STUTTERING, LISPING AND CORRECTION 
OF THE SPEECH OF THE DEAF THE MACMILLAN COMPANY 
NEW YORK • BOSTON • CHICAGO 
DALLAS • SAN FRANCISCO 
MACMILLAN & CO., Limited 
LONDON • BOMBAY • CALCUTTA 
MELBOURNE 
THE MACMILLAN CO. OF CANADA, Ltd. 
TORONTO STUTTERING, LISPING AND 
CORRECTION 
r 
OF THE 
SPEECH OF THE DEAF ' 
BY 
E. W. SCRIPTURE/ M. D., Ph. D. 
PROFESSOR OF EXPERIMENTAL PHONETICS, UNIVERSITY OF VIENNA; HONORARY 
LECTURER IN ENGLISH PHONETICS, KING’S COLLEGE, UNIVERSITY OF LONDON; 
FORMERLY PROFESSOR OF EXPERIMENTAL PSYCHOLOGY, YALE UNIVERSITY; LATER 
ASSOCIATE IN PSYCHIATRY AND DIRECTOR OF THE RESEARCH LABORATORY 
OF NEUROLOGY, COLUMBIA UNIVERSITY; ALSO SPEECH 
PATHOLOGIST OF THE WEST END HOSPITAL, LONDON 
AUTHOR OF ELEMENTS OF EXPERIMENTAL PHONETICS, THE STUDY OF SPEECH 
CURVES, SPEECH IN NERVOUS DISEASES, ETC. 
SECOND EDITION 
jnLcto Pork 
THE MACMILLAN COMPANY 
1923 
All riqhts reserved PRINTED IN THE UNITED STATES OF AMERICA 
Copyright, 1912 and 1923 
THE MACMILLAN COMPANY. 
Set up and electrotyped. Published November, 1912 
Second Edition revised, Published March, 1923. 
FERRIS PRINTING COMPANY 
NEW YORK CITY PREFACE TO THE FIRST EDITION 
It would be difficult to find a group of people more 
neglected by medicine and pedagogy than that of 
stutterers and lispers. The stuttering children that 
encumber the schools are a source of merriment to 
their comrades, a torment to themselves, and an irri- 
tating distraction to the teacher. As they grow older, 
the stutterers suffer tortures and setbacks that only 
dauntlessness or desperation enable them to survive. 
The lispers that are so numerous in certain schools are 
a needless retardation to the classes. 
In several European countries the state has estab- 
lished special opportunities for treating children with 
speech defects, but the matter has not received the 
full attention justified by its importance. In most 
medical faculties no place is accorded to speech defects; 
the same is true in schools of pedagogy. This was 
formerly justified on the ground that a scientific study 
of speech and its defects did not exist. In the last 
decade, however, the science of phonetics has extended 
itself to laboratory work and university teaching; 
moreover, speech clinics have been established in sev- 
eral of the foremost medical schools. The treatment 
of these defects thus stands upon an entirely new basis; 
namely, that of a carefully developed science of normal 
and pathological speech. 
V VI 
PREFACE 
The views here expressed as to the nature of stutter- 
ing and lisping, and the methods of treatment proposed 
are the results of three lines of work. The first is a 
long experience in experimental psychology in the 
laboratory of the University of Leipzig and later in 
my own laboratory at Yale University. The second 
is an almost equally long specialization in experimental 
phonetics, beginning at Yale and continued for four 
years in Germany under a grant from the Carnegie 
Institution of Washington, D.C. ; some of the results 
involved were first stated in my lectures at the Uni- 
versity of Marburg (Germany). Finally, the treat- 
ment of thousands of patients in the speech department 
of the Vanderbilt Clinic and in private practice has 
developed the methods into forms that produce the 
maximum result with the minimum expenditure of 
time. 
This book has been prepared to meet the needs of 
physicians and teachers ; both are constantly confronted 
with the problem of what is to be done with a lisping 
or a stuttering child. By careful study of the symp- 
toms as described here and by plentiful experience in a 
speech clinic a physician may expect within a reason- 
able time to develop the ability to make a correct diag- 
nosis. A correct diagnosis by an expert should always 
be obtained before treatment is begun. The treatment 
of lisping proceeds along such clearly marked lines that 
the general practitioner and the regular teacher will 
have no difficulty in treating the individual cases that 
come to him in practice or in class. The results are al- 
ways gratifying ; the parent appreciates the seriousness 
of the defect, and the cure usually occurs without PREFACE 
vii 
great difficulty. The treatment of stuttering is much 
more difficult; it requires great skill and long experi- 
ence. There should be at least one physician in each 
town who is able to help the numerous stutterers who 
must otherwise be neglected. One teacher in a school 
or in a group of schools may be trained as a special 
instructor. 
I have to thank Professor H. Gutzmann, of the Uni- 
versity of Berlin, for his kindness in specially modeling 
the plaster cast shown in Fig. 39, and Mr. Walter 
Robinson for the suggestion illustrated in Figs. 90, 91. 
College of Physicians and Surgeons, 
Columbia University, New York, 1912. 
PREFACE TO THE SECOND EDITION 
Ten years of further experience with speech defects 
confirm the views expressed in the first edition, that 
stuttering is not a defect of the nervous mechanism of 
speech and that its characteristics are not troubles of 
articulation. Records and careful studies have now been 
made covering most of the diseases and defects of the 
nerves, spinal cord and brain (published in Brain, Quar- 
terly Journal of Medicine, Proc. Roy. Soc. Med., Vox, 
etc.). Nowhere do they show any resemblance to the 
records of stuttering. Stuttering is a disease of the 
mind, not a defect of the body. 
Comparison of stutterers with persons having other 
mental peculiarities shows that the trouble is connected 
with the emotions. It is a psychoneurosis whose essen- 
tial is the unconscious desire to avoid human society and 
whose mechanism consists in using ridiculous speech as a viii 
PREFACE 
means of attaining the desired isolation. The deeper 
cause varies from case to case. 
As it is a mental trouble, its treatment must be entirely 
mental. The various exercises are all designed to be used 
as means of restoring confidence in speech. Mechan- 
ically or ignorantly performed exercises are injurious. 
Other strong mental influences are to be supplied by the 
personality of the one undertaking treatment and by 
a favourable adjustment of the surroundings. 
Great success can often be achieved by the exercises 
alone used in proper surroundings by an inspired teacher. 
Many cases, however, cannot be cured without going to 
the roots of the disease. In all cases the time of treat- 
ment is greatly shortened by the radical method. This 
method consists in the proper use of psychanalysis. 
When I formerly used the Freudian form of psych- 
analysis in combination with the treatment by exercises 
and change of surroundings, I found that in all cases the 
time required was reduced to a third or a quarter of that 
required without the analysis, and that I could cure 
many cases that I had had previously to give up in despair. 
Recently I have adopted certain modifications and some- 
what improved methods of analysis by which it is possible 
to get more quickly at the stuttering complex. With 
these methods combined with exercises nearly every case 
of stuttering can be cured permanently in a few months. 
Any psychanalysis however, should be used only by a 
specialist after long training, in the hands of others it is 
directly injurious. Psychanalysis without exercises is 
useless for stuttering. 
The problem of stuttering school-children has often 
been laid before me. I always answer that success is 
obtainable by exercises in the hands of a teacher whose PREFACE 
ix 
personality inspires the children with confidence and 
who recognizes that the benefit does not come from the 
exercises but from herself. Still greater success is ob- 
tainable if the teacher is able to interest herself in the 
individual children, to understand them, and to help 
straighten out their lives. 
Part IV added to this edition is designed to intro- 
duce a much needed reform into the instruction of the 
deaf. Deaf persons who have received no instruction in 
lip-reading make a few sounds in a perfectly natural 
manner. The instruction in lip-reading produces in 
nearly every case an abnormal tone from the larynx. 
Moreover, even in the best cases really correct pronunci- 
ation is rarely, if ever, attained by the deaf who have 
never heard. Finally, the amount of labour that has to 
be expended in teaching phonation and enunciation is 
gigantic. With the methods hitherto employed it is not 
to be hoped that better results can ever be attained. 
The science of experimental phonetics, however, possesses 
methods that can be made of the utmost value to the deaf. 
In my work in 1912-13 in New York I was able to demon- 
strate that many faults of the deaf could be corrected 
completely and permanently by these methods. Special 
methods are treated in the four chapters of this part. 
Other suggestions may be obtained from Part II. 
Now that the success and value of such methods have 
been proved, every deaf school must face the question 
whether it will introduce them and produce better results, 
or will reply, as one authority did, that the children have 
so much else to learn that they cannot be bothered about 
niceties of speech. When an institution or a teacher 
is possessed by “that tired feeling/’ it may be pointed out 
that the use of the new methods so greatly lessens the X 
PREFACE 
labour of teaching lip-reading that the total amount of 
work is less than before. 
The development of the work described in Part IV is 
due to the genius of Ethel Scripture, of revered memory. 
The Chapters in Part IV first appeared in the Volta 
Review, 1913; they are published here, with some alter- 
ations, by permission of the editor. 
E. W. Scripture. 
12 Welbeck Street 
Gatterburggasse 6 
London 
Vienna CONTENTS 
Preface v 
Contents xi 
List of Illustration* xiii 
PAGE 
PART I 
STUTTERING 
CHAPTER 
I. Description. Cause . ..... 1 
II. Symptoms, Forms, Nature 10 
III. Diagnosis 42 
IV. Therapy ......... 56 
V. Methods of Treatment ..... 74 
PART II 
I. Introduction ... .... Ill 
II. Negligent Lisping . . .... 122 
III. Organic Lisping ....... 162 
IV. Neurotic Lisping 173 
Y. Cluttering .... . . 18? 
LISPING 
PART III 
SET 
I. Breathing • 196 
II. Melody 194 
EXERCISES 
xi xii 
CONTENTS 
SET 
PAGE 
III. Flexibility 197 
IV. Slowness igg 
V. Smoothness 201 
VI. Voice Quality 202 
VII. Starting and Ending Sentences .... 205 
VIII. Enunciation and Spelling 207 
IX. Expression . 208 
X. Confidence 210 
XI. Spontaneous Speech 216 
XII. Thinking 217 
XIII. Description and Relation 219 
XIV. Telephoning 221 
XV. Talking with People 222 
XVI. Relaxation 224 
XVII. Muscular Control 225 
XVIII. Word Lists 228 
PART IV 
NEW METHODS OF CORRECTING THE SPEECH 
OF THE DEAF 
I. The Organ Trainer 244 
II. The Strobilion . . . . . . . 252 
III. Graphic Records of Speech 262 
IV. Correction of Nasality 273 
Plates 283 
Index 287 LIST OF ILLUSTRATIONS 
FIG. 
1. Recording the movements of breathing by the graphic 
method 21 
2. Breath record during stuttering 23 
3. Recording the pressure of the lips by the graphic method 23 
4. Lip record of a stutterer’s attempt to say the first letter 
in the word “ Peter ” 24 
5. Recording the movements of the tongue ... 24 
6. Record of a stutterer’s cramps of the tongue in attempt- 
ing to say “ Tommy” 25 
7. Recording the mouth current 26 
8. Mouth record of “ papa” spoken normally ... 27 
9. Mouth record of “papa” with blowy “p’s” spoken by a 
stutterer 28 
10. Mouth record of “papa” with an inspiratory “p” 
spoken by a stutterer 28 
11. Mouth record of “ sleepy ” spoken normally ... 29 
12. Mouth record of “ sleepy ” spoken by a stutterer . . 30 
13. Mouth record of “ stutter ” spoken normally ... 30 
14. Mouth record of “ stutter ” spoken by a stutterer . . 31 
15. Mouth record of “ Peter Piper’s peppers ” spoken by a 
stutterer 32 
16. Melody plot for “ papa ” spoken normally (Fig. 8) . 33 
17. Melody plot for “ papa ” spoken by a stutterer (Fig. 9) . 34 
18. Mouth record of “ papa ” in a case of spastic speech . 50 
19. Mouth record of “ papa ” in a case of motor aphasia . 51 
20. Mouth record of “ papa ” in a case of bulbar paralysis . 58 
21. Scheme to illustrate the mechanism of stuttering . . 58 
PAGE 
xiii xiv 
LIST OF ILLUSTRATIONS 
FIG. 
22. Notes indicating how the phrase “ How do you do?” is 
to be sung 75 
23. Line indicating how the phrase “ How do you do?” is to 
be sung according to the notes in Fig. 22 . . . 75 
24. Line indicating how the normal voice should rise and 
fall in speaking the phrase “ How do you do?” with a 
melody similar to that indicated in Fig. 21 . . .76 
25. Line indicating the monotony of the stutterer’s voice in 
speaking the phrase “ How do you do?” . . . 76 
26. Mouth record showing the word “ papa ” as actually sung 77 
27. Melody plot to Fig. 26 77 
28. Octave twist in musical notation 78 
29. Octave twist indicated by a line 78 
30. Mouth record of “ papa” spoken with the octave twist . 78 
81. Melody plot to Fig. 30 79 
32. Mouth record of “ papa ” spoken with an unsuccessful 
attempt at the octave twist 79 
33. Melody plot to Fig. 32 80 
34. Perfect closure of the glottis 81 
35. Glottis during a breathy tone 81 
36. Yowel curve with normal beginning and ending . . 82 
37. Yowel curve with glottal catch at beginning and ending 82 
38. Mouth record of the stutterer’s correction of the inspira- 
tory “ p” in Fig. 10 89 
39. Median section of the organs of enunciation and pho- 
nation 113 
40. Artificial palate 114 
41. Palatogram for the vowel “ ee ” 115 
42. Candle flame indicator used for the mouth . . . 119 
43. Tambour indicator used for the nose .... 120 
44. Lip position for “ f ” and “ v ” . . . . . • 122 
45. Lip position for “ w ” 123 
46. Lip position for correcting “w ” into “v” . . . 124 
FAGE LIST OF ILLUSTRATIONS 
XV 
FTG. 
47. Palatogram for forward “ t ” and “ d ” . . . 125 
48. Palatogram for backward “ t ” and “ d ” . . . . 125 
49. Palatogram for “k” and “g” 125 
50. Mouth diagram for “t” and “d” 125 
51. Mouth diagram for “k ” and “ g ” 125 
52. Mouth record of “ water ” spoken normally . . . 126 
53. Mouth record of “ water ” spoken by a lisper . . . 126 
54. Palatogram for “ s ” and “ z ” 130 
55. Palatogram for occluded “ s ” and “ z ” . . . . 130 
56. Mouth diagram for “ s ” and “ z ” 131 
57. Mouth diagram for occluded “ s ” and “ z ” . . . 131 
58. Mouth record of “ sun ” spoken normally . . . 132 
59. Mouth record of “ sun ” spoken by a lisper . . . 132 
60. Tongue record for occluded “ s ” 132 
61. Correcting occluded “s ” and “z ” 133 
62. Making the interdental fricative 134 
63. Mouth record of the word “ Mitchell ” 136 
64. Mouth record of the word “ nutshell ” .... 136 
65. Palatogram for “ ch ” and “ j ” 137 
66. Mouth diagram for “ ch ” and “ j ” . . . .138 
67. Mouth diagram for “ n ” 139 
68. Mouth diagram for “ ng ” 139 
69. Palatogram for “ sh ” 140 
70. Mouth diagram for “ sh ” 140 
71. Palatogram for “ th ” 141 
72. Mouth diagram for “ th ” 141 
73. Mouth record of “ thin ” spoken normally . . . 142 
74. Mouth record of “tin” spoken normally . . . 142 
75. Mouth record of “ thin ” with occluded “ th,” by a lisper 143 
76. Correcting occluded “ th ” 143 
77. Mouth record of front rolled “ r ” by an American . 144 
78. Palatogram for English “ r ” 145 
PAGE XVI 
LIST OF ILLUSTRATIONS 
FIG. 
PAGE 
79. Mouth diagram for “ r ” 145 
80. Mouth record of English “r ” 145 
81. Mouth record of uvula “r” by a Parisian . . . 146 
82. Palatogram for “ 1 ” 146 
83. Mouth diagram for “ 1 ” 146 
84. Rod for pushing the tongue 147 
85. Pushing the tongue into position for “ r ” . . . 147 
86. Recording the nasal current and vibrations . . .151 
87. Nasal record of “sun” spoken normally . . . 152 
88. Nasal record of “ sun ” with relaxed velum . . . 152 
89. Tissue paper indicator 153 
90. Velar hook 154 
91. Velar hook in position 155 
92. Mouth record of “ dog ” 156 
93. Mouth record of “ dok ” 156 
94. Mouth record of “ dogk ” 157 
95. Mouth record of “ apa ” with the explosion of “ p ” well 
marked 158 
96. Mouth record of “ apa ” with no explosion of “ p ” . 158 
97. Hemiatrophy of the tongue 163 
98. Mouth record of “ so ” spoken normally . . .175 
99. Mouth record of “ so ” in neurotic lisping . . . 175 
100. Mouth record of “ silk ” spoken normally . . . 177 
101. Mouth record of “ silk ” in neurotic lisping . . . 177 
102. Mouth record of “ shoe ” in normal speech . . . 178 
103. Mouth record of “shoe ” in neurotic lisping . . . 179 
104. Gas capsule 244 
105. Gas capsule in use with revolving mirror .... 245 
106. Flame figures for two tones an octave apart . . . 246 
107. The organ trainer 253 
108. The strobilion 253 LIST OF ILLUSTRATIONS 
XVII 
FIG 
PAGE 
109. The strobilion disc, illuminated by an intermittent 
flame, whose flashes make the middle ring appear to 
stand still 254 
110. Strobilion exercises indicated on the strobilion staff . 260 
111. Time line, each vibration measures 1/I00th of a second 263 
112. Record of “potatoe,” in phonetic notation (poteto) . 264 
113. Records of “she” 266 
114. Records of “ too much ” 268 
115. Records of “do” 270 
116. Tambour indicator 274 
117. Making mouth and nose records 276 
118. Nose and mouth record of “thinking” .... 277 
119. Nose and mouth records of “so” 279 
120. Nose and mouth records of “spark” 280 
Plates I, II, III. Mouth diagrams for typical English sounds 283 
Plate IV. Palatograms for typical English sounds . . . 286 STUTTERING, LISPING AND CORRECTION 
OF THE SPEECH OF THE DEAF STUTTERING, LISPING AND 
CORRECTION OF THE SPEECH 
OF THE DEAF 
PART I 
STUTTERING 
CHAPTER I 
DESCRIPTION. CAUSE 
As “ stutterers” we designate individuals show- 
ing certain peculiarities of speech. One stutterer, 
for example, will make spasmodic contractions of the 
lips, tongue, etc., whereby a word like “berry” 
will be pronounced “b-b-b-b-berry.” Another will 
open his mouth wide and produce an “a-a-a-a-” 
before he can say a word. Another will find himself 
suddenly unable to speak at all at the beginning or 
in the middle of something he wants to say. Still 
others are quite unable to speak certain words. One 
young man could never speak the name of his town 
and was obliged always to buy his railway ticket to 
the next town beyond. One lady would find herself 
at a ticket office suddenly speechless and unable to 
1 2 
STUTTERING AND LISPING 
tell what ticket she wanted while an impatient crowd 
of commuters gathered behind her. 
Stuttering is a serious detriment to the person’s 
welfare. One refined stuttering girl of sixteen was 
studying typewriting and stenography, not realiz- 
ing that no office would tolerate a secretary who 
could not answer when suddenly spoken to or who 
could not use the telephone. But what was she to 
do for a living ? Even on the lower level of a shop 
girl she would be impossible. The examiners of 
immigrants at New York City often refuse admis- 
sion to stutterers on the ground that they are liable to 
be unable to make a living and likely to become public 
charges. A law student felt that on account of his 
stuttering he must relinquish his ambitions and con- 
fine himself to uncongenial work. At the best, the 
stutterer’s social life is limited and abnormal. He 
often retires from social intercourse as much as pos- 
sible and becomes more or less eccentric. One boy 
grew up in such isolation that his oddities made him 
appear feeble-minded, although he was not mentally 
defective. Excessive stuttering has been made the 
basis of divorce for cruelty. 
To most people stutterers seem comical. They DESCRIPTION. CAUSE 
3 
are the butts of innumerable anecdotes in the news- 
papers and on the stage. The stutterer learns that 
people regard him as a kind of involuntary clown and 
that his family and friends are ashamed of him. 
Few persons realize how terrible life becomes to a 
stutterer. A normal person may get a mild idea of 
it by supposing that every time before he speaks he 
is obliged to wink one eye or to open his mouth and 
yawn; the feeling of embarrassment and shame would 
soon overpower him. A stutterer is worse off; 
every time he tries to speak he is obliged to make 
a fool of himself in such a way as to make other 
people want to laugh at him. One religious but 
stuttering lady finally demanded to be “ cured or 
chloroformed.” One boy often threw himself on 
the floor, begging his mother to tell him how to die. 
Another boy asked for a letter to his father, telling 
him to keep the other children from laughing at 
him. Many stutterers become so sensitive that 
they imagine everybody is constantly making fun 
of them. The life of a stutterer is usually so full of 
sorrow that it can hardly be said to be worth living. 
At school the child is tormented by his fellow 
mates. He is usually a trial to the busy teacher 4 
STUTTERING AND LISPING 
and a hindrance to the progress of the class. He is 
often excused from oral recitation, but just as often 
the teacher constantly corrects him or ridicules 
him. Sometimes it happens that the child has a 
cramp that keeps him from starting an answer for a 
moment, but does not show itself otherwise, such a 
stutterer prefers to be thought lazy or stupid rather 
than reveal the true nature of his trouble. 
Even at home the stutterer is misunderstood and 
often tortured from the best motives. He is fre- 
quently reproved or scolded as an inattentive or 
bad boy because he “could speak properly if he 
would only try.” Many a parent is often sure that 
this is so because the child will speak properly when 
reminded to do so. The truth is that no human 
being can always think of how he is to speak before 
he speaks; the stutterer simply cannot stop stutter- 
ing of his own accord. 
Stuttering is, indeed, a serious disease. It is 
not as undesirable as mania or cancer, but most 
people would prefer to have typhoid or pneumonia 
for the simple reason that with these diseases a per- 
son either dies or recovers, whereas stuttering is a 
lifelong torture. DESCRIPTION. CAUSE 
5 
A very great injustice to the stutterer is the 
widely spread notion that stuttering is a bad habit 
which is to be corrected by reproof, scolding and 
punishment. The treatment is supposed to con- 
sist in a kind of schooling, the result depending on 
the diligence of the pupil. Lack of progress is 
attributed to inattention or laziness. Parents, 
friends, and teachers are always alert to test 
the patient’s progress. Of course, all this simply 
makes the stutterer worse, turns a mild case into a 
severe one, and drives many a sufferer to despair. 
Stuttering is a disease; it can be properly treated 
only on the principles of any other disease. Just as 
with all other diseases, some cases get well spon- 
taneously and some get well no matter how they are 
treated; yet so few recover permanently under the 
treatments in vogue that there is a widespread 
opinion that stuttering is incurable. 
The most frequent cause of stuttering is a nervous 
shock. Ghosts and other practical jokes, and, with 
very small children, such terrifying experiences as 
are found at amusement resorts (scenic railways, 
fire scenes, etc.) are often the causes of fright from 
which the child never recovers. Severe falls are just 6 
STUTTERING AND LISPING 
as often the sources of the mental shock. Surgi- 
cal operations (for cataract, adenoids, etc.) are 
occasionally the sources of stuttering. The cause of 
stuttering in all these cases is evidently the intense 
fear involved in the shock. In some cases the fear 
has developed gradually. A boy of twelve relates 
that at the age of seven, on several occasions in the 
daylight he thought he heard footsteps of some one 
following him in the hall, whereas the noise was of 
his own footsteps; thereafter he began to stutter. 
He is still afraid to walk in the dark, to be alone or to 
go to sleep in the dark. A young man of seventeen 
relates that he began to stutter in reading at seven 
years because he knew that he would make mistakes 
before the class and become nervous about it. 
Most of the stutterers from shock show a general 
condition of nervous excitability in which the pre- 
dominant element is an abnormal state of expectancy 
toward persons and events. The patient is often 
on the alert for what is going to happen. He watches 
other people and replies before they half finish their 
remarks; or he is timid to such a degree that conver- 
sation is painful. The same condition of general over- 
anxiety I have found in patients who do not stutter. DESCRIPTION. CAUSE 
7 
It is a typical psychoneurosis, that may, perhaps, be 
appropriately called the “general anxiety neurosis.” 
In addition to the kinds of nervous shock mentioned 
above, it is possible that the cause of the general 
anxiety neurosis may lie in shocks of various kinds 
occurring in infancy and childhood. This “general 
anxiety neurosis” differs from the anxiety neurosis 
of Freud in several ways. In the former the anxiety 
(or fear) is present at all times; it is ready to attach 
itself to any thought or occurrence for which a fairly 
valid reason can be found ; the patient knows that he 
is overanxious, but his anxiety always seems fully 
justified at the moment. In the latter the anxiety 
attaches itself to one particular thing, for example, 
the patient cannot cross an open space because he 
is afraid to do so; although the fear is irresistible, 
the patient usually realizes fully that it is absurd. 
A very frequent cause of stuttering is mental 
contagion by intentional or unintentional imitation. 
A boy thinks it fun to mock a stutterer, and ulti- 
mately finds that he himself cannot stop stuttering. 
A stuttering parent nearly always has one or more 
stuttering children. Even when the parent had 
stopped stuttering in youth, there are usually 8 
STUTTERING AND LISPING 
enough traces left in his speech (e.g. hard voice) to 
start the child stuttering. Stuttering has been 
known to develop in a child from playing with a 
deaf-mute wdio talked with difficulty. 
Stuttering frequently appears after whooping 
cough, also after scarlet fever, measles, influenza, 
intestinal troubles, scrofula, rickets, etc. The 
cause seems to lie in the condition of exhaustion. 
One of my cases showed symptoms of spastic 
infantile paralysis (spasticity of the legs, weakness 
and athetosis of the hands, weakness of the muscles 
of speech) with history of difficult birth. The 
difficulty in using the muscles of speech may be 
assigned as the cause of the stuttering. 
A neuropathic disposition or a condition of nerv- 
ous exhaustion is present in nearly all cases of 
stuttering. 
The first suggestion for prophylaxis is that parents 
and nurses are to avoid stories and scenes that 
frighten children. Nervous children should receive 
tonic treatment, especially open-air life. If one child 
in a family begins to stutter, he should be cured 
immediately in order to save the others. A stutter- 
ing child in school is a danger to his fellows. DESCRIPTION. CAUSE 
9 
The statistics show from 1 to 2 per cent of stut- 
terers among school children. A smaller percentage 
in the lower classes becomes trebled in the higher 
ones. Marked increases are found at the periods 
of second dentition and puberty. The relative fre- 
quency among boys and girls ranges from 2:1 to 
9:1. CHAPTER II 
SYMPTOMS, FORMS, NATURE 
The most striking symptoms are cramps or spasms 
of the muscles connected with speech. 
Abdominal cramps are nearly always present. The 
entire abdomen may suddenly become rigid, or it 
may make irregular contractions. In one case the 
wall just over the navel was drawn into a deep 
cuplike cavity. The diaphragm, as seen by the 
X-rays, may be suddenly fixed or may move down- 
ward in spasms. The spasms sometimes propel the 
abdominal wall outward in jerks. Often both 
abdominal muscles and diaphragm will become 
perfectly rigid and immovable. These contrac- 
tions produce irregular interruptions or expulsions 
of the breath instead of the steady current necessary 
for proper speech, or they give no breath at all and 
render the patient speechless. One patient of mine 
often became suddenly speechless in this way for 
ten to fifteen seconds at a time. A frequent phe- 
10 SYMPTOMS, FORMS, NATURE 
11 
nomenon is the expulsion of the breath just before 
speaking. The most frequent case is that of con- 
tinual irregularities of breathing during actual 
speech. 
Laryngeal cramps are a never-failing symptom of 
stuttering. The muscles in and around the larynx 
become tense and fixed. The tone from the larynx 
is monotonous, hard, and often husky. It is not un- 
usual to find a patient who never has any symptom 
of stuttering in the presence of the physician except 
the monotonous laryngeal tone. I have never seen 
a stutterer without this symptom. 
Cramps and spasms of the muscles of enuncia- 
tion are the ones most apparent to the observer. 
The lips may be pressed tightly together for a short 
or a long time when the patient tries to say “p” 
or “b.” In other cases they will open and shut, 
producing a series of “p”s or “b”s instead of one. 
The tongue may be pressed so tightly against the 
palate that the “ t” or the “d” is two, three, or ten 
times too long. All the sounds may be similarly 
affected. 
Less frequent but more striking are the contrac- 
tions of muscles not ordinarily used in speech. One 12 
STUTTERING AND LISPING 
patient will twist his head whenever he stutters 
badly, another will screw up one eye, another will 
contort his whole body, etc. One patient had ‘'pains 
that did not hurt” in her legs and arms while speak- 
ing. One boy of seven made horrible grimaces and 
stuck his tongue like a thick stick far out between 
his lips. One girl of twenty-two would spend one 
to two minutes in grunting like a pig and whimper- 
ing like a dog after which she would say the word 
or sentence with ease. 
All the muscles involved in speech are brought 
into a condition of greater or less over-tension 
whenever the stutterer begins to speak, although 
there may be no visible cramps or spasms or any 
stuttering in the popular sense. Over-tension is 
thus a cardinal system of stuttering. The over- 
tension is psychic (mental) and not neural; it 
appears only when the person intends to speak. 
There is no resemblance to the hypertension in 
nerve diseases. 
The trained ear readily detects the hard tone of 
the voice which results from laryngeal over-tension. 
The expert can thus tell from the first sound that SYMPTOMS, FORMS, NATURE 
13 
the patient makes whether he has started his sentence 
correctly or has begun with the stuttering tone that 
will cause him to stumble before he finishes. 
Another kind of symptom occurs in the “er,” 
“well,” etc., that the stutterer uses to get started. 
Sometimes this “starter” is an inarticulate but 
complicated grunt. Sometimes the starter is re- 
peated several times; one young lady would regu- 
larly repeat “why” ten to fifteen times before she 
could get out the first word of what she wanted to 
say, and even then she sometimes failed and had to 
begin over again. Often the patient has to make 
severe contortions of the face or the head or the 
body before he can begin. 
An almost constant symptom is excessive rapidity 
of speech. In some cases this is to be attributed to 
the desire of the stutterer to get his words out before 
he is caught or before any one can interrupt him. In 
most cases it is the expression of nervous anxiety. 
A never failing symptom is the patient’s lack of 
confidence in his ability to speak correctly. In 
some cases the mere thought “Will I be able to say 
that word?” is sufficient to make it absolutely 
impossible for the person to say it. The stutterer 14 
STUTTERING AND LISPING 
always lives with the fear that his speech may “go 
back on him.” Many a one is always thinking a 
few words ahead of what he is saying, being on the 
lookout for some word he thinks he cannot say. 
When such a word is coming, he avoids it by select- 
ing another that will serve just as well. One patient 
practically passed his life in always avoiding words; 
this mental work, being added to that of a normal 
man, kept him in a condition of nervous prostration. 
The fear of being ridiculous is nearly always 
present. The person does not want to “make a fool 
of himself.” He therefore avoids reciting in school, 
he refuses invitations to social affairs, he would 
rather live with his father’s employees in a mine than 
go to college, he shuts himself up with a servant and 
becomes a queer-mannered hermit, etc. 
A condition of mental flurry is usually present. 
When the patient starts to speak, he becomes partly 
dazed by his emotion and does not know exactly 
what he wants to say. This condition may be pres- 
ent even when he does not stutter; in trying to 
answer a question, for example, he cannot make up 
his mind just what he wishes to say. Closely con- 
nected with this is a habit of hesitating in thought SYMPTOMS, FORMS, NATURE 
15 
that sometimes arises. The mental flurry perhaps 
explains why some stutterers have most trouble 
whenever they are jocular. In some cases they 
stutter only when jocular. 
With very rare exceptions the stutterer does not 
stutter when he knows no one can hear what he says. 
Almost as rare are the cases where he stutters in 
singing or in whispering. 
The embarrassment and sad experiences of the 
stutterer often lead to an abnormal mental condi- 
tion. The patient is nervous, shy, easily embar- 
rassed, retiring, odd in his ways, sad, etc. In some 
cases the change does not go beyond an increased 
sensitiveness. Many stutterers, especially young 
women and schoolboys, acquire a permanent facial 
expression that is typical of the profoundest sadness. 
The thought of suicide is frequent. 
Three forms or stages of stuttering may be dis- 
tinguished. 
The simplest form of stuttering is that of “pure 
habit.” Such a case occurs rather frequently where 
a younger child unintentionally copies the stutter- 
ing of an older one. If the stuttering does not go 
beyond the stage of pure habit, the younger child 16 
STUTTERING AND LISPING 
drops his stuttering involuntarily when the older 
one is removed or cured. 
The habit stage is often initiated by shock or 
exhaustion. The person finds himself making inac- 
curate movements in speaking, and speaking a word 
or words indistinctly. On account of the excessive 
nervous irritability in these conditions, he feels that 
he cannot permit himself to speak in an improper 
fashion, so he instinctively tries to correct the 
inaccurate movements by an extra effort at distinct- 
ness. Such an effort produces excessive muscular 
tension; his consonants, like “p,” “b,” “f,” “d,” 
etc., are too hard and long. This in turn impresses 
itself on the memory, so that when he again makes 
the same sounds he naturally makes excessive 
muscular movements. The excessive tension readily 
becomes repetition, so that, for example, instead of a 
long “p” he says “p-p-p,” etc. Such was the case 
with a patient two and a quarter years old who 
stuttered constantly by reduplicating the conso- 
nants, saying, for example, “strawb-b-b-b-berries” 
and showing monotony of the laryngeal tone and the 
usual symptoms. After a few days of correction 
whereby the stuttered words were repeated correctly SYMPTOMS, FORMS, NATURE 
17 
with melodious intonation by the father each time 
after her, she ceased to stutter. 
A patient two years old, when seen three weeks 
after the stuttering began, could be induced to speak 
only with great difficulty on account of the feeling of 
shame that was evidently present. When she spoke, 
it was in an abnormally low tone, with stumbling and 
repetition of consonants. There was no neuropathic 
history, but a previous exhausting illness. Being 
told to sing what she wanted to say, she stopped 
stuttering and spoke naturally after a few days. In 
both these cases we may assume that the exhausted 
nervous system led to inaccurate movements. These 
produced a feeling of uncertainty and insecurity, 
which in turn aggravated the inaccuracy and led to 
excessive cramplike efforts. Every incorrectness 
of action increased the uncertainty of feeling, and 
vice versa. The parent’s correction soon made the 
child feel that it was doing something reprehensible; 
this produced not only embarrassment, but also still 
greater inaccuracy and uncertainty. 
The stuttering habit may be initiated by embar- 
rassment. It sometimes occurs that a lisping child 
becomes so nervous over his defect and over the way IS 
STUTTERING AND LISPING 
other people treat him that he begins to stutter. 
The lisping in such cases is usually due to tongue- 
tie; this is the only case in which stuttering is 
connected with tongue-tie. 
Quite a few cases occur where the stuttering habit 
is begun at three or four years of age with no history 
of shock, exhaustion, or imitation. It is possible that 
the child’s awkwardness in using his speech organs 
leads him into blunders over which he becomes 
nervous. 
The stutterer nearly always goes beyond the 
habit stage. People laugh at him, mock him, scold 
him, threaten him with punishments, or whip him. 
Usually he is obliged to repeat words he stumbles on. 
He is made to go through reading and speaking 
exercises. Extra hard words are given him to 
practice on. Speaking becomes a torture for him. 
A new element, the “fear of displeasing and of 
appearing ridiculous,” produces the “fright stage.” 
The stuttering is now a distinct psychoneurosis 
that may have the most far-reaching consequences. 
