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CHAPTER X

STUTTERING IN DETAIL

In order to give a more complete representation of the flesh-and-blood stutterer, I consider it essential to deal, to the extent that interest and relevancy will permit, with the process of stuttering itself, as my experience has led me, chiefly through introspection and retrospection, to understand it. This discussion of the production of various sounds will involve a consideration of the somatic and mental attributes of that production peculiar to my own case -- accompanying sensations, accessory movements or gestures, and states of mind.

I have said that I stutter for all practical purposes impartially on all sounds and sound combinations. It appears that the social situation under which speech is attempted, together with the bodily and mental condition at the moment, is perhaps largely responsible for the severity of the difficulty. As I have said before, the stuttering organism reacts more vigorously to some situations than to others.

One attribute is common to all my stuttering: tenseness of the somatic musculatures, more notice-

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STUTTERING IN DETAIL

able in the abdomen and shoulders. This is true regardless of the fact that particular sounds are characterized by particular types of stuttering. In the abdominal region this tensity is concentrated because of the restricted contraction of the nearby diaphragm; in the shoulders it is a function of the prolonged distention or deflation of the lungs and the consequent effect on the attendant musculatures. The effort involved in speaking with difficulty, however, is accompanied by a complete somatic contraction. Close your fist deliberately and you will feel throughout your arm the kinaesthetic experience which I mean to describe. In cases of extraordinary stuttering, I am aware of this heightened tensity of the muscles in the arms, face, neck, torso, and even in the legs. In the tongue it is especially marked.

It is not necessary, moreover, that the actual act of stuttering be in occurrence for this muscular tensity to appear. Anticipation of stuttering is often sufficient. Furthermore, this anticipation may precede the attempt to speak by a considerable length of time, even hours -- in rare cases days. I have dreaded the impending necessity of making a formal introduction, knowing that it would not come until several days later. I have experienced the bodily and mental accompaniments of stuttering far in advance of the actual of making a telephone call,

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buying a railroad ticket, presenting myself to a new employer or a strange host or hostess. The reader will possibly recall the confusion of my consciousness when the train carrying me from the "institute" was approaching home. In that instance my thoughts were almost entirely distracted, and even my vision was blurred and my sense of direction momentarily disturbed. I was hardly aware of what was going on around me. I was anticipating stuttering in a situation where stuttering meant the admission of failure -- and it must be remembered that it always means the admission of a defect, an inferiority.

It might be well to pause at this point to consider the significance of such a bodily and mental state in the classroom, for instance, or at a dance or dinner. Stuttering, it will be seen, is not a mere speech defect; it is far more than that. If, from this point of view, the school teacher can look upon a speech defective, she can appreciate at once why it is unjustly true that stutterers, on the whole, are retarded in school achievement, and are even ranked according to their intelligence, by certain experimenters, in a perfectly absurd manner. This almost criminal state of affairs should be more widely understood. All that is needed to improve it is good sense on the part of the teachers.

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It is to be understood, then, that when I was a more severe stutterer than I am at present, I was seldom permitted to forget that I stuttered. When not attempting speech, I was anxious a large share of the time lest I be called on to speak, or I was definitely looking forward to speaking, possessed of that dread and fear I have tried to describe. What I have said concerning the physical characteristics of that condition might imply the nature of the mental attributes of it. Obviously, speaking was unpleasant to me, and as a rule I tried to avoid it -- unless the situation was one that I could enjoy; I have described, in previous chapters, situations in which I rather enjoyed speaking. When I say that I tried to avoid speaking, that is exactly what I mean; I had many devices for that express purpose. With a number of these devices of avoidance and escape the reader is familiar, but there is one other which discloses so well the state of mind out of which it developed: I had a way of avoiding meeting people whom I knew, by turning a corner at the opportune moment, or going into a store or shop. There have been times -- there still are now and then -- when it is difficult for me to say the ordinary hello. Not to do so is rude, of course; I simply choose by avoidance to forestall the possibility of appearing rude.

