Report On Donald (1948)

[Music] This is A summary report on Donald Carter, who attended the University of Minnesota Speech Clinic from September 30th to December 11th. Carter came to the university in the spring of the year and had hoped to enter the College of Science, Literature, and the Arts. His grade of 93 in the entrance examinations indicated that he was ready to begin his college work. As do all incoming students, Donald took the freshman speech examination and because of his severe stuttering decided to devote all of the first quarter and more if necessary to the speech clinic. I saw him first when he came to my office for his in I'm Dr. Boyd. Won't you sit down? [Music] Thank you, sir. Tell me, when were you first aware of your stuttering? How about the [Music] third grade? And then did it become worse? Yes, it did. in in high school. I hated to recite. >> Did you ever fail any courses or have difficulty with examinations? Well, I did it have some trouble. Donald then told me of the difficulties he had encountered because of his stuttering. In the classroom, Donald, like many stutterers, did everything he could to avoid oral recitation. for example, in a written examination, he gave correctly the capital city of Argentina. But when called upon by an unsympathetic teacher to answer the identical question orally, he feared he might stutter and be ridiculed by his fellow students. Therefore, rather than attempt to give the answer he knew, he said simply, "I don't know." This teacher, who lacked insight into Donald's stuttering, accused him of being lazy and perfectly able to answer if he only wanted to. The same lack of insight was evident in the actions of his fellow students. Such a failure of others to understand the problems of a stutterer only served to convince Donald that he was not one of the group. For this reason, he became isolated from his classmates. He felt his speech defect very keenly. He was torn between the desire to join the group and not join it. He was so conscious of his stuttering that others began unconsciously to agree with him. He was different. Then as time went on, Donald began to avoid speaking to others as much as possible, especially to talkative persons who were likely to ask many questions. He even tried to escape from speaking to such people by crossing the street when he saw them approaching. When shopping, he would go to a store where he wasn't recognized and where clerks were too busy for conversation. He also found it easier to write notes to handle the clerk, thus avoiding entirely the necessity of speaking to them. Because of his fear of stuttering, Don tended more and more to avoid social contacts, retreating into a world of books. He even refused to answer the telephone. It was at this point, when he was generally discouraged and dissatisfied with himself, that Dawn first came to the clinic. Well, Don, I think we can help you. What do you say we take a look around the clinic and meet some of the people you're going to be working with? >> Fine. >> I think you'll find it interesting to learn something about these speech disorders because you'll be meeting these people from time to time. Let's stop here for just a minute now and look at this chart which shows the organization of the speech clinic. This is the group I was telling you about. For example, we have cleft pallet cases, foreign accent cases, and here's the aphasia group which we're going to visit first. There are many forms of aphasia. It is generally caused by damage to the brain as a result of a lesion or a cerebral hemorrhage. This frequently results in a partial or complete inability to speak or to understand spoken language. Let us now observe a clinician working with a student who has a cleft pallet. Cleft pallet is a congenital failure of the roof of the mouth to form properly resulting in defective speech with a marked nasal quality. Speech training begins only when the medical specialist has achieved the best possible closure between nose and mouth cavities. >> Once there was a young rat named Arthur who can never make up his frighting mind. Whenever his small friends used to ask him to go out play with him, he would only answer. >> In contrast to students with actual speech defects, many foreign students on the university campus come to the speech clinic for help in improving their pronunciation. This Chinese student has particular difficulty with the L and R sounds. >> Where shall I go to buy where oil? We know that Ella will appear today. The lion is alive. They are easily. >> My chief difficulty seems to be in the quality of my voice. The thought specialist told me that my vocal bands do not quite come together. This gives my voice a harsh quality. He seemed to feel though that if I would work in the speech clinic, my voice might be improved. A very important phase of the work in the speech clinic is the training of students who are planning to become speech clinicians. The two student clinicians at the right are not only able to observe clinical therapy as in this case with a cerebral paly student but will later get experience in working with people who have various types of speech disorders under the supervision of staff clinicians. A person with cerebopal paly frequently has an associated speech defect. In most cases, this person is born with a brain injury that causes a state of muscular incoordination in some parts of the body. This lack