If the question is asked of a patient in the fright 
stage, “Why do you stutter?” he will answer, “Be- 
cause I am afraid that I will stutter.” Many a one SYMPTOMS, FORMS, NATURE 
19 
will say that if he could only forget that he had 
stuttered, he would never stutter again. When the 
stutterer wishes to speak, the thought of his pre- 
vious failures occurs to him and he fears or knows 
that he will appear ridiculous to those before whom 
he is speaking. This element disturbs his mental 
condition. He is seized with a violent emotion that 
may be described as stage fright before a single 
person. Embarrassment, shame, fear, etc., express 
themselves in his face and often disturb his mental 
actions so that he cannot think clearly. The emo- 
tion may make him absolutely speechless, as in the 
case of many patients who cannot say a word when 
introduced to strangers. Or it may make him 
stumble over his words; naturally he stumbles in 
the way he has learned to stumble, namely, with 
stuttering cramps. 
The disturbance of mental action during the fright 
stage may produce a kind of intellectual paralysis. 
One patient was often unable to answer a question, 
not because he was afraid of stuttering, but because 
the requirement of answering actually paralyzed his 
mind so that he could not think of the answer. This 
habit had become so thoroughly formed in another 20 
STUTTERING AND LISPING 
patient that any excitement might render him 
unable to think; on the football field, where the 
system of signals required him to add numbers, he 
would, upon hearing the signals “six and four,” 
which had to be added together, have to ask his 
neighbor how much they amounted to. One stutterer 
explained the mental paralysis when asked to give 
his name or any exact information as resulting from 
the fact that he is overwhelmed by having some 
one depend on him for information that he alone 
can give. 
A third stage occurs not infrequently. The 
stutterer is no longer embarrassed by his defect. It 
is obnoxious to him, and he would like to be rid of it, 
but the fright has disappeared. This may be termed 
the “stage of indifference.” It is usually found in 
older patients; they stutter because the habit is 
firmly fixed and not because they are embarrassed. 
In many cases stuttering seems to be associated 
with a peculiarity of character. This cannot be 
attributed entirely to the presence of the stuttering. 
In one case in my experience the child had previously 
developed a condition of nervousness which had 
become very extreme on account of lack of training SYMPTOMS, FORMS, NATURE 
21 
in self-control. The stuttering habit, engrafted 
on this, became very violent. In another case the 
stuttering was associated with slowness of thought; 
Fig. 1 . — Recording the movements of breathing by the graphic method. 
Two metal cups with rubber tops are fixed over the chest by a 
band. Expansion over the chest draws air into the cups. They 
are connected by a rubber tube to a small recording tambour. 
This is a metal cup with a rubber top which moves a light recording 
lever. A line drawn by this lever on a smoked surface moved by 
clockwork gives a record of the breathing movements. The record- 
ing arrangements can be attached to the abdomen also. 
sometimes the hesitation in speech seemed to be a 
cloak for hesitation in thought. Several previous 
attempts at cure had failed to be permanent on 
account of lack of moral backbone. In another 22 
STUTTERING AND LISPING 
case the stuttering had appeared in a small boy 
who had never been taught any self-control. Very 
often stutterers are shy and bashful to an extent 
that can hardly be justified by their painful speech 
experiences. 
The stutterer’s speech movements may be accu- 
rately recorded and studied by the methods of 
experimental phonetics. 
The movements of the chest during speech may 
be recorded by the apparatus shown in Fig. 1. 
The “pneumograph” shown in the figure consists 
of two metal cups with tops of soft rubber. A tape 
runs around the body from one rubber top to the 
other. As the chest expands, the rubber tops are 
pulled outward. This draws air inward through 
the tubes which open into the metal cups. As the 
chest falls, the air passes out again. 
The “recording tambour” is a metal cup with 
a rubber top. It is connected with the pneumo- 
graph by a rubber tube. As the air is drawn into 
or expelled from the pneumograph, it passes out of, 
or into, the recording tambour and makes the rubber 
top bulge inward or outward. A lever is arranged 
to indicate the movements of the rubber top. SYMPTOMS, FORMS, NATURE 
23 
The registration occurs on a “recording drum’’ 
consisting of a metal cylinder revolved by clockwork. 
Fig. 2. — Breath record during stuttering. 
Around the cylinder a sheet of paper has been 
Fig. 3. —Recording the pressure of the lips by the graphic method. 
A small rubber bulb is placed between the lips and is attached to 
the recording tambour. 
stretched and smoked over a flame. The point of 
the lever of the recording tambour is adjusted to 24 
STUTTERING AND LISPING 
Fig. 4. — Lip record of a stutterer’s attempt to say the first letter in 
the word “Peter.” 
Instead of a single pressure the stutterer makes repeated con- 
tractions. 
touch the paper; it draws a white line in the soot. 
The paper is afterwards removed and the record is 
fixed in shellac varnish. 
To record the breath- 
ing movements the pneu- 
mograph is hung over the 
chest or the abdomen by 
a tape around the neck. 
The record reproduced in 
Fig. 2 is from a woman 
whose abdomen made 
violent movements out- 
ward during certain con- 
sonants. The records 
show the movements for 
ordinary breathing and 
the spasms during the 
Fig. 5. — Recording the movements 
of the tongue. 
A small rubber bulb is placed 
in front of or on the tongue and 
is connected to the recording 
tambour. 
attempt to say “m.” SYMPTOMS, FORMS, NATURE 
25 
The cramps of the lips may be recorded by inserting 
between them a small rubber bulb (Fig. 3) and con- 
Fig. 6. — Record of a stutterer’s cramps of the tongue in attempting to 
say “Tommy.” 
necting it to a recording tambour as described 
above. Pressure of the lips makes the line rise. The 
record of the movement of the lips in an attempt 
of a stutterer to say “Peter” is given in Fig. 4. In 
spite of the long series of convulsive movements the 
patient could not get beyond the letter “p.” 
The cramps of the point of the tongue may be 
recorded by inserting a similar bulb behind the 
teeth so that the tip of the tongue rests against it 
(Fig. 5); pressure of the tongue makes the line rise. 
The result of an effort to say “Tommy” is given in 
Fig. 6. There is first a violent spasm of the tongue 
and then a series of smaller ones. 
Most interesting records are obtained by a mouth 
recorder. A funnel of rubber (the top of a large 26 
STUTTERING AND LISPING 
stomach tube) is held over the mouth; it is connected 
to a very small and delicate registering tambour. 
The entire arrangement is shown in Fig. 7. 
A record of the word “papa ” in normal speech is 
shown in Fig. 8. The straight line at the start cor- 
Fiq. 7.—Recording speech. 
The changes in air pressure and the vibrations of the voice pass 
to a very small recording tambour and are registered on the smoked 
surface. 
responds to the time during which the lips were closed 
for the “p” — the “occlusion.” The sudden rise of 
the line is the result of the puff of air — the “ explo- 
sion ” — that issued from the mouth as the lips were 
opened at the end of the “ p.” The explosion of the SYMPTOMS, FORMS, NATURE 
27 
“ p ” shows two large vibrations. This is due to its 
suddenness, whereby the recording lever receives 
something like a sharp blow, and vibrates twice in- 
stead of once. The small vibrations that follow are 
a record of the first vowel, each vibration correspond- 
Fig. 8. — Mouth record of “papa” spoken normally. 
It begins with a straight line because the lips are closed to produce 
the letter “p,” and no air can issue from the mouth; this portion of 
“p” is called the “occlusion.” The sudden rise of the line shows 
that a sharp puff of air or “explosion” came from the mouth as the 
lips were opened ; the extra wave in this explosion is due to the vi- 
brations of the lever, resulting from the sharp explosion. The small 
waves record the vibrations of the voice for the vowel “a.” They 
are suddenly cut short by a descent of the line; this is the result of 
the closing of the lips for the second “p.” The extra wave results 
from the suddenness of this closure. The occlusion is followed by 
an explosion. The word ends with the vibrations of the final vowel. 
ing to one vibration of the vocal cords. The vibra- 
tions end by a sudden fall of the line as the lips are 
again closed for the second “p.” The record of the 
explosion for this “p ” is similar to that for the first 
one. The word closes with the vibrations of the final 
vowel. 
A record of the word “ papa ” spoken by a stutterer 
(Fig. 9) shows a very long occlusion for the first “ p,” 
followed by a tremendously long blast of air, corre- 28 
STUTTERING AND LISPING 
sponding to the explosion of the “ p.” A slow fall of 
the line after the first vowel shows that the lips were 
Fig. 9. — Mouth record of “papa” with blowy “p” ’s spoke by a stut- 
terer. 
The initial “ p ” has a very long occlusion, followed by a long and 
strong blast of air. The second “p” is an incomplete occlusion fol- 
lowed by a blast of air. Comparison with Fig. 8 shows clearly how 
the stutterer’s enunciation differed from the normal one. 
closed gradually and not suddenly for the second 
“p.” This "p” also has a blowy explosion. 
A record of the word “papa” spoken by another 
stutterer is given in Fig. 10. The record shows that 
Fig. 10. — Mouth record of “papa” with an inspiratory “p” spoken 
by a stutterer. 
The sudden descent of the line shows that the stutterer drew in 
his breath to make the “ p ” instead of closing his lips. The vowel 
vibrations follow as usual. 
instead of closing his lips and then opening them for 
the initial “p,” he drew in his breath for a moment 
and then closed his lips, thus making an inspiration SYMPTOMS, FORMS, NATURE 
29 
and an occlusion instead of an occlusion and an ex- 
plosion. 
A record of the word “ sleepy ” spoken normally is 
shown in Fig. 11. There is a gradual rise of the line 
as the air issues from the mouth during “s.” This 
falls rather suddenly as the tongue changes from the 
Fig. 11. — Mouth record of “sleepy” spoken normally. 
The gradual rise of the line registers the rush of air during the 
second “s.” The small waves record the vibrations of the voice 
during “1” and “ee.” The occlusion and the explosion for "p” 
and also the vibrations for the final vowel are similar to those in 
Fig. 8. 
“ s ” position to that for the “ 1.” There is a second 
rise with faint vibrations for the “1”; these persist 
as the line continues to fall. The rather long “1” 
includes the vibrations along the horizontal line. 
Suddenly the line rises for the vibrations of “ ee,” as 
the tongue moves from the “ 1 ” position to the more 
open one for “ ee.” It is interesting to note that the 
“ 1 ” is so much longer than the “ ee” The line sud- 
denly falls as the lips are closed for the “ p ” ; it sud- 
denly rises as they are opened with a kind of explo- 
sion. The final vowel is quite long. 30 
STUTTERING AND LISPING 
In a record (Fig. 12) of the word “sleepy” by a 
stutterer the sinking of the line shows an initial gasp 
Fig. 12. — Mouth record of “sleepy” spoken by a stutterer. 
There is a gasp before the “s.” For the “p” there is no complete 
closing of the lips and no explosion. The small vibrations during 
the “p” show that the larynx continued to vibrate instead of stop- 
followed by a rush of air for “s. ” Thereafter come 
the small vibrations indicating the semivowel “ 1 ” 
Fig. 13. — Mouth record of “ stutter ” spoken normally. 
There is first a rush of air for the “s,” then a sudden fall as the 
breath is cut off by the tongue in producing the occlusion of the “ t.” 
The sharp rise of the line registers the explosion of the “t.” The 
small vibrations belong to the vowel “ u.” The closure for the second 
“t” (“tt”) and the explosion are similar to those of the first. The 
final vibrations belong to the vowel “er.” 
and the vowel “ ee. ’ ’ A normal “ p ” would be formed 
by cutting off the breath at the lips for a moment. 
In Fig. 12, however, there is no straight line for the SYMPTOMS, FORMS, NATURE 
31 
“p” ; that is, the stutterer’s lips were not completely 
closed. Naturally there is no sudden rush of air at 
the end of the “p.” The record of the “p” shows 
small vibrations, indicating that the larynx continued 
to vibrate instead of stopping as it should have done. 
Fig. 14. — Mouth record of “stutter” spoken by a stutterer. 
There is an initial gasp followed by a strong “s” and then an 
immensely prolonged “t.” There is then another gasp. The rest 
of the word is normal. 
A normal record of the word “ stutter ” is given in 
Fig. 13. It registers the rush of air for the “ s ” by 
the upward rising line. The line suddenly falls as 
the lips are closed for the “ t.” It rises very sud- 
denly as the lips are opened to let out a puff of air, 
the explosion of the “t.” Then follow the vibrations 
of the vowel “ u.” The line falls as the tongue closes 
the mouth for the second “ t ’’-sound (indicated by 
“ tt ”). The word ends with a series of vibrations for 
the final vowel which is indicated by “ er.” 32 
STUTTERING AND LISPING 
A mouth record (Fig. 14) of the word “ stutter ” 
by a patient shows an initial gasp followed by a 
strong “a." Then comes an immensely prolonged 
“ t.” At the end of the “ t ” there is another gasp. 
The rest of the word shows no marked abnormality. 
The beginning of a stutterer’s attempt to say 
“ Peter Piper’s peppers ” is given in Fig. 15. A short 
Fig. 15.— Mouth record of “Peter Piper’s peppers” spoken by a stut- 
terer. 
The stutterer makes a gasp and a vowel sound followed by a 
blowing sound before he can say the first “p.” Such sounds are 
called “ starters.” The “ p ” is long and has a violent explosion. The 
“t” is so short as to be almost lacking. The “starter” is repeated 
before each word. 
gasp is followed by a long vowel that sounds like “u” 
in “ up.” Then conies a blowing noise made by the 
lips; it is the same as the Greek sound “ ph ” which 
is similar to the English “f.” All this has to be 
done before he can say the first “p.” The “p” 
is long; it has such a violent explosion that the large 
vibrations of the recording lever persist for a con- 
siderable time. The very short vowel “e” shows no SYMPTOMS, FORMS, NATURE 
33 
peculiarities. The “ t ” was made so abnormally 
short as to almost entirely disappear. The last 
vowel (indicated by “er”) was much prolonged. 
The “ uf ’’-sound was repeated before each word; the 
entire phrase be- 
ing spoken about 
as follows: “uf- 
Peter ufPiper’s uf- 
peppers.” 
The difference 
between the use 
of the laryngeal 
tone by normal 
speakers and by a 
stutterer can be 
illustrated by comparison of the melody of the voice 
in the two records shown in Figs. 8 and 9. The 
length of each vowel vibration is measured under a 
microscope. The number of vibrations of this length 
that would occur in one second is calculated. This 
is the pitch of the laryngeal tone at that instant. 
The result is marked by a dot on cross-section paper. 
A line connecting these dots shows the rise and fall 
of the voice. Such a diagram is termed a “ melody 
200 
170 
14C 
130 
■1C 
1> 
papa 
a 
1> 
a 
'95 
Fig. 16. — Melody plot for “papa” spoken 
normally (Fig. 8). 
Each wave of the vowels is measured. 
The pitch of the tone corresponding to 
each wave is then calculated. The results 
are indicated by a line, — the “melody 
plot” — which shows how the tone rises 
and falls. The melody plot shows that 
the voice started at a tone of 170 vibra- 
tions in the first vowel and descended to 
140. In the second vowel it started at 
130 and descended to 95. 
0 
100 
200 
300 
400 
500 34 
STUTTERING AND LISPING 
plot.” The melody plots for the records in Figs. 8 
and 9 are given in Figs. 16 and 17. The monotony 
of the stutterer’s voice is evident. 
The view of the nature of stuttering that I have pro- 
posed differs essentially from the prevalent theories. 
According to Kussmaul the enunciation of each 
single sound occurs correctly; the trouble is in 
connecting the consonants with the vowels; this 
200 
100 
125 
125 
P 
a 
P 
a 
"90 
o 
papa 
100 
200 
300 
400 
500 
600 
700 
800 
900 
Fio. 17. — Melody plot for “ papa ” spoken by a stutterer (Fig. 9). 
The first vowel maintained a tone of 125 vibrations throughout. 
The second vowel maintained the same tone for a while and then 
fell to 90. 
occurs because the respiratory, laryngeal, and enun- 
ciatory muscles do not act harmoniously. This is 
contrary to fact. In the case of a stutterer, every 
sound without exception is made more or less in- 
correctly. Even when he is speaking with apparent 
smoothness, the over-tension of the muscles (p. 12) 
is present, and the strained, monotonous laryngeal 
tone is heard. The cramps affect the sounds them- 
selves regardless of how they are followed. A stut- SYMPTOMS, FORMS, NATURE 
35 
terer does not stick on “1 ” because a vowel follows 
it, but because he feels he cannot say that particular 
word; for example, he may stick on “stove” but 
not on “ sto ” or “ stone.” 
The statement that stuttering consists purely of 
a wrong form of breathing simply neglects all the 
other defects in the stutterer’s speech. The theory 
that it consists essentially in an incoordination of 
breathing and speech movements quite misrepresents 
the condition; such incoordination appears typically 
in the speech of a person intoxicated with alcohol, 
whose speech is different in every detail from that 
in stuttering. 
The theory that stuttering consists in an exaggera- 
tion of the consonants in speech merely takes account 
of the results. Since the stutterer usually has his 
cramps on initial consonants, these sounds occupy a 
great deal more time than the following vowels, and 
also than the following consonants. There are, 
moreover, cases where the patient stutters on initial 
vowels, as in “ a-a-a-apple.” Since in German the 
initial vowel really begins with a consonant (the 
glottal catch corresponding to the spiritus lenis in 
Greek), this might be considered as consonant stutter- 36 
STUTTERING AND LISPING 
ing. But in English the initial vowels begin clearly. 
Moreover, the cramped laryngeal tone is present in 
every vowel in every case of stuttering. The 
lengthening and exaggeration of consonants or 
vowels are the results of the cramps, and these 
cramps are the results of other conditions. 
Every one of the above theories neglects just the 
one vital characteristic of the disease, namely, that 
the defect is due to the fact that the stutterer thinks 
some other person is listening to him. As long as he 
is alone, he can speak perfectly. When a stutterer, 
who has become so accustomed to me that he speaks 
perfectly in my presence, is placed at the telephone, 
he will continue to speak perfectly as long as he sees 
my finger on the switch that cuts it off; the moment 
it is removed he knows that “ central ” will hear him 
and he begins to stutter. 
It has been asserted that stuttering consists essen- 
tially of the fear of speaking. This is true as an ex- 
planation of why the person stutters as badly as he 
does when once the disease is developed. The fear of 
speaking is perhaps the most prominent symptom in 
stuttering just as in stage fright, but an underlying 
cause for this fear must be sought for. SYMPTOMS, FORMS, NATURE 
37 
The assertion has been made that stuttering is 
related to tics, to compulsive acts, to the phobias, 
and to writer’s cramp. These conditions are not 
only utterly different from stuttering, but also from 
each other. 
The essential of a tic is a persistently repeated 
impulse to a special movement that can be suppressed 
voluntarily for a short time. The tic movement 
always involves more than one muscle; it is the 
remainder of a movement that was once purposive, 
such as sniffing, twisting the head, blinking the eye, 
etc. The tic, unlike stuttering, does not involve 
any inaccuracy, uncertainty, or primary embarrass- 
ment or fear. 
A compulsive act, like that of touching all the 
posts as one goes along, or that of never stepping on 
the cracks in the sidewalk, etc., arises from an al- 
most irresistible impulse to do a certain compli- 
cated act. Like the tic, the impulse can be repressed 
for a while; but the impulse is to a definite compli- 
cated act, not to a single movement, as in a tic. 
Unlike stuttering, the compulsive acts are not pro- 
duced by any fear, and do not show any inaccuracy 
or uncertainty. 38 
STUTTERING AND LISPING 
The phobias are characterized by irresistible fears 
of objects, acts, or places, as the fear of filth, the fear 
of committing an act of desecration, the fear of cross- 
ing open places, etc. The patient with a phobia 
knows that his fear is absurd. The stutterer’s fear 
is not only reasonable but also thoroughly justified. 
Writer’s cramp is a fatigue of the nerve centers 
due to overexertion in writing. It is a dull pain or 
an actual cramp, quite unconnected with any mental 
disturbance. The cramp is spastic and not clonic. 
There is no mental compulsion, as in tics, compulsive 
ideas, and phobias. There is no embarrassment or 
fear, as in stuttering. Penmanship stuttering has 
been observed in one case.1 The embarrassment and 
fear were like those of the stutterer; the cramplike 
repeated movements were not like those of writer’s 
cramp, but were the same as those of oral stuttering. 
According to my view, stuttering is a disease 
marked by the following cardinal symptoms : 1, psy- 
chic over-tension and spasms of the muscles of 
speech, 2, anxiety (embarrassment or fear), 3, fixation 
of these conditions by habit, and 4, the existence of 
these symptoms only in the presence of other persons. 
1 Scripture, “ Penmanship Stuttering,” Jour. Am. Med. Assoc., 
May 8, 1909, Vol. LII, p. 1480. SYMPTOMS, FORMS, NATURE 
39 
The enumeration of the symptoms does not suffice 
to indicate the nature of stuttering. The fact that 
one child becomes a stutterer through imitation or 
fright or an exhaustive disease, while another does 
not, indicates some deeper difference in the mental 
or nervous constitution. 
Analysis of the stutterer’s condition of mind 
always shows a serious disturbance in his attitude 
toward other people. Most patients are shy and 
timid; the boldness or indifference in other cases is 
only a kind of bravado to cover up timidity. Much 
of this timidity is undoubtedly due to the effects of 
the stuttering, but its intensity is often out of all 
proportion to the occasion. It may well be that 
timidity is the basis on which stuttering arises. If 
this is true, stuttering would then be a condition 
in which timidity shows itself by a peculiarity in 
speech. 
Social timidity shows itself in mental symptoms 
that are approximately the same in stutterers and 
non-stutterers; there are the same strained feelings 
toward other people, the same bashfulness, etc. 
The bodily symptoms are also similar; the muscles 
of the body are more tense than they should be; 40 
STUTTERING AND LISPING 
there is often also the flushing of the face, etc. 
There are even resemblances in speech. The timid 
person, who is a non-stutterer, speaks with a tense 
voice, he often stumbles over his words and some- 
times can hardly get them out; he often sticks or 
reduplicates like a stutterer. If this “stuttery, ” 
timid speech can be supposed to be developed and 
firmly fixed in a set of habits, the result would be 
true stuttering. 
The fact that stuttering arises only in some cases 
of timidity and not in others indicates that there is 
some other element in the disease. The following 
observations may perhaps suggest what it is. In 
several cases there has been a determined effort to 
get rid of the trouble and perfect good faith on the 
part of the patient, yet I have had the feeling that 
at the bottom of his soul the patient really did not 
wish to be cured. This reminds one of some forms 
of hysteria, psychasthenia, and neurasthenia, where 
the disease is really produced by the patient in order 
to obtain some end, although he is absolutely un- 
conscious of this self-production. It may be sug- 
gested that stuttering is a defect which tends to 
exclude the person from the society of his fellows, SYMPTOMS, FORMS, NATURE 
41 
and that persons who already have this unconscious 
tendency instinctively seize upon such a means of 
encouraging it. 
The same mental condition as that underlying 
stuttering is found in many cases of neurasthenia and 
psychasthenia where quite other symptoms (head- 
ache, tremor, anxiety, etc.) appear instead of the 
speech trouble. It is often a cause of wonder why 
some neurotic patients are not stutterers. If we 
assume that the impulse to segregation from society 
will use the most likely and effective means for its 
purpose, we understand why it naturally seizes 
upon the speech function. We also understand 
that it will more readily disturb the speech when 
the mechanism of normal speech is less firmly fixed, 
as after exhausting diseases, fright, or injury by 
imitation. When the normal speech mechanism is 
strong, the psychasthenic impulse must find some 
other outlet. 
Stuttering is therefore a diseased state of mind 
which arises from excessive timidity and shows itself 
in speech peculiarities that tend toward a condition of 
segregation which will enable the person to avoid oc- 
casions where he will suffer on account of timidity. CHAPTER III 
DIAGNOSIS 
The mere repetition of a word or of an initial sylla- 
ble is often termed stuttering. Such repetitions occur 
to every one at times, especially in embarrassing 
situations. One stutterer said that every boy in 
the class stuttered when reciting Latin. Various 
other conditions, such as hysteria, multiple tics, in- 
juries to the brain, etc., may produce repetitions in 
speech. Such repetitions do not have the same 
cause or the same systematic regularity as the repe- 
titions due to stuttering in the habit stage; the 
muscular movements do not have the cramplike 
stiffness peculiar to stuttering. The symptoms are not 
the result of embarrassment and fear, as are those due 
to stuttering in the fright stage. It is quite im- 
portant to distinguish between the disease called 
stuttering — namely, the disease whose character- 
istics have been described in the preceding chapters 
— and the repetitions often called stuttering which 
42 DIAGNOSIS 
43 
are found in various other diseases. These repeti- 
tions might be called “pseudo-stuttering.” 
“Organic lisping” is an inaccurate form of speech 
produced by abnormal conditions of the speech organs. 
It may be illustrated by the case of the boy who says 
“sh” for “s” on account of a very high palate. 
Tongue-tie may cause the child to use “th” for “s.” 
The lisp disappears when the organic defect is 
corrected. There is no resemblance between the 
sounds of organic lisping and those of stuttering; in 
the former the sounds are incorrect because they 
are incorrectly made, in the latter because they 
are made with too much force. Tongue-tie 
never produces stuttering directly. I have had a 
small boy with tongue-tie who both lisped and 
stuttered. Upon cutting the tongue band he ceased 
to lisp immediately, and stopped the stuttering 
after three days. The tongue-tie caused the lisp, and 
the embarrassment over the lisp caused the stuttering. 
A full account of organic lisping is given in Part II. 
“Negligent lisping” is a term that may be applied 
to those errors of speech that are due to defective 
perception and execution of sounds. Thus “w” is 
used for “r” because the child does not clearly per- 44 
STUTTERING AND LISPING 
ceive the difference and because he does not take 
the trouble to produce the more difficult muscular 
adjustments required for the “r.” Most frequently 
the tongue is pressed a trifle too hard against the 
palate so that it closes up the small passages re- 
quired for “s” and “th,” thereby turning both of 
these sounds into “t” and producing “tun,” “toap,” 
etc., for “sun,” “soap,” etc., or “tick” for “thick.” 
Often “t” is used for “k,” as “tandy” for “candy.” 
The defective sounds remain constant, whereas 
they change in stuttering. The lisper’s “s” is 
always defective, whereas the stutterer may have 
trouble on initial “s” but not on final “s. ” Negligent 
lisping occurs in normal or phlegmatic or mentally 
dull children, whereas the stutterer is always nervous; 
some lispers, however, become much embarrassed 
by their defects, and some even become stutterers on 
account of embarrassment. Negligent lisping is 
treated in detail in Part II. 
“Stammering” is a term sometimes applied to 
the speech defects indicated by the German word 
“Stammeln”; these are the same as those just de- 
scribed under the term “negligent lisping.” Often 
the term “stammering” is applied in a confused DIAGNOSIS 
45 
way to a case of stuttering where the patient sticks 
in his speech rather than reduplicates his consonants. 
Most often the term is used as identical with “ stutter- 
ing.” It is better to eliminate the word “stammer” 
in order to avoid confusion. 
“Neurotic lisping” is a disease described here for 
the first time. The person may speak with general 
indistinctness, appearing to mumble the words, or 
the incorrectness may be confined to special sounds. 
One girl of thirteen lisped over all the consonants. 
She was an excessively nervous child, and she spoke 
with incredible rapidity. As she was gradually 
quieted down, the lisping decreased. It became evi- 
dent that the excessive nervous tension, combined 
with self-consciousness, produced a tense condition 
of the vocal organs allied to that of stuttering. She 
could not produce the smooth and delicately ad- 
justed movements of normal speech because her 
muscles were overtense. Another girl of twelve was 
afflicted with partial deafness, which had made it 
hard for her to learn to speak. Being a sensitive 
child, the correction of the parents and the embarrass- 
ment and fear before them had caused nervousness. 
She spoke improperly because she over-innervated 46 
STUTTERING AND LISPING 
the speech muscles. Neurotic lisping occasionally 
occurs in stutterers. The lisping may sometimes ap' 
pear in only a few sounds, the others being distinct. 
One case of this kind lisped only on “s”; the cause 
was a fright that had left the person excessively 
nervous. The overtension of the speech muscles, the 
nervous condition of mind, and the similarity of 
causation in some cases point to a close relation of 
nervous lisping to stuttering; they might perhaps jus- 
tify the term “spastic stuttering.” Neurotic lisping 
may be distinguished from stuttering proper by the 
fact that the overtension of the muscles is a con- 
stant one; the mental excitement seems also to be a 
steady condition, not varying as in stuttering. Fur- 
ther details are given in Part II. 
Bad cases of “cluttering” (hasty mumbled speech) 
are often confused with stuttering. Although the 
clutterer speaks with excessive rapidity and slurs 
over the. details of his words, and although he breathes 
improperly and sometimes sticks in the middle of a 
sentence, yet the defects are the result of over- 
excitement and eagerness rather than of anxiety and 
fear, as in the case of the stutterer. The clutterer 
speaks better the more he is concerned about his DIAGNOSIS 
47 
speech, the stutterer the less he worries about it 
(see Part II). 
“Tic speech” or “choreatic stuttering,” or the 
speech of the “post-choreatic neurosis” (if the terms 
may be permitted) is characterized by a system of 
spasmodic movements of constant character that 
break up the speech in a way somewhat like ordinary 
stuttering. The trouble originates in an attack of 
acute chorea. After this has passed, the patient may 
retain various spasmodic movements which are no 
longer due to the cause of the original disease, but are 
really “tics” derived from the choreatic movements. 
Such cases are frequently diagnosed as “chorea,” 
whereas they are really “multiple tics.” The 
patient with this form of speech usually has various 
other spasmodic movements of the head, arms, etc. 
The speech itself does not show the regularity of 
stuttering. The stutterer will stick constantly for 
a while on certain consonants; his trouble is nearly 
always in getting started. The tic-speaker usually 
begins smoothly and catches and jerks at any mo- 
ment ; there is no regularity or system in the sounds 
he stumbles over. The mental attitude of the 
stutterer is characterized by anxiety and fear; the 48 
STUTTERING AND LISPING 
tic-speaker does not hesitate to speak at any time, 
and is usually unabashed by his defect. 
The speech defects of “hysteria” have often 
been confused with stuttering. In one case the 
patient upon being asked a question would hesitate 
a moment, turn her eyes to one side, and make a 
movement of the head as if she had just waked up to 
the question, and then answer with a slight difficulty 
at the start. The symptom was absolutely constant. 
Corneal and pharyngeal reflexes were lacking; she 
was readily hypnotized; all of these pointed to 
hysteria. Another patient could not say words 
beginning with “w” because a word beginning with 
that letter had once shocked his feelings. Sometimes 
the patient stumbles over all words relating to certain 
topics. Such patients do not show the cramplike 
action of the stutterer, and do not have trouble all 
through their speech; the laryngeal tone is not 
monotonous; the mental attitude is quite different. 
They are cases of hysteria, or of “hysterical pseudo- 
stuttering,” and not of true stuttering. 
The diagnosis of “hysterical mutism” has been 
made in cases where the stutterer’s fright made him 
speechless in the doctor’s presence. Older persons DIAGNOSIS 
49 
that complain simply of inability to speak when 
meeting strangers will be found, on close observation, 
to stutter more or less perceptibly. 
“Hysterical aphonia” results in a whispered or 
faint tone of the voice that is present continuously in 
a sentence; there are no cramps in the mouth or face. 
The stutterer never has the whispered or the faint 
voice; he nearly always has some cramps in the 
mouth or face. He may become speechless for a 
short time, but this does not occur with the hysteri- 
cal patient. 
In the “spastic speech” of cases of infantile cere- 
bral palsy, the characteristic is over-innervation 
of all the muscles used to express the idea. In 
speaking a word the patient contracts not only 
the muscles of breathing, of the larynx, and of the 
organs of enunciation, as many a stutterer would, 
but also makes strong contractions of all the facial 
muscles. The overcontractions are those that would 
be needed to overcome heaviness of movement, and 
are often not well coordinated, whereas the stutterer’s 
overcontractions are those that express embarrass- 
ment and are perfectly coordinated for the purpose. 
In spastic speech there is none of the stutterer’s fear. 50 
STUTTERING AND LISPING 
The over-exertion is continued throughout the sen- 
tence. The syllables are equal in length, and are 
laboriously enunciated. 
A record of the word “ papa ” made by a patient 
with “ cerebral birth palsy ” is shown in Fig. 18. 
Fig. 18. — Mouth record of “papa” in a case of spastic speech. 
The occlusion (straight line) for the “p” is followed by a blowy 
explosion (upward curve). The vowel vibrations are blown upward. 
All the sounds are longer than those of the normal record (Fig. 8). 
The explosion for each of the “ p ”s is of the blowing 
kind, more like those of the stutterer’s record (Fig. 
9) than those of the normal record (Fig. 8). The 
vowels are also blown, as shown by the position of the 
line with the fine vibrations. All the sounds are 
lengthened, particularly the last vowel. 
In “motor aphasia” the patient cannot find the 
words or sounds to express what he wants to say. 
There is usually a history of trauma or apoplexy. 
Stuttering nearly always begins in childhood; aphasia 
is usually connected with old age or injury. The 
excessive nervousness of the aphasic person some- 
times resembles that of the stutterer; it has partly DIAGNOSIS 
51 
the same origin in anxiety to get out the words 
and in fear of being ridiculous. There is no ex- 
cessive muscular tension or cramp of the speech 
muscles. The laryngeal tone is normal, and not 
monotonous. Words or parts of words or letters 
Fig. 19. — Mouth record of “papa” in a case of motor aphasia. 
The syllable “pa” is spoken gently. A long pause follows. The 
word is then spoken correctly. 
may be repeated (pseudo-stuttering), but the cramps 
of the stutterer do not occur. 
One aphasic repeated a word or a phrase over and 
over before he could go on; for example, “Doctor — 
doctor — doctor Brown told me to come here. I 
bring — I bring — I bring what you told me — I 
bring — bring — bring, yes, bring, bring, I bring, 
etc;” or “I say to my — to my — to my — I say 
that to my niece, I have my girl, I have my girl, 
etc.” This is pseudo-stuttering. A stutterer does 
not repeat a word, but only sounds or syllables; he 
would have said “D-d-doctor,” “I b-b-bring,” etc. 
A record of “ papa ” by this patient is reproduced 
in Fig. 19. The first syllable is spoken normally; 52 
STUTTERING AND LISPING 
there are no cramps. Then follows a pause, after 
which the word is spoken correctly. This should be 
compared with a record of the same word by a stut- 
terer in Fig. 9. Sometimes the patient will repeat 
the first syllable a dozen times with pauses between. 
He says that he is for a while unable to recollect 
what the second syllable is. 
This aphasic syllable or word repetition is utterly 
different in its cause and its symptoms from true 
stuttering. Kussmaul calls it “ aphatic stuttering.’’ 
It is simply one of the phenomena of aphasia. 
In its early stages “multiple sclerosis” sometimes 
produces a kind of pseudo-stuttering; the later 
stages are characterized by a scanning speech in 
which each syllable is brought out with a distinct 
effort. The characteristic anxiety of the stutterer 
is absent. 
In “hereditary ataxia” (Friedreich’s) the speech 
is slowed, clumsy, and often scanning. There may 
be hesitation, but there is no true stuttering and no 
stutterer’s fear. 
In “progressive bulbar paralysis” the injury 
to the nuclei in the pons and bulb produces weak 
action of the muscles of lips, tongue, pharynx, and DIAGNOSIS 
53 
larynx. The sounds of speech become mumbled and 
indistinct. The blurred pronunciation can hardly be 
confused with stuttering. The weakness of the 
laryngeal muscles produces hoarseness, dullness, 
monotony, lowering of pitch, and finally loss of 
voice. There is no fear of speaking as in stuttering. 
Fig. 20. — Mouth record of “papa” in a case of bulbar paralysis. 
For “ p ” the line rises steadily ; this shows that the lips were not 
closed completely. The strong vibrations for the vowels correspond 
to the bellowy character of the voice. For the second “p” the lips 
were closed, but the larynx continued to vibrate. The limits be- 
tween the sounds are much blurred. 