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In this example, and throughout the previous chapters, I have implied the nature of my mind, in the sense of its being a stutterer's mind. To the degree that it is adaptive, deliberately or undeliberately, it is quite the same as other minds. That it is sensitive and responsive fails to set it off as being distinctive, save possibly in the extent of these qualities. I have been aware of stuttering as a highly important fact of my life; I have been aware of it as something which has marked me, made me different from other people. I have been fearfully, dreadfully, angrily, and despondently aware of it. And in fighting the fact of stuttering, my mind has come upon a great hope, and here and there has seized upon a tremendous joy. The deeper my despair, the greater my joy in what might often be called the commonplace. Even the life of the exile has its riches.

Having said quite enough concerning the stutterer in his general role, I shall turn to deal with the process of stuttering itself. Breathing, vocalization, and articulation must obviously be drawn into account; somatic and mental attributes of the stuttering instance must also be examined.

In stuttering on vowel sounds, the lip positions are exaggerated. Difficulty in pronouncing a as in at, e as in ever, and i as in the pronoun I, is char-

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acterized by tensely parted lips. The lips are usually overly parted, and the position is prolonged, in severe instances, to the early stages of fatigue of the lip muscles. In these sounds the jaws are spread and taut to the degree of practical immobility. The lingual muscles are comparatively tense, the tongue fills the floor of the mouth, being wide and flared, the tip extending at times across the lower front teeth. In stuttering on the back vowals, as the o in loot and in go, the lips are more rounded and protruded, but none the less tense; the tongue is compactly contracted, and a tensity of the neck muscles is more manifest. In the u sound as in use, the lips are rather lax and slightly parted. The tongue is pressed firmly against the teeth, and sometimes protrudes outward between the narrowly separated teeth; the blocking is most evident at that place, with the jaws tending to clamp but remaining parted, so that the tongue extends precariously between the teeth, which one set of muscles is trying to force apart while another set is evidently trying to close them.

Similar to this process is the one involved in blocking on the e sound as in eat. The chief difference between the two is that in pronouncing e the tongue is forced hard against the upper front teeth; or, sometimes, the tip of the tongue is drawn

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up and back, until it touches the roof of the mouth, and in this position the tongue is widely extended, so that it touches the teeth on both sides of the mouth. Difficulty on the a as in ale is very much like that on the a as in at, which I have described. The i sound as in it presents difficulty comparable to that encountered with use and ever and eat. The lips and jaws are parted, and the tongue strives tensely in a position either against the roof of the mouth or on the floor of the mouth, or midway between the two extremes; the tip of the tongue either presses firmly against the lower front teeth, less firmly against the upper front teeth, or is drawn backward into the mouth. Stuttering on the u as in up is a gasping process, with the lips inertly parted and the tongue lying inertly on the floor of the mouth. The jaws, too, seem rather passively parted, the block being chiefly a stoppage of breath in the larynx.

A respiratory stoppage will be noted as a characteristic of much of this stuttering; moreover, the stoppage occurs in some cases in the laryngeal region rather than in the buccal cavity. The stuttering is chiefly vocalic and respiratory rather than articulatory. This is especially true of stuttering on up, it, at, ever, I, over, and several other of the vowel sounds, in which it is generally found that a com-

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plete respiratory stoppage occurs in the larynx. In certain other forms of vowel stuttering, the air passage is more or less open, and the difficulty becomes more pronounced in the articulatory mechanism proper; this is seen in the hissing quality of the stuttering on eat, or on use.

While these articulatory and vocalic disturbances are going on, the lungs are in a state of prolonged distention or deflation. If the air escapes, it does so in a jerky manner. The tension of the diaphragm is keenly noticeable, and a sensation of muscular contraction is present with special emphasis in the abdominal regions, the thorax, and the shoulders. This sensation extends to the arms and hands, and becomes evident, in aggravated cases, in a weakening of the legs which suggests general exhaustion. The eyes may be tightly closed and the face disfigured by accessory grimaces. The next stages involve an observably quickened heartbeat, flushing, and perspiration, and clonic contractions externally evident in the facial regions. An instability of nervous control is manifest, especially in fidgeting, which is most apparent in the hands and fingers. Ultimate success in pronouncing the sound is instantly followed by partial relief from all this tensity, but not at all by anything resembling normal relaxation. And if speaking is continued it is probable that stuttering,

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with its unpleasant accompaniments, will be resumed shortly.

