft palate as it is raised when yawning; this will increase the flow of vocal tone through the mouth and decrease the escape of it through the nose. Much can be done, too, by development of chest resonance, the chest acting as a sounding board for the vocal tone produced in the larynx. The violin offers an excellent illustration of the importance of a sounding board, since the quality of the tone depends, not on the string which can be bought for a few pence, but on the violin itself, which is ninety percent a sounding board. So with the voice, the tone produced by the vibration of the vocal cords depends for its quality on the development of resonance, both thoracic and what is contributed to it by the resonating chambers, i.e. the mouth and nose.

One of the most important factors in voice training is to bring chest and nasal resonance into their right proportions. In cases of cleft palate the tendency must always be for nasal resonance to predominate, but the control of the soft palate necessary to form the consonants should be quite sufficient to direct the vocal tone forward through the mouth instead of upwards through the nose.

As has been already explained, voice and vowels are far more important than minutely correct consonants, therefore the patient should first concentrate on the consonants and learn to form them and when this is completed, he should ignore his consonants as far as he can and concentrate on the flow of the vocal tone and the clearness of the vowels. The first is the hard part, but it is the latter which though far easier is much more important, since the aim of the patient is to speak audibly and as normally as is possible.

It is difficult to suggest a definite age at which a patient should consult a speech therapist, because success must depend to a large extent on the efforts of the patient, but there are great advantages in an early start. When the child is about five years old the mother or nurse, under the supervision of an expert, can do a great deal to accelerate the mastery of the consonants, and thus prevent the habit of nasal tone becoming very deeply fixed, but the chief effort should be made when the patient himself has a wish to speak normally. The amount of time needed depends on the quickness and adaptability of the individual, but even when the speech has been corrected it is wise to keep in touch with the speech therapist, for the sake of occasional criticism and advice. As a general rule, therefore, it is a good plan to get some help in childhood but to concentrate when the patient has the personal wish to improve; this will be at the age of 16 or 18.

As has been emphasized already, adaptability plays a very large part in speech correction; this is clearly shown by the ability of some patients to speak almost equally well with or without their dentures. It must be clearly understood, however that a high standard of speech is only made possible in the first place by a satisfactory denture or surgical procedure, adapt-ability merely enables the patient to achieve the high standard made possible by the denture.

Anyone who has been surgically or prosthetically treated for cleft palate can learn normal or very nearly normal speech by hard work and consistent practise on these lines.