A record of “ papa ” spoken in a case of progressive 
bulbar paralysis is reproduced in Fig. 20. Instead 
of an occlusion and an explosion for the initial “ p ” 
there is a steady rise of the line, showing that the lips 
were not closed completely at any moment. For the 
second “ p ” there is also only a slight narrowing of 
the lips instead of a closure; the larynx does not stop 
vibrating for a moment as it should. 
In “pseudo-bulbar paralysis” the speech is im- 
perfectly enunciated; it may be nasalized; it may 
become an unintelligible mumble; it may even 
closely resemble stuttering (pseudo-stuttering). The 54 
STUTTERING AND LISPING 
weakness of the muscles shows itself not only in 
speech, but also in every movement; e.g. panting, 
whistling, singing, sticking out the tongue, etc. 
Similar disturbances occur in swallowing and cough- 
ing. The eye muscles and the extremities are usually 
affected. It is characteristic that, although the 
voluntary control of these muscles is injured, yet 
they act perfectly in response to emotional, auto- 
matic, and reflex stimuli; for example, although the 
patient cannot move his lips or the facial muscles 
when talking, yet he laughs and cries and expresses 
his emotions in an exaggerated manner. In his 
speech the muscular action is too weak, in contrast 
to the too strong action in stuttering. There is no 
anxiety, as in stuttering. 
In the speech of “general paralysis” the sounds are 
often slurred over, there are no cramps in enunciation, 
and single sounds are not repeated. Mistakes occur 
readily in the combination of the parts of a word. 
For example, the paralytic patient will say “ar- 
trallery” or “rartrillery, ” but it will be said without 
cramps. A stutterer would say “ a-a-a-artillery ” 
or “art-t-tillery.” The paralytic can often speak the 
word correctly by trying very hard; the stutterer DIAGNOSIS 
55 
speaks better as he speaks gently. The paretic 
“syllable repetition’’ is quite different from true 
stuttering; the paralytic will say “hippo-po-po-pot- 
musmus,” the stutterer would never say anything 
like this, though he might say “hip-pop-p-potamus.” 
The diagnosis of “insanity” with commitment to 
an asylum occurred in the case of a very bad stutterer. 
When excited, he would go through the most extreme 
contortions and gesticulations in the effort to get 
out a word, and would finally run up and down the 
room in wild exasperation at his inability to speak. CHAPTER IV 
THERAPY 
The prospect of a permanent cure of stuttering is 
good, provided the patient is willing and able to keep 
up the treatment for a sufficiently long time. The 
length of the treatment is variable. With very 
young children the cure often succeeds in one, two, 
or a few more treatments. Somewhat older children 
require three or four weeks or even months of daily 
treatment. Older persons are sometimes cured 
rapidly, but they are often very difficult to manage. 
When the patient receives treatment only during 
visits to the physician two or three times a week, a 
permanent cure may require six months or a year. 
When there is weakness of character, a permanent 
ure can be effected only by remedying the under- 
lying defect at the same time. 
The first step in the cure of stuttering is to look 
after the patient’s bodily and mental health. Most 
stutterers are anemic, all are nervous. Fresh air 
56 THERAPY 
57 
and exercise, proper hygiene of meals, sleep, and 
moral habits, regulation of school or office work, 
cod-liver ’oil, iron, arsenic, etc., are indicated. The 
treatment of the stuttering is often useless unless the 
patient is treated for his nervousness; the two 
troubles aggravate each other, and they should be 
treated simultaneously. Nose and throat should be 
in good condition; turbinates, polyps, septum, ade- 
noids and tonsils should be treated if necessary. 
At the outset it is usually necessary to explain to 
the parents how the stutterer is to be regarded at 
home, or to the patient himself how he is to regulate 
his life. The home attitude during the fright stage 
should be such that the stutterer should be encouraged 
to forget himself. His attempts at new ways of 
speaking should not be commented upon. Mistakes 
and relapses should not be noticed. The patient 
should never be blamed. With rare exceptions the 
attempt of a parent to correct or help the stutterer 
is an added irritation and a direct hindrance. 
The treatment of stuttering is based on the follow- 
ing principles. 
The “principle of a new method of speaking” is 
founded on two facts: first, that the stutterer speaks 58 
STUTTERING AND LISPING 
in an abnormal voice, which we may call the “ stut- 
ter voice”; and, second, that he does not stutter 
QUEER SPEECH 
’ SINGING 
THOUGHT TO 
BE EXPRESSED 
NORMAL 
SPEECH 
J EMOTIONAL DISTURBANCE 
STUTTERING SPEECH 
VOCAL ORGANS 
Fig. 21. — Scheme to illustrate the mechanism of stuttering. 
When the stutterer attempts to express a thought in his usual voice, 
he is obliged by the emotions connected with speaking to cramp his vo- 
cal muscles. If he expresses his thought by singing, by queer modes of 
speech, or in any other way unusual for him, he has no difficulty. 
The normal way of speaking differs so much from the stutterer’s 
voice that it is just as unusual to him as the queerest voice can be. 
He cannot stutter in a normal voice. 
when he expresses his ideas in any other voice, such 
as the singing voice. 
The scheme shown in Fig. 21 expresses these two 
facts. When the stutterer tries to express a thought in 
the presence of another person, the action of his speech THERAPY 
59 
is interfered with by the emotional condition (embar- 
rassment or fear) that is aroused at the same time. 
He therefore speaks in his stutter voice. If he tries 
to express the thought in any other way than the 
usual one, the emotional disturbance does not arise. 
This explains the familiar fact that a stutterer never 
has any trouble when he sings what he wants to say. 
Since the patient does not stutter if he speaks in 
any unusual way, he can be taught to speak in some 
kind of an odd voice. The stutterer can at any 
time speak without stuttering if he will use an 
abnormally low voice, or an abnormally high one, or 
if he will drawl the vowels or slur the consonants, 
or if he will speak in a choppy staccato voice, and so 
on. These are the methods of the “stammer 
schools” and “stutter curers.” They are objec- 
tionable because they leave the patient with a queer 
voice. He is likely to have it told him that the 
“cure is worse than the disease.” He usually gives 
up the queer voice after a while and becomes a stut- 
terer again because the queer voice itself produces em- 
barrassment and he naturally feels like discarding it. 
The essential point is that the stutterer feels his 
manner of speech to be different from his stuttering 60 
STUTTERING AND LISPING 
voice. One patient could never dictate to his 
stenographer. I found that he could not distin- 
guish one note from another in music. I told him to 
sing what he wanted to dictate. He did so without 
the slightest hesitation or difficulty, in what he 
supposed to be a singing voice; it did not differ, 
however, from his stuttering voice, except in being 
slightly easier and more natural. As long as he 
thought he was singing, he did not stutter, although 
he did not sing. The cure was a failure because 
he refused “to make a fool of himself by singing to 
his stenographer.” To have enlightened him con- 
cerning the fact that he did not sing would have 
destroyed the belief that he was singing and would 
have made him a stutterer again. There was no 
way out of the dilemma. 
There is another way of speaking which is unusual 
to the stutterer, namely, the way in which the nor- 
mal person speaks. When he speaks in this way, he 
does not and cannot stutter. The therapeutic pro- 
cedure on this principle will therefore be to teach 
him to speak normally. Each of the abnormalities 
that appear in his speech has to be determined and 
corrected. The result is perfectly normal speech. THERAPY 
61 
This is the only method of cure that should be 
permitted. 
The “principle of relaxation” is used to aid in 
overcoming the emotional condition of the stutterer. 
It is pointed out to him that he speaks in a hard, 
strained voice. He is taught to speak softly, melo- 
diously, and pleasantly. It is quite effective to get 
him to go through various exercises while lying 
down and trying to doze; a hypnoid or a hypnotic 
doze aids in relaxation. 
The “principle of habit formation” implies that 
the new way of speaking is to be drilled into the 
patient till it becomes a habit. The greatest diffi- 
culty lies in the fact that speech is so automatic that 
we practically never think before we speak. The 
training requires the patient at first to think how he 
is to speak each time before he actually speaks. The 
first steps require him to repeat sentences, poems, 
etc., after the instructor. This is continued till 
proper habits are formed. The final result must be 
a purely automatic system of speech habits. If the 
treatment falls short of complete automatism in 
the new form of speech, the patient will probably 
drop the habit and become a stutterer again. 62 
STUTTERING AND LISPING 
The “principle of spontaneity” is requisite be- 
cause, when the patient has learned to repeat per- 
fectly, he will still be unable to do so when he speaks 
of his own accord. A gradually increasing amount 
of spontaneous speech is introduced into the treat- 
ment. A good method is for the instructor to 
speak declarative sentences and questions alter- 
nately; each declarative sentence is repeated by 
the patient, but each question is answered. He is 
urged to speak the answers in the same tone and 
manner as the questions Gradually longer answers 
and then free conversations are introduced. The 
patient should finally talk freely and perfectly. 
Another method is to give the patient something to 
read. At first the instructor reads with him; soon 
the instructor drops out for an ever increasing 
number of words until the patient can read alone. 
The “principle of increasing embarrassment” 
arises from the fact that, even when the patient has 
learned to speak perfectly in the presence of the 
physician or the instructor, he is unable to do so 
under other circumstances. The patient is taught 
to speak properly before a few other persons or 
before a class. Still more difficulty is introduced by THERAPY 
63 
making introductions, speaking over the telephone, 
buying in stores, reciting in school, etc. For the 
introduction exercise the stutterer practices at first 
privately and then with gradually increasing num- 
bers of strangers. The other problems are met by 
exercises to develop confidence. 
The “principle of equilibration” responds to the 
fact that some patients are abnormally lively and 
expressive while others are retiring and depressed. 
The former type is quite the usual one among 
small boys. They are characterized by excessive 
volubility; their speech runs in a stream, they 
reply before you have finished your remark, they 
continually insert remarks in the conversation of 
others, they often talk and act in a way that is 
“fresh” or even impertinent. It often happens that 
the patient stutters only when he gets into such a 
flippant mood, or when he thinks of something funny. 
This is the mood expressed in the jokey style of talk 
of the mining camp, of the swaggering tough, and to a 
lesser degree of college boys. The very essential of 
the cure lies in repressing such patients. It is 
explained to them not only that their manner is 
improper and offensive, but also that their stuttering 64 
STUTTERING AND LISPING 
is due to their lack of self-control. They are re- 
quired to keep silent when others speak, to silently 
count four before speaking, to speak in time to a 
metronome, to speak no unnecessary word, etc. 
The other type of stutterer is ashamed to speak, 
or is dejected and depressed. Such are many of the 
older boys and the young men and women. They 
need to be encouraged. It is explained to them that 
there is a chance for them to escape from their 
bondage and that life may become bright and happy. 
Moreover, they are not to take their defect so seri- 
ously; others have the same trouble. It is useful 
to accompany such patients to stores, to their homes, 
etc.; a helpful word is inserted when needed. It is 
pointed out to them how much their speech improves 
from week to week. When a patient has serious 
trouble on certain occasions, for example, buying in 
a certain store, it is often stimulating to bet him that 
he will have the same trouble next time. 
The “principle of correct thinking” indicates that 
the abnormal habits of thought, which a stutterer 
always acquires to a greater or less degree, are to be 
corrected by appropriate exercises. 
A frequent abnormality is that of getting into a THERAPY 
35 
daze at each effort to think. The patient finds that 
he cannot decide promptly. It was typical of one 
patient that upon being asked “Which kind of dog 
do you like best?” he hesitated, and grunted, and 
finally said, “I really cannot say which I like best.” 
He was cured by being obliged to give some kind of 
decision quickly, regardless of whether it was correct 
or not. The trouble was due to the mental flurry 
or daze that had become a habit. Another patient, 
when leaving a house, found himself unable to say 
“Good-by” because some friends were waiting for 
him. The trouble arose from a conflict between the 
motive to hurry after the friends and the motive of 
not offending the host; this produced a mental 
daze that left the patient speechless. 
The school exercises of another patient were 
learned in such a hazy fashion that he had a feeling 
of uncertainty when reciting; this made him stutter 
violently. The habit of hazy knowledge may extend 
to every topic in life; the patient must be trained 
to know perfectly and surely what he does know, and 
to recognize exactly what he does not know. 
The “principle of correct enunciation” responds to 
the fact that some stutterers enunciate indistinctly 66 
STUTTERING AND LISPING 
or incorrectly. This may be due to confused and 
incorrect notions concerning sounds; such a condition 
is a form of “negligent lisping” (Part II, Chap. I). 
It is sometimes due to a general excess of muscular 
effort; this is a form of “neurotic lisping” (Part II, 
Chap. IV). The exercises for general indistinctness 
(p. 157) are to be employed. 
An important principle is “belief in the success of 
the treatment.” When the belief is strong, the 
patient makes his readjustments more eagerly and is 
bolder in using them in speaking to others; the 
consequent success encourages him and gives him 
confidence. This in turn leads to still further 
success. With a patient who is consciously or un- 
consciously doubtful of the outcome, the treatment 
becomes laborious. With such patients and with 
all who have become doubtful through failures or 
relapses, a careful psychanalysis (see below) may be 
needed to remove the doubt. 
A thorough “correction of character” has to 
be frequently carried out in order to produce a 
complete and permanent cure of the stuttering. 
Whenever possible, the patient should have his 
entire life studied and regulated by the physician. THERAPY 
67 
Defects of intellect and morality have to be treated 
by the appropriate methods. The neglect to reform 
a person’s character frequently results in failure of 
the cure to be permanent. 
The “ principle of subconscious readjustment ” 
recognizes the fact that only a very small portion 
of our mental life is conscious. From earliest infancy 
our characters have been developed by our surround- 
ings and by the experiences we have passed through. 
Our past has been mainly forgotten, but its results 
are present in our traits of character. The last one 
to have any idea of his character is the person him- 
self. The cause of the stutterer’s trouble is entirely 
unknown to him. It is purely mental but it is sub- 
conscious, and a cure is often possible only by a care- 
ful study of the patient’s subconsciousness. This 
can be done only by the methods known as “ psych- 
analysis”. Some of these methods are briefly de- 
scribed below. 
The usual conditions under which the cure is to 
be achieved include, in the first place, individual 
treatment at the physician’s office. 
My method is to give the patient a thorough 
mental and bodily examination. The general anam- 68 
STUTTERING AND LISPING 
nesis covers the history of the present illness, its 
presumable cause, heredity (stuttering, nervousness, 
asthma), past diseases, education, habits (tea, 
coffee, alcohol, tobacco, drugs, sleep, food, work, 
sex), appetite, digestion. The general status includes 
the size, height, weight, general condition (nourish- 
ment, anemia, exhaustion), general intellectual 
appearance, urinary analysis (albumen, sugar, in- 
dican), circulation (heart). Special examination of 
the organs used in speech includes the nose (septum, 
turbinates), throat (adenoids, tonsils), larynx (ca- 
tarrhal conditions), chest (diameter expanded, re- 
tracted, capacity by spirometer). The special anam- 
nesis can be obtained only gradually as the patient’s 
friendship is gained. It should furnish all sources 
of nervous strain in his life. He is asked to give 
a most careful account of his relations to the other 
members of his family, to his schoolmates or his 
friends, to chance acquaintances, to the community, 
and to mankind. On each of these topics he is to 
compare his attitude to that of other persons. The 
object is to relieve him of all feeling of strain by mak- 
ing him realize that all human beings are built on the 
same principles as he is, and that they are not stran- THERAPY 
69 
gers before whom he should have any feeling of fear 
or distance. Since the patient stutters least before 
persons who have the most sympathy with him 
and notice his trouble least, he is brought to feel 
that the whole world is much more friendly than he 
supposed. 
Without waiting to get a detailed special anam- 
nesis, work may be begun with exercises, and, in 
some cases, with psychanalysis. 
The exercises are prescribed at each sitting as 
the various faults show themselves. If the patient 
speaks too fast, one or more slowness exercises are 
ordered; if too stiffly, melody and flexibility are 
indicated; if the breathing is incorrect or the tone 
is husky, the appropriate exercises are noted, etc. 
An attendant, who has been listening to the physi- 
cian’s criticisms and explanations, then carries out 
the exercises with the patient. 
Psychanalysis is begun by free associations and 
the analysis of dreams, as described below. This 
immediately brings physician and patient into the 
closest personal relations; the latter will discuss 
matters that he would not mention otherwise; the 
special anamnesis is obtained rapidly. Moreover, 70 
STUTTERING AND LISPING 
it brings to his mind many important events of the 
past and calls his attention to many conditions in 
the present otherwise overlooked. Finally, it is 
used for a study of the patient’s subconscious con- 
i 
dition. The distinction between the conscious and 
the subconscious elements of his mental life are ex- 
plained. As he learns to realize the points in which 
his mind works differently from what it should, 
he involuntarily proceeds to a gradual correction. 
The physician should gain the patient’s friend- 
ship and devotion. His ability to develop the pa- 
tient’s confidence is one of the chief factors of the 
cure. The patient should be willing to devote a 
large amount of time to the exercises with the at- 
tendant. Office treatment has the advantage that 
it does not remove the patient from his business or 
school and also that it enables a cure to be gradually 
worked out in the environment in which the pa- 
tient must live. 
The final success or failure of the treatment de- 
pends largely on the patient’s determination to 
persist until the cure is complete. Sometimes a 
patient will spend many months with only gradual 
improvement; finally the resistances and ancient THERAPY 
71 
habits suddenly break down and the patient is cured 
rapidly. He should make up his mind that at any 
cost he will continue treatment until he speaks per- 
fectly. When he does speak perfectly, he should not 
drop the treatment. He should return at steadily 
increasing intervals for examination and for any 
needed revision. When he reaches a six-months in- 
terval, he should make a permanent arrangement 
to return at such an interval; this is not too much 
to ask, even a dentist makes that demand. It is 
true that some cases get well in a few treatments, 
and that most cases do not have relapses; but no 
one can tell beforehand how any one case will turn 
out. 
Another form of treatment is that at an institu- 
tion. The patient lives with the physician and 
attendants in a special house. He suddenly breaks 
off all connection with his past life and enters upon 
a novel series of experiences in strange surroundings 
where people constantly supervise his speech. His 
entire manner of life — bodily and mental — is 
subject to regulation. This form is very effective 
when it can be carried out. The separation from 
the family is often absolutely necessary for a cure. 72 
STUTTERING AND LISPING 
Treatment by classwork has a great advantage 
in the feeling of solidarity it awakens and in the 
inspiration of being cured together with others. It 
is used in the office and institutional forms of treat- 
ment by holding daily classes for the various exer- 
cises. The interest and enthusiasm that can be 
awakened by the various exercises, by the tele- 
phoning, by the ticket selling, by the impromptu 
vaudeville, by the debates, etc., are most beneficial. 
In the speech clinic the treatment must be mainly 
in small groups or classes. So far as possible, the 
physician should attend to the patients individually 
also. 
In connection with the public schools a careful 
examination should be made by a competent phy- 
sician of every child who does not speak perfectly. 
Stuttering must be carefully distinguished from the 
other nervous defects. In all cases of defective enun- 
ciation (Part II) there should be tests of intellectual 
development also. Many of the stutterers and some 
of the lispers can be treated in special classes con- 
ducted by trained experts under direction of the 
specialist. Whether these classes are held during 
school hours, after school hours, or in vacation is a THERAPY 
73 
matter that must depend on local conditions. Quite 
a number of the stutterers and lispers must receive 
special individual treatment. The other speech de- 
fects can be treated only on directions from the 
specialist. CHAPTER V 
METHODS OF TREATMENT 
The object of the treatment is to give the stutterer 
a normal voice and a normal state of mind. The 
following methods of treatment are those that will be 
found most efficacious : — 
Training in Melody and Flexibility 
The tone of the voice, which rises and falls as we 
speak, is produced by the vibrations of the vocal 
cords in the larynx; it may properly be termed the 
“laryngeal tone.” 
The stutterer cramps the muscles of the larynx 
so that he speaks in a monotone. The cure consists 
in putting melody and flexibility into his laryn- 
geal tone. 
By “melody” we mean the rise and fall of pitch 
for successive syllables. Melody may be indicated 
by notes on a staff or by the rise and fall of a line. 
The tones on which the words “How do you do?” 
74 METHODS OF TREATMENT 
75 
may be sung are indicated by the notes in 
Fig. 22 or by the line in Fig. 23. In speech each 
syllable has a rise and fall in 
pitch, as indicated in Fig. 24. 
The speech of the stutterer 
is monotonous and stiff, hav- 
ing neither melody nor flexi- 
bility (Fig. 25). 
A record of the word “ papa ” as actually sung is 
reproduced in Fig. 26; its melody plot is given in 
Fig. 22. — Notes indicating 
how the phrase “How 
do you do?” is to be 
sung. 
do? 
How 
do 
you 
Fig. 23. — Line indicating how the phrase “How do you do?” is to be 
sung according to the notes in Fig. 22. 
Fig. 27. Comparison of Fig. 27 with Figs. 16 and 17 
show vividly the differences in melody among the 
three forms of expression. 
The pitch of the laryngeal tone is determined by 76 
STUTTERING AND LISPING 
the degree of tension of the vocal cords. To vary 
the pitch constantly, as in Fig. 24, the cords must 
change their adjustment at every instant; that is, 
the laryngeal muscles must be freely and delicately 
do? 
How 
do 
Fig. 24. — Line indicating how the normal voice should rise and fall in 
speaking the phrase “How do you do?” with a melody similar to 
that indicated in Fig. 23. 
you 
poised and must act readily and accurately. The 
stutterer, however, cramps them up so that they can 
How 
do 
you 
do? 
Fig. 25. — Line indicating the monotony of the stutterer’s voice in speak- 
ing the phrase “How do you do?” 
move only with difficulty. He sticks to one tone 
as much as possible. His action resembles that of 
a child who cramps a pencil tightly in his hand; 
he can draw a straight line with a ruler to guide him, 
but he cannot write or draw gracefully. METHODS OF TREATMENT 
77 
The laryngeal cramp may be broken up by the 
“melody cure.” The stutterer is first taught to 
sing a song or a phrase while accompanied by the 
Fig. 26. — Mouth record showing the word “papa” as actually sung. 
The vibrations of each vowel are of the same length throughout. 
piano or another voice. His voice will rise and fall, 
as indicated in Fig. 23, and he will have no stiffness 
or cramps. Then he must speak the word on the 
200 
250 
100 - 
I> 
a 
1> 
125 
a 
papa 
700 
800 
0 
100 
200 
Fig. 27. — Melody plot to Fig. 26. 
300 
400 
500 
600 
900 
same notes, first with and then without musical 
accompaniment. This gives him the idea that he 
must put melody in place of monotony. 
The patient now learns to make his voice “ flexi- 
ble.” The instructor pronounces various words in 
such a way that the laryngeal tone passes over two 
octaves in the first important vowel; this may be 78 
STUTTERING AND LISPING 
octaves in the first important vowel; this may be 
called the “octave twist.” Fig. 28 indicates the 
method in musical notation. In Fig. 29 the general 
change is shown by a line. 
In going over two octaves in 
this way the voice passes from 
the chest register to the head 
register. For these registers the 
laryngeal adjustments are quite different. The stut- 
terer always speaks in the chest register. If he 
leaves this register, he must relax the muscles, that 
is, he must drop the cramp and 
start a new adjustment. An 
analogy may be found in raising 
a weight by the arms from below 
the waist to over the head. One set of muscles pulls 
it up to the shoulder, but an entirely different set 
Fig. 28.—Octave twist 
in musical notation 
Fig. 29.—Octave twist 
indicated by a line. 
Fig. 30.—Mouth record of “papa” spoken with the octave twist. 
The waves of the first vowel become shorter and shorter; this 
indicates that the voice rises steadily. 
must be used to get it up any further. The stutterer 
will try to raise his voice while keeping to the chest 
register; he will usually stop at the fifth or the METHODS OF TREATMENT 
79 
octave instead of going over two octaves. As 
long as he does this, the exercises do him no good 
500 
500 
400 
300 
200 
100 
125 
125' 
P 
a 
P 
a 
papa 
0 
100 
200 
300 
400 
500 
600 
700 
800 
900 
Fig. 31.—Melody plot to Fig. 30. 
The voice rises through two octaves in the first vowel. 
whatever; he must be persistently trained until the 
full octave becomes easy. 
Fig. 32.—Mouth record of “papa” spoken with an unsuccessful at- 
tempt at the octave twist. 
Although the vowel waves become shortei in the first vowel, they 
do not become as short as in Fig. 30. 
A record of the word “papa” spoken with the 
octave twist is shown in Fig. 30. The waves of the 
first vowel become shorter and shorter. The melody 80 
STUTTERING AND LISPING 
plot (Fig. 31) shows that the voice rose through 
two octaves. 
The common fault of the beginner who Sticks to 
the chest register and fails to rise two octaves is 
shown in Fig. 32. Although the waves of the first 
vowel become shorter, it is very evident that they 
200 
a oo 
125 
128 
P 
a 
1> 
a 
0 
100 
200 
300 
400 
500 
600 
700 
800 
900 
Fig. 33.—Melody plot to Fig. 32. 
The voice fails to reach an octave on the first vowel. 
did not become short enough. The melody plot 
is given in Fig. 33. 
The melodization of the voice goes on day after 
day until the stutterer can do it perfectly. 
Usually all the other kinds of stiffness and cramps 
disappear together with the laryngeal stiffness, be- 
cause the stutterer has learned to speak with a new 
voice, that is, to use a new set of habits free from 
the stuttering impulse. The object of the melodiza- 
tion and the octave twist is relaxation of the muscles METHODS OF TREATMENT 
81 
of speech. When this has been accomplished per- 
fectly and permanently, the person may speak in any 
way he pleases. 
Correcting the Vocal Quality 
The stutterer’s voice usually sounds hoarse and 
breathy. This is due to improper action of the laryn- 
geal muscles whereby the vocal lips 
are not brought closely together. 
Perfect closure is shown in Fig. 34; 
one condition for the breathy tone is 
shown in Fig. 35. 
This “stutterer’s hoarseness” can 
be readily corrected by exercises in 
which the patient sings and speaks 
“ah” with the glottal catch {coup 
de glotte) at beginning and end of 
the sound. The breath is held 
back by closing the glottis; the 
vowel begins suddenly with strong 
vibrations ; it is ended by snapping 
the glottis shut again. Figs. 36 
and 37 give records of a normal 
English vowel and a vowel marked 
off by glottal catches; they were 
Fig. 34. — Perfect 
closure of the glot- 
tis. 
The vocal cords 
close tightly to- 
gether in produc- 
ing a clear tone. 
Fig. 3 5. — Glottis 
during a breathy 
tone. 
The cords do 
not come together 
completely and 
the tone sounds 
husky or breathy. 82 
STUTTERING AND LISPING 
made by the apparatus shown in Fig. 7. Such a 
vowel begins like an initial vowel in German. It 
is usually not difficult to teach this to the patient. 
In a similar way the patient learns also to speak 
Fig. 36. — Vowel curve with normal beginning and ending. 
The voice starts to vibrate gently and ends in the same way. 
vowels. Other exercises include staccato singing and 
staccato speaking of words and sentences. 
It is a rather common fault of the stutterer to let 
the laryngeal tone (tone of the voice) cease before he 
ends the last word, whereby the end of the word is 
Fig. 37. — Vowel curve with glottal catch at beginning and ending. 
The vocal cords close tightly together and then open with a sudden 
snap as the vowel begins. The vowel is ended in the same way. 
spoken in a hoarse whisper. This is corrected by 
having him snap his glottis shut as he ends the 
word. 
Almost invariably stuttering children and women 
use a voice that is abnormally low. A child of ten 
will sometimes speak on a pitch that belongs to an 
adult. For correction a child practices singing METHODS OF TREATMENT 
83 
songs of appropriate pitch ; then he sings sentences 
to melodies he has learned; then he half sings, half 
speaks them on the correct tones, and finally he 
simply speaks them likewise. 
The stutterer’s voice is usually very poor in 
quality; it sounds thick, as though the throat were 
stuffed with cotton; there is none of the sharp 
resonance that characterizes a good singing or 
speaking voice. The method of correction is much 
the same as for a student of vocal music. The pa- 
tient is trained in singing scales, arpeggios, and songs 
in sharply resonant tones. The resonant tone is 
then carried over into speech. 
The bad quality of the stutterer’s voice is due to 
improper action of the various muscles involved in 
speaking. Some of these muscles are not sufficiently 
tense, while others are violently contracted. There 
seem to be constant relations according to the law 
that a lack of contraction of one set is accompanied 
by excessive contraction of a certain other set; thus, 
the usual failure to raise the velum (soft palate) 
sufficiently is always accompanied by strong con- 
tractions of the jaw muscles, a condition which is 
not only unnecessary, but also distinctly pernicious. 84 
STUTTERING AND LISPING 
Another common defect is underaction of the palato- 
pharyngei (rear arch of palate) with overaction of the 
palatoglossi (front arch). Very frequently there is 
overaction of the mylohyoid and geniohyoid whereby 
the larynx is pulled forward away from the backbone. 
Correction of such defective action of the muscles 
used in speech requires special exercises (Part III). 
Correcting the Breathing 
Stutterers generally have cramps of the breath- 
ing muscles, or they breathe in hurried gasps, or 
they blow out almost all their breath before speak- 
ing, etc. Usually it is sufficient to train the stutterer 
to take a breath before each sentence and not 
to let any of it out before he speaks. Exercises 
in reciting the alphabet several times in one breath, 
trying to say as much as possible of a poem like- 
wise, etc., are useful. Passive and active exer- 
cises may include the usual special calisthenic 
movements; e.g. chest lifting with expansion, up- 
ward arm stretching with resistance, standing-breath- 
ing with arms front upwards and side downwards, 
broad standing neck front sidewise bending, same 
with trunk twisting, etc. These and gymnastic 
exercises (chest weights, running, and the like) aid METHODS OF TREATMENT 
85 
in giving command of the breathing organs and 
produce a feeling of confidence in them. The ab- 
normality in breathing usually disappears when the 
stutterer speaks with the octave twist (p. 78). 
Developing Slowness 
Almost without exception stutterers talk too 
rapidly. They do not realize this fact, and they 
often refuse to believe that they talk as fast as 
another person who imitates them. They have two 
different measures of rapidity, one for themselves, 
the other for other persons. The correction of the 
fault is most difficult; it can be accomplished only by 
frequently repeated exercises and continual remind- 
ers. Many stutterers are cured in a relatively short 
time of everything but excessive rapidity; owing to its 
persistence they repeatedly relapse. Others seem able 
to speak slowly only with the utmost difficulty; in 
such cases a cure of the stuttering is often impossible 
as long as the excessive rapidity is not overcome. 
Exercises in slowness are given by having the patient 
read and repeat poems and sentences in time to a 
metronome beating 54 times a minute. Conversa- 
tion is carried on likewise. Later the conversation is 
carried on just as slowly, but without the metronome. 85 
STUTTERING AND LISPING 
Speaking with the metronome usually makes the 
voice hard, unless special attention is given to soft- 
ness. Some kind of pendulum, such as a weight 
on a string, may be used instead of the metronome. 
Quite useful is persistent drill in speaking with 
lengthened vowels, for example, “The su-u-u-u-un is 
se-e-e-etting.” The voice must be kept soft and 
melodious. 
A stutterer often thinks he gains slowness by 
putting pauses between words, whereas each single 
word is spoken as quickly as before. This produces 
jerky speech. 
Training in Proper Thinking 
A common trouble is the inability to say a certain 
word that the patient wants to use. He may be 
unable to read the names of a list because he may 
stick at any one. Or he is constantly looking ahead 
in his conversation for words he may not be able 
to say, and he spends much of his mental energy in 
substituting other words for them. 
Exercises are instituted wherein the patient gives 
the names of objects pointed to. This he does 
first by singing them and then by speaking them 
melodiously. METHODS OF TREATMENT 
87 
The most common defect is the inability to go di- 
rectly to the point to be brought out in speech. A 
series of graded exercises is to be used. A word is 
called out, to which the person is to respond with the 
first thing he thinks of. For example, when the in- 
structor says “rose,” he may answer “flower.” This 
“simple association of ideas” is to be made as quickly 
as possible. Measuring the “association time” with 
a stop watch in fifths of a second is an effective 
stimulus. In a somewhat more difficult exercise the 
patient is required to make such associations in a 
series, starting from a given word and making as 
many as possible in ten seconds. For example, on 
hearing the word “shoe” the patient may associate 
‘ ‘ lace-black-mourning-death-skeleton-medicine-doctor 
-cravat-etc.” Somewhat greater difficulty is in- 
volved when all the associations must be connected 
with the given word. Considerable more difficulty 
is introduced by requiring each association to refer 
to the preceding one in the relation of (a) part to 
whole or (b) whole to part. For example, to “room” 
the association might be “floor” (6), “board” (b), 
“house” (a), “city” (a), “street” (b), “sidewalk” 
(b), “stones” (b), “hills” (a), etc. 88 
STUTTERING AND LISPING 
The indefinite or dazed condition of mind of the 
stutterer applies specially to his notions of words. 
It is frequently accompanied by inability to spell 
correctly; in such a case exercises in spelling are to 
be used. 
Some stutterers develop the habit of frequently 
breaking off a sentence and repeating it with a 
changed construction. In such cases this may not 
be due to the desire to avoid certain words, but to 
a hesitating habit of mind. The patient should be 
required to stick to his original sentences. Exercises 
in conversation carried on entirely in short declara- 
tive sentences can be readily devised. 
Correcting Enunciation 
The excessive muscular tension of the stutterer is 
to be combated by training him to keep his muscles 
relaxed. To correct individual sounds he repeats 
words with that sound, first with the sound omitted 
and then with the sound much weakened. If the 
stutterer is troubled by initial “b,” he reads or re- 
peats words beginning with “b” but omitting that 
letter, for example, “ -utter ” instead of “ butter ” ; 
then he pronounces the same word with a very faint METHODS OF TREATMENT 
89 
“b,” thus, “butter.” This can be done for all 
sounds with which he has trouble. Words may be 
found in a dictionary or in the lists in Part III. 
The stutterer often places his tongue or lips in- 
correctly while stuttering. He may learn the correct 
positions for any sounds that trouble him and may 
Fig. 38. — Mouth record of the stutterer’s correction of the inspiratory 
“p” in Fig. 10. 
A correct occlusion is followed by a fairly successful attempt at an 
explosion. 
try to get these positions. On the principle of a 
new method of speaking (p. 57) this is often effective. 
For many stutterers it is of great benefit to study 
the positions of the vocal organs for the vowel sounds, 
as shown in the Plates at the end of this volume. 
The stutterer’s incorrect enunciation, however, usu- 
ally does not arise from the placing of the organs, 
but from abnormal use of them. 
The incorrectness in use can be accurately and 
strikingly shown by the graphic method. The record 
of a stutterer’s inspiratory “ p ” is given in Fig. 10. 
After the nature of the defect had been explained to 90 
STUTTERING AND LISPING 
him, he tried to correct his mistake; with the 
eighth attempt he was able to change the inspiratory 
“ p ” into an explosive one, as shown in Fig. 38. The 
result was not a very good “p,” but the essential 
fault had been overcome. 
Developing Confidence 
The most serious disturbance in the stutterer’s 
emotional condition is lack of confidence in his ability 
to speak when he wants to. The following procedure 
is serviceable when confidence in the voice is utterly 
gone; it can be abbreviated as may be necessary. 
A tone is produced on a piano, organ, or some 
other musical instrument. The instructor sings 
“ah” at the same time. The patient then sings 
it with the instructor while the piano sounds. This 
is repeated until the patient declares confidently 
that he is sure he can at any time sing a tone with 
the instructor and the piano. Then the patient is to 
sing the tone without the instructor. If he hesitates, 
the instructor sings also. This is repeated until he 
declares that he can at any time sing a tone with 
the piano. Thereafter two, three, and more tones 
are used in the same way; a declaration of confidence METHODS OF TREATMENT 
91 
is made at each step. Often it is convenient to 
begin at once with the arpeggio c-e-g-c' instead of 
single tones. The preceding steps are generally 
unnecessary, as it is usually possible to begin at once 
either with singing or with repeating sentences. 