For the sake of description, I have dealt with more or less extreme symptoms. There are degrees in the severity of stuttering, of course, but fundamentally stuttering is as I have depicted it (in my own case), especially on the sounds referred to above. This type of stuttering is characteristic for all qualities of vowel sounds, for the most part, and has much in common with consonantal stuttering.

In stuttering on consonantal sounds the muscular tenseness is present tn quite the same manner as it is in the stuttering on vowels. In blocking on the b and p sounds, the lips are tightly pursed, the tongue either inert or contracted tightly against the floor of the mouth, the jaws either inert or firmly closed, and no air escapes except in spurts through the nasal passages. The lungs are in a state of prolonged distention or deflation, but it will be noted that the respiratory stoppage occurs at the lips and not in the throat. The stuttering in this case is more largely articulatory than it is in vowel stuttering. The nasal m presents the same type of stuttering, save that the tongue may in some instances be tightly pressed against the roof of the mouth.

The upper front teeth press firmly on the lower lip in stuttering on f and v, and the jaws are usually,

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therefore, slightly parted; the tongue lies on the floor of the mouth, the tip curled upward more or less. Here, too, the respiratory stoppage takes place in the front of the mouth.

Stuttering on the dentals and spirants -- d, l, t, z, s, soft c, ch, th as in then, th as in thin -- and the nasal n, is usually accompanied by a tensely flared lower lip. The tongue is pressed firmly against the front hard palate or the back of the front upper teeth. The jaws may be closed firmly, but as a rule they are open and display a pincer-like tendency to close -- evidence of conflict between antagonistic musculatures. In the spirants there is generally a slow futile exhalation, resulting in a hissing sound; in the dentals proper the lungs are in a state of prolonged distention. In the case of the nasal n, the air escapes through the nose, the vocalization taking on the quality of a nasal humming; the tremor resulting from this futile vocalization is felt in the throat and tongue.

In velar stuttering, on g, k, q, and hard c, the respiratory stoppage occurs at the region of the soft palate. The tongue is firm against the roof of the mouth, far back in the buccal cavity. The jaws are open, displaying the pincer-like tendency to close, as noted in dental stuttering. The lips are open, the lower one having a slight tendency to flare tensely.

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Palatal stuttering, on h, j, and r, is similar to velar stuttering. The respiratory stoppage takes place at the mid-roof of the mouth. It should be noted that in blocking on j, the jaws are tightly closed and the lips more tense, the lower one flared somewhat.

Somatic tenseness is characteristic of consonantal stuttering, the respiratory disturbances are marked in both consonantal and vowel stuttering, and the instability of nervous control is also common to both.

Frequently I approach the articulation of a sound by employing a vocalization such as ah or uh, from which I glide into the articulation proper. This apparently serves to relax the mechanisms involved in speech, and to delay momentarily the actual attack on a troublesome word. It occurs in a moment of hopeful expectancy in which my thoughts seem to center around the real intention of avoiding stuttering by not allowing the tongue or jaws or lips to lock -- by "smuggling" the word past the articulatory mechanism while that mechanism is sufficiently relaxed to function. What happens is that I throw the mechanism off guard" by beginning the ah tone, and then glide into the articulation proper before the organism can balk. It might be thought of as a strategy of the mind directed against a part of the body. This implies that it is a voluntary process, and correctly so, for in attempting speech, I am con-

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stantly alert and watching for every opportunity to use some device that will help me over a threatening difficulty. The very recognition of the introductory or intersyllabic ah as a device only emphasizes the fact that I am always mindful of possible stuttering, that I expect to encounter it, am afraid of it and try to avoid it. To speak of the normal speech of a stutterer is hazardous at best, for it is doubtful that I, at least, ever experience the complete freedom in speaking to which the normal speaker is accustomed. Even though the articulation may appear unhampered, it is never certain that the mind is at ease in the matter.