of coordination is frequently evident in the speech mechanism. >> Imagine a movie was munching popcorn and very move how many >> the speech personality groups are made up of students with no obvious speech defects. However, they feel extremely inadequate in speaking situations and may have stage fright or feelings of self-consciousness. They come in for group psychotherapy. In the speech clinic, hearing difficulties are detected and measured with the audiometer and speech amplifying equipment. Many veterans who experience loud explosions and gunfire have received damage to their hearing mechanism. In the general population, approximately one person in 10 shows a marked hearing loss. Chronic loss of hearing often affects individual speech. So that training is necessary to preserve as nearly as possible the normal speech patterns. If a hearing aid is recommended, the individual is fitted with a suitable instrument chosen from several kinds available and he is then referred to that company's representative for purchase. Auditory training and lip reading instruction are also provided for heart of hearing cases. Using a special glass partition between two rooms, the clinician is able to speak naturally and still not be heard by the students attempting to read his lips. Training in these skills is valuable either in place of hearing aids or as a supplement to them. The speech clinic has a mobile unit financed by the Minnesota Association for Crippled Children. These clinicians are conducting a statewide survey of the speech and hearing needs of Minnesota school children testing many thousands of children during a year's time. Findings are made available to parents, to school authorities, and interested professional groups. Well, from our little tour of the clinic, you will see that quite a variety of cases are handled here. Now, uh before we join the stuttering group, are there any questions you have about your own problem? Well, uh what causes me to stutter? Well, Don, the best scientific minds in the world can't answer that question entirely. However, there are many things known which would tend to cause stuttering. Do you cure people? Most of our stutters become much more fluent. However, in your case, as with all of our stutters, what we want to do is to make you a more acceptable stutter. That means dropping out all the facial contortions and the long blocks that you have. Now, I think that if we can do that, we can help you help yourself make a better social adjustment. >> Donald began his work in the clinic by meeting the staff clinician in charge of the stuttering group. He was then asked to introduce himself to the other stutterers with whom he would be working. The fact that there were others here with the same problem gave him some comfort. He experienced relief to be able to admit he stuttered, although it was difficult at first. The first few days of the course were devoted to the identification of stuttering spasms. This was partly accomplished by working before large mirrors, so that for the first time, Don watched himself stutter. In addition to observing himself, he checked the facial contortions and other mannerisms called secondaries of a fellow stutterer. This student was asked to stand before the group and describe to the class what he did when he stuttered. When I stutter, I always squint my eyes. The mirror sessions help the stutterer to recognize the characteristics of his stuttering patterns and thus know what he must learn to eliminate. Stutterers also learn something of how these contortions develop by exploring their earlier experiences to find out what they did to avoid stuttering. Don, for example, remembered that when he was a young boy and was just becoming aware of his stuttering, his mother was worried about his speech and tried to help him. When she heard him stutter, she would tell him to lick his lips in order to avoid the block. She had heard somewhere that this helps to cure stuttering. She might have spared herself on the boy much anguish in months to come, had she sought out a qualified speech correctionist for advice. In any case, Don began licking his lips when he had speech blocks, and it actually did help for a while. But as time went on, the lip licking seemed to lose its effectiveness, and so he almost unconsciously began to use other tricks to get out of the stuttering spasms. Unfortunately, as these devices wore out, he was left with wellestablished facial contortions and breathing disturbances, which were much more noticeable than the original stuttering. What started out as easy sound repetitions developed into severe blocks involving many muscles of the body. Other stutterers were also able to remember well-intentioned advice given by their parents. One, for instance, recalled how his mother told him to speak very slowly in order to avoid stuttering. Again, this method helped for a time, but as in Dawn's case, it only produced more serious results later. I don't think it has helped me to to to talk slower. Don and other members of the group were given various tests to determine their native-handedness. Among them, the angle board test. He learned that one probable cause of stuttering arises when the usual control of the speech mechanism doesn't develop in one side of the brain. This may result when the left-handed child is taught to be right-handed. The effects of the shifting frequently manifesting itself in