Children are usually ready to sing without hesita- 
tion or diffidence, and it is often best to begin the 
treatment with simple songs, because the child knows 
that it never stutters when it sings. If the child is 
at all diffident, the instructor sings a line of it first 
alone; then the instructor and the patient sing it to- 
gether ; then, if necessary, both start together, but 
the instructor drops out while the patient keeps on; 
finally the patient sings the line alone. In this way 
he learns to sing various songs with the fullest con- 
fidence. Other words are now substituted for those 
of the first line of the song. Sentences like “This is a 
very fine day,” “My name is Jack Robinson,” etc., 
are sung to the notes of the piano. Then the 
instructor sings a question and the patient sings the 
answer; for example, “What is your name?” “My 
name is Jack Robinson.” The patient becomes 
fully convinced that he can sing anything he wants 
to say. 92 
STUTTERING AND LISPING 
Having gained so much confidence the patient is 
now to learn that he can always speak properly 
in a singsong tone. With most older patients the 
preceding practice in singing may be omitted and the 
singsong may be started at once. The best form of 
singsong is a frequently repeated “octave twist” 
(p. 57). The patient reads or repeats with the in- 
structor a sentence or a poem whereby the voice is 
made to go over the octave several times; for 
example, in the lines “A wee little boy has opened a 
store” the octave twist would be used in “wee,” 
“boy,” “o” of “opened,” and “store.” Then he 
repeats such material after the instructor, and finally 
says it alone. He practices till he is quite confident 
that he can do this perfectly. 
The instructor reads a series of sentences and 
questions (as in a traveler’s manual) in a like way. 
Whenever a statement occurs, the patient repeats it. 
When a question occurs, he answers it spontaneously, 
striving to keep the flexible intonation. The most 
careful watch is kept on the octave twist. Some 
patients persist in raising the voice only a fifth (c to 
g) instead of an octave (c to c') when repeating a 
sentence. In answering questions all patients at METHODS OF TREATMENT 
93 
once drop back to the stiff stutterer’s tone, and fail 
at first to get the octave twist. The patient’s answer 
should be used as a sentence for repetition whenever 
it does not have the proper intonation. By gradually 
developing the melodious speaking during answers 
to questions, the patient ultimately finds that he 
can always speak independently with the octave 
twist. It is pointed out to him that it is impossible 
to stutter and to use the octave twist at the same 
time; the instructor tells him, and he will agree, that 
he need never stutter again if he can only remember 
to use the octave twist always. Of course, it is im- 
possible for any one to always think of this before 
he speaks; therefore this way of speaking must be 
persistently drilled till it becomes automatic. It is 
also true that, even though he forms the habit while 
at work in the office, he will at once drop it as soon as 
he becomes worried by the presence of another 
person; further development is thus necessary, as 
follows: — 
When the patient has gained confidence in this 
work with the instructor, another person is brought in 
to listen to him. This should be done in such a way 
as not to embarrass him. If the patient is a child, 94 
STUTTERING AND LISPING 
he should first be praised for his progress, and then 
asked if he would not like to let his mother or sister 
see how well he is doing; the other person should be 
instructed beforehand to praise the patient’s success. 
With older people it is well to begin with the presence 
of the doctor’s assistant or with some one whom he 
feels not to be a critic. It may be necessary to go 
over the whole routine again in order to develop 
confidence before a third person. When this is 
accomplished, still more people are brought in. 
It is often very inspiring for the patient to go 
through these exercises in company with other 
stutterers. Strangers are gradually added to the 
group. 
If the patient stutters when reading, a similar 
method is pursued. He first reads in unison with 
the instructor. The latter stops for a few words 
at a time, leaving the patient to read independ- 
ently. Gradually the stops are longer, until the 
patient can read alone perfectly. He is to learn in 
a similar way in the presence of a third person, etc. 
Further steps in developing confidence in spon- 
taneous speech are taken by assigning topics con- 
cerning which the patient must say a few words. METHODS OF TREATMENT 
95 
For example, he is to make a few remarks about 
the furniture in the room, the weather this morning, 
the fine time he had last summer, the best way to 
reach his home, etc. For a somewhat more difficult 
exercise the instructor relates or reads an anecdote, 
a short story, a newspaper item, etc., and the patient 
is then required to give the gist in his own words. As 
a variation he may first read the material, and then 
tell about it. He may be required to give short 
accounts of what he has learned in school. 
Still further confidence is developed by requiring 
the patient to stand up and deliver speeches, either 
those that have been memorized, or spontaneous 
ones on topics that are suggested. This is best 
accomplished with a group of stutterers. The 
group is said to represent, for example, a dinner at 
which each guest has to respond to a toast. Again, 
the group is a party of tourists on an automobile; 
one of the patients is the chauffeur; they all 
make remarks on the events of the journey. Again, 
the group is in a restaurant ; one of the patients 
is the waiter, the others are guests, etc. Entire 
scenes are acted out, whereby spontaneous speech 
is constantly required. The inspiration of such a 
class is a potent factor in developing confidence. 96 
STUTTERING AND LISPING 
More difficult situations are approached by imi- 
tating them first in the office. A table with objects 
represents a store. The patient buys and sells in the 
presence of people. When he can do this perfectly, 
the instructor goes with him to stores and helps in 
the buying. In like manner a ticket booth is ar- 
ranged. For classroom work a class is organized 
/ 
and lessons in arithmetic, geometry, Latin, etc., are 
assigned, as may be appropriate. The patients are 
called up to recite, to demonstrate at the board, etc. 
Later the class is transferred to an actual classroom; 
still later outside instructors are brought in, older 
patients are appointed instructors, etc. 
The special difficulty in telephoning is met by 
practicing at first on a private line between two 
rooms. The person at the other end represents 
“central” and the people called up. The stutterer 
should also practice the part of “ central ” in order that 
the real central may not appear so strange. When 
the patient no longer gets excited, the main line 
telephone is given to him, but the switch is held down 
so that there is no connection. Some one near by 
speaks as if he were “central.” When the patient 
feels quite confident at such “dry telephoning,” METHODS OF TREATMENT 
97 
the switch is released and an actual call is sent. 
The instructor keeps close to the transmitter, so that 
at the slightest hesitation he finishes what the pa- 
tient wants to say. 
The outside situations are in general to be met by 
an attempt to get the patient’s mind directed to the 
interest of the thing and not the manner of presenting 
it. For school it is desirable to go over the exercises 
with him beforehand, explaining and illustrating 
them in such a way that he becomes fascinated with 
the subject. 
The appointment of stutterers as teachers of other 
stutterers in the office or in the clinic is very effica- 
sious in developing confidence. 
A very difficult abnormality of feeling that occurs 
in many stutterers is the mental cramp that occurs 
when they are suddenly called upon. The cramp of 
expectation in a mild degree is perfectly normal; 
for example, while waiting for cards or for dice 
to be shown, a normal person usually feels a slight 
flurry and holds his breath for a moment. With 
the stutterer this goes so far that at a knock on the 
door he will be struck absolutely speechless and be 
unable to call out. To meet with such a condition 98 
STUTTERING AND LISPING 
games with dice, counters, etc., may be practiced; 
thereafter exercises are instituted in suddenly answer- 
ing knocks, and in other situations that the patient 
describes as troublesome. 
Confidence is also developed by increasing the 
loudness and carrying power of the patient’s voice. 
He learns to speak in a full, resonant tone. Then he 
is removed to a distant room and forced to speak 
more loudly. The loud, resonant voice cannot be 
produced unless the speaker has a feeling of self- 
confidence; the cultivation of the voice thus de- 
velops the feeling directly. Moreover, a decisive, 
commanding voice causes those who hear it to attend 
in a more respectful way than they do to a hesitating, 
timid voice; this in turn produces more self-confi- 
dence in the speaker. 
Readjustment to Environment 
A very obstinate abnormality of feeling is the 
stutterer’s altered appreciation of the relation of 
himself to his environment. It arises not only be- 
cause he knows that he is abnormal in his speech, 
but also because the abnormality makes other 
people treat him differently. His feelings toward METHODS OF TREATMENT 
99 
other people are therefore very different from those 
of normal persons. This leads to an abnormal 
kind of life. 
With some patients this condition has to be 
attended to from the start, because they make no 
progress and cannnot be cured except as the abnor- 
mality is mitigated. My method is as follows: 
I first attempt to establish intimate personal rela- 
tions in the ordinary ways of acquaintanceship, so 
that the patient feels me to be his personal friend. As 
various incidents occur or as topics arise in conversa- 
tion, we discuss the rules of conduct of the average 
man, and we condemn extremes. For example, a 
patient fears to go to a post office window because 
he stuttered when he was there before and he feels 
that the clerk expects him to stutter and will be im- 
patient. It is pointed out that many hundreds of 
people have been to that window since he was last 
there, and that it is most improbable that the clerk 
would remember him. Again, the business of the 
clerk is to wait on all customers politely and pa- 
tiently; he is trained to allow for the peculiarities 
of customers, some of which are more trying than 
stuttering. Again, he is not allowed by his em- 100 
STUTTERING AND LISPING 
ployers to show the slightest impatience or discour- 
tesy. Again, the postal clerk is in the service of the 
government of which the stutterer is a member; he 
is therefore the stutterer’s employee. In this way 
the stutterer is brought to a correct understanding 
of the relations between himself and the clerk. The 
other situations in life are met similarly. 
Readjusting the Subconscious 
Recent psychological work has shown that the 
instincts and desires with which we are born are 
gradually modified and suppressed until they have 
become to a considerable extent unconscious. 
Moreover, our minds are trained to think along 
certain grooves and not to permit thoughts along 
other ones. Such a “censorship” makes it quite 
impossible, for example, for certain thoughts of love 
to arise in a European or an American girl that 
would be only the most natural thoughts for the 
negress in Africa. The person knows nothing about 
this “ censorship ” ; it has been drilled into the 
mind until it governs without being realized. The 
difference in censorship permits certain thoughts 
to be perfectly natural in the one case and keeps METHODS OF TREATMENT 
101 
them entirely absent in the other. Yet, although 
absent from consciousness, the original natural forces 
persist with undiminished energy. When properly 
directed they produce the normal successful indi- 
viduals; when improperly, they produce the group 
of diseases known as neurasthenia, psychasthenia, 
hysteria, some forms of insanity, etc. Our thoughts 
and emotions are controlled largely by the sup- 
pressed natural instincts. In a stutterer some of 
these instincts have gone wrong, and it is necessary 
to readjust them. 
A minute analysis of the patient’s mind, including 
the subconscious, is often necessary to a cure. The 
methods of psychanalysis furnish an outline of the 
patient’s subconscious life. These methods may be 
applied to the stutterer in somewhat the following 
way: — 
The patient is alone with the physician. The latter 
explains that the mind is an extremely complicated 
organ whose ways of action have to be learned by 
the most careful study. Since stuttering is ac- 
companied by a somewhat incorrect action of the 
mind, it is necessary for the stutterer to carefully 
analyze his mental condition. The physician will 102 
STUTTERING AND LISPING 
train him to do this. The training may take a long 
time. 
We judge other persons and interpret their actions 
on the basis of our own ideas; our notions of other 
people are “egomorphic.” The physician there- 
fore asks the patient to note down from time to time 
any thoughts or criticisms that may occur to him 
concerning the physician personally. The patient 
may reply, for example, that just a moment ago he 
had said to himself that in spite of his age and calm- 
ness he couldn’t help thinking that the doctor was 
really shy and bashful. It is pointed out to him 
that, utterly regardless of whether his judgment 
was correct or not, such a thought would probably 
not have occurred to a man of fearless disposition; 
the patient had sought out in the physician some 
signs of his own trouble. Of course this was not 
done consciously; the thought was merely the re- 
sult of many past experiences and habits which he 
had forgotten, but whose traces remained to make up 
his character. The patient is warned not to try to 
produce the thoughts concerning the physician, but 
to note only what comes unpremeditatedly. The 
next day perhaps he says, with many apologies, that METHODS OF TREATMENT 
103 
the thought had occurred to him that the doctor 
was not always perfectly frank and honest with 
him; the reply is, “It is you who are not perfectly 
open and honest in your dealings ; you have a tend- 
ency to get out of embarrassing situations even at 
the cost of some truth. Let your thoughts wander 
as they will, and see if you do not recollect a number 
of cases where you have acted in this way.” These 
spontaneous revelations of traits of character strike 
the patient with great force and automatically start 
a readjustment. 
During the day the restraints of life do not let 
our personalities come freely into play; we automati- 
cally suppress most of our thoughts and emotions 
and permit only a certain narrowly limited group to 
develop. Moreover, the “ censorship ” of the un- 
conscious does not permit the suppressed instincts 
and desires to become known to us. In sleep, how- 
ever, the censorship is somewhat relaxed, and our 
innermost ideas and feelings come forward in 
dreams. A study of the patient’s dreams is, there- 
fore, a most important source of information. The 
patient receives instructions to have paper and 
pencil beside the bed and to wake up and write 104 
STUTTERING AND LISPING 
down immediately all dreams each night. The ac- 
count is read off by him to the physician. The 
interpretation of some parts is immediately clear. 
When more information on any point is desired, 
the patient allows his mind to wander through a 
series of associations starting from the part of the 
dream involved; usually the explanation is forth- 
coming during such “running associations.” 
The following analysis of a patient’s dream will 
illustrate the method. The record of the dream 
was: — 
“I buy a ticket to some place, a single ticket 
because I am not coming back. At a certain sta- 
tion on the way I get off. I go to the manager’s 
office, where I find two men at work over papers. I 
stand at attention, heels together in the German 
fashion. The man has an American military cap 
of dark blue. I say to myself, ‘ Shall I give a mili- 
tary salute or take off my hat ? ’ When the manager 
turns around, I ask for the return of my money 
because I have found a patient on the train. The 
manager, who has now become a younger man, 
says ‘Yes, but it will be dear; it will cost one 
fare plus a hemorrhage, plus an infarct.’ I reply, METHODS OF TREATMENT 
105 
‘Never mind, the expense is nothing to me.’ The 
assistant reckons out what I am to get, and says it 
will be about fifty per cent.” 
The patient had originally been in doubt whether 
he should stop for treatment in this town or go 
to a physician farther off. Stopping at the nearer 
place, he had a few days before seen the doctor 
and his assistant (manager and clerk) at a scientific 
meeting. The doctor had told him he could not be- 
gin treatment till next week (he stands at attention 
waiting). The patient holds the doctor in great re- 
spect (the dream clothes him in a military costume, 
and makes him manager of the station). The doc- 
tor is, however, a personal friend; the two feelings 
are present at the same time and the patient doesn’t 
quite know how to act (shall I give a formal mili- 
tary salute or take off my hat in a friendly manner ?). 
The patient naturally expects the doctor to do him 
enough good to compensate him for what he loses by 
not going to the other place (I ask for return of my 
money for the part of the journey not taken). It is 
characteristic of dreams that the personalities are 
often changed. The patient now represents himself 
as a doctor who has found a patient on the train. 106 
STUTTERING AND LISPING 
Instead of remaining the inferior (the patient), he 
for a moment gratifies himself by feeling that he is 
the superior (the doctor), who is about to treat a 
patient. The dream now notes that the doctor is 
younger than the patient (manager is now younger). 
The patient had been somewhat worried over the 
probable expense, and feared what the dream de- 
clares (it will cost you dear). On the previous 
evening the patient had discussed the matter with a 
friend, and had remarked that the journey was not 
entirely for the sake of the treatment (one fare), but 
also to learn the method; he had also complained 
that the treatment cost him part of the time he wished 
to give to some anatomical work (hemorrhage plus 
infarct). He had finally concluded that he was ready 
to pay any price if he could be cured (never mind, 
the expense is nothing to me). The fifty per cent 
seems to refer to the fact that the treatment was 
taking about half the time from some other work. 
The further interpretation was made in connec- 
tion with the rest of the treatment. A vitally 
important defect of the patient’s character was an 
inability to properly and promptly understand his 
relations to other persons; the uncertainty as to METHODS OF TREATMENT 
107 
how he should approach another person expressed 
itself in the dream as the doubt concerning how he 
should greet the doctor. Another defect was a con- 
stant conflict between a naturally spendthrift nature 
and an acquired but annoying and ill-judged penuri- 
ousness ; the whole dream consisted of questions of 
expense. This dream, as well as many others, ex- 
pressed the patient’s thoroughly egocentric view of 
the events of life. These defects of character were 
the sources of the patient’s trouble, yet he had 
never suspected the existence of any one of them. 
As they were revealed by psychanalysis, a correc- 
tion took place automatically. 
The fundamental principles in interpreting dreams 
are (1) that the material of the dream is taken mainly 
from recent events, (2) that every dream expresses 
the fulfillment of a wish that has remained unful- 
filled, and (3) that the language of the dream in adults 
is usually symbolical and not direct. 
In children the language is not symbolical, and the 
dream shows itself at once as the expression of a 
wish. My niece, twelve years of age, had received some 
chickens which rather disappointed her on account 
of their smallness; the next morning she related a 108 
STUTTERING AND LISPING 
dream of having a lot of fine, large Cochin-Chinas. 
Her dream had fulfilled her unsatisfied wish of the 
day before. In adults the language of the dream is 
sometimes also direct. It is not unusual for my 
patients to report that they dream of losing the paper 
given them to record dreams on, of seeing me tell 
them not to record dreams, etc. Upon being told 
that these are really wishes, they confess that the 
task of recording dreams is irksome to them. 
Nearly always, however, the language of the dream 
is symbolic, and the patient sees no meaning in it. 
Many of the dreams of stutterers, however, have a 
common type. 
One stutterer dreamed repeatedly that he was a 
great social success at parties, that he was a friend of 
the King of England, etc. Another one thought that 
he and a friend, playing with great exhilaration, had 
won a football game against an entire college eleven, 
whereby he had made brilliant runs and kicks that 
had brought applause from the grand stand. In all 
such dreams the stutterer represents himself as pos- 
sessing an excess of coolness and self-confidence; 
that is, he puts himself into possession of just the 
qualities he lacks. It is also typical of stutterers’ METHODS OF TREATMENT 
109 
dreams that they refer to their relations to other 
persons. 
The method of “running associations” referred to 
above is intended to give the subconscious an oppor- 
tunity to present its material. Why should my niece, 
in the dream related above, have thought of Cochin- 
Chinas? She was induced to talk about chickens; 
before long she came out with the memory of a 
former home where she had seen such chickens. The 
stutterer who won the football game was asked to 
let his thoughts wander freely. He gave the asso- 
ciations : “football game — crowd — class — Medi- 
cal School — professor — Roosevelt — campaign,” 
all of which referred to incidents where he had had 
difficulty in speaking. The friend who played with 
him was indistinctly seen; when asked what he 
thought of when the word “friend” was spoken, 
he replied, “doctor.” The meaning of the dream 
was at once clear. With his friend the doctor 
to help his speech he was able to face a formidable 
crowd or a difficult situation and achieve success 
and applause. The wish that realized itself in the 
dream was that with the doctor’s help he might get 
over his stuttering and be able to conduct himself 110 
STUTTERING AND LISPING 
in his speech so brilliantly that he could success- 
fully face his class and all other situations that 
might present themselves. 
As the peculiarities and deformities of character 
of the stutterer present themselves spontaneously 
in the dreams and in the discussions, he learns to see 
them himself and gradually to correct them. This 
is usually more efficacious than any attempt of the 
physician to directly point out the defects. The 
psychanalysis need not go so far as in the treat- 
ment of hysteria; it has, moreover, the distinct ad- 
vantage that every such revelation of his own charac- 
ter to himself produces greater ease in the stutterer’s 
speech. The results of the treatment show them- 
selves gradually and steadily. PART IT 
LISPING 
CHAPTER I 
INTRODUCTION 
Owing to the fact that the symptoms are so often 
the same or similar, it is convenient to include under 
“lisping” several different speech disorders whose 
characteristics lie essentially in defects of enuncia- 
tion. We may distinguish four different lisping 
disorders; namely, negligent lisping, organic lisp- 
ing, neurotic lisping, and cluttering. 
The use of the word “lisp” in this larger sense 
is in accord with the original Anglo-Saxon “wlisp” 
and with the use in literature. “To lisp in num- 
bers” (Pope) refers to baby talk, of which negligent 
lisping is the survival. 
In discussing individual sounds it is desirable to 
have an alphabet. The following list gives the chief 
sounds of English with a phonetic alphabet in paren- 
theses () to indicate them, and with examples in 
Ill 112 
STUTTERING AND LISPING 
ordinary spelling. In the discussion of lisping 1 
have as far as possible avoided the phonetic alpha- 
bet and have given illustrations in ordinary English 
spelling. 
Phonetic 
Letter 
Example 
Phonetic 
Letter 
Example 
a 
ah, father 
f 
ferry 
SB 
fare 
V 
very 
e 
date 
s 
so, dose 
€ 
debt 
z 
zone, doze 
9 
her, further 
1 
show 
A 
mach 
3 
azure 
i 
peel 
e 
thin 
I 
pill 
s 
thine 
0 
pole 
c 
chew 
0 
Pawl, poll 
J 
jew 
U 
pool 
y 
you 
U 
pidl 
m 
mow 
P 
par 
n 
no 
b 
bar 
9 
si ng 
t 
foe 
j 
row 
d 
doe 
1 
low 
k 
car 
w 
woe 
g 
go 
h 
hoe 
The variations from the type are manifold, but 
finer distinctions are not useful here. We may note, 
however, that the first half of the diphthong in INTRODUCTION 
113 
u fly ” is not exactly the sound indicated by (a) but a 
somewhat different one that we may indicate by (a). 
Fig. 39. — Median section of the organs of enunciation and phonation. 
The various sounds are produced by different ad- 
justments of the vocal organs. Fig. 39 gives a median 
section through the vocal organs of the head. The 114 
STUTTERING AND LISPING 
larynx is just in front of the backbone and just be- 
low and behind the tongue. The roof of the mouth 
is formed by the hard palate, at the rear of which 
is the velum (soft palate) with the uvula hang- 
ing down. The nasal cavity extends from the 
nostrils in front to 
the pharynx in the 
rear. Median sections 
for the typical English 
sounds are given in 
Plates I, II, and III 
at the end of the vol- 
ume. The heavy line 
at the larynx indi- 
cates that the larynx 
vibrates during the 
sound; the dotted ring 
indicates that it does 
not. 
When the mouth is widely opened and properly 
illuminated, the positions of the tongue and velum 
can be observed in a mirror. 
The contact of the tongue with the hard palate 
in producing sounds may be studied by palatography. 
Fig. 40. — Artificial palate. 
A thin plate of aluminum is made 
for the roof of the mouth. It is 
dusted with chalk and placed in 
the mouth. When a sound is pro- 
duced, the tongue wipes off the 
chalk where it touches the palate. INTRODUCTION 
115 
The tongue or the roof of the mouth may be 
painted with ultramarine water color. The desired 
sound is spoken. The contact of the tongue with 
the palate is seen where the color is wiped off. 
For more exten- 
sive recording a cast 
of the roof of the 
person’s mouth is 
made, either with 
dental modeling 
compound or with 
plaster. From this 
a dentist makes a 
thin artificial palate 
or dental plate of 
vulcanite, aluminum, silver or gold (Fig. 40). 
An artificial palate may be made of eight or ten 
sheets of wet tissue paper. A sheet is pressed over 
the mold ; paste is spread over it, and another sheet 
is pressed on, etc. It is carefully worked into the 
depressions of the mold by the fingers. When 
it is perfectly dry, it is coated with black varnish. 
For an experiment the inner surface of the artificial 
palate is slightly oiled and sprinkled with powdered 
Fig. 41. — Palatogram for the vowel “ ee.’’ 
The black areas show where the 
tongue touched the palate. 116 
STUTTERING AND LISPING 
chalk. It is inserted in the mouth; the sound is 
spoken and the artificial palate is removed. The 
parts touched by the tongue appear black, the chalk 
having been removed where the tongue touched it. 
The results may be photographed, painted on a cast, 
or sketched on paper. Such a palatogram on a cast 
for the vowel “ee” is shown in Fig. 41. Palato- 
grams for typical English sounds are given in Plate 
IV at the end of the volume. 
The sounds (a, ae, e, e, i, i, o, o, u, u) are termed 
“vowels.” For all of them the lips are more or less 
opened. When the vowel “ah” is sung before a 
mirror, the velum can be seen to rise upward and 
backward; this clears the passage from the throat 
to the mouth, and cuts off the passage from the throat 
to the rear of the nasal cavity. The velum rises 
likewise for all the vowels. If the finger is placed on 
the front of the neck over the larynx while the vowels 
are sung, the vibrations of the voice will be felt dur- 
ing all of them. Observations in a mirror show that 
the vowels differ in the positions of the lips and 
tongue.1 
1 It has been proven that the laryngeal adjustments also differ 
for the various vowels. Scripture, Researches in Experimental 
Phonetics, 116, Carnegie Institution Publication No. 44. INTRODUCTION 
117 
The “ occlusives ” (p, b; t, d; k, g) are made by clos- 
ing the mouth passage at some place. The closure 
occurs at the lips for the “labial occlusives” (p, b). 
The closure at the front of the tongue for (t, d) and 
at the back of it for (k, g) causes them to be called 
“front” and “rear lingual occlusives,” respectively. 
In English an occlusive usually ends with release of 
the contact before the breath ceases, producing a 
sharp puff of air. The English occlusives are there- 
fore termed “explosives.” 
For the sounds (f, v; s, z; J, 3; 0, S) a channel per- 
mits a current of air to issue with a rushing or hissing 
effect; they are called “fricatives.” The sounds (f, v) 
are “labial fricatives”; (s, z; J, 3; 0, 5) are “front 
lingual fricatives”; there are no rear lingual frica- 
tives in English. 
For (j) the tongue leaves a moderately large 
opening at the front; for (1) the opening is at the 
sides; for (w) the small opening is at the lips; the 
opening is not so large as in the vowels and not 
so small as in the fricatives; no term for grouping 
these sounds has yet been introduced. For (h) 
there is a narrow opening at the glottis. 
For the sounds (5, j) there is occlusion by the top 118 
STUTTERING AND LISPING 
of the tongue during the first portion and a rush of 
air through a narrow channel for the second portion. 
It has been proposed to consider them as double 
sounds (tj, d3), but experimental records show vital 
differences; the two elements of occlusion and fric- 
tion are so closely united in (c, j) as to make them 
single sounds. Moreover, the positions of the tongue, 
jaw, and lips are different from those of (t, d) and 
(J, 3), as may be seen in Plate I. 
During (m, n, q) the nasal passage is open, hence 
the term “nasal.” 
During (p, f, t, k, s, f, 0) the larynx does not vi- 
brate; these consonants are called “surds.” Dur- 
ing (b, v, d, g, z, 3, 5) the larynx vibrates; they are 
called “sonants.” The sounds (m, n, q, j, w) are 
nearly always sonants. The sound (h) is usually 
surd, but sometimes sonant. All whispered sounds 
are surd. 
The vertical diagrams and palatograms for the 
consonants are given in Plates I, II, and III at the 
end of this volume. The dotted line over the larynx 
indicates that it does not vibrate for the surds; the 
heavy line indicates that it does for the sonants. 
The breath indicator shown in Fig. 42 may be used INTRODUCTION 
119 
Fig. 42. — Candle flame indicator used for the mouth. 
According as air issues or does not issue from the mouth, the candle 
flame bends or stands upright. 
to illustrate the properties of many sounds. The 
tube from the mouth is directed against a candle 
flame. When the vowels are spoken into the mouth- 120 
STUTTERING AND LISPING 
Fig. 43. — Tambour indicator used for the nose. 
The indicator is made from a thistle funnel covered with rubber. 
A piece of card hangs in front of the rubber and is fastened to it by 
glue or wax. Air issuing from the nose moves the card flap. A 
mouthpiece may be used, as in Fig. 42. 
piece, the flame is deflected. The same is true of the 
fricatives. During the occlusives the flame is up- 
right, but it is sharply deflected by the explosions 
at the ends of the occlusions. INTRODUCTION 
121 
The breath indicator shown in Fig. 43 consists of 
a thistle funnel over the top of which thin rubber 
is stretched and tied. A strip of visiting card is cut 
across and joined with tissue paper to make a hinge. 
A piece of wax holds one piece of the card to the fun- 
nel, while the other one hangs in front of the rubber 
membrane. A drop of paste connects the hanging 
flap to the membrane. The funnel is connected by 
a rubber tube to a nasal tip. When any air issues 
from the nose, it goes into the funnel and moves the 
rubber membrane; the movement is indicated by the 
flap. This indicator can be used with a mouth- 
piece like the one in Fig. 42. 
The examination of a person with incorrect enun- 
ciation should cover the typical sounds. Each con- 
sonant may be spoken with the vowel “ ah ” after 
it or in some typical word; the list on p. 112 may 
be used. 
| Although the patient may be able to speak the 
separate sounds correctly, he may mumble and con- 
fuse them in ordinary talking. CHAPTER II 
NEGLIGENT LISPING 
In order to produce speech sounds like those of 
other people an individual must hear correctly what 
other persons say; in 
order to move his 
speech organs correctly 
he must feel their 
movements and hear 
the sounds he himself 
produces. By long ex- 
perimentation the in- 
fant acquires the art 
of talking like other 
people. If, however, 
the child is careless or 
negligent in his obser- 
vation of the speech of 
other people or himself, he fails to produce the sounds 
properly and he does not even notice his errors. 
Fig. 44.— Lip position for “f” and 
“ v.” 
The lower lip is brought against 
the upper teeth. 
122 NEGLIGENT LISPING 
123 
These are the characteristics of “negligent lisping,” 
or “functional lisping.” The essential pathological 
fact is mental carelessness. The cure consists in 
teaching the patient to carefully correct his 
faults. 
If the cure is neg- 
lected, some children 
may become nervous 
about their speech and 
turn into neurotic lisp- 
ers (see Chapter IV); 
as this trouble is a 
much more serious one, 
it is not safe to neglect 
negligent lisping. In 
other children the ridi- 
cule of their comrades 
and the reproof at 
home may produce a 
true hysteria with symptoms of disturbance of mind 
(emotional complexes) and body (loss of pharyn- 
geal and corneal reflexes, etc.). 
Occasionally a defective speech organ produces a 
defective sound (organic lisping), which so confuses 
Fig. 45. — Lip position for “w.” 
The lips are projected slightly 
forward with a small opening. 124 
STUTTERfNG AND LISPING 
the child that all his sounds become incorrect (negli- 
gent lisping). 
Lip Defects 
Some persons use “v” for “w,” as in “Samivel 
Veller” for “Samuel Weller.” lor “v” the lower 
lip should be against 
the upper teeth (Fig. 
44); for “w” the two 
lips are brought near 
each other (Fig. 45). 
To correct the fault, 
the patient is told to 
say “well, word, 
wind,” etc. Just as 
he starts to say “veil, 
vord, vind,” etc., his 
lower lip is pressed 
down with a finger 
or a stick; he is thus 
forced to say “w” in- 
stead of “v.” 
The opposite defect may occur. The patient says 
“werry” for “very,” “wote” for “vote,” etc. He 
Fig. 46. — Lip position for correcting 
“w” into “v.” 
The lower lip is caught between 
the teeth when a “w” is to be 
spoken. NEGLIGENT LISPING 
125 
is told to bite his lower lip when trying to say words 
beginning with “v” (Fig. 46). 
The use of “p” for “f” and “b” for “v” arises 
from pressing the lips too tightly together. A thick 
Fig. 47. — Palato- 
gram for for- 
ward “t” and 
“d.” 
Fig. 48. — Palato- 
gram for back- 
ward "t” and 
“d.” 
Fig. 49. — Palato- 
gram for “k” 
and “g.” 
stick or a finger is stuck between the lips so that they 
cannot close tightly. This produces the fricative 
Fig. 50. — Mouth dia- 
gram for “t” and 
“d.” 
The front of the 
tongue is raised 
against the hard 
palate just behind 
the teeth. 
Fig. 51. — Mouth dia- 
gram for “k” and 
“g-” 
The back of the 
tongue is raised 
against the velum 
at the rear of the 
hard palate. 126 
STUTTERING AND LISPING 
sound. The differences are also learned by observa- 
tion of the instructor and looking at one’s self in 
Fig. 52. — Mouth record of “water” spoken normally. 
The sudden and complete cutting off of the breath during the “t” 
and the strong explosion at its end are evident. 
a mirror. The differences may be made apparent by 
a breath indicator (p. 119). 
The substitution of “s” and “z” for “f” and “v” 
rests upon the likeness in the fricative sound. Atten- 
Fig. 53. — Mouth record of “water” spoken by a lisper. 
Instead of the breath being cut off for the “t,” there is only a faint 
diminution; the sound is like “ th” instead of “t.” The laryngeal 
vibrations are continued from “a” without stopping through the 
“th” into the vowel “er.” A correct “t” has no laryngeal vibra- 
tions. 
tion is called to the fact that in words with “f ” and 
“v” the lips are closed, while in the words with "s” 
and “z” they are open. NEGLIGENT LISPING 
127 
Defects ofut,” “d,” “k,” and “g” (t, d, k, g) 
For “t” and “d” the front of the tongue is raised 
against the palate just behind the teeth (Figs. 
47, 48, 50); for “k” and “g” the rear part is 
raised (Figs. 49-51). For “t” and “d” it is usual 
to turn the tip of the tongue upward as in Fig 47. 
Many persons form the “t” and “d” by putting 
the tip farther back against the palate (Fig. 48). 
One defect in “t” and “d” is failure to completely 
close the air passage by the tongue. An additional 
defect for “t” is failure to stop the laryngeal vibra- 
tions when the sound occurs between vowels. The 
two defects are illustrated by graphic records taken 
with the mouth recorder (Fig. 7). 
A normal curve of “water” as recorded by the 
graphic method is given in Fig. 52. A slight rush of 
the breath is followed by a nearly straight line indi- 
cating the faint sound of “w.” The mouth opens 
rather suddenly and the line rises as the vibrations 
of “a” rush out. The breath is cut off completely 
during the “t.” As the tongue releases the “t,” a 
strong puff of air occurs and the line goes sharply 
upward. The record ends with the final vowel. The 
record for a lisper is shown in Fig. 53. Where there 128 
STUTTERING AND LISPING 
should be a straight line with an explosion for the “t,” 
there are strong vibrations with only a slight sinking 
of the line. This shows that the larynx did not stop 
during “t” and that the tongue did not close the 
air passage. The patient says “wather” (woSa) 
instead of “water” (wota). 
The chief fault is the failure to close the tongue 
tightly at the front. Ordinarily it is sufficient to 
explain to the patient that there are two classes 
of sounds called “occlusives” and “fricatives.” For 
the occlusives the current of air passing through 
the mouth must be cut off at some point; for the 
occlusives “t” and “d” the tip of the tongue must 
close firmly against the palate. When it does not 
do so, it produces the fricative sound “th.” The 
other defect, namely, keeping the larynx vibrating, 
disappears when the “t” is carefully made. 
A frequent defect among children is the use of “t” 
for “k,” as in “tandy” for “candy.” Sometimes 
this substitution occurs regularly; usually it is 
only in some words. The patient who says “tandy” 
will usually say “car” correctly. That is, although 
he is able to make the sound of “k,” he replaces it 
by “t” in some words through pure negligence. NEGLIGENT LISPING 
129 
Both “t” and “k” are occlusives, that is, the cur- 
rent of air is shut off entirely during the sound ; the 
patient does not take the trouble to distinguish be- 
tween them. A similar substitution is made of “d” 
for “g” (hard “g” as in “go”). The child says “Div 
me sum tandy.” The cure may begin by having 
him open his mouth wide and say “ca-ca-ca-candy.” 
He looks into the mouth of the instructor and sees 
that the tongue rises in the back; looking into a 
mirror, he learns how his own tongue is to move. 
It is sometimes useful to push the point of the 
tongue back and down by a stick (tongue depressor) 
when a word beginning with “k” or “g” is used. 
The child cannot say “t” or “d,” and he is forced 
to raise the tongue at the back. 
Similar procedures are used if “k” and “g” are 
replaced by other sounds. 
Defects of “s” and “z” (s, z) 
To produce "s” or “z” the front of the tongue 
is raised against the hard palate behind the teeth, 
while a small channel is left in the middle so that a jet 
of air is blown through. A palatogram is shown in 
Fig. 54, a mouth diagram in Fig. 56. Every modi' 130 
STUTTERING AND LISPING 
fication in the shape of this channel changes the 
character of the hissing sound. For “z” the vocal 
cords vibrate ; for “s” they do not. 