This initiatory ah is very common among normal speakers, as a tonal perseveration or undertone, and in some cases assumes the importance of a defect. In some stutterers it becomes a rigid habit, and probably a habit of no real benefit. I doubt that it is in any sense a therapy; it seems at best, the substitution of one kind of stuttering for another.

Similar to this device is another which, with me, is rather a common practice. On the whole, initial sounds, that is, sounds at the beginning of words, offer greater difficulty than sounds within words, which are usually attended to without difficulty, due to vocal momentum -- unless a sharp articulatory break occurs between syllables. Similarly, words

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imbedded in a sentence offer less difficulty than words, even the same words, at the beginning of a sentence. Knowing this, I frequently back up, so to speak, and take a running start at sounds on which I expect to encounter difficulty, in order to permit the articulatory and vocal momentum to carry me over. That is, I repeat a great number of words. I go back several words to initiate the speaking function, and then, coming to the troublesome sound, I say it while the mechanism is thus in operation. This, too, it seems to me, may become a habit of no benefit, and is simply the substitution of one kind of speech defect for another. In my case, it is favorable to rapid speech; it tends to encourage, in fact, a manner of speaking that is perhaps too rapid.

Save in periods of relatively free articulation, or of pronounced stuttering, articulation is, with me, a conscious process. Suppose a man were to say that with him walking was deliberate, that he consciously set one foot before the other, that he did this to keep from falling. That would seem strange indeed. I do not know how much aware the normal speaker is of the position of his tongue and teeth and lips, for instance, during speech, but I am under the impression that he is very little aware of it. But I consistently "form" the sounds or sound combinations by deliberately placing my articulatory organs in the

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positions where they function most effectively. This has been one of the teachings of expediency. It is a strategy designed to counteract the tenseness of the articulatory and general somatic musculatures, and involves an effort to maintain a calm state of mind and body.

An incident will illustrate what I mean. For two years I attended college in a little town, and each morning I walked about a half a mile to the college. On these morning walks I regularly met a certain elderly gentleman who walked in the opposite direction, and we came to exchange greetings. Upon seeing him approaching, I would consciously relax, place my lips together gently and put my tongue in the proper position; then, as he brushed past me, I would open my lips, release my tongue, and greet him, "Morning." On one occasion I lost control of my assumed poise, my jaws locked, my lips pursed tightly, and my tongue contracted rigidly. As my elderly friend walked by with a cheery "Good morning!" I was in the midst of a valiant struggle with that part of my anatomy involved in speech, and was forced to pass him with a silence that he must have mistaken for rudeness or deep thought. But when he was a short distance behind me, I suddenly won my fight, and the great effort with which I had been trying to speak caused me literally to shout into the

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vacant street, "Morning!" He must have been quite perplexed.

It is to be understood, then, that this deliberate articulation results in success that ranges all the way from comparatively unhesitating speech to the various types of stuttering which I experience. A person to whom I am talking is probably seldom aware of what I am doing; even when I appear to be talking freely, I am stuttering inwardly to a considerable degree. This fact, which is true of other stutterers as well as myself, accounts in part for the popular notion that stutterers are rare; they conceal their defect in a number of ways, but the keen observer is aware that speech defectives are quite common.

When this enforced relaxation is employed throughout one's waking hours, more or less, it amounts to a considerable task. Regardless of its questionable therapeutic value, it is imposingly expedient, and whatever its relation may be to speech itself, it has other notable effects. The effect which it has on the entire organism, including the mind, only illustrates that speech is an extremely complicated function and not limited in any real sense strictly to the respiratory, vocal and articulatory mechanisms. This enforced calmness does have a real influence on the entire organism. It is an influence of discipline, that is chiefly restraint, but a

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restraint that is after all commendable. Whatever may be the proper viewpoint to assume in the ancient argument by which Cotton Mather thundered his way to a dubious immortality, whether, that is, a man is born moral, immoral, or unmoral, the fact remains that the nature of man is such that he may vitiate his own best purpose and oppose his own well-being. The glaring fact that a man is capable of self-criticism and self-restraint may be the best argument upholding the wisdom of self-discipline. At all events, the man who sentences himself to an enduring tranquillity and calm is sure to gain many benefits; it is not even necessary to quote Aristotle in order to maintain that view. That the tranquility be first imposed in order to avoid stuttering is a fact that becomes lost from the ultimate point of view of importance; the significant fact is that repose be imposed at all.