stuttering. For those stutterers who are shifted back to the native side, practice in such activities as writing and playing pingpong is given. Part of our job with Donald was to help him gain a healthy attitude toward his stuttering. He learned to admit his speech problem and found his fear of stuttering before strangers diminishing. This was achieved in part by sending him and his fellow stutterers on numerous daily outside speaking situations where they were required to approach strangers and ask various questions. Later in the day, Dawn would be asked to report on his own reactions in the situation as well as those of the person stopped. Dawn and another stutterer checked each other in their performance and situations. Here, Don successfully completed his question even when a word was supplied by a listener. >> Excuse me. Uh I'm aer from the speech colonic. Uh do do you think that uh uttering need to be a handicap in getting a job? >> A job. >> And if you do get one, uh how long do you think that you would be able to keep it? >> Another part of the therapy program which helped Don to learn more about himself was the so-called eye openener session. Here, as a means of gaining personal objectivity, Don had the opportunity to hear from other stutterers and clinicians their impressions of his adequate and inadequate personality traits as they saw them. For instance, someone might say, "I don't like that smug look you often have." Then Don would list this and all other favorable and unfavorable points and in the discussion period which followed he could agree or disagree with the various items explaining his reaction to the characteristic mentioned. Don found that the inadequate personality traits lost their unh wholesome quality when he and the others could call attention to them, find humor in them, and even choose a nickname to describe them. As a means of testing himself to see how his clinical work held up in difficult situations, Don had the opportunity to stand before classroom groups and talk about various phases of stuttering. He also found it to be an excellent means of advertising his stuttering. Before coming to the clinic, Don had come to avoid using the telephone entirely because of his great fear of stuttering. Now he was required to make several calls daily to strangers in order that he might lose the fear of speaking on the telephone. What began as a dreaded assignment gradually became a much easier one. Another opportunity for analysis of his stuttering spasms came by means of the frequent recordings Don made of his voice. This self-criticism of his recorded speech helped him in evaluating his success in controlling his severe blocks. Don and the other stutters were frequently asked to speak before university classes. To his surprise, he found that as these situations were repeated, he actually began to enjoy talking and was able to go through a stuttering block without the great shame and fear he had formerly experienced. He found too that people can adjust themselves to his stuttering if his own attitude toward his speech is an unemotional and an objective one. But by consciously changing the pattern of his blocks, Dawn was gradually able to eliminate such habits as tongue and lip protrusions. As the 10-week period passed, Donald made a conscientious effort to carry out the many assignments given him and to understand the reasoning behind them as explained in frequent conferences with his clinician. And he was happy to observe that he was gaining increasingly fluent speech. The progressively more difficult assignments, the innumerable speaking situations, his own attention to handling techniques had paid off. As a matter of fact, when I saw him at the end of the session, most of his stuttering spasms had been eliminated. Come in. Oh, hello, Don. Come in and sit down. >> No, thank you, Dr. Bourd. I just wanted to see you before I left the clinic. You've really helped me a lot. >> Yes. Between you and the clinic, your speech has been greatly improved. You've got to remember the techniques that have been given you. That means putting them into practice every day. I'll remember and thanks again. >> So Donald completed his work at the speech clinic and registered in his chosen college at the university. He had overcome his dread of meeting people and now looked forward to attending university classes. After registering, he went to see his adviser and told him he had stuttered. As a practice situation for himself, Don was careful to stutter consciously once in a while, or fake stuttering, as it is called. He knew that one of the shest ways to control speech blocks is to be able to pretend to stutter, which gives him a feeling of mastery over his speech. He was cautioned about the great tendency to become lax and slip back into his old habits if he fails to maintain his objectivity toward his speech. Don's social life has also taken a decided change for the better. Now he is able to mingle with fellow students as part of the group and takes an active part in social events on campus. When he first came to the clinic, Don asked if we cure stuttering. Well, he now knows the answer to that question. Although he has not affected a so-called cure, he has laid the groundwork for fluent speech through a better integrated speech mechanism and adequate personal adjustment. We can close the speech clinic file on Donald Carter, marking it prognosis favorable. [Music]