The hiss for the “s” is frequently 
too weak, the channel being too wide. 
The defect is corrected by using greater 
pressure of the tongue. When the hiss 
is too sharp, relaxation is taught. 
The most frequent defect is that whereby the 
patient says “toap,” “toup,” “tun,” etc., for “soap,” 
“soup,” “sun,” etc., or “dink” for 
“zinc.” Instead of a rush of air dur- 
ing “s” there is complete stoppage; 
the “fricative” sound is turned into 
an “occlusive.” Through negligence 
the person presses his tongue against 
the palate a trifle too hard when 
saying “s” or “z.” This closes the 
opening that is necessary for “s” 
(Figs. 54, 56), and makes an occlusive 
(Figs. 55, 57) that sounds like “t.” 
This may be shown by graphic records 
(p. 22) by means of the mouth recorder (Fig. 7). A 
normal record for “sun” is shown in Fig. 58; a 
Fig. 54. — Palato- 
gram for “s” 
and “z.” 
Fig. 55. — Palato- 
gram for oc- 
cluded “s” 
and “z.” 
The tongue 
touches the 
palate over a 
larger area 
than in Fig. 
54. The chan- 
nel is closed by 
too much 
pressure. NEGLIGENT LISPING 
131 
record with the occlusive instead of the “s” is given 
in Fig. 59. 
With a small rubber bulb placed between the front 
of the tongue and 
the palate (Fig. 5), 
and connected to 
a registering appa- 
ratus (Fig. 3), the 
force of the pressure 
of the tongue can be 
recorded. For an 
occluded “s” it is 
greater than for the 
ordinary “s” or for 
“t” (Fig. 60). The 
occluded “s” is thus not the same as a “t”; it 
may be defined as an “s” made with excessive 
tongue pressure resulting in a sound like “t.” 
Treatment by having the patient imitate the “s” 
of a normal person usually aggravates the defect; 
he is already making too much effort with his tongue, 
and the more he tries, the greater the effort he makes. 
Sometimes he can be taught directly to relax the 
tongue, but this rarely succeeds. 
occluded 
s,z 
Fig. 56. — Mouth dia- 
gram for “s” and 
“ z.” 
The front of the 
tongue rises so as 
to form a narrow 
channel at the 
front of the palate. 
Fig. 57. — Mouth 
diagram for oc- 
cluded “s'1 and 
z.” 
The channel 
of Fig. 56 is 
closed by too 
much pressure. 132 
STUTTERING AND LISPING 
Fig. 58. — Mouth record of “sun” spoken normally. 
The record was made as shown in Fig. 7. The rising line registers 
the air issuing during “s”; this is followed by the vibrations for 
“u” and “n.” 
Fig. 59. — Mouth record of “ sun” spoken by a lisper. 
The record was made as shown in Fig. 7. The straight portion of 
the line shows that no air issued during the attempt at “s.” 
u 
- 
BBSS 
Fig. 60.—Tongue record for occluded “ s.” 
A record by the method of Fig. 5 shows that the pressure of the 
front of the tongue against the palate is small for “s,” larger for “ t,” 
and largest for occluded “s.” 
One cure consists in inserting a probe, an appli- 
cator, a toothpick, or a pencil just over the middle 
of the tongue and pressing it down as the person NEGLIGENT LISPING 
133 
begins to speak a word beginning with “s” (Fig. 
61). He cannot close the passage completely, 
and instead of saying “t” he is forced to say 
“•s.” This catches his ear, and he notices the 
difference in sound. 
Constant repetition 
enables him to train 
his tongue in the new 
way. 
Another cure con- 
sists in practicing the 
patient in making a 
sound with a sharp 
hiss. 
For other cases a 
breath indicator 
(Figs. 42, 43) is ef- 
fective. 
Frequently the “ s” 
and “z” are made with channels at the sides instead 
of the front. The hiss sounds like an “1” ; instead 
of “ soap,” “soup,” the patient seems to say “sloap” 
and “sloup.” The defect is corrected by teaching a 
correct “s,” either by imitation of the sound as 
Fig. 61.—Correcting occluded “s ” and 
“ z.” 
The small stick over the front of 
the tongue produces the channel 
necessary for “ s ” and “ z.” 134 
STUTTERING AND LISPING 
heard by the ear or by using a stick over the middle 
of the tongue, as in the case of occlusive “s” and 
“z”; the patient will close up the side channel as 
soon as one is made in the middle. 
Sometimes the “s” 
and “z” are made in 
a way that produces 
sounds like “sh.” For 
“sh” the channel in 
the middle of the 
tongue is seen to be 
broader and differ- 
ently formed when 
compared to that for 
“s.” The cure is 
often brought about 
by using a probe or 
a stick as in the pre- 
vious case; the irrita- 
tion makes the patient narrow the channel. Some- 
times it is necessary to train the patient to use 
“t” instead of “s,” and then to correct this fault 
as previously described. 
Sometimes a “th” sound is used for “s” and “z.” 
Fig. 62. — Making the interdental frica- 
tive. 
The tongue is pushed out be- 
tween the teeth. The sound re- 
sembles that of “th.” NEGLIGENT LISPING 
135 
The patient who has this fault usually sticks his 
tongue between the teeth for “s” (Fig. 62), mak- 
ing an interdental fricative not used in English. 
Sometimes it is sufficient to show him that people 
do not stick their tongues out that way. He then 
watches his own tongue in a mirror. He also learns 
to make “s” with the teeth tightly closed. A 
small stick can also be used, as in “t” for “s.” 
The patient who uses “f” for “s” is satisfied with 
the fact that he is producing a fricative sound; he 
notices no difference. He must be taught to dis- 
tinguish between the two kinds. He is to watch his 
lips in a mirror; he sees that the lower lip does not 
close against the teeth for “s.” His lips may be 
held open while he is obliged to say “s.” 
A similar case is that where a guttural fricative 
(like the German “ch” in “ich”) is used for “s.” 
The formation of “s” is to be explained and taught. 
Occasionally an utterly different sound, such as 
uk,” is used. If the correct “s” cannot be taught 
directly, the “t” is taught and then this corrected 
to “s” as described above. 136 
STUTTERING AND LISPING 
Defects of “ch” and “j” (c,j) 
The sounds “ch” and “j,” as in “church” and 
“judge,” have been considered as consonantal diph- 
thongs, each made up of two sounds, “t” with “sh” 
Fig. 63. — Mouth record of the word “Mitchell.” 
The faint vibrations for “m” are followed by stronger ones for the 
vowel “i.” The air current is cut off entirely for a short time there- 
after; this is the occlusion for the sound “ch” (“tch”). Thereafter 
the rather quick and strong rise of the line indicates an explosion of 
special form. The record ends with the vibrations for “e” and “11.” 
and “d” with “sh.” Graphic records of the sounds 
“ch” and “j” have proven that they are two inde- 
Fig. 64. — Mouth record of the word “nutshell.” 
The faint vibrations for “n” are followed by stronger ones for the 
vowel “u.” The air current is cut off for “t,” which has no explo- 
sion here. This is followed by gradual rise of the line for the frica- 
tive sound “sh.” The word ends with the vibrations for “e” and 
“11” 
pendent sounds.1 A record of the word “Mitchell” 
(Fig. 63) shows the sound “ch” — spelled “tch” here 
— to be an occlusion followed by an explosion of a 
1 Winifred Scripture, “The sounds of ‘ch’ and ‘j,’” Popular 
Science Monthly, October, 1911. NEGLIGENT LISPING 
137 
special form that is never seen in any other typical 
sound. A record of the word “nutshell” (Fig. 64) 
shows an occlusion for the “t” without any explo- 
sion, followed by a long rush of air for the “sh.” 
The sound “ch” (6) is thus quite different from the 
combination of the sounds “tsh” (tj). 
The difference between the two 
sounds can be shown in another way. 
A palatogram for “ch” or “j” shows 
that the tongue touches the palate 
farther back than for “t” or “d,” 
and that it covers a bigger space 
(Fig. 65). 
The mouth diagram is given in 
Fig. 66. The front of the tongue touches the 
palate rather far back; the lips are somewhat pro- 
truded. The differences from “t,” “d” are marked 
(Fig. 50). 
The establishment of the fact that “ch” and “j” 
are individual sounds is analogous to the proof fur- 
nished long ago that the two forms of “sh” (J, 3) 
are individual sounds, and not compounds of “s” 
and “h.” 
The typical defects are of two kinds. In one the 
Fig. 65. — Palato- 
gram for “ch” 
and “j.” 
The tongue 
touches the 
palate over a 
larger area 
than for “t” 
and "d.” 138 
STUTTERING AND LISPING 
tongue presses too tightly against the palate, in a way 
similar to that for an occluded “s” (p. 130). The 
sound is like a “t” for “ch” and a “d” for “ j.” In the 
other the tongue is not pressed tightly enough. This 
produces a sound resembling “ sh.” 
The treatment for the former is 
similar to that for the occluded “s” 
(p. 132), the purpose being to obtain 
relaxation of the tongue. For the 
latter the patient is told to press 
the tongue more strongly. 
Defects of “n ” and “ng” (n, q) 
For “n” the tongue takes the 
same position as for “t” and “d” 
(Fig. 50), but the velum is not 
raised (Fig. 67). For “ng,” as in 
“sing,” the tongue position is like 
that for “k” (Figs. 49, 51) with the velum not 
raised (Fig. 68). 
The use of “m” for “n” (the lip nasal for the 
front tongue nasal) is corrected by observation in a 
mirror, by making the patient open his lips while 
saying “n,” etc. The use of “t” or “d” for “n” 
6- 
J 
Fig. 66. — Mouth dia- 
gram for “ch” 
and “j.” 
The tongue 
touches the palate 
over a larger area 
than for “t” and 
“d” ; the lips are 
projected forward, 
and the teeth are 
rather close. NEGLIGENT LISPING 
139 
is a velar defect; it is corrected by exercises in 
raising the velum as described under Velum Defects 
below. The sound “n,” namely, the nasal with 
forward contact of the tongue, is sometimes used 
for “ng,” the nasal with rear contact, as in “good 
u 
11 
Fig. 67. — Mouth dia- 
gram for “n.” 
The tongue 
touches the palate 
at the same place 
as for “t” and 
“d.” The velum 
is lowered. 
Fig. 68. — Mouth dia- 
gram for “ng.” 
The velum is 
lowered and the 
back of the tongue 
is raised slightly to 
meet it. 
mornin” instead of “good morning.” The confu- 
sion is aided by the lack of any English letter for the 
sound “ng.” The correction is made by calling the 
patient’s attention to the difference and by making 
him open his mouth widely while making the “ng” 
in such words as “sing,” “ring,” “bring,” “calling,” 
etc. The “ng” in words like “finger” consists 140 
STUTTERING AND LISPING 
of the two sounds “n” and “g” and not of the 
single sound “ng” (g). 
Defects of the Two Forms of “sh” (f, 3) 
The two sounds indicated by “sh” are made by 
raising the front of the tongue so as to cut off all 
breath except 
through a small 
channel (Figs. 69, 
70). For (J) (“sh” 
as in “azure”) the 
larynx vibrates; for 
(3) (“sh” as in 
“show”) it does 
not. 
Sometimes the pressure of the 
tongue is too weak; the channel is 
too large, and the “sh” sounds 
faint and hollow. The defect can be corrected by 
emphasizing the tongue pressure. 
Sometimes the contact is so weak and incorrect 
that the resulting sound is more like “th.” The 
tongue is to be pressed with more force. 
When the sound “s” is made instead of “sh,” it 
Fig. 69. — Palato- 
gram for “sh.” 
The tongue 
touches the pal- 
ate along the 
sides and leaves 
a larger opening 
in front than 
for “s.” 
Fig. 70. — Mouth dia- 
gram for “sh.” 
The tongue is 
raised against the 
palate over a broad 
area further back 
than for “s.” The 
channel is longer. NEGLIGENT LISPING 
141 
indicates that the child does not properly distin- 
guish between them. 
He is to be drilled 
in careful pronunci- 
ation of words with 
such sounds. 
It occasionally 
happens that “f” is 
used for “sh.” Just 
as with “f ” for “s” 
(p. 135), he is taught to distinguish 
them, and his lips may be held 
apart. For the rare “t” for “sh” 
a procedure like that of “t” for “s” may be tried. 
Fig. 71. — Palato- 
gram for “th.” 
The tongue 
touches the 
palate in front 
over a broad 
space so lightly 
that air es- 
capes. 
Fig. 72. — Mouth dia- 
gram for “th.” 
The front of the 
tongue is raised 
against the palate, 
but a very wide 
channel is left. 
Defects of the Two Forms of “th” (0, S) 
In producing the two sounds indicated by “th” 
the front of the tongue is raised against the palate 
(Figs. 71, 72), the tip touching so lightly that the 
air escapes over it. For “th” as in “thin” the 
larynx is silent; for “th” as in “thine” it pro- 
duces a tone. 
It is very common for children to use “t” and “d ” 
for “th”; thus, they say “tin,” “tree,” “tumb” 142 
STUTTERING AND LISPING 
for “thin,” “three,” “thumb,” and “dis,” “dough,” 
“dee” for “this,” “though,” “the.” It is like 
the language of the 
loafer or the tough: 
‘ ‘ Are you wid me ? Yes, 
trou’ tick and tin.” 
The defect arises from 
pressing the tongue too 
tightly, with the result 
that no air can issue 
from the mouth ; this makes an occluded “th” that 
sounds like a “t” or a “d.” 
A mouth record (Fig. 7) of the word “ thin ” spoken 
normally is given in Fig. 
73; it is very clear that 
air issues from the mouth 
during the “ th. ” A record 
of the same word spoken 
by a lisper is given in Fig. 
75; the first sound was 
evidently an occlusion 
with an explosion similar 
to the first sound in “tin” (Fig. 74). 
The cure consists in inserting a probe or a stick at 
Fig. 73. — Mouth record of “thin” 
spoken normally. 
The rising line shows that dur- 
ing “th” the air issues from the 
mouth in a steady stream. The 
small vibrations are from the 
vowel and “n.” 
Fig. 74. — Mouth record of “ tin ” 
spoken normally. 
The straight line indicates 
the occlusion of the “t”; 
the sharp upward movement 
is the result of its explosion. 
The small vibrations are from 
the vowel and “n.” NEGLIGENT LISPING 
143 
Fig. 75. — Mouth record of “thin” with occluded “th,” by a lisper. 
The sudden depression of the line at the start indicates a strong 
jerk of the tongue whereby air is drawn in for an instant. The 
straight line indicates that the tongue is held tightly against the 
palate. The sudden upward jerk is the explosion of the occluded 
“th.” The occluded “th” is longer than the normal “th” or “t”; 
this is a result of the excessive effort. Its explosion is stronger than 
that of “t ” 
the side of the mouth 
above the tongue (Fig. 
76). When the patient 
tries to say “t,” his 
tongue is pressed down 
across the tip and he 
is forced to say “th.” 
It is also useful to 
teach the use of the 
interdental fricative 
(p. 134) as a substitute 
for the defective “th.” 
The breath indicator is 
often effective (Fig. 42). 
Fig. 76. — Correcting occluded “th.” 
A stick is held across the front of 
the tongue, so that it cannot be 
pressed tightly against the palate. 144 
STUTTERING AND LISPING 
Children often use “f” and “v” for “th,” sub- 
stituting one fricative for another. The defect 
is explained to the patient. He is to observe in a 
mirror that for words like “thin,” “thimble,” “this,” 
“though,” etc., the lips remain apart. If necessary, 
Fig, 77. — Mouth record of front rolled “r” by an American. 
The larger vibrations result from the flapping of the tip of the 
tongue; the very fine vibrations are the record of the laryngeal 
vibrations, that is, of the tone of the voice. 
the lower lip may be held down by a stick or the 
finger. 
Defects of “r” and “l” (i, 1) 
The original sound from which English derives 
its “r,” as in “run,” was the rolled or trilled “r,” 
which is indicated phonetically by (r). The rolled 
“r,” which is no longer used in English, is the only one 
in German, French, Italian, and most other languages. 
To produce the rolled “r” with the point of the 
tongue, its front portion is pressed against the 
palate tightly except at the point. The pressure of NEGLIGENT LISPING 
145 
the breath causes the point to flap. A mouth record 
by the apparatus shown in Fig. 7 is given in Fig. 77. 
In English “ r ” 
the tongue position 
is the same, but the 
point is held away 
from the palate 
(Figs. 78, 79); there 
is no flapping or 
rolling. A mouth 
record of “ sorrow ” 
(Fig. 80) shows small 
vibrations for the 
“ r ” like those of a vowel. The phonetic letter is (j). 
In large cities like Berlin and Paris, and regularly 
Fig. 78. — Palato- 
gram for Eng- 
lish “r.” 
The side and 
front of the 
tongue are 
raised; the 
channel in the 
middle is wider 
than for “sh,” 
but not so wide 
as for the 
vowels. 
Fig. 79. — Mouth dia- 
gram for “r.” 
The front of the 
tongue is raised 
against the palate, 
but the tip does 
not quite touch it. 
Fig. 80. — Mouth record of English “r.” 
The record is of the word “sorrow.” The rising line at the start 
indicates the air issuing during the “s.” The small vibrations are 
those of two vowels with “r” between them. The vibrations for 
“r” do not differ from those for the vowels except in minor details. 
in Yiddish, the rolled “r” is produced by forming 
a groove in the rear of the tongue in which the 146 
STUTTERING AND LISPING 
uvula is allowed to rest. The breath causes the 
uvula to vibrate. A mouth record is shown in Fig. 81. 
The phonetic letter is (r). 
Fig. 81. — Mouth record of uvula “r” by a Parisian. 
The larger vibrations result from the flapping of the uvula; the 
finer ones are the record of the laryngeal vibrations, that is, of the 
tone of the voice. 
For “1” the tongue is tight in front and open along 
the sides (Figs. 82, 83). 
The most com- 
mon defect in Eng- 
lish is the use of the 
easy sound “w” for 
the difficult sound 
“r.” The cure con- 
sists in getting the 
tongue in the right 
place for “u.” One 
method is to teach the rolled “r”; the rolling is 
to be done with the tip of the tongue. When the 
patient can talk with the rolled “r,” he simply 
1 
Fig. 82. — Palato- 
gram for “1.” 
The tongue 
touches the 
palate at the 
front, leaving 
free passage at 
each side. 
Fig. 83. — Mouth dia- 
gram for “1.” 
The front of the 
tongue touches the 
palate. NEGLIGENT LISPING 
147 
drops the roll while using the same tongue position. 
When the person cannot get the tongue right for 
the rolled “r,” it 
is useful to use an- 
other sound that 
requires the point 
of the tongue 
against the palate. For example, he is told to repeat 
“sun, run, sun, run,” 
etc., or “tun, run, 
tun, run,” etc. 
In more difficult 
cases the patient ob- 
serves the tongue of 
another person say- 
ing “r.” He finds 
that it touches the 
teeth along the sides, 
but is free in front; 
this is particularly 
clear when the “r” 
is rolled. With a mirror he tries to get the same 
position. 
The instrument shown in Fig. 84 is made by 
Fig. 84. — Rod for pushing the tongue. The 
rod is made of an aluminum applicator 
(twice the size of the figure). 
Fig. 85. — Pushing the tongue into 
position for “r.” 
The rod pushes the front of the 
tongue up and back. 148 
STUTTERING AND LISPING 
bending a light wire (aluminum applicator). With 
it the front of the tongue can be pushed upward and 
backward into the position for “r” (Fig. 85). 
Sometimes “1” is used for “r.” It is like the 
Mongolian lisp used by the Chinaman, who says 
“Melican man here light away.” The patient is 
shown that for “1” the tongue is open along the 
sides while tight at the tip. The action is thus 
the reverse of that for “r.” For the correction of 
this obstinate defect the tongue is drawn back into the 
mouth so that it cannot be released at the sides; 
the point is turned up. A flat stick or a small rod 
(aluminum applicator) bent to the form shown in 
Fig. 84 may be put under the tongue to push it 
back and up. 
Children of foreign-born parents sometimes use 
the lingual or uvular rolled “r” instead of thesmooth 
English “r.” Their peculiarity may be illustrated 
as follows: “Rrrobert makes a rrring arrround it” 
or “Rimobert makes a RRRing aRRRound it” instead 
of “Robert,” etc. It is usually sufficient to teach 
the difference by ear between the English “r” and 
the rolled “r.” For more difficult cases a breath 
recorder (Fig. 7) may be used; the indicator makes NEGLIGENT LISPING 
149 
a steady movement for the English “r,” while it 
vibrates heavily for the rolled “r.” 
The “r” may be omitted or replaced by other 
sounds, as “n,” “t,” “w,” etc. The use of “w” for 
“r” is very frequent; the child is sometimes en- 
couraged to say “vewy,” “pwetty,” etc., because it 
sounds “cute.” Both tongue and lips take the posi- 
tions for “w” instead of those for “r” (Plate II). 
Even when the tongue is in the position proper for 
“r,” the lips may have the position for “w.” This 
makes a peculiar “r” with a “w” tinge. These defects 
are to be corrected by teaching the patient to make 
exaggerated or rolled “r”s. Words are recited with 
exaggerated “r”s, rolled and not rolled. The lower 
lip may be held down to hinder the “w” move- 
ment. 
The usual defect for “1” consists in the use of an 
“r” or in dropping the “1.” In both cases the cure 
consists in imitation or in explanation with observa- 
tion of the tongue. In order to enforce the fact 
that the tongue must touch at the tip for “1,” it 
is useful to draw the tongue back and then throw 
the tip sharply into place against the palate as an 
initial “1” is to be pronounced. 150 
STUTTERING AND LISPING 
If a nasal sound is used for “1, ” the correction is to 
be made by pinching the nose, by the nasal indicator, 
etc., as described under “Velum Defects.” 
Velum Defects 
For all English sounds except the nasals “m, n, ng,” 
the velum, or soft palate, must rise so as to close 
more or less completely the passage from throat to 
nose. When this is not done, the speech has a dull, 
nasal snorting character. 
The vowels may be tested by the following list: 
for “ah” (a), “ah, arm, art”; for (se), “at, after, 
am”; for “aye” (e), “aid, ate, ale”; for “eh” 
(«), “ebb, effort, egg” ; for “ee” (i), “eel, eat, easy” ; 
for (i) “it, in, ill”; for “oh” (o), “old, owe, oak”; 
for “awe” (o), “awe, awful, ought”; for “oo” (u), 
“fool, boor, tool” ; for (u), “full, pull, bull.” 
The occlusives may be tested by the words “ape, 
pa, upper; able, bee, obey ; at, tar, utter; add, do, 
odor; oak, caw, ochre; egg, go, ago.” 
The fricatives may be tested by the words “eff, 
fare, offer; eave, veal, ever; ess, see, essay; ease, zee, 
easy; shoe, ash, usher; azure, pleasure: thin, 
oath, ether; though, bathe, either.” NEGLIGENT LISPING 
151 
The sounds of “r” and “1” may be tested by the 
words “run, arrow, law, ell, fellow.” 
If the velum does not rise during the vowels, 
they have a nasal character reminding one of the 
Fig. 86. — Recording the nasal current and vibrations. 
A small glass tip is inserted into one of the nostrils. Currents of 
air and vibrations from the nose pass down the rubber tube to the 
small recording tambour, whose lever traces a line on the recording 
surface. 
French nasal vowels. If it does not rise during “s,” 
that sound appears like a nasal snort. For the oc- 
clusives (p, b, t, d, k, g) the lips or the tongue close the 
air passage in front and the velum closes the nasal 
passage; the air, which accumulates under some 152 
STUTTERING AND LISPING 
pressure, is released by the lips or the tongue; this 
causes a slight puff or explosion from the mouth. If 
the velum is dropped before the release, the explosion 
Fig. 87. — Nasal record of “sun” spoken normally. 
occurs through the nose, producing peculiar snorting 
sounds for “p,” “b,” “t“d,” “k,” and “g.” 
Graphic records may be obtained by the arrange- 
ment shown in Fig. 86. For example, the nasal rec- 
Fig. 88. — Nasal record of “sun” with relaxed velum. 
ord of “sun” with correct “s” (Fig. 87) shows no 
emission of air during “s,” that with nasalized “s” 
(Fig. 88) shows a strong snort. The snorting “ s ” 
is what has been described as “nasal sigmatism” ; the 
other snorting sounds have not been specially named. 
Sometimes it is sufficient to explain these principles 
to the patient and let him feel the improper nasal 
breathing on the back of his hand. A tissue paper 
flag (Fig. 89) or a light piece of cotton is also 
effective. NEGLIGENT LISPING 
153 
It is often very effective to use a breath indicator 
which shows when air issues from the nose (Fig. 43). 
The patient must learn to make all the vowels and 
the proper consonants without letting air escape 
Fig. 89. — Tissue paper indicator. 
The passage of breath through the nose or the mouth moves the 
piece of paper. 
from the nose. This he must do in continuous speech 
also. 
The muscles that press the velum against the rear 
of the pharynx can be strengthened by a velar hook 
(Fig. 90) made of a rubber penholder whose end is 
softened in hot water and bent, or of a bent laryngeal 
electrode. The hook is inserted behind the velum 154 
STUTTERING AND LISPING 
and the vowels are spoken or sung while the hand 
pulls on the handle of the hook (Fig. 91). 
Very effective is the application of a laryngeal 
electrode with a very mild faradic current to the 
Fig. 90. — Velar hook. 
velum. The slight shock induces the person to 
draw the velum up. 
An appeal to the ear may be made by using the 
nasal tip and rubber tube shown in Fig. 86 with the free 
end placed to the ear. When the velum is properly 
raised during “ a,” “ s,” “ papa,” etc., very little is 
heard in the ear. When the velum is not raised, 
the sound through the tube is very loud. The tube NEGLIGENT LISPING 
155 
is placed to the patient’s ear and the instructor puts 
the tip to his nose, while he pronounces the words. 
Fig. 91. — Velar hook in position. 
The hook has been placed behind the velum, which is raised against 
a slight resistance from the hand. 
Then the tip is transferred to the patient’s nose so 
that he can listen to himself. 
Larynx Defects 
The use of surd “s” (as in “sun”) for the sonant 
“s” (as in “does” or “zone”) sometimes occurs. 
Such a patient pronounces “lies” and “doze” as 
if they were “lice” and “dose.” He is taught the 156 
STUTTERING AND LISPING 
difference between surd and sonant; he puts his 
finger over the larynx (Adam’s apple) and feels it 
Fig. 92. — Mouth record of “dog.” 
The record was taken with the apparatus shown in Fig. 7. The 
straight line at the beginning represents the stoppage of breath 
during “d.” The following vibrations are those of the vowel. The 
faint vibrations where the line begins to sink are those during the 
occlusion of “g.” Strong vibrations appear at the end, that is, during 
the explosion of “g.” 
vibrate while he sings or speaks a prolonged vowel 
with a“z” (as in “does” or “zone”). 
Fig. 93. — Mouth record of “dok.” 
The record differs from that in Fig. 92 in having no vibrations 
during the sound after the vowel, namely, during “k.” 
Similar confusion may occur with the other sounds; 
“t” may be used for “d,” “k” for “g,” etc., and like- 
wise the reverse. 
The most common trouble is that the larynx stops 
vibrating before the sonant is really finished. Thus, 
the person appears to say “dok” instead of “dog”; 
in reality the last sound was half “g” and half “k,” NEGLIGENT LISPING 
157 
and he said “dogk.” Mouth records of the three 
cases are given in Figs. 92, 93, 94. The trouble can 
usually be corrected by training the ear. 
General Indistinctness 
The negligence may go so far that the patient 
speaks in a generally slurred manner. Ordinarily 
Fig. 94. — Mouth record of “dogk.” 
There are faint vibrations after the vowel, showing that the sound 
began as “g” and not as “k” ; these die away and none are found 
at the time of the explosion, showing that the sound ended in “k.” 
this is corrected by having him repeat sounds, words, 
and sentences after a careful speaker. The following 
points are to be especially noticed. 
The sounds “p, b, t, d, k, g” are produced with the 
lips or tongue stopping the air passage. When the 
stoppage is released, the air comes out with a slight 
puff or explosion. When the air pressure is allowed 
to fall before release of the lips or the tongue no 
explosion occurs. This is the normal pronunciation 
in French ; in English it indicates negligence. 158 
STUTTERING AND LISPING 
A graphic record (Fig. 7)of the normal “p” (Fig. 95) 
shows the sharp explosion at the end of the occlusion. 
Fig. 95. — Mouth record of “apa” with the explosion of “p” well 
marked. 
The record was taken with the apparatus shown in Fig. 7. The 
waves at the beginning are those of the first vowel. Then follows 
the straight line for the occlusion of “p.” The sharp upward move- 
ment of the line is the result of the explosion of “p.” Thereafter 
follow the vowel waves. 
A record where the explosion is omitted is shown in 
Fig. 96. 
The cure consists in training the patient to ex- 
plode his “p”s, “t”s, etc., so that the explosion is 
Fig. 96. — Mouth record of “apa” with no explosion of “p.” 
The record is the same as in Fig. 95 without the sharp upward 
movement of the line. The “p” had no explosion. 
quite audible. The breath indicators shown in Figs. 
42, 43 with a mouthpiece are most effective. The 
patient must learn to make all his occlusives with 
marked explosions. NEGLIGENT LISPING 
159 
The “s” and other sounds are often made too 
weakly. The patient must learn to hiss the “s’7 
strongly and to make each sound with sufficient 
energy to cause it to be heard distinctly. Some- 
times the nasal sound “n” is systematically too 
wreak. It is corrected by speaking and reading with 
prolonged “n”s. 
Vowels or consonants are often slurred over too 
briefly. The training consists in reading and speak- 
ing with the vowels exaggerated in length. 
For general indistinctness it is useful to speak and 
spell words backward over a private telephone 
wire or to a person so far away that there is diffi- 
culty in understanding. The patient may prac- 
tice repeating words from a dictionary, making, for 
example, at one time all the “s”s prominent, at 
another all the “t”s, etc.; such combinations as 
“tw,” “tr,” “str,” etc., require special attention. 
Such sentences as “Peter Piper picked a peck of 
pickled peppers,” “Round the rough and rugged 
rock the ragged rascal ran,” “Shall she sell sea shells 
by the seashore,” “Tired Tommy tripped his toes,” 
etc., are useful. 
The higher degrees of indistinctness found where 160 
STUTTERING AND LISPING 
the intellectual development begins to be slightly de- 
fective are to be treated by the following system: 
Tongue gymnastics are introduced. They include, 
(1) putting out and pulling in tongue; (2) moving 
it from side to side ; (3) holding it out while 2, 3, etc., 
are counted; (4) turning up the tip of the tongue 
to the palate (with fingers if necessary). Similar 
exercises are performed in advancing the lips, bit- 
ing them, pouting, grinning, and moving the lower 
jaw. 
Respiration exercises may include blowing up 
bags, blowing out candles, blowing bubbles, etc. 
The articulation exercises are to be based on the 
principle that the child is to see how the teacher 
makes each sound; he hears the sound and is then 
to feel his own movements and see them in a mirror 
while he hears himself make the same sound. Thus, 
after seeing the action of the teacher’s lips for “f” 
and “v” he watches his own lips in a mirror. To 
distinguish between “f” and “v” he puts his hand 
over the teacher’s larynx and feels that the vibrations 
are lacking in “f” and present in “v”; then he 
feels his own larynx. The lip and tongue positions 
for the other consonants are taught similarly.* The NEGLIGENT LISPING 
161 
emission of the breath during “h” and the fricatives 
may be felt by the hand held in front of the mouth. 
Careful drill in pronouncing words and sentences 
can be carried out in connection with reading exer- 
cises. 
The training of the intellect should be carried on 
at the same time. As speech is most closely con- 
nected with thinking, the most efficacious method is 
to make the speech training the center of the entire 
instruction. CHAPTER III 
ORGANIC LISPING 
“Organic lisping” is the term that may be ap- 
plied to such speech defects as arise from anatomi- 
cal defects of the vocal organs. 
The defective speech is usually a great drawback 
to the patient’s career. It sometimes leads to fur- 
ther troubles. One boy whose enunciation of “s” 
and “z” was defective on account of overshot 
jaw had his ideas of speech so confused that he had 
failed to correct the infantile “t” for “k” (“tandy” 
for “candy”), although he could make such sounds 
perfectly. Moreover, the defect had caused him so 
much mental distress and strain that he enunciated 
his sounds with strongly contracted muscles, 
whereby they were indistinct. He thus had all 
three kinds of lisping: organic, negligent, and neu- 
rotic (Chapter IV). 
Lisping from Hare Lip or from Feeble Lips 
The former requires the surgeon. The latter may, 
in some cases, be aided by massage, electricity, and lip 
162 ORGANIC LISPING 
163 
gymnastics. The lip gymnastics include specially 
pressing them tightly together, holding them tightly 
while the breath is pressed 
against them, pouting, 
puckering, etc. If the 
lips are weak on account 
of muscular dystrophy, 
all such treatment must 
be avoided. 
Lisping from Tongue Defects 
When the tongue is too 
thick, too small, too 
clumsy, or injured, the 
resulting inaccuracies may 
be mitigated by careful 
gymnastics (p. 160) and 
training by means of mir- 
ror, palatograms (p. 114), 
etc. 
Hemiatrophy of the tongue (Fig. 97) shows itself 
in smallness of one side of the tongue, in grooves in 
the surface and in fibrillary twitchings. The speech 
is usually correct, but not always so. The speech of 
Fig. 97. — Hemiatrophy of the 
tongue. 
Degeneration of the nerve 
centers had caused one side 
of the tongue to become much 
smaller and weaker. This 
caused the patient to lisp. 
The lisping had produced 
such a condition of embar- 
rassment and fear that she 
was considered back- 
ward, although really per- 
fectly normal mentally. 164 
STUTTERING AND LISPING 
one girl of fifteen was so indistinct that she could 
not get along in school and was considered mentally 
dull. The correction and scolding at school and by 
the mother had produced intense depression. The 
cause was a hitherto unobserved hemiatrophy of 
the tongue which made it difficult to use the tongue 
properly (organic lisping); this had so confused her 
that she made all sounds indistinctly (negligent 
lisping). 
A stuttering boy of eight years was found to have 
imperfect enunciation, due to confused habits of 
enunciation arising from weakness of one side of 
the tongue. The physical defect had thus produced 
organic lisping, which had in turn produced negli- 
gent lisping. The embarrassment and shame had 
produced not only severe stuttering, but also a serious 
deformity of character. 
Lisping from, Tongue-Tie 
When the frenum of the tongue is too short, it 
prevents the tongue from rising sufficiently in front 
to cut off all the air except what passes through a 
small channel to make the “s” sound (Fig. 56). 
The sound actually produced is more like “th”; ORGANIC LISPING 
165 
e.g. “people thay I lithp, but I don’t pertheive 
it.” If the person can project the tip of the tongue 
beyond the teeth, the tongue is free enough for cor- 
rect speech. 
To cut the frenum the region is thoroughly co- 
cainized ; an incision is made with aseptic scis- 
sors ; the membranes are then torn slightly further 
by the fingers wrapped in gauze. A too deep in- 
cision risks cutting large blood vessels. 
In older people the lisp may still remain as a habit. 
It should then be treated as in the case of “t” for 
“s” (p. 130). 
There is an antiquated belief that tongue-tie 
causes stuttering. It cannot do so directly, but I 
have had cases where the lisping due to tongue-tie 
had made the person so nervous that he had become 
a stutterer (p. 43). 
Lisping from Jaw and Tooth Defects 
Overshot and undershot jaws are due mainly to 
irregular development of the teeth. The undershot 
jaw occurs also with the disease akromegaly. In ex- 
cessive cases of overshot or undershot jaw the pro- 
jection may be so great that the lips do not close 166 
STUTTERING AND LISPING 
properly for “f,” “v,” “p,” “b,”“m,”and several of 
the vowels. In these and similar cases it is frequently 
difficult to adjust the tongue quite correctly, especially 
for “s” With strongly undershot jaw the “s” sound 
may be produced as the tongue moves to its posi- 
tion to make a “t”; “tool” sounds like “stool.” 