Surprise and bewilderment are the parents not only of a mysticism that may at times be a thing of beauty, but they are also the parents of a gruesome breed of superstitions, fears and unnecessarily weird forebodings. A calm view of life in the entire does not permit their tragedies to occur. Nor is tranquillity a passive resignation to fate. It is a state in which empathy for and harmony with nature at any given moment appear paramount. Joy and

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ecstasy are not lost; they are merely transformed from jazz to symphony. Values are more deftly perceived in their true lights when one is unexcited. The poet, even in his wildest moments, is to be unmistakably distinguished from a party to a mob lynching. To say that a man is tranquil is to mean only that his organism is functioning in harmony as a whole, and in harmony with its environment; his synthesis is relatively near perfection. The chief reason why he should be in that state is that "it is better to be fully than partially alive."

The tremendous effect on the stutterer of conscious articulation is, then, not to be lightly thought of. To the extent that it is genuinely beneficial to the entire organism, it is valuable to the stutterer as a stutterer. But because the speech mechanism is comparatively integral in itself and dominates the production of speech, anything that improves the organism as a whole can have only an indirect and more or less superficial effect on the function of speech. In order to make this less an excursion into theory and more an approximation of fact, I must refer to my own experience. Conscious articulation has enabled me to conceal my defect to a large extent, because it has improved my speech to the degree that it has enabled me to speak without apparent difficulty. The emphasis is to be placed on

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the word "apparent." For the consciousness of stuttering remains to some extent whether articulation is deliberate or haphazard. My speech is improved by the practice of deliberate articulation only in its outward manifestation. It has been only by getting at the basic neurology involved that my speech has been genuinely improved.

Also, it is not to be understood that this device renders speech significantly less difficult. As I said above, when this enforced relaxation is employed consistently, it amounts to a considerable task. The tendency to stutter is deeply rooted and has gained strength from long practice. To oppose it by an act of will is quite as strenuous as resignation to it. The fact must not be lost sight of that deliberate articulation is essentially stuttering; it is certainly not normal speech. It results usually in a hesitating, stumbling utterance, and in a very slow manner of speaking. By testing I have found that I speak at the rate of about fifty words a minute when employing this device, a speaking rate which is extremely below the average for normal speakers. Each word on which I would ordinarily stutter is spoken with effort and patience, and the hesitation involves an embarrassment on which I do not thrive. And it is not to be forgotten that speaking in this way is always attended by the fear and anxiety characteristic

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of the anticipation of stuttering. Obviously, it is a dubious therapy.

A consideration of the mental and emotional phase of stuttering must necessarily be largely repetitious of much that I have stated in preceding pages. I have implied in cursory references something of the nature of the fear of stuttering and the awareness of it as a fact of life. The mental and emotional phase of the process varies not so much according to the type of stuttering or the sound being attempted as according to the social situation and the momentary state of my temperament and physical health.

In this connection I want to do something to dispel a doubt that seems to be current in some quarters, by saying that I do know exactly what I want to say when I attempt to speak. I know exactly what I want to say even in cases of the most severe stuttering. In my case, at least, there need be no argument whatever concerning that.

It is to be noted that I enter on an attempt to speak with a real intention of saying something. I want to express a thought in words. But it is rarely that I am at ease in this; I anticipate difficulty and put myself on guard to avoid it. If stuttering occurs, then, it is best thought of as a restraint on my justifiable desire to speak. Every student of psychology is familiar with the responses which restraint

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of action tends to bring out in the individual. The pure response in such a situation is usually one of rage, but this might be modified considerably. When stuttering occurs, I am aware of an increased desire to speak, a desire which becomes determination. Sometimes it is elaborated into resentment of the thwarting influence, and envy of the normal speech of others. With this is blended a quality of shame; my speech inferiority is made obvious and I cannot be blind to the fact. It is this which is most in- strumental in giving rise to embarrassment. The chief reason why it is embarrassing to stutter is that other people do not stutter. Perhaps, even, they are inclined to think it funny, or to have pity on me. At all events, any such attitude on their part puts an undue degree of importance on myself in the performance of what should be a simple and ordinary act.

I want to say, however, that with the increased understanding of my speech defect which I have come to enjoy, I have been able to dispense with much of this emotional disturbance in connection with stuttering. In fact, it is just at this point that I have been tremendously benefited; it is in this regard that my stuttering has lost much of its hold on me.

I think I have said quite enough about the physi-

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cal phase of stuttering to establish its importance. To the person who has an eye merely for the obvious, stuttering is a speech defect. But in reality it is considerably more than that. Stuttering is a mental distraction and a physical drain on the energies of the individual. It interferes with his work in school especially, not only because it forces him to think of himself constantly as being something of an exile, but also because the process of stuttering makes him, in the moment of stuttering, far less capable of carrying on the thought processes than he otherwise would be. When one considers again that speech is the capacity which a man has to symbolize himself in sound and to translate himself into the understanding of others, that it is thus a deeply fundamental process and a function of the entire organism, one can better appreciate the significance of a speech defect. Stuttering is a constant mental and physical pain, and although the stutterer learns, in time, to regard this pain rather nonchalantly, it remains important and can never be wholly disregarded.

Its capacity for bringing about physical fatigue makes the matter of the stutterer's hygiene important. He generally requires more sleep than the normal speaker, and without it he is not only likely to stutter more severely, but he is likely to be less

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efficient in any undertaking. A vicious circle might readily be set up, in that the stutterer is forced to work harder to overcome the physical and social handicap imposed upon him, and in working harder increases his fatigue, lowers his resistance, and invites the stuttering to make graver inroads upon his health and peace of mind. Adequate nourishment, exercise, fresh air, and rest are important prescriptions for him; at least, I have found that to be true. The matter of physical hygiene for the stutterer, however, is so important and so involved that it can only be mentioned here. It is a field for much separate significant research and publication, which should not be neglected.

Good mental hygiene is, in this regard, even more important. For example, stutterers have probably been really injured more by unenlightened school teachers than by any other class of people with whom they have been forced to come into contact. For nearly all stutterers go to school, and in school they are generally expected to compete on even terms with pupils who do not stutter. Even the most sympathetic teachers, being merely human, are guilty of numerous oversights. The special problems of the stutterer, concerning his participation in the social life of the school, are usually given little or no attention. Yet he cannot reasonably be expected to take

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part in those games, which are so common, in which little rhymes are spoken or in which speaking of any sort is necessary. If the stutterer can play the piano or the mouth organ, or dance a jig, or build a good fire, he would no doubt be much happier doing those things at a school party. Personally, I have an intense dislike for get-together parties, hand- shaking orgies in which every one introduces himself to every one else. It is all but impossible for the stutterer to take part in such affairs.

In the classroom, moreover, the stutterer is usually expected to take part in oral recitation. In fact, certain writers on the subject of stuttering insist that stutterers should never be excused from oral recitation lest they develop bad habits and use their defect for the purpose of getting out of unpleasant tasks. What is the logic of it? Nobody insists that a lame boy be made to take part in the hundred-yard dash. It is reasoned that the stutterer should recite orally because be should face life as it is. That is not facing life as it is. That is not facing the obvious fact that the stutterer is not able to talk sufficiently well to make an oral recitation which does him justice. To really face the facts of life is to admit that the stutterer is after all a stutterer, just as a lame boy is, after all, lame. A great deal of careful study concerning the stuttering pupil is

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needed, and the results of the study should be broadcast.

Indeed, I hope that whatever else I have accomplished by this self-study, I have suggested a number of vital problems of research. If, by that, I have to any degree stimulated the work being carried on in the field of speech pathology, my task has been worthwhile.

The stutterer, if I may speak for him as a type, does not want pity any more than he wants contempt, but he does want the understanding which the normal respect of one human being for another tends to make possible. He is a human being, trying to make a stutterer's adaptation to a world of glib speakers. He is an exile, trying not to be also a hermit. He wants only that for which men have always fought: the right to self-assertion tempered by justice, the human heritage.

The End


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