When the upper front teeth project much beyond the 
lower ones it is frequently difficult to adjust the 
tongue so that the jet of air strikes the lower teeth 
correctly for “s” (Fig. 56); the sound is rather like 
“sh.” The procedure is like that for the similar 
cases in negligent speech. 
The gaps left by extracted teeth often affect the 
“s” in ways difficult to remedy except by insert- 
ing artificial teeth. 
Sometimes a canine tooth is bent inward in such 
a way as to hinder the tongue in making “t”; a 
slight “s” sound precedes the “t.” 
For many jaw and tooth defects the most impor- 
tant therapeutic procedure is orthodontism. If the 
child is under sixteen years old, he should be put in 
the care of an orthodontist. Older cases are usually 
hopeless. ORGANIC LISPING 
167 
Lisping from High Palatal Arch 
The defect mainly affects the “s” ; the person has 
difficulty in getting the tongue properly against the 
palate to produce the small channel. Sometimes he 
lets the air escape at the sides. Sometimes the at- 
tempt to press the tongue up tightly leads to a strong 
spasmodic pressure at every “s.” One such pa- 
tient with the “s” spasm was often supposed to be a 
person who stuttered only on “s.” In one case the 
patient, eleven years old, had given up all effort at us- 
ing the tongue for “s,” replacing it by a pause filled 
by a cramp in the larynx. He pronounced “sink” 
apparently like “ink” ; in reality the pronunciation 
was (’ink), where (’) indicates the glottal catch. 
The distortion of speech caused by the omission of 
the “s” had produced so much trouble that the boy 
had acquired the strained, hoarse voice and the sad 
face of a stutterer. The defect can be cured or 
alleviated by careful attempts to get the proper 
position. The spasmodic cases are helped by train- 
ing in soft and relaxed speaking. With the patient 
just mentioned who always omitted the “s, ” the cure 
consisted in teaching him to use “ts” for “s,” 168 
STUTTERING AND LISPING 
whereby he would say “tsoup” for “soup.” As soon 
as the habit was formed, he dropped the “t” and 
retained the “s.” 
Lisping from Cleft Palate 
When the velum cannot close the rear passage 
through the nose, all the sounds except nasals are 
modified. All the explosives become nasal sounds, 
thus “p” and “b” become “m,” “d” becomes 
"n,” “g” becomes “ng,” “t” and “k” become surd 
“n” and “ng,” “s” becomes a snort, etc. The 
vowels are all nasal. 
After the velum has been closed by operation, 
there may be little or no ability to raise it into place 
across the pharynx. Its muscles can be strengthened 
by the velar hook (p. 154). Exercises can be devised 
for teaching the use of the velum, such as blowing out 
a candle, playing a mouth harmonica, etc. The pa- 
tient does them at first while holding his nose closed 
with his fingers ; he gradually lessens the finger pres- 
sure and tries to substitute velar action. 
With a light illuminating the interior of the mouth, 
the patient observes his velum in a mirror as he sings 
“ah” on a low note and then on a high note. The ORGANIC LISPING 
169 
velum should rise for both notes, more for the higher 
ones. Exercises with a nasal indicator, tissue paper 
flag, etc., as described for negligent speech (p. 153), 
aid in giving the proper control. Electrical stimula- 
tion (p. 154) is often very effective. 
To make the velum rise during the occlusives 
“p, b, t, d, k, g” they are pronounced singly and in 
words with much prolonged occlusions and sharp 
explosions at the end. This cannot be done unless 
the velum is properly raised. 
Occasionally some of the velar associations are very 
firmly fixed ; special devices must be tried to break 
them up. Thus, if the velum persists in remaining 
down for "s,” rods of various sizes may be placed 
over the tongue (p. 143, Fig. 76). 
The loss of air during speech with a cleft palate 
naturally leads the patient to take breath repeatedly 
within a sentence. The habit may persist after the 
operation; in such a case systematic breath exer- 
cises are to be performed. 
The great effort involved in speaking with a cleft 
palate may lead the patient to overexertion of all his 
speech muscles; this produces a grimacing speech; 
that is, the muscles of the face overact. This is 170 
STUTTERING AND LISPING 
liable to persist after operation. Relaxation is 
taught by speaking with no lip motion (as in ven- 
triloquism), by singing, by exercises in melodious 
speech (p. 74), etc. The nervous rapidity of speech 
requires exercise in slowness (p. 85). 
Lisping from Relaxed Palate after Adenoids 
When a person has large bunches of adenoids, the 
closure of the velum is made against them. After 
s 
they have been removed, the velum sometimes 
makes the same amount of movement as before. 
This leaves a gap between it and the rear wall of 
the pharynx whereby all sounds become nasal. 
The treatment is the same as for negligent lisping 
(p. 150). 
Lisping from Obstructed Nasal Passages 
The obstruction deprives the nasal sounds more 
or less of their peculiar ring. Thus “m” sounds 
like “b,” “n” like “d,” etc. 
This condition is found temporarily in severe 
colds; the turbinates in the nostrils become swollen 
and the nasal cavities are more or less closed. Per- 
manently enlarged turbinates or a deflected septum 
may cause a similar result. With large adenoids the ORGANIC LISPING 
171 
passage through the upper pharynx is also more or 
less obstructed. 
In regard to speech this condition is the opposite 
of that with cleft palate. The nasalization from 
cleft palate, etc., consists in adding nasal tones to 
sounds where they do not belong. The denasaliza- 
tion from obstruction consists in eliminating nasal 
tones when they should be present. 
No special voice treatment can improve this condi- 
tion. For colds the treatment comprises a laxative 
(Seidlitz powder, citrate of magnesia), cleansing with 
antiseptic sprays, menthol, coryza w'ool, etc. Tur- 
binates, adenoids, and tonsils are referred to special- 
ists. 
Lisping from Defective Hearing 
When the hearing is diminished, the child may fail 
to grasp the finer essentials of the sounds. In mild 
cases the words may be spoken loudly into his ear. 
Each incorrect sound may also be treated separately 
as described in the chapter on Negligent Lisping. 
Hearing tubes are often useful. 
In more severe cases lip reading should be taught 
in a way somewhat similar to that for deaf children. 
By feeling the teacher’s larynx and his own larynx 172 
STUTTERING AND LISPING 
and by listening to loud tones from a musical in- 
strument the child gets a definite idea of pitch and 
of the adjustment he must make in his larynx in 
order to produce musical sounds. Then by watch- 
ing the instructor’s face and by looking in the 
mirror he learns the positions of the lips for the 
individual sounds. In a similar way he learns the 
positions of the tongue for “t,” “d,” “k,” “g,” etc. 
The positions are explained by the diagrams in the 
plates at the end of this book. The tongue posi- 
tions for the vowels and consonants can be taught 
in this way. 
To show the various amounts of breath that issue 
during the vowels, during “h,” during the frica- 
tives, and for the explosions in the occlusives, the 
patient’s hand is put before the instructor’s mouth 
and then before his own. A slate, a cold piece of 
metal, or the breath indicators described on pages 
119-121 can be used for the same purpose. The 
presence or the absence of nasality can be shown 
in a simlar way. As much as possible the child 
should be made to hear all the sounds. When such 
children are spoken to, they should be able to see 
the face of the instructor. CHAPTER IV 
NEUKOTIC LISPING 
Patients with this trouble often enunciate sounds 
in ways that resemble negligent speech. The failure 
of the methods of treatment for negligent speech 
first made it clear to me that this disorder was of 
an entirely different nature. 
One patient used “t” for “s,” “d” for “z,” and 
“t” and “d” for the two forms of “th,” the tongue 
action being the same as that described on pp. 130, 
141. The patient also said “tsoe” instead of “shoe.” 
The occlusives (t, d, k, g) were used correctly, but 
they had no explosions (p. 157). This was quite in 
contrast to the false occlusives “t” and “d” used 
for “s,” “z,” “th,” as these had strong explosions. 
The patient had learned to talk clearly, but at four 
years of age she fell, striking her head; she remained 
unconscious for several hours. 
A few days afterwards she had convulsions; they 
were frequently repeated till the age of six. The 
173 174 
STUTTERING AND LISPING 
defect in speech appeared shortly after the fall. 
She now has a tremor of the entire body when she 
attempts to speak. There is also a tremor of the 
lips during “p” and “b” and a tremor of the laryn- 
geal tone when a vowel is sung. It is hard to get her 
to produce any loud or long sound; every sound, 
even a simple hiss, is produced in a manner indica- 
tive of excessive timidity and almost of fright. These 
conditions never occur in cases of negligent lisping; 
the patients are always perfectly cool and deliberate; 
they are sluggish and phlegmatic instead of nervous. 
The similarity of her mental condition to that of the 
stutterer is evident. 
Graphic records were made of the air current for 
the mouth while she pronounced some sounds. 
The arrangement was that shown in Fig. 7. When a 
current of air issues from the mouth, the recording 
lever rises and the white line bends upward. A de- 
scent of the line indicates that the air current is 
diminished or cut off. The decrease of the air current 
may be due to some adjustment of the tongue or 
lips or to a cessation of the pressure from the chest. 
The record for “so” in Fig. 98, spoken by a 
normal person, shows that the air current steadily NEUROTIC LISPING 
175 
increased during the first part of the “s” and then 
fell somewhat. The small waves in the record are 
due to the laryngeal vibrations; in “so” they indi- 
Fig. 98. — Mouth record of “so” spoken normally. 
The first part of the line registers the emission of the air during 
the “s” ; it rises and falls smoothly. The small vibrations indicate 
the waves of the vowel. 
cate the vowel. A record of “so” spoken by the 
patient is given in Fig. 99. Instead of the gradually 
increasing and diminishing air current for “s,” the 
Fig. 99. — Mouth record of “so” in neurotic lisping. 
There is very little emission of the air for the “a” ; it is suddenly 
cut short by complete stoppage. The sudden descent of the line at 
the beginning indicates that the tongue was drawn sharply back. 
The larger waves after the step show the explosion as the “t”-like 
sound is completed by the release of the tongue. The small vibra- 
tions are those of the vowel. 
patient merely starts the current, and then not only 
cuts it off, but actually causes the line to fall below 
zero. 
For the normal “s” the tongue is placed against 
the roof of the mouth in such a way as to leave a 176 
STUTTERING AND LISPING 
small channel in the middle, through which a jet of 
air is directed against the lower teeth. A palato- 
gram for normal “s” is shown in Fig. 54 ; a mouth 
diagram of the position of the tongue is shown in 
Fig. 56. During the normal “s” a current of air 
passes to the recording apparatus and causes the line 
to rise steadily. 
The record in Fig. 99 indicates that the patient 
pressed the tongue so hard against the top of the 
mouth that she closed up the small channel; more- 
over, in doing this she made such a forcible move- 
ment of the tongue that air was actually drawn into 
the mouth for an instant. The sudden rise of the 
line indicates that, as the tongue was released from 
its place, the air burst from behind it in the form of 
a sharp puff, or explosion, that acted like a blow 
on the recording membrane. The sound produced 
by such action is like that of “t.” Apparently the 
patient substituted “t” for “s.” In like manner 
for “z” she used a sound like “d.” 
The mechanism for the defective “s” is like that 
for occluded “s” (p. 130), as indicated by the palato- 
gram in Fig. 55 and the mouth diagram in Fig. 57. 
The tongue is pressed against the palate harder NEUROTIC LISPING 
177 
than it should be; the small channel is thereby- 
closed. 
The graphic record of “silk” (Fig. 100) in normal 
speech shows a rather long emission of air for “s,” 
Fig. 100. — Mouth record of “silk” spoken normally. 
The “s” and the vowel are indicated as in Fig. 98. The “1” 
is represented by some small vibrations at the end of the vowel. 
The “k” begins as a fall in the line due to cutting off the breath by 
the tongue; it ends in a strong upward movement due to the ex- 
plosion as the tongue is released. 
followed by waves for the vowel and “1.” The “k” 
begins as the vowel waves cease; the line falls be- 
Fig. 101. — Mouth record of “silk” in neurotic lisping. 
There is first a brief intake of breath, then an emission of breath 
corresponding to a normal “s.” This is followed by an occlusion 
with an explosion. The sound is thus partly a normal “s,” as in 
Fig. 98, but mainly an occlusion with an irregular explosion. The 
following fine vibrations belong to the vowel and “1.” The “k” is 
represented by a straight line due to the stoppage of the breath by 
the tongue; the abnorm ality is shown by the lack of an explosion 
wave for the “k,” the breath being stopped before the tongue is 
released. 
cause the current of air is cut off by the tongue; 
the explosion of* the “k” is marked by the sudden 
rise of the line at the close. 178 
STUTTERING AND LISPING 
The record of “silk” (Fig. 101) by the patient shows 
a sharp inrush of air followed by a sudden rise of 
the line with some emission of air thereafter. The 
inrush of air indicates presumably an extremely 
brief gasp as she starts the tongue movement. The 
sudden rise shows that the sound “s” is begun. 
This sound is at first a true though faint “s,” some 
air being emitted. There follows, however, a sudden 
Fig. 102. — Mouth record of “shoe” in normal speech. 
The emission of air during the “sh” is similar to that of “s” in 
Fig. 98. The record ends with the vowel vibrations. 
drop of the line ; this shows that the breath has been 
stopped and that the sound has become an occlusive. 
The sudden rise of the line thereafter shows that this 
sound, like most occlusives in English, ended with 
an explosion. The first part of the sound was thus 
a true “s,” while the second was an occlusive “s” 
with an explosion. The remainder of the record 
shows the waves for the vowel and “1” followed 
by a straight line for the occlusive “kThe “k” 
is abnormal, having no explosion. 
The record of “shoe” in Fig. 102 is that for normal NEUROTIC LISPING 
179 
speech. It shows an emission of breath during “sh” 
similar to that for “s” in Fig. 98. The action of the 
tongue for “sh” is like that for “s” in forming a 
channel through which the air is directed. A 
palatogram for normal “sh” is given in Fig. 69; 
a mouth diagram in Fig. 70. 
A record of neurotically lisped “shoe” is given 
Fig. 103. — Mouth record of “shoe” in neurotic lisping. 
The straight line, the sudden fall, and the strong waves show that 
the tongue closed the mouth, was sharply drawn back, and was then 
released with a strong explosion. Then followed a faint breathy 
sound like a weak “s.” The record ends with the vowel vibrations. 
To the ear the word sounded somewhat like “tsoe.” 
in Fig. 103. There is a sudden intake of breath; this 
is abruptly released. This indicates that at the 
start the tongue was placed tightly against the palate. 
As it was released to form “sh,” it permitted a slight 
puff of air to pass. This would produce a short 
“t.” The “t” was followed by a rather faint emis- 
sion throughout the “sh.” There was no occlusion 
during or after the emission ; otherwise the line would 
have descended at some point as in the “s” of Fig. 
99. That the passage was not wide open, however, is 180 
STUTTERING AND LISPING 
shown by the slight elevation of the line during the 
emission of the breath and by the sudden rise (slight 
explosion) in the line at the end of the “sh” just 
before the vowel begins. The sound is not so open 
as in the normal “sh.” The impression on the ear 
was that of “tsoe” rather than “shoe.” 
For the two forms of “th” as in “thick” and 
“this,” she used sounds resembling “t” and “d.” 
For “th” the tongue is pressed against the palate 
at the sides, but the contact in front is so light that 
the air escapes (Fig. 71). The patient pressed the 
tongue too tightly and cut off the air entirely. 
The condition for “k” noted in Fig. 101 is typical 
for all her occlusives, i.e. sounds involving a complete 
closure of the mouth passage; namely, “p,” “b,” 
“t,” “d,” “k,” hard “g.” In these she regularly 
weakens the breath pressure before they end, so that 
they have no explosions when the tongue or the lips 
release the tension. This is quite in contrast to the 
incorrect occlusives that she makes out of the frica- 
tives “s” and “sh,” etc., to which she gives strong 
explosions. 
The case seems at the first view to be one of what 
has been termed “negligent lisping” (p. 122). Children NEUROTIC LISPING 
181 
with this trouble regularly substitute “t” for as,” 
“d” for “z,” and “t” and “d” for the two forms 
of “th,” just as this person does. The defect arises 
from the same cause, namely, pressing the tongue too 
tightly against the palate. 
The excessive tongue action in negligent lispers 
arises from negligent observation and careless action. 
The children with negligent speech are usually those 
that have grown up in surroundings unfavorable to 
careful enunciation, as among the poorer classes or 
where baby talk has been encouraged. This patient, 
however, had learned to talk clearly. Moreover, she is 
not careless about her speech, but overanxious. Her 
tongue touches her palate not simply because she is 
too negligent to take the pains to leave a small open- 
ing, but because it is seized by an uncontrollable 
spasm. 
It is evident that we have here a form of speech 
characterized by quick nervous muscular action in- 
stead of the deliberate smooth action required for nor- 
mal sounds. In trying to make the “s,” for example, 
the patient is too nervous to carry out the fine 
adjustment requisite; she presses the tongue too 
tightly and thus makes a “t.” The result for the 182 
STUTTERING AND LISPING 
hearer is the same as in negligent lisping, but the 
nervous processes in the two diseases are quite dif- 
ferent. 
Can this be a form of stuttering where the exces- 
sive contractions are quite limited ? A never-failing 
symptom in stuttering is the excessive contraction 
of the laryngeal muscles whereby the laryngeal tone 
becomes hard and monotonous; here the laryngeal 
tone is rather soft and timid. Moreover, the stut- 
tering cramps are never confined exclusively and 
constantly to just a few sounds. They frequently 
vary from time to time, the trouble being on “p,” 
for example, during one month and on “s” during 
another month. Again, the stutterer will have 
trouble not on a single consonant wherever it occurs, 
but on consonants in a certain position, generally 
initial ones. Facial and bodily contortions often oc- 
cur with stuttering, but I have never found tremor 
present. We must conclude, I think, that this is not 
a case in any way resembling stuttering, although 
the cause may be the same. 
Another case was that of a girl of thirteen who lisped 
over all the consonants. Her speech was at times 
almost unintelligible. Treatment along the lines NEUROTIC LISPING 
183 
of muscular and mental education indicated for 
negligent lisping produced no result. She was an 
excessively nervous child, and she spoke with in- 
credible rapidity. As she was gradually quieted down, 
the lisping decreased. It became evident that the 
excessive nervous tension, combined with self-con- 
sciousness, produced a tense condition of the vocal 
organs allied to that of stuttering. She could not 
produce the smooth and delicately adjusted move- 
ments of normal speech because her muscles were 
overtense. 
Another case of nervous lisping was that of a girl 
of twelve whose speech was mumbled. Her 
mother thought her tongue was too long; her 
father thought there was something the matter 
with her intelligence. The methods for curing 
negligent lisping were fruitless. It became evident 
that partial deafness had made it .hard for her 
to learn to speak. Being a sensitive child, the con- 
stant correction by the parents and the embarrass- 
ment and fear before them had produced a condition 
of nervousness much as in the previous case. 
She spoke improperly because she overinnervated 
the speech muscles. She began to improve under 184 
STUTTERING AND LISPING 
quieting treatment. Unfortunately the parents did 
not trust the diagnosis, and preferred to regard the 
defect as one of intellect. 
Neurotic lisping is rather frequently found combined 
with stuttering. A patient twenty-eight years old was 
a typical stutterer. At the same time his speech was, 
aside from his stuttering, so indistinct that he was 
frequently asked to repeat a word. For example, 
he would say that he had been to Hartford in such a 
way as to leave it in doubt if he had said “ Harwood,” 
“Harvard,” “Havre,” or something similar. The 
“s”s and “n”s were weak and often inaudible. 
The explosions of the occlusives “p,” “b,” “t,” “d,” 
“k,” “g” were generally omitted. The “r” sounded 
sometimes like “u” and sometimes like “1.” The 
words were often contracted to unintelligible 
mumblings. Treatment by the methods used for 
negligent lisping made the trouble worse. The 
treatment for his stuttering included methods that 
caused the patient to relax his vocal muscles. It 
was noticed that during such relaxation the con- 
sonants were often spoken correctly. It was thus 
evident that the lisping was due to excessive general 
innervation, that is, that it was neurotic lisping. NEUROTIC LISPING 
185 
For differential diagnosis we may sum up as fol- 
lows : Neurotic lisping is allied to stuttering in its 
causation (fright, nervous strain) and in the pres- 
ence of an emotional disturbance. It differs in hav- 
ing excessive muscular tension of a constant rather 
than a spasmodic kind; this results in speech some- 
what like lisping and not in the peculiar sounds of 
the stutterer. It differs from negligent lisping in 
the fact that it appears in nervous persons and not 
in phlegmatic or dull ones, and that the muscular 
movements are cramplike instead of careless. 
The general treatment is mainly that for neuras- 
thenia. General hygiene, mode of life (school, 
profession), moral habits, eyestrain, nose and throat 
conditions, etc., must be considered. Arsenic, 
quinine, strychnine, and other tonics, cold rubs, 
lukewarm or cold half baths, sprays, moist packs, 
electrotherapy, massage, change of climate, and sea 
baths may be tried. Open-air exercise is always 
admirable. Hypnotism and other forms of psy- 
chotherapy are often most efficient. 
The special speech treatment consists in ex- 
plaining the trouble to the patient and then having 
him repeat sentences, answer questions, and talk 386 
STUTTERING AND LISPING 
in a relaxed way. The relaxation may be brought 
about voluntarily or by suggestion. An efficacious 
method of suggesting relaxation is to have the patient 
recline on a couch and gradually fall into a semi-doze 
while repeating sentences or conversing. CHAPTER V 
CLUTTERING 
Cluttering is characterized by great nervousness 
that shows itself in excessive rapidity of speech with 
indistinct enunciation. When the patient starts 
to speak, he hastens recklessly through what he 
has to say. The nervous hurry of his mind makes 
him form and combine the sounds imperfectly. 
Sounds, syllables, and words are mumbled together. 
The breathing may become spasmodic and irregular. 
A normal person can speak as rapidly as a clutterer 
without necessarily losing the distinctness in enun- 
ciation ; it is the clutterer’s nervousness that produces 
the defect. 
Cluttering is usually combined with stuttering, but 
it can be distinguished from it. In the one there is 
nervous haste; in the other there is nervous fear. 
The clutterer speaks better the more he thinks about 
his speech, the stutterer often speaks better the less he 
thinks about it. The clutterer shows negligence and 
187 188 
STUTTERING AND LISPING 
lack of self-control; the stutterer cannot release him- 
self from anxiously watching over his speech. My 
experience has included only a few cases of clutter- 
ing without stuttering. Quite a few stutterers are 
also clutterers. 
Cluttering sometimes produces stuttering. The 
cluttering child is ridiculed or made anxious in 
other ways until the “stutterer’s fear” is produced. 
One unusually bright but excessively nervous and self- 
willed boy of six had developed a language of his own, 
which he spoke at excessive speed. This speech was 
intelligible only to his younger brother, who had 
learned to speak in the same way. His notions of 
spelling were likewise completely confused. The 
troublesome situations that had resulted from the 
cluttering had embarrassed the boy and made him 
anxiously nervous, with the result that he both 
cluttered and stuttered. 
Negligent lisping, when it includes many sounds, 
resembles cluttering in the general indistinctness 
of speech, but the two disorders can be distinguished 
by the fact that in cluttering the speech is quick and 
hasty, whereas in negligent lisping it is of normal or 
slow speed. With very slow speech the cluttering CLUTTERING 
189 
sometimes disappears, the negligent lisping remains. 
All sorts of sounds are affected in many cases of 
cluttering; in negligent lisping a definite set is 
affected. It is my experience that some clutterers 
make a set of defective sounds, such as “s” or 
“sh,” incorrectly even when they speak slowly. It 
is not correct to say such cases have negligent lisp- 
ing also, because the cause — namely, the mental 
attitude — is utterly different in the two cases. 
The therapy consists of tongue gymnastics, of 
exercises in enunciating words singly and in com- 
bination, and in speaking slowly and distinctly. 
If the clutterer is forced to enunciate certain sounds, 
such as the explosives (p. 117) or “s” very distinctly, 
he is obliged to speak slowly, and can thus learn to 
enunciate all sounds better. The breath indicator 
(p. 119) can be used. In severe cases the treatment 
may begin with singing. The nervousness may be 
combated by proper hygiene, tonics, rest cures, 
hypnotics, or psychanalysis. PART 111 
EXERCISES 
SET I 
BREATHING (p. 84) 
1. Active Calisthenics 
A. Standing, breathing while raising arms fore 
upward and side downward. 
B. Same, raising arms side upward and down- 
ward. 
C. Broad standing (that is, with feet separated), 
neck firm (that is, finger tips touching back of neck, 
elbows out), sideward bending alternately right and 
left (breathe in on upward movement). 
D. Broad standing, neck firm, turn trunk to right 
and then to left as far as possible, inspire on return- 
ing to position. 
E. Broad standing, hands on hips, turn to right as 
far as possible, then forward and backward, inspire 
on returning to position; continue turning to left. 
190 EXERCISES 
191 
F. Broad standing, arms raised upward, bend 
forward, rise up. 
(In all these exercises inspiration through the nose 
should occur as the ribs are expanded, expiration 
through the nose as they are moved inwards. Each 
movement is to be performed five times or more.) 
2. Regulation of Breathing 
A. Standing, place one hand on the chest and the 
other on the abdomen; take a long breath, enlarging 
the chest in all directions, and drawing the abdomen 
in. Expire by letting the chest fall and the abdomen 
spring out. Repeat this, always trying to enlarge 
the chest still more, and trying to blow out a 
stronger breath on expiration. 
B. Same on inspiration, but not using the hands. 
On expiration, let the breath pass out slowly. Re- 
peat this, trying to make the breath last longer and 
longer. 
C. Same, except that a powerful “ah” is sung. 
D. Same inspiration, sing “ah” as long as possible, 
crescendo-diminuendo. 
(Breathing is to be done with open mouth. Each 
movement is to be performed five times or more.) 192 
STUTTERING AND LISPING 
3. Breathing and Use of Twist (p. 78) 
A. Raise the arms side upward, inhaling, lower 
side downward, singing “ah” on middle c. 
B. Raise the arms side upward, inhaling; lower 
side downward, singing “ah” sliding from middle c 
to high c (octave twist). 
C. Likewise, speaking words of one syllable with 
the octave twist. 
D. Likewise speaking words of two syllables with 
the octave twist on the first vowel. 
(Each step is to be done a number of times.) 
4. Regulation of Breath in Singing 
A. Sing a short song with inspiration before each 
line. 
B. Sing two lines with one breath. 
C. Sing three lines with one breath. 
D. Sing four lines with one breath. 
5. Regulation of Breath in Reading 
Take a full breath before each sentence or phrase; 
wait one second, not letting any breath out. Then 
speak the sentence or phrase slowly in one breath; 
do not breathe in the middle. Use a text with short 
sentences, poems, and longer prose pieces. EXERCISES 
193 
6. Regulation of Breath in Speaking 
Holding a stick in the hand, raise it each time before 
speaking, while breath is inspired vigorously. After 
waiting one second with bated breath, speak as in- 
truded. 
A. Read a short sentence after the instructor. 
B. Answer the question of the instructor. 
C. Make a sentence concerning some topic assigned 
by the instructor. 
D: Give a description of some object pointed out 
by the instructor, breathing vigorously before each 
sentence. 
(The first two parts of this exercise can be con- 
veniently combined into the “statement and question 
exercise.” The instructor gives a series of state- 
ments and questions. Each statement is to be 
repeated, and each question is to be answered. The 
confidence gained by the pupil in repeating the 
statement helps him in answering the questions. A 
book on “travel talk” supplies convenient material. 
See also p. 92.) 194 
STUTTERING AND LISPING 
SET II 
melody (p. 74) 
7. Giving the Idea of Melody 
A. Sing a short song in the key appropriate for the 
pupil’s voice with inspiration before each line. 
B. Speak the words of this song on the same notes, 
the piano being played at the same time. 
C. Same as B without the piano. 
D. Speak the words melodiously, that is, with a 
rise and a fall of the voice, but not necessarily on 
the same notes as the song. 
E. Speak the words of the song melodiously, but 
with perfect freedom. 
8. Introducing Melody into Speech (p. 91) 
A. Sing a short song, speaking the last word of each 
line instead of singing it. 
B. Repeat, speaking the last two words. 
C. Repeat, speaking the last three words. 
D. Continue in the same wayp adding word by 
word until the whole song can be spoken perfectly. 
E. Sing some statement, for example, “New York 
is a very large city.” Repeat it, speaking the last EXERCISES 
195 
word. Then repeat it, speaking the last two words. 
Continue as before. 
F. Question and answer. The instructor gives the 
question, the patient gives the answer. First sing 
them, then speak the last word, then last two words, 
etc. 
9. Introducing Melody into Recitation 
A. Recite: 
“Oh, look at the moon! She is shining up there. 
Oh, mother, she looks like a lamp in the air. 
Last week she was smaller, just like a bow; 
This week she is larger and round as an 0.” 
The voice is to rise and fall somewhat in the follow- 
ing way: 
moon shining 
look 
the is there. 
Oh, at she up 
B. Recite other pieces of verse and prose likewise. 
10. Introducing Melody into Conversation 
A. A question is sung on some simple melody or on 
the notes c, e, g, c', or as a chant on one or two notes. 
The answer is sung likewise. It is of no account 196 
STUTTERING AND LISPING 
whether the syllables exactly fit the notes or not. 
This is repeated until there is no difficulty; each 
of the following steps is also to be repeated until at 
least fair success is obtained. 
B. Statements are alternated between two per- 
sons in the same musical way. At first the state- 
ments may be disconnected; “Rice grows in 
the Southern states”; “New York is the largest 
city in America.” Gradually they are to be turned 
into a connected conversation. 
C. Same as A, but speak the words with piano 
accompaniment. 
D. Same as B, but with words spoken to accom- 
paniment. 
E. Question and answer without the piano, but 
with attempt at the melody used before. 
F. Statements likewise. 
G. Question and answer melodiously, but freely. 
H. Statements likewise. 
11. Training the Ear to Control the Voice 
A. Sing “ma” on each of the notes as indicated. EXERCISES 
197 
B. Sing “ma” on each of the notes of the scale 
going upward and downward. 
C. Sing “ma” on each of the notes of the scale, 
beginning and ending it very faintly, and making 
it long. 
D. Sing “ma” upward and downward on the 
notes c, e, g, c'. 
SET III 
FLEXIBILITY (p. 74) 
12. Singing 
A. Sing the vowel “ah/’ through the notes of 
the octave. 
B. Strike the lowest note of the octave, then the 
highest; sing the vowel “ah,” half on the lowest 
note, half on the highest. 
C. Sing the vowel continuously (portamento) 
over the octave (octave twist). 198 
STUTTERING AND LISPING 
D. Practice singing the different vowels over the 
octave in this way. 
E. Sing a series of one-syllable words with long 
vowels, running the vowels up in the same way. 
13. Speaking 
A. The instructor speaks a word with the octave 
twist. The pupil repeats it. 
B. Same with sentences, putting the octave twist 
on the first important vowel (the first important 
vowel is not necessarily the first vowel). 
C. Same with poems, putting the octave twist 
on the first important vowel in each line. 
D. Same with prose, putting the octave twist on 
the first important vowel in each phrase. 
E. Statement and question exercise (see note to 
Exercise 6) with the octave twist. 
SET IV 
SLOWNESS (p. 85) 
(It is advisable to give the “octave twist” to the 
first important vowel in each sentence, as under 
Flexibility, Exercise 13, B.) EXERCISES 
199 
14. Speaking with Lengthened Vowels 
A. Repeat, after the instructor, single monosyl- 
lables, making the vowel three times as long as nor- 
mally. 
B. Repeat words of more than one syllable, 
lengthening the chief vowel likewise. 
C. Repeat short sentences likewise. 
D. Read words from a book likewise. 
E. Read poems likewise. 
F. Read prose likewise. 
G. Answer questions likewise. 
H. Tell a short story likewise. 
15. Speaking Together (pp. 62, 94) 
A. Repeat or read a poem in unison with another 
person speaking slowly. 
B. Repeat or read it alone slowly. 
C. Repeat or read a prose piece with another 
person slowly. 
D. Repeat or read it alone slowly. 
E. Alternate C and D, a few sentences of each. 
F. Read conversation (dramas, traveler’s manual, 
etc.) slowly with another person. 
G. Free conversation, question and answer. 200 
STUTTERING AND LISPING 
16. Metronome Exercise (p. 85) 
A. Speak sentences to a metronome beating 54 
to a minute, with one syllable to each beat. 
B. Statement and question exercise likewise 
(see note to Exercise 6). 
C. Tell a connected story likewise, such as what 
you had for breakfast, how you spent last summer, etc. 
D. Repeat A, B, C while some one holds the finger 
on the metronome ready to act whenever you speak 
too fast. 
E. Repeat A, B, C, D without the metronome. 
F. Repeat A, B, C, D without the metronome, 
taking care to eliminate all jerkiness of speech. 
17. Speaking with Sticks 
A. Repeat sentences, striking the stick to each em- 
phatic vowel and keeping time with the metronome 
at 54 a minute. 
B. Same without the metronome. 
C. Question and answer likewise (see note to 
Exercise 6). 
D. Same without the metronome. 
E. Tell a story about breakfast, etc., keeping time 
to the metronome. EXERCISES 
201 
SET V 
SMOOTHNESS 
18. Linking 
A. Repeat and read sentences, linking all the words 
together, that is, making no pause or interruption 
between the different words. The whole sentence 
should be spoken as if it were one word, or just as in 
French. “ Thecoverofthebookisred.” “Thecarpet- 
onthefloorisgreen.” “ Theelectriclightisvery conven- 
ient.” “ TheturkeycomesonThanksgivingDay.” 
B. Repeat and read short stories likewise. 
C. Repeat sentences and answer questions likewise. 
19. Vowel Start 
A. Read sentences, making the first important 
vowel in each sentence at least three times as long 
as usual. Speak it with the octave twist. Speak 
the rest of the sentence as described in the exercise 
on “Linking.” 
B. Read likewise. 
C. Repeat sentences and answer questions like- 
wise. 
D. Conversation likewise. 202 
STUTTERING AND LISPING 
SET VI 
VOICE QUALITY (p. 81) 
20. Tone Placing by Chanting 
A. Chant one line of a poem or a prose statement 
on one note. 
B. Repeat this on other notes. 
C. Same, dropping to a lower note on the last word. 
D. Same, short story. 
E. Same, statements, question and answer. 
21. Tone Placing with 11 Bee-bee-bee ’ ’ 
A. Strike middle c and sing “bee-bee-bee,” mak- 
ing the vowel sharp as in the French word “pique”; 
this is far more sharp than the English wTord “peek.” 
Go up the scale for an octave in the same wray. 
B. Same with “bee-ah.” 
C. Same with “bee-ay.” 
D. Same with “bee-oh.” 
E. Same with “bee-you.” 
F. Same with “bah.” 
G. Same with “bay.” 
H. Same with “boh.” 
7. Same with “bou.” EXERCISES 
203 
All these vowels should be sung in a ringing, very 
slightly nasal tone, that is, in what is termed a “ for- 
ward tone.” 
22. Tone Placing with “ Ma” 
A. Strike middle c and sing ‘‘ mmmmmmaaaaaah.” 
Hold “m” until the vibrations are felt strongly on 
the lips; then simply open the mouth to let the 
“ah” out, being careful to keep the same quality 
of tone as in “m.” For a high voice begin above 
middle c. 
B. Repeat up the scale for an octave. 
C. Same with “mee” ; same with “moh” ; same 
with “moo.” 
D. Repeat on arpeggios of three and four notes. 
Mama mama ma 
etc. 
Ma ma ma ma ma ma ma 
etc. 204 
STUTTERING AND LISPING 
23. Husky Tone 
A. Strike middle c and sing “ah,” beginning and 
ending it with the glottal catch (p. 81). Continue 
up the scale. 
B. Sing arpeggios likewise. 
C. Sing “ah” to the notes of a song likewise. 
D. Sing a song, cutting all the words sharply 
apart. 
24. Trumpet and Megaphone 
A. Hold a small trumpet to your lips. Shout 
through it the phrase “Pie-apples, ten cents a water 
pail,” using the sharp tones that would be used by 
a peddler calling out on the street. Use other phrases 
in the same way, for example, “Nice fresh straw- 
berries.” 
B. Call out railway stations in a similar way. 
C. Same with a small megaphone. Note that you 
have to make somewhat more of an effort to get the 
sharpness with the megaphone. 
D. Repeat all the preceding without anything 
before the mouth. Make a special effort to get the 
sharp ringing tone. EXERCISES 
205 
SET VII 
STARTING AND ENDING SENTENCES 
25. Strengthening the First Word 
A. Sing short sentences, striking a note on the 
piano as you sing the first syllable. Instead of 
using the piano you may strike a bell or a table or 
you may hit your knee or make a gesture as in beat- 
ing time. 
B. Repeat the same sentences, with the same 
accompaniment in the same way, but singing only 
the first word. 
C. Speak them with the same accompaniment 
on the first syllable. 
D. Question and answer are sung with the ac- 
companiment on the first syllable. 
E. As before, but only the first syllable sung, 
the rest being spoken. 
F. As before, but all spoken. 
G. Tell a story, singing the first word of each 
sentence with the accompaniment. 
H. Tell a story without singing, but accompany- 
ing each first syllable. 206 
STUTTERING AND LISPING 
26. Emphasizing Periods 
A. Read short sentences, striking a bell or a piano 
note at the period. 
B. Read a story likewise. 
C. Question and answer likewise. 
D. Tell a story likewise. 
E. Raise a heavy weight in the hand and hold it 
till a period is reached. Read and speak sentences, 
stories, etc. 
27. Lowering Tones at the End 
A. Chant sentences on one note, but drop by a 
fifth — sol to do — on the last syllable. Use the 
piano at first, but gradually omit it. 
B. Speak sentences on a rather high tone, and 
drop on the last word. 
28. Clear Endings 
A. Sing sentences, cutting the last word short 
with the glottal catch. 
B. Speak sentences, singing the last word sharply. 
C. Speak sentences, making sure that the last 
syllable is sharp. EXERCISES 
207 
SET VIII 
ENUNCIATION AND SPELLING (p. 88) 
29. Typical Sounds (p. 117) 
A. Indicate by printed or written letters on 
paper, blackboard, or chart the typical explosives 
“p, b, d, t, k, g”; show their explosions by paper 
flags or the breath indicator (pp. 153, 119). 
B. Indicate the typical fricatives “ f, v, s, z, sh, 
th.” 
C. Indicate the occlusive-fricatives “ch and j.” 
D. Indicate the nasals “m, n, ng, ” showing that 
air issues through the nose. 
E. Indicate the liquids “1, r. ” 
F. Indicate the semi-vowels “w, y.” 
30. Combination of Sounds into Syllables 
A. Combine each of the explosives “ p, b, t, d, k, g ” 
with various vowels; indicate the result on paper, 
blackboard, or chart and speak it at the same time; 
thus, “pa, pay, pee, po, pu, ba, bay, bee, bo, boo,” etc. 
B. Same with fricatives and the other sounds of 
the previous exercise; thus “fa, fay, fee, fo, foo, 
va, vay, vee, vo, voo,” etc. 208 
STUTTERING AND LISPING 
C. Form syllables with explosives followed by 
“r” and the vowels: thus, “pray, pree, pro, proo, 
bray, bree, bro, broo,” etc. 
D. Same with “1” instead of “r”; thus, “play, 
plee, plo, ploo, blay, blee, bio, bloo,” etc. 
31. Division of Words into Syllables (p. 88) 
A. Learn to spell words, dividing them into syl- 
lables according to the dictionary. Pronounce each 
syllable separately, for example, “a-c, ac, c-e-1, 
cel, e-r, er, a-t-e, ate, accelerate.” 
SET IX 
EXPRESSION 
32. Giving the Idea of Emphasis 
A. Sing “ah” with notes on the piano as 
indicated. 
This gives an idea of emphasis by change in pitch. 
B. Sing “ah” on one note but with different 
lengths as indicated. EXERCISES 
209 
This gives the idea of emphasis by change of 
length. 
C. Sing “ ah ” on the same note and with the same 
length, making the first one of each group of three 
louder than the others. 
This gives the idea of emphasis by change in loud- 
ness. 
33. Developing Expression 
In eacli of the following exercises the instructor 
first shows the pupil just what he is to do. He 
criticizes the pupil's deficiency, and imitates him 
where he fails to get the proper expression. 
A. Repeat a poem with expression. 
B. State a certain fact in a very melodious and 
expressive way. 
C. When the instructor gives a question in a very 
melodious and expressive voice, answer it by taking 
a few words from the question. 
D. As before, but answer freely with the same 
melody and expression as in the question. 
E. Recite poems and prose pieces with proper 
expression. 210 
STUTTERING AND LISPING 
F. Read dialogues with the proper change of ex- 
pression for each character. 
G. Read and speak jokes with an effort to give the 
most effective expression. 
SET X 
CONFIDENCE (p. 90) 
34. Reading Together (pp. 62, 94) 
A. Read a poem together with the instructor. 
Read alternate lines together and alone. 
B. Same with sentences. 
C. Read a prose speech together; the instructor 
is to remain silent occasionally. 
D. Read a prose piece; the instructor is to join 
in at the first intimation of difficulty. 
E. Read statements and questions sometimes to- 
gether, sometimes alone (see note to Exercise 6). 
F. Read parts in a drama; the instructor joins in 
whenever the pupil has difficulty. 
G. Read a paragraph, and then tell its contents in 
your own language; the instructor joins in wherever 
there is any difficulty. EXERCISES 
211 
35. Speaking Together (p. 62) 
A. Repeat a poem in unison with another person, 
speaking slowly. 
B. Repeat it alone slowly. 
C. Repeat a prose piece with another person slowly. 
D. Repeat it alone slowly. 
36. Reading with Decided Voice (p. 98) 
A. Call off the railroad stations from a time-table 
through the megaphone. The voice must ring out 
clearly and decidedly. 
B. Same without the megaphone. 
C. Read headlines from a newspaper in a similar 
way. 
D. Read short sentences likewise. 
E. Read short poems likewise. 
F. Read short prose pieces likewise. 
G. Read jokes likewise. 
Speaking with Confidence (pp. 94, 95) 
A. Call out railroad stations with the megaphone; 
the voice must be clear and decided. 
B. Same without the megaphone. 
C. Make geographical statements with and without 212 
STUTTERING AND LISPING 
the megaphone; for example, “The Atlantic Ocean 
is east of the United States.” 
D. Make historical statements likewise (that is, 
with and without the megaphone); for example, 
“George Washington was the first president of the 
United States.” 
E. Question and answer likewise. 
F. Relate a story of an incident likewise. 
G. Make a speech likewise. 
H. Take part in a debate likewise. 
I. Take part in a continuous story which is ar- 
ranged as follows: One person tells a story which 
he makes up as he goes along; he suddenly stops, 
and the next person is immediately to continue the 
story according to his own ideas; he, in turn, sud- 
denly stops and the following person continues. 
This is kept up until the story reaches the first person. 
38. Buying (p. 96) 
A. You are supposed to be a storekeeper with a 
number of objects before you ; other people go to the 
store, inquire about articles, discuss the prices and 
buy. This must all be done with proper attention 
to slowness and melody of speech. EXERCISES 
213 
B. Take the part of the buyer. 
C. The store is turned into a railroad ticket office 
with yourself alternately as ticket agent and as trav- 
eler. Various questions concerning trains, accommo- 
dations, etc., are to be asked. 
D. The ticket office becomes the box office at the 
theater; the questions are to include location and 
seats, exchange of tickets, etc. 
39. Introducing (p. 63) 
A. The instructor introduces himself to you; 
you reply, “I am glad to meet you.” 
B. Introduce yourself to the instructor. 
C. The instructor introduces some other person 
to you, you reply “I am glad to meet you” or 
“How do you do?” 
D. The instructor introduces you to another per- 
son ; you say “How do you do?” 
E. Introduce yourself to another person. 
F. Introduce the instructor to different persons. 
G. Introduce different persons to the instructor. 
H. Introduce two familiar persons to each other. 
/. Introduce strangers to each other. 
As much as possible the stutterer should feel that 214 
STUTTERING AND LISPING 
the instructor is at hand to speak for him in case of 
any difficulty. 
40. Public Speaking (p. 95) 
A. Prepare a short speech to make on an assigned 
topic, and deliver it in the presence of the instructor. 
B. Same in the presence of several people. 
C. Make an impromptu speech on a given topic in 
the presence of the instructor. 
D. Same in the presence of other people. 
The number of the people is to be gradually in- 
creased until the stutterer feels ready to get up at any 
moment and make a short speech on any topic. 
41. Scenes from Life (p. 95) 
A. A group of people is supposed to be in some 
familiar situation; for example, eating at a restau- 
rant, riding in an automobile, forming a box party at 
the theater, etc. The instructor works out the situa- 
tion by description, while the persons, including the 
pupil, make the appropriate remarks. For example, 
if the scene is at the restaurant, the instructor takes 
the part of the waiter, while the other persons order 
what they wish to eat, discuss the bill of fare, etc. 
If the scene is at the theater, the instructor tells a EXERCISES 
215 
story of the play while the persons discuss the inci- 
dent, the house, their neighbors etc. In the auto- 
mobile party, the instructor takes the part of the 
chauffeur while the party travels to various places 
and discusses what he has seen. 
B. Similar scenes are worked out, the patient tak- 
ing the leading part. 
C. The group of persons is supposed to represent 
a club, the instructor occupying the chair. Various 
members are to make motions and discuss them, 
officers are to be elected, etc. 
D. The stutterer is made chairman of the club. 
42. School Work (p. 96) 
A. The stutterer is to prepare and recite to the 
instructor some of his school exercises. 
B. He is to do the same before several people. 
C. The group is to be gradually increased till it 
forms quite a class. The instructor is to be the 
teacher and is to call on the patient or patients to 
recite. 
D. The exercise is transferred to a schoolroom. 
E. Outside teachers are called in to conduct the 216 
STUTTERING AND LISPING 
SET XI 
SPONTANEOUS SPEECH 
43. Collection of Ideas (pp. 14, 19, 62) 
A. Say some word referring to an object placed 
before you or pointed out; the word must have some 
application to or connection with the object. You 
may say ‘‘large” referring to its size, or “black” 
referring to its color, or “read” referring to its use, 
or “table” referring to its position, or “yesterday” 
referring to something it reminded you of, etc. 
B. Make a statement slowly and melodiously con- 
cerning some object placed before you or pointed out 
to you. 
C. Name the objects you see on one side of the 
room, proceeding systematically from left to right 
and speaking slowly and melodiously. 
D. Describe an object placed in front of you, us- 
ing single words and proceeding systematically; for 
example, if a telephone is placed before you, you 
will first use words referring to its appearance, then 
to its use, then to its faults, then to its history, etc. 
Always adopt some such system in selecting words. EXERCISES 
217 
E. Same as D, but complete sentences are to be 
used instead of single words. 
. F. Short sentences are to be spoken concerning 
objects not seen but more or less familiar; for 
example, breakfast, a distant city, George Washing- 
ton, Atlantic Ocean, etc. 
G. A more extended account is required concerning 
similar objects, as in F. 
44. Increasing the Embarrassment (p. 62) 
A. Part or all of the preceding exercise is to be 
carried out in the presence of additional people. 
[f B. When this can be done perfectly, you are to be 
called on to make short speeches on topics that have 
been given you before. 
C. You are to make speeches on topics of your own 
choosing. 
SET XII 
THINKING (p. 86) 
45. Single Associations of Ideas 
A. The name of an object is called out. You call 
out the name of some other object that suggests 
itself to your mind. If you are in doubt what to say, 218 
STUTTERING AND LISPING 
choose some object that is often seen together with 
the one mentioned. For example, on hearing the word 
“horse” you reply “cart.” This process is called 
“association of ideas.” For the present you are to 
associate slowly, taking as much time as you wish. 
Practice for several times with the following list 
of words; then add other words. 
hand 
shoe 
coat 
tooth 
boat 
sail 
rope 
pump 
lamp 
theater 
piano 
street 
school 
foot 
glove 
sock 
nose 
canoe 
pin 
seat 
lake 
bell 
hotel 
gun 
head 
collar 
hair 
eye 
motor 
water 
whip 
wheel 
road 
ticket 
dance 
ring 
bell 
muscle 
pencil 
B. Upon hearing each of the words just used, make 
a sentence about it. It does not matter what the 
sentence states. EXERCISES 
219 
C. Upon hearing each of the words make a sen- 
tence defining it. 
D. Upon hearing each of the words state some fact 
about the object implying something in regard to its 
location or its use, or something that preceded it, 
or caused it, or followed it, or resulted from it, or 
had some relation to it. 
46. Running Associations 
Starting with any given word, let the mind bring 
up a long series of thoughts. These thoughts 
should not revolve around the original word, but 
should pass away into other subjects. If necessary, 
the rule may be adopted of obliging the mind to leave 
the original word within three associations. 
SET XIII 
DESCRIPTION AND RELATION 
47. Description (p. 19) 
A. Describe an object placed before you; if you 
have any difficulty, you are to adopt some system, 
such as proceeding from top to bottom or according 
to cause and effect, etc. 
B. Same with simple pictures. 220 
STUTTERING AND LISPING 
C. Same with complicated pictures. 
D. Same with what you see in the room or out of 
the window. 
E. Same with a simple topic from memory, such as 
breakfast this morning, house where you live, school, 
well-known buildings, etc. 
F. Same with a longer experience, such as a journey, 
a visit to a theater, the plot of a story, etc. 
G. All the preceding exercises are to be performed 
in the presence of one other person, then two, and so 
on. 
48. Relation 
A. Read aloud a short story, for example, one of 
iEsop’s fables; then with the book open before you 
relate the contents of the story. 
B. Same with the book closed. 
C. Relate some story that you have previously 
read, for example, Robinson Crusoe, Cinderella, etc. 
D. Same with some previous experiences, such as 
last summer, last Christmas, etc. 
E. Read a joke and then tell it. 
F. Tell some funny story that you read some time 
ago. EXERCISES 
221 
G. Tell what you would like to do next summer, 
next Christmas, etc. 
H. All these exercises are to be done in the presence 
of one additional person, then two persons, etc. 
I. Pretend that you are conducting a scene in 
vaudeville. 
SET XIV 
TELEPHONING (p. 96) 
49. Private Line 
A. Call up some one on the private telephone, 
using the system of your town as nearly as possible. 
First call “ central,” and then speak with the person 
desired. You are to speak slowly and melodiously. 
B. Take the part of “central” and then of the 
person called up. 
C. Repeat A and B in the presence of other people. 
D. Do some of the most difficult exercises over 
the telephone with the instructor or some other 
person at the other end. 
50. Main Line 
A. Put your finger on the telephone switch so 
that when you take the receiver off the hook, the 222 
STUTTERING AND LISPING 
telephone is not connected with ‘‘ central. ’ ’ Some one 
sitting beside you takes the part of “ central ” and the 
person to whom you wish to speak. Carry out exer- 
cises as on the private line. 
B. With the instructor close beside you, call up 
“central” and then some friends; if you have the 
slightest hesitation, the instructor will speak for 
you. 
C. When you succeed perfectly as in B, try the 
telephone independently. The instructor is to criti- 
cize your success. 
SET XV 
TALKING WITH PEOPLE (p. 90) 
51. General Conversation 
A. In a group of two people, talk on assigned 
topics of conversation, with material prepared be- 
forehand. 
B. Then with three people, and so on, gradually 
increasing the number in the group. 
C. Gradually bring in strangers. 
D. Same as A, with topics not prepared beforehand 
(impromptu conversation). EXERCISES 
223 
E. Same with three or more people. 
F. Same with strangers. 
52. Coolness in Argument 
A. Argue a question with the instructor. 
B. Argue a question with somebody else. 
C. Argue a question in a group of three. 
D. Debate a topic with some person before a small 
group. 
E. Debate a political question with interruptions 
from the audience. 
53. Transacting Business 
A. Sitting at a desk, you ring a bell as a signal for 
a person to enter. As he approaches your desk, you 
greet him and ask him what he wants. If he is 
applying for a position, inquire into his qualifications 
and then dismiss him; if he wants to buy or sell or 
transact some other business, you are to promptly 
settle the matter, speaking very slowly and melodi- 
ously. A series of persons is interviewed in like 
manner. 
B. You are to take the part of the person entering 
the office for business. 224 
STUTTERING AND LISPING 
SET XVI 
RELAXATION (p. 61) 
54. General Relaxation 
A. Lie on a couch, close your eyes, and purposely 
try to relax every limb. 
B. Some one passes his hands over the various 
limbs, feeling that the muscles are all relaxed. This 
is repeated four or five times at intervals of about 
fifteen minutes. 
C. Get your mind fixed on the thought of relaxa- 
tion and quietness. Lie perfectly quiet in this way 
for five minutes on the first occasion, for ten minutes 
on the next, and so on for an increasing length of 
time up to a half hour. 
55. Speaking 
A. You are to lie on a couch in a relaxed condition. 
Some one speaks a sentence to you very slowly and 
melodiously; you are to repeat it likewise. 
B. Repeat sentences and reply to questions in the 
usual way (p. 92). 
C. Exercises in description and relation (p. 219) are 
carried out in this relaxed condition. EXERCISES 
225 
SET XVII 
MUSCULAR CONTROL 
56. Tongue Gymnastics (p. 160) 
A. Thrust the tongue out and draw it back 
quickly; do the same slowly. 
B. Move the tongue from side to side outside of 
the mouth, first slowly, then quickly. 
C. Same inside of the mouth. 
D. Touch the point of the tongue to the upper lip. 
E. Touch the point of the tongue to the roof of 
mouth, keeping the mouth open; same with the 
mouth shut. 
F. Touch the point of the tongue to the upper 
front teeth. 
G. Place the thumb and finger on each side of 
the tongue; broaden and narrow the tongue by use 
of the muscles within the tongue; this is felt by the 
fingers. 
H. Place the thumb and finger below and above 
the tongue; repeatedly thicken the tongue; this is 
felt by the fingers. 226 
STUTTERING AND LISPING 
57. Lip Gymnastics 
A. Without projecting the lips, alternately con- 
tract them to a round circle while saying “oh,” 
and draw the corners back while saying “eh.” 
B. Same, on different tones. 
C. Same, speaking sentences. 
58. Relaxing the Jaw (p. 83) 
A. Place the hands at the back of the cheeks; 
notice the swelling of the masseter muscles during 
speech; relax them by dropping the jaw. 
B. Speak the vowels, dropping the jaw at the same 
time. 
C. Speak sentences, dropping the jaw as much as 
possible. 
D. Leave the mouth open for long periods of 
time. 
59. Fixation of the Larynx (p. 83) 
A. With the fingers, press backward and down- 
ward on the hyoid bone; resist its rising while you 
pretend to swallow. 
B. Sing “ah,” pressing the hyoid bone backward; 
alternate in singing “ah” with and without pressing. EXERCISES 
227 
Try to make the “ ah ” without pressing sound like 
the “ ah ” with pressing. 
C. Speak vowels, words, and phrases as in B. 
60. Jaw Position 
A. Insert two fingers vertically between the teeth; 
speak the vowels in this position; speak sentences 
also. 
B. While looking in a mirror, speak all the 
vowels, keeping the mouth as widely open as before, 
or nearly so. 
C. With the mirror, speak sentences, opening the 
mouth as widely as before on the broad vowels, 
such as “ah” and “oh.” 
61. Rear Palatal Arch (p. 84) 
A. Look in the mirror; observe the rear palatal 
arch; whisper “ah” softly and loudly alternately; 
observe that the arch is narrow for the loud whisper. 
B. Try to narrow the arch by a voluntary effort 
without whispering. 
C. When the ability to narrow the arch is obtained, 
sing out a loud “ah” at the moment of narrowing. 
D. Same with other vowels. 
E. Same, speaking the vowels. 228 
STUTTERING AND LISPING 
SET XVIII 
WORD LISTS 
62. Words beginning with “p” 
pack 
pad 
paint 
pair 
pay 
peel 
pear 
pen 
pie 
piece 
pink 
plain 
play 
plum 
point 
pole 
post 
pound 
pour 
preach 
63. Words ending with “p” 
ape 
cape 
cap 
cheap 
deep 
drape 
grape 
hope 
help 
keep 
lap 
leap 
loop 
map 
mop 
nape 
rope 
stop 
tape 
top 
64. Words with “p” in the middle 
appeal 
appear 
apple 
appoint 
approach 
apron 
chapel 
clapper 
dipper lisping 
dripping repeat 
happen repel 
helping repent 
reply 
report 
reproach 
ripple 
65. Words beginning with “b” 
bad 
bag 
bake 
ball 
band 
bank 
bark 
bat 
bead 
bear 
bed 
bee 
bend 
bet 
bill 
bind 
bite 
black 
blank 
bloom EXERCISES 
229 
66. Words ending with “b” 
Arab 
babe 
bribe 
cab 
crab 
crib 
cube 
daub 
drab 
garb 
grab 
probe 
sob 
stab 
stub 
tab 
tub 
tube 
verb 
web 
67. Words with “b” in the middle 
cable 
dribble 
fable 
labor 
lobster 
marble 
medal 
nibble 
obey 
object 
obscure 
observe 
obtain 
rabbit 
ribbon 
robbin 
rubber 
stumble 
tumble 
warble 
68. Words beginning with “t” 
table 
tack 
take 
talk 
tame 
tape 
taste 
tea 
tell 
test 
toe 
top 
town 
trade 
train 
trunk 
trust 
tune 
twist 
twine 
69. Words ending with “t” 
at 
ate 
bat 
bit 
boat 
cat 
coat 
eat 
fat 
fit 
get 
hit 
not 
nut 
ought 
put 
rate 
rust 
what 
wet 230 
STUTTERING AND LISPING 
70. Words with “t” in the middle 
attach 
attack 
attain 
attend 
attire 
battle 
bitter 
butter 
fatal 
fitting 
letter 
matter 
mutter 
outer 
patter 
rattle 
tattle 
utter 
vital 
water 
71. Words beginning with “d” 
dance 
dare 
dark 
dash- 
date 
day 
dead 
deaf 
debt 
deep 
dell 
depth 
desk 
dew 
dim 
dine 
dive 
dog 
doll 
draft 
. 72. Words ending with “d” 
add 
bad 
bed 
bid 
fed 
glad 
had 
lead 
lid 
load 
mad 
made * 
mud 
odd 
pad 
raid 
road 
rude 
sad 
sled 
73. Words with “d” in the middle 
address 
adept 
binding 
bundle 
bondage 
boulder 
cadet 
cedar 
childish 
conduct 
cradle 
edition 
endless 
fading 
federal 
feeding 
fiddle 
gladden 
harden 
widen EXERCISES 
231 
74. Words beginning with “k” 
cab 
catch 
care 
creep 
crop 
cross 
cry 
cube 
cuff 
cup 
cure 
cut 
keep 
key 
kick 
kill 
kind 
king 
kiss 
kite 
75. Words ending with “k” 
ache 
bake 
beak 
beck 
bleak 
cake 
duck 
drake 
flake 
kick 
like 
make 
neck 
oak 
pack 
peck 
pick 
pluck 
risk 
stick 
76. Words with “k” in the middle 
aching 
baker 
barking 
drinking 
flicker 
knuckle 
leaking 
locket 
looking 
market 
masker 
milky 
occur 
package 
picture 
picnic 
raking 
scrape 
scream 
screw 
77. Words beginning with “g” 
gain 
game 
gas 
gate 
gay 
get 
gift 
gild 
girl 
give 
glad 
glade 
glance 
glare 
glass 
gleam 
globe 
glow 
go 
gold 232 
STUTTERING AND LISPING 
78. Words ending with “g” 
bag 
beg 
big 
bug 
clog 
dig 
dog 
drag 
egg 
fog 
frog 
mug 
pig 
rag 
rug 
sting 
tag 
tongue 
tug 
wig 
79. Words with “g” in the middle 
again 
aggrieve 
aghast 
aglow 
agony 
agree 
anger 
angle 
argue 
baggage 
braggart 
bugle 
bungle 
digging 
dragging 
laggard 
longer 
organ 
program 
rugged 
80. Words beginning with “ch” 
chain 
chair 
chalk 
change 
chap 
cheap 
cheat 
check 
cheer 
chicken 
chief 
child 
chill 
chimney 
chin 
chip 
chisel 
chocolate 
choke 
chop 
81. Words ending with “ch” 
batch 
beach 
botch 
church 
crutch 
grouch 
latch 
lurch 
much 
notch 
peach 
perch 
pitch 
pouch 
preach 
reach 
Scotch 
screech 
smirch 
such EXERCISES 
233 
82. Words with “ ch” in the middle 
bleaching 
butcher 
etcher 
fetching 
hitching 
itching 
latching 
lurching 
perching 
pitcher 
preacher 
scorching 
Scotchman 
screeching 
searching 
teacher 
twitchiug 
urchin 
watcher 
witching 
83. Words beginning with “j” 
Jack 
jail 
jam 
jar 
jaw 
jerk 
jet 
jewel 
jig 
job 
jockey 
John 
joint 
joke 
jury 
judge 
jug 
jump 
joy 
justice 
84. Words ending with “j” 
dodge 
dredge 
edge 
fringe 
hedge 
judge 
lodge 
marriage 
porridge 
purge 
rage 
sage 
sledge 
smudge 
stage 
urge 
age 
bridge 
budge 
courage 
85. Words with “ j” in the middle 
adjoin 
arranging 
baggage 
conjurer 
engaging 
enjoy 
ginger 
injury 
language 
luggage 
manger 
prodigious 
regent 
reject 
rejoice 
religious 
Roger 
stranger 
tinged 
unjust 234 
STUTTERING AND LISPING 
86. Words beginning with “f” 
face 
fact 
fail 
faint 
fair 
faith 
fall 
false 
fame 
fan 
fare 
farm 
fast 
fault 
feel 
fell 
fight 
fine 
fire 
fish 
87. Words ending with “f” 
bluff 
chafe 
cliff 
cuff 
elf 
grief 
gruff 
half 
hoof 
if 
laugh 
leaf 
life 
muff 
off 
puff 
rough 
safe 
snuff 
stuff 
88. Words with “f ” in the middle 
affair 
affect 
afford 
afraid 
buffet 
coffee 
differ 
efface 
effect 
effort 
laughter 
lifting 
lofty 
offer 
office 
often 
puffy 
roughen 
stuffy 
toughen 
89. Words beginning with “v” 
vague 
vain 
vale 
valve 
van 
vast 
vault 
veil 
vain 
verb 
vest 
vine 
voice 
void 
vote 
valley 
value 
vapor 
very 
vigor EXERCISES 
235 
90. Words ending with “v” 
above 
brave 
cave 
crave 
dive 
drive 
five 
give 
glove 
groove 
grove 
have 
live 
move 
pave 
rave 
save 
valve 
wave 
weave 
91. Words with “v” in the middle 
braver 
diving 
evade 
even 
event 
ever 
every 
evil 
evince 
favor 
fever 
flavor 
having 
level 
lever 
movement 
never 
over 
river 
silver 
92. Words beginning with “ s ” 
sack 
sad 
safe 
sail 
same 
school 
scrub 
sea 
seed 
sell 
set 
silk 
sin 
since 
sit 
skate 
slate 
slave 
sleep 
slice 
93. Words ending with “s” 
base 
brass 
case 
crease 
dress 
face 
grease 
hiss 
kiss 
lace 
lease 
loss 
loose 
miss 
moss 
place 
race 
rice 
slice 
us 236 
STUTTERING AND LISPING 
94. Words with “s” in the middle 
ascent 
aside 
asleep 
assay 
assign 
assist 
assure 
astir 
astray 
basket 
biscuit 
casket 
dresser 
essay 
essence 
fasten 
listen 
loosen 
master 
tasty 
95. Words beginning with “z” 
zeal 
zest 
zinc 
zodiac 
zone 
zoo 
zebra 
zephyr 
zenith 
zero 
zigzag 
zither 
Zion 
zouave 
zounds 
zoology 
Zeus 
Zulu 
96. Words ending with “z” 
bees 
breeze 
cries 
craze 
daze 
freeze 
graze 
hers 
his 
has 
haze 
lose 
maze 
nose 
praise 
rise 
seize 
size 
tease 
trees 
97. Words with “z” in the middle 
busy 
breezy 
bruising 
cozy 
dizzy 
dozen 
fuzzy 
freezing 
grisly 
hazy 
lazy 
lizard 
losing 
nasal 
prison 
prize 
result 
resume 
scissors 
weasel EXERCISES 
237 
98. Words beginning with “sh” (surd) 
shade 
shaft 
shake 
shall 
shame 
shape 
share 
sharp 
shed 
sheet 
shelf 
shell 
ship 
shock 
shoot 
shop 
shore 
short 
show 
shut 
99. Words ending with “sh” (surd) 
ash 
bush 
cash 
dash 
dish 
fish 
flash 
fresh 
lash 
mash 
push 
plush 
rash 
sash 
slash 
smash 
trash 
thrush 
wash 
wish 
100. Words with “ sh” (surd) in the middle 
ashes 
bashful 
blushing 
brushes 
bushel 
bushy 
cashier 
clinching 
crashing 
crushing 
dashing 
fishy 
flashing 
flushing 
hushing 
freshness 
rashly 
rushing 
washing 
pushing 
101. Words with “ sh” (sonant) 
adhesion 
azure 
cohesion 
decision 
delusion 
derision 
division 
elision 
evasion 
invasion 
leisure 
measure 
Parisian 
pervasion 
pleasure 
precision 
seizure 
treasure 
vision 
visual 238 
STUTTERING AND LISPING 
102. Words beginning with “th” (surd) 
thank 
thaw 
thick 
thief 
thin 
thing 
think 
third 
thirst 
thorn 
thought 
thread 
three 
thrift 
thrill 
throat 
throb 
throw 
thrust 
thud 
103. Words ending with “th” (surd) 
bath 
blithe 
both 
breath 
broth 
death 
depth 
earth 
faith 
fourth 
fifth 
lithe 
month 
moth 
mouth 
path 
tooth 
width 
wrath 
wroth 
104. Words with “th” (surd) in the middle 
athirst 
athlete 
athwart 
author 
bathos 
earthly 
Ethel 
ether 
ethereal 
lengthen 
Matthew 
method 
monthly 
pathway 
pathetic 
pathos 
southerly 
strengthen 
youth 
zither 
105. Words beginning with “th” (sonant) 
than 
that 
the 
them 
then 
there 
they 
these 
thine 
this 
thou 
though 
thus 
they 
therefore EXERCISES 
239 
106. Words ending with “th” (sonant) 
bathe 
breathe 
clothe 
swathe 
lathe 
smooth 
soothe 
loathe 
107. Words with “th” (sonant) in the middle 
another 
bathing 
bother 
breathing 
brother 
either 
father 
feather 
further 
gather 
heather 
mother 
lather 
leather 
neither 
other 
panther 
rather 
together 
weather 
108. Words beginning with “ w” 
wad 
wag 
waif 
wail 
weak 
wealth 
wear 
wax 
wish 
wit 
wolf 
worn 
willow 
wily 
wince 
wife 
wafer 
wager 
wagon 
waffle 
109. Words with “w” in the middle 
awake 
aware 
bewail 
bewitch 
bower 
cower 
dowry 
fewer 
jewel 
lower 
mowing 
power 
rower 
sewer 
slower 
sowing 
towel 
tower 
trowel 
vowel 240 
STUTTERING AND LISPING 
110. Words beginning with “y” 
yacht 
yard 
yarn 
yawl 
yawn 
ye 
year 
yearn 
yeast 
yell 
yellow 
yelp 
yes 
yesterday 
yet 
yield 
yoke 
you 
young 
youth 
111. Words beginning with “ r” 
race 
rack 
raft 
rag 
rasp 
rat 
rate 
rave 
rid 
ride 
ridge 
rig 
rob 
robe 
rock 
rod 
rule 
run 
rung 
rush 
112. Words with “r” between vowels 
arrow 
berry 
current 
direct 
errand 
ferry 
garret 
hurry 
marry 
merry 
mirror 
moral 
narrow 
parrot 
pirate 
sorry 
terrace 
terror 
turret 
worry 
113. Words with “r ” after a consonant 
braid 
branch 
brass 
brave 
bread 
break 
crab 
drip 
drive 
droop 
drop 
drum 
dry 
fraud 
free 
frost 
fruit 
fry 
grape 
grease EXERCISES 
241 
114. Words beginning with “l” 
lad 
lake 
lame 
lamp 
leaf 
leak 
lean 
left 
let 
lick 
lie 
limp 
lion 
lip 
live 
loaf 
long 
loose 
lot 
low 
115. Words ending with “ l ” 
animal 
annual 
appal 
appeal 
avail 
owl 
bail 
bawl 
bell 
bewail 
bill 
boil 
call 
camel 
cereal 
chill 
deal 
dial 
eel 
fool 
116. Words with “ l ” between vowels 
alarm 
alert 
allow 
alley 
along 
aloud 
alum 
elect 
elegant 
element 
elephant 
elevate 
eleven 
elope 
eloquent 
island 
illegal 
illumine 
illusion 
olive 
117. Words beginning with “ m” 
machine 
mad 
made 
magic 
magnet 
maiden 
mail 
mane 
major 
maker 
malice 
mama 
milk 
monkey 
move 
must 
man 
measure 
meat 
meal 242 
STUTTERING AND LISPING 
118. Words ending with “ m ” 
aim 
beam 
comb 
come 
gleam 
gloom 
gum 
home 
jam 
lamb 
limb 
ram 
some 
swim 
thumb 
Tom 
ream 
rim 
room 
seam 
119. Words with “ m” in the middle 
amaze 
amount 
bemoan 
comma 
company 
dreamer 
former 
hammer 
limit 
mama 
mimic 
moment 
murmur 
plumber 
roomy 
steamer 
summer 
summit 
swimmer 
trimming 
120. Words beginning with “ n ” 
name 
neck 
nest 
nice 
niece 
niche 
night 
nine 
no 
nod 
noon 
noose 
north 
not 
note 
now 
nudge 
number 
nurse 
nutshell 
121. Words ending with “ n” 
alone 
balloon 
bean 
brine 
dawn 
fine 
gone 
gun 
John 
moan 
moon 
pan 
pine 
pint 
prune 
rain 
run 
ruin 
sun 
win EXERCISES 
243 
122. Words with “ n ” in the middle 
Annie 
banner 
bonny 
briney 
corner 
counter 
dinner 
fountain 
honor 
lining 
money 
only 
panel 
render 
running 
sooner 
tender 
whining 
winner 
wonder 
123. Words with “ ng ” 
ailing 
bending 
being 
bringer 
covering 
caring 
counting 
crawling 
having 
killing 
laughing 
living 
nothing 
pudding 
remaining 
ring 
ringing 
singer 
willing 
wringer PART IV 
NEW METHODS OF CORRECTING THE 
SPEECH OF THE DEAF 
CHAPTER I 
THE ORGAN TRAINER 
The tone of the voice, or the laryngeal tone, is 
always imperfect in the deaf, even after the best 
instruction. It is too weak or too loud, too husky 
Diaphragm 
4r 
Jet. 
Speaking 
Tube 
Fig. 104.—Gas capsule. 
Gas 
or too breathy or too tight, too high or too low, etc. 
It is always monotonous and devoid of melody. 
Using a principle of experimental phonetics, I will 
244 THE ORGAN TRAINER 
245 
describe one method of overcoming the monotony 
of the voice. 
In the first place, it is necessary for the reader 
to become familiar with a method of showing the 
vibrations of the voice to the eye that will be used 
Fig. 105.—Gas capsule in use with a revolving mirror. 
frequently. Figure 105 shows what may be termed 
a “flame box”; it is a form of the “manometric 
capsule,” devised by Koenig of Paris. The box is 
divided into two parts by a diaphragm of rubber 
or mica. On one side illuminating gas or acetylene 
enters and issues as a small flame; the other side is 246 
STUTTERING AND LISPING 
connected by a tube to a mouthpiece. When a 
person sings into the mouthpiece, the vibrations of 
his voice shake the diaphragm. This causes the 
gas at the jet to issue in waves. The flame thus 
repeats the vibrations of the voice. When the 
flame is observed in a revolving mirror (Fig. 105), 
Upper C. 
Middle C. 
Fig. 106.—Flame figures for two tones an octave apart. 
the vibrations can be seen separately. They are 
narrow for a high tone, broad for a low one. Figure 
106 shows the flames for middle C twice as broad as 
those for upper C. 
The apparatus shown in Figure 107 may appropri- 
ately be termed the “ Organ Trainer.” It com- 
prises two “flame boxes” placed close together. 
One of these is connected to an organ in such a THE ORGAN TRAINER 
247 
way that the vibrations of the reeds are communi- 
cated to the flame. The person sings in the other 
one. When the mirror is turned, two bands of 
vibrations are seen. 
Fig. 107.—The organ trainer. 
It is easy to make the deaf child understand that 
his flame vibrations must match the organ vibra- 
tions. When middle C is played, his vibrations 
must be wide. He naturally tries all sorts of tones, 248 
STUTTERING AND LISPING 
but is soon able to make a tone with wide vibra- 
tions—that is, he sings middle C. With upper C 
he tries till he matches the finer vibrations. 
This method enables us, in the first place, to 
get the voice of the deaf within the right ranges of 
pitch. A little girl of 12 years, with a deep bass 
that would do credit to a pilot, readily learns to 
speak in a high tone. A boy of 16 with a shrill 
falsetto can be made to use a man’s voice. I 
have tried this method on a large number of deaf 
pupils and have been able to get every one of them 
to sing and speak in tones appropriate to sex and 
age. 
This method makes it possible, also, to introduce 
some modulation into the speech of the deaf. If 
the pupil learns only two tones—middle C and 
upper C— his speech will be pleasanter than if he 
has absolute monotony. It is, however, not diffi- 
cult to teach three or four or even five tones with 
this apparatus. In this way quite as much modu- 
lation can be taught as the ordinary American 
citizen is accustomed to use. For example, it is 
not difficult to get an intelligent child to say THE ORGAN TRAINER 
249 
How do you do, Doc-tor? 
It is possible to do even more. Researches in 
experimental phonetics have proven that the laryn- 
geal tone is never—absolutely never—constant in 
pitch for a single instant. It is always rising and 
falling even in the shortest vowel that can be 
spoken. Can some of this inflection be taught to 
the deaf? 
If the notes of an octave are played rapidly in 
succession, the eye sees the flame vibrations grow 
steadily narrower. The pupil gets, with astonish- 
ing ease, the idea of sliding his voice up over the 
octave instead of making a sudden jump. In 
fact, it is much easier to sing an octave interval 
“ portamento” thus 
than to make a sudden jump from middle C to 250 
STUTTERING AND LISPING 
upper C. This “octave twist,” or “octave glide,” 
can be readily introduced into words. Finally, 
the pupil can be taught to speak sentences with 
octave glides; for example: 
Good 
Morn.... ing 
When a child can do this, he is taught to modu- 
late his voice within a smaller range in the most 
varied ways. For example, he can learn to use 
a more natural inflection, such as the following: 
Good 
Morn... 
mg 
The result of all this training is a marvelous 
change from the disagreeable monotony of the 
deaf to an agreeable inflection. 
This method puts into practice the fundamental 
principles of “control of the voice by the eye as 
a means of teaching control of the voice by the 
muscle sense.” The pupil sees the result he has THE ORGAN TRAINER 
251 
to obtain. He feels around with the muscles of 
his larynx until he gets the right result. This he 
does again and again till the sensations in his mus- 
cles guide him in just what he has to do. When he 
has once learned how, he can use his voice just as 
well as a normal person. CHAPTER II 
THE STROBILION 
The strobilion is an apparatus for teaching con- 
trol of the pitch of the voice by means of sight. 
The disc shown in Fig. 108 consists of 15 rings of 
alternating white and black spaces. The inner ring 
has eight white spaces, the next has nine, etc. 
The entire series is 8, 9, 10, 10%, 12, 13%, 15, 16, 
18, 20, 21%, 24, 26%, 30, 32. These numbers 
correspond to the relations of vibrations in the 
diatonic scale. Thus, if “do” is a note having 
eight vibrations a second, “re” will have nine, 
“mi” will have ten, etc. 
In front of the disc there is a scale marked with 
the syllables “do, re, mi,” etc., opposite the cor- 
responding rings. 
The disc is fixed on the axle of an electric motor, 
whose speed can be regulated by resistance. When 
the motor is set going, the disc revolves and its 
entire surface appears an even gray. 
252 THE STROBILION 
253 
The disc is illuminated by a small flame from a 
flame box supplied by acetylene. The construc- 
tion of this flame box is described in the preceding 
Fig. 108.—The Strobilion 
chapter. The membrane in the box must be of thin 
mica in this apparatus. 
When a tone is sung into the mouthpiece of the 
flame box, the flame vibration produces a series 254 
STUTTERING AND LISPING 
of flashes of light. The disc is illuminated as many 
times a second as there are vibrations in the tone 
sung. Between the illuminations there is darkness. 
109.—The Strobilion disc, illuminated by an intermittent flame, 
whose flashes make the middle ring appear to stand still. 
If the white spaces of any ring of the disc are 
passing the flame at a rate equal to the number of 
vibrations of the tone, that ring will split up into THE STROBILION 
255 
a series of white and black spaces that appear 
to stand still (Fig. 109). All of the other rings will 
remain gray. The reason for this is that the eye 
sees the space only by flashes. At one flash of light 
the white disc of a certain ring is seen, for example, 
at the top. During the darkness before the next 
flash it moves forward. If the next flash occurs 
at the moment the next white space has moved 
to the top, the eye perceives no movement, and the 
observer sees the second white space where the 
first was. At the next flash the third white space 
has moved to the top, and so on. Consequently 
the observer sees a white space at the top and 
other white and black spaces around the ring just 
the same as if the ring actually stood still. This 
will be true only of one ring, namely, the one whose 
white spaces move exactly in agreement with the 
flashes. 
The resistance, with the motor, is arranged to 
give great changes of speed. If the disc is made 
to revolve 16 times a second, the number of spaces 
passing the flame in a second will be 16 x 8; this 
gives 128 in the inner ring, 144 in the second ring, 
and so on, up to 512 in the outer ring. If the 256 
STUTTERING AND LISPING 
speed of the motor is increased to 20, there will be 
160 in the inner ring, 180 in the second, and so on. 
The tone “do” can thus be placed at any point 
on the musical scale for the first ring and the other 
notes will have their proper numbers of vibrations. 
The scale of two octaves can thus be adjusted to 
any voice, from the lowest bass to the shrillest 
treble. 
There is no need for any sharps or flats to change 
the scale; that is done by changing the speed. For 
example, a song written in the key of c can at once 
be transposed to the key of d (two sharps) by speed- 
ing the motor 25 per cent faster. 
The disc can be adjusted to any given note. 
When a pitch pipe of c = 256 is blown into the tube 
(it is best to remove the mouthpiece), the speed of 
the motor can be changed till the inner ring remains 
still. It is then known that 256 spaces per second 
are passing on the inner ring; the speed of the 
motor must therefore be 32 revolutions per second; 
the numbers of spaces for the other rings are readily 
calculated. 
If a tone from any musical instrument is brought 
into the tube, its pitch can be told by noting THE STROBILION 
257 
which ring stands still. The same is true of any 
tone that may be sung. The strobilion can thus 
be used to give the pitch of any tone that reaches 
it in a way to make the flame vibrate. 
What happens when the number of vibrations 
of the tone reaching the flame is not exactly identical 
with the number of spaces passing in any ring? 
Suppose the disc to be revolving so that 80 spaces 
of the inner ring pass in one second and that the 
tone has 79 vibrations a second. Between two 
flashes the white space will have moved not only to 
the position of the next, space, but also l/80th 
further. The result is that the white space, instead 
of being still, appears to creep slowly forward by 
l/80th of the distance between corresponding points 
on the two spaces. Thus, if the vibrations of the 
tones are one less per second in number than the 
number of spaces per second, the ring will appear 
to move forward by one space per second. It will 
be readily understood that for a difference of two 
vibrations it will move two spaces per second, and 
so on. When the tone has fewer vibrations than 
the number of passing spaces,, the ring appears to 
move forward; when it has more, the ring moves 258 
STUTTERING AND LISPING 
backward. It is thus possible to tell, with great 
accuracy, just how many vibrations lower or higher 
the tone is than the ring that stands still. 
The deaf pupil is told to sing into the mouth- 
piece. At first he will sing in such a faint or tight 
voice that nothing happens, or in such a bellow 
that he blows the flame out. The first lesson may 
be profitably used to teach him to regulate the 
power of his voice. Indeed, one of the most valu- 
able uses of the strobilion is to teach proper control 
of the breath and proper relaxation of the muscles 
of the larynx and throat in producing voice. 
Then he is made to see that a person can make 
a certain ring stand still by singing into the mouth- 
piece. When he makes the attempt he sees that 
the wrong ring stands still. If the disc has to be 
speeded up to match a shrill falsetto tone, he readily 
understands that he must sing lower. An important 
result thus obtained is that the pupil learns the 
correct register in which to use his voice. 
The next step is to sing a tone so that a certain 
ring remains absolutely still (Fig. 110-A). The pupil 
feels around with his voice; he sees sometimes one 
ring stand still, sometimes another. Finally he 259 
THE STROBILION 
hits the desired one. This he repeats over and over 
till he learns to strike it rightly each time. 
A common fault with the pupil is that he starts 
too low and raises his voice; he is made to notice 
that he travels over lower rings before reaching the 
correct one (Fig. 110-B). By watching his teacher 
he gets the idea that the correct ring must appear 
instantly without any initial slide. 
The next step is to teach the musical intervals. 
The teacher points to the ring “do”; the pupil 
must sing the correct note. Then he points to 
“sol”; the pupil must raise his voice instantly to 
a note that makes “sol” without passing over any 
of the other notes (Fig. 110-C). In this way all the 
intervals of the octave are taught. 
The slide, or portamento, is easily taught. After 
singing “do,” the pupil is to pass to “sol” or “do” 
above by making all the intervening rings flash 
out as his voice is raised (Fig. 110-E). It is much 
easier to pass from one note to another by a slide 
than to jump over the interval clearly. The com- 
plete scale (Fig. 110-F), with all of its intervals cor- 
rect, is ultimately acquired. 
It is evident that a whole course of instruction 260 
STUTTERING AND LISPING 
J1 Ji C n f f 
Fig. 110.—Strobilion exercises indicated on the strobilion staff. 
A. A constant tone, sung on middle “do.” D. An interval of an octave. 
B. Incorrect beginning for “do.” E. A slide, or portamento, over an octave. 
C. An interval of a fifth. F. The scale sung staccato. 
do 
si 
la, 
Sol 
fa, 
me 
re 
do 
st 
la 
Sol 
fa 
7711 
TO 
clo THE STROBILION 
261 
in singing can be carried out not only for the deaf, 
but also for the hearing person. In fact, the 
apparatus is in use for singers who have difficulty 
in accurately pitching their voices or in getting 
intervals. 
The purpose, however, is not to make singers of 
the deaf, but to give them such a control of their 
vocal cords that they can modulate their tones in 
speech. 
Although the strobilion is somewhat complicated 
in theory, it is not much more difficult to use than 
the double-flame trainer previously described. It 
has the inestimable advantage of the greatest 
accuracy in controling the voice and of almost 
innumerable applications. CHAPTER III 
GRAPHIC RECORDS OF SPEECH 
The first extensive researches with graphic 
records of speech were those of the Abbe Rousselot 
on one of the French dialects. Many further studies 
of French and other languages have come from his 
laboratory of experimental phonetics at the College 
de France. The method is available for the most 
varied researches on voice and speech in the various 
languages and dialects, on their modifications by 
defect and disease, on the peculiarities and troubles 
of singers, on the correctness of oratorical speech, 
etc. In short, there is hardly a problem of speech, 
from correcting a German’s mispronunciation of 
English to the analysis of a maniac’s ravings, to 
which this method has not or cannot be applied 
with profit. Strangely enough, no attempt has ever 
been made to apply it to the speech of the deaf. 
A sheet of glazed paper is fastened around a 
metal cylinder and is smoked over a gas flame. The 
262 GRAPHIC RECORDS OF SPEECH 
263 
cylinder is then placed on a clock-work that can 
revolve it rapidly and regularly. The recording 
apparatus is showm in use in figure 7, p. 26. 
When a record is to be made, the drum is wound 
up and set in motion. A tuning-fork of 100 vibra- 
tions a second is held so that a fine point or bristle 
on the end of one of the prongs touches the smoked 
surface. This draws a wavy line, each wave of 
which measures 1/100th of a second (Fig. 111). The 
Fig. 111.—Time line; each vibration measures l/100th of a second. 
speed of the drum is thus always known. The point 
of the recorder is then placed to the drum. The 
person speaks the desired words and the recorder 
is moved away. 
The top line of Figure 112 gives a record of 
“potato,” spoken normally. It begins with a 
straight line, due to the occlusion of the “p”—that 
is, to the period during which the breath is stopped 
by the closure of the lips. The sudden movement of 
the line upward is due to the explosion of the “p” as 
the lips are opened. The explosion is so sharp that 264 
STUTTERING AND LISPING 
Fig. 112. Records of “potato,” in phonetic notation (poteto). 
The small waves are the record of the vibrations of the voice during the vowels. The straight 
lines show where the breath was cut off by the occlusives “p” and “t.” Each occlusion ends in an 
explosion, shown by the sudden rise ot the line with the large vibrations First line: normal record. 
Second line: record by C. F.: the vowels and the occlusions are too long and the explosions are 
long and breathy. Third line: spoken by C. F., after comparing his record with the normal one.” GRAPHIC RECORDS OF SPEECH 
265 
the lever makes several large vibrations before it 
comes to rest. The small waves are a record of the 
vibrations of the vowel “o.” These are suddenly- 
cut short and the line drops for the occlusion of 
the “t.” The “t” has an explosion, but it is not 
so strong or so sharp as that of the ap.” The small 
waves that follow are a record of the vowel “a.'r 
The second “t” has an occlusion somewhat shorter 
and an explosion somewhat sharper than those of 
the first “t.” The word ends with the vibrations 
of the vowel “o.” In the figure the lettering is 
in the international phonetic alphabet; the sound 
of the second vowel is indicated by “e.” 
The second line of figure 4 gives a record of the 
same word by C. F. (15 years of age, totally deaf 
since 7 years of age, under oral instruction for 8 
years). We notice in the first place that the word 
was spoken far too slowly. By applying dividers, 
or a scale, to the last vowel, "o,” we find that it is 
fully twice as long as it should be. This last fact 
was explained to C. F., whereupon he made the 
record shown in the third line of the figure. In the 
effort to correct his drawl he made the vowels even 
a little shorter than the normal ones. Comparison 266 
STUTTERING AND LISPING 
of line 3 with line 2 shows that the explosions of 
the “p” and the two “t’s” were made quickly and 
snappily instead of breathily, as in line 2. 
Fig. 113.—Records of “she.” First line: record of "she” spoken normally, in phonetic 
notation (/i); during the fricative “sh” the line rises gradually. Second line: 
record by C. F., which sounded like Vt8e” (t3i), with a very brief “s”; the 
straight line records the long occlusion for the “t”; the normal explosion for “t” 
(see Fig. 112) is lacking; it is replaced by a weak fricative sound indicated by 
the slight rise in the line. Third line: C. F. attempts to make “sh” like that 
in the first line; the result is “ts,” the “s” being exaggerated. Fourth line: C. F. 
pronounces “she” correctly, except for making “sh” a trifle too long. 
The same pupil was asked to read from a book. 
The pronunciation of “she” seemed peculiar. He GRAPHIC RECORDS OF SPEECH 
267 
was asked to make a record. The result is shown 
in the second line of figure 113. A normal record 
was then made (first line of figure 113) and shown to 
him. He at once understood that he did not emit 
breath enough for the consonant, so he tried that 
alone. The result is given in the third line. He 
had no difficulty in understanding that he had 
first made an occlusive (namely, “t") and then put 
a fricative after it instead of producing a fricative 
alone. A further attempt is shown in the fourth 
line. The fricative sound is somewhat too long, 
but otherwise it is correct. One other fault was 
involved in his pronunciation, namely, the use of 
“s” for “sh." He first said what sounded like 
“tse" (tsi). He had made a “t "-sound with an 
“s"-like explosion. After the record in the third 
line he was told not to say “s”, but “sh." The 
last line shows that he did this successfully. 
The first line of figure 114 shows a normal record 
of “too much." The occlusion of the “t" and its 
explosion are followed by the vibrations of the first 
vowel. The line for the “m" is at the zero level, 
because the lips are closed and no air issues; there 
are faint vibrations, because “m” is voiced. The 268 
STUTTERING AND LISPING 
vowel “oo” is registered by strong vibrations. The 
line falls suddenly as the tongue closes the mouth- 
Fig. 114.—Records of “too much.” First line: “too much” (tumAfc), spoken normally. 
The occlusion and the explosion of “t” are similar to those in Fig. 112. The 
vibrations of “oo” are followed by the weak vibrations of “m.” The strong 
vibrations of “u” are followed by the occlusion, with long fricative ending of “ch.” 
Second line: record by A. O.; there is no explosion for “t”; the “m” is unvoiced; the 
word ends with an occlusion, namely, "t” without its explosion. Third line: lecord 
by A. O., after learning that in the first line; the initial “t” has an explosion; the 
“m”is not voiced; the final sound is “t” followed by “sh”; the entire iecord is 
exaggerated owing to over-enunciation. 
passage for “ch”; it rises and remains up a while 
for the last part of “ch.” We note that the record GRAPHIC RECORDS OF SPEECH 
269 
of “ch” consists of an occlusion, followed by a 
breathy sound. 
The second line of figure 114 shows a record of 
“too much” by A. O. (17 years old, totally deaf 
since birth, under oral instruction for 4 years). 
The initial “t” had no explosion and the last sound 
was a simple occlusion, like a “t” without the 
explosion. The normal record was explained to 
him. After half an hour’s practise he made the 
record shown in the third line. The initial “t” 
has a highly exaggerated explosion. For “ch” he 
has an occlusion, followed by a fricative sound, but 
the change from the former to the latter is too 
sudden. This occurred because he used the front- 
shut instead of the top-shut position of the tongue 
for the first part of “ch” and also because all his 
speech movements were nervously exaggerated. 
The correction of his over-enunciation and of the 
voiceless “m” (shown by lack of vibrations in the 
records) was reserved for another occasion. 
It was noticed that instead of “How do you do?” 
A. O. said something that sounded like “ How ho hou 
ho?” The record of the last word, “do,” spoken 
normally, is shown in the top line of figure 115. 270 
STUTTERING AND LISPING 
The occlusion, the explosion, and the vowel waves 
are clearly marked. The record of the last word 
Fig. 115.—Records of “so.” First line: “do” (du), spoken normally. 
Second line: last word of “How do you do?” by A. O.; instead of 
“d” there are a short inspiration, a short breath, and a short “d,” 
without explosion. Third line: “do,” by A. O.; the occlusion lacks 
vibration (it is unvoiced); it does not end with an explosion. Fourth 
line: A. 0. succeeds in introducing an explosion after the occlusion, 
but it is still unvoiced. Fifth line: A. O. voices the occlusion, but 
omits the explosion. Sixth line: A. O. voices the occlusion fairly 
well; the explosion is too violent. 
in the phrase spoken by A. O. is shown in the second 
line. It shows a brief fall in the line, due to a slight GRAPHIC RECORDS OF SPEECH 
271 
inspiratory gasp which he was accustomed to make. 
This is followed by a slight rise in the line that 
records a short and rather weak “h.” The “h” 
ends in some vibration. The following piece of 
straight line, with faint vibrations, corresponds to a 
correctly made occlusion for “d.” The record 
indicates the nature of the boy’s mistake. Instead 
of ending the preceding vowel by closing the tongue 
against the palate, he inspires through his mouth, 
blows out a short “h,” starts his larynx vibrating, 
and only after all this does he use his tongue for “ d.” 
The record of normal “do” in the first line was 
then shown to him. His attempt at this word 
alone is shown in the third line. The occlusion of 
the “d” is present, but there are no vibrations and 
there is no explosion; the sound was rather a “t,” 
with no explosion. The vowel vibrations are cor- 
rectly made. 
It was easy to get him to make an explosion for 
the “d” (fourth line), and fair success was achieved 
in introducing voice (fifth line). The best record 
obtainable in the half hour at disposal is shown in 
the fifth line. The “d” is not perfectly voiced and 
its explosion is exaggerated. 272 
STUTTERING AND LISPING 
This method is of such practical value that it 
will probably be introduced in many places. In 
using the apparatus, the recording drum must run 
so rapidly that the surface of the smoked paper 
travels at the rate of least 100 millimeters a second. 
Its speed must be very regular. 
To smoke the drum it is removed from its axle 
and placed on a special support. A sheet of glazed 
paper, gummed on one end, is placed around the 
drum. A gas flame is held closely under it while 
it is turned rapidly. 
After a record has been made, the paper is cut 
off and passed through a pan containing a solution 
of shellac. The solution of shellac should be so 
weak that the paper will dry rapidly and not remain 
sticky, and so strong that when it is dry the black 
will not come off when rubbed by the thumb. CHAPTER IV 
CORRECTING NASALITY 
With a good light shining into the mouth an 
archway is seen at the back. The broad top part 
is called the velum, or soft palate. The small 
ridges at each side are called the pillars of the 
velum; the small tip hanging down in the middle 
is the uvula. 
When a vowel such as “ah” is made, the velum 
is drawn back and upward. This closes the passage 
through the nose. Reference to Plates I, II and 
III will show for which sounds the nasal passage 
should be closed. They include all the consonants 
except the nasals. For the sounds “m, n, ng,” the 
velum is drawn down so that the nasal passage is 
fully open (Plate II.) 
Any improper or unusual action of the velum 
changes the sounds. If the velum is dropped during 
a vowel it becomes “nasal”; this is frequently the 
case in the speech of Americans. 
273 274 
STUTTERING AND LISPING 
The proper use of the velum is one of the points 
in the instruction of the deaf. The passage of 
air and sound through the nose can be shown by 
Fig. 116.—Tambour indicator. 
The glass nasal tip is inserted in a nostril. Whenever air passes 
through the nose the light lever on the tambour moves. 
the familiar methods of holding nose with the 
fingers, by holding a mirror before the nose, etc. 
Two convenient forms of nasal indicators are shown CORRECTING NASALITY 
275 
in Figures 43 and 89. The candle indicator 
(Fig. 42) can likewise be made available by using 
the nasal tip as in Fig. 43. The tambour indicator 
(Fig. 116) is the most convenient of all. It is 
possible that the velum hook (Figs. 90, 91) may be 
of use for the deaf; I have not tried it. 
The graphic method can be introduced by adding 
a point to the tambour so that it will write on the 
recording drum (Fig. 86). It is still better to use 
the speech recorder (Fig. 7) in connection with the 
nasal recorder, as in Fig. 117. The lower line 
records the speech as it leaves the mouth; the upper 
line records the passage of air through the nose. 
Such a nose and mouth record of “thinking” 
is shown in Fig. 118. The lower line has a sharp 
rise that registers the air issuing from the mouth 
for “th.” Then follow the waves of the vowel. 
The line sinks to the horizontal and remains so 
for “n”; small waves can be seen. The horizontal 
line continues without waves for “k.” This ends 
in an upward jerk for the explosion of “k.” After 
the waves for “i” the line is again horizontal wth 
faint waves for “ng.” The upper or nasal line 
does not move during “th,” Then it rises rapidly Fig. 117.—Making nose and mouth records. 
A recording tambour of the type shown in Fig. 116 is placed above a mouth recorder so that both records are made simultaneously CORRECTING NASALITY 
277 
Fig. 118.—Nose and mouth record of “thinking.” 
For the sounds “n” and“ng” the nasal line rises as always. It also rises for both the vowels because 
they precede nasal sounds. 278 
STUTTERING AND LISPING 
with strong waves during “i.” Ordinarily “i” 
has no emission of air through the nose, but before 
a nasal sound (m, n, ng) it is regularly nasalized, as 
in this case. A strong current of air is shown for 
“n.” The sudden descent of the line indicates the 
closing of the nasal passage for “k.” Again the 
rise of the nasal line shows that “i” is nasalized 
before the following nasal. The “ng” is strongly 
nasalized. 
The deaf often nasalize improperly. It was 
observed that one deaf pupil nasalized “so” in 
some way. A double record was made, with the 
result shown in the lower part of Fig. 119. A 
normal record was then made, as in the top part 
of this figure. It was pointed out to the pupil in 
the first place that his word was entirely too long 
(a piece has been left out in the figure). Then it 
was pointed out that a vast amount of air issued 
from his nose during “s” instead of none at all. 
The flatness of the mouth record for “s” in his 
case needed no comment; it was simply the result 
of the open nasal passage. The vowel was also 
entirely nasalized. After a few trials he was able 
to speak the word correctly. CORRECTING NASALITY 
279 
Fig . 119.—Nose and mouth records of “so.” 
The first record is by a normal voice. The mouth record (lower line) shows the rush of air for 
“s” followed by the vibrations of the vowel. The nasal record (upper line) shows no emission of 
air from the nose till the word has been finished. The second record is by a deaf child; a portion 
from the middle is omitted. The air for the “s” issues almost entirely through the nose instead 
of the mouth. 280 
STUTTERING AND LISPING 
P i k. 
Fig. 120.—Nose and mouth records of “speak.” 
The “s,” “i” and “k” in the lower record are improperly nasalized. CORRECTING NASALITY 
281 
A girl 15 years old, totally deaf from birth, 
was observed to produce some kind of nasality in 
the word “speak.” A double record (lower part of 
Fig. 120) showed that she improperly nasalized 
the entire word except “p.” A normal record 
was shown her (upper part of figure). After an 
astonishingly brief practice she learned to speak 
the word correctly. P 
t 
k 
l» 
d 
gr 
w 
f 
J 
V 
s 
z 
/ 
S' 
0 
* 
Plate I. — Mouth Diagrams for Typical English Sounds. in 
n 
9 
j 
1 
h 
II 
u 
o 
PliATE II. — Mouth Diagrams for Typical English Sounds cl 
A 
9 
6 
9 
;e 
e 
i 
i 
Plate III.— Mouth Diai 
grams for Typical English Sounds a,o,A,o,u,u 
a 
a? 
e 
e 
i 
i 
t,d 
k,g- 
0»i 
s,z 
J, 3 
hi 
N » «*T. 
.Plate IV. — Palatograms for Typical English Sounds INDEX 
Abdominal movements recorded, 
24. 
Adenoids, 170. 
Akromegaly, 165. 
Anxiety neurosis, 7. 
Aphopia, hysterical, 49. 
Argument, 223. 
Artificial palate, 115. 
Association of ideas, 87, 217. 
Belief in success, 66. 
Breath indicator, 118, 153. 
Breathing, 84, 190. 
Breathy voice, 81. 
Bulbar paralysis, 52. 
Business, 223. 
Buying, 212. 
Candle flame indicator, 117. 
Censorship, 100. 
Character in stuttering, 20. 
Chest movements recorded, 22. 
Choreatic stuttering, 47. 
Class work, 72. 
Clear endings, 28. 
Cleft palate, 168. 
Clinic treatment, 72. 
Cluttering, 46, 187. 
Colds, 171. 
Collection of ideas, 216. 
Compulsive act, 37. 
Confidence, 13, 90, 210. 
Contagiousness of stuttering, 7. 
Continued story, 212. 
Control of the voice by ear, 196. 
Conversation, 222. 
Coolness in argument, 223. 
Correct enunciation, 65. 
Correct thinking, 64. 
Correction of character, 66. 
Coup de glotte, see Glottal catch. 
Cramps in stuttering, 10. 
Deaf, methods of correcting 
speech, 244. 
Defective enunciation, see Lisping. 
Defective hearing, 171. 
Deflected septum, 170. 
Denasalization, 170. 
Description, 219. 
Diagnosis of stuttering, 42. 
Disease as a cause of stuttering, 8. 
Dreams, 103. 
Drum, 23. 
Embarrassment, 3, 15, 17, 217. 
Emphasis, 208. 
Emphasizing periods, 206. 
Ending, 205. 
Enunciation, 88, 207. 
Equilibration of character, 63. 
Exercises, 69, 190. 
Exhaustion as a cause of stutter- 
ing, 8, 16. 
Experimental phonetics, 22. 
Explosives, 117. 
Expression, 208. 
Flamebox, 245. 
Fear as a cause of stuttering, 6. 
Feeble lips, 162. 
Fixation of the larynx, 226. 
Flame indicator, 119. 
Flexibility, 74, 197. 
Flurry, 14. 
Forms of stuttering, 15. 
Freud, 7, 67. 
Fricatives, 117. 
Fright stage of stuttering, 118. 
Functional lisping, 123. 
Gas capsule, 245. 
General anxiety neurosis, 7. 
287 288 
INDEX 
General conversation, 222. 
General indistinctness, 157 
General paralysis, 54. 
Glottal catch, 81. 
Graphic records, see Records. 
Habit formation, 61. 
Habit stage of stuttering, 15. 
Hare lip, 162. 
Hemiatrophy of the tongue, 163. 
Hereditary ataxia, 52. 
High palatal arch, 167. 
Hoarse voice, 81. 
Hoarseness, 81. 
Home, the stutterer at, 4, 57. 
Husky tone, 204. 
Hyperphonia, 12. 
Hypertonicity, 12. 
Hysteria, 48. 
Hysterical aphonia, 49. 
Hysterical mutism, 48. 
Ideas, collection of, 216. 
Imitation as a cause of stutter- 
ing, 7. 
Increasing embarrassment, 62. 
Indifferent stage in stuttering, 19. 
Infantile cerebral palsy, 49 
Insanity, 55. 
Institutional treatment, 71. 
Intellectual disturbance in stutter- 
ing, 65, 119. 
Introducing, 213. 
Jaw defects, 165. 
Jaw position, 227. 
Kussmaul, 34, 52. 
Laryngeal tone, 11, 23, 74, 244. 
Larynx, fixation of, 226. 
Larynx defects, 155. 
Lengthened vowels, 199. 
Linking, 201. 
Lip defects, 124. 
Lip gymnastics, 163, 226. 
Lip movements recorded, 25. 
Lip reading, 172. 
Lips in connection with lisp- 
ing, 162. 
Lisping, as a cause of stuttering, 
17, 164; defined, 111; negligent, 
122; organic, 162; neurotic, 173. 
Loudness of voice, 98. 
Lowering tones at end, 206. 
Marometric capsule, 245. 
Megaphone, 204. 
Melody, 74, 194. 
Melody cure, 77. 
Melody plot, 33. 
Mental cramp, 97. 
Mental daze, see Intellectual dis- 
turbance. • 
Mental flurry, 14. 
Metronome, 200. 
Monotony, 11, 33. 
Motor aphasia, 50. 
Mouth recorder, 25. 
Multiple sclerosis, 52. 
Muscular action, defects of, 83. 
Muscular control, 225. 
Muscular dystrophy, 163. 
Mutism, hysterical, 48. 
Nasality 150; of the deaf, 273. 
Nasals, 118. 
Nature of stuttering, 34. 
Negligent lisping, 43, 112. 
Neurotic lisping, 145, 173. 
New method of speaking, 57. 
Occlusives, 117. 
Octave twist, 78, 192. 
Office treatment, 67. 
Operation as a cause of stutter- 
ing, 6. 
Organic lisping, 43, 162. 
Organs of enunciation and phona- 
tion, 113. 
Organ trainer, 246. 
Overshot jaw, 165. 
Overtension in stuttering, 12. 
Palatal arch, 227. 
Palate defects, 167, 168, 170. 
Palatography, 114. 
Penmanship stuttering, 38. 
Periods, 206. 
Phobia, 38. INDEX 
289 
Phonetic alphabet, 112. 
Phonetics, 22. 
Pneumograph, 22. 
Principles for treating stuttering, 
57. 
Progressive bulbar paralysis, 52. 
Prophylaxis of stuttering, 8. 
Pseudobulbar paralysis, 53. 
Psychanalysis, 67, 69. 101. 
Psychoneurosis, stuttering as a 
form of, 7. 
Public speaking, 214. 
Quality of voice, 81. 
Reading. 94, 192. 
Reading together, 210. 
Reading with decided voice, 211. 
Readjusting the subconscious, 100. 
Readjustment of environment, 98. 
Rear palatal arch, 227. 
Recording drum, 23. 
Recording tambour, 22. 
Records, of breathing, 22; of pres- 
sure of the lips, 23; of move- 
ments of the tongue, 24, of 
speech, 26-32; of speech in 
nerve diseases, 50-53; of speech 
to show octave twist, 72-79; of 
glottal catch, 82; of speech in 
stuttering. 23, 24, 25, 28. 30, 31, 
32, 89; of lisping, 132; of “ch” 
and “tsh,” 136; of “r,” 144, 145, 
146; of nasal currents and vibra- 
tions, 151, 152; of laryngeal in- 
correctness, 156, 157; of “apa,” 
158; of neurotic lisping, 178-179; 
of speech of the deaf, 262; of 
nasality in the deaf, 275. 
References, 245. 
Relation, 220. 
Relaxation, 61, 224. 
Relaxed palate, 170. 
Relaxing the jaw, 226. 
Revolving mirror, 276. 
Running associations, 104, 109, 
219. 
School, the stutterer at, 3. 
School work, 215. 
Sentences for indistinctness, 159. 
Septum, 170. 
Shock as a cause of stuttering, 6, 
16. 
Singing, 90, 91, 192, 197. 
Slowness, 85, 198. 
Smoothness, 201. 
Social timidity, 39. 
Sonants, 118. 
Spasms in stuttering, 10. 
Spastic speech, 49. 
Speaking. 92, 193, 198, 224. 
Speaking together, 211. 
Speaking with confidence, 211. 
Speech clinic, 72. 
Spelling, 208. 
Spontaneous speech, 94. 216. 
Stages of stuttering, 15. 
Stammering, 44. 
Starting, 201, 205. 
Statement and question exercise, 
193. 
Statistics of stuttering, 9. 
Stekel, 62. 
Strengthening first word, 205. 
Strobilion, 252. 
Stuttering, description. 1: detri- 
ment to welfare, 2; at school, 3; 
at home, 4; a disease. 4; re- 
garded as a habit, 5; causes, 5; 
connected with nervousness, 6; 
contagiousness, 7; after exhaus- 
tive diseases, 8; prophylaxis, 
8; statistics, 9; symptoms, 10; 
forms or stages of. 15; habit 
stage. 15; fright stage. 18; in- 
different stage, 20; connection 
with character, 20; experi- 
mental study of, 22: nature of, 
34; Kussmaul’s theory, 34; re- 
lation to other neuroses, 37; 
author’s theory, 38; differen- 
tial diagnosis, 42; therapy, 56. 
Subconscious, 70. 
Subconscious readjustment, 67. 
Talking with people, 222. 
Tambour, 22. 
Tambour indicator, 121. 
Technical terms, 246. 290 
INDEX 
Telephoning, 96, 221. 
Theory of stuttering, 36. 
Therapy of stuttering, 56. 
Thinking, 86, 217. 
Tic, 37. 
Tic speech, 47. 
Tissue paper indicator, 153. 
Tone of voice, see Laryngeal tone. 
Tone placing, 202. 
Tongue defects, 163. 
Tongue gymnastics, 160, 225. 
Tongue movements recorded, 25. 
Tongue-tie, 18, 43, 164. 
Tooth defects, 165. 
Transacting business, 223. 
Trumpet, 204. 
Turbinates, 170. 
Undershot jaw, 165. 
Velar hook, 153. 
Velum defects, 150, 168. 
Vocal quality, 81, 202. 
Voice tone, see Laryngeal tone. 
Vowels, 116. 
Word lists, 228. 
Writer’s cramp, 38.